Gastric cancer epidemiology from 2009 to 2019 in Dnipro Region, Ukraine.

BACKGROUND: Gastric cancer (GC) is in top-five the most frequent cancers in Ukrainian males and is the third cause of death among patients with cancer. GC keeps its leading position in cancer ranks despite the decline in incidence and mortality over the last 50 years. Local epidemiological information will help in better targeting medical and public health interventions. PATIENTS AND METHODS: The data about 8438 patients with newly diagnosed GC between 2009 and 2019 was obtained from Dnipro Cancer Registry. RESULTS: Incidence decreased from 24.5 to 22.6, mortality decreased from 21.4 to 15.7 (per 100000), death rate increased from 0.64 to 1.04 between 2009 and 2019. Over 11 years of observation incidence was 23.4, mortality was 19.4, death rate was 0.721. Standardised incidence ratio was 1.42, standardised mortality rate was 1.67; age-standardised incidence was 25.5, age-standardised mortality was 21.2 (European standard). Median (95% confidence interval (95% CI)) survival of the patients was 172 (165-178) days. One-year survival rate fluctuated between 27% and 34%. Male sex and older age were associated with higher risk of death (hazard ratio (95% CI) - 1.08 (1.03-1.13) vs females and 1.15 (1.12-1.17) per 10-years increase of age, respectively). CONCLUSIONS: The study describes the trends in epidemiology of gastric cancer in Dnipro region, Ukraine, between 2009 and 2019. The need for the national prevention strategy of GC in Ukraine was identified.

APPROVAL OF THE USE OF THE SHORT FORM 19 OF THE CHILD'S ORAL HEALTH IMPACT PROFILE (COHIP-SF 19) FOR DENTAL PUBLIC HEALTH NEEDS.

OBJECTIVE: The aim: Is an adaptation, determination of psychometric properties, and approbation of the use of COHIP-SF 19 for the needs of dental public health in the Ukrainian sample of children and teenagers. PATIENTS AND METHODS: Materials and methods: A cross-sectional validation study was conducted on a sample of 236 Ukrainian children aged 6 to 18. The psychometric indicators of the questionnaire were evaluated; analysis of the reliability and internal structure of the methodology based on correlation and factor analysis, calculation of Chronbach's alpha; reliability of re-testing (Intraclass Correlation Coefficient); assessment of convergent and discriminant validity (Mann-Whitney U test, ROC analysis, and correlation analysis). STATISTICA 6.1 (StatSoftInc., № AGAR909E415822FA) was used to analyze the results. The ethics of the study was confirmed by the conclusion of the relevant commission. RESULTS: Results: After cultural direct and reverse translation of the original version, the Ukrainian version of COHIP-SF 19 UK was obtained. The internal consistency of the subscales and COHIP-SF 19 UK was generally sufficient (Cronbach's alpha is greater than 0.7). Sufficient reliability of retesting, convergent and discriminant validity of the methodology was proved. The presence of a correlation between COHIP-SF 19 UK indicators and self-assessment of children's health and quality of life was determined. CONCLUSION: Conclusions: The study proved that COHIP-SF 19 UK is a reliable valid method for assessing the quality of life-related to oral health among Ukrainian children and adolescents, and its good psychometric properties are sufficient for research in the field of dental public health.

Assessment of appropriateness of hospitalisations in Ukraine: analytical framework, method and findings.

OBJECTIVES: This article reviews the applicability of a customised version of the Appropriateness Evaluation Protocol (AEP) to evaluate the magnitude of inappropriate hospitalisations in two regions of Ukraine. DATA AND METHODS: The original AEP was modified to develop a customised tool, which included criteria for the appropriateness of hospitalisation and duration of inpatient stay. The customisation of the tool followed the Delphi procedure. We randomly selected 381 medical records to test the feasibility and reliability of the method and 800 medical records to evaluate the scope of inappropriate hospitalisations. We used descriptive and analytical statistics, receiver operating characteristic curve analysis and Cohen's kappa to check the consistency between the findings of primary reviewers and experts. RESULT: We observed high levels of agreement in conclusions of primary reviewers (reference standard) and experts during testing of the reliability and validity of the method. The external validity check showed that the use of the tool by different experts provided high accuracy: 95.1 sensitivity, 76.6 specificity and area under ROC-curve (AUC)=0.948 (р<0.001) for analysis of the appropriateness of admissions; 95.3 sensitivity, 84.7 specificity and AUC=0.900 (р=0.001) for the duration of hospitalisations. Cohen's kappa coefficient (κ) indicated agreement in expert evaluations of 0.915 (95% СІ 0.799 to 1.000) and 0.812 (95% СІ 0.749 to 0.875), respectively.We found that over one-third of admissions (38.1%; 95% СІ 33.9 to 43.5) and over half of total bed-days were unnecessary (57.4%; 95% СІ 56.4 to 58.5). The highest levels of stay were observed in hospitals' general medicine departments (64.6%; 95% СІ 63.0 to 66.3)compared with other departments included in the analysis. CONCLUSION: The proposed method is robust in assessing the appropriateness of hospitalisations and duration of inpatient stays. The quantified levels of unnecessary hospital care indicate the need for improving efficiency and quality of care and optimising the excessive hospital capacities in Ukraine.

Hypnosis Influence on the Perfusion in Perforator Flaps in Early Postoperative Period: A Series of 18 Cases.

In practice worldwide, there are experiences affecting different body functions via central control mechanisms with the help of psychotherapy methods. In plastic and reconstructive surgery, there is the experience of applying hypnosis, with the main goal of eliminating pain. The aim of this research is to study the impact of hypnosis on the perfusion level in perforator flaps in the early postoperative period, which could enhance flap survival. PATIENTS AND METHODS: For studying the impact of hypnosis on blood circulation in perforator flaps, the analysis of a 18 cases has been conducted. All patients had hypnosis sessions on the second day after the reconstruction, and some had additional sessions on the third and fifth days. In the state of trance, the patient was given specially organized instructions aimed at improvement of perforator flap perfusion. Monitoring of microcirculation in the flap during hypnosis sessions was carried out using a Moor VMS-LDF1 Laser Doppler Perfusion and Temperature Monitor. RESULTS: When applying hypnosis, the vast majority of patients had significant increases in perfusion as well as flap surface temperature rise. Most of the patients had significant increases in perfusion during the second part of the hypnosis session in synchrony with hypnosis instruction translation aimed at increasing perfusion. CONCLUSIONS: The results of our research cannot be distributed widely in medical practice, but, despite that, they illustrate the central nervous system influence on perforator flap perfusion. Including hypnosis in a medical protocol can contribute to increasing the effectiveness of flap surgery.