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Quality of life and functional outcomes in tongue cancer patients: a long-term, prospective, comparative study.

The tongue has an indispensable role in communication, swallowing and breathing. Tongue cancer treatment involves direct resection of the tumor and surrounding tissue, which can limit many essential functions of the tongue. There are few patient-reported quality of life studies involving tongue cancer exclusively. There is also a lack of data on the outcomes of quality of life regarding different reconstructive methods, adjuvant non-surgical therapies and other predicting factors. Our objective is to assess the quality of life, functional status, and predicting factors in patients with tongue cancer up to one year after surgical resection. Thirty-six patients with tongue cancer were prospectively identified between October of 2017 and January 2021. Patients were examined before and one, three, six and twelve months after surgical resection with the validated University of Washington Quality of Life questionnaire (UW-QOL). Data collection included patient age, sex, TNM staging, size of resection, neck dissection, tracheostomy, reconstructive method and adjuvant therapies. Outcome scores were compared using the Friedman test. Multiple linear regression analysis was used to identify the predictors of quality of life and functional status. The use of UWQOL scores as dependent variables revealed the following predicting factors: age, tobacco use, radiotherapy, chemotherapy, reconstruction method and neck dissection. The most relevant findings in our study are that flap reconstruction becomes increasingly necessary when a glossectomy resection is over 45 mm, in order to maintain tongue function. We established that the reconstructive flap type does not influence quality of life in the long term. Also, we have found that cervical sentinel node biopsy provides better quality of life over neck dissection in the first 3 months after surgery.

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Butter from Different Species: Composition and Quality Parameters of Products Commercialized in the South of Spain.

Butter is an important product for the dairy industry due to its particular sensory attributes and nutritional value, while the variability of the composition of the fatty acids in the milk can alter the nutritional and physical properties of butter and its acceptance by consumers. Butter is highly appreciated for its distinctive flavor and aroma; however, one of its main drawbacks lies in the difficulty in spreading it at low temperatures. Several types of butter that are present in the market were used in this study. We assessed the variability in the composition of the samples regarding their texture, color properties, and volatile organic compound profiles. We analyzed samples commercially produced from sheep's milk (SB), goat's milk (GB), and cow's milk (CB); samples from the latter species with (CSB) and without salt (CB); and the low-fat (CLB) version. All the physicochemical composition parameters were significantly affected by the effect of the type of butter, although only 29 out of the 45 fatty acids examined were identified in the butter samples analyzed. The textural properties of the butters were influenced by both their solid fat content and the fatty acid profile. In addition, the origin of the milk not only affected the texture parameters but also the color of the butters and the compounds associated with traits such as odor and flavor. Through the multivariate data analysis of butter fatty acids and volatile compound percentages, we observed a clear differentiation of the samples based on the species of origin.

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Incidence of delirium in older people with cancer: Systematic review and meta-analysis

PurposeDelirium is a prevalent neuropsychiatric syndrome in older people with cancer. However, there are no meta-analyses assessing its incidence exclusively in this population. This study aims to assess the incidence proportion of delirium in older people with cancer in the hospital area. MethodsA systematic review and meta-analysis were carried out. MEDLINE, Scopus, and EBSCO were searched from inception to December 2021. PRISMA guidelines were followed. Inclusion criteria were original peer-reviewed studies with experimental (randomised controlled trials), observational, and cross-sectional designs assessing delirium older inpatients (≥65 years) with oncological diseases in medical and post-surgical hospital areas and using validated screening or diagnostic methods. A web-based system was used to manage the screening process. Study quality was assessed with Joanna Briggs Institute Critical Appraisal tools. The statistical analysis was performed in RevMan v5.4.0 (Cochrane Collaboration, Oxford, UK), using a random-effects model to calculate incidence and 95% confidence intervals (CIs). ResultsBased on 37 included articles, the incidence proportion of delirium ranged from 3.8% to 61.4%, in a total of 11,847 older patients with cancer. Meta-analysis showed a pooled incidence of 22.6% (95% confidence interval 18.5%, 26.7%; I2 = 97%, p < 0.001). The main tools for detection were the Diagnostic Statistical Manual criteria and the Confusion Assessment Methods scale. ConclusionsThe incidence proportion of delirium in older inpatients with cancer is 22.6%. Incidence in the medical setting was higher than in the post-surgical areas. There is a need for high-quality studies examining delirium in older people with cancer.

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Residential green and blue spaces and working memory in children aged 6–12 years old. Results from the INMA cohort

Availability of green and blue spaces in the area of residence has been related to various health outcomes during childhood, including neurodevelopment. Some studies have shown that children living in greener and/or bluer areas score better on cognitive tasks although the evidence is inconsistent. These protective effects are hypothesized to occur in part through reductions in air pollution exposure and odds of attention-deficit/hyperactivity disorder (ADHD). This study analysed the effects of residential green and blue spaces on working memory of children in the Spanish INfancia y Medio Ambiente (INMA) birth cohort and the potential joint mediating role of air pollution and ADHD. The study samples were composed of 1738 six-to eight-year-olds (M = 7.53, SD = 0.68, 49% female) and 1449 ten-to twelve-year-olds (M = 11.18, SD = 0.69, 50% female) living in Asturias, Gipuzkoa, Sabadell or Valencia, Spain. Individual Normalized Difference Vegetation Index (NDVI) values in 100-, 300- and 500-m buffers and availability of green and blue spaces >5000 m2 in 300-m buffers were calculated using Geographic Information Systems software. Individual NO2 values for the home environment were estimated using ESCAPE's land use regression models. ADHD diagnosis was reported by participants' parents via a questionnaire. Working memory was measured with numbers and colours (in the younger group only) N-back tests (2- and 3-back d’). Mixed-effects models informed of the beneficial effects of NDVI in a 300-m buffer on numerical working memory in the younger sample although the results were not consistent for all d’ scores considered and failed to detect significant effects through the candidate mediators. Availability of major blue spaces did not predict working memory performance. Provision of green spaces may play a role in children's working memory but further research is required.

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Time‐calibrated phylogeny of <i>Daphne</i> (Thymelaeaceae): Pre‐mediterranean temporal origin of the sclerophyllous <i>Daphne gnidium</i>

AbstractThe sclerophyllous syndrome is characterized by well‐defined traits (evergreen coriaceous leaves, inconspicuous flowers, and fleshy fruits). It has been hypothesized that lineages displaying the sclerophyllous syndrome show lower speciation rates than non‐sclerophyllous lineages after the establishment of the mediterranean climate. Daphne gnidium displays sclerophyllous traits and some differentiation into three subspecies (gnidium, mauritanica, maritima), but the spatio‐temporal origin of this taxonomic group is unknown due to the lack of a time‐calibrated phylogeny of the whole genus. Here, we inferred phylogenetic relationships and divergence times of Daphne (32 species, 238 samples) and other genera of Thymelaeaceae (16 genera, 38 species, 34 samples) using the internal transcribed spacer (ITS), which revealed that the current circumscription of Daphne is profoundly polyphyletic because some species are nested within the genera Wikstroemia and Edgeworthia. In contrast, D. gnidium formed a well‐supported clade as recognized in taxonomic accounts (subgenus Spachia). We found morphological and phylogenetic support for Daphne mauritanica as a monophyletic lineage sister to D. gnidium. Divergence between D. gnidium and D. mauritanica appears to have predated the establishment of seasonally dry conditions, which supports a pre‐mediterranean temporal origin of the lineage. A phylogeographical analysis within D. gnidium based on 66 nrDNA (ITS) and 84 cpDNA (rps16, trnV) sequences agreed with the low differentiation of the species in the Pleistocene despite its large distribution range. Altogether, D. gnidium illustrates one more example of the sclerophyllous syndrome with no speciation after the onset of the mediterranean climate.

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The Confusion Assessment Method Could Be More Accurate than the Memorial Delirium Assessment Scale for Diagnosing Delirium in Older Cancer Patients: An Exploratory Study.

Older people with cancer carry a high risk of delirium, an underdiagnosed syndrome due to its diagnostic complexity and often subtle presentation. Tools based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) are available to different health professionals. Our aim is to assess the prevalence of delirium in older people with cancer in an inpatient unit and the accuracy of the Confusion Assessment Method (CAM) and Memorial Delirium Assessment Scale (MDAS). This exploratory, cross-sectional study included people aged 65 years or older with a diagnosis of cancer and admitted to the medical oncology unit from June 2021 to December 2022. The diagnostic accuracy of CAM and MDAS was analyzed against the gold standard medical diagnosis based on DSM-5 criteria by two medical oncologists. The cutoff point for the MDAS was determined using a receiver-operating characteristics (ROC) curve. Among the 75 included patients (mean age 71.6 years, standard deviation 4.1; 52% males), the prevalence of delirium was 62.7%. The most prevalent types of cancer in patients with delirium were hematological and lung cancer. The scale with the highest diagnostic accuracy was the CAM, with a sensitivity of 100% and specificity of 86%, followed by the MDAS, with a sensitivity of 88% and specificity of 30%. The presence of cognitive impairment hindered the detection of delirium. The CAM scale was more accurate than the MDAS pre-existing cognitive impairment in our sample. Further studies are needed to analyze the diagnostic accuracy of delirium tools in older populations with cancer and in the presence of cognitive impairment.

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Knowledge and belief in the times of COVID-19: A comparative analysis of epistemicity in English newspaper discourse of two stages of the pandemic.

This paper sets forth a quantitative analysis of expressions of epistemicity, a category covering the expression of commitment to the information transmitted and comprising epistemic modality and evidentiality, in a corpus of 400 newspaper articles from The Guardian concerning the COVID-19 pandemic. 200 articles were written in April 2020; the other 200 were written between January and April 2022, after massive vaccination and an extraordinary increase in medical knowledge. The analysis distinguishes between a number of subtypes of epistemic expressions and three kinds of authorial voice. The results show that the April 2020 articles contain more epistemic expressions, of both weak commitment (might, perhaps, apparently…) and strong commitment (know, clearly, surely…), which suggests a greater need to distinguish the known from the unknown in this period, due to the pervasive state of uncertainty. The analysis has social implications, since it gives readers an opportunity to appreciate the careful assessments of epistemicity found in the corpus and therefore to consider the convenience of obtaining information from quality media. These social implications, together with the methodology of the analysis, contribute to the potential of the paper for pedagogical applications.

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Treatment of Chronic Pain in Patients with Osteoarthritis of the Hip and Knee with a Combination of Hydroxytyrosol, Omega 3 Fatty Acids and Curcumin: Results of a Pilot Study

Chronic pain is the most common symptom of osteoarthritis and is very often accompanied by limitations in the performance of activities of daily living and has a negative impact on patients’ quality of life. It is estimated that 14% of the elderly population routinely use NSAIDs for pain management, not without serious adverse effects. Objective: We aimed to test the efficacy and possible side effects of OliminaDol (encapsulated combination of purified hydroxytyrosol, omega-3 fatty acids and curcumin) in the treatment of chronic osteoarthritis pain. Seventy-four patients with a diagnosis of osteoarthritis who had chronic pain were selected. The therapeutic intervention consisted of self-administering one capsule of the supplement every 12 h for 30 days. A visual analogue scale (VAS) was used for pain assessment. The efficacy was assessed by comparing the means of pain intensity at baseline and at the end of treatment. The data on the National Cancer Institute (NCI-CTCAE) version 4 criteria were also analyzed. Results: Thirty-six patients were evaluable for the primary objective. The mean value + standard deviation of pain intensity measured by the VAS scale at day +1 was 5.78 + 0.15 and the mean value of pain 30 days after initiation of treatment was 4.19 + 0.22. There was a decrease in pain intensity of 1.63 + 2.28 with p = 0.000. A total of 27 patients (75%) had pain reduction and in 19 of them (52.7%), the difference was greater than 2 points on the VAS scale. OliminaDOL administration was associated with very few and insignificant side effects, notably constipation in two patients (5.4%) and a fishy taste in three patients (8.1%). Conclusions: The administration of OliminaDOL produced a significant decrease in the mean value of pain intensity without side effects. These results, together with other published studies, demonstrate the possibility that some supplements, or a combination of them as in our case, can be an alternative for the treatment of chronic pain.

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