Impaired General Health Research Articles

Hospitalized Women Have Anxiety and Worse Mental Health Scores than Men.

This study aimed to assess the levels of anxiety, depression, and quality of life in hospitalized men and women using the Hospital Anxiety and Depression Scale (HADS), Beck's Anxiety Inventory (BAI), and Short Form-36 Health Survey Questionnaire (SF-36). 60 patients of both sexes were recruited from at the outpatient department of the Hospital Universitário de Vassouras (HUV). The HADS-Anxiety (HADS-A) and BAI questionnaires were used to assess anxiety; the HADS-Depression (HADS-D) questionnaire to assess levels of depression, and the SF-36 to assess the quality of life. The results indicated that hospitalized women had higher levels of anxiety when compared to men. No difference was observed in the levels of depression between men and women. Regarding quality of life, women showed more deterioration in general and mental health compared to men. Thus, the findings suggest that hospitalized women have higher levels of anxiety when compared to men and that this increase can lead to worse general and mental health. Professionals should be aware of possible psychological changes in hospitalized women as they can affect the overall quality of life.

PERIODONTAL STATUS OF INSTITUTIONALIZED ELDERLY

Impaired general health in institutionalized elderly has an impact on oral health and dental status, especially on periodontal health and oral hygiene. The periodontal health of institutionalized elderly people is influenced by a number of other factors such as: multimorbidity, dependence in maintaining oral hygiene, limited abilities and mobility and the use of numerous medications. Progression of periodontal disease is characterized by the presence of increased destruction of periodontal tissues. The destruction of periodontal tissues is seen through the presence and increased clinical loss of the attachment, but also through the presence of gingival recession and resorption of the alveolar bone. The most common form of periodontal disease in older adults is chronic periodontitis. Due to the chronicity of this disease, most of the detected periodontal disorders are due to the accumulation of the disease over time. The interaction of the highly prevalent xerostomia and the inability to maintain oral hygiene at a satisfactory level in institutionalized elderly leads to an increased incidence of dental plaque. Due to that, the elderly have an increased risk of manifesting dental caries and periodontal diseases. Taking into account the aforementioned facts about oral health, the presence of numerous dental and oral problems, as well as the increased health needs and impaired health in institutionalized elderly people, the aim of this paper was to assess periodontal health among institutionalized elderly people over 65 years of age. Assessment of periodontal status among institutionalized elderly was done by using the Ramfjord Periodontal Disease Index. The research was conducted in the period from April to July 2018 in the Department “Mother Teresa”, part from the Gerontological Institute “Thirteenth November” - Skopje. It included a total number of 75 people over the age of 65 who were accommodated in the department and gave their consent to participate in the research. The dental clinical examination was performed in the long-term care institution, in the office or in the rooms of the institutionalized elderly or in a room determined for that purpose. The examination of the subjects was performed on a patient sitting on a chair, lying in bed or placed in a wheelchair. For the examination a dental probe, a dental mirror and disposable gloves and a portable lamp for artificial illumination were used. The average number of present (remaining) teeth in the respondents was 5.81± 7.34 (range 0-24, with Confidence interval from 4.09 to 5.52).The mean value of the simplified OHI Green Vermilion index obtained for the presence of dental plaque was 2.33 ± 0.51 (range from 1.33 to 3.00, with Confidence interval from 2.15 to 2.51). The average value for the Ramfjord index (for assessment of periodontal health) was 4.57 ± 0.74 (range 2.5 to 6.00, with Confidence interval 4.33 to 4.82). Most of the subjects after the appropriate analysis had moderately advanced periodontitis (68.42% of the subjects). Based on the obtained data and subsequent analysis of the results we had found high percentage of people with unsatisfactory oral hygiene and high prevalence of periodontal disease.

The OrBiD (Oral Health, Bite Force and Dementia) Pilot Study: A Study Protocol for New Approaches to Masticatory Muscle Training and Efficient Recruitment for Longitudinal Studies in People with Dementia.

Research with people with dementia is a great challenge in terms of recruitment, study participation and adherence to interventions resulting in less research activity and higher financial, organizational and personnel efforts. As dementia progresses, there is a deterioration in general and oral health and chewing function. Oral treatment options often focus on healthy patients. Interventions for people with dementia are needed. The aims of the paper were to describe the study protocol of the OrBiD (Oral Health, Bite Force and Dementia) pilot study as well as the description of two new methodological approaches. These are (A) an efficient recruitment process of people with dementia, simultaneous double study participation and (B) a novel approach to train the masticatory muscles by using physiotherapy. A novel methodology for the recruitment process (A) and, in particular, for the assignment of subjects to the experimental and control groups was developed and successfully tested. Additionally, a physiotherapy program (B) to train strength and coordination of the masticatory muscles was newly developed with the challenge to ensure that this training could also be carried out with people with cognitive impairments and dementia, if necessary, in cooperation with their relatives or caregivers. This was also successfully implemented. Recommendations for a feasibility assessment of a study involving people with dementia were made considering the organizational effort, the required personnel, structural and financial resources, the required number of subjects and the type of study design. When planning crossed studies, it must be ensured that the content, the interventions or their possible results of the study arms do not influence each other. The overall aim of this paper is to demonstrate the sustainable and efficient feasibility of studies with people with dementia.

Improved 60-day survival but impaired general health in Swedish ICU-COVID patients: An ambidirectional population-based study.

BackgroundSurvival among critically ill COVID‐19 patients varies between countries and time periods. Mortality rates up to 60% have been reported in intensive care units (ICUs). Standard‐of‐care has evolved throughout the pandemic. The purpose of the study was to explore management and mortality of COVID‐19 ICU‐patients during the first pandemic wave and assess their post‐ICU health status.MethodsWe conducted an exploratory observational ambidirectional population‐based study of ICU‐patients with COVID‐19 in a Swedish county during 1 March‐30 June 2020. Primary outcome was 60‐day mortality with secondary outcomes including treatments, complications, self‐reported general health and dyspnoea post‐discharge. Patients were consecutively divided into equal tertiles with cut‐offs on April 4 and April 20, 2020, to analyse time trends.ResultsOne hundred patients, median age was 63 years, were included, and 60‐day mortality rate was 22%. Ninety‐one percent had moderate/severe ARDS and 88% required mechanical ventilation. In the first tertile of patients 60‐day mortality was 33%, declining to 15% and 18% in the following two. This reduction paralleled increased use of thromboprophylaxis, less steep rise of treated ICU‐patients per day and expanded ICU resources. Four months post‐discharge, 63% of survivors reported self‐assessed decline in general health retrospectively compared to prior COVID‐19.ConclusionsIn this cohort, the initial 60‐day mortality quickly declined, despite continuous admittance of critically ill patients. This was parallel to adaptation to increased workload and more intense thromboembolic prophylaxis. A majority of survivors reported declined general health four months after discharge. Further studies on long‐term health status of ICU‐survivors are indicated.

Impact of COVID-19 First Wave on Psychological and Psychosocial Dimensions: A Systematic Review

A systematic review of the literature investigating the effects of the COVID-19 pandemic on psychological and psychosocial factors was completed. Published literature was examined using electronic databases to search psychosocial factors such as beliefs and media persuasion, social support, coping, risk perception, and compliance and social distancing; and psychological factors as anxiety, stress, depression, and other consequences of COVID-19 that impacted mental health among the pandemic. A total of 294 papers referring to the first wave of the COVID-19 pandemic (December 2019–June 2020) were selected for the review. The findings suggested a general deterioration of mental health, delineating a sort of “psychological COVID-19 syndrome”, characterized by increased anxiety, stress, and depression, and decreased well-being and sleep quality. The COVID-19 effect on the psychological dimensions of interest was not the same for everyone. Indeed, some socio-demographic variables exacerbated mental health repercussions that occurred due to the pandemic. In particular, healthcare workers and young women (especially those in postpartum condition) with low income and low levels of education have been shown to be the least resilient to the consequences of the pandemic.

Clinically Manifesting, Naturally Occurring Fowl Glioma in a Leghorn Chicken in Germany.

Fowl glioma-inducing virus (FGV), a strain of avian leukosis virus (ALV) subgroup A, is the causal agent of fowl glioma characterized by multiple nodular astrocytic growths, gliosis, and lymphocytic encephalitis. Also associated with FGV infection are cases of cerebellar hypoplasia, perineuromas, and nonsuppurative myocarditis. Though fowl glioma has been recognized in several countries, most reports of FGV infection come from Japan. A 9-mo-old brown leghorn from a German farm with nine leghorns was presented to a veterinarian with an impaired general health with torticollis, tremor, and incoordination. Histopathology revealed multifocal nodular astrocytic growths, gliosis, and a lymphoplasmacytic encephalitis. Immunohistochemically, neoplastic astrocytes showed positivity for anti-ALV antibody. FGV was detected in the brain with nested reverse transcription-polymerase chain reaction (RT-PCR) and subsequent sequencing of PCR product. The remaining eight birds were screened for the presence of ALV with real-time RT-PCR. Four leghorns tested positive for exogenous ALV in nested RT-PCR with an identical nucleotide sequence as the leghorn with neurological symptoms. To the authors' knowledge this is the first report of a natural FGV infection in a brown leghorn in Germany with clinical manifestation.

Prediction of xerostomia in a 75-year-old population: A 25-year longitudinal study

ObjectivesTo follow the same individuals from age 50 up to 75 years to report on prevalence, persistence, progression, remission, incidence and predictors for xerostomia. MethodsA questionnaire was distributed to all 50-years-olds (1992) in two Swedish counties (N = 8888) and repeated at the age of 65 (2007) and 75 years (2017). 3060 individuals responded on all three occasions (response rate 42.5%). Xerostomia was assessed with two questions. Additional questions addressed inter alia general/oral health and oral function. ResultsReported prevalence of daytime xerostomia were 23.3% and 14.7%, and 39.5% and 27.5% in women and men, age 50 and 75, respectively. Night-time prevalence was higher. At age 50, 27.4% women and 24.0% men reported having dry mouth, and at age 75, 61.0% and 53.8%, respectively. At all time points, women reported significantly more xerostomia than men. Progression (deterioration) was common, and persistence (continuing presence) was high, while 25-year incidence for daytime xerostomia was 16.2% and 12.8%, and 33.6% and 29.8% at night-time, for women and men, respectively. Based on reports at age 50, regression analyses showed that prediction for developing xerostomia during the observation period, and reporting xerostomia at age 75 years, were female gender, impaired general health, chewing, jaw opening and intraoral problems, dissatisfaction with dental appearance, low education and having white/plastic filling. ConclusionsXerostomia is common in older people, especially at night and in women. It can be predicted by diverse factors reported earlier in life. Clinical SignificanceClinicians need to be made aware of that elderly often suffers from dry mouth so that they can recommend effective measures to eliminate or ease the patients accompanying symptoms and also exclude or lessen possible negative impact on oral health related to xerostomia.

DEVELOPMENT OF NEW TYPES OF MEAT AND FISH SEMI-FINISHED PRODUCTS OF HERODIETIC NUTRITION

Health is a unique value of humanity, especially in the global era of the COVID-19 pandemic, so improving the health of the population is the main task of a society that strives for prosperity and sustainable development. The food industry is critical to humanity and the planet. The question of the expediency of a balanced diet to ensure the quality and prolong the duration of socially active life is becoming increasingly important in almost all countries of the world. The creation of new food is due to many factors: global climate change, leading to certain problems in crop and livestock, the general deterioration of human health associated with new technologies for growing, processing and production of food, which is a prerequisite for inventing preventive or curative food and beverages. The meat industry, as the most important branch of the national economy, provides the country’s population with one of the main sources of protein. With its multi-vector development, one of the important directions is the production of frozen products, including meat and meat-containing cut semi-finished products. Despite the unstable economic situation in the country and low purchasing power of the population, especially the elderly, among the main factors shaping the dynamics of this segment is the deepening of intersectoral cooperation, namely in the meat industry – expanding the range of frozen semi-finished products. Given the above, a timely and promising direction is the development of recipes and improving the technology of production of meat and fish semi-finished products using meat (turkey fillet), fish (hake), vegetable raw materials and blends of oils (high oleic sunflower and grape seed oils). According to the results of research, recipes were developed and the nutritional value of the new product was calculated.

Relación entre exposición a riesgos psicosociales y salud: un estudio de cohorte mediante el COPSOQ-Istas21

ObjectiveTo estimate the prospective relationships between exposure to psychosocial risks dimensions included in the COPSOQ-Istas21 and the deterioration of general and mental health and sleep problems among workers residing in Spain. MethodCohort whose baseline corresponds to the 2016 Psychosocial Risks Survey with a new measurement after one year. ResultsSocial capital and interpersonal relations and leadership dimensions, as well as work̶life conflict, were related to all health variables. Dimensions of work organization and job contents did it especially with the mental health, the quantitative demands with the general health and the emotional ones with the mental health. The dimensions related to job insecurity did not show relationships with health. ConclusionsThe results obtained reinforce the role of the COPSOQ-Istas21 as a useful instrument for the evaluation and prevention of psychosocial risks at work.

Knowledge, Attitude, Practice and Acceptance of COVID-19 Vaccine among Elderly in Chiang Mai, Thailand

Aims: This study determined the knowledge, attitudes, and practices regarding COVID-19 and assessed the acceptance of the COVID-19 vaccine among the elderly in Chiang Mai, Thailand. Instrument & Methods: From February to May 2021, a cross-sectional study was conducted among 450 elderly 60 years old and above who lived in Chiang Mai Municipality. The questionnaire collected demographic characteristics, knowledge, attitude, practice about COVID-19, and acceptance of the COVID-19 vaccine. Descriptive statistics are used to analyze. Findings: The results showed that 48.4% of the participants were male, 51.6% were female, and the mean±SD age was 68.2±7.3 years. Participants have sufficient knowledge, attitude, and practice about COVID-19, and the mean±SD score is 9.7±1.3, 4.2±0.8, and 3.98±0.5, respectively. The mean±SD score of the knowledge, attitude, and acceptance of the COVID-19 vaccine were 4.3±1.4, 2.9±1.9, and 2.2±0.9, respectively. This study's major issue is 95.1% of people strongly agree that maintaining social distancing can protect them and their families from contracting COVID-19, and 92.7% strictly follow the guidelines to prevent the spread of COVID-19. The policy can ultimately control the disease. 81.3% of respondents acknowledged vaccines are vital to the health of the elderly and believe that vaccination can reduce morbidity and mortality. Also, 75.8% of people know that the COVID-19 vaccine can cause side effects. Conclusion: The elderly in Chiang Mai, Thailand, have adequate knowledge and awareness about COVID-19 and are generally optimistic about resolving the pandemic and addressing the public concerns, raising awareness about COVID-19 vaccination as a disease-control method to prevent further deterioration of general public health due to COVID-19.

Subcutaneous Daratumumab with Rapid Corticosteroid Tapering in Relapsed or Refractory Multiple Myeloma Patients: Part 3 Update of the Open-Label, Multicenter, Phase 1b Pavo Study

Subcutaneous Daratumumab with Rapid Corticosteroid Tapering in Relapsed or Refractory Multiple Myeloma Patients: Part 3 Update of the Open-Label, Multicenter, Phase 1b Pavo Study

10.P. Workshop: Mental health of older people

Abstract Due to a general health deterioration, decline in functional ability, accumulated stressful events related to loss and bereavement, and unfavorable socio-economic circumstances, older adults are known to be vulnerable to the development of mental health problems, sometimes leading to serious mental disorders. Approximately 20% of adults aged 60 and over, suffer nowadays from a mental or neurological disorder. This problem is possibly even more distinct in the context of the recent Covid-19 pandemic where health protecting measurements like restricting physical and social contact, disproportionally affect the mental health of older people who are already at higher risk of social isolation and loneliness. However, according to the WHO, mental health impairment in older people is still a highly under-identified, and under-estimated public health issue, often surrounded by shame and stigma, which hinders an adequate mental health promoting approach in this population. This workshop wants to contribute to new findings in the role that certain factors can play in protecting and promoting the mental health of older people. Research during circumstances of a crisis, like the Covid-19 pandemic, may reveal new insights in this context, although the long-term effects are not yet clear, and longstanding factors may not be overlooked. Dr Sunwoo Lee (Czech Republic) performed a large survey about mental health of older adults in 27 European countries and will discuss the important role that resilience and optimism can play in promoting mental health in older adults in the midst of a pandemic crisis. Dr. Cynthia Engels (France) investigated changes in daily activities and mental health of older adults during the lockdown period in France. She will report about the most important changes found and what it meant for peoples' wellbeing and social contacts. Prof. Patricia De Vriendt (Belgium) further focused on the daily activities of older men and women during the Covid lockdown in Belgium and discovered a significant gender difference in the extent to which they succeed to engage in meaningful activities during this crisis. She will discuss how crucial this meaning in activities is for older adults to maintain in good mental health. Finally, Prof. Jutta Lindert (Germany and US) will share the rather surprising findings of a large nationwide study in the United States among older adults showing how daily discrimination is related to impaired cognitive functioning in older men and women. She points to the importance of reducing discrimination, especially when the Covid-crisis is behind us, as an important factor in supporting mental health in this older population. Key messages Resilience, optimism and meaningful activities are important factors in mental health promotion for older adults. Discrimination has a negative impact on older adults' cognitive function.

RELATION BETWEEN MATERNAL QUALITY OF LIFE WITH MOTOR FUNCTIONING OF CEREBRAL PALSY CHILDREN AFTER PHYSIOTHERAPY REHABILITATION

OBJECTIVE: To find the relationship between quality of life of mothers of cerebral palsy children and child's motor functioning after at least 3 months of rehabilitation.
 METHODS: This cross-sectional study was conducted at Liaquat National Hospital, Karachi, Pakistan from August to November 2019. Total 35 cerebral palsy (CP) children and their mothers were involved. Assessment of mother’s health done through Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36) and children's motor functioning through Gross Motor Function Measure (GMFM-88). 
 RESULTS: While comparing the results of SF-36 in GMFM-88, we found that children’s mothers with low GMFM score had a general health deterioration compared to children with higher GMFM score. Mothers who are having a child with cerebral palsy, with GMFM between 1-80 had to cut down the amount of time spend on work while mothers whose child’s GMFM was between 1-20 were limited in kind of work and other activities as well as they accomplished less than she would like, and they didn’t do their work as carefully as usual. Due to low GMFM (1-20) of kids’ mothers even suffered from moderate level of body ache. Likewise, in children’s mothers with lower GMFM ratings (1-20 & 21-40) have disturbed work intervention due to affected physical and emotional health. Similarly, social interaction has also been affected.
 CONCLUSION: This study illustrates that mother of cerebral palsy patient deal with severe physical and mental fatigue. While paying attention only to children’s issues, the health of caregiver mothers also needs special considerations.

Helcococcus ovis associated with septic arthritis and bursitis in calves \u2013 a case report

BackgroundSeptic arthritis often occurs in young calves when the passive transfer of maternal immunoglobulins has failed, which results in hypogammaglobulinaemia in the calf. Another important cause is suboptimal herd health management which often leads to general health impairment and, subsequently, to septic arthritis.Case presentationA dairy farmer consulted the Herd Health Service of the University Clinic reporting general herd health impairment, a high incidence of respiratory diseases, unsatisfactory weight gain and arthritis in calves, as well as mastitis and high milk cell counts. Clinical examinations were performed, and diagnostic measures were taken. A transtracheal lavage (TTL) was performed, and synovial swab samples were taken from the carpal joint and the subcutaneous tarsal bursae of two calves. Microbiological examinations of synovial swabs revealed co-infections of Trueperella pyogenes and Helcococcus ovis in one calf and Helcococcus ovis in pure culture in the other. The TTLs confirmed the presence of Mycoplasma spp. associated with respiratory diseases.ConclusionsHelcococcus ovis is currently regarded as a co-infective bacterial agent. However, it seems to play a significant role as the primary pathogen in this case.

Health status of fathead minnow (Pimephales promelas) populations in a municipal wastewater effluent-dominated stream in the Canadian prairies, Wascana Creek, Saskatchewan.

Their unique hydrological and climatic conditions render surface water systems in the southern Canadian Prairies at an elevated risk from exposure to contaminants released from municipal wastewater effluents (MWWEs). The aim of this study was to characterize the potential health effects and their underlying molecular mechanisms in populations of fathead minnow (Pimephales promelas; FHM) in Wascana Creek, an effluent dominated stream in Southern Saskatchewan, Canada. Studies were conducted during the spawning season in 2014 and 2015 to assess responses in terms of overall health, reproductive functions, plasma sex steroid hormone levels, and expression of selected genes along the hypothalamus-pituitary-gonadal axis. FHM downstream of the effluent fallout had lower gonadosomatic indices and significantly greater hepatosomatic indices compared to upstream populations. In both male and female FHMs, significantly greater occurrence and severity of gonadal degradation and delayed maturation were observed in downstream fish compared to upstream fish. Downstream males also displayed lower scores of secondary sexual characteristics and a decreasing trend in plasma 11-ketotestosterone levels. Interestingly, no indications of exposure to estrogenic compounds, such as occurrence of testicular oocytes were observed, which was in accordance with the lack of presence of key biomarkers of estrogenic exposure, such as induction of vitellogenin. In general, expression of the majority of transcripts measured in FHMs downstream of the effluent fallout was significantly downregulated, which supports observations of the general deterioration of the health and reproductive status of these fish. Chemical analysis indicated that 10 pharmaceuticals and personal care products (PPCPs) were present at the downstream site, some at sufficiently great concentrations that may present a risk to aquatic organisms. With continuous exposure to a diverse number of stressors including high nutrient and ammonia levels, the presence of a variety of PPCPs and other contaminants, Wascana Creek should be considered as an ecosystem at risk.

General health status of youth with autism with and without intellectual disabilities transitioning from special education, and its relationship to personal and family circumstances: longitudinal cohort study

Objective: Transition from school to early adulthood incurs many changes and may be associated with deterioration in general health in youth with autism. We aimed to investigate this. Method: The National Longitudinal Transitions Study-2 is a USA nationally representative sample of youth receiving special education services, aged 13–17 at wave 1, followed-up over 10 years in five data collection waves. We conducted random-effects ordered logistic regressions to determine the odds ratios (OR) with 95% confidence intervals of wave, age, sex, ethnicity/race, additional intellectual disabilities, parental/guardian relationship status, and household income being associated with general health status in youth with autism. Results: Across waves, only between 74.3%–69.6% had excellent/very good health (71.7%–58.8% in those with co-occurring intellectual disabilities), but wave was not associated with health status. Associations were with age OR = 1.18 (1.04, 1.33), co-occurring intellectual disabilities OR = 1.56 (1.00, 2.44), and household income OR = 0.61 (0.40, 0.94) at $30,001–$50,000, OR = 0.44 (0.27, 0.72) at $50,001–$70,000, and OR = 0.34 (0.20, 0.56) at $70,001+. Sex, ethnicity/race, and parental/guardian relationship status were not associated with health status. Conclusion: There was little change in general health status longitudinally across the transitional period, but the proportion with excellent/very good health was low at each wave. Transitional planning should consider co-occurring intellectual disabilities, and the wider socioeconomic context in which children/youth with autism are raised. Lack of other longitudinal studies indicates a need for replication.

Health management and care following the Fukushima nuclear power plant accident: overview of Fukushima Health Management Survey

Following the accident at Fukushima Daiichi nuclear power plant, Fukushima Prefecture is conducting the Fukushima Health Management Survey, which has been contracted out to Fukushima Medical University. The purpose of this survey is to investigate the exposure doses and health conditions of the residents of Fukushima Prefecture in order to prevent, diagnose, and treat diseases at an early stage, and to maintain and improve the health of residents in the future.This survey consists of a basic survey to estimate external exposure doses and detailed surveys to investigate health conditions. The detailed surveys comprise: (i) thyroid ultrasound examination; (ii) comprehensive health check; (iii) mental health and lifestyle survey; and (iv) pregnancy and birth survey.In the basic survey, the external exposure dose was estimated for >466,000 people during the first 4 months after the accident; it was estimated to be <5 mSv for 99.8% of residents.The thyroid ultrasound examination included four rounds of echo examinations covering approximately 380,000 children aged <18 years at the time of the accident in each round. The first, second, third, and fourth examinations identified 116, 71, 31, and 21 children with thyroid cancer/suspected cancer, respectively. The Fukushima Prefectural Oversight Committee analysed the results from the first and second examinations, and evaluated that 'the detected increased rate is unlikely to be the impact of radiation'. However, the Oversight Committee is deliberating the future direction of thyroid examination, taking into consideration the advantages and disadvantages of the examination as well as ethical viewpoints.In the comprehensive health check, approximately 210,000 people in the evacuation area were examined, and increased rates of lifestyle-related diseases [e.g. obesity, hypertension, diabetes, and dyslipidaemia (low high-density-lipoprotein cholesterol)] were confirmed. In the mental health and lifestyle survey, approximately 210,000 people, including residents in the evacuation area, were examined. A deterioration in general mental health was found for the period immediately after the accident across a wide range of age groups, and although recovery was seen over the years, the rate of mental health issues remains above the national average. The pregnancy and birth survey revealed that the pre-term birth rate, low-birthweight rate, and rate of congenital anomalies did not differ from the national average.The purpose of Fukushima Health Management Survey is not only to collect data on the health of the residents of Fukushima Prefecture, but to provide direct support to residents regarding the health issues clarified by the survey. Moreover, various initiatives are being implemented in cooperation with various local government authorities with the aim of maintaining and promoting the health of the residents.

Daratumumab in Combination with Carfilzomib and Dexamethasone in Patients (pts) with Relapsed Multiple Myeloma (MMY1001): An Open-Label, Phase 1b Study

Daratumumab in Combination with Carfilzomib and Dexamethasone in Patients (pts) with Relapsed Multiple Myeloma (MMY1001): An Open-Label, Phase 1b Study

Long-Term Patient-Centred Follow-up in a Prospective Cohort of Patients with COVID-19.

IntroductionTo better define COVID-19 long-term impact we prospectively analysed patient-centred outcomes, including general health and symptom duration.MethodsBarthel index (BI), St. George’s Respiratory Questionnaire adapted to patients with COVID-19 (aSGRQ) and WHO Clinical Progression Scale (CPS) were measured at enrolment and at 6 weeks from the onset of symptoms. Persistence of most frequently reported symptoms was assessed at 6 weeks and, among symptomatic patients, at 12 weeks from the onset of symptoms. Predictors of impaired general health over time were identified using an ordinal multilevel multivariate model.ResultsA total of 448 patients (55% men, median age 56 years) were enrolled. WHO-CPS showed mild, moderate and severe disease in 48%, 42% and 10% of patients at admission and mild disease in all patients at follow-up, respectively. BI and aSGRQ were normal in 96% and 93% patients before COVID-19 but only in 47% and 16% at COVID-19 diagnosis and in 87% and 65% at 6-week follow-up. Male gender was identified by all three assessments as a predictor of impaired general health (BI, OR 2.14, p < 0.0001; aSGRQ, OR 0.53, p = 0.003; WHO-CPS, OR 1.56, p = 0.01). Other predictors included age, ICU admission and comorbidities (e.g. cardiovascular disease and cancer) for BI, hospital admission for aSGRQ, age and presence of comorbidities for WHO-CPS. At 6- and 12-week follow-up, 39% and 20% of patients, respectively, were still reporting symptoms. Fatigue and breathlessness were the most frequently reported symptoms.ConclusionsLong-term follow-up facilitates the monitoring of health impairment and symptom persistence and can contribute to plan tailored interventions.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40121-021-00461-3.

Isatuximab plus carfilzomib and dexamethasone versus carfilzomib and dexamethasone in elderly patients with relapsed multiple myeloma: IKEMA subgroup analysis.

8026 Background: A prespecified interim efficacy analysis of the Phase 3 IKEMA study (NCT03275285) demonstrated that isatuximab (Isa) plus carfilzomib (K) and dexamethasone (d) (Isa-Kd) significantly improved progression-free survival (PFS) compared with Kd in patients (pts) with relapsed multiple myeloma (RMM) (HR 0.531; 99% CI, 0.318–0.889; P=0.0007), with a clinically meaningful increase in minimal residual disease negativity (MRD-) (29.6% vs 13.0%) and complete response (CR) (39.7% vs 27.6%) rates, and a manageable safety profile. This subgroup analysis of IKEMA examined efficacy and safety in pts aged &lt;70 and ≥70 years. Methods: Pts with 1–3 prior lines of therapy were randomized 3:2 to receive Isa-Kd (n=179) or Kd (n=123). The primary end point was PFS, as assessed by an independent response committee. We compared outcomes in pts &lt;70 vs ≥70 years; division into different or additional age groups resulted in smaller sample sizes. Results: Of the 302 randomized pts, 71.5% were aged &lt;70 years (Isa-Kd: 70.9%; Kd: 72.4%) and 28.5% were aged ≥70 years (Isa-Kd: 29.1%; Kd: 27.6%). Consistent with the significant improvement of PFS in the overall population, the addition of Isa to Kd resulted in improved PFS independently of age (Table). The CR, ≥very good partial response (VGPR), and MRD- rates were higher with Isa-Kd vs Kd. Within the Isa-Kd arm, CR rate and ≥VGPR rate were similar in elderly and younger pts. MRD- was observed in 32.3% of younger pts and 23.1% of elderly pts with Isa-Kd. In both arms, Grade ≥3 and serious treatment-emergent adverse events (TEAEs) were more frequently reported in elderly pts vs pts &lt;70 years old (Table). For both age groups, the incidence of Grade ≥3 TEAEs was higher whereas the incidence of serious TEAEs was similar between Isa-Kd and Kd. In the elderly subgroup, 3 (5.9%) pts receiving Isa-Kd and 1 (2.9%) receiving Kd had fatal TEAEs (Isa-Kd, infection; Kd, general health deterioration due to progressive disease). The most common Grade ≥3 TEAEs in pts aged &lt;70 and ≥70 years treated with Isa-Kd vs Kd were hypertension (18.3% vs 17.0% [&lt;70 years] and 25.5% vs 26.5% [≥70 years]) and pneumonia (14.3% vs 9.1% [&lt;70 years] and 21.6% vs 20.6% [≥70 years]). Conclusions: The addition of Isa to Kd improved PFS and quality of response in elderly pts, with a manageable safety profile, consistent with the benefit observed in the overall IKEMA study population. Isa-Kd provides a potential new treatment option for elderly pts with RMM. Funding: Sanofi. Clinical trial information: NCT03275285. [Table: see text]