Greater Incidence Research Articles

SOCIAL INEQUALITIES AND YOUTH

The struggle against social inequalities in Brazil has been the center of analysis in several areas of knowledge. Scholars, public managers, researchers, and public policymakers strive to diagnose and implement measures to reduce inequalities in the Brazilian context. Among the multiple forms of manifestation of such inequalities, the social markers of gender, race, and social class are the most investigated. However, color or race occupies a central space in most of the debates given the process of the socio-historical constitution of Brazil. In this debate, besides the aspects that are related to the Brazilian development process characteristics, whose dynamics have produced erasures and silencing throughout the country's history, black youth are among those included. As a consequence, the partial inclusion of the black, brown, or indigenous populations in this process has translated into higher levels of economic and social vulnerability, with greater incidence in some communities. The present reflection analyzes the impact of the social racial marker among the black Brazilian youth. The bibliographical-investigative methodological procedure is used.

Latent Causes and Magnitude of Farmers-Herder Agricultural Resource Conflicts that has Formed the New Wave of Conflict in Nigeria

The research paper analysed the fine causes of farmer herder conflicts in Nigeria and also examined the magnitude of the conflict in terms of its evolution from an agricultural resource conflict to a less definable crisis that threatens to tear down the fabric of national unity. Continual misconceptions and misinterpretations of causes and motives of the conflict project further the polarized nature of Nigerian inter-ethnic interactions and the gradual diminishing of national identity. Greater incidence and intensity of the farmer-herder conflict has given rise to more violent herders and a tribal militia movement seeking to match the aggression. Analysts have expressed fear of these conflicts spiralling into a complex civil war and the need for the government to grab a hold of the conflicts for the sake of the parties involved. A total of 384 farmers and herders from conflict prone areas have been used for this study. The results and transcripts of the FGD were collated and summarised, they formed the substance of the tables developed. The key objective of the study is to arrive at some of the less empirical but silently impactful causes and magnitude of the farmer-herder conflicts which has been declared the deadliest conflict form in Nigeria. Developing a long-term, far-reaching and all-inclusive framework for the mutually beneficial use of land resources by all factions embroiled in this conflict is a first step to resolving the conflicts has been recommended.

Cervical Cancer Prevention and High-Risk HPV Self-Sampling Awareness and Acceptability among Women Living with HIV: A Qualitative Investigation from the Patients' and Providers' Perspectives.

Routine cervical cancer screening is important for women living with HIV (WLH) due to the greater incidence and persistence of high-risk HPV (HR-HPV) infection. HR-HPV self-sampling has been proposed to overcome barriers to in-office cervical cancer screening in underserved populations. However, little is known about baseline knowledge of HR-HPV and the acceptability of HR-HPV self-sampling among WLH. This paper describes WLH’s experiences and needs regarding cervical cancer screening, specifically HR-HPV self-sampling, and seeks to reconcile their experiences with the views of their providers. In total, 10 providers and 39 WLH participated in semi-structured interviews and group discussions, respectively. Knowledge of cervical cancer and HR-HPV was generally limited among WLH; when present, it was often due to personal experience of or proximity to someone affected by cervical cancer. Most WLH were not familiar with HR-HPV self-sampling but, despite some of the providers’ skepticism, expressed their willingness to participate in a mail-based HR-HPV self-sampling intervention and highlighted convenience, ease of use, and affordability as facilitators to the uptake of HR-HPV self-sampling. The experiences identified can be used to guide patient-centered communication aimed at improving cervical cancer knowledge and to inform interventions, such as HR-HPV self-sampling, designed to increase cervical cancer screening among under-screened WLH.

Discussion and expostulations on postoperative worsening of hearing following middle ear surgeries

BackgroundHearing assessment after middle ear surgery has always been of interest to otologists for one of its major unavoidable and unpredictable complication is hearing loss. As the initial indication for operation is to treat precisely this problem, this complication poses a major dilemma for surgeons. We, thus, aimed to detect the proportion of postoperative worsening of hearing, causes, and risk factors in patients undergoing middle ear surgery.MethodThis retrospective descriptive study was conducted in the department of otolaryngology of a tertiary care center and data of medical records were retrieved from January 2016 until December 2020. This study included middle ear surgery patients with pre- and postoperative audiometric results. Those patients whose hearing worsened post-operatively (where bone conduction deteriorated > 10 dB) were noted and assessed accordingly.ResultsThe medical records regarding morphological and audiological outcomes of 178 patients were available. We observed auditory degradation after surgery in eight patients (five primary cases and three revision cases), with an overall incidence rate of 4.49%. The mastoidectomy was performed in seven cases, either cortical (n = 5) and modified radical (n = 2). Modified radical mastoidectomy showed the greatest incidence of hearing loss (40%) among all surgical procedures. Except in one case, where sudden, profound loss occurred following otorrhoea on third day, hearing loss was progressive in rest of cases.ConclusionA patient with deteriorating hearing after middle ear surgery must be evaluated properly. There is an increased chance of hearing loss following surgery that involves more ossicular manipulation, drilling, extensive disease clearance, and revision. Utmost care must be taken while operating around ossicles and during disease clearance in key areas. Proper consent should be taken from such patients to avoid future litigations.

Examining the Intersection between Gender, Community Health Workers, and Vector Control Policies: A Text Mining Literature Review.

ABSTRACT.Gender intersects with healthcare systems; this is equally true for arboviral vector control efforts. However, there is as yet no comprehensive analysis as to how vector control is gendered. Hence, our objective is to provide the first thematic scoping and spatial distribution of the literature on gender, community health workers, and vector control. The authors use a systematic review approach to collect the academic literature on gender, community health workers, and vector control in Web of Science, Scopus, and PubMed (7,367 articles). After applying the exclusion criteria, 2,812 articles were analyzed using machine learning techniques: text mining and quantitative text analysis. The authors use topic modeling to assess the thematic scope of the literature and analyze the spatial distribution of themes. Our results show that the literature’s spatial scope is strongly represented by the global south as research was conducted mainly in Latin America, Africa, and Asia, places with greater incidence of vector-borne disease and with health systems, which incorporate community healthcare workers. However, there are significant spatial heterogeneities in where and how research is conducted. The topic analysis reveals that the literature predominantly considers issues of sex (e.g., pregnancy) and gender as it relates motherhood. Gendered considerations occur upon implementation of vector control policies, rather than being mainstreamed into their development and delivery. There is a need to deepen the analysis to allow for gendered aspects to be understood beyond binary sex differences and/or reproductive health.

Фактори, що впливають на контроль артеріального тиску в пацієнтів з ренопаренхімною та есенціальною артеріальною гіпертензією

Метою нашого дослідження було порівняти контроль артеріального тиску (АТ) у широкій українській популяції пацієнтів з есенціальною та ренопаренхімною артеріальною гіпертензією (АГ) та оцінити фактори, що асоціюються з недосягненням цільового АТ протягом тримісячного антигіпертензивного лікування, окремо в кожній групі. В аналіз було включено дані 9259 пацієнтів. Усі пацієнти залежно від причини АГ були розподілені на дві групи. У першу групу увійшло 2197 (23,7 %) осіб з ренопаренхімною АГ, у другу групу — 7062 (76,3 %) особи з есенціальною АГ. 531 лікар на свій розсуд призначав антигіпертензивні препарати в дозах, які вважав потрібними. Контроль ефективності лікування відбувався під час 4 візитів протягом 3 місяців. Пацієнтам на візитах вимірювали офісний АТ, проводили електрокардіографію, оцінку прихильності до лікування за допомогою стандартної анкети, оцінку серцево-судинного ризику та опитування згідно з розробленою авторами дослідження анкетою. Мультифакторний регресійний аналіз застосовували для виявлення незалежних предикторів недостатньої ефективності терапії. Виявлено, що ренопаренхімна АГ порівняно із есенціальною АГ асоціювалася з більшою частотою ускладнень (серцева недостатність, інсульт), супутніх станів (ішемічна хвороба серця, цукровий діабет), факторів ризику (дисліпідемія, вік, ожиріння, обтяжена спадковість, високий рівень систолічного АТ), і в таких хворих більш частим було ураження органів-мішеней (гіпертрофія лівого шлуночка, порушення функції нирок). Цільовий АТ (< 140/90 мм рт.ст.) було досягнуто в 53,9 % пацієнтів першої групи та 60,7 % (Р < 0,001) пацієнтів другої групи. При цьому порівняно з другою групою середня кількість препаратів, які отримували хворі з ренопаренхімною АГ, та частота застосування комбінованої терапії були достовірно більшими — 2,20 ± 0,02 проти 2,04 ± 0,01 (Р < 0,001) та 64 проти 57,1 % (Р < 0,001) відповідно. В обох групах на початку дослідження лише незначна кількість пацієнтів мала високу прихильність до лікування —20,1 та 23,5 % відповідно в першій та другій групах (Р < 0,001). Покращення прихильності хворих до лікування спостерігалося в обох групах: достовірно зменшилася частка пацієнтів із низькою прихильністю та збільшилася частка із високою та помірною. Проте в кінці дослідження більше осіб з ренопаренхімною АГ, ніж із есенціальною, характеризувалися як пацієнти з низькою прихильністю. В обох групах поганий контроль АТ асоціювався з початковим рівнем систолічного та діастолічного артеріального тиску. Більш висока прихильність до лікування в кінці дослідження (а не на початку) та вживання свіжих овочів і фруктів зменшували ймовірність поганого контролю АТ також в обох групах. В осіб з ренопаренхімною АГ більш старший вік та більша кількість препаратів асоціювалися із недосягненням цільового АТ, тоді як додаткова фізична активність, навпаки, збільшувала шанси на успішне лікування. Наявність серцевої недостатності та інфаркту міокарда в анамнезі збільшувала ймовірність недосягнення цільового АТ лише в осіб другої групи. Наявність вищої освіти та робочий статус зменшували ймовірність недосягнення цільового АТ лише в групі хворих з есенціальною АГ. Отже, пацієнти з ренопаренхімною АГ були більш тяжкою категорією хворих з АГ, і вони потребують більшої уваги та більш агресивного ведення й корекції інших факторів ризику, а не тільки АТ. Виявлені спільні та відмінні фактори, що асоціювалися з відсутністю досягнення цільового АТ, необхідно враховувати для більш ефективного ведення пацієнтів з АГ різної етіології.

ACUITY OF PEDIATRIC INFLAMMATORY BOWEL DISEASE ADMISSIONS PRE AND DURING THE COVID-19 PANDEMIC

BACKGROUNDThe COVID19 pandemic has introduced new challenges to the diagnosis and management of pediatric Inflammatory Bowel Disease (IBD). Many patients have had limited access to their providers through telemedicine and may choose to delay non-emergent treatment for fear of risking exposure in healthcare settings. Additionally, the “hygiene hypothesis” would suggest that decreased microbial exposure secondary to social isolation may result in greater incidence of new IBD diagnoses and worsened exacerbations of preexisting disease, particularly in urban populations. We hypothesize that these factors resulted in worsened disease status upon admission.METHODSWe conducted a retrospective chart review of pediatric patients with IBD admitted to a tertiary care center before the onset of the COVID19 pandemic (01/01/18 – 03/01/20) and during the pandemic (03/01/20 – 08/01/21). All patients ≤18 yrs old who were admitted for a flare or new diagnosis of IBD were included. Variables collected included: demographics, admission indication, length of stay, laboratory markers of disease severity, surgical or endoscopic procedures performed during admission, and new treatments started on discharge. Data were analyzed using paired t-tests. Study was IRB approved.RESULTSThe pre-COVID (N=50) and during-COVID (N=52) populations were similar in regard to demographic and clinical characteristics. More patients during-COVID19 underwent major surgical interventions (11.5% vs. 0%, p=0.007), and were started on biologic therapies or steroids (38.5% vs. 26%, p=0.09 and 11.5% vs. 0%, p=0.007 respectively). Length of stay was also increased during-COVID (5.5 days vs. 4.9 days, p=0.3). UC patients admitted during-COVID exhibited more severe thrombocytosis (483 vs. 419, p=0.2) while CD patients admitted during-COVID exhibited more severe anemia (10.7 vs. 11.6, p=0.1) and hypoalbuminemia (2.7 vs. 3.1, p=0.04). Although not significant, more patients during-COVID were admitted from urban areas (63.5% vs. 56%, p=0.2).DISCUSSIONIncreased length of stay and incidence of major surgical interventions and biologic therapy initiation suggest that pediatric patients admitted for a flare or new diagnosis of IBD during the COVID19 pandemic experienced worsened disease severity. More severe thrombocytosis, anemia, and hypoalbuminemia upon admission supports this correlation. We hypothesize that many families chose to delay presentation given fear of exposure to COVID19. Furthermore, partial department closures may have led to delays in seeing patients in-person and ultimately admission. Lastly, we suspect that during-COVID fewer patients were admitted from rural areas given they experienced less emotional stress and physical isolation than their urban peers. Uninterrupted exposure to farm animals and peers at school may have had a protective effect on microbiome balance and stress level.

Differences in cardiovascular risk levels between cleaning staff and hotel housekeepers.

Background and objectiveCardiovascular diseases are the leading cause of morbidity and mortality worldwide, with a greater incidence in the most disadvantaged social classes. In this study, we aimed to evaluate the level of cardiovascular risk in cleaning workers.MethodsThis was a descriptive, cross‐sectional study in 46.632 cleaning workers (40.169 women and 6.463 men). Thirty‐one different scales related to cardiovascular risk were studied (14 assessing overweight and obesity, 5 determining the risk of nonalcoholic fatty liver disease, 5 scales of cardiovascular risk, 4 atherogenic indices, and 3 scales of metabolic syndrome, among others). The results obtained were divided between personnel who perform their cleaning tasks in the hotel and catering industry and those in other sectors.ResultsThe prevalence of obesity and arterial hypertension in cleaning workers was over 20% in both sexes. A similar amount was observed in moderate or high values on the REGICOR (Registre GIroní del COR) scale. More than 15% presented metabolic syndrome according to the NCEP ATPIII (National Cholesterol Education Program‐Adult Treatment Program III) criteria, while over 10% of women and 20% of men had a high risk of nonalcoholic fatty liver disease assessed with the fatty liver index.ConclusionCardiovascular risk is higher, in both sexes, in the group of cleaning workers who work in companies other than hotels.

Dentigerous cyst accompanied by a calcifying epithelial odontogenic tumor: a case report

Introduction: Calcifying epithelial odontogenic tumor (CEOT) is a rare benign, but locally infiltrating neoplasm which accounts for less than 1% of all other odontogenic tumors. The tumor is often associated with impacted teeth and is twice as prevalent in the mandible. Dentigerous cysts are developmental odontogenic cysts, commonly manifesting in the second and third decades of life. A greater incidence in men than in women with a ratio of 1.6:1 and 61.4% associated with impacted or unerupted teeth. Observation: A 17-year-old Indian male reported to the hospital with an asymptomatic lesion associated to an impacted lower first molar with the presence of radiopaque entity inside. The radiological differential diagnosis was calcifying odontogenic tumor, adenomatoid odontogenic tumor and dentigerous cyst. The lesion was completely enucleated under general anesthesia and was sent for histopathologic examination. Discussion: Calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic neoplasm derived from epithelial tissue, forming 0.4–3.0% of all intraosseous odontogenic tumors. A dentigerous (follicular) cyst is a developmental odontogenic cyst usually attached to the crown of an unerupted tooth lined by reduced enamel epithelium. Conclusion: The patient is still under follow-up and has not shown any signs of recurrence in past 8 months after surgery.

An infected case of small dentigerous cyst on intraoral radiograph and orthopantomography

Dentigerous cyst is the second most common odontogenic cyst, which affects the jaws. It accounts for 15% of all true cysts in the jaws. This cyst is mostly associated with the crown of unerupted teeth involving crown of impacted mandibular third molars followed by maxillary canine and maxillary third molars. Dentigerous cysts can occur at any age, but the greatest incidence is in the second to fourth decades of life. Dentigerous cysts have the potential for attaining large size and tend to absorb roots of involved teeth. Dentigerous cysts have the potential to develop odontogenic tumors such as ameloblastoma and malignancies such as oral squamous cell carcinoma and mucoepidermoid carcinoma. The progressive nature of dentigerous cysts may show expansion and result in pathological fractures of jawbones. The early detection of this cyst decreases the severity of the disease. Here is a case report of an infected dentigerous cyst that was detected on intraoral radiograph and orthopantomography.

Beneficial Effects of Broccoli (Brassica oleraceavaritalica) By-products in Diet-induced Obese Mice

Obesity currently affects the whole world, with greater incidence in high-income countries, with vast economic and social costs. Broccoli harvest generates many by-products equally rich in bioactive compounds with potential anti-obesity effects. This study aimed to evaluate the anti-obesity effects of broccoli by-products flour (BF) in obese mice. A commercial high-fat diet formulation (representing a Western diet) was used to induce obesity in mice. BF (0.67% or 1.34% weight/weight) was incorporated as a chemoprevention compound into a control and a hypercholesterolemic diet, at two different concentrations, and fed for 14 weeks to C57BL/6J mice. For a therapeutic approach, two groups were fed with the hypercholesterolemic diet for 10 weeks, and then fed with BF-supplemented diets in the last 4 weeks of the study. BF supplementation helped to maintain a lower body weight, reduced adipose tissue accumulation, and enhanced the basal activity of superoxide dismutase and glutathione S-transferase. Although BF supplementation tended to reduce the relative liver weight increased by the Western diet, the differences were not significant. BF appears to have a beneficial effect in preventing weight gain and fat accumulation induced by hypercholesterolemic diets.

Abstract PO-255: Cervical cancer prevention and HPV self-sampling awareness and acceptability among women living with HIV: A qualitative investigation from the patients' and providers' perspectives

Abstract Background: Women living with HIV (WLH) bear a disproportionate risk of invasive cervical cancer due to greater incidence and longer persistence of high-risk HPV infection. Emerging strategies that involve women collecting their own cervicovaginal sample as an alternative to traditional office-based HPV screening may be a promising approach to reach women who face several obstacles to timely care, such as WLH. Little is known, however, about the facilitators and barriers to HPV self-sampling uptake that may be unique to this particularly vulnerable population. Purpose: This study describes their knowledge, experiences, and needs regarding cervical cancer screening, specifically HPV self-sampling, and seeks to reconcile it with the views of their providers' who have been proven to have great influences on their patients' decision-making processes. Methods: In this qualitative study, we recruited 10 providers and 39 WLH from the Washington DC metropolitan region to participate in semi-structured interviews and focus group discussions. Emergent themes were assessed using an inductive process, employing an open coding method. Results: Knowledge of cervical cancer and HPV was generally limited among WLH; and as expressed by the providers, was often fueled by proximity to someone affected by cervical cancer or personal experience. Most WLH were not familiar with HPV self-sampling: but despite some of the providers' skepticism, expressed their willingness to try it. While some providers worried that it would be an added burden, the WLH highlighted convenience, ease of use, and affordability as facilitators to the uptake of HPV self-sampling. Conclusions: The experiences identified herein may be used to (1) inform tailored interventions designed to increase cervical cancer prevention among under-screened WLH and (2) guide patient-centered communication strategies to improve engagement, patient satisfaction, quality of life, and health outcomes among vulnerable populations. Citation Format: Daisy Le, Annie Coriolan Ciceron, Min (Jaime) Jeong Jeon, Jose Bordon, Jeanne Jordan, Anne Monroe. Cervical cancer prevention and HPV self-sampling awareness and acceptability among women living with HIV: A qualitative investigation from the patients' and providers' perspectives [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-255.

Therapeutic possibilities of coriaria myrtifolia L. in high dilutions

Background: Homeopathy literature shows references about Coriaria myrtifolia L. at some important Homeopathic Materia Medica: Allen,TF [1], Voisin H [2] and Vijnovsky B [3]. Those reports are unsatisfactory to fulfill a contemporary standardized study basis on: origin and description, preparation, medicine general action, sensations and modalities; demanding a broader investigation.
 
 Aims: Identify therapeutic possibilities on Coriaria myrtifolia L. from ratifying and broadening the homeopathic materia medica knowledge.
 
 Methodology: Literature review on botanical, biochemical and pharmacological data [4-12]. The use of plant in various fields since XVIII century and analyzes of clinical-toxicological reports described in medical reviews published.
 
 Results: Coriaria myrtifolia L. is a toxic shrub, growing wild in western Mediterranean region. The entire plant contains a sesquiterpene-lactone called coriamyrtin, a potent convulsivant neurotoxin. Clinical manifestations of acute intoxication includes: Central Nervous System – generalized tonic-clonic seizures, recurrent, which may evolve to status epilepticus, coma, apnea and death. Respiratory Tract – respiratory depression due to anoxia, respiratory arrhythmia alternating with apnea, respiratory muscles tetanization evolving to respiratory arrest. Cardiovascular System – central excitatory action which may initially promote increased blood pressure followed by heart failure, as a result of the seizures, due to anoxia and acidosis, leading to cardiac arrest. Gastrointestinal Tract – nausea, vomiting and stomach pains that precede seizures; since there is no evidence of toxin direct action on mucosa, those symptoms may relate to Central Nervous System action (attributed to impairment of cranial nerve VIII). Knowledge of these aspects gave us possibility to build a Coriaria myrtifolia L. materia medica with broader clinical indications.
 
 Conclusion: Coriaria myrtifolia L. is a valuable source to be used in high dilutions as medicine indicated for epileptic syndromes treatment, characterized by tonic-clonic seizures, mainly presenting a malignant tendency, with recurrent seizures, which may evolve to status epilepticus and potential mortality risk. Among the clinical indications proposed stand out etiologies of great incidence at emergency rooms such as metabolic or vascular primary disorders, or resulting from systemic diseases (diabetes, hepatopathy, nephropathy), encephalitis and meningitis with or without Acquired Immunodeficiency Syndrome, withdrawal syndrome from alcohol or drugs, exogenous poisoning, poisoning or overdose of alcohol or drugs, traumatic brain injury and intracranial expanding lesions.

Vaccine access shrinks disparities between long-term care and community rates of COVID-19 mortality.

This longitudinal secondary data analysis examines differences in COVID-19 incidence and mortality among long-term care facility (LTCF) residents with those living in the community in South Carolina (SC) throughout the pandemic, including the time of vaccine availability. Data came from the SC Department of Health and Environmental Control (SCDHEC). Descriptive statistics and trends for cases of infections and deaths were calculated. Cox proportional hazards were used to compare COVID-19 mortality in LTC residents to community dwelling older adults, controlling for age, gender, race, and pre-existing chronic health conditions. Until early January of 2021, significantly greater incidence rates of infection (116.2 per 10,000 per month) and hazard of death after infection (HR=1.83, 95% CI: 1.70-1.98) were experienced among LTC residents as compared to older adults in the community even after statewide mask mandates and visitation guidance. Since vaccine availability, COVID incidence rates among LTC residents fell by half (59.5 per 10,000 per month after vaccines), and the relative hazard of death compared to older adults in the community was diminished (HR=1.44, 95% CI:1.29-1.61). Reducing the gap between LTCF and community-wide infection and mortality rates suggests that vaccination against COVID-19 is correlated with reduced disease spread in the greater community and in LTCF. Results indicate that policies and regulations addressing LTC resident and staff vaccination may effectively protect the most vulnerable older adults and the workforce providing their care while mask mandates and visitation guidance do not.

Outpatient Care and Short Hospitalization for the Elderly Patient with Inguinal Hernia

Introduction: The surgery of hernial disease of abdominal wall and especially of the inguinofemoral hernia has increase but in fact its prevalence is unknown. The objective of present study was to assess the result of surgical treatment of the inguinofemoral region hernia in third-age patients seen in the "Dr. Enrique Cabrera" Teaching General Hospital. Methods: A study was conducted in 2186 third-age patients operated on of inguinofemoral hernia from January, 2000 to December, 2020 in the above mentioned hospital. In all cases patients had the alternative to be operated on in ambulatory way or with a short hospital stay. Also, were included the patients operated on as an urgency. From the patients operated on in an elective way were excluded those suffering of associated, cardiopulmonary or thromboembolic ASA-III type diseases (classification of the American Society of Anesthesiology). Results: The great incidence of the inguinal hernia was found in ages from 60-69 years (59,3%). The indirect right inguinal hernia was the more frequent. The Desarda's anatomical surgical technique was the more applied one in the inguinal hernia and theLichtenstein's prosthetic technique with the 32% was the following in frequency. There were 20 relapses (0,9%). Local anesthesia was applied in the 75,4% of patients, in ambulatory way in the 76,4%. The total of complications was of 78 (7,1%). Conclusions: The surgical treatment of inguinofemoral hernias, ambulatory or with a short hospital stay is a suitable procedure in third-age patients since to increase the comfort of patients, to decrease the hospital infection risk, to reduce the waiting lists and the hospital costs.

167. Incidence of Acute Kidney Injury with Aminoglycoside Impregnated Foreign Body Implantation

BackgroundDuring orthopedic surgeries, antibiotic impregnated cement is sometimes used to prevent infection. Elution from these cements can lead to systemically detectable levels of aminoglycosides, a known adverse effect of which is nephrotoxicity. The purpose of this study is to determine if the implantation of aminoglycoside impregnated cement is associated with subsequent development of Acute Kidney Injury (AKI).MethodsA retrospective chart review from 1/1/2018-1/1/2021 was conducted to identify a relationship between aminoglycoside impregnated cement and subsequent development of AKI. Data were extracted from Electronic Health Records (Epic) and SAP Business Objects WebI. All patients with knee or hip arthroplasty or hardware removal procedures conducted at a Legacy Health facility during the specified time frame were included. Patients were excluded from the study if < 2 serum creatinine levels were drawn during that hospitalization, AKI occurred prior to the procedure, or dialysis was required at baseline. The primary outcome was development of AKI, a > 150% increase from baseline serum creatinine according to the Acute Kidney Injury Network (AKIN) criteria. The power level was set to 80% with an alpha level of 0.05. A multiple regression analysis was conducted to control for confounding variablesResultsA total of 2229 patients were included (591 received aminoglycoside cement,1638 did not). Aminoglycoside impregnated cement implantation was not associated with an increased incidence of AKI (1.5% versus 2.3%, P = 0.25). After controlling for covariates, aminoglycoside cement was not associated with development of AKI (adjusted OR 0.68, P = 0.32). ConclusionThe results of this study suggest aminoglycoside impregnated foreign body implantation was not associated with a greater incidence of AKI development compared to implantation of foreign bodies lacking aminoglycosides. It is possible that development of AKI post-discharge was not identified in patients with uncomplicated procedures due to omission of lab draws once discharged. Patients admitted for longer durations were more likely to have multiple serum creatinine labs drawn during hospitalization, and likely had multiple comorbid conditions or complications, innately biasing and predisposing AKI development.Disclosures All Authors: No reported disclosures

Berberine increases the expression of cytokines and proteins linked to apoptosis in human melanoma cells

Melanoma is the most lethal form of skin cancer, and its incidence has increased considerably in the last decades. Melanoma presents difficult treatment with strong resistance of tumor cells, due to its extremely invasive nature with high capacity to metastases. Berberine (BBR), an isoquinoline alkaloid, is a molecule found in several medicinal plants, and has been studied in several diseases, demonstrating antimicrobial, antidiabetic and anti-inflammatory properties and anti-tumorigenic effects. In SK-MEL-28 cells, 50μM BBR treatment for 24h decreased cell viability by 50 percent. This concentration generated cell death both by early apoptosis and necrosis, with an increase in the DNA damage index. BBR increased (*p < 0.05) the proportion of cells in G1/G0 phase and decreased (###p < 0.005) the percentage of cells in S phase. The alcaloid increased (****p < 0.001) ROS production compared to untreated controls with an increase in activated caspase 3 and phosphorylated p53 protein levels. In addition, BBR significantly enhanced ERK as well as both pro- and anti-inflammatory cytokine expression compared to untreated controls. BBR has important antiproliferative effects and may be alone or in adjunct therapy a promising candidate for melanoma treatment, a cancer with great incidence and high lethality.

Predictive Factors of Cholelithiasis After Prophylactic Administration of Ursodeoxycholic Acid Following Laparoscopic Bariatric Surgery: Tehran Obesity Treatment Study.

Cholelithiasis is a well-known consequence of obesity as well as rapid weight loss especially after bariatric surgery. A routine postoperative course of ursodeoxycholic acid (UDCA) is recommended as a prophylactic measure against gallstone formation. However, the efficacy of UDCA after bariatric surgery and predictors of cholelithiasis despite prophylaxis are not well understood. We assessed the incidence and predictors of de novo cholelithiasis after bariatric surgery in patients who received UDCA prophylaxis. Uniform data from 2629 consecutive patients who underwent either sleeve gastrectomy or gastric bypass between March 2013 and 2018 were collected prospectively. All patients received a 6-month course of UDCA 300mg twice daily. Cholelithiasis was assessed with abdominal ultrasound at baseline as well as 6, 9, 12, 18, and 24months postoperatively. The association between cholelithiasis and its predictors was examined by Cox proportional hazards models and restricted cubic spline regression. The cumulative rate of cholelithiasis in 24months after surgery was 10.8% (n = 283) with the greatest incidence within the first year. After multivariate analysis, 6-month body mass index (BMI) loss was found to be the only independent predictor for postoperative cholelithiasis (HR = 1.10 [95% CI: 1.04-1.16]). The concordance index for predicting cholelithiasis was 0.60 (0.56-0.64) for 6-month BMI loss. Early postoperative rapid weight loss as represented by 6-month BMI loss is the main predictor of de novo cholelithiasis after bariatric surgery, although this parameter does not have enough power for discrimination of postoperative cholelithiasis.

Viability and Vigor of Cerrado Cashew Seeds (Anacardium humile) on Different Substrates

The little cashew from the Cerrado (Anacardium humile) is a kind of family anacardiáceaceas, a shrubby plant of great incidence in the Brazilian Cerrado. It is a small pseudofruit, of acidic and juicy flavor, which is known to have colors ranging from yellow to red. It can be consumed naturally or in juices, drinks, sweets. However, its true fruit is the chestnut. Seed germination is influenced by factors such as the substrate, which can be improved in order to improve germination, resulting in the acquisition of more vigorous seedlings. The experiment was conducted in a greenhouse at the Federal Institute of Education, Science and Technology of Tocantins, city of Gurupi/TO, from 26 October 2017 to 15 February 2018. Seeds were collected directly from the pseudofruits. The highest root length value was obtained for seedlings of the following substrates: bs + ws + pb (7.1 cm and 12.5 cm) and ws (6.7 cm and 10.7 cm), intermediate values: or + rs + vl (6.3 cm and 10.0 cm) and hw + vl + sawdust + cp + ws (5.5 cm and 9.5 cm), and lower values on substrates: bs (5.7 cm and 8.0 cm) and bs + rs + sawdust (6,6 cm e 9,0 cm). It was also observed that the highest value referring to the first emergency count and seedling emergence once again stood out the substrates bs + ws + pb (61.0 % and 87.5 %) and ws (56.2% and 86.2 %). Intermediate results were obtained from hw substrates + vl + sawdust + cp + ws(44.0 % and 81.0 %) and or + rs + vl (48.4 % and 81.2 %) and lower for bs substrates (37.5% and 72.0 %) and bs + rs + sawdust (45.3% and 77.0 %). The substrates: bs + ws + pb and washed sand provided the highest values of viability and vigor in cashew seeds.

Abstract 11564: Epicardial Adipose Tissue Thickness as a Mortality Risk Marker in Covid-19

Intro: Cardiac involvement in COVID-19 infection is common. Epicardial adipose tissue functions as an inflammatory depot, and a thickness (EAT-T) &gt;5mm is associated with increased cardiovascular risk. The present study assessed the significance of increased EAT-T in patients with COVID-19. Methods: A retrospective cohort study of 149 consecutive patients diagnosed with COVID-19 between March 2020 to January 2021 was performed. Inclusion criteria were lab-confirmed COVID-19 infection and having a Chest CT scan without contrast during hospitalization. EAT-T was measure in right ventricle free wall (Figure 1). Characteristic of patients and comparisons were analyzed by T-Test and Chi-square. Log-linear analysis and cumulative logistic regression was carried out to predict effect between EAT-T and mortality Results: The mean age was 67 ± 15 years, 65% were male, and time from onset of symptoms was 7 ± 5 days. Forty-seven (31.5%) patients required mechanical ventilation, and 34 (22.8%) required vasopressors. Medical therapy included convalescent plasma (36%), Remdesivir (28%), Tocilizumab (46%), Enoxaparin (64%), and Dexamethasone (39%). There were 36 (24.2%) in-hospital deaths, with a greater incidence amongst patients with an EAT-T &gt; 5 mm versus ≤ 5 mm (95 vs 5%, p=.001). Notably, age was not significantly different on patients with in-hospital mortality (69 vs 66 years, p=0.5), and higher EAT-T by 2.17 mm on patient with acute respiratory distress syndrome (p=.001) and 10.9 mm in myocardial infarction (p=.02). In multivariable analysis an EAT-T &gt;5mm was associated with an increased risk of mortality (OR 12.3, 95% CI 3-55, p=.001). In the presence of EAT-T &gt; 5 mm, no effect was observed by chronic kidney disease, hypertension, coronary artery disease, dyslipidemia, or body mass index (p &gt;0.5). Conclusions: In patients with COVID-19, an EAT-T &gt; 5 mm is associated with increased risk of in-hospital mortality and may provide important risk stratification.