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Jakobušić Brala C, Karković Marković A, Kugić A, Torić J, Barbarić M. Combination Chemotherapy with Selected Polyphenols in Preclinical and Clinical Studies-An Update Overview. Molecules 2023; 28:molecules28093746. [PMID: 37175156 PMCID: PMC10180288 DOI: 10.3390/molecules28093746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
This review article describes studies published over the past five years on the combination of polyphenols, which are the most studied in the field of anticancer effects (curcumin, quercetin, resveratrol, epigallocatechin gallate, and apigenin) and chemotherapeutics such as cisplatin, 5-fluorouracil, oxaliplatin, paclitaxel, etc. According to WHO data, research has been limited to five cancers with the highest morbidity rate (lung, colorectal, liver, gastric, and breast cancer). A systematic review of articles published in the past five years (from January 2018 to January 2023) was carried out with the help of all Web of Science databases and the available base of clinical studies. Based on the preclinical studies presented in this review, polyphenols can enhance drug efficacy and reduce chemoresistance through different molecular mechanisms. Considering the large number of studies, curcumin could be a molecule in future chemotherapy cocktails. One of the main problems in clinical research is related to the limited bioavailability of most polyphenols. The design of a new co-delivery system for drugs and polyphenols is essential for future clinical research. Some polyphenols work in synergy with chemotherapeutic drugs, but some polyphenols can act antagonistically, so caution is always required.
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Affiliation(s)
- Cvijeta Jakobušić Brala
- Faculty of Pharmacy and Biochemistry, University of Zagreb, A. Kovačića 1, 10 000 Zagreb, Croatia
| | - Ana Karković Marković
- Faculty of Pharmacy and Biochemistry, University of Zagreb, A. Kovačića 1, 10 000 Zagreb, Croatia
| | - Azra Kugić
- Faculty of Pharmacy and Biochemistry, University of Zagreb, A. Kovačića 1, 10 000 Zagreb, Croatia
| | - Jelena Torić
- Faculty of Pharmacy and Biochemistry, University of Zagreb, A. Kovačića 1, 10 000 Zagreb, Croatia
| | - Monika Barbarić
- Faculty of Pharmacy and Biochemistry, University of Zagreb, A. Kovačića 1, 10 000 Zagreb, Croatia
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Pietruszewska W, Burduk P, Rosiak O, Podlawska P, Zakrzewski B, Barańska M, Kowalczyk M, Piątkowski J, Śmigielski G, Solarz P, Staszak M, Wierzbicka M, Mikaszewski B. Impact of COVID-19 on Head and Neck Cancer Advancement Measured by Increasing Numbers of Urgent Dyspnea Cases-What Could Be Improved in the Event of Subsequent Pandemics? J Clin Med 2022; 11:6385. [PMID: 36362613 PMCID: PMC9659278 DOI: 10.3390/jcm11216385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/17/2022] [Accepted: 10/25/2022] [Indexed: 08/26/2023] Open
Abstract
The COVID-19 pandemic has altered all aspects of the healthcare system's organization and impacted patients with head and neck cancer (HNC) who have experienced delayed diagnosis and treatment. The pandemic resulted in the admission of patients with severe dyspnea and a need for tracheotomy due to extremely advanced HNC. This study's objective was to evaluate the clinical characteristics of two multi-center cohorts, "pre-COVID-19" and "COVID-19", of HNC patients admitted as emergencies for dyspnea. The therapeutic activity of HNC patients in four University Departments of Otolaryngology was studied over two time periods: September-February 2019/2020 and 2020/2021. A group of 136 HNC patients who underwent a tracheotomy in two-time cohorts, pre-COVID-19 (N = 59) and COVID-19 (N = 77), was analyzed. The mean tracheotomies incidence proportion was 1.82 (SD: 1.12) for the pre-COVID-19 and 3.79 (SD: 2.76) for COVID-19 period. A rise in the occurrence of emergency dyspnea was observed in the COVID-19 cohort, and the greatest increase was seen in the centers with the highest limitations on planned surgeries. In the pre-COVID-19 period, 66% of patients presented with symptoms for more than a month in comparison to 78% of patients in the COVID-19 period (p = 0.04). There was a higher incidence of laryngeal and laryngopharyngeal cancer in the COVID-19 period (63% vs. 75%, respectively). The number of tracheotomies performed under general anesthesia dropped in favor of local anesthesia during COVID-19 (64% vs. 56%, respectively) due to extremely advanced HNC. In the COVID-19 cohort, most patients received a telemedicine consultation (N = 55, 71%) in comparison to the pre-COVID-19 period (N = 14, 24%). Reorganization of the referral system, adjustment of treatment capacity for an increased number of HNC, and a reserve for more extensive resection and reconstruction surgeries should be made in the profile of otorhinolaryngological departments, ensuring future HNC treatment is not hampered in case of a new pandemic wave.
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Affiliation(s)
- Wioletta Pietruszewska
- Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, 22 Kopcińskiego Str., 90-153 Lodz, Poland
| | - Paweł Burduk
- Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 75 Ujejskiego, 85-168 Bydgoszcz, Poland
| | - Oskar Rosiak
- Balance Disorder Unit, Department of Otolaryngology, Medical University of Lodz, 22 Kopcińskiego Str., 90-153 Lodz, Poland
| | - Paulina Podlawska
- Department of Otolaryngology and Laryngological Oncology, University of Medical Sciences, 49 Przybyszewskiego Str., 60-357 Poznań, Poland
| | - Bartosz Zakrzewski
- Department of Otolaryngology and Laryngological Oncology, University of Medical Sciences, 49 Przybyszewskiego Str., 60-357 Poznań, Poland
| | - Magda Barańska
- Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, 22 Kopcińskiego Str., 90-153 Lodz, Poland
| | - Magdalena Kowalczyk
- Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, 22 Kopcińskiego Str., 90-153 Lodz, Poland
| | - Jakub Piątkowski
- Department of Otolaryngology, Faculty of Medicine, Medical University of Gdańsk, 17 Smoluchowskiego, 80-214 Gdańsk, Poland
| | - Grzegorz Śmigielski
- Department of Otolaryngology, Faculty of Medicine, Medical University of Gdańsk, 17 Smoluchowskiego, 80-214 Gdańsk, Poland
| | - Paweł Solarz
- Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 75 Ujejskiego, 85-168 Bydgoszcz, Poland
| | - Marta Staszak
- Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 75 Ujejskiego, 85-168 Bydgoszcz, Poland
| | - Małgorzata Wierzbicka
- Department of Otolaryngology and Laryngological Oncology, University of Medical Sciences, 49 Przybyszewskiego Str., 60-357 Poznań, Poland
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszynska 32, 60-479 Poznan, Poland
| | - Bogusław Mikaszewski
- Department of Otolaryngology, Faculty of Medicine, Medical University of Gdańsk, 17 Smoluchowskiego, 80-214 Gdańsk, Poland
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Haier J, Mayer M, Schaefers J, Geyer S, Feldner D. A pyramid model to describe changing decision making under high uncertainty during the COVID-19 pandemic. BMJ Glob Health 2022; 7:bmjgh-2022-008854. [PMID: 35940628 PMCID: PMC9364040 DOI: 10.1136/bmjgh-2022-008854] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/18/2022] [Indexed: 11/15/2022] Open
Abstract
The COVID-19 pandemic put healthcare systems, hospitals and medical personal under great pressure. Based on observations in Germany, we theorise a general model of rapid decision-making that makes sense of the growing complexity, risks and impact of missing evidence. While adapting decision-making algorithms, management, physicians, nurses and other healthcare professionals had to move into uncharted territory while addressing practical challenges and resolving normative (legal and ethical) conflicts. During the pandemic, this resulted in decisional uncertainties for healthcare professionals. We propose an idealised risk-based model that anticipates these shifts in decision-making procedures and underlying value frameworks. The double pyramid model visualises foreseeable procedural adaptations. This does not only help practitioners to secure operational continuity in a crisis but also contributes to improving the conceptual underpinnings of the resilience of healthcare during the next pandemic or similar future crises situations.
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Affiliation(s)
- Joerg Haier
- Comprehensive Cancer Center Hannover, Hannover Medical School, Hannover, Germany
| | - Maximilian Mayer
- Center for Advanced Security, Strategic and Integration Studies, University of Bonn, Bonn, Germany
| | - Juergen Schaefers
- Comprehensive Cancer Center Hannover, Hannover Medical School, Hannover, Germany
| | - Siegfried Geyer
- Institute for Sociology, Hannover Medical School, Hannover, Germany
| | - Denise Feldner
- Bridgehead Advisors, Strategic Advisory Think Tank, Berlin, Germany
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Haier J, Beller J, Adorjan K, Bleich S, De Greck M, Griesinger F, Hein A, Hurlemann R, Mees ST, Philipsen A, Rohde G, Schilling G, Trautmann K, Combs SE, Geyer S, Schäfers J. Decision Conflicts in Clinical Care during COVID-19: A Patient Perspective. Healthcare (Basel) 2022; 10:1019. [PMID: 35742070 PMCID: PMC9222354 DOI: 10.3390/healthcare10061019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 12/16/2022] Open
Abstract
(1) Background: Uncertainty is typical for a pandemic or similar healthcare crisis. This affects patients with resulting decisional conflicts and disturbed shared decision making during their treatment occurring to a very different extent. Sociodemographic factors and the individual perception of pandemic-related problems likely determine this decisional dilemma for patients and can characterize vulnerable groups with special susceptibility for decisional problems and related consequences. (2) Methods: Cross-sectional data from the OnCoVID questionnaire study were used involving 540 patients from 11 participating institutions covering all major regions in Germany. Participants were actively involved in clinical treatment in oncology or psychiatry during the COVID-19 pandemic. Questionnaires covered five decision dimensions (conflicts and uncertainty, resources, risk perception, perception of consequences for clinical processes, perception of consequences for patients) and very basic demographic data (age, gender, stage of treatment and educational background). Decision uncertainties and distress were operationalized using equidistant five-point scales. Data analysis was performed using descriptive and various multivariate approaches. (3) Results: A total of 11.5% of all patients described intensive uncertainty in their clinical decisions that was significantly correlated with anxiety, depression, loneliness and stress. Younger and female patients and those of higher educational status and treatment stage had the highest values for these stressors (p < 0.001). Only 15.3% of the patients (14.9% oncology, 16.2% psychiatry; p = 0.021) considered the additional risk of COVID-19 infections as very important for their disease-related decisions. Regression analysis identified determinants for patients at risk of a decisional dilemma, including information availability, educational level, age group and requirement of treatment decision making. (4) Conclusions: In patients, the COVID-19 pandemic induced specific decisional uncertainty and distress accompanied by intensified stress and psychological disturbances. Determinants of specific vulnerability were related to female sex, younger age, education level, disease stages and perception of pandemic-related treatment modifications, whereas availability of sufficient pandemic-related information prevented these problems. The most important decisional criteria for patients under these conditions were expected side effects/complications and treatment responses.
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Affiliation(s)
- Jörg Haier
- Comprehensive Cancer Center Hannover, Hannover Medical School, 30625 Hannover, Germany; (J.B.); (J.S.)
| | - Johannes Beller
- Comprehensive Cancer Center Hannover, Hannover Medical School, 30625 Hannover, Germany; (J.B.); (J.S.)
- Medical Sociology Unit, Hannover Medical School, 30625 Hannover, Germany;
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, 81377 Munich, Germany;
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany;
| | - Moritz De Greck
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt am Main, 60528 Frankfurt, Germany;
| | - Frank Griesinger
- Department of Hematology and Oncology, Pius-Hospital Oldenburg, Carl von Ossietzky University, 26129 Oldenburg, Germany;
| | - Alexander Hein
- Department of Gynecology and Obstetrics, Erlangen University Hospital, 91054 Erlangen, Germany;
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany
| | - René Hurlemann
- Department of Psychiatry, Carl von Ossietzky University, 26129 Oldenburg, Germany;
| | - Sören Torge Mees
- Department of General, Visceral and Thoracic Surgery, Friedrichstadt General Hospital, 01067 Dresden, Germany;
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, 53105 Bonn, Germany;
| | - Gernot Rohde
- Department of Respiratory Medicine and Allergology, University Hospital, Goethe University, 60590 Frankfurt am Main, Germany;
| | - Georgia Schilling
- Department of Hematology, Oncology, Palliative Care and Rheumatology, Asklepios Hospital Altona, Asklepios Tumorzentrum, 22763 Hamburg, Germany;
| | - Karolin Trautmann
- Department of Hematology and Oncology, University Hospital Carl Gustav Carus, 01307 Dresden, Germany;
| | - Stephanie E. Combs
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany;
| | - Siegfried Geyer
- Medical Sociology Unit, Hannover Medical School, 30625 Hannover, Germany;
| | - Jürgen Schäfers
- Comprehensive Cancer Center Hannover, Hannover Medical School, 30625 Hannover, Germany; (J.B.); (J.S.)
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Beller J, Schäfers J, Haier J, Geyer S, Epping J. Trust in Healthcare during COVID-19 in Europe: vulnerable groups trust the least. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2022; 31:1-10. [PMID: 35345647 PMCID: PMC8944407 DOI: 10.1007/s10389-022-01705-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 03/06/2022] [Indexed: 12/30/2022]
Abstract
Aim We examined predictors of trust in the healthcare system during the COVID-19 pandemic in 27 European countries. Subjects and methods We used population-based data drawn from the Living, working and COVID-19 survey (N = 21,884, 52% female, ages 18 to 92 years) covering 27 European countries dated June and July 2020. Multilevel linear regression, linear regression, and regression-tree analyses were conducted. Results We found that most participants tended to trust the healthcare system, although a substantial part could still be classified as distrusting (approx. 21%). Multiple variables, including being middle-aged or of older age, being female, lower levels of education, unemployment, worse general health status, having income difficulties, having unmet needs for healthcare, no healthcare contact during the COVID-19 pandemic, higher mental distress, and loneliness, were significantly associated with lower levels of trust. Among these variables mental distress, income difficulties, and unmet needs for healthcare emerged as especially important and, across European regions and countries, consistent predictors for lower trust in the healthcare system during the COVID-19 pandemic. Conclusions Medically vulnerable subgroups, such as individuals with unmet healthcare needs, higher levels of mental distress, and older age, as well as people living in socially and economically vulnerable situations, such as higher levels of loneliness and financial difficulties, were the least trusting of the healthcare system during the COVID-19 pandemic. As these vulnerable subgroups are also at highest risk for contracting COVID-19 and experiencing negative COVID-19-related outcomes, more targeted prevention and intervention efforts should be implemented in these groups. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-022-01705-3.
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Affiliation(s)
- Johannes Beller
- Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Jürgen Schäfers
- Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Jörg Haier
- Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Siegfried Geyer
- Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Jelena Epping
- Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
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Baiamonte D, Mannone P, Giannarini G, DI Gregorio G, Tulone G, Biancolini R, Giaimo R, Vella M, Pavan N, Ficarra V, Bartoletti R, Simonato A. Role of hygienic measures against COVID-19 on infective complications after urological interventions. Minerva Urol Nephrol 2022; 74:124-125. [PMID: 35272454 DOI: 10.23736/s2724-6051.22.04756-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Davide Baiamonte
- Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy -
| | - Piero Mannone
- Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Gianluca Giannarini
- Unit of Urology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Gianpaolo DI Gregorio
- Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Gabriele Tulone
- Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Roberto Biancolini
- Department of Urology, San Bartolomeo a Sarzana Hospital, Azienda Sociosanitaria Ligure5, La Spezia, Italy
| | - Rosa Giaimo
- Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Marco Vella
- Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Nicola Pavan
- Department of Urology, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Vincenzo Ficarra
- Section of Urology, Gaetano Barresi Department of Human and Pediatric Pathology, University of Messina, Messina, Italy
| | - Riccardo Bartoletti
- Unit of Urology, Department of Translational Research and New Technologies, University of Pisa, Pisa, Italy
| | - Alchiede Simonato
- Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
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