Two-Year-Span Breast Cancer Screening Uptake in Japan after the COVID-19 Pandemic and Its Association with the COVID-19 Vaccination

There is limited information on whether the COVID-19 pandemic was associated with decreased breast cancer screening uptake and if COVID-19 vaccination was associated with an increase in screening uptake. Our study explored the uptake of breast cancer screening in Japan after the COVID-19 pandemic and assessed its association with the COVID-19 vaccination. We analyzed data from the Japan COVID-19 and Society Internet Survey (JACSIS), a web-based prospective cohort survey, and we included 6110 women without cancer history who were aged 40 to 74 years that participated in the 2012 and 2022 surveys. We examined the regular breast cancer screening uptake before and after the pandemic and employed a multivariable Poisson regression model to seek any association between COVID-19 vaccination and screening uptake. Of 6110, 38.2% regularly participated in screening before the pandemic and 46.9% did so after the pandemic. Individuals unvaccinated due to health reasons (incidence rate ratio (IRR) = 0.47, 95% CI: 0.29-0.77, p = 0.003) and for other reasons (IRR = 0.73, 95% CI: 0.62-0.86, p < 0.001) were less likely to undergo screening compared to fully vaccinated individuals. There was no long-term decrease in breast cancer screening uptake after the pandemic in Japan. Vaccination was linked to increased uptake, but there was no dose relationship.

The Management of Opioid-Induced Constipation in Cancer and Advanced Illness: A Meta-Analysis

CONTEXT

Constipation is a common problem among patients with cancer. By some accounts, about 60% of cancer patients experience constipation. There is limited empirical evidence of the clinical effectiveness of pharmacologic agents in opioid-induced constipation in advanced diseases.

OBJECTIVES

We sought to quantitatively summarize the therapeutic effectiveness of the pharmacologic means of managing opioid-induced constipation.

METHODS

Randomized control trials (RCTs) identified from medical literature databases that reported quantitative measures of the effect of pharmacotherapeutic agents to treat opioid induced constipation in patients with cancers and other advanced illnesses were included in this study. A conventional random effects meta-analysis was conducted including >3 trials with the same exposure and outcome assessed, and a network-meta-analysis was conducted for all placebo-controlled trials.

RESULTS

Eighteen studies that examined the effect of various pharmacotherapeutic agents were included. The medications were Methylnatrexone (N = 5), Naldemedine (N = 5), other conventional agents (N = 4) and herbal medicines (N = 4). In conventional meta-analysis, methylnaltrexone increased the proportion achieving rescue-free laxation by 2.68 fold (95% CI: 1.34, 5.37; P = 0.0054) within 4 hours of the administration compared to placebo. In network meta-analysis, the pooled RR of the pharmacotherapeutic agents on rescue-free bowel movements as 2.26 (95% CI: 1.52, 3.36) for methylnaltrexone, 1.58 (95% CI: 0.94, 2.66) for naldemedine, and 0.74 (95% CI: 0.45, 1.23) for polyethylene glycol, compared to placebo.

CONCLUSION

Methylnatrexone and Naldemedine have currently shown promise in randomized trials concerning opioid-induced constipation in cancer and advanced illness. It is imperative that future research ascertain not just the relative therapeutic efficacy but also the cost-benefit analyses of these newer regimens with more commonly used and accessible laxatives.

Knowledge, risk perception and practices related to antibiotic resistance among patent medicine vendors in Sokoto metropolis, Nigeria

Background

Resistance to antibiotics is now a serious threat to global health, and inappropriate use of drugs has been identified as a major contributing factor in the developing countries.

Objectives

The aim of this study is to assess the knowledge, risk perception, and practices related to antibiotic resistance among patent medicine vendors (PMVs) in Sokoto metropolis, Nigeria.

Materials and Methods

A cross-sectional study was conducted among 200 PMVs selected by multi-stage sampling technique. Data were collected with a set of pretested, self administered, semi structured questionnaire.

Results

A larger proportion (83, 42.1%) of the 197 respondents who completed the questionnaire were aged 20 29 years. Most of them were males (80.2%) and had tertiary education (80.7%). Most of the respondents had adequate knowledge of the causes of antibiotic resistance (94.9%), and its prevention (98.0%). Most of the respondents also perceived antibiotic resistance as a serious threat to their own health (95.4%), and the health of their clients (89.4%). Practices favorable to the development of antibiotic resistance were very prevalent among the respondents. Majority of respondents (59.9%) consistently sell antibiotics to clients without doctor's prescription, and close to half of them (49.2%) consistently practice self-medication.

Conclusion

Despite high levels of knowledge of the causes, prevention, and perception of the risks associated with antibiotics resistance, practices favorable to its development were very prevalent among PMVs in Sokoto, Nigeria. Government should regulate and closely monitor PMVs' practices in order to avert the looming crisis in medical practice that will become inevitable if there are no potent antibiotics.