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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is known to present with pulmonary and extra-pulmonary organ complications. In comparison with the 2009 pandemic (pH1N1), SARS-CoV-2 infection is likely to lead to more severe disease, with multi-organ effects, including cardiovascular disease. SARS-CoV-2 has been associated with acute and long-term cardiovascular disease, but the molecular changes govern this remain unknown. In this study, we investigated the landscape of cardiac tissues collected at rapid autopsy from SARS-CoV-2, pH1N1, and control patients using targeted spatial transcriptomics approaches. Although SARS-CoV-2 was not detected in cardiac tissue, host transcriptomics showed upregulation of genes associated with DNA damage and repair, heat shock, and M1-like macrophage infiltration in the cardiac tissues of COVID-19 patients. The DNA damage present in the SARS-CoV-2 patient samples, were further confirmed by {gamma}-H2Ax immunohistochemistry. In comparison, pH1N1 showed upregulation of Interferon-stimulated genes (ISGs), in particular interferon and complement pathways, when compared with COVID-19 patients. These data demonstrate the emergence of distinct transcriptomic profiles in cardiac tissues of SARS-CoV-2 and pH1N1 influenza infection supporting the need for a greater understanding of the effects on extra-pulmonary organs, including the cardiovascular system of COVID-19 patients, to delineate the immunopathobiology of SARS-CoV-2 infection, and long term impact on health.

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TARGET POPULATION: These recommendations apply to adults with glioblastoma who have been previously treated with first-line radiation or chemoradiotherapy and who are suspected of experiencing tumor progression. QUESTION: In patients with previously treated glioblastoma, is standard contrast-enhanced magnetic resonance imaging including diffusion weighted imaging useful for diagnosing tumor progression and differentiating progression from treatment-related changes? LEVEL II: Magnetic resonance imaging with and without gadolinium enhancement including diffusion weighted imaging is recommended as the imaging surveillance method to detect the progression of previously diagnosed glioblastoma. QUESTION: In patients with previously treated glioblastoma, does magnetic resonance spectroscopy add useful information for diagnosing tumor progression and differentiating progression from treatment-related changes beyond that derived from standard magnetic resonance imaging with and without gadolinium enhancement? LEVEL II: Magnetic resonance spectroscopy is recommended as a diagnostic method to differentiate true tumor progression from treatment-related imaging changes or pseudo-progression in patients with suspected progressive glioblastoma. QUESTION: In patients with previously treated glioblastoma, does magnetic resonance perfusion add useful information for diagnosing tumor progression and differentiating progression from treatment-related changes beyond that derived from standard magnetic resonance imaging with and without gadolinium enhancement? LEVEL III: Magnetic resonance perfusion is suggested as a diagnostic method to differentiate true tumor progression from treatment-related imaging changes or pseudo-progression in patients with suspected progressive glioblastoma. QUESTION: In patients with previously treated glioblastoma, does the addition of single-photon emission computed tomography (SPECT) provide additional useful information for diagnosing tumor progression and differentiating progression from treatment-related changes beyond that derived from standard magnetic resonance imaging with and without gadolinium enhancement? LEVEL III: Single-photon emission computed tomography imaging is suggested as a diagnostic method to differentiate true tumor progression from treatment-related imaging changes or pseudo-progression in patients with suspected progressive glioblastoma. QUESTION: In patients with previously treated glioblastoma, does 18F-fluorodeoxyglucose positron emission tomography add useful information for diagnosing tumor progression and differentiating progression from treatment-related changes beyond that derived from standard magnetic resonance imaging with and without gadolinium enhancement? LEVEL III: The routine use of 18F-fluorodeoxyglucose positron emission tomography to identify progression of glioblastoma is not recommended. QUESTION: In patients with previously treated glioblastoma, does positron emission tomography with amino acid agents add useful information for diagnosing tumor progression and differentiating progression from treatment-related changes beyond that derived from standard magnetic resonance imaging with and without gadolinium enhancement? LEVEL III: It is suggested that amino acid positron emission tomography be considered to assist in the differentiation of progressive glioblastoma from treatment related changes.

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BACKGROUND/AIMS: The oxidative stress sensor transient receptor potential melastatin-2 (TRPM2) ion channel has recently gained attention in many types of cancer. The lung tissue is highly susceptible to oxidative stress-mediated injury and diseases; therefore, we aimed to determine whether TRPM2 plays an essential role in protecting lung cancer cells from oxidative damage while promoting cancer cell survival and metastasis. METHODS: We used two non-small cell lung (NSCLC) cell lines A549 and H1299 as a lung cancer model. We investigated the functional expression of TRPM2 using electrophysiology, qRT-PCR and Western blots. CFSE and flow cytometry were used to study TRPM2 role in proliferation, cell cycle and apoptosis. Gap closure chambers and Three-Tiered Chemotaxis Chamber were used to study the role of TRPM2 in metastasis. SCID mice were used to study the role of TRPM2 in lung tumor growth and metastasis. RESULTS: we demonstrate that TRPM2 is functionally expressed in NSCLC cells and that its downregulation significantly inhibits cell proliferation and promotes apoptosis. These results were concomitant with an induction in DNA damage and G2/M cell cycle arrest. TRPM2 silencing inhibits also lung cancer cells invasion ability and alters EMT processes. Mechanistically, TRPM2 downregulation causes an increase in the intracellular levels of reactive oxygen (ROS) and nitrogen (RNS) species, which in turn causes DNA damage and JNK activation leading to G2/M arrest, and an ultimate cell death. Finally, TRPM2 downregulation suppresses the growth of human lung tumour xenograft in SCID mice and TRPM2 depleted tumours exhibited a significant reduction in the mRNA expression level of EMT markers compared to the control tumors. CONCLUSION: Our data provide new insights on the functional expression of TRPM2 in lung cancer, its essential role in tumour growth and metastasis through the control of JNK signaling pathway, and that TRPM2 could be exploited for targeted lung cancer therapies.

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OBJECTIVE: Major depressive disorder (MDD) is the most common psychiatric disorder among breast cancer patients and is associated with substantial functional impairment. Although several outcome studies have explored the utility of psychotherapy for breast cancer patients with subsyndromal depression symptoms, only a few clinical trials have explored the efficacy of behavior therapy for patients with well-diagnosed MDD. An additional limitation of this research is that little is known about factors that best predict treatment outcome. METHOD: In the context of a recent randomized trial of behavior activation and problem-solving therapy for depressed breast cancer patients (n = 80; Hopko et al., 2011), this study explored predictors of treatment outcome with selected demographic (age, education, marital status, occupational status), psychosocial (pretreatment depression and environmental reward, coexistent anxiety disorders, social support, history of psychotherapy) and cancer-related variables (cancer stage, duration of cancer diagnosis, and cancer treatment). RESULTS: Positive treatment outcome as defined by Beck Depression Inventory-II (Beck et al., 1996) response and remission criteria was associated with being married, increased social support, not actively undergoing cancer treatment during psychotherapy, and having a history of psychotherapy. CONCLUSIONS: The efficacy of behavior therapy for depressed breast cancer patients may depend on several patient variables. Implications for the provision of behavior therapy for breast cancer patients are discussed.

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AIMS: Cardiac troponins are measured in acute coronary syndrome (ACS) and other conditions. The authors investigate the prognostic significance of cardiac troponin T (TnT) test and comorbid medical conditions. METHODS: Consecutive patients admitted to the Aintree University Hospital, Liverpool, between 2 January 2004 and 29 February 2004 who had TnT measurement were included. Patients were separated into normal (<0.01 µg/l) or raised TnT levels (≥ 0.01 µg/l), and further categorised into: (1) normal TnT with unstable angina; (2) normal TnT with non-ACS; (3) raised TnT with ACS; and (4) raised TnT with non-ACS. Cox regression was used to identify prognostic variables, and logrank test to compare 7-year survival. RESULTS: Of 1021 patients, 313 had raised TnT (195 ACS, 118 non-ACS) and 708 normal TnT (80 ACS, 628 non-ACS). Age (HR 1.06; 95% CI 1.05 to 1.07), congestive cardiac failure (HR 1.37; 95% CI 1.11 to 1.69), cerebrovascular disease (HR 1.37; 95% CI 1.10 to 1.71), chronic obstructive airway disease (HR 1.44; 95% CI 1.19 to 1.75), liver disease (HR 4.16; 95% CI 2.37 to 7.31), renal disease (HR 1.83; 95% CI 1.27 to 2.64), tumour (HR 1.39; 95% CI 1.07 to 1.79), lymphoma (HR 4.81; 95% CI 2.07 to 11.16), metastatic cancer (HR 3.55; 95% CI 2.32 to 5.45) and a higher Charlson's comorbidity score (HR 1.20, 95% CI 1.13 to 1.26) were adverse predictors. Both raised TnT with ACS (HR 1.92, 95% CI 1.54 to 2.39) and raised TnT with non-ACS (HR 2.37, 95% CI 1.87 to 3.00) were associated with worse survival. Raised TnT with non-ACS had a worse survival than raised TnT with ACS (p=0.001). CONCLUSION: Hospitalised patients with raised TnT levels from any cause predicted a higher mortality than normal TnT, with worst survival in those without an obvious ACS.

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Although hand dermatitis (HD) is a frequent occurrence for many health professionals, little is known about the prevalence of HD among medical students, particularly in Australia. A questionnaire-based survey of HD was administered to 261 students at a medical school in tropical northern Australia during 2004 (98.9% response rate). The prevalence of HD varied by year of study, ranging from 9.7% to 20.4% (P=0.322), with an overall prevalence of 17.4%. HD prevalence was significantly higher in those with current allergic disease (P=0.012). Some students (13.8%) reported a reaction immediately after exposure to latex products, a finding which was associated with higher prevalence of HD (P=0.001). HD may be more prevalent among students of a tropical Australian medical school than among their counterparts studied elsewhere. The identification of allergy as a significant correlate again stresses the importance of allergic disease and its relationship with skin conditions.

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Cyanoacrylate (CA) and its homologues have a variety of medical, dental and commercial applications as adhesives. The increasing use of CA in dentistry, particularly as an adhesive and sealing glue, has raised concerns regarding its potential toxicity in humans. Reported toxicity of CA is uncommon in the dental workplace, but may manifest as conditions such as urticaria, contact dermatitis and other dermatoses. Dental staff using CA adhesives should avoid direct contact with CA and use appropriate personal protective measures. Maintaining higher levels of humidity, optimizing room ventilation and using special air conditioning filters in the working environment may be useful in minimising the toxicity of volatile CA adhesives.

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We conducted an epidemiological investigation of musculoskeletal disorders (MSD) among a complete cohort of 222 female nursing students in Yamanashi prefecture, central Japan. This study involved a retrospective analysis of data gathered by means of a self-reported, anonymous questionnaire. Symptom descriptions and evaluation criteria were drawn from previously validated studies. Slightly more than one-third of all nursing students (36.9%) reported a current MSD at some body site. By location, shoulder MSD was the most common condition; affecting 14.9% of them. This was followed by MSD of the lower back (13.5%), neck (9.5%), knee (5.0%), forearm (2.7%), legs (2.3%) and feet (1.8%). Headache was also reported by 4.5%. There were no statistically significant differences between MSD prevalence and year of study in the nursing course (P for trend=0.9534). However, previous hospital work was found to increase the risk of shoulder MSD by a factor of 4.4 (OR 4.4, 95%CI 1.3-13.3, P=0.0107) among the students within this study. Overall, our investigation showed that MSD was less common among a Japanese cohort than in previous reports of nursing students and working nurses.

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The present research investigated the prevalence of musculoskeletal disorders (MSD) among a previously understudied group of Asian nursing professionals in a rural setting. A total of 305 female nurses (84% response rate) were recruited from a university teaching hospital in Yamanashi prefecture, central Japan. Data were gathered by means of a self-reporting questionnaire. Lower back pain (LBP) was the most commonly reported MSD, affecting 59% of all nurses. This was followed by MSD of the shoulder (46.6%), neck (27.9%), knees (16.4%) and upper leg (11.8%). Working in the surgical department was shown to increase the risk of any MSD 2.7 times when compared to nurses in the other departments (odds ratio 2.7, 95% confidence interval 1.2-6.7, P = 0.0202). Overall, our study shows that MSD are reasonably common among registered nurses in a rural Japanese hospital. These staff may also be at greater risk of suffering MSD than their city-based nursing counterparts and foreign colleagues, particularly with respect to LBP.

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BACKGROUND: Although hand dermatitis represents a common occupational disease among hospital nurses, epidemiologic studies of this nature are comparatively rare in Japan. METHODS: We recruited a complete cross-section of nurses from a teaching hospital in central Japan. Data was gathered by means of a self-reported questionnaire, with hand dermatitis symptoms and evaluation criteria drawn from previously validated research. Participants were categorised according to their hospital department during the analysis. RESULTS: A total of 305 questionnaires were successfully completed and returned (response rate: 84%). There were statistically significant differences in hand dermatitis prevalence between the departments (p < 0.05), ranging from 6% in psychiatry to 48% in the surgical unit and averaging 35% across the entire group. A history of allergic disease was shown to increase the risk of hand dermatitis (odds ratio = 3.7, 95% confidence interval: 2.1 - 6.6). Washing their hands more than 15 times per work shift also increased the risk (odds ratio = 2.0, 95% confidence interval: 1.2 - 3.4). CONCLUSION: This study has shown that hand dermatitis prevalence varies among Japanese nurses depending on their hospital department, and is generally quite high when compared to other reports.

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OBJECTIVES: Although musculoskeletal disorders (MSD) represent a significant occupational issue for most nursing home staff, few epidemiological studies have been conducted in Korea. METHODS: We investigated the prevalence of, and risk factors for, MSD within South Korea's largest nursing home using a previously validated, self-reporting questionnaire. RESULTS: From a total of 130 registered employees, 91 (70.0%) successfully completed questionnaires were obtained. The majority were female (80.2%, n=73), with an age range of 27 to 62 years and an average age of 47.0 years (SD 8.0). MSD occurred in varying amounts and was classified into distinct categories depending on body site. The most commonly affected region was the shoulder (reported by 35.2%), followed by the arm (22.0%), knee (20.9%) and lower back (19.8%). Three statistically significant risk factors were consistently identified among all 4 MSD sites: manually handling patients (OR 5.1 to 20.8), changing a patient's clothes (OR 6.7 to 30.1) and working as a nursing aide (OR 3.7 to 74.3). CONCLUSIONS: Overall, the present results suggest that employment within a South Korean nursing home incurs certain hazards depending on job description and daily work tasks. The MSD prevalence differed from other occupations within South Korea and previous nursing home studies.

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<p><b>OBJECTIVES</b>Although musculoskeletal disorders (MSD) represent a significant occupational issue for most nursing home staff, few epidemiological studies have been conducted in Korea.</p><p><b>METHODS</b>We investigated the prevalence of, and risk factors for, MSD within South Korea's largest nursing home using a previously validated, self-reporting questionnaire.</p><p><b>RESULTS</b>From a total of 130 registered employees, 91 (70.0%) successfully completed questionnaires were obtained. The majority were female (80.2%, n=73), with an age range of 27 to 62 years and an average age of 47.0 years (SD 8.0). MSD occurred in varying amounts and was classified into distinct categories depending on body site. The most commonly affected region was the shoulder (reported by 35.2%), followed by the arm (22.0%), knee (20.9%) and lower back (19.8%). Three statistically significant risk factors were consistently identified among all 4 MSD sites: manually handling patients (OR 5.1 to 20.8), changing a patient's clothes (OR 6.7 to 30.1) and working as a nursing aide (OR 3.7 to 74.3).</p><p><b>CONCLUSIONS</b>Overall, the present results suggest that employment within a South Korean nursing home incurs certain hazards depending on job description and daily work tasks. The MSD prevalence differed from other occupations within South Korea and previous nursing home studies.</p>

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BACKGROUND: Continuing advances in medical care and nutrition have prolonged the lifespan and expanded the elderly demographic world-wide. Despite increasing elderly populations within Taiwanese nursing homes, there has been a lack of dermatologic surveys, and the prevalence of skin conditions within this group is unknown. METHODS: To establish the prevalence of skin disease within nursing homes in southern Taiwan, we undertook a dermatologic and epidemiologic investigation of 398 patients in Tainan City, southern Taiwan, between November 1999 and February 2000. RESULTS: This study revealed that more than half of all nursing home patients suffered from fungus (61.6%) and xerosis (58.3%), while other pruritic skin diseases, such as dermatitis and scabies, were less prevalent at 7.3% and 3.3%, respectively. Risk factors for fungal infection included bedridden status (risk ratio (RR), 1.2; 95% confidence interval (CI), 1.1-1.4) and male gender (RR, 1.2; 95% CI, 1.0-1.3). Xerosis was statistically correlated with an age range of 80-90 years (RR, 1.2; 95% CI, 1.0-1.4) when compared to other age ranges. Current scabies diagnosis was strongly associated with a previous history of scabies (RR, 8.9; 95% CI, 1.7-21.1). CONCLUSIONS: Our study provides clinically relevant data regarding the prevalence of skin diseases in institutionalized Taiwanese patients for the first time. The results suggest that scabies persists within some nursing homes despite treatment, and that some patients remain undiagnosed. The dermatologic needs of these Taiwanese patients are not currently being satisfied.

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UNLABELLED: Although the number of nursing homes is increasing in Australia, few studies have investigated the dermatologic condition of their patients. To address this issue, we conducted one of the first skin disease investigations of nursing home residents in Queensland, Australia. METHODS: Our predominant data source was the attending physicians' medical reports, which are updated monthly following their physical examination of each patient. Specialist podiatrists' monthly progress notes were also used as were daily nursing reports. RESULTS: Just over half the patients (54.4%) had at least one skin disease registered among their medical records. Xerosis (dry skin) was the most common affliction, affecting 29.5% of the patients, followed by onychomycosis (tinea unguium) at 22.5% and dermatitis (8.9%). Skin cancer was recorded in 4.9%, while excoriation (3.1%) and unspecified keratosis (2.2%) were slightly less common. Being bedridden was identified as a risk factor for both xerosis (OR 3.9, 95% CI 1.8-8.7) and onychomycosis (OR 18.0, 95% Cl 7.5-49.0). CONCLUSION: Overall, our research suggests that skin diseases are reasonably common among Australian nursing home patients. The presence of certain dermatologic conditions differed from other reports.

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AIM: To investigate ergonomic and demographic issues reported by palliative care workers in southern Taiwan. METHOD: A structured questionnaire was completed by staff members from 11 nursing homes within southern Taiwan. Questions focused on age, sex, height, weight, shift-work details, duration of current employment, nature of current employment, the presence of injury and pain during the past 12 months, the phase lag before the onset of injury, and sick leave details. RESULTS: A total of 125 health-care workers were recruited. Most were female (89.3 percent) and employed full-time (64.8 percent) as patient care assistants (55.2 percent). Most workers were regularly involved in patient-handling tasks (61.6 percent). Almost half (36.8 percent) had suffered a musculoskeletal disorder within the previous year. Lower back injury was reported by 12.0 percent of all employees. Changing patients'clothes and changing their bed linen were associated statistically with musculoskeletal injury (odds ratio (OR) 2.9, 95 percent confidence interval (CI) 1.4-6.3 and OR 2.8, 95 percent CI 1.4-6.1), respectively. Moving the patients was also related to injury during our research (OR 2.5, 95 percent CI 1.2-5.4). CONCLUSION: This study has revealed various ergonomic and demographic issues reported by palliative care workers in southern Taiwan for the first time. The prevalence of certain injuries and symptoms are different from other reports.

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To establish the prevalence of skin disease among nursing home workers in southern Taiwan, dermatological examination was performed on 75 nursing home staff from 11 institutions in Tainan county. Fungal infections were the most common skin diseases identified, affecting 21.4% of all employees. Other conditions included xerosis (13.3%), scabies (10.7%) and dermatitis (8.0%). Fungus was found mainly on the feet and hands (68.7% and 31.3% of all fungal cases respectively). Most xerosis sites were identified on the lower leg (90.0% of all xerosis cases), while all workers with scabies had the disease on their forearm. Dermatitis was diagnosed predominately on the forearm (50.0% of all dermatitis cases). The prevalence of fungus and scabies was higher than other studies, while dermatitis occurred less frequently than previous reports. Although not statistically significant, we believe that wet work and occupational contact with nursing home patients may have been important risk factors for these conditions.

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Australia is a developed country with a high standard of living, small population and large land area. Manufacturing is currently the largest economic contributor, although mining and agriculture are also significant industries. There are around 10 million employees in total, with retail trade and manufacturing being the largest employers. Manufacturing currently has the highest incidence of workplace injury, although around 5% of all Australian workers suffer from some kind of occupational disease or injury every year. Occupational Health and Safety (OHS) legislation is individually managed and enforced by the 8 states and territories. Training and registration for OHS professionals varies between the speciaities and usually requires a combination of academic qualifications and workplace experience. Non-medical personnel constitute a large proportion of OHS professionals in Australia.

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We investigated the prevalence of musculoskeletal disorders (MSD) and skin disease within a Japanese compact disk (CD) manufacturing plant. For this study, a stratified cross-section of workers completed self-reported questionnaires distributed over a 6-month time period. Low back pain (LBP) was the most commonly reported category (affecting 20.1%), followed by MSD of the shoulder (15.4%), neck (10.1%) and head (5.4%). Dermatitis was the most frequent skin disease (affecting 8.1%), followed by eczema (3.4%), acne (3.4%) and xerosis (2.7%). The odds of suffering neck MSD was 10.8 times higher among staff who sat in a chair all day (95% CI 1.8-112.8, P < 0.05). Standing all day was also a risk factor for this condition (OR 8.2, 95% CI 1.2-81.7, P < 0.05). Female gender increased the risk of shoulder MSD 4.3 fold (95% CI 1.4-13.7, P < 0.05), as did alcohol consumption (OR 3.3, 95% CI 1.1-11.9, P < 0.05). The odds of suffering any skin disease were significantly enhanced by working longer than 12 months in one's current job (OR 10.7, 95% CI 1.5-7.3, P < 0.05) and having a history of atopic disease (OR 7.2, 95% CI 2.6-21.4, P < 0.001). Overall, the staff within our study reported generally lower levels of MSD and skin disease than in previous investigations of other workplaces.

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