Epidemiologic Features, Survival, and Prognostic Factors Among Patients With Different Histologic Variants of Glioblastoma: Analysis of a Nationwide Database

Background: Glioblastoma (GBM) is the most common primary intracranial malignancy. Previous studies found incidence of GBM varies substantially by age, sex, race and ethnicity, and survival also varies by country, ethnicity, and treatment. Gliosarcoma (GSM) and giant cell glioblastoma (GC-GBM) are different histologic variants of GBM with distinct clinico-pathologic entities. We conducted a study to compare epidemiology, survival, and prognostic factors among the three.Methods: We identified GBM patients diagnosed between 2000 and 2016 using the Taiwan Cancer Registry and followed them using the death registry. Survival was compared among conventional GBM and two histologic variants. The potential confounding factors evaluated in this study included registered year, age, sex, and treatment modality (resection, radiotherapy, and chemotherapy).Results: We enrolled 3,895 patients, including 3,732 (95.8%) with conventional GBM, 102 (2.6%) with GSM, and 61 (1.6%) with GC-GBM. GC-GBM patients had younger mean age at diagnosis (49.5 years) than conventional GBM patients (58.7 years) and GSM patients (61.3 years) (p < 0.01). The three groups had similar sex distributions (p = 0.29). GC-GBM had a longer median survival [18.5, 95% confidence interval (CI): 15.8–25.3 months] than conventional GBM (12.5, 95%CI: 12.0–13.0 months) and GSM (12.8, 95%CI: 9.2–16.2 months), and the differences in overall survival did not attain statistical significance (p = 0.08, log-rank test). In univariate analysis, GC-GBM had better survival than conventional GBM, but the hazard ratio (0.91) did not reach statistical significance (95%CI: 0.69–1.20) in the multivariate analysis. Young ages (≤ 40 years), female sex, resection, radiotherapy, and chemotherapy were factors associated with better survival in overall GBMs. In subtype analyses, these factors remained statistically significant for conventional GBM, as well as radiotherapy for GSM.Conclusion: Our analysis found conventional GBM and its variants shared similar poor survival. Factors with age ≤ 40 years, female sex, resection, radiotherapy, and chemotherapy were associated with better prognosis in conventional GBM patients.

Epidemiologic Features and Influencing Factors of Norovirus Outbreaks in the City of Wuxi, China from 2014 to 2018

The study investigated the genotypic changes and epidemiologic features of norovirus outbreaks and factors influencing the attack rate and outbreak duration in Wuxi from 2014 to 2018. Norovirus outbreaks, monitored through surveillance system, were investigated. The norovirus-positive specimens from outbreaks were collected and genotyped using a dual polymerase-capsid genotyping protocol based on a one-step polymerase chain reaction (PCR) amplicon. The genotypes were analyzed by Norovirus Typing Tool Version 2.0. A total of 74 norovirus outbreaks were reported in Wuxi from 2014 to 2018. Most (93.2%) norovirus outbreaks were caused by GII genotypes. The predominant norovirus genotypes in outbreaks have changed from GII.17 (20.3%) in 2014–2015 to GII.P16/GII.2 (40.5%) in 2017–2018. GII.P16/GII.2 in 2017–2018 season were more prevalent than GII.17 in 2014–2015 season (χ2 = 4.741, P = 0.029). 56.7% of the outbreaks occurred in primary schools. The re-outbreak rate was 16.2%. 66.7% of re-outbreaks were caused by norovirus variants different from previous genotypes. Outbreaks in nonprimary school settings (odds ratio [OR]: 4.007; 95% CI: 1.247–12.876) and those leading to temporary school or institution closure (OR: 20.510; 95% CI: 1.806–232.937) were reported with a higher attack rate. The outbreaks in primary schools (OR: 4.248; 95% CI: 1.211–14.903), re-outbreaks (OR: 6.433; 95% CI: 1.103–37.534) and longer report timing (OR: 8.380; 95% CI: 2.259–31.089) declared a significantly longer duration. It is of great importance that the monitoring of norovirus outbreaks for the emergence of novel strains, along with responsive prevention and control intervention should be strengthened in adults and school-age population, especially in primary students and preschool children.

COVID-19 in Douala-Cameroon: Epidemiologic features, challenges to fight the pandemic, and psychosocio-economic impacts

Coronaviruses are a family of viruses that can cause illnesses such as the common cold, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). In 2019, a new coronavirus was identified as the cause of a disease outbreak that originated in China. Cases of COVID-19 have been reported in a growing number of cities worldwide. Cameroon recorded the first case of the Coronavirus on March 6, 2020 and thereafter, there was a geometric increase in the number of cases. In response to this, the government announced firm measures in an effort to curb the exponential increase of the Coronavirus cases in the country. Despite the measures, the number of cases has continued to increase, coupled with another unwanted socio-economic phenomenon. This study aims to present the challenges to fight COVID-19 in Cameroon urban settlements as with the case of Douala metropolitan city, to examine its geographical distribution pattern, and to apprehend its socio-economic impacts on Douala city dwellers. Data used here derived from local and national health statistics, and from a cross-sectional study conducted in Douala city from May to December 2020. Results reveal that coherent measures were taken by health officials to fight the pandemics. However, spread of the virus has continued in the city, under a differentiated dissemination pattern. Findings also revealed that during lockdown, the city witnessed downturn in the economy, increase in domestic violence and mental health problems. The study recommends the effective follow-up of the measures put in place by the government as well as all the stakeholders, the financial support of enterprises and an aggressive sensitization of the population.

The Effect of Limbal Autograft Location at Primary Pterygium Excision on Anterior and Posterior Corneal Astigmatism: A Comparative Prospective Study

Purpose: The aim of the study is to evaluate the effect of limbal autograft location on corneal astigmatism in inferior and superior conjunctival autografted pterygium surgery.Methods: Patients were divided into 2 groups as diagnosed with primary pterygium and planned to receive surgical treatment. Pterygium surgery was performed 25 patients with superior and 25 patients with inferior limbal autograft who have similar epidemiologic features. Cornea anterior and posterior surface keratometry (K) 1, K2, Kmax, peripheric radius (Rper) (the mean radius of curvature of the 7.0-9.0 mm ring area), refractive astigmatism and axis values, were examined. Corneal irregularity indices were the index of surface variance (ISV), index of vertical asymmetry (IVA, mm), index of height asymmetry (IHA, μm), index of height decentration (IHD, μm). The data were compared pre and postoperative and the effect of graft location on results was evaluated.Results: K1 which is from the values of the cornea front face has risen after surgery both of superior and inferior groups (p=0.011). However, no postoperative significant difference was detected in terms of the change. Otherwise, both of groups (p<0.001) have changed regarding astigmatism and Rper, but no postoperative significant difference was found in terms of the change. There were not any differences between groups regarding the changes of postoperative back face values. A significant decrease was detected on ISV, IVA, IHD values of the SLAG group (p<0.001) and ILAG group (p<0.001) in terms of all corneal anterior surface indices. However, there was no significant difference between the groups regarding the results of postoperative (p>0.05).Conclusion: The effects of pterygium surgery with limbal autograft were not significant on corneal astigmatism. However, we suggest that for the cases which need the protection of bulbar conjunctiva or when it can not be used, inferior bulbar conjunctiva preference can achieve successful results.