Duration-response association between occupational exposure and pancreatic cancer risk: meta-analysis

BACKGROUND

Evidence is lacking on the occupational exposure time window to chemical agents related to pancreatic cancer risk.

AIMS

This study performed meta-regression and meta-analysis to examine the dose-response association between occupational exposure duration to chemical agents and pancreatic cancer risk.

METHODS

We searched and reviewed studies on exposure duration and pancreatic cancer in five databases (Cochrane Library, EMBASE, PubMed, ScienceDirect and Web of Science) from inception to 16 May 2022. Exposure refers to the years a worker was exposed to any chemical agent, and outcome variables were pancreatic cancer incidence and mortality.

RESULTS

We identified 31 studies, including 288 389 participants. In the meta-regression, the positive dose-response association indicated pancreatic cancer risk increased slightly with every additional year of exposure duration (slope = 1.01; 95% confidence interval [CI] 1.00-1.02). Pancreatic cancer risk increased with an exposure duration of 1-10 (relative risk [RR] = 1.04; 95% CI 1.02-1.06), 11-20 (RR = 1.11; 95% CI 1.05-1.16), and 21-30 years (RR = 1.39; 95% CI 1.12-1.73).

CONCLUSIONS

Pancreatic cancer risk increased as occupational exposure duration increased, with an exposure time window ranging from 1 to 30 years.

Factors predicting diuretic resistance in patients with acute decompensated heart failure

Background

Heart failure is a leading cause of hospitalisation and mortality with high incidence and ever-increasing prevalence in the world. Although novel methods in management of acute decompensated heart failure (ADHF) have been developed, mortality and rehospitalisation rates remain high. Loop diuretics have been shown to be effective in relieving congestion and have been recommended in many heart failure guidelines. Continuous use of loop diuretics may cause complications in the form of diuretics resistance. The prevalence of diuretic resistance ranges from 20–35% in the heart failure population and has been shown to be a predictor of mortality and an increased incidence of hospitalisation. Until now there are debates in determining the clinical indicators of diuretic resistance. However, the clinical characteristics of patients with acute decompensated heart failure that predict the development of diuretic resistance have not been widely studied and previous studies have shown different results from one another.

Purpose

This study aims to identify factors that influence the occurrence of diuretic resistance in ADHF patients based on clinical profiles, medical histories, and laboratory findings.

Methods

This was a retrospective cohort study on patients treated due to ADHF from January-December 2019. Diuretic resistance was defined as a diuresis response less than 1400 ml in the first 24 hours after administration of 40 mg of intravenous furosemide.

Results

Data from 535 patients were analysed. The prevalence of diuretic resistance in this study was 68%. Independent predictors obtained from multivariate logistic regression analysis were Type II Diabetes Mellitus (p=0.013), history of prior iv loop diuretics >6 days (p=0.002), history of oral loop diuretic dose >80 mg/day (p=0.006), LVEF ≤49% (p=0.002), BUN ≥21 mg/dL (p<0.001) and serum chloride <98 mmol/L (p<0.001). In addition, a scoring system has been generated from the final model with AUC 0.749.

Conclusions

Independent predictors for diuretic resistance obtained from this study were DM, history of prior iv loop diuretics >6 days, history of oral loop diuretic dose >80 mg/day, LVEF ≤49%, BUN ≥21 mg/dL and serum chloride <98 mmol/L.

Funding Acknowledgement

Type of funding sources: None.

The new challenge of partial oxidation of methane over Fe2O3/NaY and Fe3O4/NaY heterogeneous catalysts

As one of the most important gases that abundantly contribute to air pollution, methane becomes the most leading gas that challenges researchers to utilize it in more functional products such as methanol. In this study, the conversion process involved iron oxide species supported by sodium Y (NaY-Z) zeolite as the catalysts. This work highlighted the preparation of Fe₂O₃ and Fe₃O₄ modified NaY zeolite to investigate their catalytic performance on partial oxidation of methane to methanol, with trace amount of oxygen (0.5% in N₂), in a batch reactor. The as-prepared catalysts were characterized using FTIR, XRD, SEM, and BET. The structure of NaY zeolite and its modified catalysts were confirmed. The pristine NaY-Z shows the highest activity followed by Fe₂O₃/NaY-3.52 (3.52 wt% of Fe loading) with high selectivity to formaldehyde (80%). Very high selectivity (∼100%) towards methanol was observed in the reactions on Fe₂O₃/NaY-1.70 and Fe₃O₄/NaY-2.55 catalysts, although the total amount of product was decreased. It was noticeable that Fe₃O₄/NaY-3.22 is an active catalyst and has good selectivity to methanol (70%).

OR35. Exercise Effect on Global Myocardial Function Score in Patients with Refractory Angina Undergoing Extracorporeal Shockwave Myocardial Revascularization (ESMR): A Study focusing on Speckle Tracking and Exercise Stress Echocardiography

Aims

Refractory angina pectoris (RAP) is defined as the occurrence of frequent angina attacks uncontrolled by optimal drug therapy. Extracorporeal shockwave myocardial revascularization (ESMR) is one of the alternative therapies that can be performed to treat RAP. Stress echocardiography is necessary to determine the inducible myocardial segments. To date, study evaluating the effect of exercise on myocardial function using WMSI and GLS was still limited. The aim of this study was to show the effect of exercise on global myocardial function evaluated using GLS and WMSI from echocardiography.

Methods and Results

This is a cross sectional and single center study of 9 Refractory Angina Pectoris patients underwent stress echocardiography from April - June 2021 in Mohammad Hoesin General Hospital, Palembang. Pre and post exercise WMSI and GLS were obtained and analyzed using McNemar non-parametric test. There were no significant differences between both pre and post GLS (p = 0.500) and WMSI (p = 0.250) through exercise stress echocardiography.

Conclusion

Our study showed no significant difference of global myocardial function evaluated by GLS and WMSI, pre and post exercise. Segmental myocardial function analysis seems to be more potential as useful assessment for RAP undergoing ESMR procedure.