Breath Volatile Organic Compounds in Surveillance of Gastric Cancer Patients following Radical Surgical Management

As of today, there is a lack of a perfect non-invasive test for the surveillance of patients for potential relapse following curative treatment. Breath volatile organic compounds (VOCs) have been demonstrated to be an accurate diagnostic tool for gastric cancer (GC) detection; here, we aimed to prove the yield of the markers in surveillance, i.e., following curative surgical management. Patients were sampled in regular intervals before and within 3 years following curative surgery for GC; gas chromatography-mass spectrometry (GC-MS) and nanosensor technologies were used for the VOC assessment. GC-MS measurements revealed a single VOC (14b-Pregnane) that significantly decreased at 12 months, and three VOCs (Isochiapin B, Dotriacontane, Threitol, 2-O-octyl-) that decreased at 18 months following surgery. The nanomaterial-based sensors S9 and S14 revealed changes in the breath VOC content 9 months after surgery. Our study results confirm the cancer origin of the particular VOCs, as well as suggest the value of breath VOC testing for cancer patient surveillance, either during the treatment phase or thereafter, for potential relapse.

Birth defects and associated antenatal care factors related with 1st trimester of pregnancy

Background

Ultrasound (US) can help monitor normal fetal development and screen for any potential problems. The prenatal detection of fetal anomalies allows for optimal perinatal management.

Aim

The aim was to assess congenital anomalies at births and their associated antenatal care factors.

Methods

Data source - Health Care Monitoring Datalink (HCMD), including two data sources: Medical Birth Register and ambulatory care data provided by public and private health care providers about US. Screening was detected by specific manipulation code: 50694 - routine US screening in the 1st trimester of pregnancy. All singleton birth in 2018 (n = 12955) were included in the data analysis. OR (odds ratio) were calculated. Multiple regression model was adjusted for mother age, gestational age, living area and antenatal care factors.

Results

The mean mother age was 30.3 (SD 5.4) and gestational age 39.3 (SD 1.8). The use of ICD-10 code O28 - abnormal findings on antenatal screening of mother - was observed in a small number of cases. 2.4% (n = 305) abnormal findings on antenatal screening of mother were detected at ambulatory care visits. From these cases 7.5% (n = 23) were diagnosed congenital anomalies at birth. Totally 2.8% (n = 362) of births were registered congenital anomalies. Congenital anomalies at birth have higher and statistically significant odds of invasive diagnostic methods in pregnancy (OR = 2.0; 95%CI 1.2-3.6; p < 0.01) and abnormal findings on US screening (OR = 2.6; 95%CI 1.7-4.2; p < 0.001). Slightly higher frequency of congenital anomalies at birth but not statistically significant (p > 0.05) were observed for 1st trimester genetic screening (OR = 1.5), preterm deliveries (OR = 1.4) and living in urban area (OR = 1.3).

Conclusions

Pregnancy outcome as congenital anomalies at birth related with higher maternal screening examinations prenatally. Further studies are needed to analyze the efficiency of US examinations for early prenatal detection of congenital anomalies.

Key messages

Territorial differences in infant mortality in Latvia in the first decade of the third millennium

OBJECTIVE

Infant and child mortality are some of the most substantial indicators of country welfare. Infant mortality (IM) in Latvia is constantly the highest among 25 Member States of the European Union. Since the regaining of independence in 1991, IM has decreased by almost 50%, however, it is still high enough to cause concern that the country will not be able to meet the UN Millennium Development Goals to decrease IM in Latvia by 2015. The Medical Faculty at the University of Latvia has conducted several studies identifying correlations between IM and GDP, total expenditure on health, unemployment and GINI coefficient. It is necessary to identify all IM causes and relationships which have not been studied, including the effect of social factors causing inequality between inhabitants of urban and rural areas: - The aim of the study was to determine the IM rate and the main death causes and their differences between rural and urban areas in Latvia (2000-2010).

MATERIALS

This is a register-based study. The data of 1994 deceased infants was analyzed over the time period from 2000-2010. The studied population was divided into two groups - urban and rural areas by mothers' area of residence. Descriptive and analytical methods were used for analysis - frequency distribution, correlation and regression analysis.

RESULTS

IM by maternal residence as well as IM indicators in the most common diagnostic subgroups have been higher in rural areas in the entire studied period (2000-2010). The decrease proportion of IM was more rapid in rural regions with a period average of 6.2% in comparison to urban regions - 2.6%. Annual decrease of IM from perinatal period conditions was 50% lower in rural than urban areas; annual decrease of IM from congenital malformations, deformations and chromosomal abnormalities was 20% lower in urban than rural areas; annual decrease in other diagnostic groups was 40% lower in urban than rural areas. During the study period, differences in infant mortality based on maternal socio- demographic factors, maternal health as well as pregnancy and obstetric history have been found, but the results of statistical analysis cannot be used to define these relationships as statistically significant in either areas.

CONCLUSIONS

infant mortality in Latvia due to various conditions prevailing during perinatal period, external causes and sudden infant death syndrome can be substantially decreased - by improving the theoretical and technical capacity of obstetric departments in rural areas as well as educating society on preventable causes of death.