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Yap S, Luo Q, Wade S, Ngo P, Goldsbury D, Sarich P, Banks E, Weber M, Canfell K, David M, Steinberg J. Impact of weighting on the association between sociodemographic characteristics, health behaviours and cancer, cardiovascular and all-cause mortality in the Australian 45 and Up Study. Cancer Epidemiol 2024; 90:102567. [PMID: 38603997 DOI: 10.1016/j.canep.2024.102567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/11/2024] [Accepted: 03/23/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Weighting can improve study estimate representativeness. We examined the impact of weighting on associations between participants' characteristics and cancer, cardiovascular and all-cause mortality in the Australian 45 and Up Study cohort. METHODS Raking weighted cohort data to the 2006 Australian population for seven sociodemographic characteristics. Deaths were ascertained via linkage to routinely collected data. Cox's proportional hazards regression quantified associations between 11 sociodemographic and health characteristics and cancer, cardiovascular and all-cause mortality. The ratios of hazard ratios (RHRs) compared unweighted and weighted estimates. RESULTS Among 195,052 included participants (median follow-up 11.4 years), there were 7200 cancer, 5912 cardiovascular and 21,840 all-cause deaths. Overall, 102/111 (91.9%) weighted HRs did not differ significantly from unweighted HRs (100%, 86.5% and 89.2% of 37 HRs for cancer, cardiovascular and all-cause mortality, respectively). Significant differences included a somewhat stronger association between single/widowed/divorced (versus married/de-facto) and cardiovascular mortality (unweighted HR=1.25 (95%CI:1.18-1.32), weighted HR=1.33 (95%CI:1.24-1.42), RHR=1.06 (95%CI:1.02-1.11)); and between no school certificate/qualification (versus university degree) and all-cause mortality (unweighted HR=1.21 (95%CI:1.15-1.27), weighted HR=1.28 (95%CI:1.19-1.38), RHR=1.06 (95%CI:1.03-1.10)). CONCLUSION Our results support the generalisability of most estimates of associations in the 45 and Up Study, particularly in relation to cancer mortality. Slight distortion of a few associations with cardiovascular or all-cause mortality were observed.
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Affiliation(s)
- Sarsha Yap
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia.
| | - Qingwei Luo
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Stephen Wade
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Preston Ngo
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - David Goldsbury
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Peter Sarich
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Marianne Weber
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Michael David
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia; School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
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Rattay K, Robinson LR. Identifying Risk Factors for Attention-Deficit/Hyperactivity Disorder (ADHD): a Public Health Concern and Opportunity. Prev Sci 2024:10.1007/s11121-024-01667-w. [PMID: 38598041 DOI: 10.1007/s11121-024-01667-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/11/2024]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders with significant individual and societal negative impacts of the disorder continuing into adulthood (Danielson et al. in Journal of Clinical Child and Adolescent Psychology, in press; Landes and London in Journal of Attention Disorders 25:3-13, 2021). Genetic and environmental risk (e.g., modifiable exposures such as prenatal tobacco exposure and child maltreatment) for ADHD is likely multifactorial (Faraone et al. in Neuroscience & Biobehavioral Reviews 128:789-818, 2021). However, the evidence for potentially modifiable contextual risks is spread across studies with different methodologies and ADHD criteria limiting understanding of the relationship between early risk factors and later childhood ADHD. Using common methodology across six meta-analyses (Bitsko et al. in Prevention Science, 2022; Claussen et al. in Prevention Science 1-23, 2022; Dimitrov et al. in Prevention Science, 2023; Maher et al. in Prevention Science, 2023; Robinson, Bitsko et al. in Prevention Science, 2022; So et al. in Prevention Science, 2022) examining 59 risk factors for childhood ADHD, the papers in this special issue use a public health approach to address prior gaps in the literature. This introductory paper provides examples of comprehensive public health approaches focusing on policy, systems, and environmental changes across socio-ecological contexts to improve health and wellbeing through prevention, early intervention, and support across development using findings from these meta-analyses. Together, the findings from these studies and a commentary by an author independent from the risk studies have the potential to minimize risk conditions, prioritize prevention efforts, and improve the long-term health and wellbeing of children and adults with ADHD.
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Affiliation(s)
- Karyl Rattay
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Lara R Robinson
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention, Atlanta, GA, USA
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153
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Rami FZ, Li L, Le TH, Kang C, Han MA, Chung YC. Risk and protective factors for severe mental disorders in Asia. Neurosci Biobehav Rev 2024; 161:105652. [PMID: 38608827 DOI: 10.1016/j.neubiorev.2024.105652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 03/22/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024]
Abstract
Among 369 diseases and injuries, the years lived with disability (YLDs) and disability-adjusted life-years (DALYs) rates for severe mental illnesses (SMIs) are within the top 20 %. Research on risk and protective factors for SMIs is critically important, as acting on modifiable factors may reduce their incidence or postpone their onset, while early detection of new cases enables prompt treatment and improves prognosis. However, as most of the studies on these factors are from Western countries, the findings are not generalizable across ethnic groups. This led us to conduct a systematic review of the risk and protective factors for SMIs identified in Asian studies. There were common factors in Asian and Western studies and unique factors in Asian studies. In-depth knowledge of these factors could help reduce disability, and the economic and emotional burden of SMIs. We hope that this review will inform future research and policy-making on mental health in Asian countries.
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Affiliation(s)
- Fatima Zahra Rami
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Ling Li
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Thi Hung Le
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Chaeyeong Kang
- Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Mi Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Republic of Korea
| | - Young-Chul Chung
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.
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Bartosiewicz A, Wyszyńska J, Matłosz P, Łuszczki E, Oleksy Ł, Stolarczyk A. Prevalence of dyslipidaemia within Polish nurses. Cross-sectional study - single and multiple linear regression models and ROC analysis. BMC Public Health 2024; 24:1002. [PMID: 38600553 PMCID: PMC11008020 DOI: 10.1186/s12889-024-18542-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/07/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Maintaining good health is vital not only for own well-being, but also to ensure high-quality patient care. The aim of this study was to evaluate the prevalence of dyslipidaemia and to determine the factors responsible for the development of this disorder among Polish nurses. Lipid profile disorders are the most prevalent and challenging risk factors for the development of cardiovascular disease. Nurses have significant potential and play a crucial role in providing care and treatment services. METHODS This cross-sectional study involved nurses and included measurements of body weight composition (Tanita MC-980), body mass index, waist circumference, blood pressure (Welch Allyn 4200B), lipid profile, and fasting blood glucose (CardioChek PA). RESULTS The results revealed that more than half of the nurses (60.09%) were overweight or obese, with 57.28% exhibiting elevated blood pressure, 32.25% having fasting glucose levels, and 69.14% experiencing dyslipidaemia. Multiple model evaluation using ROC curves demonstrated that multiple models accurately predicted hypercholesterolemia (AUC = 0.715), elevated LDL (AUC = 0.727), and elevated TC (AUC = 0.723) among Polish nurses. CONCLUSION Comprehensive education programmes should be implemented that include the latest advances in cardiovascular disease prevention. Regular check-ups, as well as the promotion and availability of healthy food in hospital canteens, are essential.
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Affiliation(s)
- Anna Bartosiewicz
- Institute of Health Sciences, Medical College of Rzeszów University, Rejtana 16 C, 35-959, Rzeszów, Poland.
| | - Justyna Wyszyńska
- Institute of Health Sciences, Medical College of Rzeszów University, Rejtana 16 C, 35-959, Rzeszów, Poland
| | - Piotr Matłosz
- Institute of Physical Culture Sciences, Medical College of Rzeszów University, 35-959, Rzeszów, Poland
| | - Edyta Łuszczki
- Institute of Health Sciences, Medical College of Rzeszów University, Rejtana 16 C, 35-959, Rzeszów, Poland
| | - Łukasz Oleksy
- Department of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-007, Kraków, Poland
| | - Artur Stolarczyk
- Department of Orthopedics and Rehabilitation, Medical University of Warsaw, 04-749, Warsaw, Poland
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155
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Miyazaki N, Iwasaki T, Sakai H, Watanuki R, Tanizawa Y, Cai Z, Kawaguchi T, Tsurutani J, Nagashima K. Risk factors for recurrence in patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative early breast cancer in Japan: a systematic literature review and meta-analysis. Curr Med Res Opin 2024:1-11. [PMID: 38597173 DOI: 10.1080/03007995.2024.2332436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/14/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND The clinicopathological factors indicating risk of recurrence are used to guide the choice of perioperative therapy in patients with breast cancer. Although several risk factors for recurrence have been reported in patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) early breast cancer in Japan, there has been no systematic review quantifying potential risk factors. METHODS We performed a systematic literature review and meta-analysis using the MEDLINE, Embase, Cochrane CENTRAL, and Japan Medical Abstract Society databases to identify risk factors for recurrence in HR+/HER2- early breast cancer in Japan. The primary outcome was relapse-free or disease-free survival (RFS/DFS), and the secondary outcomes were overall survival and breast cancer-specific survival (BCSS). RESULTS Searches identified 42 eligible publications. Meta-analyses identified lymph node metastasis (hazard ratio: 2.76 [95% confidence interval: 1.97-3.88]), large tumor size (1.67 [1.24-2.23]), high histological grade (1.50 [1.04-2.16]), and high nuclear grade (2.02 [1.61-2.54]) as risk factors for RFS/DFS. Lymph node metastasis (2.43 [1.28-4.63]), large tumor size (1.80 [1.24-2.62]), and high histological grade (2.02 [1.44-2.84]) were also risk factors for overall survival, and high progesterone status was a possible favorable prognostic factor for BCSS (0.20 [0.10-0.42]). CONCLUSIONS Identified risk factors were consistent with the previous reports, and this study provides quantitative summary of risk factors for HR+/HER2- early breast cancer recurrence in Japan. (PROSPERO Registration ID, CRD42022338391.).
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Affiliation(s)
- Naoki Miyazaki
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Toshiki Iwasaki
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Hitomi Sakai
- Advanced Cancer Translational Research Institute, Showa University, Tokyo, Japan
| | - Rurina Watanuki
- Department of Breast Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yoshinori Tanizawa
- Japan Drug Development and Medical Affairs, Eli Lilly Japan, Kobe, Japan
| | - Zhihong Cai
- Japan Drug Development and Medical Affairs, Eli Lilly Japan, Kobe, Japan
| | - Tsutomu Kawaguchi
- Japan Drug Development and Medical Affairs, Eli Lilly Japan, Kobe, Japan
| | - Junji Tsurutani
- Advanced Cancer Translational Research Institute, Showa University, Tokyo, Japan
| | - Kengo Nagashima
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
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156
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Jiménez-Martín D, García-Bocanegra I, Risalde MA, Napp S, Domínguez M, Romero B, Moreno I, Martínez R, Cano-Terriza D. Mycobacterium tuberculosis complex in domestic goats in Southern Spain. Prev Vet Med 2024; 227:106204. [PMID: 38604014 DOI: 10.1016/j.prevetmed.2024.106204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 04/13/2024]
Abstract
Tuberculosis (TB) is a zoonotic infectious disease caused by bacteria belonging to the Mycobacterium tuberculosis complex (MTC), which can affect a wide variety of domestic and wild animal species. Although the role of goats as a reservoir of MTC bacteria has been evidenced, information about the circulation of MTC strains in this species is still very scarce. The aim of the present study was to determine the seroprevalence, spatial distribution, risk factors and MTC spoligotypes circulating in goats from Andalusia (Southern Spain), the Spanish region with the largest goat census and a hotspot area of TB in both cattle and wild ungulates. A total of 2155 serum samples from 80 goat flocks were analyzed by an in-house ELISA using the P22 protein complex as a coating antigen. Antibodies against MTC were detected in 473 goats (21.9%, 95% CI: 20.2-23.7) and the true seroprevalence was 22.3% (95% CI: 20.6-24.1). Seropositivity was found in 72 (90.0%) of the 80 flocks analyzed. The generalized estimating equation model showed that the management system (higher seroprevalence on intensive and semi-intensive farms), and the presence of hospital pens inside the regular stables, were risk factors potentially associated with MTC exposure in goats in Southern Spain. The spatial analysis identified a significant spatial cluster (p < 0.001) in Eastern Andalusia. A total of 16 different MTC spoligotypes, including five of M. caprae and eleven of M. bovis, were identified in goats between 2015 and 2022 in the study area, with SB0157 as the most frequently isolated. The results obtained indicate widespread and non-homogeneous spatial distribution of MTC in goat herds from Southern Spain. The high individual and herd-level seroprevalence values found suggest that goats could play a significant role in the maintenance and transmission of MTC in the study area. Our results highlight the importance of implementing control measures in this species.
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Affiliation(s)
- Débora Jiménez-Martín
- Departamento de Sanidad Animal, Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain
| | - Ignacio García-Bocanegra
- Departamento de Sanidad Animal, Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain; CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Spain.
| | - María A Risalde
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Spain; Departamento de Anatomía y Anatomía Patológica Comparadas y Toxicología, Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain
| | - Sebastián Napp
- IRTA, Animal Health Research Centre (CReSA IRTA-UAB), Bellaterra, Spain
| | - Mercedes Domínguez
- Unidad de Inmunología Microbiana, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Beatriz Romero
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET) y Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Inmaculada Moreno
- Unidad de Inmunología Microbiana, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Remigio Martínez
- Departamento de Sanidad Animal, Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain
| | - David Cano-Terriza
- Departamento de Sanidad Animal, Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain; CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Spain
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157
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Danilovic A, Suartz CV, Torricelli FCM, Marchini GS, Batagello C, Vicentini FC, Nahas WC, Mazzucchi E. Play it safe: renal function after bilateral flexible ureteroscopy for kidney stones. World J Urol 2024; 42:226. [PMID: 38594574 DOI: 10.1007/s00345-024-04924-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 03/05/2024] [Indexed: 04/11/2024] Open
Abstract
PURPOSE We searched for perioperative renal function deterioration risk factors in patients that underwent bilateral flexible ureteroscopy (fURS) for kidney stones. METHODS From August 2016 to February 2020, symptomatic patients > 18 years old with bilateral kidney stones up to 20 mm in each side were prospectively studied. Serum creatinine samples were collected on admission to surgery, immediate postoperative (IPO), on POD 3, 10, and 30. Estimated glomerular filtration rate (eGFR) was calculated using Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI) without a race coefficient. RESULTS Thirty patients underwent bilateral fURS. Comparing to preoperative eGFR, median IPO and POD3 eGFR (p < 0.001) were significantly lower, and POD10 (p = 0.092) and POD30 (p = 0.648) were similar to preoperative eGFR. During follow-up, 22/30 (73.3%), 14/30 (46.7%), and 7/30 (23.3%) of the patients presented a decrease > 10% eGFR, > 20% eGFR, and > 30% eGFR, respectively. Multivariate analysis demonstrated that lower preoperative eGFR is a risk factor for eGFR < 60 mL/min/1.73 m2, p = 0.019 [1.021-1.263; 1.136]; ASA > 1 is a risk factor for decrease of eGFR > 10%, p = 0.028 [1.25-51.13; 8.00]; longer operative time is a risk factor for decrease of eGFR > 20%, p = 0.042 [1.00-1.05; 1.028]; and operative time ≥ 120 min is a risk factor for decrease of eGFR > 30%, p = 0.026 [0.016-0.773; 0.113]. CONCLUSIONS Renal function suffers a reversible decrease after bilateral fURS. Our study suggests that adequate selection of patients and maintaining operative time < 120 min are relevant factors in preventing acute renal function deterioration following bilateral fURS.
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Affiliation(s)
- Alexandre Danilovic
- Urology, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, 7 and. Sala 7175, São Paulo, SP, 05403-000, Brazil.
| | - Caio Vinicius Suartz
- Urology, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, 7 and. Sala 7175, São Paulo, SP, 05403-000, Brazil
| | - Fabio Cesar Miranda Torricelli
- Urology, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, 7 and. Sala 7175, São Paulo, SP, 05403-000, Brazil
| | - Giovanni Scala Marchini
- Urology, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, 7 and. Sala 7175, São Paulo, SP, 05403-000, Brazil
| | - Carlos Batagello
- Urology, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, 7 and. Sala 7175, São Paulo, SP, 05403-000, Brazil
| | - Fabio Carvalho Vicentini
- Urology, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, 7 and. Sala 7175, São Paulo, SP, 05403-000, Brazil
| | - William C Nahas
- Urology, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Eduardo Mazzucchi
- Urology, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, 7 and. Sala 7175, São Paulo, SP, 05403-000, Brazil
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Dowgiałło-Gornowicz N, Lech P, Katkowski B, Walędziak M, Proczko-Stepaniak M, Szymański M, Karpińska I, Major P. Risk factors for bariatric surgery in patients over 65 years of age-a multicenter retrospective cohort study. Langenbecks Arch Surg 2024; 409:115. [PMID: 38589572 PMCID: PMC11001652 DOI: 10.1007/s00423-024-03304-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 04/03/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE Societies are aging, life expectancy is increasing, and as a result, the percentage of elderly people in the population is constantly increasing. When qualifying patients over 65 years of age for bariatric surgery, the benefits and risks should be carefully assessed. Weighing risk factors against each other to improve the quality of life and better control of obesity-related diseases. The study aimed to determine risk factors for bariatric surgery among patients over 65 years of age. METHODS A multicenter, retrospective analysis of patients undergoing laparoscopic bariatric procedures from 2008 to 2022. The patients were divided into two groups: complicated (C) and uncomplicated (UC). Uni- and multivariate logistic regression analysis was performed to obtain significant, independent risk factors. RESULTS There were 20 (7.0%) patients in C group and 264 (93.0%) patients in UC group. The most common complication was intraperitoneal bleeding (8, 2.8). There was no postoperative mortality. The mean follow-up was 47.5 months. In a multivariate logistic regression analysis, length of stay and %EWL significantly corresponded to general complications (OR 1.173, OR 1.020). A higher weight loss before surgery lowered the risk for hemorrhagic events after surgery (OR 0.889). A longer length of stay corresponded to leak after surgery (OR 1.175). CONCLUSIONS Bariatric and metabolic surgery appears to be a safe method of obesity treatment in patients over 65 years of age. The most common complication was intraperitoneal bleeding. A prolonged hospital stay may increase the risk of leakage, while a higher weight loss before the surgery may lower the risk of bleeding.
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Affiliation(s)
- Natalia Dowgiałło-Gornowicz
- Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, 10-045, Olsztyn, Poland.
| | - Paweł Lech
- Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, 10-045, Olsztyn, Poland
| | - Bartosz Katkowski
- Department of General and Vascular Surgery, Specialist Medical Center, 57-320, Polanica Zdrój, Poland
| | - Maciej Walędziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, 04-141, Warsaw, Poland
| | - Monika Proczko-Stepaniak
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-214, Gdańsk, Poland
| | - Michał Szymański
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-214, Gdańsk, Poland
| | - Izabela Karpińska
- 2nd Department of General Surgery, Jagiellonian University Medical College, 30-688, Cracow, Poland
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Cracow, Poland
| | - Piotr Major
- 2nd Department of General Surgery, Jagiellonian University Medical College, 30-688, Cracow, Poland
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159
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Zhang Y, Fu T, Chen L, Ouyang Y, Han X, Chen D. Face presentation at term: incidence, risk factors and influence on maternal and neonatal outcomes. Arch Gynecol Obstet 2024:10.1007/s00404-024-07406-4. [PMID: 38594406 DOI: 10.1007/s00404-024-07406-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 01/28/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES The incidence, diagnosis, management and outcome of face presentation at term were analysed. METHODS A retrospective, gestational age-matched case-control study including 27 singletons with face presentation at term was conducted between April 2006 and February 2021. For each case, four women who had the same gestational age and delivered in the same month with vertex position and singletons were selected as the controls (control group, n = 108). Conditional logistic regression was used to assess the risk factors of face presentation. The maternal and neonatal outcomes of the face presentation group were followed up. RESULTS The incidence of face presentation at term was 0.14‰. After conditional logistic regression, the two factors associated with face presentation were high parity (adjusted odds ratio [aOR] 2.76, 95% CI 1.19-6.39)] and amniotic fluid index > 18 cm (aOR 2.60, 95% CI 1.08-6.27). Among the 27 cases, the diagnosis was made before the onset of labor, during the latent phase of labor, during the active phase of labor, and during the cesarean section in 3.7% (1/27), 40.7% (11/27), 11.1% (3/27) and 44.4% (12/27) of cases, respectively. In one case of cervical dilation with a diameter of 5 cm, we innovatively used a vaginal speculum for rapid diagnosis of face presentation. The rate of cesarean section and postpartum haemorrhage ≥ 500 ml in the face presentation group was higher than that of the control group (88.9% vs. 13.9%, P < 0.001, and 14.8% vs. 2.8%, P = 0.024), but the Apgar scores were similar in both sets of newborns. Among the 27 cases of face presentation, there were three cases of adverse maternal and neonatal outcomes, including one case of neonatal right brachial plexus injury and two cases of severe laceration of the lower segment of the uterus with postpartum haemorrhage ≥ 1000 ml. CONCLUSIONS Face presentation was rare. Early diagnosis is difficult, and thus easily neglected. High parity and amniotic fluid index > 18 cm are risk factors for face presentation. An early diagnosis and proper management of face presentation could lead to good maternal and neonatal outcomes.
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Affiliation(s)
- Yongqing Zhang
- Department of Obstetrics, School of Medicine, Women's Hospital, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang, People's Republic of China
| | - Tiantian Fu
- Department of Obstetrics, School of Medicine, Women's Hospital, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang, People's Republic of China
| | - Luping Chen
- Department of Obstetrics, School of Medicine, Women's Hospital, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang, People's Republic of China
| | - Yinluan Ouyang
- Department of Obstetrics, School of Medicine, Women's Hospital, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang, People's Republic of China
| | - Xiujun Han
- Department of Obstetrics, School of Medicine, Women's Hospital, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang, People's Republic of China.
| | - Danqing Chen
- Department of Obstetrics, School of Medicine, Women's Hospital, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang, People's Republic of China.
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Chen W, Wang Z, Wang G, Cao C, Hong B, Liu J, Xie F, Wang R. A meta-analysis of risk factors for a Dacron-cuffed catheter related infection in hemodialysis. BMC Nephrol 2024; 25:126. [PMID: 38589798 PMCID: PMC11003140 DOI: 10.1186/s12882-024-03568-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/30/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVE To provide theoretical basis for prevention of a Dacron-cuffed catheter related infection (CRI), the risk factors of CRI in hemodialysis patients were systematically evaluated. METHODS Eight databases, including PubMed, Cochrane library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (CBM), Wanfang Database and Chinese Scientific Journal Database (VIP), were searched to screen out literatures related to the risk factors of long-term indwelling a Dacron-cuffed CRI in hemodialysis. Meta-analysis of risk factors for a Dacron-cuffed CRI in hemodialysis and publication bias test were performed using RevMan 5.4 software. RESULTS After screening, 13 literatures involving a Dacron-cuffed CRI were included, with a total of 625 patients, and the infection rate was 11.7%. The combined OR value and 95% confidence interval (CI) of all factors were: Combined with Diabetes (1.94, 1.51 ~ 2.50), Hb (1.82, 1.35 ~ 2.44), age (2.38, 1.06 ~ 5.34), catheter indwelling time (1.79, 1.21 ~ 2.66), serum albumin (2.26, 1.25 ~ 4.08), catheter indwelling site (3.29, 1.74 ~ 6.23) and the number of tube placement (5.40, 2.65 ~ 11.02). CONCLUSIONS The main risk factors for a Dacron-cuffed CRI in hemodialysis were combined with diabetes, hemoglobin level, age, catheter indwelling time, serum albumin level, femoral vein catheter indwelling and catheterization times. In other words, hemodialysis patients are at higher risk of CRI if they have diabetes, or if they have a lower hemoglobin level, or if they are older, or if they have a longer duration of catheterization, or if they have a lower serum albumin level, or if they have a femoral vein catheter, or if they have more catheters.
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Affiliation(s)
- Wen Chen
- Department of Nephrology, The First Affiliated Hospital, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Zaoju Wang
- Department of Nephrology, The First Affiliated Hospital, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Guoping Wang
- Department of Nephrology, The First Affiliated Hospital, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Chunyu Cao
- Department of Nephrology, The First Affiliated Hospital, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Bo Hong
- Department of Nephrology, The First Affiliated Hospital, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Jinying Liu
- School of Basic Medicine, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Fuhua Xie
- School of Basic Medicine, Gannan Medical University, Ganzhou, 341000, Jiangxi, China.
| | - Runxiu Wang
- Department of Nephrology, The First Affiliated Hospital, Gannan Medical University, Ganzhou, 341000, Jiangxi, China.
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161
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Hwang SH, Shin H, Stybayeva G, Kim DH. Perinatal Risk Factors in Relation to Asthma and Allergic Rhinitis in Children and Adolescents. Clin Exp Otorhinolaryngol 2024:ceo.2024.00024. [PMID: 38584131 DOI: 10.21053/ceo.2024.00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/08/2024] [Indexed: 04/09/2024] Open
Abstract
Objectives To evaluate the associations between birth-related exposures and postnasal factors and risk for allergic rhinitis and asthma in children and adolescents. Methods We conducted a comprehensive search of five literature databases up until May 2023. To estimate the associations between birth-related exposures (birth weight, mode of delivery, prematurity, sex, maternal age, and parental history of allergy) and postnatal factors (birth order, number of siblings, exclusive, and duration of breastfeeding) and allergic disease, we calculated pooled odds ratios with 95% confidence intervals. In addition, we performed subgroup analyses according to allergic disease, birth order, number of siblings, and parental history of allergy. Methodological quality of the included studies was assessed using the Newcastle-Ottawa scale. Results This meta-analysis included 31 studies with 218,899 patients. Among the birth-related exposures, low birth weight, maternal age, and prematurity (<37 weeks) showed no significant associations with risk for asthma or allergic rhinitis in childhood or adolescence. On the other hand, male sex, family history of allergy, and cesarean section were related to higher risk for asthma or allergic rhinitis. Among postnatal factors, exclusive breastfeeding, long duration (>6 months) of breastfeeding, birth order second or later, and presence of sibling(s) showed preventive effects against allergic disease in offspring. Conclusion The risks for allergic rhinitis and asthma were higher in male patients delivered by cesarean section and with a family history of allergy. By contrast, exclusive and long duration (>6 months) breastfeeding and the presence of sibling(s) reduced the risk of developing respiratory allergic disease.
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Affiliation(s)
- Se Hwan Hwang
- Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyesoo Shin
- Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Gulnaz Stybayeva
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Markoulli M, Fricke TR, Arvind A, Frick KD, Hart KM, Joshi MR, Kandel H, Filipe Macedo A, Makrynioti D, Retallic N, Garcia-Porta N, Shrestha G, Wolffsohn JS. BCLA CLEAR Presbyopia: Epidemiology and impact. Cont Lens Anterior Eye 2024:102157. [PMID: 38594155 DOI: 10.1016/j.clae.2024.102157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
The global all-ages prevalence of epidemiologically-measured 'functional' presbyopia was estimated at 24.9% in 2015, affecting 1.8 billion people. This prevalence was projected to stabilise at 24.1% in 2030 due to increasing myopia, but to affect more people (2.1 billion) due to population dynamics. Factors affecting the prevalence of presbyopia include age, geographic location, urban versus rural location, sex, and, to a lesser extent, socioeconomic status, literacy and education, health literacy and inequality. Risk factors for early onset of presbyopia included environmental factors, nutrition, near demands, refractive error, accommodative dysfunction, medications, certain health conditions and sleep. Presbyopia was found to impact on quality-of-life, in particular quality of vision, labour force participation, work productivity and financial burden, mental health, social wellbeing and physical health. Current understanding makes it clear that presbyopia is a very common age-related condition that has significant impacts on both patient-reported outcome measures and economics. However, there are complexities in defining presbyopia for epidemiological and impact studies. Standardisation of definitions will assist future synthesis, pattern analysis and sense-making between studies.
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Affiliation(s)
- Maria Markoulli
- School of Optometry and Vision Science, UNSW Sydney, Australia.
| | - Timothy R Fricke
- School of Optometry and Vision Science, UNSW Sydney, Australia; Department of Optometry and Vision Science, University of Melbourne, Australia; National Vision Research Institute, Australian College of Optometry, Melbourne, Australia
| | - Anitha Arvind
- Department of Optometry, School of Medical and Allied Sciences, GD Goenka University, India
| | - Kevin D Frick
- Johns Hopkins Carey Business School, USA; Johns Hopkins Bloomberg School of Public Health Departments of International Health and Health Policy and Management, USA; Johns Hopkins School of Medicine, Department of Ophthalmology, USA
| | - Kerryn M Hart
- School of Medicine, Faculty of Health, Deakin University, Australia; Member Support and Optometry Advancement, Optometry Australia, Australia
| | - Mahesh R Joshi
- School of Health Professions, University of Plymouth, United Kingdom
| | - Himal Kandel
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Australia; Sydney Eye Hospital, Australia
| | - Antonio Filipe Macedo
- Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Sweden; Centre of Physics of Minho and Porto Universities, School of Sciences, University of Minho, Braga, Portugal
| | | | - Neil Retallic
- Specsavers Optical Group, La Villiaze, St. Andrew's, Guernsey, United Kingdom
| | - Nery Garcia-Porta
- Applied Physics Department, Optics and Optometry Faculty, University of Santiago de Compostela, Spain; Institute of Materials (iMATUS) of the University of Santiago de Compostela, Spain
| | - Gauri Shrestha
- Optometry Department, BPK Centre for Ophthalmic Studies, Institute of Medicine, Nepal
| | - James S Wolffsohn
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom
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163
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Yu YB. Risk factors for lymph node metastasis in superficial esophageal squamous cell carcinoma. World J Gastroenterol 2024; 30:1810-1814. [PMID: 38659479 PMCID: PMC11036495 DOI: 10.3748/wjg.v30.i13.1810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 02/01/2024] [Accepted: 03/13/2024] [Indexed: 04/03/2024] Open
Abstract
In this editorial, we comment on the article by Wang et al published in the recent issue of the World Journal of Gastroenterology in 2023. We focused on identifying risk factors for lymph node metastasis (LNM) in superficial esophageal squamous cell carcinoma (SESCC) patients and how to construct a simple and reliable clinical prediction model to assess the risk of LNM in SESCC patients, thereby helping to guide the selection of an appropriate treatment plan. The current standard treatment for SESCC is radical esophagectomy with lymph node dissection. However, esophagectomy is associated with considerable morbidity and mortality. Endoscopic resection (ER) offers a safer and less invasive alternative to surgical resection and can enable the patient's quality of life to be maintained while providing a satisfactory outcome. However, since ER is a localized treatment that does not allow for lymph node dissection, the risk of LNM in SESCC limits the effectiveness of ER. Understanding LNM status can aid in determining whether patients with SESCC can be cured by ER without the need for additional esophagectomy. Previous studies have shown that tumor size, macroscopic type of tumor, degree of differentiation, depth of tumor invasion, and lymphovascular invasion are factors associated with LNM in patients with SESCC. In addition, tumor budding is commonly associated with LNM, recurrence, and distant metastasis, but this topic has been less covered in previous studies. By comprehensively evaluating the above risk factors for LNM, useful evidence can be obtained for doctors to select appropriate treatments for SESCC patients.
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Affiliation(s)
- Yan-Bo Yu
- Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
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164
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Farzadfar F, Yousefi M, Jafari-Khounigh A, Khorrami Z, Haghdoost A, Shadmani FK. Trend and projection of non-communicable diseases risk factors in Iran from 2001 to 2030. Sci Rep 2024; 14:8092. [PMID: 38582931 PMCID: PMC10998837 DOI: 10.1038/s41598-024-58629-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 04/01/2024] [Indexed: 04/08/2024] Open
Abstract
This study aims to investigate the trends and project the major risk factors of Non-communicable Diseases (NCDs) in Iran. We obtained the trend of prevalence of main risk factors related to NCDs in 30 to 70-year-old-individuals. The data were extracted from WHO STEP wise approach to NCDs risk factor surveillance (STEPS) survey. Also,the previous studies conducted at national and subnational levels from 2001 to 2016 were employed. The prevalence of risk factors was projected by 2030 using Bayesian Model Averaging (BMA) and Spatio-temporal model stratified by sex and province. The percent change for the age-standardized prevalence of smoking in men between 2001 and 2016 was calculated to be - 27.0. Also, the corresponding values for the risk factors of diabetes, hypertension, obesity and overweight, physical inactivity (PI), and mean of salt intake were - 26.1, 29.0, 70.0, 96.8, 116.6, and 7.5, respectively. It is predicted that smoking and these risk factors will undergo a change to show values of - 1.26, 38.7, 43.7, 2.36, and 15.3 by 2030, respectively. The corresponding values in women for the time interval of 2001-2016 were - 27.3, 26.3, 82.8, 1.88, 75.2, and 4.2, respectively. Plus, projections indicate that the 2030 variation values are expected to be - 25.0, 16.7, 37.5, 28.7, 26.7, and 10.9 respectively. This study showed that the prevalence of four risk factors of PI, overweight and obesity, hypertension, and diabetes is increasing in Iran. Therefor, it is necessary to carry out effective interventions to adopt a healthy lifestyle and reduce the risk factors.
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Affiliation(s)
- Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Yousefi
- Department of Mathematics and Statistics, Memorial University of Newfoundland, St John's, NL, Canada
| | - Ali Jafari-Khounigh
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Khorrami
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - AliAkbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Khosravi Shadmani
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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165
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Maksimović Z, Babić S, Zahirović A, Rifatbegović M. Seroprevalence of leptospirosis among stray dogs in Bosnia and Herzegovina. Comp Immunol Microbiol Infect Dis 2024; 109:102171. [PMID: 38598876 DOI: 10.1016/j.cimid.2024.102171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/14/2024] [Accepted: 04/05/2024] [Indexed: 04/12/2024]
Abstract
Leptospirosis is a (re) emerging zoonosis that occurs worldwide. This study aimed to assess seroprevalence of leptospirosis and to identify the most common reactive serovars and risk factors for seropositivity in apparently healthy stray dogs of unknown vaccination status in the Sarajevo region of Bosnia and Herzegovina. Positive microscopic agglutination test titres (≥ 1:25) were detected in 3.87% (156/4028) of samples and most of the sera reacted against one serovar (85.9%). Dogs were most commonly reactive to Canicola (40.4%) and Hardjo (33.3%), followed by Pomona (15.4%) Tarassovi (14.7%), Icterohaemorrhagiae (8.3%), Grippotyphosa (5.8%), Bratislava (1.3%) and Saxkoebing (0.6%). Dogs older than one year had higher odds of seropositivity compared to younger dogs. The seropositivity was higher in spring and autumn than in summer. These results advocate for the need of a control strategy for this zoonosis in the country, which should include sero-surveillance, monitoring, and the inclusion of additional serovars in the testing.
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Affiliation(s)
- Zinka Maksimović
- Department of Pathobiology and Epidemiology, Veterinary Faculty, University of Sarajevo, Zmaja od Bosne 90, Sarajevo 71000, Bosnia and Herzegovina
| | - Senka Babić
- Department of Pathobiology and Epidemiology, Veterinary Faculty, University of Sarajevo, Zmaja od Bosne 90, Sarajevo 71000, Bosnia and Herzegovina.
| | - Amir Zahirović
- Department of Clinical Sciences, Veterinary Faculty, University of Sarajevo, Zmaja od Bosne 90, Sarajevo 71000, Bosnia and Herzegovina
| | - Maid Rifatbegović
- Department of Pathobiology and Epidemiology, Veterinary Faculty, University of Sarajevo, Zmaja od Bosne 90, Sarajevo 71000, Bosnia and Herzegovina
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Onat İ, Kocagöz R, Öz MD, Yeniay L, Tiftikçioğlu YÖ, Zekioğlu O, Serin G, Özdemir M, Gür E, Süzen HS, Orhan H. Blood and tissue levels of persistent organic pollutants and genetic susceptibility in patients with breast cancer. Environ Toxicol Pharmacol 2024; 108:104433. [PMID: 38583790 DOI: 10.1016/j.etap.2024.104433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/22/2024] [Accepted: 04/04/2024] [Indexed: 04/09/2024]
Abstract
We investigated possible associations between the internal concentrations of POPs and correlations between blood and tumor tissue concentrations in patients who underwent surgery for breast cancer and breast reduction as controls. Genetic variations in CYP1A1, GSTP1, GSTM1, and GSTT1 and hOGG1 were evaluated to determine whether they represent risk factors for breast cancer. Certain POPs have been found to be associated with breast cancer development. GST-P1 polymorphism represented a significant risk for breast cancer with unadjusted OR. However, the GSTT1 null polymorphism represented a significant risk for breast cancer when OR adjusted for age and smoking status. CYP1A1 polymorphism was a significant risk factor for breast cancer, regardless of whether the OR was adjusted. These results suggest that exposure to certain POPs, GSTT1 and CYP1A1 polymorphisms, age, and smoking status are risk factors for breast cancer. In addition, the blood concentrations of some POPs represent surrogates for breast tissue concentrations.
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Affiliation(s)
- İlgen Onat
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Ege University, Bornova-İzmir 35040, Turkey
| | - Rasih Kocagöz
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Ege University, Bornova-İzmir 35040, Turkey
| | - Merve Demirbügen Öz
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Ankara University, Tandoğan, Ankara 06350, Turkey
| | | | | | - Osman Zekioğlu
- Department of Medical Pathology, Faculty of Medicine, Ege University, Bornova-İzmir 35040, Turkey
| | - Gürdeniz Serin
- Department of Medical Pathology, Faculty of Medicine, Ege University, Bornova-İzmir 35040, Turkey
| | | | - Ersin Gür
- Department of Plastic and Reconstructive Surgery, Turkey
| | - Halit Sinan Süzen
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Ankara University, Tandoğan, Ankara 06350, Turkey
| | - Hilmi Orhan
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Ege University, Bornova-İzmir 35040, Turkey; İzmir Biomedicine and Genome Center (İBG-İzmir), Balcova-İzmir 35340, Turkey.
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Nasser A, de Zwart BJ, Stewart DJ, Zielke AM, Blazek K, Heywood AE, Craig AT. Risk factors predicting the need for intensive care unit admission within forty-eight hours of emergency department presentation: A case-control study. Aust Crit Care 2024:S1036-7314(24)00028-6. [PMID: 38584063 DOI: 10.1016/j.aucc.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Patients admitted from the emergency department to the wards, who progress to a critically unwell state, may require expeditious admission to the intensive care unit. It can be argued that earlier recognition of such patients, to facilitate prompt transfer to intensive care, could be linked to more favourable clinical outcomes. Nevertheless, this can be clinically challenging, and there are currently no established evidence-based methods for predicting the need for intensive care in the future. OBJECTIVES We aimed to analyse the emergency department data to describe the characteristics of patients who required an intensive care admission within 48 h of presentation. Secondly, we planned to test the feasibility of using this data to identify the associated risk factors for developing a predictive model. METHODS We designed a retrospective case-control study. Cases were patients admitted to intensive care within 48 h of their emergency department presentation. Controls were patients who did not need an intensive care admission. Groups were matched based on age, gender, admission calendar month, and diagnosis. To identify the associated variables, we used a conditional logistic regression model. RESULTS Compared to controls, cases were more likely to be obese, and smokers and had a higher prevalence of cardiovascular (39 [35.1%] vs 20 [18%], p = 0.004) and respiratory diagnoses (45 [40.5%] vs 25 [22.5%], p = 0.004). They received more medical emergency team reviews (53 [47.8%] vs 24 [21.6%], p < 0.001), and more patients had an acute resuscitation plan (31 [27.9%] vs 15 [13.5%], p = 0.008). The predictive model showed that having acute resuscitation plans, cardiovascular and respiratory diagnoses, and receiving medical emergency team reviews were strongly associated with having an intensive care admission within 48 h of presentation. CONCLUSIONS Our study used emergency department data to provide a detailed description of patients who had an intensive care unit admission within 48 h of their presentation. It demonstrated the feasibility of using such data to identify the associated risk factors to develop a predictive model.
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Affiliation(s)
- Ahmad Nasser
- Intensive Care Unit, Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia; Faculty of Medicine, University of Queensland, Herston, Queensland, Australia.
| | - Blake J de Zwart
- Intensive Care Unit, Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia
| | - David J Stewart
- Intensive Care Unit, Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia; School of Medicine, Griffith University, Meadowbrook, Queensland, Australia
| | - Anne M Zielke
- Intensive Care Unit, Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia
| | - Katrina Blazek
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia
| | - Anita E Heywood
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia
| | - Adam T Craig
- Faculty of Medicine, University of Queensland, Herston, Queensland, Australia; School of Population Health, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia
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Schubert L, Mbekwe-Yepnang AM, Wassermann J, Braik-Djellas Y, Jaffrelot L, Pani F, Deniziaut G, Lussey-Lepoutre C, Chereau N, Leenhardt L, Bernier MO, Buffet C. Clinico-pathological factors associated with radioiodine refractory differentiated thyroid carcinoma status. J Endocrinol Invest 2024:10.1007/s40618-024-02352-z. [PMID: 38578580 DOI: 10.1007/s40618-024-02352-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/27/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE Risk factors for developing radioiodine refractory thyroid cancer (RAIR-TC) have rarely been analyzed. The purpose of the present study was to find clinical and pathological features associated with the occurrence of RAIR-disease in differentiated thyroid cancers (DTC) and to establish an effective predictive risk score. METHODS All cases of RAIR-DTC treated in our center from 1990 to 2020 were retrospectively reviewed. Each case was matched randomly with at least four RAI-avid DTC control patients based on histological and clinical criteria. Conditional logistic regression was used to examine the association between RAIR-disease and variables with univariate and multivariate analyses. A risk score was then developed from the multivariate conditional logistic regression model to predict the risk of refractory disease occurrence. The optimal cut-off value for predicting the occurrence of RAIR-TC was assessed by receiver operating characteristic (ROC) curves and Youden's statistic. RESULTS We analyzed 159 RAIR-TC cases for a total of 759 controls and found 7 independent risk factors for predicting RAIR-TC occurrence: age at diagnosis ≥ 55, vascular invasion, synchronous cervical, pulmonary and bone metastases at initial work-up, cervical and pulmonary recurrence during follow-up. The predictive score of RAIR-disease showed a high discrimination power with a cut-off value of 8.9 out of 10 providing 86% sensitivity and 92% specificity with an area under the curve (AUC) of 0.95. CONCLUSION Predicting the occurrence of RAIR-disease in DTC patients may allow clinicians to focus on systemic redifferentiating strategies and/or local treatments for metastatic lesions rather than pursuing with ineffective RAI-therapies.
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Affiliation(s)
- L Schubert
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France
| | - A M Mbekwe-Yepnang
- Laboratory of Epidemiology, Institut de Radioprotection et de Sureté Nucléaire, BP 17, 92262, Fontenay aux Roses, France
| | - J Wassermann
- Medical Oncology Department and Thyroid and Endocrine Tumors Department, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Y Braik-Djellas
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France
| | - L Jaffrelot
- Medical Oncology Department and Thyroid and Endocrine Tumors Department, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - F Pani
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France
| | - G Deniziaut
- Pathology Department, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - C Lussey-Lepoutre
- Nuclear Medicine Department, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
- PARCC-Inserm U970, 56 rue leblanc, 75015, Paris, France
| | - N Chereau
- Department of Endocrine Surgery, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - L Leenhardt
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France
| | - M- O Bernier
- Laboratory of Epidemiology, Institut de Radioprotection et de Sureté Nucléaire, BP 17, 92262, Fontenay aux Roses, France
| | - C Buffet
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France.
- Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne Université, CNRS UMR 7371, INSERM U1146, Paris, France.
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Schwalbe N, Nunes MC, Cutland C, Wahl B, Reidpath D. Assessing New York City's COVID-19 Vaccine Rollout Strategy: A Case for Risk-Informed Distribution. J Urban Health 2024:10.1007/s11524-024-00853-z. [PMID: 38578336 DOI: 10.1007/s11524-024-00853-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 04/06/2024]
Abstract
This study reviews the impact of eligibility policies in the early rollout of the COVID-19 vaccine on coverage and probable outcomes, with a focus on New York City. We conducted a retrospective ecological study assessing age 65+, area-level income, vaccination coverage, and COVID-19 mortality rates, using linked Census Bureau data and New York City Health administrative data aggregated at the level of modified zip code tabulation areas (MODZCTA). The population for this study was all individuals in 177 MODZCTA in New York City. Population data were obtained from Census Bureau and New York City Health administrative data. The total mortality rate was examined through an ordinary least squares (OLS) regression model, using area-level wealth, the proportion of the population aged 65 and above, and the vaccination rate among this age group as predictors. Low-income areas with high proportions of older people demonstrated lower coverage rates (mean vaccination rate 52.8%; maximum coverage 67.9%) than wealthier areas (mean vaccination rate 74.6%; maximum coverage 99% in the wealthiest quintile) in the first 3 months of vaccine rollout and higher mortality over the year. Despite vaccine shortages, many younger people accessed vaccines ahead of schedule, particularly in high-income areas (mean coverage rate 60% among those 45-64 years in the wealthiest quintile). A vaccine program that prioritized those at greatest risk of COVID-19-associated morbidity and mortality would have prevented more deaths than the strategy that was implemented. When rolling out a new vaccine, policymakers must account for local contexts and conditions of high-risk population groups. If New York had focused limited vaccine supply on low-income areas with high proportions of residents 65 or older, overall mortality might have been lower.
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Affiliation(s)
- Nina Schwalbe
- School of Pathology, Faculty of Health Science, University of the Witwatersrand, January 1 Smuts Avenue, Braamfontein, Johannesburg, 2000, South Africa.
- Heilbrunn Department of Population and Family Health, Columbia University, 722 W 168Th St, New York, NY, 10032, USA.
| | - Marta C Nunes
- Medical Research Council, Vaccines & Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2000, South Africa
- Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon (HCL), and Centre International de Recherche en Infectiologie (CIRI), Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Université Claude Bernard Lyon 1, Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Clare Cutland
- Wits African Leadership in Vaccinology Expertise (Wits-Alive), School of Pathology, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Brian Wahl
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Daniel Reidpath
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU, UK
- School of Social Sciences, Monash University, Clayton, VIC, 3125, Australia
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170
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Krokstad MA, Sund E, Rangul V, Bauman A, Olsson C, Bjerkeset O. Secular trends in risk factors for adolescent anxiety and depression symptoms: the Young-HUNT studies 1995-2019, Norway. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02373-2. [PMID: 38578474 DOI: 10.1007/s00787-024-02373-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 01/08/2024] [Indexed: 04/06/2024]
Abstract
In recent decades, increases in mental health problems in adolescents have been reported from several large population-based surveys. This raises questions about changes in underlying risk and protective factors that can inform future intervention strategies. Population data were collected from 1995 to 2019 in three waves of the Young-HUNT studies in Norway to map decennial trends in the prevalence of established risk factors for, and their associations with, adolescent mental health problems. All adolescents (aged 13-19 years) attending lower and upper secondary school in the county of Trøndelag were invited, representing three historical cohorts of 25,245 unique adolescents. Mental health problems (HSCL-5) and established mental health risk factors were self-reported. Using a generalized linear model and linear regression, we calculated changes in relative and absolute differences between risk factors and mental health problems. Overall, the prevalence of established risk factors for mental health problems in adolescence increased markedly between 1995 and 2019, especially in girls. Prominent increases were observed for fatigue, bullying, musculoskeletal pain and migraine, loneliness, and overweight. Furthermore, with the exception of excess alcohol use and family economy, associations between each risk factor and adolescent mental health problems strengthened over the same time span in girls, but less among boys. Our findings suggest that several modifiable risk factors for poor mental health in adolescence are increasing, especially among girls, and should be targeted in community, school, and in clinical settings.
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Affiliation(s)
- Morten Austheim Krokstad
- Faculty of Health Sciences and Nursing, Nord Universitet-Levanger Campus, Levanger, Norway.
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Erik Sund
- Faculty of Health Sciences and Nursing, Nord Universitet-Levanger Campus, Levanger, Norway
- Department of Public Health and Nursing, HUNT Research Centre, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Vegar Rangul
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Public Health and Nursing, HUNT Research Centre, Norwegian University of Science and Technology, Levanger, Norway
| | - Adrian Bauman
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Craig Olsson
- Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Melbourne Victoria, Parkville, Australia
- School of Psychology, Faculty of Health, Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Ottar Bjerkeset
- Faculty of Health Sciences and Nursing, Nord Universitet-Levanger Campus, Levanger, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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171
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Lin CH, Chen YA, Jeng JS, Sun Y, Wei CY, Yeh PY, Chang WL, Fann YC, Hsu KC, Lee JT. Predicting ischemic stroke patients' prognosis changes using machine learning in a nationwide stroke registry. Med Biol Eng Comput 2024:10.1007/s11517-024-03073-4. [PMID: 38575823 DOI: 10.1007/s11517-024-03073-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 03/13/2024] [Indexed: 04/06/2024]
Abstract
Accurately predicting the prognosis of ischemic stroke patients after discharge is crucial for physicians to plan for long-term health care. Although previous studies have demonstrated that machine learning (ML) shows reasonably accurate stroke outcome predictions with limited datasets, to identify specific clinical features associated with prognosis changes after stroke that could aid physicians and patients in devising improved recovery care plans have been challenging. This study aimed to overcome these gaps by utilizing a large national stroke registry database to assess various prediction models that estimate how patients' prognosis changes over time with associated clinical factors. To properly evaluate the best predictive approaches currently available and avoid prejudice, this study employed three different prognosis prediction models including a statistical logistic regression model, commonly used clinical-based scores, and a latest high-performance ML-based XGBoost model. The study revealed that the XGBoost model outperformed other two traditional models, achieving an AUROC of 0.929 in predicting the prognosis changes of stroke patients followed for 3 months. In addition, the XGBoost model maintained remarkably high precision even when using only selected 20 most relevant clinical features compared to full clinical datasets used in the study. These selected features closely correlated with significant changes in clinical outcomes for stroke patients and showed to be effective for predicting prognosis changes after discharge, allowing physicians to make optimal decisions regarding their patients' recovery.
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Affiliation(s)
- Ching-Heng Lin
- Division of Intramural Research, Disorders and Stroke, National Institute of Neurological, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
- Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Bachelor Program in Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
| | - Yi-An Chen
- Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Jiann-Shing Jeng
- Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu Sun
- Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Cheng-Yu Wei
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
| | - Po-Yen Yeh
- Department of Neurology, St. Martin de Porres Hospital, Chiayi, Taiwan
| | - Wei-Lun Chang
- Department of Neurology, Show Chwan Memorial Hospital, Changhua County, Taiwan
| | - Yang C Fann
- Division of Intramural Research, Disorders and Stroke, National Institute of Neurological, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA.
| | - Kai-Cheng Hsu
- Department of Medicine, China Medical University, Taichung, Taiwan.
- Artificial Intelligence Center for Medical Diagnosis, China Medical University Hospital, No. 2, Yude Rd., North Dist., Taichung, 404332, Taiwan.
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan.
| | - Jiunn-Tay Lee
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
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172
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Carlos JC, Quinones VMT, Adversario MPL, Nailes JM, Songco JC, Garcia DR, Cacayorin MG, Cero MPV, Benedicto-Delfin MPA, Blanco MCC, Natividad NS, Bernabe JD, Chacon HCT, Ascue RAC, Paggao JNK, Comendador LOP, Hernandez-Suarez G, Guzman-Holst A. Seroprevalence and Shifting Endemicities of Hepatitis A Virus Infection in Two Different Geographical Areas in the Philippines. Infect Dis Ther 2024:10.1007/s40121-024-00955-w. [PMID: 38578515 DOI: 10.1007/s40121-024-00955-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/29/2024] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION Infection with hepatitis A virus (HAV) is often asymptomatic in young children, but most adolescents and adults will have symptoms ranging from nausea and tiredness to acute liver failure and even death. The risk of severe disease is higher in older adults and people with pre-existing liver disease. Immunization is recommended in regions with low HAV endemicity levels, i.e., where people get infected later in life. In the Philippines, recent epidemiologic data on HAV infection are lacking. The objective of this study was to assess age-specific seroprevalence and evaluate risk factors associated with HAV seropositivity. METHODS People from two geographic areas (urban and rural) were recruited/enrolled and stratified by age group. HAV-specific immunoglobulin G (IgG) antibodies were measured with a chemiluminescent microparticle immunoassay. Sociodemographic parameters, hepatitis medical history, disease knowledge, hygiene measures and sanitation were assessed via a purpose-made questionnaire. Age at midpoint of population immunity (AMPI) was estimated using Kaplan-Meier curves. Logistic regression analyses were carried out to determine factors that were statistically significantly associated (p < 0.05) with HAV seropositivity. RESULTS Overall, 1242 participants were included in the analysis; 250/602 (41.5%) participants from urban regions and 283/640 (44.2%) participants from rural regions tested positive for HAV IgG antibodies. AMPI was 35 and 37 years for the rural and urban region, respectively. Higher education was associated with lower HAV seropositivity prevalence ratios, while not living in the same region for the last 5 years, regularly consuming street food and lack of handwashing after defecation were associated with a higher likelihood of HAV seropositivity. CONCLUSION Results suggest that HAV endemicity is low in the Philippines. Factors associated with HAV seropositivity were traveling, consuming street food and lack of basic hygienic gestures. Immunization might be an option to protect vulnerable populations against severe hepatitis A disease.
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Affiliation(s)
- Josefina C Carlos
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Vinna Marie T Quinones
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | | | - Jennifer M Nailes
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Jangail C Songco
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Donaliz R Garcia
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Michelle G Cacayorin
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - May Priscilla V Cero
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | | | - Ma Christina C Blanco
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Nadjah S Natividad
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Jacqueline D Bernabe
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | | | - Ronald Alvin C Ascue
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Jayme Natasha K Paggao
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
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do Nascimento Lima H, Monárrez-Espino J, Nerbass FB, Moura-Neto JA, Sesso R, Lugon JR. Comparison of 1-year survival between patients initiating chronic hemodialysis under public and private health insurance: register-based data analysis from Brazil. Int Urol Nephrol 2024:10.1007/s11255-024-04018-4. [PMID: 38578392 DOI: 10.1007/s11255-024-04018-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/29/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE Brazil has one of the world's highest numbers of patients on hemodialysis (HD). Most dialysis centers are private and perform HD for patients with private and public health insurance. We compared 1-year survival between patients initiating chronic HD with public and private health insurance. METHODS This is an HD register-based retrospective cohort. Adult patients starting HD from January 2011 to December 2021 were included. Survival analysis was stratified according to the period entered in the HD register. Multivariate Cox regression focused on 1-year survival differences between private and public patients. RESULTS In the final sample (n = 5114), 68.5% of participants had public and 31.3% to private health insurance, with overall 1-year survival of 92.8% and 89.9%, respectively (p = 0.002). Crude analysis showed a slightly higher survival rate among patients with public health insurance than those with private health insurance (91 vs. 87%, p = 0.030) in the first period (2019-21). However, the adjusted hazard ratio (HR) did not remain significantly higher for patients with private health insurance compared to those with public health insurance (HR = 1.07; 95% CI 0.80-1.41; p = 0.651), even after propensity score matching of the groups by several baseline features. CONCLUSION Brazilian chronic HD patients funded by either private health plans or the public system have a similar 1-year mortality risk after controlling for several sociodemographic and clinical parameters.
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Affiliation(s)
- Helbert do Nascimento Lima
- Medicine Department, University of the Region of Joinville (Univille), Rua Rio do Sul 270, Joinville, Santa Catarina, 89202-201, Brazil.
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
- Brazilian Society of Nephrology, SBN, Sao Paulo, Brazil.
| | - Joel Monárrez-Espino
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - José A Moura-Neto
- Internal Medicine Division, Bahiana School of Medicine and Public Health, Salvador, Brazil
- Brazilian Society of Nephrology, SBN, Sao Paulo, Brazil
| | - Ricardo Sesso
- Nephrology Division, Federal University of São Paulo, Sao Paulo, Brazil
- Brazilian Society of Nephrology, SBN, Sao Paulo, Brazil
| | - Jocemir Ronaldo Lugon
- Nephrology Division, Universidade Federal Fluminense (UFF), Niterói, Brazil
- Brazilian Society of Nephrology, SBN, Sao Paulo, Brazil
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174
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Tang M, Dang P, Liu T, Yang K, Wang Y, Tse G, Liu H, Liu Y, Chan JSK, Liu C, Li G. Risk factors and outcomes of pericardial effusion in cancer patients receiving PD-1 inhibitors. Int J Cardiol 2024:132029. [PMID: 38583590 DOI: 10.1016/j.ijcard.2024.132029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 03/21/2024] [Accepted: 04/04/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Programmed cell death 1 (PD-1) inhibitors can induce various adverse reactions associated with immunity, of which cardiotoxicity is a serious complication. Limited research exists on the link between PD-1 inhibitor use and pericardial effusion (PE) occurrence and outcomes. METHODS We conducted a retrospective study at the First Affiliated Hospital of Xi'an Jiaotong University from 2017 to 2019, comparing cancer patients who developed PE within 2 years after PD-1 inhibitor therapy to those who did not. Our primary outcome was the all-cause mortality rate at one year. We applied the Kaplan-Meier method for survival analysis. Multivariate logistic regression was utilized to identify PE risk factors, adjusting for potential confounders. RESULTS A total of 91 patients were finally included, of whom 39 patients had PE. Compared to non-PE group, one-year all-cause mortality was nearly 5 times higher in PE group (64.10% vs. 13.46%, P < 0.001). Patients who developed PE within 2 years of taking PD-1 inhibitors were significantly associated with increased all-cause mortality compared with those who did not (HR: 6.26, 95%CI: 2.70-14.53, P < 0.001). Multivariable logistic regression showed that use of sintilimab (OR: 14.568, 95%CI: 3.431-61.857, P < 0.001), history of lung cancer (OR: 15.360, 95%CI: 3.276-72.017, P = 0.001), and history of hypocalcemia (OR: 7.076, 95%CI: 1.879-26.649, P = 0.004) were independent risk factors of PE development in patients received PD-1 inhibitors therapy. CONCLUSIONS In cancer patients receiving PD-1 inhibitors, PE was associated with higher one-year mortality. Use of sintilimab, and history of lung cancer or hypocalcemia were linked to PE occurrence.
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Affiliation(s)
- Manyun Tang
- Key Laboratory of Surgical Critical Care and Life Support (Xi'an Jiaotong University), Ministry of Education, China; Department of Hepatobiliary Surgery and Liver Transplantation, The Second Affiliated Hospital of Xi'an Jiaotong University, China
| | - Peizhu Dang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Tong Liu
- Key Laboratory of Surgical Critical Care and Life Support (Xi'an Jiaotong University), Ministry of Education, China; Department of Hepatobiliary Surgery and Liver Transplantation, The Second Affiliated Hospital of Xi'an Jiaotong University, China
| | - Kun Yang
- Key Laboratory of Surgical Critical Care and Life Support (Xi'an Jiaotong University), Ministry of Education, China; Department of Hepatobiliary Surgery and Liver Transplantation, The Second Affiliated Hospital of Xi'an Jiaotong University, China
| | - Yifei Wang
- Key Laboratory of Surgical Critical Care and Life Support (Xi'an Jiaotong University), Ministry of Education, China; Department of Hepatobiliary Surgery and Liver Transplantation, The Second Affiliated Hospital of Xi'an Jiaotong University, China
| | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China; Epidemiology Research Unit, Cardiovascular Analytics Group, PowerHealth Limited, Hong Kong, China; School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Hui Liu
- Biobank of The First Affiliated Hospital of Xian Jiaotong University, Xi'an, China
| | - Yufeng Liu
- Biobank of The First Affiliated Hospital of Xian Jiaotong University, Xi'an, China
| | - Jeffrey Shi Kai Chan
- Cardio-Oncology Research Unit, Cardiovascular Analytics Group, PowerHealth Research Institute, Hong Kong, China
| | - Chang Liu
- Key Laboratory of Surgical Critical Care and Life Support (Xi'an Jiaotong University), Ministry of Education, China; Department of Hepatobiliary Surgery and Liver Transplantation, The Second Affiliated Hospital of Xi'an Jiaotong University, China.
| | - Guoliang Li
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Glele Ahanhanzo Y, Olatoundé Agnidé Ally F, Dansou P, Sossa Jérôme C, Kpozehouen A, Sopoh GE. Internet addiction, new contemporary reality in Benin: exploratory analysis of associated factors among medical and paramedical students in 2022. Sante Publique 2024; 36:109-120. [PMID: 38580460 DOI: 10.3917/spub.241.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
INTRODUCTION Nowadays, Internet addiction is a major concern due to the growing number of Internet users and the consequences associated with this addiction. PURPOSE OF THE RESEARCH In this study, we aimed to determine the prevalence of and factors associated with Internet addiction among health sciences students at the University of Abomey-Calavi. METHODS A cross-sectional study was conducted among 346 students from the Faculty of Health Sciences and the National Institute of Medical and Health Sciences at the University of Abomey-Calavi. Participants were selected using simple random sampling. Internet addiction was assessed using K. Young’s “Internet Addiction Test.” Logistic regression modeling was employed to explore factors associated with Internet addiction. The strength of the association was assessed using odds ratios; the confidence interval (CI) was 95%; and a p-value < 0.05 in the final model was considered significant. RESULTS The prevalence of Internet addiction was 31.8% (95% CI: [23.26% - 41.38%]). Factors associated with Internet addiction were the participant’s field of study, poor relationships with friends and family, communication difficulties, depression, and psychoactive substance consumption. CONCLUSIONS Evidence of Internet addiction exists among students in health sciences institutions in Benin. These findings can support the development of prevention and intervention strategies centered on addressing a public health issue that is still insufficiently recognized.
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Affiliation(s)
- Yolaine Glele Ahanhanzo
- Institut régional de santé publique, Département d’épidémiologie et de biostatistiques, Ouidah, Bénin
| | | | - Pleck Dansou
- Institut régional de santé publique, Département d’épidémiologie et de biostatistiques, Ouidah, Bénin
| | - Charles Sossa Jérôme
- Institut régional de santé publique, Département de promotion de la santé, Ouidah, Bénin
| | - Alphonse Kpozehouen
- Institut régional de santé publique, Département d’épidémiologie et de biostatistiques, Ouidah, Bénin
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Berends HI, Stadhouder A, van Royen BJ, Journée HL, Gouw AA. Risk factors for neurophysiological events related to intraoperative halo-femoral traction in spinal deformity surgery. Eur Spine J 2024:10.1007/s00586-024-08221-w. [PMID: 38578448 DOI: 10.1007/s00586-024-08221-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 02/01/2024] [Accepted: 03/07/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE This study identifies risk factors for neurophysiological events caused by intraoperative halo-femoral traction (IOHFT) in patients with adolescent idiopathic scoliosis (AIS), and neuromuscular scoliosis (NMS). METHODS Neurophysiological integrity was monitored using motor evoked potentials (MEPs). IONM event was defined as a decreased MEP amplitude of more than 80% of baseline in, at least, one muscle. Time between application of IOHFT and event, affected muscles, surgical stage, and time between removal of IOHFT and recovery of MEPs were described. Characteristics (age, height, weight, diagnosis, Cobb angle, and flexibility of the curve) of patients with and without IOHFT-events were compared using analysis of variance. Binary logistic regression analyses were performed to identify predictors. RESULTS The study included 81 patients (age 15.6 ± 2.4 years, 53 females, AIS: n = 47, NMS n = 34). IOHFT-events occurred in 11 patients (13%; AIS n = 4, NMS n = 7). IOHFTevents affecting all limbs occurred pre-incision in NMS. Events affecting only the legs occurred during all stages of surgery. Patients with IOHFT-events were smaller (p = 0.009) and had stiffer curves (p = 0.046). Height was a predictor (odds ratio, 0.941; 95% confidence interval = 0.896-0.988). All MEPs recovered after removing IOHFT. CONCLUSION Neurophysiologic events due to IOHFT were common, with the majority in patients with NMS. A shorter stature was a risk factor, and larger Cobb angle and stiffer curve were associated with IOHFT-events. Events occurred at any stage of surgery and involved upper and lower limbs. With an adequate response on IOHFT events, none of the patients had postoperative neurological impairments due to IOHFT.
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Affiliation(s)
- Hanneke I Berends
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Department of Clinical Neurophysiology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Movement Sciences, [Musculoskeletal Health], Amsterdam, The Netherlands.
| | - Agnita Stadhouder
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, [Musculoskeletal Health], Amsterdam, The Netherlands
| | - Barend J van Royen
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, [Musculoskeletal Health], Amsterdam, The Netherlands
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Henricus L Journée
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Department of Neurosurgery University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Alida A Gouw
- Department of Neurology, Clinical Neurophysiology and MEG Center, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
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177
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Jin X, Wu X, Xu W, She C, Li L, Mao Y. Gender differences in the impact of anatomical factors on non-contact anterior cruciate ligament injuries: a magnetic resonance study. BMC Musculoskelet Disord 2024; 25:264. [PMID: 38575985 PMCID: PMC10996128 DOI: 10.1186/s12891-024-07390-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024] Open
Abstract
PURPOSE To identify MRI-detected anatomical risk factors for non-contact anterior cruciate ligament (ACL) injuries across genders. METHODS A retrospective analysis was performed on 141 ACL-reconstructed patients (35 females, 106 males) and 142 controls (37 females, 105 males) from January 2020 to April 2022. Inclusion criteria were primary non-contact ACL injuries. The tibial plateau slope, lateral femoral condyle index, Insall-Salvati index, and patellar tendon angle were measured, using binary logistic regression for gender-specific risk evaluation. RESULTS Increased lateral tibial plateau slope, reduced intercondylar notch width index, lateral femoral condyle index, and patellar tendon angle correlated with ACL injuries in both genders. The Insall-Salvati index was a significant risk factor in females but not in males. CONCLUSION This study identifies the lateral tibial plateau slope, notch width index, lateral femoral condyle index, and patellar tendon angle at near-extension as risk factors for ACL injuries in both genders, with the Insall-Salvati index also implicated in females.
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Affiliation(s)
- Xixin Jin
- Department of Orthopedics, The Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, 215004, P.R. China
| | - Xujin Wu
- Department of Orthopedics, The Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, 215004, P.R. China
| | - Wei Xu
- Department of Orthopedics, The Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, 215004, P.R. China
| | - Chang She
- Department of Orthopedics, The Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, 215004, P.R. China
| | - Liubing Li
- Department of Orthopedics, The Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, 215004, P.R. China
| | - Yongtao Mao
- Department of Orthopedics, The Second Affiliated Hospital, Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, 215004, P.R. China.
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178
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Wu C, Ling Z, Wang Y, Lv Y, Miao Z, Liu L, Ji X. Clinical Analysis of Risk Factors and Perinatal Outcomes in Recurrent Pre-Eclampsia with Severe Features. Reprod Sci 2024:10.1007/s43032-024-01529-4. [PMID: 38575810 DOI: 10.1007/s43032-024-01529-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/22/2024] [Indexed: 04/06/2024]
Abstract
To analyze the differences in risk factors and pregnancy outcomes between recurrent and initial pre-eclampsia(PE) with severe features. Data from recurrent (n = 128) and initial (n = 904) PE with severe features who terminated their pregnancy or gave birth at 20 weeks of gestation or later at the tertiary teaching hospital (Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital) from January 2016 to December 2022 were collected. Risk factors for recurrent PE with severe features and differences in pregnancy outcomes between the two groups were assessed using the chi-square test, student t-test, or nonparametric test. Independent risk factors for recurrent PE with severe features were further analyzed by logistic regression. (1) Logistic regression analysis identified 3 independent risk factors for recurrent PE with severe features: history of cesarean section, rural residence and chronic hypertension. In addition, assisted reproductive technology (ART) is an independent risk factor for initial PE with severe features; (2) The incidence of oligohydramnios, chorioamnionitis, preterm birth, stillbirth, fetal growth restriction (FGR) and abnormal umbilical blood flow was higher in the recurrent PE with severe features group than in the initial PE with severe features group(P < 0.05). In contrast, the incidence of premature rupture of membrane (PROM) and postpartum hemorrhage (PPH) was higher in the group of initial PE with severe features(P < 0.05); (3) In the recurrent PE with severe features group, gestational age(GA) of birth and birth weight were lower than those in the initial PE with severe features group(P < 0.05). Also, the incidence of mild asphyxia, the rate of neonatal intensive care unit (NICU) hospitalization, length of stay in NICU, and the rate of abandoning treatment in the recurrent PE with severe features group were higher than those in the initial PE with severe features group(P < 0.05). 3 independent risk factors was identified for recurrent PE with severe features: history of cesarean section, rural residence and chronic hypertension. Women with recurrent PE with severe features are more likely to have adverse perinatal outcomes than those with initial PE with severe features.
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Affiliation(s)
- Chengqian Wu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210000, China
| | - Zhonghui Ling
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210000, China
| | - Yixiao Wang
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210000, China
| | - Yan Lv
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210000, China
| | - Zhijing Miao
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210000, China
| | - Lan Liu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210000, China.
| | - Xiaohong Ji
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210000, China.
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179
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Zhang T, Lv H, Zhao X, Zeng N, Hui Y, Chen S, Wu N, Xu M, Wu Y, Xing A, Shi H, Zhang S, Liang X, Wang Y, Wu S, Cui L, Wang Z, Liu Y. Serum uric acid is associated with midbrain enlarged perivascular spaces: Results from Multi-modality Medical imaging sTudy bAsed on KaiLuan Study (META-KLS). Prog Neuropsychopharmacol Biol Psychiatry 2024; 133:111000. [PMID: 38580007 DOI: 10.1016/j.pnpbp.2024.111000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/15/2024] [Accepted: 03/30/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Serum uric acid (SUA) is a major cause of cardiovascular and cerebrovascular diseases. Whether and to what extent the excess risk of enlarged perivascular spaces (EPVS) conferred by SUA is unknown. The study was conducted to investigate the association between SUA and EPVS in different brain regions. METHODS Data are from Multi-modality medical imaging study based on Kailuan study (META-KLS) in this cross-sectional study. Participants were divided into five groups based on SUA levels, and EPVS in basal ganglia (BG), centrum semiovale (CSO) and midbrain (MB) was systematically assessed and divided into Low and High group. Odds ratio (OR) and 95% confidence intervals (95% CIs) for high EPVS outcomes were estimated using multivariable logistic regression analysis. Restricted cubic spline (RCS) was used to further investigate dose-response relationship. RESULTS A total of 1014 participants aged 25-83 years from 11 centers were enrolled in the study. In the multivariable-adjusted model, SUA, as an independent risk factor, correlated positively with high degree of MB-EPVS (OR, 1.002; 95% CI, 1.000 to 1.004; p = 0.023) in general population. In addition, RCS further demonstrated the linear association between SUA and MB-EPVS (p = 0.072). No association was found between SUA and BG-EPVS or CSO-EPVS. CONCLUSION SUA was an independent risk factor of MB-EPVS. High SUA levels were more predictive of increased risk occurrence of high degree of MB-EPVS, supporting a linear association between SUA and MB-EPVS and further indicating that SUA may play an important role in cerebral small vessel disease. TRIAL REGISTRATION The KaiLuan Study and META-KLS were registered online (ChiCTR2000029767 on chictr.org.cn and NCT05453877 on Clinicaltrials.gov, respectively).
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Affiliation(s)
- Tong Zhang
- Department of Rheumatology and Immunology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xinyu Zhao
- Clinical Epidemiology & EBM Unit, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing, China
| | - Na Zeng
- School of Public Health, Peking University, Beijing, China
| | - Ying Hui
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shuohua Chen
- Department of Cardiovascular Lab, Kailuan General Hospital, Tangshan, Hebei, China
| | - Ning Wu
- Department of Medical Imaging, Yanjing Medical College, Capital Medical University, Beijing, China
| | - Mingze Xu
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China; Beijing Intelligent Brain Cloud Inc, Beijing, China
| | - YunTao Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Aijun Xing
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Huijing Shi
- Department of Rheumatology and Immunology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Shun Zhang
- Department of Psychiatry, Kailuan Mental Health Center, Tangshan, Hebei, China
| | - Xiaoliang Liang
- Department of Psychiatry, Kailuan Mental Health Center, Tangshan, Hebei, China
| | - Yongxin Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China; Department of MR, Kailuan General Hospital, Tangshan, Hebei, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Liufu Cui
- Department of Rheumatology and Immunology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Yanying Liu
- Department of Rheumatology and Immunology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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180
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Ben-Amram H, Azrad M, Cohen-Assodi J, Sharabi-Nov A, Edelstein S, Agay-Shay K, Peretz A. Biofilm Formation by Hospital-Acquired Resistant Bacteria Isolated from Respiratory Samples. J Epidemiol Glob Health 2024:10.1007/s44197-024-00215-7. [PMID: 38564110 DOI: 10.1007/s44197-024-00215-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Hospital-acquired resistant infections (HARI) are infections, which develop 48 h or more after admission to a healthcare facility. HARI pose a considerably acute challenge, due to limited treatment options. These infections are associated bacterial biofilms, which act as a physical barrier to diverse external stresses, such as desiccation, antimicrobials and biocides. We assessed the influence of multiple factors on biofilm production by HARI -associated bacteria. METHODS Bacteria were isolated from samples of patients with respiratory HARI who were hospitalized during 2020-2022 in north Israel. Following antibiotic susceptibility testing by disc diffusion or broth microdilution, biofilm formation capacities of resistant bacteria (methicillin-resistant staphylococcus aureus, extended spectrum beta-lactamase-producing Escherichia coli and Klebsiela pneumonia, and multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii) was assessed using the crystalline violet staining method. Data regarding season, time to infection, bacterial species, patient age and gender, year, and medical department were collected from the patient medical records. RESULTS Among the 226 study isolates, K. pneumonia was the most prevalent (35.4%) bacteria, followed by P. aeruginosa (23.5%), and methicillin-resistant staphylococcus aureus (MRSA) (21.7%). A significantly higher rate of HARI was documented in 2022 compared to 2020-2021. The majority of isolates (63.3%) were strong biofilm producers, with K. pneumonia (50.3%) being most dominant, followed by P. aeruginosa (29.4%). Biofilm production strength was significantly affected by seasonality and hospitalization length, with strong biofilm production in autumn and in cases where hospitalization length exceeded 30 days. CONCLUSION Biofilm production by HARI bacteria is influenced by bacterial species, season and hospitalization length.
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Affiliation(s)
- Hila Ben-Amram
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- The Clinical Microbiology Laboratory, Ziv Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Maya Azrad
- The Clinical Microbiology Laboratory, Tzafon Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Jackie Cohen-Assodi
- The Clinical Microbiology Laboratory, Ziv Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | | | - Shimon Edelstein
- The Infectious Diseases, Ziv Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, 1311502, Safed, Israel
| | - Keren Agay-Shay
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Avi Peretz
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
- The Clinical Microbiology Laboratory, Tzafon Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
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181
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Matniyaz Y, Luo YX, Jiang Y, Zhang KY, Wang WZ, Pan T, Wang DJ, Xue YX. Short- and Long-term survival prediction in patients with acute type A aortic dissection undergoing open surgery. J Cardiothorac Surg 2024; 19:171. [PMID: 38566106 PMCID: PMC10988835 DOI: 10.1186/s13019-024-02687-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 03/24/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Acute Type A aortic dissection (ATAAD) is a life-threatening cardiovascular disease associated with high mortality rates, where surgical intervention remains the primary life-saving treatment. However, the mortality rate for ATAAD operations continues to be alarmingly high. To address this critical issue, our study aimed to assess the correlation between preoperative laboratory examination, clinical imaging data, and postoperative mortality in ATAAD patients. Additionally, we sought to establish a reliable prediction model for evaluating the risk of postoperative death. METHODS In this study, a total of 384 patients with acute type A aortic dissection (ATAAD) who were admitted to the emergency department for surgical treatment were included. Based on preoperative laboratory examination and clinical imaging data of ATAAD patients, logistic analysis was used to obtain independent risk factors for postoperative in-hospital death. The survival prediction model was based on cox regression analysis and displayed as a nomogram. RESULTS Logistic analysis identified several independent risk factors for postoperative in-hospital death, including Marfan syndrome, previous cardiac surgery history, previous renal dialysis history, direct bilirubin, serum phosphorus, D-dimer, white blood cell, multiple aortic ruptures and age. A survival prediction model based on cox regression analysis was established and presented as a nomogram. The model exhibited good discrimination and significantly improved the prediction of death risk in ATAAD patients. CONCLUSIONS In this study, we developed a novel survival prediction model for acute type A aortic dissection based on preoperative clinical features. The model demonstrated good discriminatory power and improved accuracy in predicting the risk of death in ATAAD patients undergoing open surgery.
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Affiliation(s)
- Yusanjan Matniyaz
- Department of Cardiac Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Number 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
- Department of Cardiac Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Number 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
| | - Yuan-Xi Luo
- Department of Cardiac Surgery, Affiliated Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Number 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
| | - Yi Jiang
- Department of Cardiac Surgery, Affiliated Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Number 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
| | - Ke-Yin Zhang
- Department of Cardiac Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Number 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
| | - Wen-Zhe Wang
- Department of Cardiac Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Number 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
| | - Tuo Pan
- Department of Cardiac Surgery, Affiliated Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Number 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China.
| | - Dong-Jin Wang
- Department of Cardiac Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Number 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China.
- Department of Cardiac Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Number 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China.
- Department of Cardiac Surgery, Affiliated Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Number 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China.
- Department of Cardiac Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Number 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China.
| | - Yun-Xing Xue
- Department of Cardiac Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Number 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China.
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Wang S, Wang C, Gao Y, Tian Y, Liu J, Wang Y. Risk factors of 30-day and long-term mortality and outcomes in open repair of thoracoabdominal aortic aneurysm. J Cardiothorac Surg 2024; 19:170. [PMID: 38566230 PMCID: PMC10986091 DOI: 10.1186/s13019-024-02666-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Open repair of thoracoabdominal aortic aneurysm (TAAA) was characterized by significant risk of postoperative mortality and morbidity. The aim of this study was to determine the perioperative predictors of early and long-term mortality in patients undergoing open repair of TAAA. Besides, the postoperative outcomes in patients with open repair of TAAA were described. METHODS This is a single-center retrospective study, and 146 patients with open repair of TAAA from January 4, 2011, to November 22, 2018 was involved. Categorical variables were analyzed by the Chi-square test or Fisher's exact test, and continuous variables were analyzed by the independent sample t-test and the WilCoxon rank-sum test. Multivariate Logistic regression and Cox regression were applied to identify the predictors of 30-day and long-term mortality, respectively. The Kaplan Meier curves were used to illustrate survival with the Log-rank test. RESULTS The 30-day mortality was 9.59% (n = 14). Older than 50 years, the intraoperative volume of red blood cell (RBC) and epinephrine use were independently associated with postoperative 30-day mortality in open repair of TAAA. Long-term mortality was 17.12% (n = 25) (median of 3.5 years (IQR = 2-5 years) of follow-up). Prior open thoracoabdominal aortic aneurysm (TAAA) repair, aortic cross-clamping (ACC) time, intraoperative volume of RBC and use of epinephrine were independently correlated with long-term mortality. CONCLUSIONS Identifying perioperative risk factors of early and long-term mortaliy is crucial for surgeons. Intraoperative volume of RBC and use of epinephrine were predictors of both early and long-term mortality. In addition, patients of advanced age, prior open repair of TAAA and prolonged ACC time should be paid more attention.
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Affiliation(s)
- Sudena Wang
- Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Chunrong Wang
- Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yuchen Gao
- Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yu Tian
- Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Jia Liu
- Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yuefu Wang
- Department of Surgery Intensive Care Unit, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
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Huber A, Kovács E, Horváth A, Sahin-Tóth J, Kaptás Á, Juhász E, Kristóf K, Dobay O. Prevalence, serogroup distribution and risk factors of Neisseria meningitidis carriage in high school and university students in Hungary. Vaccine 2024; 42:2271-2277. [PMID: 38423809 DOI: 10.1016/j.vaccine.2024.02.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/12/2024] [Accepted: 02/22/2024] [Indexed: 03/02/2024]
Abstract
Neisseria meningitidis causes life-threatening invasive meningococcal disease (IMD) with high mortality worldwide. Asymptomatic pharyngeal meningococcus colonisation is an important reservoir for the spread of the bacterium. The aim of this study was to determine N. meningitidis colonisation rates in asymptomatic high school and university students and to identify risk factors for carriage. Oropharyngeal swab samples and data from a self-reported questionnaire were obtained from overall 610 students, among them 303 university students and 307 high school students, aged between 15 and 31 years in Budapest, Hungary, between November 2017 and December 2018. Meningococcal carriage and serogroup of N. meningitidis were determined by RT-PCR from DNA extracted directly from the specimen. N. meningitidis was identified in 212 (34.8 %) of the participants. Significantly higher carriage rate was found among high school students (48.9 %) compared to university students (20.5 %). Peak of colonisation rate was among 17-19-year-old students (48.7 %). Most carriage isolates were non-typable (87.3 %). From the 212 meningococcus carriers, 19 were colonised by serogroup B (9 %), 5 by serogroup C (2.4 %), and 1 had serogroup Y (0.5 %). Significantly higher colonisation rate was found among males (42.4 %) than in females (33.1 %). Antibiotic use in the past 2 months has decreased the rate of meningococcal colonisation. Recent respiratory infection, active or passive smoking and attending parties have not influenced meningococcal colonisation rate significantly. In conclusion, we have found high asymptomatic meningococcus carriage rate among high school students and young adults, however, the majority of the colonizing meningococci were non-typable.
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Affiliation(s)
- Annamária Huber
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
| | - Eszter Kovács
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
| | - Andrea Horváth
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
| | - Judit Sahin-Tóth
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
| | - Ákos Kaptás
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
| | - Emese Juhász
- Institute of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Katalin Kristóf
- Institute of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Orsolya Dobay
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary.
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Oertel J, Sharif S, Zygourakis C, Sippl C. Acute low back pain: Epidemiology, etiology, and prevention: WFNS spine committee recommendations. World Neurosurg X 2024; 22:100313. [PMID: 38510335 PMCID: PMC10951075 DOI: 10.1016/j.wnsx.2024.100313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/21/2024] [Indexed: 03/22/2024] Open
Abstract
Objective Acute low back pain is a highly prevalent condition that poses significant challenges to healthcare systems worldwide. In this manuscript, we present the most current, evidence-based guidelines from the World Federation of Neurosurgical Societies (WFNS) Spine Committee on the epidemiology, etiology, and prevention of acute low back pain (LBP) lasting ≤ 4 weeks. Methods We performed a literature review 2012-2022 using the PubMed, Medline, and CENTRAL databases with the keywords "acute low back pain", "acute back pain", "low back pain", "epidemiology", "etiology", "costs", "risk factor", "cultural", "developed", "developing" and "prevention". Systematic screening criteria were applied, resulting in 13 final articles on epidemiology and etiology of LBP, 2 manuscripts on costs, 5 articles on risk factors, and 23 articles on prevention strategies for acute LBP. These were presented at two separate international meetings, where members of the WFNS Spine Committee voted on five final consensus statements presented here. Results and Conclusions: There is a high incidence and prevalence of acute LBP, particularly in high-income countries, which is felt to be at least partially due to demographic shifts with an aging population and lifestyle changes including higher rates of obesity and physical inactivity. Acute LBP has a significant impact on quality of life and ability to work, resulting in high direct and indirect costs worldwide. Early diagnosis and appropriate management of acute LBP is recommended to prevent this pain from turning into chronic LBP. The WFNS Spine Committee's recommendations respresent the latest guidelies to help improve patient care for acute LBP worldwide.
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Affiliation(s)
- Joachim Oertel
- Department of Neurosurgery, Saarland University Medical Centre, Kirrbergerstrasse 100, Gebaeude 90.5, 66421 Homburg Saar, Germany
| | - Salman Sharif
- Department of Neurosurgery, Liaqat National Hospital and Medical School, Stadium Road, Karachi 74800, Pakistan
| | - Corinna Zygourakis
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Christoph Sippl
- Department of Neurosurgery, Saarland University Medical Centre, Kirrbergerstrasse 100, Gebaeude 90.5, 66421 Homburg Saar, Germany
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185
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Na J, Wu S, Chen L, Qi Y, Yuan Y, Feng G, Wang X, Hei M. Clinical Outcomes and Medical Burdens of Neonatal Arrhythmias in Children's Hospitals in China: A Protocol for Multi-Center Retrospective Cohort Study. Pediatr Cardiol 2024; 45:814-820. [PMID: 38374353 PMCID: PMC10960737 DOI: 10.1007/s00246-024-03421-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/16/2024] [Indexed: 02/21/2024]
Abstract
Neonatal arrhythmias are significant contributors to infant mortality. Timely diagnosis and treatment are essential for neonates with non-benign arrhythmias to avoid severe complications, and ongoing treatment and follow-up are sometimes needed. The main objective of this study will be to understand the incidence and demographic characteristics of arrhythmias in hospitalized neonates in China and the related factors of outcomes. A secondary objective will be to establish the first follow-up system for neonatal arrhythmias in China. The medical burdens of neonatal arrhythmias in China will also be investigated. The data from the Futang Research Center of Pediatric Development (FRCPD) database between January 2016 and December 2021 were obtained. Newborns admitted to member hospitals with a discharge diagnosis of "neonatal arrhythmia" (ICD-10 code P29.151) or "arrhythmia" (ICD-10 code I49.904) were included. The medical record information was collected and classified into two groups: heart failure and non-heart failure. The differences between the two groups and independent risk factors for neonatal arrhythmias complicated with heart failure were analyzed. In addition, a follow-up study of patients discharged from Beijing Children's Hospital was conducted to evaluate their outcomes at the age of 3 years old. Factors influencing hospitalization costs were analyzed using rank-sum tests and multiple linear regression. It is anticipated that the study findings will provide new and comprehensive data on the health needs of neonatal arrhythmias in China. The study will establish the first follow-up system for neonatal arrhythmias in China. This study will help reduce the burden of patients and their families as well as the society.
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Affiliation(s)
- Jia Na
- Department of Cardiology, Beijing Children's Hospital Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Songwei Wu
- Department of Neonatal Center, Beijing Children's Hospital Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Lu Chen
- Department of Neonatal Center, Beijing Children's Hospital Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Yujie Qi
- Department of Neonatal Center, Beijing Children's Hospital Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Yue Yuan
- Department of Cardiology, Beijing Children's Hospital Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Guoshuang Feng
- Big Data and Engineering Research Center, Beijing Children's Hospital Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Xinyu Wang
- Big Data and Engineering Research Center, Beijing Children's Hospital Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Mingyan Hei
- Department of Neonatal Center, Beijing Children's Hospital Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
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186
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Putz J, Kestel V, Herout R, Borkowetz A, Leike S, Thomas C, Baunacke M. [Urogenital tumors following kidney transplantation-monocentric analysis of incidences and overview of urological preventive measures]. Urologie 2024; 63:341-350. [PMID: 38512472 PMCID: PMC10990984 DOI: 10.1007/s00120-024-02317-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Urogenital tumors are among the most common solid malignancies after kidney transplantation (TX). OBJECTIVE We analyzed the incidence and mortality of urogenital tumors after kidney TX in our own patient population as well as answered the question of recommended follow-up necessity and frequency in this cohort. MATERIALS AND METHODS Retrospective monocentric data collection of tumor diseases and the most common urogenital tumors after kidney TX at the Transplant Center Dresden between 2010 and 2020 was done. From this, we derived recommendations for a useful follow-up concept. RESULTS A total of 13% (93/710) of kidney TX patients developed a neoplasm. Older patients (60.1 ± 10.6 vs. 53.8 ± 12.5; p < 0.001), with higher Charlson scores (≥ 4: 68% vs. 46%; p < 0.001) and a previous tumor history (18% vs. 8%; p < 0.001) were more likely to develop a neoplasm after transplantation. In the multivariate analysis, previous tumor history was found to be an independent predictor of tumor development after renal transplantation (OR 2.2; 95%-KI [1.2-4.1]; p = 0.01). Urogenital tumors accounted for 30% (28/93) of all malignancies. Renal cell carcinoma of the native kidney was the most common (n = 12) neoplasm, followed by prostate cancer (n = 9). CONCLUSION Most solid malignancies after kidney TX arise from the urinary tract. Due to their frequency, there is an urgent need for specialized urological therapy and long-term follow-up care. Even before listing for TX, risk factors can be recognized and individual concepts for follow-up care can be developed.
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Affiliation(s)
- J Putz
- Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - V Kestel
- Medizinische Fakultät, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Dresden, Deutschland
| | - R Herout
- Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - A Borkowetz
- Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - S Leike
- Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - C Thomas
- Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - M Baunacke
- Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
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187
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Costa E, Pedroso AR, Matos R, Cunha Rodrigues M, Padrão E, Sousa-Neves J, Rolo R. Predictive factors for dose reduction and discontinuation of nintedanib in fibrotic interstitial lung diseases: Real life data. Respir Med 2024; 225:107603. [PMID: 38513874 DOI: 10.1016/j.rmed.2024.107603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/13/2024] [Accepted: 03/13/2024] [Indexed: 03/23/2024]
Abstract
Nintedanib, an intracellular inhibitor targeting multiple tyrosine kinases, has emerged as a standard treatment for various fibrotic lung diseases. Despite its efficacy, side effects such as nausea, diarrhea, and hepatotoxicity often lead to dose reduction or discontinuation. In this retrospective analysis at an university hospital's interstitial lung disease clinic, we aimed to identify baseline characteristics associated with dose adjustment or treatment discontinuation. Of the 58 patients included, 41.4% maintained the full nintedanib dose, while 31.0% required dosage reduction, and 27.6% discontinued treatment due to adverse events, predominantly gastrointestinal and hepatotoxic effects. Multivariate analysis revealed body surface area (BSA) as an independent and significant baseline risk factor (adjusted Odds Ratio [aOR] 0.22), suggesting a 78% decreased chance of requiring dose modification for every decimal point increase in BSA. A BSA cutoff of ≤1.73 m [2] exhibited a sensitivity of 73% and specificity of 91.7%, with significant impact on one-year survival under full-dose treatment (p < 0.001). Lower BSA was associated with early onset adverse effects, particularly gastrointestinal, supporting the need for regular clinical monitoring. The study emphasizes the importance of recognizing baseline factors to ensure the safety and tolerability of nintedanib, thereby preventing the progression of pulmonary fibrosis. These findings contribute to the evolving understanding of nintedanib management in fibrotic interstitial lung diseases, guiding clinicians in personalized treatment approaches.
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Affiliation(s)
- Emanuel Costa
- Rheumatology Department, Hospital de Braga, Braga, Portugal.
| | | | - Rita Matos
- Internal Medicine Department, Hospital de Braga, Braga, Portugal
| | | | - Eva Padrão
- Pneumology Department, Hospital de Braga, Braga, Portugal
| | | | - Rui Rolo
- Pneumology Department, Hospital de Braga, Braga, Portugal
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188
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Gu J, Du C, Wei F. Risk factors for loss of follow-up in patients with intrahepatic cholangiocarcinoma at one year after surgery: A retrospective analysis. Asian J Surg 2024; 47:1845-1846. [PMID: 38182502 DOI: 10.1016/j.asjsur.2023.12.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/25/2023] [Indexed: 01/07/2024] Open
Affiliation(s)
- Jing Gu
- Department of General Surgery, Cancer Center, Division of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang Province, China; Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang Province, China
| | - Chengfei Du
- Department of General Surgery, Cancer Center, Division of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang Province, China; Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang Province, China
| | - Fangqiang Wei
- Department of General Surgery, Cancer Center, Division of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang Province, China.
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189
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Hebert SV, Green MA, Mashaw SA, Brouillette WD, Nguyen A, Dufrene K, Shelvan A, Patil S, Ahmadzadeh S, Shekoohi S, Kaye AD. Assessing Risk Factors and Comorbidities in the Treatment of Chronic Pain: A Narrative Review. Curr Pain Headache Rep 2024:10.1007/s11916-024-01249-z. [PMID: 38558165 DOI: 10.1007/s11916-024-01249-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE OF REVIEW Chronic pain affects a significant portion of the population globally, making it a leading cause of disability. Understanding the multifaceted nature of chronic pain, its various types, and the intricate relationship it shares with risk factors, comorbidities, and mental health issues like depression and anxiety is critical for comprehensive patient care. Factors such as socioeconomic status (SES), age, gender, and obesity collectively add layers of complexity to chronic pain experiences and pose management challenges. RECENT FINDINGS Low SES presents barriers to effective pain care, while gender differences and the prevalence of chronic pain in aging adults emphasize the need for tailored approaches. The association between chronic pain and physical comorbidities like cardiovascular disease, chronic obstructive pulmonary disease (COPD), and diabetes mellitus reveals shared risk factors and further highlights the importance of integrated treatment strategies. Chronic pain and mental health are intricately linked through biochemical mechanisms, profoundly affecting overall quality of life. This review explores pharmacologic treatment for chronic pain, particularly opioid analgesia, with attention to the risk of substance misuse and the ongoing opioid epidemic. We discuss the potential role of medical cannabis as an alternative treatment with a nuanced perspective on its impact on opioid use. Addressing the totality and complexity of pain states is crucial to individualizing chronic pain management. With different types of pain having different underlying mechanisms, considerations should be made when approaching their treatment. Moreover, the synergistic relationship that pain states can have with other comorbidities further complicates chronic pain conditions.
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Affiliation(s)
- Sage V Hebert
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Melanie A Green
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Sydney A Mashaw
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - William D Brouillette
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Angela Nguyen
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Kylie Dufrene
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Anitha Shelvan
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Shilpadevi Patil
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Shahab Ahmadzadeh
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Sahar Shekoohi
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA.
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
- Department of Pharmacology, Louisiana State University Health Sciences Center at Shreveport, Toxicology, and Neurosciences, Shreveport, LA, 71103, USA
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190
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Yadav R, Chauhan MB, Yadav C, Ranga S, Ahuja P, Tanwar M, Balhara N, Kadian L, Chauhan P, Tanwar N, Ahlawat C. Awareness data on cervical cancer among females of rural and urban areas of Haryana, India. Data Brief 2024; 53:110168. [PMID: 38384314 PMCID: PMC10879805 DOI: 10.1016/j.dib.2024.110168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/27/2024] [Accepted: 02/01/2024] [Indexed: 02/23/2024] Open
Abstract
A cross-sectional study was done to assess the degree of current awareness and behaviors about cervical cancer among females in urban and rural areas of North India. This survey was conducted on one thousand females (500 rural and 500 urban). A well-structured questionnaire was designed to collect information about participants' knowledge on cancer of cervix uteri such as age, height and weight measurements, marital status, menstrual status, personal hygiene, age at menarche, sexual history, pregnancy and abortion history, use of contraceptive pills for birth-control, smoking, alcohol consumption, and other relevant information. The data was collected by conducting face-to-face interviews after obtaining the verbal consent of the participants. The data has the potential to reduce disease burden by spreading awareness about symptoms and risk factors of cervical cancer as well as implementation of effective early screening strategies.
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Affiliation(s)
- Ritu Yadav
- Department of Genetics, Maharshi Dayanand University, Rohtak, Haryana 124001 India
| | - Meenakshi B. Chauhan
- Department of Obstetrics and Gynecology, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana 124001 India
| | - Chetna Yadav
- Department of Genetics, Maharshi Dayanand University, Rohtak, Haryana 124001 India
| | - Shalu Ranga
- Department of Genetics, Maharshi Dayanand University, Rohtak, Haryana 124001 India
| | - Parul Ahuja
- Department of Genetics, Maharshi Dayanand University, Rohtak, Haryana 124001 India
| | - Mukesh Tanwar
- Department of Genetics, Maharshi Dayanand University, Rohtak, Haryana 124001 India
| | - Nikita Balhara
- Department of Genetics, Maharshi Dayanand University, Rohtak, Haryana 124001 India
| | - Lokesh Kadian
- School of Medicine, Indiana University, Indianapolis, IN 46202 United States
| | - Preeti Chauhan
- Department of Biotechnology, Chandigarh Group of Colleges, Landran, Mohali, Chandigarh 140307 India
| | - Neha Tanwar
- Department of Genetics, Maharshi Dayanand University, Rohtak, Haryana 124001 India
| | - Chavi Ahlawat
- Department of Genetics, Maharshi Dayanand University, Rohtak, Haryana 124001 India
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191
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Almqvist L, Andersson M, Backman H, Rönmark E, Hedman L. No remission in 60% of those with childhood-onset asthma - A population-based cohort followed from 8 to 28 years of age. Respir Med 2024; 224:107581. [PMID: 38417585 DOI: 10.1016/j.rmed.2024.107581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/14/2024] [Accepted: 02/25/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Although remission occur, childhood-onset asthma may persist until adulthood. Since few longitudinal population-based studies have followed a cohort from childhood until adulthood, the knowledge on predictors of persistence of asthma is sparse. AIM To estimate persistence of asthma from 8 to 28 years and its associated factors. METHODS Within the OLIN (Obstructive Lung Disease in Northern Sweden) studies, a cohort was recruited in 1996 (age 8y, n = 3430) and followed annually with questionnaires about asthma and risk factors until 19y. Clinical examinations included skin prick tests (at 8, 12 and 19y) and lung function tests (17 and 19y) whereof a subsample performed bronchial hyperreactivity test. We identified n = 248 with asthma at 8y whereof 170 (69%) participated in a follow-up at 28y (73% of possible to invite). RESULTS Of the 170 participants at 28y, 105 (61.8%) had persistent asthma (women: 49/76, 64.5%; men: 56/94, 59.6%, p = 0.513). Factors collected at recruitment: allergic sensitization (OR7.8, 95%CI 3.0-20.2), severe respiratory infection (OR2.6, 95%CI 1.1-6.3) and higher asthma severity score (OR1.6, 95%CI 1.1-2.4) were associated with asthma at 28y after adjustment for sex, family history of asthma, breastfeeding <3 months and eczema. Replacing allergic sensitization with rhinoconjunctivitis in the model yielded OR3.4 (95%CI 1.5-8.0). Bronchial hyperreactivity at age 17y associated with asthma at 28y (OR9.0, 95%CI 1.7-47.0). CONCLUSIONS Among children with asthma onset by 8y, 62% still had asthma at age 28 years. Persistent asthma was associated with allergic sensitization, rhinoconjunctivitis, severe respiratory infection, a more severe asthma and bronchial hyperreactivity.
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Affiliation(s)
- Linnéa Almqvist
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden.
| | - Martin Andersson
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Helena Backman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Linnéa Hedman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
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192
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van Trier TJ, Jørstad HT, Scholte Op Reimer WJM, Sunamura M, Ter Hoeve N, Aernout Somsen G, Peters RJG, Snaterse M. Patients' preferences for secondary prevention following a coronary event. Prev Med Rep 2024; 40:102681. [PMID: 38495768 PMCID: PMC10940170 DOI: 10.1016/j.pmedr.2024.102681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/19/2024] Open
Abstract
Objective Despite clear evidence on the effectiveness of secondary prevention, patients with coronary artery disease frequently fail to reach guideline-based risk factor targets. Integrating patients' preferences into treatment decisions has been recommended to reduce this gap. However, this requires knowledge about patient treatment preferences. Therefore, through a survey study, we aimed to explore which risk factors patients self-perceived, prioritised for improvement, and needed support with after a recent hospitalisation for coronary heart disease. Methods A digital questionnaire was presented to patients > 18 years recently discharged (≤3 months) from an acute coronary care unit in the Netherlands (Europe). Patients could select from eight cardiovascular risk factors that they (1) self-perceived, (2) prioritised for improvement, and (3) needed support to improve. Patients' perceived risk factors were compared to those documented in the medical records. Results Respondents (N = 254, 26 % women), mean age 64 (SD 10) years, identified 'physical inactivity' more frequently than their medical records (140 patients vs. 91 records, p < 0.001), while three other risk factors were reported with equal and four with lower frequency. 'Physical inactivity', 'overweight' and 'stress' were most frequently prioritised for improvement (82 %, 88 % and 78 %) and professional support (64 %, 50 % and 58 %), with 87 % preferring lifestyle optimisation if this would reduce drug use. Conclusions Patients with a recent coronary event show significant disparities in identifying risk factors compared to their medical records. They tend to prefer improving lifestyle- over drug-modifiable risk factors, particularly physical inactivity, overweight and stress, and indicate the need for support in improving these factors.
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Affiliation(s)
- Tinka J van Trier
- Department of Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Harald T Jørstad
- Department of Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Wilma J M Scholte Op Reimer
- Department of Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Research Group Chronic Diseases, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Madoka Sunamura
- Capri Cardiac Rehabilitation Rotterdam, Rotterdam, The Netherlands
- Franciscus Gasthuis & Vlietland Hospital, Rotterdam, The Netherlands
| | - Nienke Ter Hoeve
- Capri Cardiac Rehabilitation Rotterdam, Rotterdam, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC Medical Center, Rotterdam, The Netherlands
| | - G Aernout Somsen
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands
| | - Ron J G Peters
- Department of Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Snaterse
- Department of Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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193
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Hong EJ, Yoon HJ, Kwon MJ, Kim JY, Kim JE, Park YL, Lee S, Bae Y, Lee SH. Factors Associated With Achieving Complete Skin Clearance Compared to Almost Complete Skin Clearance in Patients With Moderate to Severe Psoriasis Treated With Biologics: A Retrospective Chart Review. Ann Dermatol 2024; 36:91-98. [PMID: 38576247 PMCID: PMC10995612 DOI: 10.5021/ad.23.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/24/2023] [Accepted: 12/13/2023] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Biologics have demonstrated high efficacy in achieving 'almost complete' skin clearance in patients with moderate to severe psoriasis. Nonetheless, achieving 'complete' skin clearance remains a treatment goal for some highly biologics-resistant patients, as residual lesions impact their quality of life. OBJECTIVE The risk factors for failure to achieve a Psoriasis Area and Severity Index (PASI) 100 response in patients with good response to biologics remain unknown. METHODS This retrospective study evaluated the risk factors by comparing patients who achieved complete skin clearance (PASI100) with those who achieved almost complete skin clearance (PASI90). A database of 131 psoriasis patients treated with biologics, who achieved a PASI90 or PASI100 response, was reviewed from a tertiary referral hospital in South Korea. The patients were classified into PASI90 and PASI100 groups according to their PASI response. RESULTS The PASI100 group had a lower prevalence of smoking history (adjusted odds ratio [OR], 0.34; 95% confidence interval [CI], 0.14-0.85; p=0.021) and psoriasis on the anterior lower legs at baseline (adjusted OR, 0.18; 95% CI, 0.03-0.99; p=0.049) than patients in the PASI90 group. CONCLUSION This study suggested that smoking history and psoriatic skin lesions on the anterior lower legs are considered as the risk factors for the failure to achieve a PASI100 response in psoriasis patients treated with biologics.
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Affiliation(s)
- Eun Ji Hong
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Hee Jung Yoon
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Min Jung Kwon
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Jae Yun Kim
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Jung Eun Kim
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Young Lip Park
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - SangHoon Lee
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Youin Bae
- Department of Dermatology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
| | - Sul Hee Lee
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
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194
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Niu C, Li P, Du X, Zhao M, Wang H, Yang D, Wu M, Jing W. Risk factors for anxiety in patients with epilepsy: A meta-analysis. Epilepsy Behav 2024; 153:109665. [PMID: 38368787 DOI: 10.1016/j.yebeh.2024.109665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Epilepsy is a very common neurological disease, and it is important to focus on both controlling seizures and alleviating the psychological problems associated with this disease.Anxiety is an important risk factor for epilepsy and seriously affects the quality of life of patients with epilepsy (PWE). However, several risk factors for anxiety in PWE are relatively controversial and understudied. This meta-analysis was performed to identify potential risk factors for anxiety in PWE with the aim of reducing the incidence of anxiety and improving the quality of life among the individuals. METHOD The PubMed, Embase and Cochrane Library databases were systematically searched up to July 2023 to find eligible original English studies. All the search results were reviewed based on our inclusion and exclusion criteria. We calculated the combined odds ratios (ORs), standard mean differences (SMDs) and their corresponding 95% confidence intervals (CIs) to evaluate the effect of the included risk factors on anxiety in PWE. RESULTS Twenty-four studies involving 5,403 PWE were ultimately included. The pooled results of our meta-analysis showed that female sex (OR = 1.67; 95 % CI: 1.30,2.15; p < 0.001), unmarried/divorced/widowed (OR = 0.83; 95 % CI: 0.72,0.96; p = 0.011), low socioeconomic status (OR = 0.47; 95 % CI: 0.33,0.67; p < 0.001), education levels below high school (OR = 1.74; 95 % CI: 1.36,2.23; p < 0.001), a history of trauma (OR = 2.53; 95 % CI: 1.69,3.78; p < 0.001), monotherapy (OR = 0.49; 95 % CI: 0.39,0.62; p < 0.001), AED-induced psychiatric side effects (OR = 2.45; 95 % CI: 1.20,4.98); p = 0.014), depression (OR = 5.45 95 % CI: 2.49,11.94; p < 0.001), a history of suicide (OR = 3.56; 95 % CI: 1.72,7.38; p = 0.001), and illness-related shame (OR = 2.76; 95 % CI: 2.17,3.52; p < 0.001) were risk factors for anxiety. CONCLUSION This meta-analysis showed that female, unmarried, low socioeconomic status, education level below senior high school, a history of trauma, monotherapy, AED-induced psychiatric side effects, depression, a history of suicide, and shame were risk factors for anxiety in PWE. However, further research is needed to determine the effect of other potential risk factors on anxiety in PWE. In addition, most of the studies included in this meta-analysis were not uniform in scale, and the risk factors were not comprehensive; therefore, larger prospective studies in different countries are needed to further investigate these risk factors.
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Affiliation(s)
- Cailang Niu
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| | - Penghong Li
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| | - Xueqing Du
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| | - Mina Zhao
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| | - Haobo Wang
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| | - Debo Yang
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| | - Maolin Wu
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| | - Wei Jing
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
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195
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Zhang M, Zhang Y, Zhang W, Zhang Y, Zhao L, Jing H, Gao X, Nie Z, Zhu S, Zhang S, Zhang X. Prevalence and risk factors of colorectal neoplasia in individuals aged 40-49 years: Findings from screening program in China. J Gastroenterol Hepatol 2024; 39:694-700. [PMID: 38200678 DOI: 10.1111/jgh.16468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 11/25/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND AND AIM The incidence of colorectal cancer (CRC) in individuals under 50 is increasing worldwide. We conducted an analysis of colonoscopy findings in high-risk individuals under 50 in the CRC screening program in Tianjin, China, to determine the detection rate and risk factors of advanced adenomas (AA), advanced colorectal neoplasia (ACN), colorectal neoplasia (CN). METHODS Our study investigated individuals aged 40-49 who underwent CRC screening and completed colonoscopy, 2012-2020, while the 50-54 age group served as a control. We compared the detection rates of AA, ACN, and CN among three age groups using univariate and multivariable logistic regression analyses, and investigated the risk factors associated with AA, ACN, and CN among individuals aged 40-49. RESULTS We found a gradual increase in the detection rate of AA, ACN, and CN among individuals aged 40-54. The detection rates for AA (OR 0.58; 95% CI 0.41-0.81), ACN (OR 0.58; 95% CI 0.43-0.77), and CN (OR 0.64; 95% CI 0.56-0.74) were lower in individuals aged 40-44 compared to 45-49. The detection rates of AA (OR 1.08; 95% CI 0.87-1.34) and ACN (OR 1.12; 95% CI 0.93-1.35) in individuals aged 45-49 were comparable with 50-54. Besides, lifestyle factors, BMI, and FIT are not associated with the detection rates of AA, ACN, and CN among individuals aged 40-49. CONCLUSIONS Our study reveals screening data in individuals under 50, indicating comparable detection rates of AA and ACN in individuals aged 45-49 and 50-54. These findings provide valuable data support for optimizing the optimal age to initiate screening.
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Affiliation(s)
- Mingqing Zhang
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
| | - Yongdan Zhang
- School of Medicine, Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
| | - Wen Zhang
- Center for Applied Mathematics, Tianjin University, Tianjin, China
| | - Yong Zhang
- Center for Applied Mathematics, Tianjin University, Tianjin, China
| | - Lizhong Zhao
- School of Medicine, Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
| | - Haoren Jing
- School of Medicine, Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
| | - Xinyu Gao
- School of Medicine, Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
| | - Zhenguo Nie
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
| | - Siwei Zhu
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
| | - Shiwu Zhang
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
- Department of Pathology, Tianjin Union Medical Center, Tianjin, China
| | - Xipeng Zhang
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
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196
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Li Z, Zhou G, Jiang L, Wang M. Analysis of related factors for pathological upgrading of cervical biopsy from CIN3 to cancer after conical resection. BMC Cancer 2024; 24:401. [PMID: 38561685 PMCID: PMC10985929 DOI: 10.1186/s12885-024-12186-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND To investigate related factors for postoperative pathological upgrading of cervical biopsy to cervical cancer (CC) in patients with cervical intraepithelial neoplasia (CIN)3 after conical resection. METHODS This retrospective study collected data from patients diagnosed with CIN3 by cervical biopsies at the author's Hospital between January 2012 and December 2022. The primary outcome was the pathological results of patients after conical resection. The pathological findings were categorized into the pathological upgrading group if postoperative pathology indicated CC, while those with normal, inflammatory, or cervical precancerous lesions were classified into the pathological non-upgrading group. The factors associated with upgrading were identified using multivariable logistic regression analysis. RESULTS Among 511 patients, there were 125 patients in the pathological upgrading group (24.46%). The patients in the upgrading group were younger (47.68 ± 9.46 vs. 52.11 ± 7.02, P < 0.001), showed a lower proportion of menopausal women (38.40% vs. 53.02%, P = 0.0111), a lower proportion of HSIL (40.00% vs. 57.77%, P = 0.001), a higher rate of HPV-16/18 positive (25.60% vs. 17.36%, P = 0.011), a higher rate of contact bleeding (54.40% vs. 21.50%, P < 0.001), lower HDL levels (1.31 ± 0.29 vs. 1.37 ± 0.34 mmol/L, P = 0.002), higher neutrophil counts (median, 3.50 vs. 3.10 × 109/L, P = 0.001), higher red blood cell counts (4.01 ± 0.43 vs. 3.97 ± 0.47 × 1012/L, P = 0.002), higher platelet counts (204.84 ± 61.24 vs. 187.06 ± 73.66 × 109/L, P = 0.012), and a smaller platelet volume (median, 11.50 vs. 11.90 fL, P = 0.002).The multivariable logistic regression analysis showed that age (OR = 0.90, 95% CI: 0.86-0.94, P < 0.001), menopausal (OR = 2.68, 95% CI: 1.38-5.22, P = 0.004), contact bleeding (OR = 4.80, 95% CI: 2.91-7.91, P < 0.001), and mean platelet volume (OR = 0.83, 95% CI: 0.69-0.99, P = 0.038) were independently associated with pathological upgrading from CIN3 to CC after conical resection. CONCLUSION Age, menopausal, contact bleeding, and mean platelet volume are risk factors of pathological upgrading from CIN3 to CC after conical resection, which could help identify high risk and susceptible patients of pathological upgrading to CC.
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Affiliation(s)
- Zhifang Li
- Department of Gynaecology, Anqing Municipal Hospital, Anhui Medical University, Anqing, Anhui Province, P.R. China.
| | - Guiju Zhou
- The Second Affiliated Hospital of Anhui Medical University, Anqing, Anhui Province, P.R. China
| | - Longfan Jiang
- Department of Gynaecology, Anqing Municipal Hospital, Anhui Medical University, Anqing, Anhui Province, P.R. China
| | - Mengjie Wang
- Department of Gynaecology, Anqing Municipal Hospital, Anhui Medical University, Anqing, Anhui Province, P.R. China
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197
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Sebothoma B. An Analysis of Risk Factors for Hearing Function in Adults Living with Human Immunodeficiency Virus in Gauteng, South Africa. Indian J Otolaryngol Head Neck Surg 2024; 76:1637-1644. [PMID: 38566657 PMCID: PMC10982266 DOI: 10.1007/s12070-023-04375-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 09/23/2022] [Indexed: 04/04/2024] Open
Abstract
The aim of this study was to explore risk factors for hearing loss or affecting hearing function in adults living with HIV. A quantitative cross-sectional design was employed. A non-probability purposive sampling method was used to select and recruit 132 participants aged 18 years and above from an HIV clinic within the Academic Hospital in Gauteng Province, South Africa. Participants' hearing were tested using, video otoscopy, tympanometry, pure tones, and speech audiometry. Of the 22.73% prevalence of hearing loss in the sample, the multiple logistic regression, controlling for other variables, indicated that age (AOR) = 1.049; 95%CI: 1.0005 to 1.0978) (p-value = 0.048) and extended use of antiretroviral therapy (AOR) = 1.0073; 95%CI: 0.9312 to 1.0896)) (p-value = 0.856) were strongly associated with the development of hearing loss. Although the odds of male participants to have hearing loss was 2.3572 (95%CI: 0.9394 to 5.915) compared to females, this association was marginal (p-value = 0.068). Current findings provide evidence for the risk factors for hearing loss in adults living with HIV. Given that an extended use of ART and a higher number of CD4 are strongly associated with hearing loss, these findings raise important implications for a focused monitoring for this population in order to identify early signs of hearing loss and implement timeous intervention to reduce the potential impact of hearing loss.
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Affiliation(s)
- Ben Sebothoma
- Department of Speech pathology and Audiology, University of the Witwatersrand, Private Bag X3, Wits, Johannesburg, 2050 South Africa
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198
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Ren J, Wang C, Zhang P, Xu J, Bao Y. Epidemiological characterization and risk factors of rhinitis and rhinoconjunctivitis among preschool children in Shanghai, China. Int J Pediatr Otorhinolaryngol 2024; 179:111906. [PMID: 38492328 DOI: 10.1016/j.ijporl.2024.111906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/14/2023] [Accepted: 02/27/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Previous studies have reported an increasing prevalence of childhood allergic rhinitis in developing countries. There is still a lack of the recent epidemiology of allergic rhinitis among Chinese preschool children. Therefore, this study explored the prevalence of rhinitis symptoms and identified their associations with potential risk factors among children at the age of 3-6 in Shanghai, China. METHODS Validated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was adopted to collect information about rhinitis symptoms and potential risk factors. Univariate and multivariate logistic regression analyses were used to assess associations between risk factors and allergic rhinitis and rhinoconjunctivitis. RESULTS A total of 6183 questionnaires were included in our study. The prevalence of rhinitis ever, current rhinitis, and physician-diagnosed rhinitis were 32.6%, 29.2%, and 14.3%, respectively, while the prevalence of current rhinoconjunctivitis was 11.3%. The higher prevalence was observed in boys than in girls in terms of rhinitis ever, current rhinitis, current rhinoconjunctivitis and doctor-diagnosed rhinitis. Autumn had the highest prevalence among four seasons. In our multivariate logistic regression analyses, history of allergic diseases and paracetamol use in the last year showed positive associations with the increased risk of both current rhinitis and rhinoconjunctivitis, and antibiotic use was an independent significant risk factor only for current rhinitis. Genetic factors, including maternal and paternal rhinitis, asthma, and eczema, were significantly associated with the prevalence of current rhinitis. Similar associations were seen between these factors and current rhinoconjunctivitis, except for paternal eczema. Among environmental factors, smoking exposure at home, heavy truck traffic in home's street, floor heating system were independent risk factors for both current rhinitis and rhinoconjunctivitis in the adjusted model, while cleaning the house less than once a week was only associated with current rhinitis. CONCLUSION The prevalence of current rhinitis was 29.2% among children aged 3-6 in Shanghai, China. Sex differences and seasonal variations were observed in the prevalence of rhinitis symptoms. The identified risk factors would provide a basis for policy makers and medical experts to take intervention measures to prevent allergic rhinitis and rhinoconjunctivitis.
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Affiliation(s)
- Jie Ren
- Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Chengdong Wang
- Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Pingbo Zhang
- Shanghai Tonxin Clinic, Shanghai, 200082, China; Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Jing Xu
- Yangpu District Maternity and Child Healthcare Hospital, Shanghai, 200082, China
| | - Yixiao Bao
- Shanghai Tonxin Clinic, Shanghai, 200082, China.
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199
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Hu S, Chen X, Zheng G, Zhao Y, He X, Liu X, Lu F, Lin Y. The Prevalence and Risk Factors of Blepharoptosis in an Elderly Asian Population. Aesthetic Plast Surg 2024; 48:1298-1305. [PMID: 38168822 DOI: 10.1007/s00266-023-03804-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Age-related blepharoptosis, or ptosis, affects vision and appearance. Associations with age, gender, BMI, and diabetes have been explored, but the link to blood lipids remains unclear. The impact on refraction also lacks consensus. This study addresses gaps by investigating ptosis prevalence and factors in a representative Chinese population, aiming for a comprehensive understanding. METHODS A cross-sectional study was conducted among individuals aged 50 and above who were willing to participate in comprehensive systemic check-ups, behavioral questionnaires, and ophthalmic examinations at Yaoxi Community Health Center in Wenzhou City, Zhejiang Province. RESULTS The prevalence of blepharoptosis among the elderly participants at this health center was 27.16%. Individuals with blepharoptosis tended to be older, male, exhibited slightly higher body mass index, wider waist circumference, engaged in lower exercise frequency, and had a higher prevalence of hypertension, diabetes, and with-the-rule astigmatism compared to their counterparts without these conditions. Adjusting for all other confounding variables, older age, being male, higher fasting plasma glucose (FPG), and lower exercise frequency displayed statistically significant relationships with blepharoptosis. After examining the distribution of blepharoptosis degrees within relevant factor subgroups, we noted a higher prevalence of severe ptosis in subgroups associated with older age, male gender, higher FPG, and against-the-rule astigmatism. CONCLUSION The notable associations with age, gender, FPG, and exercise level suggest a multifactorial etiology for blepharoptosis. The observed link between with-the-rule astigmatism and blepharoptosis implies a potential contributory role in the refractive aspect of blepharoptosis. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Shiqi Hu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, 270 Xueyuan West Road, Lucheng District, Wenzhou, 325027, Zhejiang, China
| | - Xi Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, 270 Xueyuan West Road, Lucheng District, Wenzhou, 325027, Zhejiang, China
| | - Gu Zheng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, 270 Xueyuan West Road, Lucheng District, Wenzhou, 325027, Zhejiang, China
| | - Yiming Zhao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, 270 Xueyuan West Road, Lucheng District, Wenzhou, 325027, Zhejiang, China
| | - Xin He
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, 270 Xueyuan West Road, Lucheng District, Wenzhou, 325027, Zhejiang, China
| | - Xinting Liu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, 270 Xueyuan West Road, Lucheng District, Wenzhou, 325027, Zhejiang, China
| | - Fan Lu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, 270 Xueyuan West Road, Lucheng District, Wenzhou, 325027, Zhejiang, China.
| | - Yanyan Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, 270 Xueyuan West Road, Lucheng District, Wenzhou, 325027, Zhejiang, China.
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200
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Carvajal Rico J, Alaeddini A, Faruqui SHA, Fisher-Hoch SP, Mccormick JB. A Laplacian regularized graph neural network for predictive modeling of multiple chronic conditions. Comput Methods Programs Biomed 2024; 247:108058. [PMID: 38382304 DOI: 10.1016/j.cmpb.2024.108058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/25/2024] [Accepted: 02/02/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND AND GOALS One of the biggest difficulties facing healthcare systems today is the prevalence of multiple chronic diseases (MCC). Mortality and the development of new chronic illnesses are more likely in those with MCC. Pre-existing diseases and risk factors specific to the patient have an impact on the complex stochastic process that guides the evolution of MCC. This study's goal is to use a brand-new Graph Neural Network (GNN) model to examine the connections between specific chronic illnesses, patient-level risk factors, and pre-existing conditions. METHODS We propose a graph neural network model to analyze the relationship between five chronic conditions (diabetes, obesity, cognitive impairment, hyperlipidemia, and hypertension). The proposed model adds a graph Laplacian regularization term to the loss function, which aims to improve the parameter learning process and accuracy of the GNN based on the graph structure. For validation, we used historical data from the Cameron County Hispanic Cohort (CCHC). RESULTS Evaluating the Laplacian regularized GNN on data from 600 patients, we expanded our analysis from two chronic conditions to five chronic conditions. The proposed model consistently surpassed a baseline GNN model, achieving an average accuracy of ≥89% across all combinations. In contrast, the performance of the standard model declined more markedly with the addition of more chronic conditions. The Laplacian regularization provided consistent predictions for adjacent nodes, beneficial in cases with shared attributes among nodes. CONCLUSIONS The incorporation of Laplacian regularization in our GNN model is essential, resulting in enhanced node categorization and better predictive performance by harnessing the graph structure. This study underscores the significance of considering graph structure when designing neural networks for graph data. Future research might further explore and refine this regularization method for various tasks using graph-structured data.
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Affiliation(s)
- Julian Carvajal Rico
- Department of Mechanical Engineering, The University of Texas at San Antonio, San Antonio, TX, 78249, United States of America
| | - Adel Alaeddini
- Department of Mechanical Engineering, The University of Texas at San Antonio, San Antonio, TX, 78249, United States of America.
| | - Syed Hasib Akhter Faruqui
- Department of Engineering Technology, Sam Houston State University, Huntsville, Tx, 77341, United States of America
| | - Susan P Fisher-Hoch
- School of Public Health Brownsville, The University of Texas Health Science Center at Houston, Houston, TX, 78520, United States of America
| | - Joseph B Mccormick
- School of Public Health Brownsville, The University of Texas Health Science Center at Houston, Houston, TX, 78520, United States of America
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