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Guo M, Ruan G, Ding X, Yu Y, Tian L, Shen J, Bai X, Jiang L, Zheng W, Shu H, Zhang X, Yang H. The influence of sleep factors and dietary habits on the disease pattern of ulcerative colitis patients with long and short disease courses - a multicentre cross-sectional analysis. Ann Med 2024; 56:2313685. [PMID: 38346400 PMCID: PMC10863541 DOI: 10.1080/07853890.2024.2313685] [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: 07/26/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Ulcerative colitis (UC) is a disease characterized by chronic relapsing-remitting inflammatory disorders and is associated with environmental changes. AIM To explore the disease patterns of Chinese UC patients and to determine controllable related environmental factors. METHODS This multicentre cross-sectional study was performed using a questionnaire survey. Data on clinical characteristics and environmental factors were collected. Patients with a disease course ≥5 years were defined as the long course group, and those with a disease course < 5 years were defined as the short course group. RESULTS A total of 588 effective questionnaires were collected. The proportion of the chronic continuous pattern was the highest among patients with a long disease course (46.8%), and in patients with a short disease course, the proportion of the active to remission pattern was the highest (53.3%). In patients with a long disease course, a higher proportion of patients with adequate sleep was found in the active to remission pattern than in the chronic intermittent (72.1% vs. 43.3%, p = 0.008) and chronic continuous (72.1% vs. 52.4%, p = 0.016) patterns. In patients with a short disease course, the frequency of shellfish and shrimp was higher in the chronic continuous pattern group than in the active to remission pattern group (P = 0.001 and 0.017 respectively). CONCLUSIONS For early diagnosis patients, dietary guidance should be actively carried out. With the prolongation of the disease course, attention should be given to the sleep quality of patients.
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Affiliation(s)
- Mingyue Guo
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gechong Ruan
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueli Ding
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yanbo Yu
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, P.R, China
| | - Linglin Tian
- Department of Gastroenterology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Jun Shen
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Inflammatory Bowel Disease Research Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Xiaoyin Bai
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lingjuan Jiang
- Medical Research Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Weiyang Zheng
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huijun Shu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaolan Zhang
- Department of Gastroenterology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hong Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Gao H, Zhang Y, Pan Y, Zhao M, Qi Y, Zhou M, Chan SSC, Huang S, Song P, Tang K, Sun L, Yuan C. Patterns of pediatric and adolescent female genital inflammation in China: an eight-year retrospective study of 49,175 patients in China. Front Public Health 2023; 11:1073886. [PMID: 37727603 PMCID: PMC10506404 DOI: 10.3389/fpubh.2023.1073886] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 08/22/2023] [Indexed: 09/21/2023] Open
Abstract
Background Genital inflammation is one of the most frequent clinical complaints among girls, which was easily overlooked by the general public. This study aimed to investigate the patterns and epidemiological characteristics of pediatric and adolescent female genital inflammation in China. Methods A retrospective observational study (2011 to 2018) was conducted among all female patients under the age of 0-18 years at the Department of Pediatric and Adolescent Gynecology of The Children's Hospital, Zhejiang University School of Medicine. Data were collected from the electronic medical records. The abnormal vaginal discharge of patient was collected for microbiological investigation by bacterial and fungal culture. Descriptive analysis was conducted to evaluate the genital inflammation pattern and epidemiological characteristics, including age, season, and type of infected pathogens. Results A total of 49,175 patients met the eligibility criteria of genital inflammation and 16,320 patients later came to the hospital for follow-up over the study period. The number of first-visit increased gradually from 3,769 in 2011 to 10,155 in 2018. The peak age of the first visit was 0-6 years old. Non-specific vulvovaginitis, lichen sclerosis, and labial adhesion were the top three genital inflammation. Among the top five potential common pathogens of vaginal infection, the prevalence of Haemophilus influenzae cases was the highest (31.42%, 203/646), followed by Streptococcus pyogenes (27.74%, 176/646), Candida albicans (14.09%, 91/646), Escherichia coli (8.51%, 55/646), and Staphylococcus aureus (6.35%, 41/636). The specific disease categories and pathogens of genital inflammation vary by age groups and season. Conclusion Our study summarizes the pattern of pediatric and adolescent female genital inflammation over an 8-year period in China, emphasizing the need for more public awareness, healthcare services and research in this field.
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Affiliation(s)
- Huihui Gao
- Department of Pediatrics and Adolescent Gynecology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yuchen Zhang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yanzheng Pan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Mengjia Zhao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Ye Qi
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Mingming Zhou
- Department of Clinical Laboratory, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Symphorosa S. C. Chan
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, China
| | - Siyi Huang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Peige Song
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Liying Sun
- Department of Pediatrics and Adolescent Gynecology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Changzheng Yuan
- Department of Pediatrics and Adolescent Gynecology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
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Pakkiyaretnam M, Francis VR, Francis GR, Raheem S, Sanjeev R, Rajavarman R, Ramesh R. Demographic Characteristics and Disease Pattern Among Non-COVID-19 Patients Admitted to Medical Units of a Tertiary Care Hospital in Sri Lanka During Lockdown of the COVID-19 Pandemic: A Comparison During and Before Lockdown. Cureus 2023; 15:e45248. [PMID: 37842446 PMCID: PMC10576610 DOI: 10.7759/cureus.45248] [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] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND The COVID-19 infection was rapidly spreading almost all over the world, and the first case was confirmed on 27th January 2020 by a foreign tourist in Sri Lanka. The first Sri Lankan citizen with COVID-19 was confirmed on 11th March 2020. Soon after the confirmation of the disease, long days of lockdown were imposed in almost all parts of the world, including Sri Lanka, to control the spread of the disease. Objectives: To determine the demographic characteristics such as age, sex, number of patients, and disease pattern among non-COVID-19 patients admitted to the medical units during the lockdown of the COVID-19 pandemic and to compare these characteristics with the data before the lockdown. METHODS This was a cross-sectional analytical study. It was conducted at the Teaching Hospital in Batticaloa, Sri Lanka. All the non-COVID-19 patients admitted to medical wards and intensive care units (ICU) were included in this study. Patients admitted to the medical intensive care unit (MICU) and coronary care unit (CCU) were considered ICU admissions in this study. They were studied over a period of one month during lockdown (11th March 2020 to 10th April 2020) and compared with the patients admitted one month prior to the lockdown (11th February 2020 to 10th March 2020). RESULTS Totally, 2340 non-COVID-19 patients (52.5% males) were admitted before the lockdown, and 1376 non-COVID-19 patients (56.2% males) were admitted during the lockdown. This reduction in admission is statistically significant (p-value is <0.001, df=3715). Patients admitted to the wards before lockdown were 2283 (97.6%) and during lockdown were 1309 (95.1%). ICU admissions were N=57 (2.4%) before lockdown and N=67 (4.9%) during lockdown. The common age distribution before the lockdown showed that 26.4% were 31-50 and 41.5% were 51-70 years. Similarly, during lockdown, the age distribution disclosed that 28.9% were 31-50 years and 42.9% were 51-70 years. The disease pattern demonstrated that before lockdown, the majority of patients were admitted for routine hemodialysis (13.2%), to get an injection (9.9%), ischemic heart disease (8.4%), chronic kidney disease (7.3%), and viral fever, including dengue (7.2%). Likewise, during lockdown, more patients were admitted for routine hemodialysis (10.7%), viral fever, including dengue (9.3%), ischemic heart disease (8.8%), to get an injection (8.5%), and chronic kidney disease (5.9%). Conclusion: There was a significant reduction in the number of non-COVID-19-related admissions during the period of lockdown. However, there was not much difference in the proportion of admissions according to gender, age, and disease pattern before and during lockdown. More number of male patients were admitted than female patients. Most of the admitted patients were under the age group of 51-70 years. The highest number of patients were admitted for routine hemodialysis before and during lockdown. However, a slightly higher number of patients were admitted to the ICU during lockdown. Therefore, strengthening the ICU facilities may be an important preparation to accommodate more patients in the future if a similar kind of emergency lockdown occurs in a pandemic situation. In addition, admissions due to non-communicable diseases (NCD) didn't fall in proportion during the pre-COVID-19 period and the lockdown period. Therefore, the redistribution of healthcare facilities needs to be done wisely to face the challenges caused by the NCDs.
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Affiliation(s)
- Mayurathan Pakkiyaretnam
- Department of Clinical Sciences, Faculty of Health-Care Sciences, Eastern University of Sri Lanka, Batticaloa, LKA
- University Medical Unit, Teaching Hospital Batticaloa, Batticaloa, LKA
| | - Vaithehi R Francis
- Department of Pathophysiology, Faculty of Health-Care Sciences, Eastern University of Sri Lanka, Batticaloa, LKA
- Microbiology, Teaching Hospital Batticaloa, Batticaloa, LKA
| | - George Rajeevan Francis
- Department of Clinical Sciences, Faculty of Health-Care Sciences, Eastern University of Sri Lanka, Batticaloa, LKA
- Cardiology, Teaching Hospital Batticaloa, Batticaloa, LKA
| | - Sanooz Raheem
- Department of Clinical Sciences, Faculty of Health-Care Sciences, Eastern University of Sri Lanka, Batticaloa, LKA
| | - Rajavarthani Sanjeev
- Department of Human Biology, Faculty of Health-Care Sciences, Eastern University of Sri Lanka, Batticaloa, LKA
| | - Rajeswaran Rajavarman
- Department of Human Biology, Faculty of Health-Care Sciences, Eastern University of Sri Lanka, Batticaloa, LKA
- Emergency Medicine, Teaching Hospital Batticaloa, Batticaloa, LKA
| | - Ramanathan Ramesh
- General Internal Medicine, Teaching Hospital Batticaloa, Batticaloa, LKA
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Solomon OA, Ibirongbe DO, Solomon OO. Morbidity Pattern Among Adult Patients at the National Health Insurance Scheme Clinic of a Tertiary Hospital, Southwest Nigeria. Cureus 2023; 15:e37529. [PMID: 37193450 PMCID: PMC10182778 DOI: 10.7759/cureus.37529] [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] [Accepted: 04/13/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND For adequate planning of healthcare services, a good knowledge of the burden and pattern of morbidity and mortality in the community is a key requirement. This study aimed at describing the morbidity pattern among patients at a National Health Insurance Scheme (NHIS) clinic in Southwestern Nigeria. METHOD This was a cross-sectional study. Secondary data was extracted from case notes of 5,108 patients who visited the NHIS Clinic in a tertiary health facility in Southwestern Nigeria, from 2014 to 2018, using the International Classification of Primary Care (ICPC-2) to categorize the diseases. Data analysis was done using IBM SPSS Statistics for Windows, Version 25.0 (Released 2018; IBM Corp., Armonk, NY, USA). RESULT Females were 2,741 (53.7%), males were 2367 (46.3%), and the mean age was 36.7±9.5 years. General and unspecified diseases were the commonest presentations. Malaria (1,268; 45.5%) was the commonest disease among the patients. Sex and age were associated with disease distribution (p-value = 0.001). CONCLUSION Public health preventive strategies and measures should be undertaken to address the priority diseases as shown in this study.
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Affiliation(s)
- Olusoji A Solomon
- Department of Family Medicine, Faculty of Clinical Sciences, Ekiti State University, Ado Ekiti, NGA
| | - Demilade O Ibirongbe
- Department of Community Medicine, University of Medical Sciences (UNIMED), Ondo, NGA
| | - Oluremi O Solomon
- Department of Community Medicine, Faculty of Clinical Sciences, Ekiti State University, Ado Ekiti, NGA
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Roomaney RA, van Wyk B, Cois A, Pillay-van Wyk V. Multimorbidity Patterns in a National HIV Survey of South African Youth and Adults. Front Public Health 2022; 10:862993. [PMID: 35444991 PMCID: PMC9015099 DOI: 10.3389/fpubh.2022.862993] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 01/26/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Information pertaining to multimorbidity is frequently informed by studies from high income countries and it is unclear how these findings relate to low and middle income countries, where the burden of infectious disease is high. South Africa has a quadruple burden of disease which includes a high HIV prevalence and a growing burden of non-communicable diseases. This study aimed to analyse the prevalence and patterns (disease classes or clusters) of multimorbidity in South Africa. Methods A secondary analysis of individuals over the age of 15 years who participated in the Fifth South African National HIV Prevalence, Incidence, Behavior and Communication Survey, 2017 (SABSSM 2017) was done. Six disease conditions were identified in the analysis (cancer, diabetes, heart disease, hypertension/high blood pressure, tuberculosis, and HIV). Chi-square tests were used to test for the differences in disease prevalence by sex. Common disease patterns were identified using a latent class analysis. Results The sample included 27,896 participants, of which 1,837 had comorbidity or multimorbidity. When taking population-weighting into account, multimorbidity was present in 5.9% (95% CI: 5.4–6.4) of the population The prevalence of multimorbidity tended to be higher among females and increased with age, reaching 21.9% in the oldest age group (70+). The analyses identified seven distinct disease classes in the population. The largest class was “Diabetes and Hypertension” (36.3%), followed by “HIV and Hypertension” (31.0%), and “Heart disease and Hypertension” (14.5%). The four smaller classes were: “HIV, Diabetes, and Heart disease” (6.9%), “TB and HIV” (6.3%), “Hypertension, TB, and Cancer” (2.8%), and “All diseases except HIV” (2.2%). Conclusion As the South African population continues to age, the prevalence of multimorbidity is likely to increase which will further impact the health care system. The prevalence of multimorbidity in the population was relatively low but reached up to 20% in the oldest age groups. The largest disease cluster was the combination of diabetes and hypertension; followed by HIV and hypertension. The gains in improving adherence to antiretrovirals amongst treatment-experienced people living with HIV, should be expanded to include compliance with lifestyle/behavioral modifications to blood pressure and glucose control, as well as adherence to anti-hypertension and anti-diabetic medication. There is an urgent need to improve the early diagnosis and treatment of disease in the South African population.
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Affiliation(s)
- Rifqah Abeeda Roomaney
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.,School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Brian van Wyk
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Annibale Cois
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.,Division of Health Systems and Public Health, Department of Global Health, University of Stellenbosch, Stellenbosch, South Africa
| | - Victoria Pillay-van Wyk
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
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Chen A, Stein R, Baldassano RN, Huang J. Learning Longitudinal Patterns and Subtypes of Pediatric Crohn Disease Treated With Infliximab via Trajectory Cluster Analysis. J Pediatr Gastroenterol Nutr 2022; 74:383-388. [PMID: 34908016 PMCID: PMC8885908 DOI: 10.1097/mpg.0000000000003370] [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] [Indexed: 12/10/2022]
Abstract
BACKGROUND The objective of this study is to identify subgroups of pediatric Crohn disease (CD) who had differential responses to the infliximab treatment through trajectory cluster analysis of disease activity using data from electronic health records. METHODS We conducted a retrospective study of 295 pediatric patients with CD who had been treated with infliximab for a minimum of one year at the Center for Inflammatory Bowel Disease at The Children's Hospital of Philadelphia between January 2010 and December 2017. The evolution of disease was described, and subgroups of patients were identified using trajectory analysis of longitudinal data of C-reactive protein (CRP). We compared patient characteristics, biomarker for disease activity, and long-term surgical outcomes across subgroups. Cox regression models were used to evaluate the added value of the subgroup classification to baseline phenotype and location in prediction of long-term surgical outcomes. RESULTS We identified three subgroups of patients with differential relapse-and-remission profiles (n = 33, 65 and 197 from subgroup 1 to 3), which represented patients with a higher risk of infliximab non-response, with infliximab response but with occasional disease flares, and patients with long-term response. Patients with the best treatment response had a significantly lower frequency of complicated disease phenotypes (P = 0.01), including perianal involvement (P = 0.05), lower baseline CRP (P < 0.01) and calprotectin (P = 0.01), and lowest risk of IBD-related gastrointestinal surgery within 10 years of starting treatment (P < 0.01). CONCLUSIONS Readily available longitudinal data from electronic health records can be leveraged to provide deeper characterization of treatment response in pediatric CD.
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Affiliation(s)
- Andrew Chen
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Ronen Stein
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania
| | - Robert N. Baldassano
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania
| | - Jing Huang
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA
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Yao L, Dong W, Wan JY, Howard SC, Li M, Graff JC. Graphical Trajectory Comparison to Identify Errors in Data of COVID-19: A Cross-Country Analysis. J Pers Med 2021; 11:955. [PMID: 34683095 DOI: 10.3390/jpm11100955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022] Open
Abstract
Data from the early stage of a novel infectious disease outbreak provide vital information in risk assessment, prediction, and precise disease management. Since the first reported case of COVID-19, the pattern of the novel coronavirus transmission in Wuhan has become the interest of researchers in epidemiology and public health. To thoroughly map the mechanism of viral spreading, we used the patterns of data at the early onset of COVID-19 from seven countries to estimate the time lag between peak days of cases and deaths. This study compared these data with those of Wuhan and estimated the natural history of disease across the infected population and the time lag. The findings suggest that comparative analyses of data from different regions and countries reveal the differences between peaks of cases and deaths caused by COVID-19 and the incomplete and underestimated cases in Wuhan. Different countries may show different patterns of cases peak days, deaths peak days, and peak periods. Error in the early COVID-19 statistics in Brazil was identified. This study provides sound evidence for policymakers to understand the local circumstances in diagnosing the health of a population and propose precise and timely public health interventions to control and prevent infectious diseases.
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Abghari-Gerst M, Armstrong WR, Nguyen K, Calais J, Czernin J, Lin D, Jariwala N, Rodnick M, Hope TA, Hearn J, Montgomery JS, Alva A, Reichert ZR, Spratt DE, Johnson TD, Scott PJH, Piert M. A comprehensive assessment of 68Ga-PSMA-11 PET in biochemically recurrent prostate cancer: Results from a prospective multi-center study in 2005 patients. J Nucl Med 2021; 63:567-572. [PMID: 34326126 PMCID: PMC8973291 DOI: 10.2967/jnumed.121.262412] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 04/08/2021] [Revised: 06/28/2021] [Indexed: 11/16/2022] Open
Abstract
We prospectively investigated the performance of the prostate-specific membrane antigen (PSMA) ligand 68Ga-PSMA-11 for detecting prostate adenocarcinoma in patients with elevated prostate-specific-antigen (PSA) after initial therapy. Methods: 68Ga-PSMA-11 hybrid positron emission tomography (PET) was performed in 2005 patients at the time of biochemical recurrent prostate cancer (BCR) following either radical prostatectomy (RP) (50.8 %), definitive radiation therapy (RT) (19.7 %), or RP with post-operative RT (PORT) (29.6 %). Presence of prostate cancer was assessed qualitatively (detection rate = positivity rate) and quantitatively on a per-patient and per-region basis creating a disease burden estimate from presence or absence of local (prostate/prostate bed), nodal (N1: pelvis) and distant metastatic (M1: distant soft tissue and bone) disease. The primary study endpoint was the positive predictive value (PPV) of 68Ga-PSMA-11 PET/CT confirmed by histopathology. Results: Following prostatectomy, the scan detection rate increased significantly with rising PSA levels (44.8 % at PSA < 0.25 to 96.2 % at PSA > 10 ng/mL; P < 0.001). The detection rate significantly increased with rising PSA levels in each individual region, overall disease burden, prior androgen deprivation, clinical T-stage, and Gleason grading from prostatectomy specimen (P < 0.001). Following RT, the detection rate for in-gland prostate recurrence was 64.0 % compared to 20.6 % prostate bed recurrences after RP and 13.3 % following PORT. PSMA-positive pelvic nodal disease was detected in 42.7 % following RP, in 40.8 % after PORT and 38.8 % after RT. In patients with histopathologic validation the PPV per-patient was 0.82 (146/179). The SUVmax of histologically proven true positive lesions was significantly higher than false positive lesions (median 11.0 (IQR 6.3 - 22.2) vs 5.1 (IQR 2.2 - 7.4) P < 0.001). Conclusion: We confirmed a high PPV of 68Ga-PSMA-11 PET in BCR and the PSA level as the main predictor of scan positivity.
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Affiliation(s)
| | - Wesley Robert Armstrong
- Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, UCLA
| | - Kathleen Nguyen
- Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, UCLA
| | - Jeremie Calais
- Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, UCLA
| | - Johannes Czernin
- Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, UCLA
| | - David Lin
- Department of Radiology and Biomedical Imaging, UCSF
| | | | | | - Thomas A Hope
- Department of Radiology and Biomedical Imaging, UCSF
| | - Jason Hearn
- Department of Radiation Oncology, University of Michigan
| | | | - Ajjai Alva
- Internal Medicine Department, University of Michigan
| | | | | | | | | | - Morand Piert
- Radiology Department, University of Michigan, United States
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Pu JJ, McGrath CP, Leung YY, Choi WS, Yang WF, Li KY, Su YX. The Impact of Coronavirus Disease 2019 on the Disease Pattern of Oral and Maxillofacial Surgery Inpatients: A Comparative Study. Front Med (Lausanne) 2021; 8:613663. [PMID: 33996845 PMCID: PMC8116897 DOI: 10.3389/fmed.2021.613663] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 10/03/2020] [Accepted: 03/19/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: Oral and maxillofacial surgery (OMFS) is a high-risk specialty involving airway and aerosol-generating procedures, which is potentially of more risk in the era of coronavirus disease 2019 (COVID-19). We aimed to identify the impact of COVID-19 on the disease pattern of OMFS inpatients and surgeries under general anesthesia in a comparative study. Materials and Methods: We reviewed the admission and operating theater records of OMFS patients from Jan 1 to Aug 31 in 2020 and 2019. The total number of cases, presenting disease patterns, and proportion of essential and non-essential medical services were compared between 2020 and 2019. Results: There were 664 admissions and 356 general anesthesia surgical procedures included in this study. Both admission and surgery numbers were significantly reduced in 2020, compared with 2019 (p = 0.012 and 0.007, respectively). The proportion of malignancy cases increased significantly, whereas that of cleft lip and palate and temporomandibular disorder (TMD) decreased. There was a significant increase in the proportion of essential services compared with non-essential services in 2020 compared with 2019. Conclusion: Our results first reported the epidemiological data of the impact of COVID-19 on OMFS disease pattern in a comparative study. The change of disease pattern and caseload will have a long-term impact on OMFS patient care, education, and training during the pandemic. Our paper provides evidence for health policy makers to consider the relocation of medical resources and optimization of medical education and services.
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Affiliation(s)
- Jingya Jane Pu
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Colman Patrick McGrath
- Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Yiu Yan Leung
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Wing Shan Choi
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Wei-Fa Yang
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Kar Yan Li
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Yu-Xiong Su
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
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Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of Type 2 Diabetes - Global Burden of Disease and Forecasted Trends. J Epidemiol Glob Health 2021; 10:107-111. [PMID: 32175717 PMCID: PMC7310804 DOI: 10.2991/jegh.k.191028.001] [Citation(s) in RCA: 1027] [Impact Index Per Article: 342.3] [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: 06/26/2019] [Accepted: 10/27/2019] [Indexed: 12/15/2022] Open
Abstract
The rising burden of type 2 diabetes is a major concern in healthcare worldwide. This research aimed to analyze the global epidemiology of type 2 diabetes. We analyzed the incidence, prevalence, and burden of suffering of diabetes mellitus based on epidemiological data from the Global Burden of Disease (GBD) current dataset from the Institute of Health Metrics, Seattle. Global and regional trends from 1990 to 2017 of type 2 diabetes for all ages were compiled. Forecast estimates were obtained using the SPSS Time Series Modeler. In 2017, approximately 462 million individuals were affected by type 2 diabetes corresponding to 6.28% of the world’s population (4.4% of those aged 15–49 years, 15% of those aged 50–69, and 22% of those aged 70+), or a prevalence rate of 6059 cases per 100,000. Over 1 million deaths per year can be attributed to diabetes alone, making it the ninth leading cause of mortality. The burden of diabetes mellitus is rising globally, and at a much faster rate in developed regions, such as Western Europe. The gender distribution is equal, and the incidence peaks at around 55 years of age. Global prevalence of type 2 diabetes is projected to increase to 7079 individuals per 100,000 by 2030, reflecting a continued rise across all regions of the world. There are concerning trends of rising prevalence in lower-income countries. Urgent public health and clinical preventive measures are warranted.
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Affiliation(s)
- Moien Abdul Basith Khan
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Muhammad Jawad Hashim
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Jeffrey Kwan King
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Romona Devi Govender
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Halla Mustafa
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Juma Al Kaabi
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
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Minnaar CA, Baeyens A, Ayeni OA, Kotzen JA, Vangu MDT. Defining Characteristics of Nodal Disease on PET/CT Scans in Patients With HIV-Positive and -Negative Locally Advanced Cervical Cancer in South Africa. ACTA ACUST UNITED AC 2020; 5:339-345. [PMID: 31893232 PMCID: PMC6935993 DOI: 10.18383/j.tom.2019.00017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Indexed: 11/29/2022]
Abstract
Literature reports increased FDG nodal uptake in HIV-positive patients. Our aim is to identify differences in presentation and characteristics of FDG-avid lymph nodes between HIV-positive and HIV-negative locally advanced cervical cancer (LACC) patients in our clinical setting. We evaluated 250 pre-treatment 18F-FDG PET/CT imaging studies from women screened for a phase III randomised controlled trial investigating modulated electro-hyperthermia as a radiosensitiser (Ethics approval: M120477). The number of nodes; size; maximum standardised uptake value (SUVmax); symmetry; and relationship between nodal size and SUVmax uptake, were assessed by region and by HIV status. In total, 1314 nodes with a SUVmax ≥ 2.5 were visualised. Of 128(51%) HIV-positive participants, 82% were on antiretroviral therapy (ART) and 10 had a CD4 count <200 cells/µL. Overall pattern of presentation and nodal characteristics were similar between HIV-positive and -negative groups and the uniformity in presentation of the nodes draining the cervix strongly suggests these nodes may be attributed to malignancy rather than HIV infection. Novel findings: HIV infection is associated with: >four nodes visualised in the neck, symmetrical inguinal lymph nodes, increased rates of supraclavicular node visualisation; FDG-avid axillary nodes were more common, but not exclusive, in HIV-positive participants. 18F-FDG PET/CT is a reliable staging method for LACC in HIV-positive patients who are not in acute stages of HIV infection, have a CD4 count >200 cells/µL, and/or are on ART and there is a potential risk of underestimating metastatic spread by attributing increased nodal metabolic activity to HIV infection in these patients.
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Affiliation(s)
- Carrie Anne Minnaar
- Division of Radiobiology, Department of Radiation Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ans Baeyens
- Division of Radiobiology, Department of Radiation Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Division of Radiobiology, Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Olusegun Akinwale Ayeni
- Department of Nuclear Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Jeffrey Allan Kotzen
- Department of Radiation Oncology, Wits Donald Gordon Medical Centre, Johannesburg, South Africa; and
| | - Mboyo-Di-Tamba Vangu
- Department of Nuclear Medicine, Department of Radiation Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Mittal P, Agarwal SK, Singh G, Bhowmik D, Mahajan S, Dinda A, Bagchi S. Spectrum of biopsy-proven renal disease in northern India: A single-centre study. Nephrology (Carlton) 2019; 25:55-62. [PMID: 30834630 DOI: 10.1111/nep.13582] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 02/26/2019] [Indexed: 01/10/2023]
Abstract
AIM Pattern of kidney diseases varies across geographies due to multiple factors. There is a paucity of information from South Asia due to the absence of nationwide/regional biopsy registries. This study aimed to delineate the spectrum of renal parenchymal diseases in our region. METHODS Records of kidney biopsies done in our nephrology department between 2006 and 2016 were analysed. Clinico-pathological correlation was done from the available records. RESULTS Of the 3275 biopsy evaluated, 61.9% were males, and mean age was 33.2 ± 14.2 years. 6.2% patients were elderly (age ≥ 60 years). Nephrotic syndrome (60.3%) was the commonest indication for biopsy. On histology, 73.0% patients had primary glomerulonephritis (GN), 15.5% secondary GN, 5.3% tubulo-interstitial and 3.7% vascular disease. Focal segmental glomerulosclerosis (FSGS) was the commonest primary GN accounting for 18.2% of all GNs, followed by minimal change disease (16.8%), membranous nephropathy (MN) (16.0%) and IgA nephropathy (10.4%). Lupus nephritis (10.6%) and amyloidosis (3.7%) were the commonest secondary GN. The commonest cause of nephrotic syndrome was minimal change disease (22.9%), acute nephritic syndrome was lupus nephritis (30.6%), rapidly progressive renal failure was pauci-immune crescentic GN (24.5%). IgA nephropathy was the commonest etiology of asymptomatic urinary abnormalities (26.3%) and gross haematuria (50%). About 60.9% patients of undetermined chronic kidney disease had glomerular diseases, and 13.6% had chronic tubulointerstitial nephritis. Lupus nephritis and acute cortical necrosis were significantly more common in females compared with males. CONCLUSION This is one of the largest cohorts of kidney biopsies from India, and it delineates the unique features and differences in the pattern of kidney disease in our population.
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Affiliation(s)
- Parmod Mittal
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay K Agarwal
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | - Geetika Singh
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Dipankar Bhowmik
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Mahajan
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Dinda
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Soumita Bagchi
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
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Morani AC, Bathala TK, Surabhi VR, Yedururi S, Jensen CT, Huh WW, Prasad S, Hayes-Jordan A. Desmoplastic Small Round Cell Tumor: Imaging Pattern of Disease at Presentation. AJR Am J Roentgenol 2019; 212:W45-54. [PMID: 30673334 DOI: 10.2214/AJR.18.20179] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The purpose of this study is to evaluate the clinical, pathologic, and multimodality cross-sectional imaging features of a cohort of 94 patients with desmoplastic small round cell tumor (DSRCT). MATERIALS AND METHODS This retrospective study of 94 patients with pathologically verified DSRCT was conducted at a tertiary cancer center between 2001 and 2013. Epidemiologic, clinical, pathologic, and imaging findings were recorded. Tumor size, location, and shape and the distribution pattern of metastases at presentation were analyzed. RESULTS DSRCT most often occurred in young patients (median age, 21.5 years; range, 5-53 years), showing a marked predominance in male patients (86 male patients vs eight female patients). Eighty nine-patients (95%) were white (defined in this study as white or Hispanic), four were African American, and one was of Asian descent. Most patients had symptoms, with abdominal pain noted as the most common symptom. At initial presentation, 85 patients (90%) had multifocal disease, nodular disease, diffuse omental and peritoneal disease, or a combination of these conditions. Thirty-eight patients (40%) had diaphragmatic involvement. Thirty-two patients (34%) had liver metastases, and 49 patients (52%) had retroperitoneal involvement in the form of implants, tumoral extension, or nodal involvement. With regard to thoracic findings, 33 patients (35%) had nodal disease, 17 (18%) had pleural effusions, and only two (2%) had lung metastases at presentation. Twelve patients (13%) had calcified lesions. CONCLUSION DSRCT is a rare, multifocal peritoneal malignancy with frequently disseminated abdominal disease at presentation. In the abdomen, disease most commonly involves the omentum and peritoneum, followed by the retroperitoneum. The liver is the most common solid visceral metastatic site. A substantial number of patients have diaphragmatic involvement. In the thorax, nodal and pleural involvement is more common than lung involvement.
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Tabbal AOA, Humedi SSA. Surveillance of the Most Prevalent Medical Diseases among Pediatric Age Groups and Evaluation of the Control Measures Used At Tabuk Hospitals, Saudi Arabia. Open Access Maced J Med Sci 2017; 5:182-187. [PMID: 28507625 PMCID: PMC5420771 DOI: 10.3889/oamjms.2017.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 01/17/2017] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND: During the last decades, medical recordings has increased dramatically leading to more awareness of the diseases commonly affecting paediatric age groups opening a wide entrance to the prevention of possible complications and decrease its incidence. AIM: This article aims to assess the prevalence of the commonly encountered paediatric medical diseases by affected system among admitted paediatric patients of different age groups in Tabuk and to identify their burden. METHODS: This is a retrospective research studying disease pattern according to age, gender, nationality, admission status and length of stay. RESULTS: Admissions due to respiratory system disorders were the most common among children under the age of six years (39.7%). Acute gastroenteritis was the most common disease leading to hospitalisation of children below the age of three years and cast a financial burden heavily on family and society. CONCLUSIONS: Respiratory diseases and acute gastroenteritis constitute a significant burden of childhood illnesses in Tabuk City. Efforts are required to reduce the impact to achieve the Saudi ministry of health (SMOH) Goal. Even though Rota vaccine is added to the national Saudi program of vaccination schedule, other causes should be looked for, and preventive measures are important as a part of public education.
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Abstract
In recent years, homelessness has been recognized as a growing urban social problem in various countries throughout the world. The health problems of the homeless are considerable. The purpose of this study was to elicit, with sociodemographic profiles, the disease patterns among Tokyo's homeless. The subjects were 1,938 men who stayed at a welfare institution from 1992 to 1996. Diagnosed diseases/injuries and sociodemographic profiles were analyzed. The disease patterns of the homeless were compared to those of the male general population. Of the subjects, 8.3% were admitted to the hospital; 64.0% received outpatient care. Their observed morbidity rates by disease category were greater than those of the male general population in both Japan and Tokyo. Comorbidity of alcoholic psychosis/alcohol-dependent syndrome to both liver disease and pulmonary tuberculosis were greater than the average (P < .01). Construction work brought a higher risk of pulmonary tuberculosis (odds ratio = 2.0) and dorsopathies (odds ratio = 1.4) than did other jobs (P < .05). Disease patterns among the homeless in Tokyo were characterized by alcoholic psychosis/alcohol-dependence syndrome; liver disease; pulmonary tuberculosis; diabetes mellitus; fractures, dislocations, sprains, strains; hypertension; and cerebrovascular disease. Although the sociodemographic backgrounds of Tokyo's homeless have become more diverse, the principal occupation of the homeless was unskilled daily construction work, which underlay the characteristics of their disease patterns.
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Affiliation(s)
- T Takano
- Department of Public Health and Environmental Science, School of Medicine, Tokyo Medical and Dental University, Japan.
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