Annual Incidence Rate Research Articles

Analysis of the Seasonal Distribution Characteristics of Hand, Foot, and Mouth Disease in a Southern China

Hand, foot, and mouth disease (HFMD) is a common infectious disease affecting children, particularly prevalent in Asian countries. In a city in southern China, the annual number of HFMD cases exceeds 40,000, yet this data has not been thoroughly analyzed to date. The Chinese Center for Disease Control and Prevention collected data on HFMD cases in this southern city from 2014 to 2019, with cases recorded on a monthly basis. We aimed to analyze the seasonal distribution characteristics of HFMD in the city using two methods: the Concentration Method and the Seasonal Index Method. The study aims to fill the existing data gap and provide insights for developing effective prevention and control strategies. Over the six-year period from 2014 to 2019, a total of 187,887 cases of HFMD were reported in the province. The average annual incidence rate was 48.94 per 100,000 population. The concentration ratio (M) was calculated to be 0.335, with annual M values ranging from 0.151 to 0.554, indicating a significant degree of seasonality in the incidence of HFMD. The seasonal index (C) exceeded 100% from April to July, peaking in June at 228.418%, which suggests that the epidemic season for HFMD in this city is from April to July. Given the distinct seasonal characteristics of HFMD in the southern city, it is imperative that prevention and control measures are implemented in advance of the peak season. Concurrently, robust surveillance and early warning systems should be maintained to mitigate the spread of HFMD and prevent outbreaks.

Genome Analysis of Japanese Yersinia pseudotuberculosis Strains Isolated From Kawasaki Disease Patients and Other Sources and Their Phylogenetic Positions in the Global Y. pseudotuberculosis Population.

Yersinia pseudotuberculosis (Ypt) is a gram-negative bacterium that infects both humans and animals primarily through fecal‒oral transmission. While Ypt causes acute gastroenteritis in humans, an association with Kawasaki disease (KD), a disease that primarily affects infants and young children and causes multisystemic vasculitis, has also been suspected. Although KD represents a significant health concern worldwide, the highest annual incidence rate is reported in Japan. Previously, a geographical origin-dependent population structure of Ypt comprising the Asian, transitional, and European clades was proposed. However, genomic data on KD-associated Ypt strains is currently unavailable. In this study, to analyze the phylogenetic and genomic features of KD-associated strains, we determined the whole-genome sequences of 35 Japanese Ypt strains, including 11 KD-associated strains, and constructed a genome set (n = 204) representing the global population of Ypt by adding publicly available Ypt genomes. In a phylogenetic analysis, all sequenced Japanese strains, including the KD-associated strains, belonged to the Asian clade, which appeared to be the ancestral clade of Ypt, and the KD-associated strains belonged to multiple lineages in this clade. Strains from patients with Far East scarlet-like fever (FESLF), a KD-related disease, also belonged to the Asian clade. Moreover, no KD strain-specific genes were identified in pan-genome-wide association study analyses. Notably, however, the gene encoding a superantigen called Yersinia pseudotuberculosis-derived mitogen (YPM) showed a distribution pattern highly biased to the Asian clade. Although further studies are needed, our results suggest that Asian clade strains may have a greater potential to trigger KD.

Socioeconomic Burden of Pulmonary Embolism in Europe: Shifting Priorities and Challenges for Novel Reperfusion Strategies.

In-hospital case fatality related to acute pulmonary embolism (PE) has been falling since the beginning of this century. However, annual incidence rates continue to climb, and an increasing number of PE survivors need long-term follow-up, chronic anticoagulation treatment, and readmission(s) to the hospital. In European countries, median reimbursed hospital costs for acute PE are still moderate compared with the United States but can increase several-fold in patients with comorbidities and those necessitating potentially life-saving reperfusion treatment. The use of catheter-directed treatment (CDT) has constantly increased in the United States since the past decade, and it has now entered a rapid growth phase in Europe as well, estimated to reach an annual penetration rate of up to 31% among patients with intermediate-high- or high-risk PE by 2030. Ongoing randomised controlled trials are currently investigating the clinical efficacy and safety of these devices. In addition, they will deliver data permitting calculation of their cost-effectiveness in different health care reimbursement systems, by revealing the extent to which they can reduce complications and consequently the need for intensive care and the overall length of hospital stay. After discharge, key cost drivers are related to chronic cardiopulmonary diseases (other than PE itself) leading to frequent readmissions, persistent symptoms, and functional limitations which result in poor quality of life, productivity loss, and substantial indirect costs. Implementation of structured outpatient programmes with a holistic approach to post-PE care, targeting overall cardiovascular health and the patient's well-being, bears the potential to cost-effectively reduce the overall socioeconomic burden of PE.

Trends in cutaneous melanoma mortality and incidence in European Union 15+ countries between 1990 and 2019.

Cutaneous melanoma (CM) is the leading cause of skin cancer mortality with associated high healthcare costs. Up-to-date reporting of epidemiological trends for CM is required to project future trends, assess the burden of disease and aid evaluation of new diagnostic, therapeutic and preventative strategies. To describe the trends in CM mortality, incidence, mortality-to-incidence indices (MIIs) and disability-adjusted life years (DALYs) over the last three decades. A population-based cross-sectional study of the Global Burden of Disease (GBD) database between 1990 and 2019 was performed. Nineteen high-income countries with similar health expenditure and classified as having high-quality mortality data including the United Kingdom, the United States, Australia and selected European Union countries were included. Annual age-standardized incidence rates (ASIRs), age-standardized death rates (ASDRs) and DALYs for each country were extracted. Mortality-to-incidence indexes were calculated by dividing the ASDR by the ASIR. Trends were described using Joinpoint regression analysis. Almost all countries demonstrated increasing ASDR in males over the observation period with greatest percentage increase in Greece (+87%), and there was greater heterogeneity between countries in females. CM mortality was greater for males than females in all countries. Most recent Joinpoint analysis shows significantly decreasing mortality in all countries except the United Kingdom (+0.5% males between 2007 and 2019, +0.1% females between 2002 and 2019). Incidence rates increased in all countries, with evidence of plateau from 2015 onwards. While MIIs cannot be used as a proxy for survival, statistically significant decreases in MII were observed in all countries. Overall, DALYs remained static. Over the past 30 years, CM mortality and incidence has increased in most EU15+ countries. There is evidence that in recent years, CM mortality is decreasing. The burden of disease as assessed using DALYs has remained mostly unchanged. Future work should not solely focus on expensive innovative therapies, but also on optimizing primary prevention.

The epidemiologic trend of multiple sclerosis in Razavi Khorasan Province, Iran in fifteen-year period.

Multiple sclerosis (MS) is a major global health problem as a growing debilitating disease and according to the Global Burden of Diseases study in 2016 has had a 40 % prevalence increase in Iran during the 3 previous decades; far more from the Global prevalence which only increased about 10 %. Razavi Khorasan is the second most populous province in Iran with over 6.5 million people and its MS status is not clear; therefore, this study aims to define the current epidemiologic trend of MS in Razavi Khorasan METHODS AND MATERIALS: We performed this cross-sectional, analytical study in Khorasan Razavi Multiple sclerosis Center during 2021-2023. The data was extracted from the registry system for MS patients held in the center. The cases were all MS patients of the province numbered 4723. The sex- and age- standardized ratios were measured and the annual incidence and prevalence rates of MS were calculated using the province population information and so the epidemiologic trend of MS in the province was obtained. Of over 4700 MS patients in the province in 2021, 78 % were female. More than 40 % had academic education. In 2021 most patients lived in their 4th (about 40 %) and 5th (about 28 %) decades of life. Most of the patients were aged 20-29 years (37 %) and 30-39 years (34 %) at the time of diagnosis and the average duration of disease was 7 years among all patients until 2021. The annual incidence in Khorasan Razavi rose gradually from 1.57 to 6.40 person-years during 2006-2020; with a steeper slope in females compared with males. The prevalence of MS in 2021 was about 71.7 per 100,000 population (112.7 for females and 31.3 for males), approximately 80 % more than the prevalence in 2006 relative to population growth. There is an upward trend of multiple sclerosis in Razavi Khorasan; which is probably one of the fastest growth patterns in the region because it has been about two-fold as fast as in Tehran with the highest prevalence rates in Iran. Therefore, there should be extensive plans for managing the disease with secondary prevention in the coming years to decrease the complications and disabilities associated with disease progression.

Trends in the incidence of the Epstein-Barr virus-associated malignancies extranodal NK/T-cell lymphoma and nasopharyngeal carcinoma in Taiwan.

Nasopharyngeal carcinoma (NPC) and extranodal NK/T-cell lymphoma (ENKTL) are associated with the Epstein-Barr virus (EBV). The current study aimed to evaluate the trends in the incidence of ENKTL and NPC in Taiwan within the last 15-30 years. To assess the incidence of ENKTL from 2008 to 2021 and NPC from 1995 to 2021, an epidemiological study was performed using population-based registry data from the Taiwan Cancer Registry. The secular trends in the annual incidence rates were expressed as average annual percent change (AAPC). During the study period, 872 new ENKTL diagnoses and 39412 new NPC diagnoses were reported. The annual age-adjusted incidence rates of ENKTL and NPC decreased significantly, with an AAPC of -2.47 (p = 0.014) and -1.16 (p < 0.001), respectively. The incidence rates of NPC from 1995 to 2021 in the 20-44-, 45-64-, and ≥65-year-old age groups decreased from 5.23 to 4.42 per 100,000 person-years (AAPC = -0.45, p = 0.011), from 15.28 to 11.36 per 100,000 person-years (AAPC = -1.21, p < 0.001), and from 10.48 to 7.24 per 100,000 person-years (AAPC = -1.91, p < 0.001), respectively. The age-specific incidence rates of ENKTL in the 45-64-year-old age group significantly decreased from 0.46 to 0.32 per 100,000 person-years during 2008-2021 (AAPC = -3.37, p = 0.008). The incidence of ENKTL between 2008 and 2021 in the 20-44- and ≥65-year-old age groups also decreased from 0.16 to 0.11 per 100,000 person-years and from 0.87 to 0.79 per 100,000 person-years, respectively. Interestingly, the EBV seroprevalence in Taiwan remained stable from 1984 to 2007. Nonetheless, there was a downward trend in the EBV seroprevalence in early childhood, with a decrease of approximately 20% in children aged 4 years and nearly 50% in children aged <2 years. Based on these findings, the downward trend in the incidence of NPC/ENKTL could be affected by the decline in early EBV infection rates. Considering that the EBV seroprevalence remained stable but the incidence rate of early EBV infection decreased during the same period, delayed EBV infection or factors other than EBV might play an important role in the downward trend in the incidence of NPC/ENKTL in Taiwan. Nevertheless, further investigations should be performed to assess these results.

Increasing Incidence of Apple Valsa Canker and Predominance of Cytospora mali in Gyeongsangbuk-do, South Korea

From 2015 to 2023, a survey was conducted to determine the occurrence of apple Valsa canker disease in major apple-producing regions in Korea. Infected branches were collected for the isolation and identification of the pathogens. During the survey period, a total of 38 fungal strains were isolated from trees infected with apple Valsa canker disease. A phylogenetic analysis using a combined dataset of the internal transcribed spacer (ITS) region and large subunit (LSU), actin (act1), RNA polymerase II (rpb2), and translation elongation factor 1-α (tef1-α) gene sequences was performed, identifying all of the isolates as Cytospora mali. According to the survey, the average annual incidence rate of apple Valsa canker disease was 2.8%. The infection rate was 2.2% in 2015, and it showed a decreasing trend until 2017. However, in 2018, the incidence rate began to gradually increase, reaching 4.2% in 2022 and sharply rising to 6.8% in 2023. The increasing incidence of apple Valsa canker disease is causing significant economic damage to apple producers, highlighting the need for effective control measures. Although a total of 21 pathogen species causing apple Valsa canker disease have been reported in East Asia, this study confirmed that C. mali is the dominant species causing the disease in Korea.

Understanding the exodus: a 15-year retrospective cohort study on the pattern and determinants of migration among Nigerian doctors and dentists

ABSTRACT Background Nigeria faces a critical shortage of healthcare professionals yet experiences a significant annual exodus of doctors and dentists. This alarming trend threatens the country’s ability to provide equitable healthcare. Objective This study investigated the patterns and determinants of migration among doctors and dentists who graduated from the University of Benin, Nigeria, 15 years ago. Methods We conducted a retrospective cohort study that tracked 274 of the 379 (72.3%) eligible cohort. We computed the migration incidence rate per person-year from 2008 to 2023, covering 3,455 person-years of follow-up and analysed migration drivers as push and pull factors across macro-, meso-, and micro-levels. Results Fifteen years post-graduation, 48.9% (134/274) of the cohort had migrated. While the annual incidence rate of migration remained stable for the first 8 years, it spiked after 2016, reaching 11.4 per 100 person-years in 2023. Among those who migrated, the majority (96.3%, 129/134) relocated outside the African continent. The top three destination countries were the UK (48.5%, 65/134), Canada (20.9%, 28/134), and the USA (19.4%, 26/134). The leading push factors were insecurity of lives and property (57.8%), concerns about children’s futures (50.3%), and limited career development opportunities (45.9%). The primary pull factors included security (56.3%), permanent residency (49.6%), and better pay in the destination country (46.7%). Significant predictors of migration included younger age, timing of marriage, and residency training status. Conclusions To avert an impending crisis, the Nigerian government must address the root causes driving the increasing migration of doctors and dentists.

Incidence and outcomes of in-hospital resuscitation for cardiac arrest among paediatric patients in Jordan: a retrospective observational study.

To investigate the incidence and survival rates of paediatric patients receiving resuscitation for in-hospital cardiac arrest (IHCA) in a teaching hospital in Northern Jordan, comparing initial pulseless rhythms and bradycardia rhythm with poor perfusion. Retrospective observational study SETTING: An university-affiliated tertiary hospital in Northern Jordan, covering January 2015 to December 2022. All hospitalised paediatric patients aged 1 month-18 years who received cardiopulmonary resuscitation (CPR) for cardiac arrest were included in the study. Resuscitation attempts were categorised into initial pulseless rhythm events and bradycardia with poor perfusion events. Incidence rate of paediatric CPR and the survival to hospital discharge rate. A total of 504 paediatric patients received CPR during the study period, with an incidence rate of 6.26 per 1000 paediatric admissions. The annual incidence rate was significantly reduced by an average of 5.5% for the total sample but increased by 25.0% for bradycardia events (n=110, 21.8%). The percentage of patients who sustained return of spontaneous circulation (ROSC) was 25.0%. Survival to hospital discharge was low at 4.8% while showing an increasing trend by an average of 24.0% per year. Bradycardia events had a significantly higher ROSC rate (34.6% vs 22.3%); but an insignificant higher survival rate (6.4 vs 4.3). Patients with neurological or cardiovascular medical conditions, those in non-intensive care unit departments, and those with respiratory causes had higher odds of survival to discharge. While the incidence rate of paediatric IHCA in Jordan is comparable to developed countries, the survival rate is much poorer. The study highlights the importance of strengthening healthcare infrastructure, establishing national legal and ethical frameworks around resuscitation policies and establishing robust data registries to monitor and optimise care practices.

Blue light cystoscopy- as an improvised diagnostic modality for bladder tumours

Bladder cancer remains a significant global health concern, being the 10th most common malignancy worldwide and the 6th most common neoplasia in males, with alarming annual incidence and mortality rates. The current narrative review was planned to delve into the multifaceted landscape of bladder cancer, exploring its epidemiology, risk factors and diagnostic modalities. While white light cystoscopy has long been considered the gold standard for bladder cancer diagnosis and surveillance, the emergence of blue light cystoscopy has ushered in a new era of early detection. Numerous studies have demonstrated BLC's superiority in reducing the risk of progression and recurrence of this lethal cancer. However, the widespread adoption of this technology remains elusive. Recent advancements in diagnostic procedures have revolutionised imaging modalities, with blue light cystoscopy and narrow-band imaging emerging as promising replacements for white light cystoscopy. Clinical trials have underscored the superior performance of blue light cystoscopy over white light cystoscopy, with reduced recurrence and progression rates. For non-muscle invasive bladder cancer, Bacillus Calmette-Guérin immunotherapy remains the gold standard adjuvant therapy, while cystectomy is considered for cases resistant to Bacillus Calmette-Guérin or with a high risk of progression. Transurethral resection of bladder tumour followed by intravesical chemotherapy is a key intervention for early-stage bladder cancer. Blue light cystoscopy is poised to overcome the limitations of white light cystoscopy by providing comprehensive visualisation of neoplastic boundaries, particularly benefiting late-detected squamous-type non-muscle invasive urothelial carcinomas associated with lower survival rates. The current findings highlighted the transformative potential of blue light cystoscopy and other emerging diagnostic techniques, offering a ray of hope in the battle against bladder cancer, while emphasising the need for wider adoption and integration into clinical practice. Key Words: Bladder carcinoma, Blue light cystoscopy, White light cystoscopy, Urothelial carcinoma, Non-muscle invasive carcinoma, Narrow-band imaging.

The epidemiology and clinical presentation of seropositive neuromyelitis optica spectrum disorder in a US population.

To define the epidemiology and clinical presentation of seropositive neuromyelitis optica spectrum disorder (NMOSD) in a large US health system. We completed a retrospective observational study of adult patients in the University of Colorado Health System from 1 January 2011 to 31 December 2020, using Health Data Compass (HDC), a data warehouse that combines electronic health information with claims and public health data in Colorado. We screened HDC for patients with either (1) an abnormal aquaporin-4 IgG test or (2) any G36 ICD-10 code. We extracted key clinical elements by chart review and confirmed diagnosis by the 2015 International Panel for NMO Diagnosis criteria. Annual incidence and prevalence rates were calculated. Our population consisted of 2,475,591 individuals contributing 11,103,522.72 person-years of observation. In total, 115 seropositive NMOSD patients were identified. The average yearly incidence was 0.22 per 100,000 person-years. Age and sex-adjusted prevalence (per 100,000) was 4.33, and highest among those identifying as Asian or Pacific Islander (17.72), and Black (14.74), as separately by Hispanic ethnicity (8.02). Prevalence was higher in women (6.20:1 female:male ratio). Transverse myelitis (45%) and optic neuritis (43%) were the most common presenting clinical syndromes. In total, 6% of initial presentations were characterized by short-segment transverse myelitis without other features. Seropositive NMOSD incidence is higher in our cohort than many contemporary studies. Women and those identifying as Asian or Pacific Islander, Black, and Hispanic shoulder the highest burden of disease. Clinical onset with short-segment myelitis underscores the need for serum aquaporin-4 IgG testing in acute myelitis presentations.

Spatiotemporal dynamics of malaria and climate influence on its incidence in Condorcanqui Province, 2005–2022

BackgroundAmazonas is a region in northern Peru with the second-highest incidence of malaria. Approximately 95% of the cases are reported in the Condorcanqui province, where native communities living along the banks of Santiago River lack access to potable water, sewage, and electricity. This study aimed to analyse malaria’s spatial, temporal, and climatic characteristics in Condorcanqui to guide future studies and prevention strategies.MethodsA database provided by DIRESA-Amazonas was evaluated. Database included cases from 44 health facilities serving 112 native communities. According to the malaria control programs implemented in Peru, the study was divided into three periods: 2005–2010, 2011–2016, and 2017–2022. A Spearman correlation analysis was also conducted to assess the relationship between malaria incidence and climate variables.ResultsDuring the study periods, 10,632 cases were reported, including Plasmodium vivax (84.87%), Plasmodium falciparum (14.91%) and Plasmodium malariae (0.23%) infections. Annual incidence rates (AIRs) significantly varied across the study periods (p < 0.001). A significant reduction in malaria incidence occurred during the first period, largely attributed to PAMAFRO programme interventions. Subsequent periods, showed a gradual increase in cases, with a peak of P. vivax in 2019 and the reintroduction of P. falciparum. Males and individuals aged 0–11 years presented the greatest number of cases. Significant correlations were found between malaria incidence and the Oceanic Niño Index (ONI) at lag0 (ρ = 0.14, p = 0.037), corrected precipitation at lag1 (ρ = 0.16, p = 0.020), and minimum wind speed at lag1 (ρ = 0.15, p = 0.024).ConclusionsMalaria incidence in Condorcanqui has increased over the last 5 years, driven by climatic influences such as the ONI, precipitation, and low wind speeds. Without immediate preventive efforts, cases are expected to continue rising. Effective control strategies must tackle the social, economic, and political issues that heighten vulnerability, such as poverty and limited healthcare access. Maintaining control initiatives and tailoring them to local needs will be essential for achieving long-term reductions of malaria in Peru.

Incidence and Proportion of Primary Focal Segmental Glomerulosclerosis (FSGS) among a Racially and Ethnically Diverse Adult Patient Population between 2010 and 2021.

Focal segmental glomerulosclerosis (FSGS) refers to a pattern of glomerular injury but also includes primary FSGS which is considered as an immune mediated glomerulopathy. We sought to determine the incidence of primary FSGS and proportion of FSGS patients with primary FSGS among a large diverse patient population in the United States. A cross-sectional study (2010-2021) was performed within an integrated health system in patients (age ≥18yrs) with biopsy-proven FSGS. Among biopsies with FSGS as the first diagnosis on pathology report, chart reviews were performed to determine primary FSGS, defined as podocyte foot process effacement ≥80% on electron microscopy. The proportion of patients with primary FSGS and annual incidence rates (per 100,000 patient-years) were calculated. Standardized incidence rates were determined by age, sex, and race and ethnicity based on US population structure of the five-year (2018-2022) American Community Survey estimates. We identified 3,838 patients with FSGS reported on biopsy. Among 1,502 with FSGS as the principal diagnosis, 637 met criteria for primary FSGS (mean [SD] age 55.5 years [17.9], 56.5% male, 35.6% Hispanic, 28.7% White, 17.9% Asian/Pacific Islander, and 16.0% Black). The mean standardized incidence rate [CI] of primary FSGS was 1.7 [0.9, 2.5] per 100,000 patient-years during the study period. The standardized annual incidence rates ranged from 1.3 - 2.4 per 100,000 patient-years. Incidence rates (per 100,000 patient-years) were highest among Black (3.2), Asian (2.7), and Pacific Islander (2.8) patients. Primary FSGS accounted for 16.6% of biopsy-proven FSGS. Primary FSGS is a likely a rare disease with incidence highest among Black, Asian, and Pacific Islander people. More precise identification of primary FSGS may facilitate work to improve understanding of this glomerulopathy and improve kidney outcomes.

Retrospective analysis of spatiotemporal variation of scrub typhus in Yunnan Province, 2006-2022.

Scrub typhus is a life-threatening zoonotic infection. In recent years, the endemic areas of scrub typhus have been continuously expanding, and the incidence rate has been increasing. However, it remains a globally neglected disease. Yunnan Province is a major infected area, and the study of spatiotemporal and seasonal variation scrub typhus in this region is crucial for the prevention and control of the disease. We collected surveillance data on scrub typhus cases in Yunnan Province from 2006 to 2022. Using methods such as spatial trend analysis, Moran's I, and retrospective temporal scan statistics, the spatial and seasonal changes of scrub typhus were analyzed. The study period recorded 71,068 reported cases of scrub typhus in Yunnan Province, with the annual incidence rate sharply increasing (P<0.001). Approximately 93.38% of cases are concentrated in June to November (P = 0.001). Nearly 98.0% of counties were affected. The center of gravity of incidence migrates in a south and west direction. The incidence of scrub typhus was positively correlated spatially, and the spatial clustering distribution was significant. The most likely spatial cluster of cases (relative risk = 14.09, P<0.001) was distributed in Lincang, Dehong, Baoshan, Banna, and Puer. Significant positive correlations between the number of scrub typhus cases and average temperature, precipitation and relative humidity. In Yunnan Province, scrub typhus is widely transmitted, with an increasing incidence, and it exhibits distinct seasonal characteristics (from June to November). The center of gravity of incidence has shifted to the south and west, with higher incidence rates observed in border regions. The risk clustering regions encompass all border prefectures. This pattern is significantly correlated with climatic factors such as average temperature, precipitation, and relative humidity. The relevant departments should strengthen the monitoring of scrub typhus, formulate prevention and control strategies, and provide health education to local residents.

Forecasting cardiovascular disease risk and burden in China from 2020 to 2030: a simulation study based on a nationwide cohort

BackgroundCardiovascular disease (CVD) remains a significant public health challenge in China. This study aimed to project the burden of CVD from 2020 to 2030 using a nationwide cohort and to...

Differential Ultrasound Rates Mirror Sex Disparities in Thyroid Cancer.

Background: Expanding ultrasound use has increased the detection of thyroid cancer. Incidence has always been higher among females, a disparity that has grown over time. The sex difference in thyroid cancer is understudied in the context of diagnostic testing, particularly among privately insured adults in whom thyroid cancer is most common. We evaluated the association between thyroid ultrasound, fine needle aspiration biopsy (FNAB), and cancer incidence by sex in a large, integrated health system. Methods: This longitudinal retrospective cohort study included Kaiser Permanente of Washington enrollees aged 18 and over who underwent thyroid ultrasound from 1997 to 2019. Data included electronic billing claims for patients linked to tumor registry diagnoses. We estimated (1) annual overall ultrasound, FNAB, and cancer incidence rates; (2) the proportion of ultrasound requiring FNAB; and (3) cancer diagnoses per FNAB. A Poisson model with offset determined the relationship between sex and the proportion of ultrasound requiring FNAB adjusting for patient and sociodemographic characteristics. Results: A total of 33,589 patients underwent ultrasound (78% females; mean age 56). Ultrasound rates per 100,000 covered lives, defined as insured individuals per year, increased five-fold among males (111.11-490.97) and >four-fold among females (382.27-1331.14) between 1997 and 2019. FNAB rates also increased over time (rates per 100,000: 174.09-430.37 in females vs. 58.38-189.13 in men). Overall, FNAB rates per ultrasound changed little over time, and FNAB per ultrasound was greater in males compared with females (Adj rate ratio = 1.06 [confidence interval 1.01-1.11]). Cancer incidence was higher in females over the study period, but cancer incidence per FNAB was similar between sexes (both 0.06, p = 0.4). Conclusions: Sex disparities in thyroid ultrasound rates are stark and are a likely driver of sex disparities in thyroid cancer incidence. Interestingly, ultrasound-triggered FNAB was more common in males and changed little over time, challenging the prevailing understanding that females have much higher rates of thyroid cancer. Although the population-based differences between sexes for FNAB and cancer were large, the differences among people who had ultrasound were small.

Tick-Borne Encephalitis Virus Surveillance-Vaccination- and Infection-Induced Seroprevalences in Western Austria 2024.

Reported tick-borne-encephalitis (TBE) cases have been increasing in Western Austria, but no data are available on vaccination- and infection-specific seroprevalence. This study aimed to estimate current TBEV-seroprevalence in the region and inform prevention programs by comparing anti-NS1-based-incidence rates with reported case numbers and vaccination coverage. Between December 2023 and February 2024, serum samples from 4619 blood donors in Western Austria were collected and analyzed using TBEV- and WNV-IgG-ELISA assays. Seropositive samples were tested with a TBEV-anti-NS1-IgG-ELISA to distinguish infections from vaccinations. Borderline samples were retested with serum neutralization and triple-NS1-assays. The overall anti-TBEV-IgG-seroprevalence was 80.1% (95%CI 78.9-81.3); 2.7% (95%CI 2.3-3.2) of donors tested positive for anti-TBEV-NS1 IgG antibodies, indicating previous infection. The notified incidence rate in Western Austria was 2.7/100 000/year, compared to 136.2/100 000/year based on anti-TBEV-NS1-seropositive donors, denoting a substantial number of unreported cases (mean manifestation index 1.9%). The number of donors with TBEV-infections varied considerably by district, highlighting potential hotspots for TBEV-infections. The high anti-NS1-based, estimated annual TBE incidence rates show significant differences between districts, highlighting the need for targeted prevention programs. The high rate of undiagnosed TBE cases further suggests that estimated anti-NS1-based incidence rates should be considered when defining high-risk areas.

Trends in Incidence of Head and Neck Cancers in Dibrugarh District, Assam, India; During the Period 2003-2016.

Head and neck cancers are considered to be the most common cancers in developing countries, especially in Southeast Asia. In India, it accounts for one-fourth of male cancers and one-tenth of female cancers. An attempt was made to study head and neck cancer trends in the Dibrugarh district of Assam, North-East India, India. All sites viz., oral cavity and mobile tongue, oropharynx, hypopharynx, larynx, nasopharynx and others were considered separately for both the sexes to carry out the present analysis. Using the data from the Population-Based Cancer Registry, Upper Assam, Dibrugarh, annual crude incidence rate and age-specific rate were calculated for the period from 2003 to 2016. Mann-Kendall and Sen's Slope non-parametric analysis were applied to examine the trend in the percentages of Head and Neck cancers. The most frequent incidence site for HN cancers was the hypopharynx (33.50%). The disease was common among the males (78.87%) compared to the female (21.13%) population in Dibrugarh district. HN cancers are more prone to the age group 50-70years (60.93%) compared to the individuals with less than 50years (26.51%). Combining all the sites of HN cancers in male showed a significant decrease in incidence, whereas in female increasing trend was noted over a period of time. A slight decline in the percentage of head and neck cancer was documented in Dibrugarh when we combined both sexes. The results obtained from the current investigation will laid the scientific framework for proper planning and organization of prevention, diagnosis and treatment of HN cancers in Dibrugarh district, Assam.

Clinical burden, treatment, and disease control in patients with chronic spontaneous urticaria: Real-world evidence.

Chronic spontaneous urticaria (CSU) is an unpredictable inflammatory skin condition with substantial clinical burden that affects 0.23-0.78% of the United States population. To describe the incidence and prevalence of patients with a record of CSU diagnosis, treatment patterns, disease control, and clinical and economic burden in a United States (US) cohort of patients with CSU. Adults with a record of CSU diagnosis within the US HealthVerity claims database were eligible. Age- and sex-adjusted prevalence/incidence rates were calculated for January 2017 to December 2022. Clinical characteristics were described during the 1 year prior to CSU diagnosis (baseline) and the time after (follow-up). Proxy events representing uncontrolled CSU (any record of prescriptions for corticosteroids, biologics, or immunosuppressants [excluding all antihistamines and over-the-counter medication] or any CSU-related inpatient admissions or emergency room or urgent care visits) were used to identify patients with uncontrolled CSU. Health care resource utilization (HCRU) and health care costs were described. Overall, 200,298 patients were followed-up for a median of 2.3 years after diagnosis. Estimated cumulative prevalence of diagnosed CSU was 0.57% (women: 0.80%; men: 0.32%). The average annual incidence rate was 0.08%. Corticosteroids were the most prescribed treatment during follow-up among the 166,195 patients prescribed ≥1 treatment (94.3%). Proxy events were observed in 59.1% of patients. HCRU and health care costs increased from baseline in patients with uncontrolled CSU during follow-up. Of patients with CSU who were prescribed treatment, >50% experienced uncontrolled CSU, which was associated with increased HCRU and health care costs.

Non- Tuberculous mycobacterial infection and pulmonary disease In Northern Israel: a focus on M. simiae

The prevalence of non-Tuberculous Mycobacteria pulmonary disease (NTM-pd) is rising globally. Previously, we described a high prevalence of M. simiae isolation in Israel. What is the prevalence of NTM-pd and M. simiae-pd in Northern Israel? Which factors are associated with mortality among people with NTM? We retrospectively recorded all samples from Clalit Health Services- Haifa district reference mycobacteria laboratory for growth of NTM, between January 2010 and March 2021. We manually reviewed a random sample of corresponding patients' electronic medical files and extracted demographic, clinical, and radiological data, as well as data on the course of the disease. Univariate and multivariate analyses were performed to assess factors associated with features of NTM-pd and mortality. 2968 clinical isolates from 1501 people yielded NTM species. The relative abundance of M. simiae, MAC and other species increased over the study period. Among the 550 patients' files reviewed, clinical presentation, fulfilment of established criteria for NTM-pulmonary disease, and mortality rates were not significantly different between patients with M. simiae, MAC and M. kansassi/szulgai species, with 27.7, 35.3, and 27.8% of people fulfilling criteria for NTM-pd. Factors associated with mortality included age, male sex, and immunosuppression. Compared to MAC isolation, M. simiae was associated with elevated mortality: HR 1.84 (95% CI 1.05-3.23). The extrapolated national annual incidence rate of NTM- pd was 1.7-2.0:100,000 population. Infection with M.simiae is prevalent in Israel, and although considered minimally pathogenic, demonstrated similar clinical and radiologic features to MAC-pd.