Male Cases Research Articles

Trends in Pediatric Neck Injuries During Sporting Activities

Background: Although neck injuries secondary to sporting activities in the pediatric demographic presenting to the emergency department (ED) are common, predictors of needing higher-level care (HLC) outside immediate treatment and release are not clear. The aim of this study was to describe how these neck injuries present in the United States (US) and identify predictors of HLC. Methods: We interrogated the US National Electronic Injury Surveillance System (NEISS) database for presentations to the ED of pediatric patients (aged 6–18 years old) whose primary complaint was neck injury in the setting of sport between 2014 and 2023. Statistical analysis utilized weighted estimates to evaluate incidence and then univariate and multivariate regression analyses were carried out to identify parameters associated with HLC for these patients. Results: Overall, a national weighted total of 360,885 ED presentations were estimated to have occurred in the last decade without any statistical change over the years. The mean age was 12.7 years, with more males (60.0%) than females (40.0%). The most common race observed was Black (50.6%), and these injuries most commonly occurred at a sporting complex (62.9%). Neck strains (59.9%) were the most common diagnosis seen across all presentations, followed by neck pain (29.1%), neck contusions (including abrasion) (6.4%), neck fractures (1.7%) and neck lacerations (0.8%). Ultimately, the majority of presentations were treated and released from the ED (95.5%). There were 4.5% of presentations, however, that did require HLC. Older age (OR 1.07, p = 0.004), male gender (OR 1.51, p = 0.002), involvement of other body part(s) (OR 1.45, p = 0.007) and non-strain neck injuries (OR 11.8, p < 0.001) were all independent, statistically significant predictors of HLC. Football (18.6%) was the most common sport associated with these presentations overall, but this was driven mostly by male cases. For females, the most common sport associated with these presentations was cheerleading (12.3%). Conclusions: In the last decade, neck injuries secondary to sporting activities in the pediatric demographic presenting to the ED have remained consistent. We have identified a unique set of predictors for presentations requiring HLC. These findings can be used in tandem with the findings that there are a number of gender-specific sports that drive these presentations to develop more sensitive and specific protocols for both primary prevention and ED triaging.

Type A monoamine oxidase; its unique role in mood, behavior and neurodegeneration.

Monoamine oxidase catalyzes oxidative deamination of monoamine transmitters and plays a critical role in the pathogenesis of neuropsychiatric diseases. Monoamine oxidase is classified into type A and B (MAO-A, MAO-B) according to the substrate specificity and sensitivity to inhibitors. The isoenzymes are different proteins coded by different genes localized on the X-chromosome, but they have identical intron-exon organization, similar protein structure and enzymatic mechanism and are considered to be derived from the same ancestral gene. The isoform-specific transcription organization regulates expression and function of MAO-A in response to cellular signaling pathways and environmental factors. MAO-A shows distinct properties and functions: isoform-specified polymorphisms, localization in catecholamine neurons, expression during early embryonic stage, regulation of brain architecture development and mediation of death and survival of neuronal cells. MAO-A is more flexible to genetic and environmental changes than MAO-B. Defective MAO-A expression impairs embryonic brain development and causes adult abnormal mood and behavior, as shown by human male cases with MAO-A deletion. This paper presents the regulation of brain MAO-A expression epigenetically by interaction between genetic and environmental factors. Association of aberrant MAO-A expression and activity with aggression, asocial behaviors, depressive disorders, and neurodegenerative diseases is discussed. Novel therapeutic strategy for psychiatric diseases by intervention to the regulation of MAO-A expression and activity is proposed.

Impact of GRM7 Gene Variations on Glioblastoma Risk in the Iranian Population

AIMThe metabotropic glutamate receptor, GRM7 is a gene in the neurotransmitters prognostic signatures. Downregulation of this gene is associated with the progression of glioma tumors and has a negative impact on the immune response. MethodsIn the present study, we aim to assess the associations between rs6782011 and rs779867 SNPs within this gene and risk of glioblastoma multiforme (GBM) in Iranian population. ResultsThere was a noteworthy difference in distribution of genotypes (P value=0.001) and alleles (P value= 0.0002) of rs779867 between total GBM cases (n=299) and total normal controls (n=302). In addition, the significant difference in genotypes and alleles distribution was observed for both male and female GBM cases vs. respective normal controls. For rs6782011 variant, the significant difference in genotypes distribution was observed between male GBM cases (n=187) vs. respective normal controls (n=156) (P value=0.004) and between total GBM cases (n=299) vs. total normal controls (n=302) (P value=0.02). However, there was no significant difference in genotypes distribution between female GBM cases and respective normal controls (P value= 0.1). Distribution of rs6782011 alleles was not different between total GBM cases and normal controls; and between male GBM cases and male normal controls. However, there was a significant difference in alleles distribution between female GBM cases and female normal controls. Conclusion: Taken together, the mentioned polymorphisms might affect risk of GBM in Iranian population. Future studies are needed to elaborate the underlying mechanism.

Drug-Resistant Tuberculosis in Rural Eastern Cape, South Africa: A Study of Patients’ Characteristics in Selected Healthcare Facilities

This study investigated the characteristics and outcomes of drug-resistant tuberculosis patients in selected rural healthcare facilities in the Eastern Cape, South Africa. A retrospective review of clinical records from 456 patients, covering the period from January 2018 to December 2020, revealed a statistically significant relationship between DR-TB types and age groups (Chi-square statistic: 30.74, p-value: 0.015). Younger adults (19–35 years) and middle-aged adults (36–50 years) are more frequently affected by RR-TB and MDR-TB, which are the most prevalent forms of DR-TB. Less common types, including Pre-XDR, XDR, and INH TB, were observed in smaller numbers. The study suggests that DR-TB imposes a heavy burden on the working age population. Gender analysis shows that while the frequency of DR-TB differs between males and females, the percentage distribution of DR-TB types is relatively equal. Both genders are predominantly affected by RR-TB and MDR-TB, which together account for nearly 90% of cases. Pre-XDR, XDR, and INH-resistant TB are much less common, comprising only a small percentage of cases in both males and females. High-risk behaviors such as smoking and drinking are linked to a wider diversity of DR-TB types, while occupations like mining and prison work show higher rates of RR-TB and MDR-TB. In HIV-positive individuals, DR-TB is more common, but the distribution of DR-TB types between HIV-positive and negative groups shows no statistically significant difference. However, HIV-positive individuals have a 20% lower survival rate (65%) compared to HIV-negative patients (85%). Financial stability and comorbidities also significantly influence outcomes, with patients having stable income and fewer high-risk comorbidities experiencing better survival and treatment outcomes. The findings underscore the importance of addressing socioeconomic disparities and strengthening healthcare infrastructure to improve DR-TB treatment outcomes in rural Eastern Cape.

ESTUDO EPIDEMIOLÓGICO DOS CASOS DE DENGUE NO MUNICÍPIO DE LUÍS EDUARDO MAGALHÃES-BA, NO PERÍODO DE 2015 A 2023

Dengue is an arbovirus prevalent worldwide, being a seasonal systemic disease, of acute, infectious and febrile nature, transmitted to humans by infected females of Aedes aegypti and Aedes albopictus. Thus, this study aims to describe the epidemiological profile of reported cases of dengue in the municipality of Luís Eduardo Magalhães-BA, from 2015 to 2023. A retrospective, analytical study with a quantitative and epidemiological approach was carried out, using data provided by the Information System for Injuries and Notifications (SINAN/DATASUS) and Epidemiological Surveillance of Luís Eduardo Magalhães (LEM). This research complied with the standards established by the National Health Council through Resolution No. 466/12 of December 12, 2012. It was found that a total of 5,408 cases were reported in the period from 2015 to 2023. The year 2021 was the one with the highest number of reported cases (n = 1895), followed by the year 2019 (n = 1,332) and 2022 (n = 1,316. It was found that the female sex was the most affected, with 2,960 cases, against 2,434 cases of males. The most prevalent age was 20 to 39 years, with 2,331 cases, followed by the age group from 40 to 59 years, with 1,026 cases. Regarding the confirmation criterion, 2,275 cases were laboratory, 1,008 were clinical-epidemiological and 1,158 cases were reported as under investigation. Given the results presented, it was possible to verify that dengue acts in an oscillatory manner in the municipality of Luiz Eduardo Magalhães-BA, with the years 2019, 2021 and 2022 being those that presented the highest number of cases, with females being the most affected by dengue

Multidisciplinary Approach of a Male Case of Imported Malaria, HIV Chronic Infection, and Latent Syphilis

Background: The current economic and social crisis in Latin America has caused migration to the USA, bringing with it Public Health challenges due to the importation of various infectious diseases. Migrants, particularly those with chronic conditions, such as HIV infection and other sexually transmitted infections (STI), are at greater risk due to pharmacological interruption and access to medical care, so the timely detection of diseases acquired during their migration, such as malaria, is crucial to avoid health complications. Objective: To outline by a multidisciplinary approach (Infectology, Parasitology, Epidemiology, molecular Biology, Venereology, and Public Health) the diagnosis and management of a male case with malaria imported to Mexican territory, HIV chronic infection, and latent syphilis. Methods: A male migrant of Venezuelan nationality attended the Clínica Especializada Condesa Iztapalapa in Mexico City for health complications. A comprehensive analysis of laboratory and molecular tests was performed to confirm HIV infection. During the STI diagnostic algorithm, latent syphilis was detected and microscopic observation of blood smears revealed parasitic forms compatible with malaria. Standard and molecular tests were applied under the operational definition for malaria cases for identification, diagnosis, and treatment. Finally, study of clinical history and migration route by questioning for the investigation of the imported case was performed. Results: The immigrant was diagnosed with HIV chronic-stage infection with interrupted antiretroviral therapy (ART), latent syphilis, and malaria by Plasmodium vivax. The ART administered was chosen based on the possible drug interaction with antimalarials and genetic barrier to the HLA-B* allele. Finally, antimicrobial therapy against syphilis was penicillin. From the analysis of the migratory route, incubation time of imported malaria, and questioning, we speculated that the migrant acquired the P. vivax infection in Panama. Conclusions: This case highlights the complex health problems faced by migrants with HIV infection, particularly when they contract additional infections such as malaria during migration and highlights the need for comprehensive access to healthcare and ART, antimalarial and antimicrobial treatments to mitigate the health risks of this vulnerable population.

Impact of non-pharmacological interventions on incidence of hand, foot and mouth disease during the COVID-19 pandemic: a large population-based observational study

BackgroundHand, foot, and mouth disease (HFMD) is a highly prevalent and contagious disease, particularly in children under five years old. Its transmission route resembles that of COVID-19. During the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) were implemented to curb viral spread, which may have concurrently reduced HFMD incidence.MethodsUtilizing HFMD surveillance data from the Anhui Provincial Center for Disease Control and Prevention (2015–2020) and varying levels of COVID-19 emergency measures, a Bayesian structural time series model predicted the counterfactual HFMD incidence and quantified the causal relationships with NPIs.ResultsDuring the implementation of NPIs, the 915 cases observed between weeks 4 and 20 of 2020 reflected a 94.9% reduction from the expected cases number (915 vs. 17,790), avoiding approximately 16,875 cases. The relative reduction of male cases (95.2%) was similar to that of female cases (94.3%). Different age groups the number of cases decline roughly similar were 93.1%, 95.3%, 97.8%, 94.9%.ConclusionDuring the COVID-19 pandemic, NPIs implemented in response to COVID-19 effectively reduced HFMD incidence. NPIs should be promoted for future control of enteric infectious diseases such as HFMD.

Females at a Clear Disadvantage with Postoperative Myocardial Infarction Symptoms.

Cardiovascular disease remains the leading cause of death in women. Gender bias and blindness are coming into focus as relevant risk factors for patients. To date, there have been no studies that target surgeons' potential gender bias in recognizing postoperative myocardial infarction (MI). An online clinical vignette describing a patient with postoperative MI was randomized for gender. Possible diagnoses, the next steps in management, and questions on gender bias were assessed. A total of 205 surveys were analyzed. MI was recognized in 55.6% of the male case studies vs. 32.0% of the female case studies in the first question (p < 0.005). Cardiac diagnostics were initiated significantly more in male case studies (94% vs. 76%, p = 0.001). Female surgeons listed MI as the first diagnosis twice as often as male surgeons overall (43% vs. 23%, p = 0.027). Female surgeons were also more likely to mention MI across the survey at all compared to male surgeons (89% vs. 67%, p = 0.0002). Board-certified surgeons diagnosed MI by the end of the survey significantly more (88.2%) than residents (75.0%) and medical students (75.0%, p = 0.047). Overall, this study was able to demonstrate the presence of both gender bias and gender blindness in surgeons' assessment of postoperative myocardial infarction symptoms with a clear disadvantage for female patients and a superior awareness for female surgeons.

Colorectal cancer with a germline BRCA1 variant inherited paternally: a case report.

BRCA genes have well-known associations with breast and ovarian cancers. However, variations in the BRCA gene, especially germline variations, have also been reported in colorectal cancer (CRC). We present the case of a rectal cancer with a germline BRCA1 variation inherited from the paternal side. A 39-year-old male was admitted with rectal cancer. The patient underwent surgical resection and the pathologic diagnosis was adenocarcinoma. Next-generation sequencing was performed and a BRCA1 variant was detected. Reviewing the public database and considering the young age of the patient, the variant was suggested to be germline. The patient's father had had prostate cancer and next-generation sequencing testing revealed an identical BRCA1 variant. In the BRCA cancer group, there is relatively little attention paid to male cancers. The accumulation of male CRC cases linked to BRCA variations may help clarify the potential pathological relationship between the two.

Evaluation of spermatic DNA fragmentation in smoking normospermic infertile individuals

Aim: In approximately 20% of infertile couples, the male factor is the only main cause. In recent years, it has been hypothesized that sperm DNA integrity may be a better indicator than routine semen analysis. Although the effects of smoking on male infertility have not yet been proven, smoking is considered a reasonable risk factor for infertility. In our study, we aimed to evaluate DNA damage in normospermic infertile men who smoke and do not smoke using the acridine orange method. Material and Methods: This study was conducted on semen samples from 50 male cases, 25 of whom were smokers and non-smokers, who met the infertility criteria and applied to the urology clinic of Dicle University Medical Faculty Hospital. Microscopic examinations and morphological evaluations were performed in accordance with the WHO 2010 criteria. The acridine orange method was applied to evaluate DNA fragmentation and DNA fragmentations were calculated. Statistical analysis of the obtained data was performed using the Mann-Whitney U Test. Results: In our study, in the smoking group, age was significantly associated with the duration of infertility, concentration with total motile sperm count, total sperm count with total motile sperm count, and amorphous head anomaly (p&lt;0.01). In the non-smoking group, age and infertility were significantly associated with the duration, volume and total count, concentration and total count, total motile sperm count, and DNA fragmentation (p&lt;0.01). However, there was no statistical difference between the smoking and non-smoking groups in terms of semen parameters and DNA fragmentation (p&gt;0.05). Conclusion: In order to obtain more reliable results, it is thought that large-scale studies are needed in the same groups and in the general population. Keywords: sperm, infertility, DNA fragmentation, smoking

Survey on the Prevalence of Buruli Ulcer in Patients with Chronic Wounds in Pointe-Noire

Background &amp; objective: Buruli Ulcer (BU) is a human skin infection caused by Mycobacterium ulcerans, an environmental mycobacterium. This pathology is most prevalent in humid tropical regions, particularly near swampy or flood-prone areas. In Pointe-Noire, a coastal city in the Republic of Congo, Buruli ulcer is a health threat requiring ongoing surveillance and awareness-raising efforts to control its spread. The aim of this study was to determine the prevalence of Buruli ulcers in patients consulting for chronic wounds in Pointe-Noire. Methods: This was a descriptive cross-sectional study conducted from June 10, 2023 to September 18, 2024. We recruited 69 patients with chronic wounds consulted at the Adolphe Sicé General Hospital, the Tié Tié Referral Hospital, and the Pointe Noire Operational Sector. Mycobacterium ulcerans was systematically detected using the qPCR technique targeting the M. ulcerans IS 2404 specific insertion element on swab samples. Results: 69 patients with suspected BU were enrolled, with 57% (39) male and 43% (30) female subjects. The mean age was 47.7 ± 18.5, ranging from 6 to 94 years, and the most represented age group was [30-60] (66.7%). The wounds observed in our patients were mainly ulcerative in 94.2% (65) and localized to the lower limbs in 97.1% (67). The overall prevalence of Mycobacterium ulcerans infection was 2.89%. The age group affected was &lt; 15 years, with 01 positive male case and [30-60], with 1 positive female case. Conclusion: The study carried out in Pointe-Noire revealed a Buruli ulcer prevalence of 2.86% among the 69 patients with chronic wounds tested, with 02 positive cases.

Abstract 4137646: Transcriptomic Profiling of Human Myocardium at Sudden Death to Define Vulnerable Substrate for Lethal Arrhythmias

Background: While some chronic pathological substrates for sudden cardiac death (SCD) are well-known (e.g., coronary disease and left ventricular [LV] dysfunction), the vulnerable myocardial state predisposing to fatal arrhythmia remains a critical barrier to near-term SCD prevention. Hypothesis: Myocardium of autopsy-defined SCDs exhibit distinct expression profiles vs. non-cardiac sudden deaths and trauma deaths that reflect its acute vulnerable state in the hours to days before SCD, as expression arrests upon death. Goals/Aims: Define the vulnerable myocardial substrate for lethal arrhythmia by targeted RNA profiling. Methods: We used autopsy to adjudicate arrhythmic from non-arrhythmic causes in 1,265 sudden deaths in San Francisco from 2011-2018. We performed a transcriptomic evaluation of LV sampled at the time of SCD from 245 consented cases using a curated panel of 448 genes with known or hypothesized association with SCD. Results: Comparison between Arrhythmic (n=129) and Non-Arrhythmic (n=116) cohorts revealed 31 differentially upregulated and 36 downregulated genes (p-adj&lt;0.05), related to collagen-containing extracellular matrix (upregulation of FAP , FMOD , LTBP2 ), ion transport (upregulation of KCNA5 and KCNN3 , and downregulation of KCNJ8, KCNK1, KCNJ5 ), and contraction (downregulation of MYH6 ). Fibrosis-related genes showed the highest magnitude increased expression in Arrhythmic vs. Non-arrhythmic deaths and vs. published transcriptomes from end-stage heart failure. After molecular stratification by known markers for mature ( COL1A1, COL1A2, COL3A1) and active ( POSTN , MEOX1 ) fibrosis, cases with highest expression of both had the highest proportion of arrhythmic cause of death (27/36 [75%]) vs. cases with low expression of both (87/181 [38%], p=0.006) or vs. mature only (10/14 [71%]) or active only (5/14 [36%]). Activated fibroblast gene expression was enriched in Arrhythmic female vs. Arrhythmic male cases, among other sex-specific differences in ion channel and myosin (upregulation of SCN4B , SCN8A , KCNAB1 in females, KCNJ4 and MYH7B in males) expression. Conclusions: RNA profiling of myocardium at SCD identifies active fibrosis, undetectable by conventional clinical methods, in the presence of fixed scar and selected ion channel dysregulation (more pronounced among female cases) as an acute vulnerable substrate for fatal arrhythmias, and may identify patients at elevated near-term risk for SCD and novel pathways for intervention.

Long linguofacial trunk with infrahyoid origin.

The linguofacial trunk (LFT) is the conjoined origin of the lingual (LA) and facial (FA) arteries. We present an uncommon case of LFT due to its origin, length, and diameter. The computed tomography angiogram of an adult male case was evaluated. On the right side, the external carotid artery (ECA) gave off a large LFT before reaching the greater hyoid horn, with an outer diameter of 3.7 mm. The outer diameter of the ECA of 3.4 mm. The ECA and the LFT were on the outer side of the greater hyoid horn. After an ascending course of 20.9 mm anteriorly to the ECA, the LFT branched into the LA and FA. Bilateral elongated styloid processes reaching laterally to the oropharyngeal isthmus were also assessed. In conclusion, care should be taken not to confuse a large LFT with the ECA on the outer side of the greater hyoid horn.

V-V ECMO for severe Chlamydia psittaci pneumonia presenting with sudden cardiac arrest: A case report and literature review.

Psittacosis, also known as parrot fever, is an infectious disease caused by Chlamydia psittaci, which can lead to C psittaci pneumonia. Clinical manifestations are highly nonspecific, which can vary from asymptomatic infection to severe pneumonia and even death. In this case presentation, we reported one 65-year-old male case of C psittaci pneumonia who was admitted to our hospital on December 2, 2022 due to the chief complaints of poor appetite and fatigue for 3 days as the clinical manifestations. He denied contact with birds but admitted riding horses 1 week ago. Chlamydia psittaci pneumonia of patient was confirmed through metagenomic sequencing of bronchoalveolar lavage fluid under bronchoscopy. Patient was treated with V-V ECMO, invasive mechanical ventilation and CRRT. On December 12, the patient was successfully weaned off V-V ECMO and discharged on December 20, 2022. During postoperative follow-up, CT scan in a local hospital revealed the infiltrative lesions of the lung were absent. This case prompts that metagenomic next-generation sequencing is a feasible diagnostic tool for psittacosis, which can rapidly worsen and even cause sudden cardiac arrest. V-V ECMO might be a viable emergency therapeutic option.

ÍNDICE DE IMUNIZAÇÃO DE TUBERCULOSE NO MUNÍCIPIO DO SUL DO TOCANTINS-GURUPI-TO.

The present article in question focuses on the tuberculosis immunization rate in the municipality of Gurupi, which is located in the south of the state of Tocantins. Tuberculosis is an infectious disease caused by Koch’s Bacillus (Mycobacterium tuberculosis) and transmissible in its pulmonary form. In this study, a quantitative research of a documentary, statistical and retrospective nature was carried out as a data collection instrument, in addition to searching for concepts in some articles collected in the databases of the virtual library Scielo, Lilacs, Google Scholar that were related to the topic addressed and to the intended objectives. The data collected on the Datasus platform were tabulated in tables with the various variables found, including age, race, sex, education level, among others. Therefore, epidemiological research showed an expansion of tuberculosis in the last 10 years in the municipality. From this perspective, the predominance of male tuberculosis cases stands out, in a mixed-race population and people with only elementary school education.

Our experience of laproscopic cholecystectomy with associated complications and their treatment: a study of 200 cases

Background: The aim of this study was to evaluate the intraoperative and postoperative complications of laparoscopic cholecystectomy along with their treatment. Methods: The study was conducted in a tertiary care government teaching hospital in central Gujarat, India. And conventional laparoscopic cholecystectomy was performed after all relevant investigations. Results: In our analysis of 200 cases of planned laparoscopic cholecystectomy, we have found that the median age of patients undergoing operation was 47 years. In our study, 140 (67%) of the patients were female and 60(33%) male cases. It is noted that there were more complications in male patients (OR=2.95, CI 95%, 1.42-4.23, p&lt;0.001). The total number of complications were 60 (30%) out of which 45 (22%) were found to be intraoperative complications and rest were post operative complications. In our study, most common complication encountered was iatrogenic perforation which caused spillage of stones or bile 35 (17.5%) followed by bleeding from gallbladder fossa 12 (6%). CBD injury which is one of the most dreaded complications of laparoscopic cholecystectomy occurred in only 1 patient (0.5%). Among the post operative complications bleeding from abdominal cavity 12 (6%), bilioma 7 (3.5%) and infection of surgical wounds 4 (1.5%) were common. There was a total rate of 5% conversions to open surgery. Conclusions: Adopting laparoscopic cholecystectomy as a new technique for treatment of cholelithiasis, introduced a new spectrum of complications. Major biliary and vascular complications are life threatening, while minor complications cause patient discomfort and prolongation of the hospital stay. It is important recognizing IOC complications during the surgery so they are taken care of in a timely manner during the surgical intervention.

Pattern of Drowning among Autopsies Conducted at Baroda Medical College and S.S.G Hospital

Drowning kills at least 3,72,000 people every year and is the 3rd leading cause of unintentional deaths. In addition to the human tragedy, drowning represents a huge economic problem with direct and indirect costs, including many Disability-Adjusted Life Years. In India, there is limited knowledge about the epidemiology of drowning.The objective of the study was to study the incidence, manner and epidemiology of deaths due to drowning in and around Vadodara region.The present study was conducted from May 2022 to April 2023 in Government Medical College, Baroda on 82 cases to study the various epidemiological parameters of drowning. In this study period, 1989 cases of post-mortem examination were done out of which 82 cases were of drowning deaths. A maximum number of cases were seen in the age group of 21–30 years with 43% cases of males, dominating the study population. 62% of deaths were accidental in nature and occurred during the rainy season. The most common place of occurrence of drowning was river (38%) followed by water canal (31%). Soddening of hands and feet was the most common external feature of drowning followed by the presence of froth at mouth and nostril. Drowning is a most ignored public hazard worldwide with serious implications for the society. Public awareness regarding safety measures and drowning prevention strategies suitable to the needs of geographical region should be adapted.

Temporal trends of thyroid cancer in China and globally from 1990 to 2021: an analysis of the global burden of Disease Study 2021

The incidence of thyroid cancer (TC) is increasing annually worldwide, with a growing burden. This study aims to analyze temporal trends in the burden of TC by age and sex in China and globally from 1990 to 2021, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs) rates, and to predict future trends. We obtained data on TC in China and globally from 1990 to 2021 from the Global Burden of Disease (GBD) database. Using the Joinpoint regression model, we calculated and analyzed the trends in age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). Specifically, we estimated the annual percent change (APC), the average annual percent change (AAPC), and the corresponding 95% confidence intervals (95% CI) for each metric. Additionally, we conducted a decomposition analysis to investigate the impact of aging, population growth, and epidemiological factors on the incidence and mortality rates of TC. Furthermore, the autoregressive integrated moving average (ARIMA) model was employed to predict the burden of TC from 2022 to 2036. From 1990 to 2021, the ASIR for TC in China increased from 1.249 (95% uncertainty interval [UI]: 1.009–1.473) per 100,000 to 2.473 (95% UI: 1.993–3.088) per 100,000. Conversely, the ASMR decreased from 0.473 (95% UI: 0.403–0.550) per 100,000 to 0.387 (95% UI: 0.307–0.472) per 100,000. Both males and females demonstrated an upward trajectory in ASIR. However, while the ASMR for females decreased, that for males showed an overall increase despite a decline in the last decade. The age of peak onset for TC ranged from 30 to 79 years, whereas the age of peak mortality was between 50 and 89 years. The analysis using the AAPC indicates that the growth in the ASIR (AAPC = 2.242, 95% CI: 2.112–2.371) and ASPR (AAPC = 2.975, 95% CI: 2.833–3.117) in China exceeds the global rate. Furthermore, the reduction in ASMR (AAPC = -0.651, 95% CI: -0.824 - -0.479) and ASDR (AAPC = -0.590, 95% CI: -0.787 - -0.392) in China is also more pronounced than globally. Decomposition analysis indicates that the increasing TC burden in China is primarily driven by population aging, whereas globally, population growth plays a more significant role. Projections based on predictive models suggest that from 2021 to 2036, the ASIR for both China and the global population is expected to continue rising, while the ASMR is anticipated to decline further. The incidence rates of TC in China and globally have shown a continuous upward trend, which is expected to persist over the next 15 years. Additionally, although the number of male TC cases is relatively lower compared to females, the overall ASMR and ASDR for males have shown an upward trend, despite a slight decline in recent years. This highlights the need to enhance prevention, diagnosis, and treatment measures, and to develop differentiated screening and treatment strategies based on age and sex.

Microplastics are detected in bull epididymal sperm and polystyrene microparticles impair sperm fertilization.

An increase in global infertility has coincided with the accumulation of microplastics (MPs) in the environment. This trend is particularly troubling because only 10% of male infertility cases can be attributed to identifiable causes, leaving a knowledge gap in our understanding of their underlying factors. To bridge this, it is important to explore the connection between the accumulation of MPs and the observed decline in male fertility. We assessed the presence of microplastics in epididymal sperm from bulls and used it as baseline concentrations for sperm exposure. MPs were detected in all epidydimal sperm (ES) samples, with a mean concentration of 0.37μgmL-1. Next, to investigate the effects of MPs on fertility, bovine sperm was exposed to three different concentrations of a mixture of 1.1, 0.5, and 0.3μm polystyrene (PS) beads: (1) 0.7μgmL-1, blood concentration of PS in cows (bPS); (2) 0.37μgmL-1, based on the concentration of total MPs found in ES (esMP); and (3) 0.026μgmL-1, based on the concentration of PS found in ES (esPS). All sperm samples incubated with PS exhibited reduced motility compared with the control at 0.5h. However, PS exposure did not affect acrosome integrity or induced oxidative stress. Embryos produced from sperm exposed to PS had reduced blastocyst rates, in addition to increased ROS formation and apoptosis. By employing physiological exposure, this research provided evidence of MPs in bovine epididymal sperm and demonstrated the detrimental effect of PS on sperm functionality.

Expert consensus of multi-disciplinary collaboration on bladder-preserving treatment for bladder cancer in China (2024 edition)

Bladder cancer is one of the common malignant tumors in urology. According to statistics, there will be 613 791 new cases of bladder cancer in the world in 2022, and the number of new cases of bladder cancer in China will be approximately 92 900, accounting for approximately 15% of new cases of bladder cancer in the world, ranking 11th in the spectrum of malignant tumors in China, among which there are approximately 73 200 new cases in males, ranking 8th in the spectrum of male malignant tumors. Bladder urothelial cancer accounts for approximately 90% of all bladder malignant tumors. It can be divided into non-muscle-invasive bladder cancer and muscle-invasive bladder cancer according to whether it invades the bladder muscle layer. Radical cystectomy is the standard treatment for muscle invasive bladder cancer patients and bacillus calmette-guerin (BCG) unresponsive high-risk non-muscle invasive bladder cancer patients. Nevertheless, due to the patient's underlying diseases and the deterioration of the quality of life caused by surgery, many patients refused or are not suitable for radical cystectomy. Therefore, it is vital to find a bladder-preserving treatment that can achieve cure other than radical cystectomy. Bladder-preserving therapy that balances tumor control and quality of life serves as an alternative and supplement to radical cystectomy. This consensus is based on contemporary evidence-based medicine, combined with native clinical practice and experiences of bladder preservation in a multidisciplinary treatment manner. To some extent, this consensus serves as a guidance for bladder preservation of bladder cancer in China. The consensus aims to discuss issues including organizational structure and workflow of multidisciplinary treatment, the selection of patients for bladder-preserving therapy, treatment options and regimens, efficacy evaluation, follow-up, as well as regimen choices of recurrence after bladder-preserving therapy.