Diseases Of Circulatory System Research Articles

Features of molecular phenotype and ultrastructure of smooth muscle cells in ascending aorta in premature born rats

Preterm birth can contribute to the development of diseases of circulatory system in adulthood due to the incompleteness of the morphogenesis of the blood vessels wall. Smooth muscle cells are the leading cell population in the middle shell of the aortic wall and are plastic in nature, i. e. they are able to change their phenotype depending on the conditions of their environment. The presence of synthetically active smooth muscle cells in the aortic wall of an adult individual is a predictor of the formation of a wide range of cardiovascular diseases. The aim of our study is to identify the morphofunctional features of molecular phenotype and ultrastructure of smooth muscle cells of ascending aorta wall in rats born 12 and 24 hours prematurely. The paper presents the results of immunohistochemical and morphometric, as well as ultrastructural analysis of ascending aorta wall in Wistar rats born 12 and 24 hours prematurely. It has been shown that preterm birth leads to a later change in the phenotype of smooth muscle cells from synthetic to contractile, which can negatively affect the morphofunctional state of the cardiovascular system.

Features of causes of indirect certified disaster-related death in areas affected by the Fukushima Daiichi nuclear power plant accident: an observational study

ObjectivesTo investigate the details of disaster-related deaths due to the indirect health effects of the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident following the Great East-Japan Earthquake in 2011 and...

Assessment of the economic damage from the premature death of children and adolescents as a result of certain diseases caused by electromagnetic radiation

Subject. This article discusses the issues related to the value of human life. Objectives. The article aims to assess the effect of electromagnetic radiation on the life expectancy of children and adolescents. Methods. For the study, we used a methodology for assessing the average life value based on the utility theory. Results. The article presents the results of the assessment of economic damage in the premature death of children and adolescents under the age of 19 as a result of neoplasms and diseases of the blood circulatory system. Conclusions. It is necessary to reduce the incidence of neoplasms and diseases of the blood circulatory system, as well as increase health care costs. Reducing mortality can improve the demographic situation in the country, though the economic damage remains significant.

Exploring mortality risk factors and specific causes of death within 30 days after hip fracture hospitalization

This study examined the sex-specific mortality risk and causes of death soon after hip fracture in Taiwan. The objective of this study was to evaluate the 30-day mortality risk and cause of death in patients with hip fracture and identify its associated risk factors. We conducted a retrospective cohort study using data from the National Health Insurance Research Database in Taiwan from 2000 to 2015. This study included patients aged 50 years or older who were admitted to a hospital with a hip fracture diagnosis for the first time. Of 285,891 patients hospitalized for their first hip fracture, 8,505 (2.98%) died within 30 days. The mortality risk of hip fracture declined from 3.76% in 2000 to 2.92% in 2015. Circulatory system diseases like ischemic heart disease and cerebrovascular disease were the most common cause of death and accounted for 22% of deaths within 30 days after fracture. Accidents and unintentional injuries caused 18% of deaths, followed by malignant neoplasms in 10% of deaths. Multivariate Cox regression identified older age, male sex, higher Charlson Comorbidity Index (CCI), suburban or rural residence, and lower income as risk factors for hip fracture mortality. The 30-day mortality risk of hip fractures has decreased but remains correlated with male sex, older age, and comorbidities. Circulatory diseases were the main cause of death. Early identification and treatment by experienced clinicians may optimize outcomes, minimize complications, and reduce mortality risk in the 30 days following hip fracture.

EPIDEMIOLOGY OF MALIGNANT PROSTATE NEOPLASMS IN THE SUMY REGION

Introduction. One of the most critical medical and social challenges facing the male population globally is the prevalence of malignant tumors of the prostate gland. Cancer-related mortality ranks the second position in Ukraine and worldwide, following cardiovascular diseases. Therefore, early diagnosis remains the most promising and effective strategy for combating malignant tumors. Objective: to investigate the prevalence and frequency of diagnosis of malignant prostate neoplasms in the Sumy region. Materials and Methods. The study utilized statistical data from the medical records of patients with prostate disease treated at the Urology Departments of Sumy Clinical Hospital of St. Panteleimon and Sumy City Clinical Hospital from 2018 to 2022. Results. The statistical analysis revealed that the prevalence of prostate diseases among patients aged 40-54 years was 21.5%, among those aged 55-74 years it was 34.3%, and for patients over 75 years it was 44.2%. An examination of the data regarding when patients sought medical help from the onset of the disease highlighted that most men with prostate cancer were asymptomatic, contributing to the spread of the disease and complicating early-stage diagnosis. Cardiovascular diseases and urinary system disorders (e.g., urolithiasis, benign prostatic hyperplasia, chronic prostatitis, and acute prostatitis) were common comorbidities in these patients. Conclusion. The statistical analysis identified a rising trend in the incidence of malignant prostate tumors in men over 50. Diseases of cardiovascular and urinary system were the most prevalent comorbidities in patients with prostate tumors. The majority of the patients were hospitalized late in the course of the disease.

Clinical, genomic, and proteomic perspectives in the analysis of comorbid conditions in type 2 diabetes mellitus: a retrospective study.

Type-2 Diabetes Mellitus (T2DM) affects millions globally, with escalating rates. It often leads to undiagnosed complications and commonly coexists with other health conditions. This study investigates two types of prevalent comorbidities related to T2DM-the circulatory system (DCM1) and digestive system diseases (DCM2)-using clinical, genomic and proteomic datasets. The aim is to identify new biomarkers by applying existing machine learning (ML) based techniques for early detection, prognosis and diagnosis of these comorbidities. Here, we report a cross-sectional retrospective analysis from a T2DM dataset of T2DM associated concordant comorbidities (diseases with shared pathophysiology and management) from the Diastrat cohort (a T2DM cohort) recruited at the Northern Ireland Centre for Stratified Medicine (NICSM), in Northern Ireland. In the clinical data analysis, we identified that lipidemia was shown to negatively correlate with depression in the DCM1 group while positively correlate with depression in the DCM2 group. In genomic analysis, we identified statistically significant variants rs9844730 in procollagen-lysine (PLOD2), rs73590361 in beta-1,4-N-acetyl- galactosaminyl-transferase (B4GALNT3) and rs964680 in A kinase (PRKA) anchor protein 14 (AKAP14) which appear to differentiate DCM1 and DCM2 groups. In proteomic analysis, we identified 4 statistically significant proteins: natriuretic peptides B (BNP), pro-adrenomedullin (ADM), natriuretic peptides B (NT-proBNP) and discoidin (DCBLD2) that can differentiate DCM1 and DCM2 groups and have built robust ML model using clinical, genomic, and proteomic markers (0.83 receiver operative characteristics curve area, 84% positive predictive value and 83% negative predictive value and a classification accuracy of 83%) for prediction of DCM1 and DCM2 groups. Our study successfully identifies novel clinical, genomic, and proteomic biomarkers that differentiate between circulatory and digestive system comorbidities in Type-2 Diabetes Mellitus patients. The machine learning model we developed demonstrates strong predictive capabilities, providing a promising tool for the early detection, prognosis, and diagnosis of these T2DM-associated comorbidities. These findings have the potential to enhance personalized management strategies for patients with T2DM, ultimately improving clinical outcomes. Further research is needed to validate these biomarkers and integrate them into clinical practice.

Redox Imbalance and Cardiovascular Pathogenesis: Exploring the Therapeutic Potential of Phytochemicals

Abstract: The intriguing role of the oxidation system in cardiovascular disease lies in its contribution to chronic and acute increases in intracellular reactive oxygen species (ROS), driving the progression of cardiovascular diseases (CVDs). ROS, produced as by-products of oxidative physiological and metabolic events, act as mediators in various signaling pathways contributing to cardiovascular pathology. The delicate equilibrium between the production of free radicals and antioxidant defense shifts in favor of the former, resulting in redox imbalance and extensive cellular damage. Among CVDs, coronary artery disease (CAD) remains as the leading cause of death globally. Understanding the significance of oxidative damage in the dysfunction of endothelial cells, atherosclerosis, and other pathogenic events and pathways is crucial for preventing and managing CVD. Consequently, it is imperative to comprehend the mechanism/s underlying the pathogenic alterations of CVD due to oxidative damage to develop effective prevention strategies. Many studies have reported bioactive phytochemical/s as potential therapies against CVDs, modulating ROS generation, controlling the CVD-related inflammatory mediators and protecting the vascular system. Therefore, this review provides an update for understanding how the phytoconstituents exhibit preventive roles in oxidative stress-related CVD, thus improving the quality of life of people. This study conducted a thorough literature search on CVD, oxidative imbalance, and phytoconstituents. The search was performed using multiple search engines and the main keywords, and only English publications until June 2023 were included. However, there is a need for more research and clinical trials to fully elucidate the efficacy and safety of these phytochemicals for managing the disease.

Povezanost med vročinskimi valovi in obiski na Internistični prvi pomoči Univerzitetnega kliničnega centra Ljubljana v obdobju 2013–2017

Background: Heatwaves have a severe impact on the number of deaths and emergency department visits, making them the most hazardous natural disaster due to climate change in many regions of the world. Our aim was to assess the short-term association between emergency department visits and heat waves from 2013 to 2017 to see whether any difference in the number of visits occurred at the Emergency Department in Ljubljana University Medical Centre during that period. Methods: The design of our study is a retrospective cross-sectional epidemiologic study. We estimated relative risks (RR) for a number of ED visits during heatwave days and reference period days for the observed diagnoses (all causes, diseases of the circulatory system, respiratory system, endocrine diseases, diseases of the digestive system and genitourinary diseases) sex, and age (from 19 to 74 years old, 75 years old and older), as well as 99.6% confidence intervals (CI) and excess ED visits in percent (%) associated with heatwaves occurring in the years from 2014 to 2017. Data were analyzed for the patients arriving at the Emergency Department of the Ljubljana University Medical Centre during summer time, from May to September. The region covers around 550,000 people and is considered an urban and rural area. Results: The results of our study showed that there was no statistically significant increase in number of ED visits during heatwaves for all causes in all observed years. We noticed even statistically significant protective phenomena between heatwaves and the number of ED visits. These happened in the years 2015 and 2017 for both sexes and circulatory system diseases, in 2016 for men, circulatory system diseases, and in 2015 for respiratory system diseases. We showed a statistically significant association between heatwaves and the number of visits in the ED for endocrine diseases in 2013. Conclusion: Despite the increased heat load in the last observed years, the number of ED visits in Ljubljana has remained stable or even decreased. Further studies on how each intervention affects the behavior of the observed population are needed to clarify whether public health measures and inter-sectoral cooperation impact the number of ED visits.

The trends of arterial hypertension and ischemic heart disease in Lithuanian population (1983-2023)

Abstract Background During the past two decades, in Lithuania, the morbidity and mortality from circulatory system diseases such as ischemic heart disease (IHD) have been increasing. The increasing incidence of IHD can be linked to the IHD prevention program implemented in Lithuania, which was launched in 2005. This study aimed to determine and evaluate the prevalence of IHD, their risk factors, and trends among middle-aged (45-64 years) urban males and females in Lithuania over the last 40 years. Methods During our study, the changes in the prevalence of arterial hypertension (AH) and IHD, among Kaunas city inhabitants aged 45-64 years in six population-based cohorts (1982-1983 (n = 1660), 1986-1987 (n = 1152), 1992-1993 (n = 824), 2001-2002 (n = 978), 2006-2008 (n = 4604) and 2023 (n = 554)) were analyzed. AH was defined when the arterial blood pressure was ≥140/90 mmHg or a person had taken antihypertensive drugs during 2 weeks. IHD was defined when a person had a previous myocardial infarction (MI) and/or ischemic changes on electrocardiogram (ECG) were assessed by Minnesota codes. The prevalence of AH and IHD changes were evaluated using regression analysis. Results During 1983-2023, the prevalence of AH among males aged 45-64 significantly increased from 58.7% (1982-1983) to 72.7% (2023) (p = 0.04), but among females aged 45-64 the prevalence of AH tended to decrease from 63.0% (1982-1983) to 50.9% (2023) (p = 0.18). The prevalence of IHD among males aged 45-64 was without significant changes and was from 14.4% (1982-1983) to 13.6% (2023) (p = 0.7), but among females aged 45-64 the prevalence of IHD significantly decreased from 21.7% (1982-1983) to 16.6% (2023) (p = 0.04). Conclusions From 1983 to 2023, among Lithuanian middle-aged urban males, the prevalence of AH significantly increased, but the prevalence of IHD was stable, meanwhile, among Lithuanian middle-aged urban females the prevalence of AH tended to decrease, but the prevalence of IHD significantly decreased. Key messages • From 1983 to 2023, among Lithuanian middle-aged urban males, the prevalence of AH significantly increased, meanwhile among females - tended to decrease. • Over 40 years, the prevalence of IHD among Lithuanian males was without significant changes, but among females - significant decreased.

Dementia in migrants living in Lazio region, Italy: prevalence and population characteristics

Abstract Background Given ongoing demographic and epidemiological transitions, dementia prevalence is expected to rise among both native populations and migrants. Understanding this phenomenon is crucial for healthcare planning. This study, part of the IMMIDEM project (GR-2021-12372081), aims to estimate dementia prevalence in Lazio by migrant status. Methods A cross-sectional study was conducted on individuals aged ≥50, living in Lazio and receiving assistance from the Regional Health Service as of December 31, 2022. A validated algorithm based on Health Information Systems identified patients with dementia. Migrant status was defined by Country of birth, categorized as native Italians, migrants from Highly Developed Countries (HDCs) and from High Migratory Pressure Countries (HMPCs). Age-standardized prevalence of dementia was estimated overall and by migrant status, and 95% confidence intervals (CI) were calculated. Dementia population characteristics were described and compared according to migrant status using χ2test. Results The study included 3,976,160 individuals: 88.9% Italians, 1.7% migrants from HDCs, and 9.4% from HMPCs. Among them, 38,708 had dementia, with a prevalence of 8.48‰ (CI: 8.39-8.57). Dementia prevalence by migrant status was 8.68‰ (CI: 8.58-8.77) in Italians, 6.90‰ (CI: 6.19-7.62) in HDCs migrants, and 5.73‰ (CI:5.37-6.10) in HMPCs migrants. Demographic traits across migrant categories reveal distinct age and gender patterns, with more elderly Italians and a higher male percentage among migrants. From a clinical perspective, Italians showed a higher percentage of circulatory system diseases than migrants (23.5% Italians, 19.2% HDCs, 18.7% HMPCs, p = 0.001), along with a greater percentage of anti-dementia drug prescriptions (54.4% Italians, 50.9% HDCs, 47.4% HMPCs, p < 0.001). Conclusions The study found lower dementia prevalence among migrants compared to native Italians, with reduced access to healthcare services, especially in individuals from HMPCs. Key messages • The dementia prevalence in migrants is lower than in native Italians. • These findings suggest potential underdiagnosis and undertreatment, urging policymakers and healthcare providers to address these healthcare disparities.

Exploring Rhodiola rosea: A Comprehensive Review of Its Adaptogenic Effects and Medical Relevance

Introduction Rhodiola rosea L. is an adaptogen with an international reach, widely used in modern medicine. Scientific studies indicate that extracts obtained from Rhodiola rosea L. have a beneficial effect on various pathological conditions, including circulatory system diseases, neurological disorders and metabolic ailments. The wide range of applications of these compounds, combined with potentially low toxicity, makes Rhodiola rosea L. a promising candidate for integration in therapies supporting the treatment of diseases affecting various body systems. The aim of this review is to analyze contemporary research on the potential properties of Rhodiola rosea L., as well as to establish the foundation for further research and development of preparations based on this plant. Materials and Methods The review was conducted by searching PubMed and other scientific databases focusing on currently available publications. The literature available in the PubMed database was reviewed using the following keywords: “rhodiola rosea”, “adaptogen”, "cardiovascular diseases”, “neurological diseases”, “diabetes”. The analysis of 45 articles published between 1998-2023 was used to write the paper.

Age Differences and Prevalence of Comorbidities for Death and Survival in Patients with COVID-19: A Single-Center Observational Study in a Region of Southern Italy.

The SARS-CoV-2 outbreak has resulted in a considerable number of deaths worldwide. The virus damages the pulmonary artery endothelium, leading to a condition known as microvascular pulmonary inflammatory thrombotic syndrome (MPITS), which can be fatal and cause multiple organ failure. The presence of preexisting comorbidities has been shown to significantly impact the severity and prognosis of patients with SARS-CoV-2 infection. The objective of this study was to compare the age groups of patients with coronavirus disease 2019 (COVID-19) and to identify the prevalence of comorbidities associated with death and survival in an area of southern Italy. The data set consisted of 1985 patients with confirmed cases of SARS-CoV-2 infection who were admitted to the A.O.U. San Giovanni di Dio e Ruggi d'Aragona Hospital in Salerno between January 2021 and December 2022. The results were presented for the overall population and stratified by outcome and age group. All analyses were performed using the XLSTAT (Lumivero, 2024, Paris, France) and STATA software (release 16.1, StataCorp LLG, College Station, TX, USA, 2019) packages. In the study, population, 636 cases (32%) resulted in death, with a higher prevalence in the 60-79 age group, followed by the ≥80 and 30-59 age groups. The most prevalent diseases among deceased and surviving patients with confirmed cases of SARS-CoV-2 infection were those affecting the circulatory system (61.5% vs. 55.5%), the respiratory system (55.8% vs. 26.2%), and the metabolic system (25.9% vs. 25.4%). In patients aged 30-79, respiratory diseases were the primary cause of mortality, whereas in those aged ≥80, circulatory system diseases were more prevalent. Among survivors, cardiovascular diseases were the most common comorbidities across all age groups, followed by respiratory diseases and endocrine, metabolic, and immune disorders. Moreover, these comorbidities were associated with an elevated risk of mortality. The study emphasizes the substantial influence of age and comorbidities on the mortality associated with SARS-CoV-2 infection. These findings highlight the necessity for targeted interventions to manage comorbid conditions in patients with SARS-CoV-2 infection, particularly in older adults.

Comparative analysis of the frequency of comorbid diseases in axial psoriatic arthritis and other variants of axial spondyloarthritis. Data from a hospital cohort

Objective: to compare the frequency of comorbid diseases in axial psoriatic arthritis (axSpA) and in other variants (OV) of axial spondyloarthritis (axSpA).Material and methods. We studied 60 patients, 30 with axPsA (15 men and 15 women, mean age – 49.1±10.4 years, disease duration – 12.6±6.9 years) and 30 with OV axSpA (16 men and 14 women, mean age – 42.9±9.7 years, disease duration – 16.30±8.3 years). All patients underwent a standard rheumatological examination. The diagnosis of comorbid diseases was confirmed using ICD-10 codes. The Cumulative Illness Rating Scale (CIRS), Charlson comorbidity index (CCI) and the weighted version of Functional Comorbidity Index (w-FCI) were used to assess comorbidity.Results and discussion. Comparative analysis of the two groups revealed that axPsA patients were older than OV axSpA patients (p <0.05). Occurrence of back pain before the age of 40 was observed in 60% of axPsA cases, compared to 86.7% in OV axSpA (p<0.05). The limitation of spinal and hip mobility was less severe in axPSA than in OV axSpA. The median side flexion was 12.3 [10; 15] and 9.5 [8; 11] cm, the Schober test was 4.2 [3; 5] and 3.0 [2; 4] cm and intermalleolar distance was 95.9 [86; 102] and 83.0 [75; 100] cm, respectively (p<0.05). Patients with axPsA were more likely to have peripheral arthritis compared to patients with OV axSpA: 27 (90%) and 11 (36.7%) cases, respectively (p<0.05) and higher laboratory indices of activity: median ESR, 31.9 [10; 38] and 20.4 [5; 14] mm/h, and CRP, 20.5 [2.8; 20.7] and 13.6 [0.9; 12.0] mg/L, respectively (p<0.05). In the axPsA and OV axSpA groups, circulatory system diseases were found in 50 and 50% of patients, metabolic disorders in 76.6 and 76.6%, and gastrointestinal diseases in 46.7 and 70 %. Obesity was more common in axPsA than in OV axSpA – in 40 and 16.7% of patients, respectively (p<0.05).Conclusion. A high frequency of comorbidities, mainly cardiovascular and metabolic diseases, was found in both groups. These data should be considered in the choice of therapy and optimization of existing treatment algorithms.

A comparative study of blood viscometers of 3 different types.

The greater the viscosity of the blood, the more difficult its flow becomes, leading to an increased incidence of diseases caused by blood circulation disorders. These diseases are commonly associated with the cardiovascular and cerebrovascular systems. High blood viscosity is a primary cause of circulatory system diseases. Studies have shown that accurately measuring blood viscosity and applying this data in clinical trials can help prevent circulatory system diseases. Viscosity data can vary depending on the measurement methods used, even when these methods are based on hydrodynamic principles. Despite using approved blood viscometers, the results often differ depending on the type of viscometer used, potentially causing confusion within the medical field. Informing the medical community about these differences and the level of error associated with each measurement method can help reduce this confusion. To our knowledge, the degree of difference in viscosity measurement results due to different measurement methods and the reasons for these differences have not yet been thoroughly explored. In this study, we selected three blood viscosity measurement methods registered with the Ministry of Food and Drug Safety of Korea to analyze the same canine blood. The viscosity measurements were carried out using each device and compared. The parallel plate and scanning capillary methods yielded similar viscosity values, while the cone plate method showed lower viscosity values. The viscosity of blood, as measured by the three viscometers, differed, indicating that more experimental data must be accumulated to evaluate the cause of these differences. In this paper, we identified several causes of inconsistency and suggested measures to avoid this confusion. However, confirming that the test results show systematic differences is expected to assist clinicians who diagnose and prescribe treatments based on blood viscosity results. The findings of this comparative study are anticipated to serve as a starting point for establishing guidelines or standards for blood viscosity measurement methods.

The cost of obesity and related NCDs in Brazil: An analysis of hospital admissions, disability retirement benefits, and statutory sick pay

ObjectivesThis study analyses the prevalence of overweight/obesity in Brazil, and its costs regarding hospital admissions (HA), disability retirement benefits (DRB), and statutory sick pay (SSP) associated with obesity-related non-communicable diseases (NCDs). Study designTime-series study. MethodsThis study analyses data from the VIGITEL system (2010–2019) to calculate the body-mass index (BMI) of adult residents in Brazil's state capitals. Data on HA, DRB, and SSP were obtained from Brazil's SIH/SUS and AEPS Infologo systems. Pearson's correlation and linear regression models were applied. The study selected 23 diseases of the International Classification of Disease (ICDs) belonging to chapters C; E; I; and K. Cost values in BRL were deflated using IPCA. ResultsThe results showed a significant increase in overweight and obesity rates in Brazil, with BMI rising by 0.09 kg/m2 annually. Regression analysis revealed that each 1-point increase in the average BMI of the population is associated with an increase of 81,772 (BRL 237.51 million/year) new HA per year, 5541 (BRL 18.8 million/year) new DRB granted per year, and 42,360 (BRL 131 million/year) new SSP per year. Also, every 1 % increase in the share of the Brazilian population with obesity is associated with an increase of 16,973 (BRL 48.8 million/year) new HA per year, 1202 (BRL 3.97 million/year) new DRB granted per year, and 8686 (BRL 26.8 million/year) new SSP per year. Regressions for deflated values showed lower significance, suggesting a strong impact of inflation on health costs in Brazil. ConclusionsObesity prevalence in Brazil implies high direct and indirect costs for the Brazilian government, especially considering circulatory system diseases.

Using mathematical models in the assessment of the circulatory system in employees working under harmful occupational conditions

Introduction. According to the results of medical examinations of metallurgists, in the structure of newly identified somatic morbidity, circulatory system diseases (CSD) are one of the leading pathologies. To assess the prevalence of CSD in workers in harmful working conditions, it is possible to use various mathematical solutions as a tool. The objective of the study was to substantiate the possibility of using variance analysis and classification tree (CT) methods to assess the prevalence of circulatory diseases in industrial workers. Materials and methods. Data of medical examinations and a questionnaire-based survey of three hundred eight workers of steel production were input into a database. The interrelationship between CSD and individual and occupational risk factors was examined using a one- and two-way ANOVA. The classification tree method was used for a multivariate analysis. Results. The one- and two-way ANOVA revealed a statistically significant correlation between the CSD family history (p=0.001) and age, years of occupational exposure, overweight, blood glucose level, total cholesterol (p<0.05) and the CSD prevalence in the steel workers. We applied the classification tree method to make decisions on referring the subjects to potentially “healthy” and “sick” workers by determining the CSD prevalence in relation to various combinations of risk factors. Limitations. This study is limited to the results of medical examinations of the workers collected over a one-year period. Conclusions. Our experience in using the analysis of variance and classification tree to evaluate the CSD prevalence in ferrous industry employees allows recommending them for use in assessing the prevalence of various diseases in workers exposed to occupational hazards.

Comparative analysis of the primary morbidity in the population in the territory of accumulated risk over the post-operation period of a chemical enterprise

Introduction. The long-term operation of the chemical enterprise has led to the formation of an area of accumulated harm to public health. The purpose of the study is to investigate the trend in newly identified morbidity in various population groups living in areas of accumulated chemical pollution of the environment. Materials and methods. The primary morbidity rate of the population of Usolye-Sibirskoye was assessed retrospectively according to official statistical reporting – during 1985–1995. and 2016–2022. Relative rates of incidence among children and adults (per 1000 population) were calculated. The trend in the incidence of malignant neoplasms was studied using regression analysis and growth (decrease) rates. Results. Over 2016–2022 there was a gain in the incidence in the population: in 0–14 years children by classes: certain conditions in the perinatal period, blood diseases, neoplasms; in 15–17 years adolescents: by class of disease of the circulatory system, blood, endocrine and genitourinary systems, congenital malformations, neoplasms; in the adult population by classes of diseases including congenital malformations, diseases of the endocrine system, circulatory system, musculoskeletal system and blood diseases, neoplasms. Limitations are due to changes in the structure of statistical reporting forms and various etiological factors for diseases included in one class of diseases. Conclusion. During the post-operation period of the city-forming enterprise, an increase in incidence in children and adults was revealed. Undoubtedly, the formation of pathology was influenced not only by the unfavourable environmental situation in the city, but also by socio-economic conditions. To optimize medical and preventive measures to improve and preserve public health, it is necessary to conduct further studies of the health status in the population in the area of accumulated chemical pollution.

Influence of patient characteristics and discharge destination on circulatory system diseases readmissions among older heart failure patients

IntroductionHeart failure (HF) prevalence is rising, particularly among older people, constituting a significant cause of hospitalization. Discharge destinations, including nursing homes (NH), play a crucial role in post-hospitalization outcomes but remain underexplored. MethodsA retrospective study utilizing the Spanish National Health System's Minimum Basic Data Set identified older HF patients (≥75 years) discharged from acute hospitals between 2016 and 2019. Patient demographics, comorbidities, and discharge destinations were analyzed. Predictors of 30-day readmissions for circulatory system diseases and NH admission were assessed using multilevel logistic regression models. ResultsOf 157,330 index episodes, 2.8 % were discharged to NH, more frequently in females. Thirty-day readmission incidence was 9.3 %, with HF exacerbations accounting for 80.6 % of cases. Predictors of 30-day readmission included renal failure (OR: 1.38), severe hematological disorders (OR: 1.30), and history of coronary revascularization surgery (OR: 1.23), while discharge to NH lowered the risk (OR: 0.70). Admission to NH was associated with neurological diseases (OR: 3.27), cardiogenic shock (OR: 3.19), stroke (OR: 2.68), advanced cancer (OR: 2.51), with higher likelihood among females (OR: 1.23). After propensity score-matched analysis, patients discharged to NH had significantly lower 30-day readmission rates than those discharged home (6.4 % vs. 28.9 %, adjusted OR: 0.169). ConclusionDischarge to NH is infrequent but associated with lower readmission risk for older HF patients. Female gender, specific comorbidities, and acute conditions influence NH admission. Enhanced collaboration between HF units and NH is crucial for optimizing post-hospitalization outcomes. Further research and policy initiatives are needed to improve care coordination and reduce HF readmissions.

Comparative study for fatigue prevalence in subjects with diseases: a systematic review and meta-analysis

Fatigue is one of the common symptoms in individuals with diseases or disorders, significantly affecting quality of life (QoL) and the prognosis of diseases. This study aimed to comprehensively compare the features of fatigue across a wide range of diseases. We systematically searched the PubMed and Cochrane Library databases from inception to March 31st, 2021, and conducted a meta-analysis to generate precise estimates. The analyses were stratified by classification of diseases, gender, and severity of fatigue (moderate and severe), and study quality was assessed using the Newcastle–Ottawa Scale (NOS). In total, 214 articles (233 prevalence data) met our eligibility criteria, covering 102,024 participants (mean 438 ± 1,421) across 88 diseases. Among these, seventy-eight data sets (52,082 participants) and thirty-nine data sets (10,389 participants) reported gender- and severity-related fatigue prevalence. The overall prevalence among subjects with 88 diseases was 49.4% [95% CI 46.9–52.1]. According to the International Classification of Diseases-10 (ICD-10) classification, the highest prevalence of fatigue (65.9% [95% CI 54.9–79.6]) was observed in patients with mental/behavioral diseases, whereas the lowest prevalence (34.7% [95% CI 24.5–49.2]) was found among those with circulatory system diseases. A slight female dominance (43.5% vs. 49.8%) was observed in the total data, with the most notable female predominance (1.8-fold) seen in patients with low back pain. The top disease groups with a moderate to severe level of fatigue included gastroparesis (92.3%), pulmonary hypertension (90.0%), chronic obstructive pulmonary disease (COPD, 83.2%), and multiple sclerosis (80.0%). These results are the first to comprehensively show the comparative features of fatigue prevalence among subjects across 88 diseases. Our findings provide valuable reference data for future research on fatigue and for the management of patients with fatigue.Prospero registration number: CRD42021270494

The effect of MIND diet on sleep status, anxiety, depression, and cardiometabolic indices in obese diabetic women with insomnia: study protocol for a randomized controlled clinical trial {1}

BackgroundThe Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is a plant-based and anti-inflammatory diet that has the ability to protect and manage cardiovascular and nervous system diseases. Regarding that insomnia and cardiovascular problems are x`common in type 2 diabetes mellitus (T2DM), the present study will assess the effectiveness of the MIND dietary pattern on sleep quality, cardiometabolic indicators, and other psychological indicators.MethodsForty-four overweight/obese T2DM women with insomnia, aged 30–65 years, will voluntarily participate in this randomized controlled trial and will be randomized to receive either a MIND low-calorie diet (MLCD) or a low-calorie diet (LCD) over a 3-month period. Before and after the study, sleep quality, some biochemical and cardiometabolic indices, cortisol, brain-derived neurotrophic factor (BDNF), high-sensitivity C-reactive protein (hs-CRP), and oxidative stress indicators will be assessed.DiscussionThe use of dietary interventions in the management of T2DM complications is practical and safe. This research seeks to investigate the capacity of the MIND diet in the management of insomnia and cardiovascular problems of DM. It is expected that the results of this research will provide new perspectives on using an ideal dietary regimen to treat these health conditions.Trial registrationIRCT20181111041611N8. Registered on August 7, 2023. https://www.irct.ir/trial/71772