Cumulative Prevalence Research Articles

Implantable cardioverter defibrillators among elderly survivors of out-of-hospital cardiac arrest

Abstract Background Survivors of out-of-hospital cardiac arrest (OHCA) with a shockable rhythm are at increased risk of cardiac arrest, and clinical practice guidelines recommend placement of an implantable cardioverter defibrillator (ICD) in the absence of a reversible cause and an expected meaningful survival of at least one year. Contemporary data on the prevalence of secondary prevention ICD placement among OHCA survivors remain limited. Purpose Examine patterns of secondary prevention ICD implantation in survivors of OHCA due to a shockable rhythm in a large national registry. Methods Using 2013-2019 data from the Cardiac Arrest Registry to Enhance Survival (CARES) linked to Medicare files, we identified 3,226 patients aged >65 years who survived to discharge following OHCA due to an initial shockable rhythm from January 1, 2013 to December 31, 2019. Patients with severe neurological disability, prior history of cancer, and those discharged to hospice were excluded. We calculated cumulative prevalence of ICD implantation at discharge, 90 days, and 6 months post cardiac arrest. Multivariable hierarchical regression models with random hospital effects were used to determine the adjusted association of patient characteristics with ICD implantation and quantify the extent of variation in ICD implantation across sites, using a median odds ratio (OR) and 95% confidence interval (CI). Results Patients’ mean age was 72.2 years; 23.5% were women, 10% were Black and 4% Hispanic. Among 3,226 OHCA patients, 997 (30.9%) received an ICD before discharge; 1,266 (39.2%) received an ICD within 90 days of cardiac arrest, and 1,287 (39.9%) received an ICD by 6 months. After adjusting for differences in demographics and co-morbidities, the odds of receiving an ICD at discharge were significantly lower in patients aged 85 years and older, women, patients with prior history of stroke or diabetes, patients who presented with acute myocardial infarction (P<0.05 for all). There was no significant difference in ICD implantation by race and ethnicity (P=0.94) (Table 1). Even after adjusting for patient demographics, co-morbidities, and presentation with acute myocardial infarction, there was large variation in hospital rate of ICD implantation at discharge, with a median odds ratio of 1.65 (95% CI 1.41-1.86). Conclusion Fewer than 1 in 3 patients with OHCA due to a shockable rhythm are discharged with a secondary prevention ICD. Although implantation of ICD was associated with patient variables, there was no difference in ICD implantation by race and ethnicity. There was large variation across hospitals in ICD implantation even after adjusting for patient variables highlighting an opportunity for improving post-arrest management of cardiac arrest survivors.

Impact of Irrigation Source on the Dissemination and Persistence of Coliforms and Foodborne Pathogens in Fresh Tomato High Tunnel-dripline System from Small Specialty Crop Farms

This study investigated the impact of irrigation sources (pond, stream, and well) in high tunnel-dripline systems on the dissemination and persistence of foodborne pathogens (Escherichia coli O157, Listeria monocytogenes, Campylobacter spp., Salmonella spp., and the ‘big six’ Shiga toxin-producing E. coli [STEC]) in small specialty crop farms (SSCFs). Ten SSCF-growing fresh tomatoes using high tunnel-dripline systems were sampled between January and November 2022. Selective enrichment combined with PCR was used to detect the selected foodborne pathogens in the irrigation water (n = 240), soil (n = 240), and tomato fruits (n = 120). Overall, surface-originated water sources (streams and ponds) having potential contact with farm animals or wildlife harbored higher pathogen burden (cumulative prevalence of all the pathogens) compared to subsurface water source (well and underground spring water). STEC O26, O45, and O103 were detected at high frequency (up to 88% per SSCF per time point) in the water source and associated dripline irrigation system of 4/6 SSCFs using stream and pond water. Other foodborne pathogens (especially, L. monocytogenes) were detected in 6/10 SSCFs, but at low frequency (<25% per SSCF per time point). The prevalence of foodborne pathogens in the 10 SSCFs over time was positively correlated with the length of high tunnel and planting date (r2 = 0.93 and 0.79, respectively; P < 0.006). Our study highlighted that dripline irrigation systems may allow the long-distance transport of foodborne pathogens from the contaminated water source to the field. Risk assessment and mitigation measures should be implemented to assure the quality of the water source used for irrigation in SSCF.

Occupational differences in SARS-CoV-2 infection: the Japan COVID-19 and Society Internet Survey (JACSIS) study in 2022

BackgroundDuring the coronavirus disease (COVID-19) pandemic, essential workers (e.g. medical workers) may be at a high prevalence of contracting COVID-19; however, the trend remains unclear in Japan. This study aimed to investigate occupational differences in the prevalence of COVID-19.MethodsData were retrieved from the 2022 Japan COVID-19 and Society Internet Survey. We analyzed the self-reported SARS-CoV-2 infection as of October 2022. We included 21,875 participants aged 20–64 years. Participants were classified into five occupation groups (“medical workers,” “off-site medical workers,” “care workers,” “other essential workers”, and “non-essential workers”), as well as those unemployed. The prevalence ratio of COVID-19 was computed using Poisson regression. We included sex, age, SARS-CoV-2 vaccination history, number of households, education level, and residential area as covariates. Additionally, we performed similar analyses for three time periods: (1) August–September 2022, (2) October 2021 to July 2022, and (3) before September 2021.ResultsThe overall cumulative prevalence of COVID-19, as of October 2022, was 16.5%. Regarding occupation, medical workers had a higher prevalence than non-essential workers (23.5% vs 16.2% (difference: 7.2% point [95% confidence interval (CI): 4.2–10.2])). Similar results were observed among care workers compared with non-essential workers (22.1% vs 16.2% (difference: 5.9% point [95% CI: 2.5%–9.3%])). Other essential workers had a similar prevalence to non-essential workers (17.6% vs 16.2% (difference: 1.4% point [95% CI: -0.1%–2.8%]). In relative terms, medical workers and care workers were associated with an increased prevalence of COVID-19 (prevalence ratio: 1.44 [95% CI: 1.20–1.73] and 1.36 [95% CI: 1.11–1.66], respectively). In addition, we found that younger age, living in endemic region (e.g., Tokyo and Osaka), and living with more than four people contributed to the higher prevalence. According to the time period, the prevalence was significantly higher in medical and care workers than in non-essential workers only during August–September 2022, which corresponded to the severest outbreak period in Japan.ConclusionsIn Japan, medical and care workers had a higher prevalence of contracting COVID-19 compared to non-essential workers. However, this trend emerged during the peak of the COVID-19 spreading in the summer of 2022.

Age of Emergence of Disparities in Asthma Prevalence and Morbidity among US Children.

Early-life exposures may precipitate asthma, but their contribution to disparities in asthma is less clear. To elucidate racial, ethnic, and socioeconomic status (SES) disparities in the age trajectory of asthma burden among US children. We analyzed three datasets: (1) 2016-2021 National Children's Health Survey (NCHS) (n=223,551); (2) 2015-2017 Child Asthma Call-Back Survey (ACBS) (n=4,289); and (3) 2018-2019 National Inpatient Sample (NIS) (n=23,713 children with asthma). We examined cumulative asthma prevalence by individual-year of age and children's race and ethnicity or SES (NCHS); mean age at asthma diagnosis by race and ethnicity and SES, unadjusted and adjusted for confounders (ACBS); and asthma hospitalization rates overall and per child with asthma by individual year of age and race and ethnicity (NIS). Among White children, cumulative asthma prevalence rises gradually through childhood, to 6.6% at age 5 and 16.1% by age 17. Prevalence rises more sharply in early childhood among Black children, reaching 17.6% at age 5 (RR 2.6;95%CI 1.9,3.8), but plateaus after age 9, with a consequent decline in Black-White relative disparities into adolescence. Disparities according to SES follow a similar trajectory, emerging early and subsequently narrowing. Similarly, Black, Hispanic and low-income children with asthma are diagnosed at an earlier age than White (or high-income) children. The asthma hospitalization rate rises in the first years of life among all children, but most rapidly among Black children, with a peak absolute Black-White gap at age 4; the relative gap remains wide throughout childhood and peaks at age 10. However, per child with asthma, relative disparities in White-Black hospitalizations rise through age 15. Disparities in asthma prevalence emerge in early childhood and then narrow, suggesting that reducing early-life adverse environmental exposures may be key to asthma prevention. Policies to improve the social determinants of health during gestation and childhood, e.g. environmental equity and family income support, are needed.

Burden of rheumatic diseases among people with diabetes: A systematic review and meta-analysis

Diabetes mellitus type 2 (DM2) is a prevalent metabolic condition affecting over 500 million people globally and associated with serious comorbidities, including various rheumatologic conditions. Some studies have reported a significant association between rheumatological conditions and DM2. However, the global burden of rheumatological conditions among people with DM2 remains unknown. The aim of this study was to assess the cumulative prevalence of rheumatological conditions in DM2 patients. An extensive electronic search was conducted utilizing multiple databases of studies published until January 2024. The quality of the studies included in the review was evaluated using a modified version of the Newcastle-Ottawa Scale (NOS). The overall quality of the studies included was rated as moderate. The review included a total of 13 studies, with 830,649 DM2 patients reported to have rheumatological conditions. Eleven studies were used to determine the individual results of rheumatoid arthritis (RA), gout, and osteoarthritis (OA). The pooled prevalence of OA was 26% (95%CI: 19–32%) and the prediction interval ranged from 6% to 51%. The pooled prevalence of gout disease was 1% (95%CI: 0.0–5.0%), and the prediction interval ranged from 0% to 99%. For RA, the combined prevalence was 0.3% (95%CI: 0.2–0.5%) and the prediction interval ranged from 0% to 5%. In conclusion, this review suggests a considerable prevalence of OA among DM2 patients, while the prevalence of RA and gout was minimal. Early diagnosis and management of certain rheumatologic conditions in individuals with DM2 may help improve health outcomes and prevent premature mortality. Further research is warranted to explore and understand the mechanisms underlying the association between DM2 and rheumatological conditions.

Prevalence of cumulative cardiovascular risk factors among women of childbearing age in France: Results of the GYNRISK® survey

Global burden of cardiovascular disease is growing worldwide among women, particularly in younger women. Corresponding increases in the number and severity of cardiovascular risk factors (CVRF) associated with a greater impact in women could explain this increase in incidence. The prevalence of CVRF remains poorly known within young women, especially their cumulative prevalence. This study aimed to determine the prevalence of traditional and emerging CVRF, including female-specific CVRF, in young French women of childbearing age (16–45 years). The GYNRISK® survey aimed to analyse the magnitude and cumulation of CVRF. Two thousand women, representative of the general population, completed a self-administered, computer-assisted web interviewing survey.Results highlighted the high prevalence of traditional CVRF (73.8 % with at least one CVRF). Modifiable CVRF were also particularly high, especially overweight/obesity (31.3 %), tobacco/cannabis consumption (24.0 %), sedentary lifestyle (55.4 %), low fruit and vegetable intake (83.6 %), and poor health literacy (87.2 %). Additionally, a high prevalence of accumulated CVRF was reported, with 37.8 % of young French women having ≥2 traditional CVRF, 69.6 % having ≥1 traditional and ≥1 emergent CVRF, and 73.3 % having ≥1 traditional in addition to ≥1 lifestyle associated CVRF. Among women receiving combined hormonal contraception (CHC), 34.0 % had a contraindication for CHC due of the presence of CVRF (single or cumulative) according to recommendations. GYNRISK® survey highlighted the need for more data in this understudied population of young women. Increasing knowledge, screening, prevention, and information, with targeting on modifiable CVRF must be a priority to reduce women cardiovascular burden.

Клинические популяционно-генетические исследования наследственных болезней среди детского населения Северной Осетии – Алании

Currently, there is limited understanding about the cumulative prevalence, diversity, and frequency of distinct orphan hereditary diseases (OHDs) in the pediatric population, both within the Russian Federation and in the global literature. This gap exists despite a significant demand for such knowledge in healthcare and society. Variability and heterogeneity of the above indicators are common across different populations, reflecting significant genetic heterogeneity of OHDs. The study aimed to assess OHDs in the pediatric population of the Republic of North Ossetia – Alania (RNO-A). A total of 543,817 people were evaluated, including 145,560 children aged 0–18 years. The cumulative prevalence of autosomal recessive (AR), autosomal dominant (AD), and X-linked (XL) OHDs was determined. The findings indicate an overall prevalence of OHDs among children of the RNO-A of 1 : 119, meaning that approximately 1% of children are diagnosed with these conditions. Notably, the total burden in children of all types of OHDs in rural areas exceeds that in urban areas and district centers by more than twofold. We identified 1,241 patients from 1,037 families with 241 distinct OHDs (109 with AD inheritance, 102 with AR inheritance, and 30 with XL inheritance). Three diseases were particularly prevalent in this population and have not been documented in similar studies: congenital myasthenia type 12, a rare form of congenital adrenal cortex dysfunction (3-beta-hydroxysteroid dehydrogenase deficiency), and brachydactyly E — amelogenesis — mental retardation — nanism syndrome. Thus, the population of the RNO-A exhibits a unique spectrum of OHDs caused by rare mutations, some of which are infrequent in other populations of the world and the Russian Federation. The significantly higher prevalence of these disorders in rural populations is noteworthy, underscoring the need for tailored, region-specific programs aimed at preventing childhood disability and/or mortality.

Association of hypertension and long-term blood pressure changes with new-onset diabetes in the elderly: A 10-year cohort study.

To explore the correlation between new-onset diabetes (NOD), hypertension and blood pressure management among elderly individuals in China. A cohort analysis involved 1380 participants aged 60 years or older, initially free of diabetes in 2008, from the Chinese Longitudinal Healthy Longevity Survey. Follow-up assessments occurred every 2-3 years. The relationship between hypertension, blood pressure changes and NOD was analysed using multivariable-adjusted Cox regression. By 2018, 102 participants developed diabetes, while 1278 remained without diabetes. The cumulative diabetes prevalence increased from 3.1% at 3 years to 7.4% at 10 years. Hypertension prevalence increased from 20.9% at baseline to 41.0% at 10 years, with higher rates in those diagnosed with diabetes during follow-up. Multivariate analysis identified age, gender, baseline hypertension and systolic blood pressure (SBP) as independent predictors of NOD. Hypertension combined with overweight/obesity significantly increased the risk of NOD (hazard ratio [HR] 2.837; 95% confidence interval [CI], 1.680-4.792). We evaluated participants' blood pressure management levels in 2008 and 2011, then tracked the onset of diabetes from 2011 to 2018. Compared with participants with an average SBP below 120 mmHg in 2008 and 2011, those with SBP of 140 mmHg or higher had an 8-fold higher risk of developing NOD (adjusted HR8.492, 95% CI 2.048-35.217, P = .003), the highest risk group. Participants with SBP of 130-139.9 mmHg also had a significantly increased risk (adjusted HR 5.065, 95% CI 1.186-21.633, P = .029), while those with SBP of 120-129.9 mmHg showed no significant difference (HR 2.730, 95% CI 0.597-12.481, P = .195). Consistently high SBP (≥ 130 mmHg) further increased NOD risk (adjusted HR 3.464, 95% CI 1.464-8.196, P = .005). Significant predictors of NOD included age, gender, baseline hypertension and blood pressure management. Maintaining SBP consistently below 130 mmHg may be an effective strategy to reduce the incidence of NOD in the general elderly population.

Splenic complications in pediatric sickle cell disease: A retrospective cohort review.

To delineate the natural history of splenic complications other than loss of splenic function in children with sickle cell disease (SCD), we performed a retrospective chart review of patients with SCD treated at the Texas Children's Hospital. We determined the dates of diagnoses of splenic complications, the number of acute splenic sequestration crises (ASSC), and hydroxyurea treatment in pediatric patients with SCD. We also examined the association of hydroxyurea therapy with the onset and severity of ASSC. The cumulative prevalence of splenic complications was 24.7% for splenomegaly, 24.2% for ASSC, 9.6% for hypersplenism, and 5.6% for splenectomy. The cumulative prevalence of splenic complications was highest in patients with hemoglobin Sβ0 (69.2%), intermediate in hemoglobin SS (33.3%), low in hemoglobin SC (9.0%), and non-existent in hemoglobin Sβ+. The overall event rate of ASSC was 8.3 per 100 patient-years. The event-rate was 28.4 for hemoglobin Sβ0, 10.9 for hemoglobin SS, and 3.5 for hemoglobin SC. Patients with hemoglobin SS and hemoglobin Sβ0 on hydroxyurea therapy had a significantly higher occurrence of ASSC than those who were not, with event rates of 14.2 and 3.1, respectively. The event rate was also higher for children who started hydroxyurea before age 2years than for those who started after this age (19.8 and 9.2, respectively). The prevalence and severity of splenic problems vary widely between different sickle cell genotypes, with hemoglobin Sβ0 having the most severe complications. Hydroxyurea therapy is associated with increased incidence of ASSC, particularly when initiated before 2years of age.

Increased cardiovascular morbidity and reduced life expectancy in a large Italian cohort of patients with resistance to thyroid hormone β (RTHβ).

Decreased survival and higher cardiovascular morbidity have been recently reported in a UK cohort of 61 RTHβ patients, but there is no evidence from other countries. Retrospective cohort study from an historical group of 284 Italian RTHβ patients, diagnosed between 1984 and 2023. We collected data on diagnosis of 284 cases and longitudinal data of 249 RTHβ who carried heterozygous pathogenic variants in the THRB gene. We studied how thyroid function and recognized risk factors for cardiovascular disease, such as hypertension and diabetes, affected overall mortality and major cardiovascular events. The cumulative prevalence of sinus/supraventricular tachycardia and atrial fibrillation was 40% and 18%, respectively. FT4 values 57% higher than the upper limit of normal were associated with premature cardiovascular manifestations. Major cardiovascular events (MACEs) occurred in RTHβ patients at a median age (IQR) of 59.4 years (50.4-66.4) and early mortality resulted in a mean of 11 years of life lost. While at univariable analysis hypertension, dyslipidemia, high fasting glucose/diabetes were also associated with MACEs, at multivariable analysis only age at diagnosis, increased fT4 levels, and male gender remained significantly associated with MACEs and age at diagnosis and higher fT4 levels with mortality. Previous thyroidectomy or radioiodine therapy had no statistically significant effect in the prevention of major cardiovascular events or all-cause mortality. These data should raise the general awareness on the cardiovascular risk and prompt a proactive cardiovascular monitoring in RTHβ, especially in men and those with fT4 levels above 30 pmol/L.

Association of early post-transplant hyperglycaemia and diabetes mellitus on outcomes following heart transplantation.

Early post-transplant hyperglycaemia (EPTH) and post-transplant diabetes mellitus (PTDM) are common following solid organ transplantation and may be associated with adverse outcomes. We studied the prevalence of EPTH and cumulative 5-year prevalence of PTDM in a modern cohort of heart transplant recipients who were free from diabetes at baseline as well as the association of EPTH, PTDM and pre-transplant T2DM with adverse transplant-related outcomes. Retrospective cohort study of heart transplant recipients followed for 5 years at a single centre in Sydney, Australia. A total of 141 patients were included, of whom 25 had pre-existing type 2 diabetes mellitus (T2DM) and 116 were free from diabetes at baseline. In patients without pre-existing T2DM, 88 of 116 (76%) experienced EPTH, which was associated with higher rates of acute rejection and hospitalizations, and lower 5-year survival. PTDM developed in 45 of 116 (39%) patients, all of whom had experienced EPTH. Both PTDM and pre-existing T2DM were associated with increased rates of graft rejection and hospitalization, and greater than three-fold increased likelihood of death compared to patients that remained free from diabetes. EPTH and PTDM are highly prevalent following cardiac transplantation. EPTH develops within days of transplant and is strongly associated with progression to PTDM. Pre-existing T2DM, PTDM and EPTH are associated with greater hospitalization, increased episodes of rejection and worse 5-year survival compared to patients who remained free from diabetes during follow-up.

Alignment of parent-proxy report and teen self-report of adverse childhood experiences among U.S. teens

PurposeData on adverse childhood experiences (ACEs) among teens is collected using a single informant, a parent-proxy, or teen self-report. Little is known about alignment between these approaches. MethodsSurveys were administered online to teens ages 15–17 and their parents (n = 522 dyads) using the AmeriSpeak panel. We present descriptive statistics on the prevalence and measures agreement for 18 ACEs based on teen self-report and parent-proxy report. We fit multivariable models examining associations between teen and household demographic characteristics and discordance in ACE report. ResultsBased on teen-self report and parent-proxy report, cumulative and individual ACE prevalence was overall similar. However, discordance was found in individual ACE reports within teen-parent dyads (discordance ranged: 2.9–21.2 %). Lowest agreement was among ACEs related to abuse, neglect, and violence victimization and highest among household challenges. Furthermore, parent-teen dyads with LGB+ youth (vs. heterosexual) and Black, Hispanic, and multiracial or another race (vs. White) youth were more likely to have discordant responses among several ACEs. ConclusionsSurveillance and programmatic efforts should consider the type of ACE and the reporter when using data to inform prevention strategies. Teen self-report for abuse, neglect, and violence victimization and community challenges ACEs are particularly important to capture.

COVID-19 Policy Decisions in Manitoba and the Experiences of the Red River Métis: A partnership-based, whole-population linked administrative data study

Systematically marginalized populations, like Red River Métis, have been greatly affected by COVID-19. Manitoba’s Indigenous COVID-19 vaccine policy initially delayed prioritization of Métis. Our research team, which included Métis partners, examined the consequences of these decisions (COVID-19 infections, health service use, vaccine uptake) among Métis, and how earlier prioritization could have improved outcomes. This retrospective cohort study linked data from the Métis Population Database to whole-population COVID testing and vaccination data, and administrative data on health service use. Restricted mean survival time models tested whether vaccination uptake differed between Métis and all other Manitobans (AOM), adjusting for sociodemographic characteristics and comorbidities. A Bayesian model will simulate how prioritization of Métis for vaccination two weeks earlier could have impacted infections. Cumulative prevalence of COVID-19 infection rates were similar among Métis and AOM until May 2021 when rates became higher among Métis. Between May and December 2021, rates of first vaccination were lower among Metis than AOM, as were second vaccination rates between July and November 2021. Métis were more likely than AOM to be hospitalized due to Covid-19 between March and August 2021 and visit physicians for COVID related reasons from October 2020 to Feb 2021 and November 2021 to March 2022. Our analyses simulated what would have occurred had Métis been prioritized for vaccination two weeks before AOM, alongside other Indigenous peoples. Understanding the experiences of Métis relative to AOM is critical to identifying public health strategies which close gaps in vaccine uptake and infections.

The impact of depression on platelet activation, cardiocerebral vascular events and arteriovenous fistula dysfunction in patients undergoing haemodialysis

Depression is a common psychiatric disorder among patients undergoing maintenance haemodialysis (MHD). Depression may reportedly contribute to poor prognosis in several ways, including its effects on platelet function. We hypothesised that depression contributes to the occurrence of cardiocerebral vascular events (CCVE) and dysfunction of arteriovenous fistula (DAVF) in patients undergoing MHD through its effects on platelets. In this prospective cohort study, patients undergoing MHD were recruited and divided into depression and non-depression groups according to their Hamilton Depression Scale (HAMD) scores. The 286 enrolled patients had 103 occurrences of depressive symptoms (prevalence = 36.01%). Compared with the non-depression group, depression group had a significantly higher cumulative prevalence of CCVE and DAVF during follow-up. Cox regression analysis indicated that higher HAMD scores and lower plasma platelet distribution width (PDW) were common risk factors for CCVE and DAVF. Furthermore, HAMD scores were significantly negatively correlated with plasma PDW and was the main variable affecting changes in PDW, as indicated by multiple linear regression analysis. Depression may increase the risk of CCVE and DAVF in patients undergoing MHD by activating platelets. Plasma PDW may be a convenient indicator of platelet activation status and may predict the risk of CCVE and DAVF.

Epidemiology and clinical correlates of hidradenitis suppurativa in primary care in Italy.

Hidradenitis suppurativa (HS) is a persistent skin disorder that is characterized by painful lesions or pus-filled lumps, mostly occurring in areas where the skin flexes. It is a disfiguring condition that significantly reduces the quality of life of those affected. Developing new, effective treatments for HS is crucial, but it is important that it be recognized and diagnosed early, especially in primary care settings. To assess the epidemiology and clinical correlates of HS in a primary care setting. The study utilized the Italian Health Search Database (HSD). A case-control design was adopted to investigate the clinical correlates of HS. Cases were classified as either "definite" or "probable" using an operational algorithm. Up to 10 controls were matched to each case based on factors such as calendar period, age, sex, and duration of follow-up. Cumulative prevalence of HS increased from 0.06% in 2002 to 0.46% in 2021. When only "definite" cases were considered, the prevalence was almost 10 times lower (0%-0.02%). Several clinical correlates were found to be positively associated with HS, including obesity, dyslipidemia, hypertension, autoimmune/inflammatory diseases, and depression. This study found that correct diagnoses of HS were made, as demonstrated by the expected relationship with clinical correlates. These associations were consistent when probable cases were included in the analysis. This evidence could serve as a foundation for proposing a decision support system for general practitioners to help identify HS in individuals with certain coexisting conditions.

Association between sex work occupational stigma and inconsistent condom use: findings from a community-based cohort of women sex workers in Vancouver, Canada (2014–2022)

BackgroundWomen sex workers face substantial health inequities due to structural barriers including criminalisation and stigma. Stigma has been associated with HIV-related inequities among marginalised populations, however, we know less about...

Greater ischiatic notch plane versus parasacral block in dogs undergoing pelvic limb surgery: a retrospective noninferiority cohort study on perioperative opioid consumption

ObjectiveTo compare perioperative opioid consumption in dogs undergoing pelvic limb surgeries and receiving a lumbosacral plexus block by combining a lumbar [lateral pre-iliac (LPI)] block with a lumbosacral trunk [i.e. parasacral (PS group) or greater ischiatic notch plane (GIN group)] block.Study design Retrospective, descriptive, exploratory, noninferiority cohort study. MethodsMedical records of 37 client-owned dogs were analyzed. Intraoperative (primary outcome) and postoperative (24 hours) opioid use, 24 hour cumulative pain scores and prevalence of complications were compared between the two groups. Opioid use was quantified in morphine equivalents (ME, mg kg–1 ). The noninferiority limit for intraoperative opioid consumption was set at 0.05 ME kg–1 hour–1. Demographic data, procedure duration, surgery type and perioperative dexmedetomidine and ketamine use were also collected. A t-test or Wilcoxon rank-sum test, a Fisher's exact test and multivariable linear regression were used. Significance was set at p < 0.05. ResultsThe GIN and PS groups comprised 17 and 20 dogs, respectively. Total intraoperative ME consumption was 0.17 (0.11–0.21) and 0.22 (0.16–0.30) mg kg–1 hour–1 for the GIN and PS groups, respectively (p = 0.077). The noninferiority analysis adjusted by surgery type and body mass revealed that the mean difference between the groups (GIN – PS) was –0.039 (95% CI –0.11–0.03, p = 0.247) ME mg kg–1 hour–1, indicating that the GIN group was not inferior to the PS group regarding intraoperative ME consumption. Dexmedetomidine and ketamine use, postoperative ME consumption and pain scores were similar between groups. Conclusions and clinical relevanceThis retrospective study and preliminary observations support the clinical use of the GIN plane block, demonstrating its noninferiority to the PS block when combined with the LPI block for multimodal perioperative analgesia in dogs undergoing pelvic limb surgeries.

РАСПРОСТРАНЕННОСТЬ И ЗАБОЛЕВАЕМОСТЬ МОЧЕКАМЕННОЙ БОЛЕЗНЬЮ В ЯРОСЛАВСКОЙ ОБЛАСТИ

In modern society, urolithiasis is one of the most common diseases. The study of trends in the incidence and prevalence of the disease is important in practical medicine. The estimated annual increase in urolithiasis is about 3%. The causes of this phenomenon are discussed, and so far they are not fully known. The purpose of the study is to assess the cumulative incident and prevalence of urolithiasis among the adult population living in various municipal districts of the Yaroslavl region based on the analysis of statistical reports of state medical institutions and medical documentation for the period from 2018 to 2023. Materials and methods: A retrospective analysis of the statistical data of the work of state medical organizations of the Yaroslavl region for this period was carried out. An analysis of the total number of adult patients attached, changes in the number of patients attached, and the total number of patients diagnosed with urolithiasis was performed using the relevant International Classification of Diseases codes N20.0, N20.1, N20.2, N20.9, N23.Results and discussions. The results showed that in the city of Yaroslavl over the past 6 years there has been a natural increase in the adult population. However, a decrease in numbers was recorded between 2020 and 2021, possibly due to the negative consequences of the COVID-19 pandemic. There is also a steady trend towards a decrease in the adult population in regions outside the regional center. Conclusion: It can be noted that urolithiasis is a widespread chronic disease of the urogenital system among the adult population living in various areas of the Yaroslavl region.

Cannabis Use from Early Adolescence to the Mid-Twenties in Children of Immigrant and Nonimmigrant Parents: Findings from a Prospective Longitudinal Cohort Study

AbstractThis study compares the developmental course of cannabis use in adolescents with versus without an immigrant background. Data came from a Swiss prospective-longitudinal cohort study (n = 1445) with nine assessments between ages 7 and 24. Parents reported their immigration history; adolescents self-reported their past-year cannabis use five times between ages 13 (in 2011) and 24 years (in 2022). Latent growth curve models revealed a curvilinear increase in cannabis use, with a peak at age 20. Adolescents whose parents had immigrated showed a less steep increase in cannabis use during adolescence and a lower cumulative prevalence of cannabis use by age 24. Specific cultural and religious backgrounds were linked with lower odds of cannabis use. Interventions in early adolescence need to consider immigration, cultural, and religious backgrounds.

Changes in Antibiotic Use and Disruptions to Antimicrobial Resistance Detection in South Africa and Uganda, 2019 – 2020

Background: The COVID-19 pandemic disrupted routine health services worldwide, including systems to detect antimicrobial resistance (AR). AR is a mounting global health threat with some studies showing the highest mortality rate from AR infection is in Sub-Saharan Africa (SSA). Antibiotic use is a major contributor to AR. We sought to characterize COVID-19-related changes to antibiotic use and AR detection capacity in two countries in SSA from 2019 to 2020. Methods: Health facilities (HF) in South Africa and Uganda were surveyed as part of a larger study assessing disruptions to essential health services in SSA in the context of COVID-19. Modified stratified random sampling of HF by facility level was conducted in regions with high COVID-19 cumulative prevalence. Hospital pharmacists were surveyed to identify perceived changes in antibiotic use. Among facilities with the capacity to detect AR, surveys were conducted with AR laboratory managers to identify perceived changes in staff, equipment, training, and supplies. Descriptive data analysis was conducted using frequencies and proportions. Results: A total of 39 HFs in South Africa and 45 HFs in Uganda responded to the antibiotic use survey. Increases in total antibiotic use from 2019 to 2020 were reported by 82% (23/28) of HF in South Africa and 68% (27/40) in Uganda. Increased use of antibiotics for multi-drug resistant bacteria (per World Health Organization Reserve classification) was reported by 36% (9/25) and 38% (8/21) of HFs in South Africa and Uganda, respectively. 19 HFs in South Africa and 12 HFs in Uganda responded to the AR detection capacity survey. HFs in both countries reported decreases in laboratory staff responsible for AR (33% [13/40] in South Africa and 31% [11/35] in Uganda). Decreased availability of reagents and consumables for bacteriology and antimicrobial susceptibility testing was reported by 50% (8/16) and 33% (4/12) of HFs, and decreased availability of specimen collection supplies for bacterial cultures was reported by 41% (7/17) and 42% (5/12) of HFs in South Africa and Uganda, respectively. Diversion of laboratory supplies was reported in both countries (32% [6/19] in South Africa and 25% [3/12] of HF in Uganda). Conclusions: HFs in South Africa and Uganda reported increases in antibiotic prescribing, a risk factor for increased AR, concurrently with disruptions in AR detection capacity during the early phases of the COVID-19 pandemic. These findings emphasize the importance of investing in bacteriology and AR testing in SSA and maintaining support during infectious disease pandemics.