Decreased Life Expectancy Research Articles

Здоровый образ жизни как средство управления рисками для здоровья: компоненты и факторы. Аналитический обзор

Healthy lifestyle promotion is a strategic task within health protection and healthcare worldwide. A prevailing contribution made by non-communicable diseases into premature death and a decrease in life expectancy makes it necessary to search for effective prevention and technologies able to persuade people to adhere to health protection behavior. The review concentrates on approaches to defining, structuring and empirical study of persuasive design of healthy lifestyle. Substantiation is provided for including physical, mental and social health protection into healthy lifestyle. The review also discusses a possibility to use the Health-Promoting Lifestyle Profile (HPLP II) scale to analyze health behavior, including Asian countries. Structural components of healthy lifestyle are identified on the basis of the HPLP II scale. Additionally, several mainstream health behavior theories and models have been selected and analyzed, which explain people’s health behavior. They provide a theoretical basis for exploring influential factors of a healthy lifestyle. Contributions made by sociodemographic and cognitive factors have also been outlines and substantiation has been provided for the necessity to consider such factors as self-efficacy and subjective health perception when developing individual prevention. This research holds valuable reference and guiding significance for the design and implementation of strategies aimed at influencing people's healthy lifestyles in related fields.

Beyond Haze: Unveiling the Health Crisis of Urban Smog

With the industrial growth and urbanization in large cities of Pakistan, the smog has become a lurking adversary amidst the haze impacting millions of people every winter season. Pakistan ranks at number 3 in the countries with poor air quality as of 2019, the main reason of which is the persistent smog. It is formed the presence of severe atmospheric pollutants suspended in air which gives it a yellowish black dense appearance. These pollutants mainly originate from industries due to the burning of fuels in industries, and from automobile exhausts due to the release of harmful gases such as ozone, nitrogen oxides and sulfur oxide along with the particulate matter such as dust and volatile compounds in air. It not only reduces visibility and obscures the skyline but is known to have serious implications for human health. Various studies associate smog with the respiratory and eye infections, allergies, and lungs cancer. The particulate matter present in the smog such as PM10 reach the lower levels of the respiratory tract and is responsible for irritation and allergies. Moreover, they carry other harmful materials, such hydrocarbons and poisonous gases with them as well that enter the blood stream via gaseous in alveoli [1]. The constituents in smog have been reported to elevate the risk of adenocarcinoma and squamous cell carcinoma in lungs in the people with chronic respiratory conditions. People from all age groups are affected with the youngest and immunocompromised individuals more susceptible to perilous effects of smog depending upon the time of exposure. Apart from respiratory system, there are various reports which link smog with the cardiovascular system issues as well. Researchers from the US Environmental Protection Agency (EPA) have proved the long-term exposure to PM2.5 can result in myocardial infarction and decreased life expectancy [2]. A number of multifaceted strategies are required to address this health crisis. Regulatory policies for the controlled emission of harmful matter in the air, and plans for the introducing cleaner technologies may prove beneficial to mitigate this risk and improve the overall air quality. Public awareness is equally critical to equip general masses with the knowledge about the adverse effects of smog and ways to prevent them. Smog is not merely an environmental concern, it’s a public health emergency which demands urgent attention. It’s a collected responsibility of policy makers and communities to revitalize the urban environments steering towards healthier tomorrows.

The Overview of Community Knowledge on the Use of Doen Antacid Drugs at Narisa Pharmacy

Heartburn is a condition characterized by pain in the stomach area. Heartburn is caused by a high concentration of stomach acid. Disease with the same symptoms is gastritis but with different levels, inflammation of the gastric mucosa accompanied by damage or erosion of the mucosa. Gastritis can also occur due to infection from the bacterium Helicobacter pylori. The condition of antacid drugs does which is an over-the-counter drug that can be found anywhere is a drug that can relieve the disease, but in the service of purchasing this drug it takes people who struggle in the world of pharmacy such as pharmacists to provide information. Previous researchers have found that if you do not receive treatment that is not in accordance with medical indications it can be bad for patients, namely worsening disease conditions, decreased life expectancy, and increased health care costs. This is dangerous for buyers of these drugs if they are not right on target of the diseases and drugs they buy, so researchers are interested in seeing a picture of public knowledge about the use of Antacid Doen drugs at Narisa Pharmacy. The method used in this study is descriptive with survey techniques where data collection uses questionnaires as a measuring tool containing questions about several knowledge domains, namely Know (Know) Understand (Comprehension) Analyze (Analysis) Apply (Application) Synthesize Unite Elements into a whole then use the Gutman scale as a choice of Yes and No answers, of course prioritizing respondents' rights including inclusion and exclusion criteria. This study is a Non Probability Sampling study with an Accidental Sampling approach, namely anyone who by chance comes to buy Antacid drugs Doen met at the pharmacy, the population in this study is the surrounding community who came to buy drugs at Apotek Narisa with the number of samples based on the selection of results from the Slovin formula as many as 68 respondents. The results showed that based on the total percentage value of p score = 85.61% entered the category (76%-100%) which is can be conluded as a category of good knowledge.

ВЛИЯНИЕ СМЕРТНОСТИ ОТ COVID-19 НА ИЗМЕНЕНИЕ ОЖИДАЕМОЙ ПРОДОЛЖИТЕЛЬНОСТИ ЖИЗНИ В СТАРШИХ ВОЗРАСТАХ В РЕГИОНАХ СЗФО РОССИИ

The article is a continuation of the study of life expectancy (LE) at older ages in the regions of the Northwestern Federal District of Russia [1] and is devoted to the analysis of the impact of mortality from the cause of death of COVID-19 on the life expectancy of men and women at older ages in the regions of the Northwestern Federal District of Russia. The paper presents the dynamics of life expectancy at birth and at older ages (60, 70 and 80 years) from 1990 to 2021. Particular attention is paid to the decrease in life expectancy in the period 2020–2021. The effect of excluding the cause of death from coronavirus infection on life expectancy in older ages has been studied. The regions with the maximum and minimum decrease in life expectancy during the pandemic were identified. The regions that would benefit the most and least from the exclusion of this cause of death were determined.

CLINICAL CASE OF FAMILIAL TUBEROUS SCLEROSIS

Relevance. Tuberous sclerosis is a genetic disease with an autosomal dominant type of inheritance, characterized by the presence of benign tumors in various organs, a progressive course leading to disability and a decrease in life expectancy.
 Clinical case. The pregnant's MRI of the brain revealed the presence of tubercles in the area of the cerebral cortex. At the time of 34 weeks of pregnancy, the presence of endocardial nodular formations in the fetus was revealed prenatally. MRI of the fetal brain showed the presence of a subependimal node in the area of the basal nuclei on the left. Postnatally: MRI-picture of multiple cortical-subcortical tubers, subependimal nodes, ECHO-CG-picture of multiple formations in the cavities of the heart. DNA diagnostics: the extended deletion of the TSC2 gene was determined.
 Discussion. During ultrasound of the 3rd screening of the fetus, large endocardium formations were found, which made it possible to suspect tuberous sclerosis. During the examination of the newborn, the diagnostic assumptions identified prenatally were confirmed. Since tuberous sclerosis has an autosomal dominant type of inheritance, it can be assumed that the pregnant has a high probability of having the same diagnosis.
 Conclusion. An integrated approach to the diagnosis of this disease allows you to pay attention to the patient in a timely manner and choose the appropriate treatment tactics.

Cancer Treatment Decision-Making for People Living With HIV: Physician-Reported Barriers, Facilitators, and Recommendations.

Compared with the general cancer population, people living with HIV (PLWH) and cancer are less likely to receive treatment and have significantly elevated cancer-specific mortality for many common cancer types. Physician recommendations drive the cancer therapy that patients receive, yet there is limited information assessing how cancer treatment decisions are made for people living with HIV and cancer. We sought to understand oncologist decision-making in PLWH and cancer by eliciting barriers, facilitators, and recommendations for enhancing care delivery. Participants were recruited between May 2019 and May 2021 from one academic medical center in the western United States (n = 13), another in the southeastern United States (n = 7), and community practices nationwide (n = 5). Using an inductive qualitative approach, we conducted in-depth interviews with 25 oncologists from two academic medical centers and community practices. Facilitators of cancer care delivery included readily available information regarding HIV status and stage, interdepartmental communication, and antiviral therapy adherence. Barriers included a lack of formal education on HIV malignancies, perceptions of decreased life expectancy, fear of inadvertent disclosure, and drug-drug interactions. Recommendations included improved provider communication, patient social and mental health resources, and continuing education opportunities. The study revealed drivers of cancer treatment decision-making, highlighting physician-reported barriers and facilitators, and recommendations to support treatment decision-making. This is the first known study examining oncologists' perceptions of caring for PLWH. Given that cancer is a leading cause of death among PLWH, there is an urgent need to improve care and outcomes.

Accelerated arterial thrombus formation in Hutchinson Gilford Progeria Syndrome

Abstract Introduction Arterial thrombosis is an age-associated cause of myocardial infarction and stroke, which are the leading causes of mortality and morbidity worldwide. Hutchinson-Gilford Progeria Syndrome (HGPS) is a rare genetic disorder that is caused by a point mutation in the lamin A gene. It is characterized by progressive premature aging, in which caused a decreased life expectancy. Two most frequent causes of death of children with HGPS are myocardial infarction and ischemic stroke – cardiovascular events that are tightly linked to arterial thrombosis. Despite this fact, the effect of the specific lamin A gene mutation on arterial thrombus formation remains unknown. Methods Transgenic heterozygous LmnaG609G knock-in (HGPS) mice and the corresponding wild-type (WT) littermate controls underwent photochemically-induced carotid artery endothelial injury to trigger thrombosis. Coagulation and fibrinolytic factors were measured in these animals. Ex-vivo platelet activation assay was also performed. Results HGPS mice displayed accelerated thrombus formation as underlined by shortened time to occlusion compared to WT littermates (Figure 1A-B). The level of tissue factor and von Willebrand factors are comparable between groups. No significant differences were found on factors involved in the fibrinolytic system, which was confirmed by the comparable level of D-dimers in both groups. A higher level of thrombin-antithrombin complex was observed, accompanied by lower level of antithrombin. Interestingly, HGPS animals displayed enhanced platelet activation markers expression upon ADP, collagen, and thrombin stimulation compared to WT group, demonstrating a higher platelet reactivity in progeria animals (Figure 1C). Conclusions Our study demonstrated an increased arterial thrombotic response in HGPS mice as compared to WT littermates which is, at least in part, mediated by higher platelet reactivity. This novel observation may provide a mechanistic explanation for the increased incidence of acute cardiovascular events observed in children with HGPS and warrant further clinical investigations also in consideration of available antiplatelet therapies.

Remission of nonalcoholic steatohepatitis after bariatric surgery: a single referral center cohort study

BackgroundObesity is associated with nonalcoholic steatohepatitis (NASH), which leads to an increased rate of primary liver cancers, cirrhosis, and decreased life expectancy. Metabolic/bariatric surgery (MBS) determines long-term weight loss and the resolution of obesity-related medical problems. ObjectiveThe aim of this study was to evaluate the impact of MBS on liver histologic features in individuals with obesity. SettingTertiary referral university hospital. MethodsWe retrospectively analyzed data on 37 patients undergoing MBS from a prospectively held database. All patients had a liver biopsy at the time of MBS and a second liver biopsy in case of further surgery or for NASH follow-up. Eighteen patients had NASH on the first liver biopsy. The primary endpoint was the resolution of steatohepatitis without worsening of fibrosis on the second liver biopsy. Secondary endpoints were the evolution of liver steatosis, hepatocyte ballooning, nonalcoholic fatty liver disease activity score, and biochemical parameters from the time of the first to the second liver biopsy. ResultsFifteen (83.3%) patients had significant resolution of steatohepatitis (P < .001) without fibrosis worsening. There was a statistically significant improvement of all blood tests except for low-density lipoprotein, alkaline phosphatases, and bilirubinemia. The Homeostatic Model Assessment (HOMA) index was significantly improved after MBS (P < .001), and circulating insulin and leptin concentrations were significantly reduced. Mean weight loss was 47 kg, with a 16.6 kg/m2 body mass index reduction and a % of total weight loss (%TWL) of 40.3 ±14% from the moment of MBS to the last follow-up. ConclusionMBS is effective in determining NASH regression without fibrosis worsening and in reducing HOMA index and leptin and insulin concentrations.

Излечение здравоохранения: исторический опыт старых демократий и уроки для России

Contrary to widespread belief government-run Healthcare was not the first mass affordable solution for medical problems. Governmental healthcare has not caused main breakthroughs in the mortality decrease and significant increase in average life expectancy. Safeguards for private property and ironclad protection of personal rights and liberties caused modern economic growth phenomena, a rise in wealth, and unleashed scientific and technical progress. The rise in wealth and scientific progress were the principal reasons behind progress in medicine. Nowadays huge government spending and poor efficiency make unclear the overall impact of government-run healthcare on public health. The government's Famous attempts to protect drug consumers caused huge costs possibly outweighing their benefits. The foremost public concern ought to be the numerous ethical challenges of the governmental rule in Healthcare, the power usurped by healthcare officials to decide for and instead the patient his fate.

Unhealthy lifestyles and regional differences in life expectancy in Russia

ObjectivesThe study seeks to identify the impact of smoking, sports participation, and alcohol consumption on life expectancy of men and women in Russian regions. Study designWe use official data for 2014–2020 for 77 Russian regions. We estimate factors related to life expectancy separately for men and women to account for differences in their life expectancy and lifestyles. MethodsWe run fixed-effect models to estimate regional life expectancy depending on smoking, alcohol consumption, sport participation, healthcare characteristics, and demographical and economic factors. ResultsLife expectancy was negatively associated with alcohol consumption and smoking and positively with sport participation: a 1-L increase in alcohol consumption was attributed to a 1.6-month decrease in male life expectancy and to a 1.8-month decrease in female life expectancy. If the proportion of smoking women was halved, the increase in woman's life expectancy would be 4.6 months. If sports participation rates were doubled for men and women, the expected increase in their life expectancy would be 1 and 0.9 years, respectively. Other factors attributed to life expectancy were settlement type, income inequality, characteristics of regional healthcare systems, and the COVID-19 pandemic. ConclusionWe find significant variation in life expectancy across Russian regions that can be partly explained by unhealthy lifestyles. We suggest that policies aimed at improving national health in diverse countries such as Russia adjust healthy lifestyle measures to the needs of particular region.

The impact of financial development, health expenditure, CO2 emissions, institutional quality, and energy Mix on life expectancy in Eastern Europe: CS-ARDL and quantile regression Approaches

In recent years, the interrelationships between the environment, energy, and health have received a growing amount of attention due to their substantial impact on the health of humans. By examining what influences Eastern Europeans' longevity between 1990 and 2021, this study hopes to contribute to this field of study. Energy consumption, health expenditure, pollution, institutional quality index (IQI), financial development, and other attributes profoundly impact human health. Because of the extensive network of commerce, tourism, education, religion, and treaties connecting East European countries, tests for cross-sectional dependence (CSD) and slope heterogeneity (SH) are utilized. After verifying the CSD and SH issues, the study uses the second generation's unit root and cointegration tests. As the previous test indicates, a new panel method, the cross-sectional autoregressive distributive lag (CS-ARDL) model, is required, as conventional estimations are inappropriate. The Quantile Regression (QR) method is also applied to check robustness. This study indicated that increased health expenditure, renewable energy consumption, and IQI improves health outcomes in Eastern European nations. There was a good connection between renewable energy consumption and health benefits, the study concluded. Though financial development positively impacts life expectancy, the impact is insignificant. On the other hand, the study also shows that CO2 emissions and fossil fuel consumption decrease life expectancy. These results are consistent with those obtained using the QR method. To enhance health outcomes, it is necessary to take measures to raise health spending, increase the use of renewable energy, and foster financial development over the long term. On the other hand, Eastern European nations need to shift their attention from fossil fuels to renewable energy.

Impact of Nutrition on Life Expectancy in Russian Regions

The paper studies the impact of nutrition on the life expectancy (LE) of men, as well as women in Russian regions. The empirical analysis is based on data from the Federal State Statistics Service. The panel data includes 1694 observations (77 regions of the Russian Federation in 2000–2021). The authors suggest a summary indicator of regional nutrition patterns based on the nutrition norms developed for 10 food groups by the Ministry of Health of the Russian Federation. The study was run using fixed effect models while controlling for indicators of the socio-economic development of regions.Econometric analysis shows that LE of men and LE of women increases with the decrease in the number of deviations from the regional nutrition norms. Alcohol consumption also reduces the LE of men and women, but the effect on men's life expectancy is more pronounced. As expected, the regional GRP per capita increases life expectancy, while inequality in income distribution leads to the LE decrease. The most important factor that positively affects LE of men, as well as LE of women is the proportion of urban citizens. In addition, LE is also affected by regional healthcare design: the number of doctors per 1000 people increases the LE of women; the number of hospital beds per 10 thousand people is associated with both the LE of men and LE of women. COVID-19 significantly contributed to the decrease in LE of men and especially of women. Its negative impact was already noticeable in 2020 but became particularly pronounced in 2021.The study draws attention to a significant regional variation in the LE of men and LE of women related, among other things, to deviations from the food consumption patterns. The findings may be of interest to regional authorities responsible for developing healthy nutrition policies in Russian regions and increasing the LE of men and women.

Do the pollution related to ozone pose a real health threat to the population in Upper Silesia?

Abstract Background Air pollution is a leading environmental factor, that influences human health. Although Ozone plays crucial role in the screening Earth's surface and lower atmosphere layers from the ultraviolet radiation, the troposphere ozone is proved to have negative effect on human body. Long-term exposure to a higher ozone concentration is related to a decrease in life expectancy. Objectives The objective of this study was the measurement-based assessment for determining whether the concentrations of ozone is within admissible limits or exceeded in Silesia province (5 million agglomeration) and therefore pose a threat to the local population together with the levels of PM2.5 and PM10 significantly exceeded at the same time. Material and methods The data provided by the Voivodship Inspectorate for Environmental Protection in Katowice for period 2015-2022 was used in the statistical analysis. The received data constitutes the result of 8-hour concentrations of ozone in selected air monitoring stations of Silesian province. The locations of 3 monitoring stations were found useful for the aim of this research; one site is situated in rural background area, another one is located in medium - sized city and the Katowice station is representative for urban background situation. Results The alarm level hasn't been exceeded in indicated measurements stations in Silesian Voivodship in period 2015-2022 (averaging time 1 hour: 240 µg/m3 four 3 hours). The target level has been exceeded in 2015-2017, in all three measurements stations and in the following years in one station (in Zloty Potok - 2018 and in Katowice -2019). Each year the largest number of exceedances occurred in August. Conclusions The results clearly indicate lack of hazards for general population health in terms of increased concentrations of ozone in the city centres and outside in Upper Silesia agglomeration and the situation even improved in last years. We identified the main sources of ozone. Key messages • The troposphere ozone is proved to have negative effect on human body, long-term exposure to a higher ozone concentration is related to a decrease in life expectancy. • The results clearly indicate lack of hazards for general population health in terms of increased concentrations of ozone in the city centres and outside in Upper Silesia agglomeration.

NUTRITIONAL SUPPORT FOR CANCER PATIENTS IN THE EARLY POSTOPERATIVE PERIOD

Relevance: The modern medicine, evaluating patients’ nutritional status is a priority for many specialists. The incidence of nutritional deficiency in cancer pathology increases annually by 65-85%. The nutritional status of patients is represented by a decrease in life expectancy, deterioration of immediate and long-term treatment results, a decrease in the tolerability of therapy, and a decrease in the quality of life. Early detection of nutritional insufficiency and evaluation of the patient’s nutritional status makes it possible for early provision of nutritional therapy and has a positive effect before the operation, during and after the operating period, reduces postoperative complications, and reduces the duration of stay in the hospital. This article reflects on the features of evaluating the nutritional status and methods of correction of clinical nutrition.&#x0D; The study aimed to analyze the effectiveness of cancer patients’ nutrition in the early postoperative period and determine the optimal method of its implementation.&#x0D; Methods: We compared the clinical effectiveness of enteral and parenteral nutrition methods in the complex of postoperative therapeutic measures on the hepato-pancreatic-duodenal zone.&#x0D; Results: On Days 10-12 after surgery, 12 out of 17 control group patients had normal nutritional status judging by their Subjective Global Assessment (SGA) and Nutritional Risk Index (NRI), and five had moderate malnutrition. After enteral nutrition was added (on Days 13-15), no malnutrition cases in this group were detected. The total blood protein in the subjects showed a significant difference between the average values of indicators in clinical groups for the entire study period (p&lt;0.05). The average total blood protein by Day 8 after surgery was 62.5±10.0 g/L in the leading group and 57.5±10.1 g/L in the control group. The change in the blood biochemical composition was due to the volume, duration, and nature of the surgical intervention.&#x0D; Conclusion: When using nutritional therapy in cancer patients operated on for tumors of the hepato-pancreatic-duodenal zone in the early postoperative period, the enteral route of administration of nutrient mixtures is preferred, provided there is no pronounced intestinal paresis and purulent discharge from the stomach.

Pulmonary Hypertension in Pregnancy: A Case Report

Background: Pulmonary Hypertension (PH) is a disease characterized by distressing symptoms and decreased life expectancy due to the narrowing of the blood vessels of the lungs, which often leads to right heart failure. The prevalence of PH in women is 97 cases per million, with 64% of the main causes of PH in pregnancy congenital heart defects, resulting in a very high maternal and fetal mortality rate. Case Report: A 38-year-old G4P1A2 31-week gestational age complained of shortness of breath for 5 days. Physical examination revealed blood pressure was 107/62 mmHg, Heart Rate was 98 beats per minute, respiration 40x per minute, and SpO2 88% with NRM 10 Lpm. The heart examination obtained heart sound I -II regular and a systolic murmur was heard between the left 2nd ribs. Abdominal examination was single fetus, intrauterine, breech presentation, His (+), fetal heart rate 160 beats per minute. vaginal toucher 2 cm in labour. ultrasound examination singles fetal, transverse lies, with an estimated fetal weight of 1600 grams. Echocardiography finding: ASD II L to R shunt with LV EF 60%(T), 62% (S), dilated RA-RV, TR severe, MR mild, High Probability of Pulmonary Hypertension. The patient was diagnosed with Dyspnea, Pulmonary edema caused by cardiogenic, ASD II, High probability of PH, NYHA IV, and Breech presentation in labor. Decided to perform a caesarian section and sterilization. The Male baby was born with 1570 grams Apgar Score 3-5-7. post operation patient was admitted to ICU. Twelve hours after the operation the patient had decreased control and became a PH crisis then the patient was declared dead. Results: The death of the patient, in this case, was caused by cardiogenic shock due to Pulmonary Hypertension Crisis. Conclusion: Early diagnosis along with collaborative and comprehensive management of pulmonary hypertension is needed for good maternal and fetal outcomes. Keywords: pulmonary hypertension, pregnancy, heart disease. Correspondence: Trisulo Wasyanto. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi Hospital. Jl. Kol. Sutarto 132, Surakarta 57126, Central Java, Indonesia. Email: trisulo.wasyanto@staff.uns.ac.id. Mobile: +62811294225.

The metabolic influence of duodenal mucosal resurfacing for nonalcoholic fatty liver disease.

Nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH) is a leading cause of chronic liver disease worldwide with decreased life expectancy. Duodenal mucosal resurfacing (DMR) has been associated with metabolic improvement in glycemic and hepatic parameters of type 2 diabetes, but the metabolic impact of DMR for NAFLD/NASH remains inconclusive. We conducted a meta-analysis to investigate metabolic effects of DMR in patients with NAFLD/NASH. Three major bibliographic databases were reviewed for enrollment of trials prior to January 28, 2022. We included adults with biopsy-proven NAFLD/NASH or liver magnetic resonance imaging proton density fat fraction (MRI-PDFF) >5% at baseline and focused on the metabolic difference of MRI-PDFF at 12 weeks, and HbA1c or homeostatic model assessment index for insulin resistance (HOMA-IR) at 24 weeks. Two studies involved a total of 67 participants for analysis. When compared with pre-intervention status, mean difference of MRI-PDFF, HbA1c, and HOMA-IR after DMR were -2.22 (95% CI: -12.79~8.34), -0.32% (95% CI: -0.80~0.16), and 0.15 (95% CI: -5.11~5.41) without statistical significance. For patients with NAFLD/NASH, DMR has the trend to improve liver fat at 12 weeks, and glycemic control in terms of HbA1c level at 24 weeks based on a very low quality of evidence.

THU255 Tirzepatide-induced Weight Loss In A Type 2 Diabetic Taking Oral Contraceptives

Abstract Disclosure: A. Arunachalam: None. A. Nguyen: None. N.L. Shah: None. Obesity is a global health challenge which can lead to type 2 diabetes, hypertension, cardiovascular disease, and decreased life expectancy. In addition to lifestyle intervention, pharmacotherapy to sustain weight loss has remained limited due to effectiveness, cost, and adverse effects. Tirzepatide is a dual glucose-dependent insulinotropic polypeptide and glucagon-like-peptide-1 receptor agonist currently approved for type 2 diabetes treatment. Tirzepatide-induced weight loss may provide new options for treatment of obesity. We report a 32-year-old female with a history of T2DM and PCOS originally on metformin who was started on semaglutide 0.25 mg, which was uptitrated to 0.5mg weekly for 6 months. She lost 25 lbs with no side effects. Semaglutide and OCPs were discontinued due to fertility with her weight and hemoglobin A1C rebounding off medication. She was started on tirzepatide 2.5mg weekly. At that time, she weighed 223 lbs with a hemoglobin A1C 8.2%. She was counseled to resume OCPs and improve glucose control and weight reduction prior to attempting to conceive. Once increased tirzepatide dosing to 5mg weekly, she endorsed severe nausea and intermittent epigastric abdominal pain on day of injection. She attempted to increase dose to 7.5mg weekly, but dose was reduced due to complaints of constipation and worsened abdominal pain requiring bowel regimen. She remained on tirzepatide for a total of 4 months prior to becoming pregnant while on oral contraceptives. Her weight decreased from 223 to 212 lbs with reduction in hemoglobin A1C from 8.2% to 6.1%. While initially studied for use in type 2 diabetes, tirzepatide was found to induce clinically significant weight reduction. The recent SURMOUNT-1 trial, which studied the effects of tirzepatide in non-diabetics, demonstrated that once-weekly tirzepatide at three different doses demonstrated substantial and sustained weight reduction in patients with obesity. In trials involving patients with once-weekly injectable semaglutide, the mean reduction in hemoglobin A1C was 1.8 percentage points and reduction in mean body weight was 6.5 kg. In the SURPASS-2 trial, reductions in body weight were greater with tirzepatide when compared to semaglutide with mean estimated treatment difference −1.9kg, -3.6kg, and -5.5 kg respectively based on dosing of 5mg, 10mg, and 15mg. The adverse events most commonly reported in patients on tirzepatide include nausea, vomiting, and diarrhea, which occurred most commonly during dose-escalation. Mounjaro is known to reduce the efficacy of oral contraceptive pills due to delayed gastric emptying. This delay is largest after the first dose so recommended to switch from oral to non-oral contraceptives for the first four weeks when tirzepatide is initiated. It is important to counsel patients on the decreased efficacy of oral contraceptives while on tirzepatide. &amp;lt;!--EndFragment--&amp;gt; Presentation: Thursday, June 15, 2023

Health effects of PM2.5 emissions from woodstoves and fireplaces in living spaces

Increased exposure to airborne fine particle pollution (PM2.5) can result in decreased life expectancy (DLE). However, while wood-burning in woodstoves and fireplaces for domestic space heating is a major source of indoor and outdoor PM2.5, the emission factor of PM2.5 into the occupied space was unknown for use periods of 3–4 h, as was the resulting DLE. This paper presents a three-phase analysis of the DLE due to the use of firewood for indoor residential space heating. The first phase was a measurement study of the emission of PM2.5 from wood-burning equipment, namely woodstoves and fireplaces, into the occupied space. The second phase used building thermal and airflow simulation to estimate the increased exposure to PM2.5 due to the use of wood-burning equipment. The third phase used existing correlations to predict the DLE due to domestic wood-burning. Results show that fireplaces emit 58.0 mg of PM2.5 per kg of firewood, standard woodstoves emit 21.6 mg/kg, and woodstoves with a dedicated outside air admission channel emit 1.4 mg/kg. Consequently, using a fireplace to supply a living room's heating load for 4 h/day during the evening could shorten life expectancy by 1–1.6 years, while a woodstove that is used during the same period to supply the heating needs of a single-family townhouse building could reduce overall life expectancy by up to half a year. The woodstove with outdoor air admission drastically restricted the emission of PM2.5 into the occupied space, resulting in negligible impacts on occupant life expectancy.

Продолжительность трудовой жизни населения арктического региона в контексте современных социально-демографических изменений

Finding ways to improve resource utilization in the labor market is a pressing socio-economic concern. The problem of population aging, a contemporary demographic issue, is currently being addressed by extending work life. This study analyzes work-life expectancy, using one of the regions in the Russian Arctic, namely the Arkhangelsk region, as an example. The study spans 11 years, from 2010 and 2021, encompassing the first results of the pension reform and the demographic repercussions of the Covid-19 pandemic, notably marked by a dramatic decrease in life expectancy. The key research method utilized is the Sullivan method, grounded in age-specific mortality rates and the economic activity of the opulation. Particular emphasis is placed on analyzing life expectancy trends for males and females aged 15 to 50. The findings reveal a positive trend during periods of relative socio-economic stability, contrasting with a decline during the pandemic years. Notably, there is less gender disparity in working life expectancy in the region compared to the rest of the country. This observation suggests that despite the option for earlier retirement, women's tenure in the labor market is almost equivalent to that of men. The pandemic-induced drop in life expectancy has significantly reduced periods of economic inactivity, i.e., the number of retirement years. The prospects of this research involve examining periods of employment, unemployment, and economic inactivity across specific age groups within the human life cycle to analyze whether workforce potential is used to the fullest. The findings of the study can be used to improve the region’s policy in fields such as employment, social security,and population maintenance.

The Interactive Effect of Good Governance and Oil Rent on Life Expectancy in Iran

Background: Oil revenues, as an important part of the government's revenues in Iran's oil-dependent economy, play an important role in providing public sector expenditures, including the health sector and consequently have an impact on health outputs. On the other hand, the way of using and managing oil revenues is an important factor in the way of this effect. Therefore, the main purpose of this study was to investigate the interactive effect of good governance and oil rent on life expectancy in Iran.&#x0D; Methods: The present descriptive-analytical study investigated the short-term and long-term equilibrium relationship between health output index, per capita income, oil rent, good governance index, and the cross (interactive) effect of good governance and oil rent from 1985 to 2020 using the time series data of Iran. The data used were collected from World Bank global development indicators database and international country risk guide. Also, model estimation was conducted using and autoregressive distributed lag and data analysis was performed using Eviews 10 software.&#x0D; Results: The results show that in the short and long term, the increase in oil rent improves the health output index in the country. One percent increase in the share of oil rent from gross domestic product (GDP), in the long and short term, increases the life expectancy in the country by about 0.101 and 0.668 percent, respectively. However, the interactive effect of oil rent and good governance index in the short and long term is negative and significant with coefficients of - 0.084 and - 0.515; which shows that oil rent leads to a decrease in life expectancy by weakening good governance indicators.&#x0D; Conclusions: Based on the findings of this study, it can be said that oil rent is inherently useful in promoting health in the country; but its improper use and management causes the health sector to not benefit from it and even become a loss.