Prevalence Of Disease Research Articles

A case of early childhood caries from a Medieval site in Southern Portugal: a multidisciplinary approach.

Dental caries is the most prevalent chronic infectious disease during childhood both in historical and contemporary times, but research focused on the oral health of non-adults from the past is still scant. As such, this study proposes a multidisciplinary approach to the differential diagnosis of severe dental lesions in a medieval non-adult skeleton. The skeleton of a three-year-old child recovered in the medieval necropolis of Cacela Velha (Portugal) was studied through macroscopic, radiological, elemental and stable isotope analyses. This individual exhibited enamel destruction and dentine exposure in both the maxillary and mandibular teeth, with the latter also showing changes in coloration. Elemental analysis showed that his skull presented lower values of Si, Cl, and Ca and higher of Cu compared to the control, while the concentration of P and S were significantly lower in the teeth. Early childhood caries is the most probable diagnosis for the dental lesions observed, apparently stemming from a reticulate of factors that include potential malnutrition, and the consumption of sugars in complementary feeding - even though historical sources point to the scarcity of sugar in Portugal during most of the Middle Ages.

Decoding Chemical Exposome of a Typical Regionally Prevalent Disease: Esophageal Squamous Cell Carcinoma in North China

Decoding Chemical Exposome of a Typical Regionally Prevalent Disease: Esophageal Squamous Cell Carcinoma in North China

МАГНИТНО-РЕЗОНАНСНАЯ ТОМОГРАФИЯ В ДИАГНОСТИКЕ СТЕАТОЗА ПРИ МЕТАБОЛИЧЕСКИ-АССОЦИИРОВАННОЙ ЖИРОВОЙ БОЛЕЗНИ ПЕЧЕНИ У ПОДРОСТКОВ

Incidence of overweight and obesity is increasing among the child population Worldwide. The prevalence of fatty liver disease is increasing as well. The transition to the new term “metabolically associated fatty liver disease” (MAFLD) implies the identification of hepatic steatosis and its quantitative assessment. Magnetic resonance imaging (MRI) has significant advantages for assessing hepatic steatosis, but is rarely used in pediatric practitioners’ routine. The purpose of this research was to improve the quality of MAFLD diagnosis in adolescents with obesity by identifying steatosis and liver fibrosis using MRI. Materials and methods used: 30 adolescents aged 12 to 17 y/o, 17 (56.7%) boys/13 (43.3%) girls, with obesity and diagnosed MAFLD were examined (MRI of the liver was performed with Philips Ingenia 1.5T). Results: hepatic steatosis was detected in 22 (73.3%). The percentage of liver fatty fraction was determined from 0.5% to 76%, the median was 25.50% [6.38; 38.75]. In accordance with the classification of steatosis by degree, S1 was determined in 12 (40.0%), S2 in 8 (26.7%) and S3 in 2 (7%). In 8 (26.7%) there was no steatosis (“S0”). Pancreatic steatosis was detected in 2 (6.7%). Liver steatosis was detected in the 1st degree obesity in 62.5%, in 83.3% in the 2nd degree, in 71.4% in the 3rd degree and in 77.8% in the 4th degree. All the three degrees of liver steatosis were diagnosed with a predominance of the 1st, which was determined in 40.0%, S2 in 26.7% and S3 in 7%. Conclusion: in obesity in adolescents with MAFLD and/or steatohepatitis, MRI reveals liver steatosis in 73.3% of patients. There was no difference (p=0.252) in the incidence of degrees of liver steatosis detected by MRI among different degrees of obesity. Dyslipidemia and insulin resistance were detected regardless of the presence and degree of liver steatosis. Since MRI is a non-invasive and informative method for examining children with MAFLD, it does allow rather more accurate assessment of the adipose tissue presence in the liver compared to a ‘routine’ ultrasound.

Matched Comparison Examining the Effect of Obesity on Clinical, Economic, and Humanistic Outcomes in Patients with BipolarI Disorder.

BipolarI disorder (BD-I) is associated with an increased risk of obesity, but few studies have evaluated the real-world clinical, humanistic, and economic effects associated with obesity in people with BD-I. This was a retrospective, cross-sectional analysis of responses to the 2016 and 2020 National Health and Wellness surveys. Respondents (18-64years) with a self-reported physician diagnosis of BD-I were matched to controls without BD-I based on demographic and health characteristics. Respondents were categorized by body mass index as underweight/normal weight (< 25kg/m2), overweight (25 to < 30kg/m2), or obese (≥ 30kg/m2). Multivariable regression models were used to compare obesity-related comorbidities, healthcare resource utilization (HCRU), health-related quality of life (HRQoL), work productivity, and indirect and direct costs. Before matching, the BD-I cohort was younger than the non-BD-I cohort and included more female and white respondents and a greater proportion covered by Medicaid or Medicare. After matching, the BD-I and non-BD-I cohorts had similar characteristics. A total of 5418 respondents (BD-I, n = 1806; matched controls, n = 3612) were analyzed. Obese respondents with BD-I reported the highest adjusted prevalences of high blood pressure (50%), high cholesterol (35%), sleep apnea (27%), osteoarthritis (17%), type2 diabetes (12%), and liver disease (4%). Obesity in respondents with BD-I was associated with the lowest HRQoL scores. Measures of work impairment were highest in respondents with BD-I and obesity, as was HCRU. Respondents with BD-I and obesity had the highest associated total indirect and direct medical costs ($25,849 and $44,482, respectively). Obese respondents with BD-I had greater frequencies of obesity-related comorbidities, higher HCRU, lower HRQoL, greater work impairments, and higher indirect and direct medical costs. These findings highlight the real-world burden of obesity in people with BD-I and the importance of considering treatments that may reduce this burden.

Polygenic Risk and Coronary Artery Disease Severity.

Coronary atherosclerotic burden and adverse coronary heart disease events are related phenotypes with likely shared genetic cause. We analyzed 6021 patients with available coronary angiography, genotyping, and exome sequencing data. We tested for associations of polygenic risk scores for coronary heart disease (PRSCHD) with multiple measures of coronary artery disease (CAD) severity. We assessed the interplay between PRSCHD and pathogenic/likely pathogenic variants in 3 familial hypercholesterolemia genes. We performed mediation analyses to explore whether CAD severity mediated the association of PRSCHD with prevalent coronary heart disease and incident myocardial infarction. A 1-SD increase in PRSCHD was associated with multiple measures of CAD severity, including the log Gensini score (β, 0.31 [95% CI, 0.28-0.33]). Carrying a pathogenic/likely pathogenic familial hypercholesterolemia variant was associated with a higher log Gensini score after adjustment for PRSCHD (β, 0.21 [95% CI, 0.03-0.38]). PRSCHD was associated with incident myocardial infarction over a mean follow-up of 9.2 years (hazard ratio, 1.20 [95% CI, 1.13-1.27]; P=5×10-10), and the Gensini score mediated 90% of this association. PRSCHD was associated with multiple measures of CAD severity. The association of PRSCHD with incident myocardial infarction was almost fully mediated by CAD severity, indicating a considerable genetic overlap between the 2 phenotypes.

Non-invasive myocardial work as an independent predictor of postprocedural NT-proBNP in elderly patients undergoing transcatheter aortic valve replacement.

Aortic stenosis has become the most prevalent valvular disease with increasing life expectancy and the ageing of the population, representing a significant clinical burden for health care providers. Its treatment has been revolutionized by transcatheter aortic valve replacement (TAVR) as a safe and minimally invasive option for elderly patients. Left ventricular (LV) functional measurement is of particular importance before TAVR, however, increased afterload significantly influences the conventional echocardiographic parameters. Non-invasive myocardial work examines myocardial deformation in the context of instantaneous LV pressure, thus, it might be a more reliable measure of LV function. Accordingly, we aimed to study non-invasive myocardial work and its relationship with functional outcome following TAVR.We enrolled 90 TAVR candidates (80 [75-84] years; 44% female). Using echocardiography, we quantified ejection fraction (EF), global longitudinal strain (GLS), global myocardial work index (GWI) and global constructive work (GCW) before and 12 months after the procedure. Serum NT-proBNP levels were also measured. EF did not change (52.6 ± 13.1 vs. 54.2 ± 10.5%; p = 0.199), while GLS increased (-13.5 ± 4.6 vs. -15.2 ± 3.8%; p < 0.001). GWI decreased (1913 ± 799 vs. 1654 ± 613 mmHg%; p < 0.001) and so did GCW (2365 ± 851 vs. 2177 ± 652 mmHg%; p = 0.018). History of atrial fibrillation (AF) (β = 0.349) and preprocedural GCW (β = -0.238) were independent predictors of postprocedural NT-proBNP (p< 0.001).GLS, GWI and GCW changed after TAVR while there was no alteration in EF. The preprocedural GCW and history of AF were independent predictors of postprocedural NT-proBNP. Accordingly, myocardial work indices may help patient selection and the prediction of the functional outcome in this population.

Clot lysis time and thrombin generation in patients undergoing transcatheter aortic valve implantation.

Aortic valve stenosis (AS) is the most prevalent valvular heart disease and is associated with a significant increase in mortality. AS has been shown to be linked with numerous coagulation system abnormalities, including increased fibrin deposition on the stenotic aortic valves. Transcatheter aortic valve implantation (TAVI) is the primary treatment method for patients at high surgical risk. The aim of the study was to assess the impact of treating severe AS with TAVI on thrombin generation and clot lysis time (CLT). We studied 135 symptomatic AS patients recommended for TAVI by the local Heart Team. All measurements were performed before and 5-7 days after TAVI. Alongside clinical assessment and echocardiographic analysis, we assessed clot lysis time (CLT) and thrombin generation parameters, including lag time, peak thrombin generation, time to peak thrombin generation (ttPeak), and endogenous thrombin potential (ETP). 70 patients were included in the final analysis. After TAVI, there was a significant 9% reduction in CLT despite a 12% increase in fibrinogen concentration. We observed significant increase in lag time and ttPeak (20% and 12%, respectively), and 13% decrease in peak thrombin concentration compared to pre-procedural levels. Multivariable linear regression analysis demonstrated that baseline CLT and C-reactive protein (CRP) levels were independent predictors of significant reduction in mean aortic gradient, defined as TAVI procedure success. CLT and peak thrombin concentration decreased, while Lag time and ttPeak increased significantly after TAVI. Multivariable linear regression analysis demonstrated CLT and CRP levels as independent predictors of achieving a reduction in mean aortic gradient, defining TAVI procedure success.

A chondroitin sulphate hydrogel with sustained release of SDF-1α for extensive cartilage defect repair through induction of cell homing and promotion of chondrogenesis.

Articular cartilage damage represents a prevalent clinical disease in orthopedics, with its regeneration and repair constituting a central focus in ongoing research endeavors. While hydrogel technology has achieved notable progress in the field of cartilage regeneration, addressing the repair of larger cartilage defects remains a significant and formidable challenge. In pursuit of achieving the repair of extensive cartilage defects, this study designed a polydopamine-modified chondroitin sulfate hydrogel loaded with SDF-1α (P-SCMA). This hydrogel, capable of directly providing glycosaminoglycans (GAGs), served as a platform for carrying growth factors and attracting mesenchymal stem cells for the in situ reconstruction of extensive cartilage defects. The results indicate that the P-SCMA hydrogel is capable of not only directly providing GAGs but also sustainably releasing SDF-1α. In the early stages, it promotes cell adhesion and proliferation and induces cell homing, while in the later stages, it further induces chondrogenesis by inhibiting the Wnt/β-catenin pathway. This bioactive hydrogel, which possesses the functions of providing GAGs, promoting cell proliferation, inducing cell homing and chondrogenesis, is capable of promoting cartilage repair in multiple ways, providing new perspectives for the repair of extensive cartilage defects.

Prevalence of steatotic liver disease, advanced fibrosis and cirrhosis among community-dwelling overweight and obese individuals in the USA

BackgroundThere are limited prospective data among overweight and obese individuals on the prevalence of advanced fibrosis, and cirrhosis using advanced MRI-based methods in the USA. The aim of this study...

Elucidating the conformational change of dengue envelope protein using the Markov state model

ABSTRACT Dengue virus, an arbovirus of genus flavivirus, is one of the most prevalent infectious disease causing organisms in the tropical environment leading to numerous deaths every year. The envelope protein plays a crucial role in the viral genome entry into the host cell. This is achieved through structure and oligomeric status change in the dengue envelope protein. The pre-fusion and post-fusion states’ structures of the dengue envelope protein are known although the pathway and intermediate structures involved in this process have remained in the dark till date. In this study, we have used targeted molecular dynamics (MD) simulation followed by conventional MD simulation and the Markov state model analysis to elucidate this pathway of change in conformation from the pre-fusion state to the post-fusion state. Intermediate conformations which may in the future serve as therapeutic targets have also been deduced from the Markov state model. This pathway determination may pave the way for the design of transition state analog inhibitors which prevent the dengue virus envelope protein from changing its conformation and thus establishing infection. The results obtained could lead to development of novel drugs to combat the viral infection.

Bayesian spatial analysis of incomplete vaccination among children aged 12–23 months in Nigeria

High childhood disease prevalence and under-five mortality rates have been consistently reported in Nigeria. Vaccination is a cost-effective preventive strategy against childhood diseases. Therefore, this study aimed to identify the determinants of Incomplete Vaccination (IV) among children aged 12–23 months in Nigeria. This cross-sectional design study utilized the 2018 Nigeria Demographic and Health Survey (NDHS) dataset. A two-stage cluster sampling technique was used to select women of reproductive age who have children (n = 5475) aged 12–23 months. The outcome variable was IV of children against childhood diseases. Data were analyzed using Integrated Nested Laplace Approximation and Bayesian binary regression models (α0.05). Visualization of incomplete vaccination was produced using the ArcGIS software. Children’s mean age was 15.1 ± 3.2 months and the median number of vaccines received was four. Northern regions contributed largely to the IV. The likelihood of IV was lower among women aged 25–34 years (aOR = 0.67, 95% CI = 0.54–0.82, p < 0.05) and 35–49 years (aOR = 0.59, 95%CI = 0.46–0.77, p < 0.05) compared to younger women in the age group 15–24 years. An increasing level of education reduces the risk of odds of IV. Other predictors of IV were delivery at the health facility (aOR = 0.64, 95% CI = 053–0.76, p < 0.05), and media exposure (aOR = 0.63, 95%CI = 0.54–0.79, p < 0.05). Mothers’ characteristics explained most of the variability in the IV, relatively to smaller overall contributions from the community and state-level factors (p < 0.05). The level of IV against childhood diseases was high in Nigeria. However, disparities exist across the regions and other socioeconomic segments of the population. More efforts are required to improve vaccination sensitization programs and campaigns in Nigeria.

Myrislignan ameliorates the progression of osteoarthritis: An in vitro and in vivo study

Osteoarthritis (OA) is a prevalent disease of the musculoskeletal system that causes functional deterioration and diminished quality of life. Myrislignan (MRL) has a wide range of pharmacological characteristics, including an anti-inflammatory ability. Although inflammation is a major cause of OA, the role of MRL in OA treatment is still not well-understood. In this study, we analyze the anti-inflammatory and anti-ECM degradation effects of MRL both in vivo and in vitro. Rat primary chondrocytes were treated with interleukin-1β (IL-1β) to simulate inflammatory environmental conditions and OA in vitro. The in vivo OA rat model was established by anterior cruciate ligament transection (ACLT) on rat. Our investigation discovered that MRL lowers the IL-1β-activated tumor necrosis factor-α (TNF-α), cyclooxygenase-2 (COX2) and inducible nitric-oxide synthase (iNOS) expression in chondrocytes. Moreover, MRL effectively alleviates IL-1β-induced extracellular matrix (ECM) degradation and promotes ECM synthesis in chondrocytes by upregulating the mRNA level expression of collagen-II and aggrecan (ACAN), downregulating the expression of matrix metalloproteinases-3,-13 (MMP-3, MMP-13), and a disintegrin and metalloproteinase with thrombospondin motifs-5 (ADAMTS-5). Gene expression profiles of different groups identified DEGs that were mainly enriched in functions associated with NF-κB signaling pathway, and other highly enriched in functions related to TNF, IL-17, Rheumatoid arthritis and cytokine-cytokine receptor signaling pathways. Venn interaction of DEGs from the abovementioned five pathways showed that Nfkbia, Il1b, Il6, Nfkb1, Ccl2, Mmp3 were highly enriched DEGs. In addition, our research revealed that MRL suppresses NF-κB and modulates the Nrf2/HO-1/JNK signaling pathway activated by IL-1β in chondrocytes. In vivo research shows that MRL slows the progression of OA in rats. Our findings imply that MRL might be a viable OA therapeutic choice.

Economic Assessment in Resource-Constrained Systems: Individual-Level Simulation Model in Wet Age-Related Macular Degeneration and Diabetic Macular Oedema.

Cost-effectiveness analyses typically ignore healthcare system resource constraints. Ophthalmology is affected by resource constraints because of increasing disease prevalence and the use of resource-intensive treatments. This study evaluated the impact of resource constraints on the cost-effectiveness of faricimab 6mg, compared with aflibercept 2mg and ranibizumab biosimilar 0.5mg, for treating wet age-related macular degeneration (wAMD) or diabetic macular oedema (DMO) over a 5-year horizon. A microsimulation model estimated the impact of resource constraints on patients visits, delays, costs and quality-adjusted life-year (QALY) losses due to treatment delays at a typical UK National Health Service eye hospital treating 1500 patients with wAMD and 500 patients with DMO. Patient characteristics, treatment regimens and treatment intervals were informed using published literature and expert opinion. Resource constraint was represented by limiting the number of available intravitreal injection appointments per week, with growing demand caused by rising disease prevalence. The model compared outcomes across three scenarios; each scenario involved treating all patients with one of the three treatments. Over 5years, in a resource-constrained hospital, compared with aflibercept, faricimab use resulted in the avoidance of 12,596 delays, saved GBP/£15,108,609 in cost and avoided the loss of 60.06 QALYs. Compared with ranibizumab biosimilar, faricimab use resulted in the avoidance of 18,910 delays, incurred £2,069,088 extra cost and avoided the loss of 105.70 QALYs, resulting in an incremental cost-effectiveness ratio of £19,574/QALY. Accounting for resource constraints in health economic evaluation is crucial. Emerging therapies that are more durable and require less frequent clinic visits can reduce treatment delays, leading to improved QALY outcomes and reduced burden on healthcare systems. Faricimab reduced the number of delayed injections, leading to improved QALY outcomes for patients in a healthcare system with resource constraints. Faricimab is cost-saving when compared with aflibercept and cost-effective when compared with ranibizumab biosimilar.

Differential Effect of Sex on Mortality According to Age in Heart Failure.

Heart failure exhibits sex-based differences in prevalence, clinical characteristics, and outcomes. However, these differences may have an interaction with age. This study investigates these disparities in Asian patients with acute heart failure according to age. We pooled data from the KorHF (Korea Heart Failure) and the KorAHF (Korean Acute Heart Failure) registries including 3200 patients between 2005 and 2009 and 5625 patients between 2011 and2014, respectively, hospitalized for acute heart failure in Korea. Patients were categorized by their age into 2 groups: those with age ≥70 years and those with age <70 years. The primary endpoint was in-hospital and postdischarge outcomes according to sex, stratified by age. Of 8825 patients, 45.7% had an age <70 years, and 54.3% had an age ≥70 years. Women were older on average in both groups. Differences in baseline characteristics were more apparent in the older group, with women having a higher prevalence of hypertension and valvular heart disease, whereas more men had chronic kidney disease, previous myocardial infarction, chronic obstructive pulmonary disease, and strokes. Both in-hospital and postdischarge mortalities showed differences only in the older group, with men dying more (5.08% versus 7.41%, P<0.001; 17.95% versus 22.20%, P<0.001 respectively). This pattern persisted to adjusted analyses, which revealed that men have a 54% (odds ratio, 1.54 [95% CI, 1.17-2.04]) and 30% (hazard ratio, 1.30 [95% CI, 1.13-1.51]) increased in-hospital and 1-year mortality, respectively, compared with women. In patients hospitalized with acute heart failure, male sex is an independent predictor of mortality in older patients but not younger patients.

Race, social determinants of health, and comorbidity patterns among participants with heart failure in the REasons for geographic and racial differences in stroke (REGARDS) study

BackgroundAmong individuals with heart failure (HF), racial differences in comorbidities may be mediated by social determinants of health (SDOH).MethodsBlack and White US community-dwelling participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study aged ≥ 45 years with an adjudicated HF hospitalization between 2003 and 2017 were included in this cross-sectional analysis. We assessed whether higher prevalence of comorbidities in Black participants compared to White participants were mediated by SDOH in socioeconomic, environment/housing, social support, and healthcare access domains, using the inverse odds weighting method.ResultsBlack (n = 240) compared to White (n = 293) participants with HF with preserved ejection fraction (HFpEF) had higher prevalence of diabetes [1.38 (95% CI 1.18–1.61)], chronic kidney disease [1.21 (95% CI 1.01–1.45)], and anemia [1.33 (95% CI 1.02–1.75)] and lower prevalence of atrial fibrillation [0.80 (95% CI (0.65–0.98)]. Black (n = 314) compared to White (n = 367) participants with HF with reduced ejection fraction (HFrEF) had higher prevalence of hypertension [1.04 (95% CI 1.02–1.07)] and diabetes [1.26 (95% CI 1.09–1.45)] and lower prevalence of coronary artery disease [0.86 (95% CI 0.78–0.94)] and atrial fibrillation [0.70 (95% CI 0.58–0.83)]. Socioeconomic status explained 14.5%, 26.5% and 40% of excess diabetes, anemia, and chronic kidney disease among Black adults with HFpEF; however; mediation was not statistically significant and no other SDOH substantially mediated differences in comorbidity prevalence.ConclusionsSocioeconomic status partially mediated excess diabetes, anemia, and chronic kidney disease experienced by Black adults with HFpEF, but differences in other comorbidities were not explained by other SDOH examined.

Incorporating artificial intelligence in portable infrared thermal imaging for the diagnosis and staging of nonalcoholic fatty liver disease.

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is one of the most prevalent chronic liver diseases worldwide. Thermal imaging combined with advanced image-processing and machine learning analysis accurately classified disease status in a study on mice; this study aimed to develop this tool for humans. This prospective study included 46 patients who underwent liver biopsy. Liver thermal imaging was performed on the same day as liver biopsy. We developed an image-processing algorithm that measured the relative spatial thermal variation across the skin covering the liver. The texture parameters obtained from the thermal images were input into the machine learning algorithm. Patients were diagnosed with MASLD and stratified according to nonalcoholic fatty liver disease activity score (NAS) and fibrosis stage using the METAVIR score. Twenty-one of 46 patients were diagnosed with MASLD. Using thermal imaging followed by processing, detection accuracy for patients with NAS >4 was 0.72.

Biomolecular therapies for chronic discogenic low back pain: A narrative review.

Chronic low back pain caused by intervertebral disc (IVD) degeneration, also termed chronic discogenic low back pain (CD-LBP), is one of the most prevalent musculoskeletal diseases. Degenerative processes in the IVD, such as inflammation and extra-cellular matrix breakdown, result in neurotrophin release. Local elevated neurotrophin levels will stimulate sprouting and innervation of sensory neurons. Furthermore, sprouted sensory nerves that are directly connected to adjacent dorsal root ganglia have shown to increase microglia activation, contributing to the maintenance and chronification of pain. Current pain treatments have shown to be insufficient or inadequate for long-term usage. Furthermore, most therapeutic approaches aimed to target the underlying pathogenesis of disc degeneration focus on repair and regeneration and neglect chronic pain. How biomolecular therapies influence the degenerative IVD environment, pain signaling cascades, and innervation and excitability of the sensory neurons often remains unclear. This review addresses the relatively underexplored area of chronic pain treatment for CD-LBP and summarizes effects of therapies aimed for CD-LBP with special emphasis on chronic pain. Approaches based on blocking pro-inflammatory mediators or neurotrophin activity have been shown to hamper neuronal ingrowth into the disc. Furthermore, the tissue regenerative and neuro inhibitory properties of extracellular matrix components or transplanted mesenchymal stem cells are potentially interesting biomolecular approaches to not only block IVD degeneration but also impede pain sensitization. At present, most biomolecular therapies are based on acute IVD degeneration models and thus do not reflect the real clinical chronic pain situation in CD-LBP patients. Future studies should aim at investigating the effects of therapeutic interventions applied in chronic degenerated discs containing established sensory nerve ingrowth. The in-depth understanding of the ramifications from biomolecular therapies on pain (chronification) pathways and pain relief in CD-LBP could help narrow the gap between the pre-clinical bench and clinical bedside for novel CD-LBP therapeutics and optimize pain treatment.

Epidemiology, diagnosis, and management of cardiac amyloidosis.

Cardiac amyloidosis (CA) is an infiltrative restrictive cardiomyopathy caused by the deposition of amyloid fibrils in the myocardium. It manifests in two primary subtypes: transthyretin cardiac amyloidosis (ATTR) and immunoglobulin light chain cardiac amyloidosis (AL). ATTR is further classified into wild-type and hereditary based on transthyretin gene mutation. Advances in diagnostics and therapeutics have transformed CA from a rare and untreatable condition to a more prevalent and manageable disease. Noninvasive diagnostic tools such as electrocardiography, echocardiography, and cardiac magnetic resonance can raise suspicion for CA; bone scintigraphy can non-invasively confirm ATTR, while AL necessitates histological confirmation. The severity of ATTR and AL can be assessed through serum biomarker-based staging. Treatment approaches differ, ranging from silencing or stabilizing transthyretin and degrading amyloid fibrils in ATTR to employing anti-plasma cell therapies and autologous stem cell transplantation in AL.

Comprehensive assessment of lumpy skin disease prevalence across Asia and African countries: A systematic review and meta-analysis

Lumpy Skin Disease (LSD) stands out as one of the economically significant ailments affecting both small-scale farmers and the broader livestock industry. To gauge its prevalence across Asia and Africa, this study employs a rigorous methodology combining systematic review, and meta-analysis, accounting for heterogeneity. Adhering to the guidelines set forth by the cochrane collaboration’s preferred reporting items for systematic reviews and meta-analysis, present initial search sifted through approximately 6,000 articles spanning from 1990 to 2022, using carefully crafted combinations of keywords; Boolean operators, asterisks, and quotation marks. After meticulous assessment for quality bias, employing inclusion and exclusion criteria, 52 publications were included in present study for analysis. The methodology involved in current study utilizing scientometric tools to determine LSD prevalence, with a median sample size of 293 across various studies, predominantly focusing on cattle and buffaloes. Meta-analysis outcomes were dissected based on parameters such as study period, sample size, tests employed, continents, and species, with samples stratified into two to three categories based on medians for heterogeneity assessment. Meta-analysis unveiled a pooled prevalence rate of 14% in Asia and Africa. The subgroup analysis found an 11% prevalence in Asia and Africa constituted 21%. Clinical observation showed a 19% prevalence followed by other tests and PCR with 12 and 13%, respectively. The results underscore the necessity for effective strategies to control and prevent LSD spread, mitigating its economic impact on the livestock industry. This collaborative and comprehensive assessment is crucial in combating the widespread dissemination of LSD and offers valuable insights for policymakers, veterinarians, and stakeholders in the livestock sector.

Risk factors of pulmonary tuberculosis in Indonesia: A case-control study in a high disease prevalence region

Tuberculosis (TB) remains one of the most widespread infectious diseases in the world, with high mortality and morbidity rates, contributing to a significant disease burden, particularly in developing countries. The aim of this study was to determine the risk factors of TB among the population aged 17 years (late adolescent) and above in one of the high TB prevalence countries, Indonesia. A case-control study was conducted in Banda Aceh, Indonesia, involving newly diagnosed pulmonary TB patients who visited one of the eleven community health centers in Banda Aceh. The controls were individuals matched by age and sex who lived near the cases and had no TB infection. A total of 16 risk factors were assessed. Hierarchical multivariable logistic regression models were used to examine the association between the risk factors and the occurrence of TB. A total of 196 cases and 196 controls were included in the study. Multivariable logistic regression analysis identified 11 independent predictors for the occurrence of TB after controlling possible confounders. Patients who lived in houses with insufficient light exposure were 77 times more likely to develop TB compared to those living in houses with sufficient light exposure (adjusted odds ratio (AOR): 77.69; 95%CI: 27.09, 222.79). The study also showed that people who had close contact with TB patients (AOR: 25.39; 95%CI: 2.10, 306.52), had poor knowledge of TB (AOR: 24.2; 95%CI: 6.89, 85.17), had comorbidities (AOR: 4.49; 95%CI: 1.35, 14.89), insufficient food utilization (AOR: 3.41; 95%CI: 1.51, 7.71), negative preventive behavior (AOR: 3.39; 95%CI: 1.49, 7.72), low education level (AOR: 3.08; 95%CI: 1.26, 7.55), and insufficient housing humidity (AOR: 2.89; 95%CI: 1.18, 7.12) were associated with increased the odds of having TB. Being employed, having income above minimum wage, and having good nutritional intake were protective factors for developing TB. In conclusion, the determinants of TB among people aged 17 years and older are a clear indication of the need for TB prevention programs targeting not only individual risk factors but also environmental risk factors, particularly providing adequate housing conditions. This study provided useful information that might help to develop and adopt effective policies for TB control in Indonesia.