Age Group Distribution Research Articles

Trends in incidence, treatment modalities and prognosis of esophageal adenocarcinoma in the US population

BackgroundEsophageal adenocarcinoma (EAC) was the predominant subtype of esophageal cancer in the Western population. However, an updated and comprehensive analysis of epidemiologic, clinical, and prognostic characteristics of esophageal adenocarcinoma is lacking. Materials and methodsThis was a population-based cohort study using the Surveillance Epidemiology and End-Results (SEER) Database. Patients diagnosed with EAC between 1988 and 2020 were included. Incidence trends, clinical characteristics, treatment patterns, and relative survival were systematically analyzed. ResultsThe overall age-standardized incidence rate of EAC significantly increased from 1.7 per 100000 persons in 1988 to 3.6 per 100000 persons in 2020. There were no significant changes in the distribution of age group, sex, and primary site of EAC over time. However, the proportion of EAC clinically staged as I or II decreased from 35.1 % to 27.9 %. Over time, palliative chemotherapy in metastatic EAC increased from 26.7 % to 41.3 %, combination therapy was still the main treatment strategy for nonmetastatic EAC. Despite the 5-year survival rate was less than 20 %, 1-year survival has experienced a moderate increase from 46.7 % to 53.7 %. Specifically, 1-year survival rate for nonmetastatic EAC undergoing surgery only experienced a significant increase from 80.2 % in 2004–2006 to 94.7 % in 2019–2020. For metastatic EAC, obvious improvement in 1-year survival rate was observed in those treated with systematic therapy (from 26.6 % in 2004–2006 to 41.2 % in 2019–2020). In the multivariable analysis, older age, male sex, lower household income, living without a partner, advanced TNM stage, and receiving no cancer treatment were significantly associated with poor survival. ConclusionIn summary, this population-based study of EAC patients in the US showed an increase in incidence, a shift in treatment modalities for metastatic EAC, and moderately improved 1-year survival. The search for more effective surveillance and treatment strategies should be continued in the future.

Comprehensive statistical analysis of causes of death and histopathological diagnosis in medico-legal investigations of sudden cardiac deaths

Background and objectives. Sudden cardiac deaths (SCDs) have a significant impact worldwide. Its distribution trends may vary across different communities globally. Consequently, investigating sudden cardiac deaths necessitates a regional, multi-faceted approach. This study aims to ascertain the pathological background of the patients who died in the context of sudden cardiac death and analyze it statistically to generate some trends and define the occurrence of disease. Materials and methods. We conducted a retrospective analysis of the causes of death for cases from the Legal-Medicine Department of Maramures County, Romania, between 2021 and 2023. From this cohort, we identified and selected cases of SCD and conducted a statistical analysis of the number of cases, gender distribution, age group distribution, and the underlying cardiac pathology that led to this outcome. Results. 276 sudden cardiac deaths (SCD) were identified from 1,186 autopsies. Males accounted for 75% of SCD cases, with a mean age of 58.8 years. Advanced myocardial fibrosis (41.6%) was the most frequent cause, followed by coronary artery disease (18.12%) and acute myocardial infarction (17.4%). Males had significantly more AMI cases (p = 0.045), while females had more coronary artery disease and advanced myocardial fibrosis, though not statistically significant. Conclusions. Sudden cardiac death predominantly affects males, particularly those aged 51–60, with advanced myocardial fibrosis being the most common cause. The gender difference in AMI prevalence was significant, highlighting the need for targeted prevention and diagnostic improvements. Further research in liaison with experts in all fields is required.

Impact of age on premenstrual syndrome prevalence and severity: A population-based survey in Brazil.

To evaluate the relationship between premenstrual disorders (PMD) and age, we analyzed the prevalence and severity of psycho-emotional and physical symptoms in a representative sample of Brazilian women. This observational and retrospective study analyzed data from Brazilian women aged 20-49 years from five regions of the country who reported premenstrual symptoms. Participants completed a premenstrual symptom screening questionnaire and self-reported the presence and severity of their symptoms. Among 23 104 women reporting does premenstrual symptoms, 38.91% (n = 8990) experienced PMD caused functional impairment. Finally, 5121 participants agreed to complete the adapted version of the screening questionnaire. The age group distribution was 20-29 (46.7%), 30-39 (38.3%), and 40-49 years (15%). The most prevalent and severe physical symptom was acne/oily skin in participants aged 20-29 years and headache in women aged 30-49 years. Regarding psycho-emotional symptoms, the most prevalent was anxiety/tension in women aged 20-29 years and 40-49 years and irritability/anger in those aged 30-39 years. Irritability/anger was the most severe symptom in all groups. PMD significantly impacts the quality of life of Brazilian women with varying intensity. Physical symptoms associated with PMD vary with age, while psycho-emotional symptoms, particularly irritability/anger and anxiety, were intense in Brazilian women of reproductive age. These findings inform early diagnosis and individualized treatment approaches for PMD, addressing the needs of women.

Results of assessing cerebral vasospasm following subarachnoid hemorrhage using transcranial doppler ultrasound

SUMMARY Objective: Review the results of assessing cerebral vasospasm after subarachnoid hemorrhage using transcranial doppler ultrasound. Subjects and methods: A retrospective, cross-sectional descriptive study was performed on 39 patients with subarachnoid hemorrhage treated at the Neurology Center, Bach Mai Hospital from January 2020 to September 2023. Results: The mean age of the study group was 55.12 ± 14.33. The age group distribution with the highest incidence is 41-50 years old with a rate of 35.9%. The male/female ratio is 20/19. The most common symptoms were headache (97.4%), nausea and vomiting (92.3%), The least common symptoms were convulsions and hemiplegia in 5.1% of subjects. The most common clinical severity assessed by the Hunt and Hess scale is level 2 (59%), followed by level 3 (23.1%), level 4 (10.2%), and level 1 (5.1%). Evaluation of Fisher scale found that the most common fisher level is level 4 with a rate of 33.6%, followed by level 3 (28.2%), level 1 (25.6%), the least common is grade 2 with 2.6%. The results of the second transcranial Doppler ultrasound performed on the sixth to eighth day of the disease is the time with the highest rate of vasospasm, showing the most vasospasm cerebral artery is the middle cerebral artery: right middle cerebral artery. 35.9%, left middle cerebral artery 12.8%. Next is anterior cerebral artery spasm: right anterior cerebral artery 23.1%, left anterior cerebral artery 2.6%. Right posterior cerebral artery 10.3%, left posterior cerebral artery 5.1%. Compared to the gold standard for diagnosing vasospasm, which is 128-slices MSCT, transcranial Doppler ultrasound has a sensitivity of 0.91, a specificity of 0.88, a positive predictive value of 0.91, and a negative predictive value of 0.88. The appropriateness of transcranial Doppler ultrasound and 128-slices computed tomography scan in diagnosing cerebral vasospasm after subarachnoid hemorrhage is very high, Kappa coefficient = 0.791, statistically significant with p < 0.05. Conclusion: Clinical symptoms of the disease are very diverse and non-specific, the most common symptom being headache is 97.4%. The most common Hunt and Hess scale to assess clinical severity is 2, however the most common Fisher scale is 4. Middle cerebral artery thrombosis has the highest rate of spasm, followed by the anterior cerebral artery. Compared to the gold standard for diagnosing vasospasm, which is 128-slices MSCT, transcranial Doppler ultrasound has a sensitivity of 0.91, a specificity of 0.88, a positive predictive value of 0.91, and a negative predictive value of 0.88

Analysis of Population Change of the 0-14 Year Age Group in Türkiye (2000-2022)

Age groups with wide and narrow ranges provide the opportunity to make detailed evaluations for planning studies in demographic analyses. Particularly, population pyramids are prepared using age group data by sex. In the bottom three rows of the pyramids, 0-4, 5-9, and 10-14 age group data can be used to evaluate population growth and fertility rates. In addition, age groups provide an indication of the amount of dependent and active population in a society, thus facilitating future population forecasts. Broad age ranges categorize the 0-14 age group as the young dependant population, the 15-64 age group as the active population, and the 65+ age group as the elderly dependent population. The proportional change of these age groups in certain date intervals and the reasons for which age groups are in an upward or downward trend also give an idea about the general welfare levels of countries. The current population's demographic trends guide the planning of employment, education, health, and many other socio-economic investments. Population policies are based on the proportional distribution of age groups and population projections. In this study, the change in the population of the 0-14 age group in Türkiye has been analyzed according to the Classification of Territorial Units for Statistics Level-1 (İBBS Düzey-1) since 2000. The population amount, population density, age, and gender structure of this age group are emphasized. In the research, State Institute of Statistics (DIE) 2000 General Population Census and TURKSTAT (TÜİK) Regional statistics data for 2022 were utilized. In 2000, since the Classification of Territorial Units for Statistics had not yet been established, province-based data from 2000 were evaluated and new data were created at the “İBBS Düzey-1” (CUTS Level-1) scale in order to ensure integrity in tables and graphs.

Associated bacterial and fungal infections in burn wounds: Common factors, distribution in etiology, age groups, bacterial and fungal strands – Evaluation of a single burn center experience of 20 years

IntroductionBurn intensive care unit (BICU) patients suffer from reduced immunological competence. Often bacterial and fungal infections occur as single or associated infection of the burn site. However, common factors in associated infections are discussed controversially. In this study we evaluated factors common in associated occurrence of bacterial and fungal infection in the burn population. Patients and methodsIn total 213 patients, admitted to the ICU of Cologne Merheim Clinical Center between 1988 and 2011, with associated infections were included in this study. Exclusion criteria were no bacterial, or no fungal infection, or incomplete data. Data evaluated were sex, age, type of burn injury, total body surface area (TBSA), abbreviated burn severity index (ABSI) score, 3rd degree burn, inhalation injury, length of BICU stay, antibiotic therapy, bacterial strand, fungal strand, incidence of bacteria and fungus infection, single or associated occurrence and bacteria species associated with fungus species. Statistical analysis comprised of univariate, Chi-square and Fischer Exact test, multivariate analysis, positive and negative predictive value, logistic regression analysis with the Nagelkerke, Cox/ Snell R-square. Results196 patients were included into the study, 147 male and 49 female. Total mean age was 47 years, in the fire burn group 47 years, in scalding 53 years, in electrical burn 29 years and in chemical burn 62 years. 123 male and 45 female were combusted, 15 male and 3 female scalded, 9 male had an electrical burn and 1 female a chemical burn. The mean TBSA in fire burns was 41 %, in scalding 42 %, in electrical burns 46 %, and in chemical burn 16 %. The mean ABSI in fire burn and scalding was 9, in electrical burn 8 and in chemical burn 7. The 3rd degree burns were 16 % in fire burn and 13 % in scalding and electrical burn and 0 % in chemical burn. The length of BICU stay was 49 days for fire burn, 47 days for scalding, 58 days in electrical burn and 21 days in chemical burn patients.The gram-positive bacterial strands most often found were Staphylococcus strands, gram negative Pseudomonas and Acinetobacter strands. Candida albicans was the most often present fungal strand. There was no difference in incidence between gram positive and gram-negative bacteria. In patients suffering from fire burns the most common bacteria were Staphylococcus and Pseudomonas, in scalding Acinetobacter, and in chemical burns Staphylococcus. In electrical burns no predominant bacterial strand was found. The associated occurrence of Staphylococcus and Candida albicans and Pseudomonas and Candida albicans was predominant. In patients with fire burn, 48% showed an associated infection, in scalding 21%, in electrical burn 33% and in chemical burn 100%.Combusted patients had the highest incidence of associated infection in age group 80–89 years, in scalding 40–49, 50–59 and 70–79 years, in electrical burn 20–29 years and in chemical burn 60–69 years. Most common factors of associated infections were higher age, high TBSA with 3rd degree burns and bacterial infections. Interestingly inhalation injury was highly inversely correlated to associated infection. ConclusionThe associated occurrence of bacterial and fungal wound infection is highest in burn patients with infections with Staphylococcus or Pseudomonas, the incidence is mainly found in fire burn and electrical burns. The use of oxygen in inhalation injury might prevent associated bacterial and fungal infections.

Barriers against Implementation of European Society of Gastrointestinal Endoscopy Performance Measures for Colonoscopy in Clinical Practice.

Background and Objectives: The implementation and monitoring of the European Society of Gastrointestinal Endoscopy (ESGE) performance measures for colonoscopy are suboptimal in clinical practice. Electronic reporting systems may play an important role in data retrieval. We aimed to define the possibility of systematically assessing and monitoring ESGE performance measures for colonoscopy through reporting systems. Materials and Methods: We conducted a survey during a nationwide event on the quality of colonoscopy held in Rome, Italy, in March 2023 by a self-administered questionnaire. Analyses were conducted overall and by workplace setting. Results: The attendance was 93% (M/F 67/26), with equal distribution of age groups, regions and public or private practices. Only about one-third (34%) and 21.5% of participants stated that their reporting system allows them to retrieve all the ESGE performance measures, overall and as automatic retrieval, respectively. Only 66.7% and 10.7% of respondents can systematically report the cecal intubation and the adenoma detection rate, respectively. The analysis according to hospital setting revealed no significant difference for all the items. Conclusions: We found a generalized lack of systematic tracking of performance measures for colonoscopy due to underperforming reporting systems. Our results underline the need to update reporting systems to monitor the quality of endoscopy practice in Italy.

Analysis of How Obesity Affects the Severity of Covid-19 Second Wave on Hospitalized Patients at RSUD Dr. Saiful Anwar Malang

Background : Based on WHO data, Covid-19 has officially been declared a pandemic because its spread has reached more than 100 infected countries. Several risk factors can affect the severity of Covid-19 patients, one of which is comorbid obesity. The Covid-19 pandemic occurred when the prevalence of overweight/obesity was increasing in almost every country in the world. Chronic inflammation associated with obesity, impaired immune function, and increased expression of ACE 2 contribute to disease severity and worsen clinical outcomes in obese patients with Covid-19 infection. Aim : This study aims to analyse the effect of obesity on the severity of the second wave of Covid-19 patients who were hospitalized at RSUD dr. Saiful Anwar Malang. Methods : This research is an analytic observational study with cross sectional approach. The sample consisted of 46 Covid-19 patients with obesity who were hospitalized at RSUD dr. Saiful Anwar Malng. The data acquired will be analysed using Mann Whitney non-parametric analysis test. Results : In the obese and non-pbese groups, the p-value was 0,042 and the odds ratio was 1,23. In the distribution of age and sex groups, each group obtained a p-value of 0,363 and 0,592. Conclusion : There is a significant difference in obesity among patients, with a 1,23-fold increased risk of experiencing severity compared to those who are not obese. Meanwhile, for the distribution based on age and sex, there was no significant difference, but it tended to have a more critical degree of severity towards men and older age.

Аналіз статистичних зв’язків між рівнями самогубств та випадків смерті внаслідок ушкоджень з невизначеним наміром як свідчення потенційної латентності рівня самогубств в Україні

The article analyzes the available statistical data on the levels and coefficients of the causes of death in Ukraine according to the information of the State Statistics Service of Ukraine in the period from 2005 to 2021, among which special attention that is paid to intentional self-harm (suicide) and cases of injuries with undetermined intent. Statistical categories and signs are described, according to which data are collected on cases of death from intentional self-harm in Ukraine. A partial comparison of these indicators with the indicators of other countries, in particular, the USA and the countries of the European Union, was carried out. An analysis of the dynamics of changes in the levels of registered suicides and deaths due to injuries with an undetermined intent was carried out. The unreasonableness of the excessive fluctuation of the indicator of the coefficient of deaths due to cases of injury with an uncertain intention is emphasized. For the first time, superimposition of data patterns in the categories of percentage distribution of age groups was applied, after which an analysis of the obtained results was carried out to determine the correlation using the Pearson coefficient. A comparison of death rates from deliberate self-harm was made with other categories of causes of death, including accidental drowning and submersion and accidental poisoning by other toxic substances. Additional statistical anomalies related to indicators of suicide rates and cases of injuries with undetermined intent are mentioned, in particular, regionally in Ukraine. The position that the revealed results allow us to assert the unreliability of open statistical data on the levels of suicides in Ukraine, as well as the position that cases of death due to intentional self-harm in Ukraine may be characterized by a high level of latency because of their qualification as deaths due to cases of injuries with an undetermined intent., is substantiated.

An overview of psychological analysis of patients with breast cancer undergoing total mastectomy and breast conservation surgery and its impact on objectified body consciousness at a tertiary care cancer centre.

e12537 Background: Breast cancer is the most common cancer among females, and surgery plays a central role in its treatment. Surgical treatments may have a negative psychological impact on women’s mental health regarding their body image. The purpose of this study was to compare the psychological health insights pertaining to objectified body consciousness scores before and after the surgery and also to observe whether these scores were comparable across the surgery types. Methods: This retrospective qualitative study included 706 breast carcinoma patients who underwent either Breast Conservation Surgery or Total Mastectomy at Manipal Cancer Centre, between the years 2020-2021. A validated questionnaire of Objectified Body Consciousness was used to obtain responses at diagnosis and at 6 months postsurgery and final scores were calculated for both instances. Two sample t- tests/analysis of variance and Chi-square tests were used to compare continuous and categorical variables respectively. Results: Out of total 706 breast cancer patients, 402 patients underwent Breast Conservation Surgery and 304 underwent Total Mastectomy procedure. A statistically significant change was seen in the mean Objectified Body Consciousness Score (14.22±15.44) for all patients when compared pre-operatively (72.72±11.38) and postoperatively (60.15±17.58). This change was higher in the Total Mastectomy group (29.38±11.53). Also, statistically significant rise in scores was seen with increasing age. There was a statistically significant difference between BCS and Total Mastectomy groups with respect to the distribution of age group, marital status, types of cancer, stage and grade of cancer, NACT administration and postoperative mean objectified body consciousness scores of patients (p-value <0.05). Conclusions: We could affirmatively conclude in our study that younger breast cancer patients and all patients who underwent a total mastectomy, had more psychological apprehension with the body image post-surgery, signifying these groups should be encouraged by healthcare professionals to reach out for counselling at the earliest. Knowing the pre-operative Objectified Body Consciousness scores and the type of surgery the patient is going to undergo, will help us to streamline categorical psycho-educational programs for each group and personalise our healthcare professionals to encourage women to reach out to social support groups and directed counselling at the earliest. This will help women adapt to their transformed life and be mentally prepared for the changes that are expected post-surgery.

Distribution of pacific cod Gadus macrocephalus (Gadidae) and functional structure of the habitat in the northern Japan Sea and some issues on regulation of the fishery

Seasonal and bathymetric distribution of the main age groups of pacific cod in the northern Japan Sea are considered on the data of bottom trawl surveys in 1980–2023. The main wintering and spawning accumulations, where the fish concentrate from December to January and then spawn in February-March, are formed on the external shelf and the upper continental slope along the western coast approximately between Peter the Great Bay and 47о N and along the eastern coast between Cape Krillon and 47о 30′N. The juveniles have feeding migrations from April to May, while older age groups complete the migrations a month later. They migrate in three main directions: from the areas at the mainland coast – southwestward and northeastward and from the areas at western Sakhalin — southward. The juveniles feed on shallows in Peter the Great Bay, northern Tatar Strait, and on southwestern shelf of Sakhalin between the Nevelsky Bay and Cape Krillon, whereas the feeding grounds for older groups occupy two vast areas including Peter the Great Bay with the adjacent southeastern shelf of Primorye and the shelf of northern Primorye in the Tatar Strait (to the north from 47о N) with the whole shelf of Sakhalin. In the northern Tatar Strait (northward from 48о N), the cod belonged to the Primorye and Sakhalin stocks can feed together. The feeding season lasts from June to September. The older cod feed usually deeper that the juveniles. Back migrations of cod for wintering occur from October to November. Because of a joint feeding area where the mainland and Sakhalin stocks are able to mix, the bottom trawl surveys at Primorye coast cannot be used for correct assessment of the total available catch (TAC) in this fishing district. To improve quality of the cod fishery forecasts, the methods of cohort or production analyses should be used, with the control by bottom trawl surveys data, as alternative information about the state of cod stocks, taking into account the abovementioned patterns of seasonal distribution and migrations.

Southern Horse Mackerel (Trachurus trachurus) Spatio-Temporal Distribution Patterns Based on Fine-Scale Resolution Data

In this study, the distribution patterns of southern horse mackerel are examined using commercial fine-scale resolution data. Using landings by size category and VMS data from the Portuguese commercial bottom-trawl fishery, which consistently targets horse mackerel, this study provides a comprehensive analysis of horse mackerel age distributions spanning a decade (2010–2020). Importantly, this study addresses potential biases in commercial effort data and establishes the usefulness of commercial bottom-trawl gear as a suitable method for sampling and evaluating southern horse mackerel stock dynamics. Ordered regression models were applied to allow for the modelling of the distribution of multiple age categories and investigate spatio-temporal migrations off the Portuguese coast. Southern horse mackerel show a widespread age distribution range and stable abundance with indications of seasonal and spatial patterns in the distribution of specific age groups. The insights derived from this research contribute valuable knowledge for understanding the dynamics and distribution patterns of fish populations.

Electrical injuries in children—a 6-year retrospective study

BackgroundThis study aimed to assess the clinical epidemiological characteristics of children with electrical injuries and discuss the countermeasures for the prevention of electrical injuries in children. MethodsThe children with electrical injuries were grouped according to whether or not they were admitted to the hospital for treatment into inpatient and outpatient groups. Clinical data such as gender, causes of injury and injury-causing voltage distribution in different age groups were analyzed. The factors affecting hospitalization were subjected to χ2 test, Kruskal-Wallis H test, and logistic regression analysis. ResultsA total of 321 children were included with 37 divided into inpatient group and 284 divided into outpatient group. The incidence of electrical injuries was highest in children ≤6 years old and in the summer. There were significantly different in gender, place of occurrence, cause of injury and injury-causing voltage between the two groups (p < 0.05). Injury-causing voltage is an independent risk factor affecting hospitalization of children with electrical injuries (OR = 0.116, 95 %CI = 0.040–0.334, p = 0.000). In children ≤6 years old, boys suffered electrical injuries more frequently than girls; battery powered vehicle (47.53 %) was primarily the cause of injury; most of the patients (64.64 %) were exposed to low voltage below 100 Vs, mainly in the case of adolescent children. ConclusionMale preschoolers accounted for the majority of electrical injury cases, and these accidents mostly happened in household electrical appliances and household battery cars. Overall, it is necessary to improve family electrical safety education and reinforce protective measures against electric injury to children.

Web-based questionnaire survey for exploring engagement characteristics of advance care planning in Japan: a cross-sectional study

ObjectiveDefinitive promotion of advance care planning (ACP) practices will require policy interventions tailored to the characteristics of the Japanese population and society. However, effective policies for promoting ACP are currently lacking in Japan. This study aimed to explore the characteristics of Japanese people who engaged in ACP activities through a web-based questionnaire survey, which was administered to individuals aged 25–64 years and classified into four occupational categories (non-medical/non-caregiving professionals [general population], physicians, nurses, and caregivers).ResultsThe total sample size was 1,648, with equal occupational category and age group distributions. Respondents in the general population group were less likely to discuss or document ACP than those in the other groups. Stepwise logistic regression analysis showed a significant difference in the adjusted odds ratio (aOR) of the independent variables of “attended cardiopulmonary resuscitation (CPR) training session(s)” (aOR: 1.93; 95% confidence interval [CI]: 1.18–3.15) and “having experience in performing CPR” (aOR: 2.61; 95% CI: 1.51–4.54) for respondents who discussed ACP with their families. A significant difference was observed in the aOR of the independent variable of “having experience in performing CPR” (aOR: 4.58; 95% CI: 2.30–9.13) for respondents who documented a written record of ACP.

Increasing the effectiveness of complex influence on the condition of parodontal tissue in patients with diseases of the digestive system and having fixed dentures

The study is dedicated to analyzing the effectiveness of comprehensive treatment of periodontal tissues in patients with digestive system diseases who use non-removable prostheses. The work considers the connection between periodontal diseases and digestive system disorders, emphasizing the importance of an integrated approach to treatment. A significant number of patients were included in the study, various clinical and biochemical parameters were evaluated, and a comprehensive methodological approach was used, including statistical analysis. The results of the study showed that a combined approach to treatment significantly improved the oral cavity and periodontal condition in these patients, suggesting greater effectiveness of such integrated strategies for treating periodontal diseases in individuals with digestive system disorders and non-removable dental prostheses. The findings of the study are significant for developing more effective methods of treating periodontal diseases, especially for patients with concurrent digestive system diseases. Objective: to develop and evaluate new methods of comprehensive treatment of the periodontium in patients with digestive system diseases who use non-removable prostheses. Materials and Methods: The study was conducted at the Department of Dentistry of Bukhara State Medical Institute in the years 2020–2023. Participants: 138 patients, aged 18–60, including 101 men and 37 women. Age group distribution: 78 people aged 18–39, 39 people aged 40–49, 21 people aged 50–65. All patients suffered from chronic generalized periodontitis of varying severity, had digestive system diseases, and used non-removable prostheses. The main group included 108 patients with gastrointestinal tract exacerbations: 52 with metal bridge prostheses, 28 with metal-ceramic prostheses, and 28 with dental prostheses on dental implants. The control group consisted of 30 patients: 12 with metal bridge prostheses, 10 with dental prostheses on dental implants, and 8 with metal-ceramic prostheses. Results: The treatment improved clinical-hygienic indicators in patients, reducing OHI-S and PMA indices. The microbial population in the oral cavity significantly decreased, particularly the levels of Lactobacillus and Streptococcus mutans. The effectiveness of the treatment was higher in the first group, with improved microflora and a reduction in pathogens. The use of Traumeel-S, HelboBlue, and ALT-Vostok model 03 contributed to the improvement of periodontal health. Patients experienced a restoration of metabolic processes in periodontal tissues, an increase in the levels of L-arginine and citrulline, and a decrease in nitrates and urea. The integrated approach proved effective in correcting the condition of the periodontium in patients with gastrointestinal diseases and non-removable prostheses.

A Study on SARS-CoV-2 Infection and Its Association with Co-morbidities: A Retrospective Cohort Study

Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a novel coronavirus (nCoV) that causes viral pneumonia known as Coronavirus Disease 2019 (COVID- 19). It can infect people of all age groups, and various clinical conditions are strong indicators of co-morbidities in COVID- 19. The presence of co-morbidities is crucial in determining the clinical outcome of coronavirus infections. Therefore, it is crucial to understand the demographic profile and associated risk factors of COVID-19 in this geographical region. Aim: To assess the association between SARS-CoV-2 infection and demographic characteristics and co-morbidities. Materials and Methods: A retrospective cohort study was conducted at the National Accreditation Board for Testing and Calibration Laboratories (NABL)-accredited Virology Service Laboratory (VSL) of Tripura Medical College and Dr. BR Ambedkar Memorial Teaching Hospital, Agartala, Tripura, India. All the required data was collected between May 2021 and October 2022, and data analysis was carried out from February to March 2023. After obtaining Indian Council of Medical Research (ICMR) approval, real-time Reverse Transcriptase-Polymerase Chain Reaction (rRT-PCR) was used for the detection of SARS-CoV-2 RNA. A total of 10,263 samples were included in the study. RNA extraction was performed using the viral Ribonucleic Acid (RNA) extraction Miniprep Kit protocol manufactured by MDI Membrane Technologies, and RT-PCR was conducted according to the Indian Council of Medical Research (ICMR)-approved DiAGSureTM nCoV-19 Detection Assay (Multiplex, TaqMan based) protocol developed by GCC BIOTECH. The findings were based on demographic parameters such as age group and gender distribution. Results were expressed as proportions and percentages, and statistical analysis was done by Chi-square test in Statistical Package for Social Sciences (SPSS) version 20.0. Results: Out of the 10,263 registered patients, 1471 (14.33%) were confirmed to have SARS-CoV-2 infection. The most affected age group was found to be between 21 and 40 years, with 524 (35.62%) cases. Males, 927 (63.02%) were more frequently infected than females, 544 (36.98%). Among all the SARS-CoV-2 infected patients, co-morbidities were found in 254 (17.26%) cases, and the association between co-morbidities and the rRT- PCR test results was found to be statistically significant, with a p-value=0.01. Conclusion: The highest number of SARS-CoV-2 patients were found in the age group of 21 to 40 years, predominantly among males. Patients with co-morbidities showed a significant association with SARS-CoV-2 infection. Diabetes was found to be the most prevalent risk factor among all the patients.

Financial burden of chronic kidney disease patients on maintenance hemodialysis in Chittagong, Bangladesh

Background: Chronic kidney disease (CKD) is an important public health problem. Renal replacement therapy is needed for patients who go to end-stage renal disease. Most of the evidence on its costs relates to patients receiving dialysis or kidney transplants, which shows that, in these phases, CKD poses a high burden to payers. The aim of this study was to estimate the financial burden of patients with CKD on maintenance hemodialysis. Methods: It is a 1-year observational study, carried out to collect data on 105 patients with CKD on dialysis taken from different centers in Chittagong, Bangladesh. After the collection of sociodemographic information, financial status was collected from patients who gave informed written consent to be included in the study. Data were analyzed using SPSS 20. Results: Regarding gender distribution, male was 73 (69.5%) and female was 32 (30.5%). The male-to-female ratio was 2.28:1. Age group distribution revealed 10 (9.5%) patients were at &lt;30 years, 18 (17.1%) were at 31–40 years, 23 (21.9%) were at 41–50 years, 26 (24.8%) were at 51–60 years, 20 (19.0%) were at 61–70 years, and 8 (7.6%) were &gt;71 years age. Among all most were involved in service 40 (38.1%) and business 23 (21.9%). The socioeconomic status of the patients revealed that 42 (40.0%) patients were from the upper-middle-class, and 50 (47.6%) were from the lower-middle-class. Among all, 33 (31.4%) patients took treatment from abroad. Regarding bearing of cost of the dialysis, 24 (22.9%) were self-financed, 35 (33.3%) got help from others (nonfamily members), 11 (10.5%) took loan, and 13 (12.4%) sold their stable land property. Regarding tenure of dialysis, 31 (29.5%) patients are getting dialysis &lt;1 year and 74 (70.5%) were getting it for 1–2 years. Previous monthly income before the start of dialysis was zero in 33 (31.4%) patients and it was &gt;30,000 taka/month in 34 (32.4%) patients and after the start of dialysis, present monthly income was zero per month in 67 (63.8%) patients and &gt;30,000 taka/month in 13 (12.4%) patients. Regarding expenditure for each dialysis showed 2 (1.9%) had zero taka and 46 (43.8%) patients needed 1000–2000 taka/session and 41 (39.0%) needed 2000–3000 taka/session. Conclusion: Dialysis in CKD patients is a huge financial burden to the patients themselves and their families. Government assistance should be provided to all patients who are unable to bear the cost.

Prognostic nomogram and epidemiological analysis for lung atypical carcinoid: A SEER database and external validation study.

Our study aims to delineate the epidemiological distribution of pulmonary carcinoids, including atypical carcinoid (AC) and typical carcinoid (TC), identify independent prognostic factors, develop an integrative nomogram and examine the effects of various surgical modalities on atypical carcinoid-specific survival (ACSS). Joinpoint regression model and age-group distribution diagram were applied to determine the epidemiological trend of the pulmonary carcinoids. Univariate and least absolute shrinkage and selection operator (LASSO)-based Cox regression models were used to identify independent factors, and a nomogram and web-based predictor were developed to evaluate prognosis of AC patients individually. We performed Kaplan-Meier survival analyses to compare the scope of various surgical interventions, with and without G-computation adjustment, utilising restricted mean survival time (RMST) to assess survival disparities. A total of 1132 patients were recruited from the Surveillance, Epidemiology, and End Results database (SEER) and a separate medical centre in China. The mean age of AC patients was 63.4 years and a smoking history was identified in 79.8% of AC patients. Joinpoint analysis shows rising annual rates of new AC and carcinoid cases among lung cancers. Both the proportion of pulmonary TC and AC within the total lung cancer population exhibits an L-shaped trend across successive age groups. The nomogram predicted 1, 3 and 5 years of AC with excellent accuracy and discrimination. Kaplan-Meier survival analyses, conducted both pre- and post-adjustment, demonstrated that sublobar resection's survival outcomes were not inferior to those of lobectomy in patients with stage I-II and stage III disease. This study is the first to reveal epidemiological trends in pulmonary carcinoids over the past decade and across various age cohorts. For patients with early-stage AC, sublobar resection may be a viable surgical recommendation. The established nomogram and web-based calculator demonstrated decent accuracy and practicality.

Generating synthetic data from administrative health records for drug safety and effectiveness studies.

Administrative health records (AHRs) are used to conduct population-based post-market drug safety and comparative effectiveness studies to inform healthcare decision making. However, the cost of data extraction, and the challenges associated with privacy and securing approvals can make it challenging for researchers to conduct methodological research in a timely manner using real data. Generating synthetic AHRs that reasonably represent the real-world data are beneficial for developing analytic methods and training analysts to rapidly implement study protocols. We generated synthetic AHRs using two methods and compared these synthetic AHRs to real-world AHRs. We described the challenges associated with using synthetic AHRs for real-world study. The real-world AHRs comprised prescription drug records for individuals with healthcare insurance coverage in the Population Research Data Repository (PRDR) from Manitoba, Canada for the 10-year period from 2008 to 2017. Synthetic data were generated using the Observational Medical Dataset Simulator II (OSIM2) and a modification (ModOSIM). Synthetic and real-world data were described using frequencies and percentages. Agreement of prescription drug use measures in PRDR, OSIM2 and ModOSIM was estimated with the concordance coefficient. The PRDR cohort included 169,586,633 drug records and 1,395 drug types for 1,604,734 individuals. Synthetic data for 1,000,000 individuals were generated using OSIM2 and ModOSIM. Sex and age group distributions were similar in the real-world and synthetic AHRs. However, there were significant differences in the number of drug records and number of unique drugs per person for OSIM2 and ModOSIM when compared with PRDR. For the average number of days of drug use, concordance with the PRDR was 16% (95% confidence interval [CI]: 12%-19%) for OSIM2 and 88% (95% CI: 87%-90%) for ModOSIM. ModOSIM data were more similar to PRDR than OSIM2 data on many measures. Synthetic AHRs consistent with those found in real-world settings can be generated using ModOSIM. Synthetic data will benefit rapid implementation of methodological studies and data analyst training.

Chronic Myeloid Leukemia in Adolescents and Young Adults: A SEER-Based Analysis of Characteristics and Survival Outcomes of 1565 Patients

Introduction: Adolescents and Young Adults (AYA) are individuals between 15-39 years old. There are an estimated 1 million new cases of cancers in this age group yearly [1]. Although Chronic Myeloid Leukemia (CML) is typically a disease of middle-aged and elder patients, with a median age of 62 years [1], AYA accounts for about 22.1% of all CML cases [2]. There has been little focus directed towards this age group and most studies focus on the middle-aged and elderly. Despite the remarkable improvement in the survival of CML over the years, the largest study to date [3] suggested poor survival outcomes for patients in underserved populations and with low income. We aimed to determine whether sociodemographic differences exist in the AYA age group. Method: The Surveillance, Epidemiology, and End-Result (SEER) registry research plus database 17 (2000 -2020) was used to assess and compare the survival outcomes in the AYA group and older population diagnosed with CML. Both univariate and multivariate analyses were performed. Cox proportional hazards regression was used to determine prognostic factors for survival. A two-sided p-value ≤0.05 was considered significant. Results: A total of 6,319 patients with CML were identified, of which 75.2% (n= 4754) were adults ≥40 years, and 24.8% (n= 1565) were AYAs . Amongst the AYA, 51.4% (n=804) were Non-Hispanic White (NHW), 25 % (n=390) were Hispanics, 12.1% (n=189) were Non-Hispanic Black (NHB), 10.5% (n=164) were Non-Hispanic Asian or Pacific Islander (NHAPI) and 1.2% (n=18) were Non-Hispanic American Indian/Alaska Native (NHAIA) [Table 1]. The frequency of Hispanics in the AYA group was more compared to adults ≥40 years (25% vs 12.9%). NHWs had a lower frequency in the AYA group compared to adults ≥40 years (51.4% vs 67.5%) and NHBs had a similar distribution in both age groups (12.1% vs 11.6%). The proportion of mortality attributed to CML was lower in the AYA group compared to older adults ≥40 years (7.7% vs 11.9%). The results for individual Cox regression for each racial group show that AYA Hispanic males had a worse prognosis than females (HR= 2.930, 95% CI: 1.234-6.960), such observation was not seen in other AYA races [Table 2] but it was seen in Hispanic adult males ≥40 years (HR= 1.583, 95% CI: 1.074-2.334). Also, we identified that for patients aged ≥40 years, male sex was an independent poor prognostic factor for NHW (HR= 1.259, 95% CI: 1.074-1.476) and NWB (HR=1.879, 95% CI: 1.232-2.864) [Table 2]. Conclusion: Our study shows similar demographic characteristics between AYA and adults ≥40 years old. However, AYAs are less likely to die from CML compared to adults ≥40 years. Hispanic males appear to have a worse outcome than females, an observation seen in both age groups, and is independent of other analyzed prognostic factors. More research is needed to examine and identify other prognostic factors of CML in AYA with the aim of improving their survival outcomes.