Epidemiological Factors Research Articles

Early Onset Pancreatic Adenocarcinoma (EOPAC): presentation, clinical course and treatment outcomes in comparison to Average Onset Pancreatic Adenocarcinoma (AOPAC): a retrospective cohort study

BackgroundPancreatic adenocarcinoma (PAC) is a disease of decimal prognosis, with around 50% of patients presenting with metastatic disease. Previous trials reported a high incidence of early onset pancreatic cancer (EOPAC) in Egypt, presenting about 25% of patients with PAC. The clinic-pathological features and prognosis of EOPAC needs more study.Patients and methodsA retrospective analysis of patients’ records at Shefa Al-Orman comprehensive cancer center database. Patients with histo-pathologically confirmed diagnosis of PAC. We categorized patients according to the age at diagnosis into EOPAC (≤ 50 years) and average onset PAC (AOPAC). Data on risk factors, family history, presenting symptoms, clinic-pathological features, treatment, and prognosis were extracted. Patients with histopathologically confirmed diagnosis of pancreatic cancer diagnosed between December 2016-December 2022 were included.ResultsThe study cohort consisted of 412 patients. EOPAC represented 20.3% of patients, with no significant differences in risk factors and family history compared to AOPAC. Duration of symptoms before diagnosis is longer in EOPAC, with the majority of EOPAC presenting with localized disease (23.8%) and locally advanced tumors (28.5%) compared to AOPAC. AOPAC presented more with metastatic disease (64% vs. 45.2%, p = 0.003). EOPAC are usually submitted to more aggressive treatment including radical surgery, neoadjuvant therapy, and aggressive chemotherapy regimens in metastatic disease. Disease free survival (DFS) of EOPAC was shorter than AOPAC (11 months vs. 17 months, p = 0.889), but overall survival OS was significantly longer in EOPAC (10 months vs. 6 months, p = 0.013).ConclusionPatients with EOPAC in Egypt represent around 25% of cases. EOPAC tend to have a shorter disease free survival (DFS) in patients presenting with localized disease. The overall survival (OS) is longer in EOPAC compared to AOPAC. Further studies are mandatory to identify the epidemiological and risk factors of EOPAC in Egypt.

The potential of gene drives in malaria vector species to control malaria in African environments

Gene drives are a promising means of malaria control with the potential to cause sustained reductions in transmission. In real environments, however, their impacts will depend on local ecological and epidemiological factors. We develop a data-driven model to investigate the impacts of gene drives that causes vector population suppression. We simulate gene drive releases in sixteen ~ 12,000 km2 areas of west Africa that span variation in vector ecology and malaria prevalence, and estimate reductions in vector abundance, malaria prevalence and clinical cases. Average reductions in vector abundance ranged from 71.6–98.4% across areas, while impacts on malaria depended strongly on which vector species were targeted. When other new interventions including RTS,S vaccination and pyrethroid-PBO bednets were in place, at least 60% more clinical cases were averted when gene drives were added, demonstrating the benefits of integrated interventions. Our results show that different strategies for gene drive implementation may be required across different African settings.

Delving into diversity: Exploring different risk factors of premature greying of hair.

Dear Madam, Hair is said to grey prematurely when a minimum of five grey hairs occur before the age of 20 in Caucasians, 25 in Asians and 30 in Africans1. Some authors propose using 25 years as a cut-off for people in the South Asian subcontinent. Also, there's no universal grading system for premature greying of hair (PGH). This letter addresses the various evolving risk factors for PGH in young adults worldwide. PGH may be familial or genetically influenced, traveling in an Autosomal Dominant pattern. A positive family history, in particular the paternal history is the most powerful risk factor2. PGH is also linked to nutritional deficiencies including vitamins (especially B12) and minerals. For example in one study, significantly lower levels of serum calcium, ferritin, vitamin B12, and high HDL were observed in patients3. T3 and T4 act on hair follicles to cause melanogenesis and their deficiency is therefore associated with PGH, alopecia, and changes in hair morphology. Another study found notably reduced levels of copper in cases (PGH) as compared to the control group. This study, however, did not observe lower levels of zinc or iron among the affected population. A separate case-control study concerning the association of epidemiological and biochemical factors with PGH reported that a significantly higher percentage of individuals with premature greying had atopic diathesis, led sedentary lifestyles, had family histories of the condition, smoked, and had reported higher levels of perceived stress compared to controls. Though, interestingly enough, regular application of hair oil seemed to confer a safeguarding effect against premature greying. Upon further review of the literature, it became apparent that both BMI and exposure to sunlight emerged as substantial predictors of PGH. Despite the prescription of various vitamins and minerals like biotin, calcium pantothenate, zinc, copper, and selenium (all of which have been recognized as risk factors), the outcomes have been disappointing. Calcium pantothenate is frequently recommended for premature greying of hair (PGH)4. This highlights an existing knowledge gap concerning the precise causative risk factors, necessitating further investigation for a comprehensive understanding and improved management of individuals experiencing premature greying of hair.

Epidemiology characterization and risk factors of brucellosis among older rural populations in northwest China

Brucellosis causes significant economic damage and public health problems in northwest China. The older rural population is considered a high-risk group. However, the epidemiological characteristics and risk factors for brucellosis in this population remain unclear. This study investigated these factors within this high-risk group by performing a cross-sectional study in five townships of Wuwei City, Gansu Province. Cases were screened via rose Bengal and serum plate agglutination tests. Risk factors were evaluated using a standard questionnaire form. This study included 1074 participants aged >50 years. Among them, 15 (1.4%) tested positive for Brucella. The most common symptoms were arthralgia/myalgia (n=5, 33.3%), and 10 (66.7%) cases were asymptomatic. Raising lambs artificially (odds ratio, 4.7; 95% CI, 1.3–17.0; P=0.02) increased the risk of brucellosis. The results indicated a high proportion of asymptomatic brucellosis in this group. Raising lambs artificially is a risk factor for brucellosis. The surveillance and health education of brucellosis for older rural populations in endemic areas of northwest China should been attention.

Occurrence of gangrenous mastitis and its associated risk factors in dairy goats

Gangrenous mastitis is one among the major economically important health constraint faced by goat farmers. Occurrence of gangrenous mastitis is a result of combination of host, agent and environmental factors. Alteration in any of the host, agent and environmental factors can lead to an increase in bacterial concentration and the expression of virulence factors resulting in gangrenous mastitis. The present study was conducted over a period of two years from September 2021 to September 2023. The study subjects included 30 goats affected with gangrenous mastitis, managed under semi- intensive and intensive system. The selected animals included Malabari, Jamnapari and Malabari crossbreds with age group ranging from one to eight years, parity number ranging from one to six and stage of lactation ranging from peri-parturient period, early lactation and late lactation. Information regarding the host associated and environmental risk factors were collected by a prepared proforma. Disease diagnosis was made based on clinical examination, examination of udder and milk changes. Epidemiological analysis revealed a higher occurrence of gangrenous mastitis in crossbred goats. The occurrence was also higher in the age group of 3-4 yrs, during periparturient period and in herd without proper management practices. Absence of herd and management practices like proper disinfection and isolation of animals to new shed during parturition significantly caused occurrence of gangrenous mastitis. Proper awareness regarding the epidemiological factors leading to gangrenous mastitis can help in future control strategies of caprine gangrenous mastitis. Keywords: Goat, gangrenous mastitis, epidemiology

Post‑recovery symptoms of infected cases after Omicron pandemic: a quick online cross-sectional study based on C19-YRSm in China

BackgroundThe post COVID-19 health condition of Chinese residents infected with Omicron is not clear after the change of epidemic prevention policies. This study aimed to clarify the epidemiology and associated factors about health status of rehabilitation patients.MethodsA quick questionnaire study based on C19-YRSm was conducted in mainland China through internet from May 1, 2023, to May 7, 2023. Chinese native speakers infected with Omicron variant agreed to participate were included. Persisting symptom and living habits were simultaneously inquired. Logistic regression analysis was used to identify the associated factors.ResultsIn this study 753 individuals were included. Of whom 57.90% were males, 89.38% did not seek medical service, 99.47% recovered within less than 120 days. Breathlessness (47.68%), cognitive impairment (44.89%), Anxiety/mood changes (33.20%), pain/discomfort (32.94%), fatigue or tiredness not improved by rest (32.27%) and post-exertional malaise (30.01%) were the top reported key symptoms. Less than 10% respondents reported functional limitations. The prevalence of fever was reported greater than that of other symptoms, with dry eyes at 14.87%, appetite change at 14.34%, and hair loss at 12.22%. Middle age (OR: 2.353, 95%CI: 1.171 ~ 4.729), underlying diseases (OR: 2.293, 95%CI: 1.216 ~ 4.324), severe key symptom (OR: 6.168, 95%CI: 1.376 ~ 27.642) and at least one other symptom (OR: 1.847, 95%CI: 1.225 ~ 2.718)during the recovery were the risk factors of poor overall health after infection (current overall health score <8; 74.10%), while daily exercise in recovery period (OR: 0.457, 95%CI: 0.229 ~ 0.913), a low-fat diet (OR: 0.600, 95%CI: 0.401 ~ 0.898) and the recovery time from 2 to 4 months (OR: 0.639, 95%CI: 0.445 ~ 0.918) were the protective factors.ConclusionThis is the first time to use the C19-YRSm scale to evaluate the health status in China. The study revealed prevalence of persistent symptoms within 120 days after Omicron onset.

Streptococcus suis-Associated Meningitis in a Southern Region of Vietnam.

Streptococcus suis is the most common and severe cause of meningitis in Vietnam, but the recent data about epidemiological characteristics and sequelae are still inadequate. We performed a retrospective study to describe the epidemiology, clinical characteristics, and outcomes of patients with S. suis-associated meningitis. A retrospective study was carried out by searching records from the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam, between January 2016 and January 2020. All data concerning epidemiological, clinical, and subclinical characteristics and treatment results were collected and analyzed. Over the study period, 153 cases were included in this study, with 95 cases occurring in the 2016-2017 period. The median age of all patients was 52 years (range, 29-90 years), and 70.6% of patients were male. Fifty-two patients (34%) were farmers, and the Mekong Delta was the region with the highest number of cases (60.1%). The most frequent manifestation of infection was fever (151/153, 98.7%), followed by hearing loss (64/153, 41.8%), and one patient (0.7%) died. All isolates remained susceptible to ceftriaxone, penicillin, vancomycin, and levofloxacin, whereas 99.2% of isolates were resistant to tetracycline. Occupational exposure to pigs and the consumption of contaminated food have been identified as primary risk factors associated with this zoonosis, and our study found no significant changes in epidemiological factors compared with past data. The Mekong Delta continues to be the most affected region for S. suis meningitis in southern Vietnam, with S. suis serotype 2 remaining the most relevant agent.

Epidemiological Study on Three Hundred Patients of Scabies in the Industrial Area of Dhaka, Bangladesh

Background: Scabies is a common and highly contagious skin disease caused by a mite called sarcoptes scabiei. Objective: The aim of this study was to analyze the epidemiological factors associated with scabies infection in an industrial area. Methodology: Write the study design, study place, study period and study population here. It was considering age, sex, occupation, economical condition, educational status, family history of scabies of the selected patient. Results: The age group of 1 to 10 years (28.66%) and low socioeconomic condition (58.66%), illiterate (Primary 44.00%), overcrowding living (Madrasah 37.33%) showed the highest infestation rates. Write more findings here Conclusion: In conclusion an improvement of socio-economic conditions, improve living facilities, education, social awareness may contribute to a reduction in the number of scabies infections. Journal of Monno Medical College June, 2024; 10 (1):13-16

Drug-resistance characteristics, genetic diversity, and transmission dynamics of multidrug-resistant or rifampicin-resistant Mycobacterium tuberculosis from 2019 to 2021 in Sichuan, China

BackgroundMultidrug- or rifampicin-resistant tuberculosis (TB; MDR/RR-TB) is a significant public health threat. However, the mechanisms involved in its transmission in Sichuan, China are unclear. To provide a scientific basis for MDR/RR-TB control and prevention, we investigated the drug-resistance characteristics, genetic diversity, and transmission dynamics and analyzed the demographic and clinical characteristics of patients to identify risk factors for the acquisition of MDR/RR-TB in Sichuan, Western China.MethodsWhole-genome sequencing was performed using a sample comprised of all MDR/RR-TB strains isolated from patients with pulmonary TB (≥ 15 years) at the 22 surveillance sites in Sichuan province between January 2019 and December 2021, to analyze genotypic drug resistance and genetic diversity. Moreover, we performed statistical analyses of the epidemiological characteristics and risk factors associated with the transmission dynamics of MDR/RR-TB.ResultsThe final analysis included 278 MDR/RR TB strains. Lineage 2.2, the major sub-lineage, accounted for 82.01% (228/278) of isolates, followed by lineage 4.5 (9.72%, 27/278), lineage 4.4 (6.83%, 19/278), and lineage 4.2 (1.44%, 4/278). The drug resistance rates, ranging from high to low, were as follows: isoniazid (229 [82.37%]), streptomycin (177 [63.67%]), ethambutol (144 [51.80%]), pyrazinamide (PZA, 119 [42.81%]), fluoroquinolones (FQs, 93 [33.45%]). Further, the clofazimine, bedaquiline, and delamanid resistance rates were 2.88, 2.88, and 1.04%, respectively. The gene composition cluster rate was 32.37% (90/278). In addition, 83.81% (233/278) of MDR/RR-TB cases were determined to be likely caused by transmission. Finally, patients infected with lineage two strains and strains with the KatG S315T amino acid substitution presented a higher risk of MDR/RR-TB transmission.ConclusionTransmission plays a significant role in the MDR/RR-TB burden in Sichuan province, and lineage 2 strains and strains harboring KatG S315T have a high probability of transmission. Further, high levels of FQ and PZA drug resistance suggest an urgent need for drug susceptibility testing prior to designing therapeutic regimens. New anti-TB drugs need to be used standardly and TB strains should be regularly monitored for resistance to these drugs.

Diagnosis of fungal diseases in quinoa (Chenopodium quinoa Willd) in Burkina Faso

Quinoa is an Andean pseudo-cereal crop that is mainly cultivated for its energy and protein-rich, gluten-free seeds. Quinoa is currently being popularized in Burkina Faso, but manifestations of fungal diseases have been observed on the plants. The aim of this study was to establish a causal relationship between the observed symptoms and the associated fungal pathogens. Samples of symptomatic organs were collected from the three agro-ecological zones and examined for fungal pathogen species via isolation on media. A total of six (6) diseases and twenty-nine (29) fungal species were described and identified in the collected organs. The diseases were present in the following proportions: (i) panicle browning followed by complete plant drying (45.36%), (ii) brown crown rot (41.20%), (iii) brown stalk rot (27.31%), (iv) damping-off (22.68%), (v) chlorosis with necrotic brown leaf spots (19.33%), and (vi) plant wilting (13.88%). The essential epidemiological factors of these pathologies are discussed.

Liver Cancer in the Middle East and North Africa: Epidemiology, Trends, and Risk Factors

Objectives: Considering the growing concerns about the rising incidence of this cancer in the Middle East and North Africa (MENA), this literature review presents the local epidemiology and trends of liver cancer, along with a practical estimation of its epidemiology and contributing risk factors. Design: Review Article. Setting(s): Middle East and North Africa. Outcome Measures: MEDLINE (via PubMed), Scopus, and Web of Science databases, as well as Google Scholar, were searched up to September 2024 using representative keywords and MeSH terms. Studies reporting the epidemiology of liver and intrahepatic cholangiocarcinoma in the region or an analysis of the contributing infectious diseases, non-communicable disorders, genetic predispositions, behavioral aspects, and environmental factors were included. A qualitative synthesis was performed, and the results were presented using thematic narrative synthesis. Results: Liver cancer, particularly hepatocellular carcinoma (HCC), is rapidly growing in the MENA region, driven by a combination of viral hepatitis, underlying metabolic disorders, and environmental exposures. Liver cancer epidemiology varies across the region, with countries like Egypt historically burdened by hepatitis C, while Gulf states experience rising cases linked to metabolic disorders. Projections indicate a continued increase in the incidence of liver cancer due to the ongoing obesity and diabetes epidemics. Conclusions: Despite the success of viral hepatitis management campaigns in some countries, the region faces significant challenges in controlling the rising burden of liver cancer related to metabolic disorders. Prevention strategies should focus on lifestyle and dietary interventions, alongside the need for improved cancer registries, better data collection, and policy reforms. A multidisciplinary approach, combining public health initiatives and targeted healthcare improvements, is essential to reduce regional liver cancer incidence and improve outcomes.

Risk factors for second primary breast cancer by laterality, age, and race and ethnicity.

Epidemiologic studies of risk factors for second primary breast cancer (SBC) have been conducted primarily in non-Hispanic White (NHW) women. A racially- and ethnically-diverse population-based pooled cohort of 9,639 women with first primary stage I-III invasive breast cancer (FBC) was linked with the California Cancer Registry; 618 contralateral SBC (CSBC) and 278 ipsilateral SBC (ISBC), diagnosed >6 months after FBC, were identified. Using Fine and Gray models accounting for competing risks, we assessed associations of CSBC and ISBC risk with FBC clinical characteristics and epidemiologic factors. In younger women (FBC at age <50 years), higher CSBC risk was associated with ER/PR-negative FBC [hazard ratio (HR)=1.68], breast cancer family history (HR = 2.20), and nulliparity (HR = 1.37). In older women (FBC at age ≥50 years), higher risk was associated with breast cancer family history (HR = 1.32), premenopausal status (HR = 1.49), overweight (HR = 1.39), and higher alcohol consumption (HR = 1.34). For ISBC, higher risk was associated with married status (HR = 1.94) in younger women, and overweight (HR = 1.60) among older women. For CSBC, HR estimates were generally similar across racial and ethnic groups. Even after adjustment for these risk factors, compared with NHW women, risk remained elevated for CSBC in younger African American, Asian American, and Hispanic women, and for ISBC in older African American and Hispanic women with ER/PR-positive FBC. Our findings support genetic risk evaluation, enhanced screening, and lifestyle changes in women at higher risk of SBC. Additional risk factors must contribute to the unequal burden of SBC across racial and ethnic groups.

Molecular detection and phylogeny analysis of Coxiella burnetii detected from cattle and buffalo milk based on plasmid cbhE gene in West Azerbaijan of Iran

Humans and animals may get Q fever, which is caused by the Gram-negative coccobacillus Coxiella burnetii. The symptoms of Q fever may include a self-limiting febrile illness, pneumonia, endocarditis, or hepatitis. Infections are classified as either acute or persistent. Cattle, sheep, and goats are the most prevalent reservoir animals for this zoonosis. This research was conducted to identify C. burnetii using transposable and isocitrate dehydrogenase genes (IS1111, icd) and QpH1 plasmids. A total of 142 samples of raw buffalo and cow milk were collected from various locations within the West Azerbaijan region (see map). We used "nested" PCR techniques using primers based on the IS1111 and icd genes of C. burnetii, as well as conserved and variable portions of plasmid sequences, to identify C. burnetii and their plasmids in milk samples from buffalo and calves. Out of 142 milk samples that were positive for the chromosomal transposable genes (IS1111 and icd) at a rate of 16.9 percent (95 percent CI: 14.5 percent to 19.6 percent) and 7.1 % (95 percent CI: 5.59 percent to 9.08 percent), respectively, 86 samples were positive for the QpH1 plasmid at a rate of 60.5 percent (95 percent CI: 52.35 percent to 68.2 percent). Based on a phylogenetic study of the icd and QpH1 genes, the majority of the isolates had a similarity of 99.45–99.9 percent. Conclusion: It was determined that the buffalo population in West Azerbaijan province represents a significant epidemiological factor with respect to Q fever and consequently public health.

Epidemiology of Ciguatoxin Poisoning Outbreaks in the United States Between 2001 and 2021.

This study examined data from the Centers for Disease Control and Prevention's National Outbreak Reporting System between 2001 and 2021 for confirmed outbreaks of foodborne illness due to Ciguatoxin in the United States. Previous research into Ciguatoxin illness in the United States has focused on specific states or territories-namely Hawaii, Florida, Puerto Rico, and the Virgin Islands-meaning the national distribution of outbreaks remains unclear. In addition, while specific categories of seafood (e.g., reef fish) are known to carry elevated risk of illness due to Ciguatoxin poisoning, it remains unclear the extent to which specific seafood items are associated with the odds of being hospitalized in an outbreak. This study calculated descriptive statistics for the distribution of outbreaks by state, season, site of exposure, and implicated seafood item. Then, binomial regression was used to assess the relationship between the implicated seafood item in an outbreak and hospitalization. Results provided evidence that knowing the implicated seafood item in an outbreak is associated with the odds of hospitalization (χ25 = 33.023, p < 0.0001). Even when a seafood item was found to be associated with elevated odds of hospitalization, not all cases involved hospitalization. This finding aligns with Ciguatoxin poisoning case reports, noting that key epidemiological factors include not just the seafood item consumed but also the quantity and the part consumed (e.g., the head). In conclusion, public health officials should consider Ciguatoxin poisoning outbreaks as multidimensional and utilize information about the seafood consumed as well as the quantity and parts of the seafood consumed.

Epidemiologic Characterization and Risk Factors for Congenital Syphilis in Northeast Mexico: A Case-control Study 2016–2024

Background: Congenital syphilis (CS) is an infectious disease caused by Treponema pallidum, which is transmitted through the placenta during pregnancy. Since 2001, a notable and consistent rise in the prevalence of CS cases has been observed, especially in low- and middle-income countries. Currently, information regarding the risk factors for this phenomenon has been scarcely addressed. Methods: A case-control study was conducted to analyze the risk factors for CS. Cases of CS were defined according to scenarios 1 and 2 from Centers for Disease Control criteria, while controls were considered those from scenarios 3 and 4. Data were collected from clinical records from 2016 to 2024 from a hospital in the metropolitan area of Monterrey, Mexico. Statistical analysis was conducted through SPSS V.22. Results: In total 297 syphilis-infected mothers were included in the analyses. Multivariable logistic regression analysis showed that CS was related to late maternal diagnosis, especially after birth [OR: 4.352 (1.313–14.423)]. Additionally, women with a high nontreponemal serum test titer (≥1:8) had an increased risk of delivering an infant with CS [OR: 4.380 (1.946-9.856)]. Infants born to mothers receiving adequate treatment [OR: 0.213 (0.101-0.450)] were a protective factor. Conclusion: CS is a major public health worldwide. Adequate treatment is critical for the prevention of CS. Strategies focusing on prenatal care, early diagnosis, and adequate treatment among those with high nontreponemal titer should be strengthened to prevent CS.

Demographic Profile of Violent Asphyxial deaths in JSS Medical College, Mysuru – Five year retrospective study

The epidemiological risk factors for violent asphyxia deaths can contribute to construct a socioeconomic and demographic profile of victims of asphyxial deaths. This study is also very crucial in identifying the risk factors, triggers for common asphyxia deaths and especially suicidal asphyxial deaths like hanging based on the profile and data derived from this study. This study was undertaken to analyse the different aspects of asphyxial deaths.Main focus is given to study the type of asphyxia, age, sex distribution and seasonal variation, also to know the pattern in work area, seasonal and demographic variations. Among the asphyxial deaths hanging is the commonest which constituted 81% of the total asphyxia deaths and was predominant in males. Drowning is the second most frequent type of asphyxialdeath followed by strangulation. The incidence of hanging is highest during winter season. This suggests that seasonal factors and its resulting psychological fluctuations might aggravate depression and mood, which then might finally impact the victim’s suicidal tendencies leading to increased incidences of hanging.

Leptospirosis seroprevalence and associated risk factors in dairy goats in the Brazilian semi-arid region

Leptospira spp. infection is a worldwide zoonosis that causes economic losses to goat rearing, mainly due to reproductive disorders. Hence, the objective of this research was to determine the seroprevalence and associated risk factors of leptospirosis in a goat milk-producing region in the states of Paraiba and Pernambuco, Northeast Brazil. The microscopic agglutination test was used as serological method and risk factor analysis was carried out using univariable and multivariable analyses. Out of the 937 animals sampled, 102 (10.9 %; 95 % CI = 8.9–12.9 %) were seropositive for Leptospira spp. and the most frequent serogroups were Ballum (41.2 %; 95 % CI = 31.6–50.7 %), Icterohaemorrhagiae (25.5 %, 95 % CI = 17–33.9 %) and Semaranga (23.5 %, 95 % CI = 15.3–31.8 %), with antibody titres ranging from 1:50 to 1:200. Thirty-four of 51 herds (66.7 %; 95 % CI = 53.7–79.6 %) had at least one seropositive animal. The risk factor identified in the multivariable two-level random effect binary logistic regression was the animal being an adult (odds ratio = 4.2; 95 % CI = 1.93–9.13; P < 0.001). Our results provide important information on the epidemiology and risk factors associated with goat leptospirosis seroprevalence in one of the main Brazilian goat milk-producing regions. Furthermore, the need for adopting sanitary control measures, especially those involving sanitary management practices, is highlighted.

AI Methods and Algorithms for Diagnosis of Intestinal Parasites: Applications, Challenges and Future Opportunities

Artificial intelligence (AI) transforms intestinal parasite diagnosis, particularly through deep learning models like convolutional neural networks (CNNs). This paper reviews the application of AI, especially CNNs, in automating parasite detection and classification from microscopic images. Integrating AI into parasitology diagnostics speeds up the process, reduces human error, and enhances treatment and patient outcomes. However, there is a need for more datasets reflecting the African context to ensure accurate ground-truthing, particularly in low- and middle-income countries (LMICs) across Africa. Most AI models for medical diagnosis are trained on datasets from high-income countries, which may not capture the unique epidemiological, genetic, and environmental factors prevalent in African populations. This can lead to less accurate diagnoses and treatment recommendations in African LMICs. For example, intestinal parasitic infections are common in many African regions, yet the datasets used to train AI models often lack sufficient representation from these areas. Developing datasets that reflect the diverse African context is crucial for improving the accuracy and reliability of AI-based diagnostic tools. Issues like overfitting, data privacy, and cost also require attention. Collaboration between researchers, healthcare professionals, and technologists is essential to address these challenges. Standardized protocols for data collection, model training, and validation are necessary for reliable AI systems. Combining AI with traditional techniques holds promise for better parasite diagnosis, ultimately improving African healthcare outcomes

Fatores de risco para psicoses

The main objective of this article is to introduce undergraduate medical students to the concept of psychosis. The authors discuss the criteria for diagnosing psychosis and provide an overview of the epidemiology and risk factors for psychotic disorders such as: childhood trauma, cannabis use, migration, discrimination, social disadvantage, and skin color. The observation of these factors is essential in the evaluation of psychiatric patients, as it helps in predicting the development of psychosis.

Two Decades of Progress in Personalized Medicine of Colorectal Cancer in Serbia-Insights from the Institute for Oncology and Radiology of Serbia.

It is projected that, by 2040, the number of new cases of colorectal cancer (CRC) will increase to 3.2 million, and the number of deaths to 1.6 million, highlighting the need for prevention strategies, early detection and adequate follow-up. In this study, we aimed to provide an overview of the progress in personalized medicine of CRC in Serbia, with results and insights from the Institute for Oncology and Radiology of Serbia (IORS), and to propose guidance for tackling observed challenges in the future. Epidemiological data were derived from official global and national cancer registries and IORS electronic medical records. Germline genetic testing for Lynch syndrome was performed by Next Generation Sequencing. RAS and BRAF mutation analyses were performed using qPCR diagnostic kits. Epidemiology and risk factors, prevention and early detection programs, as well as treatment options and scientific advances have been described in detail. Out of 103 patients who underwent germline testing for Lynch syndrome, 19 (18.4%) showed a mutation in MMR genes with pathogenic or likely pathogenic significance and 8 (7.8%) in other CRC-associated genes (APC, CHEK2, MUTYH). Of 6369 tested patients, 50.43% had a mutation in KRAS or NRAS genes, while 9.54% had the V600 mutation in the BRAF gene. Although significant improvements in CRC management have occurred globally in recent years, a strategic approach leading to population-based systemic solutions is required. The high incidence of young-onset CRC and the growing elderly population due to a rise in life expectancy will be especially important factors for countries with limited healthcare resources like Serbia.