Greater Risk Of Occurrence Research Articles

Incidence and mortality of post-transplant lymphoproliferative disorders after kidney transplantation: A real-world retrospective analysis in Japan.

Post-transplant lymphoproliferative disorder is a potentially life-threatening complication that has a greater risk of occurrence in the setting of immunosuppression and oncogenic viral infections after transplant surgery. Few studies have reported the cumulative incidence, histological subtypes and clinical outcomes of this disorder in kidney transplant recipients. We retrospectively investigated 34 post-transplant lymphoproliferative disorder patients diagnosed out of the 1210 kidney transplant recipients who had undergone the surgery at the two largest centers in Japan between January 1983 and December 2017. A total of 32 patients (94.1%) developed late-onset post-transplant lymphoproliferative disorder (diagnosed 1year after transplantation). The cumulative incidence rates were 0.76% and 1.59% at 5 and 10years post-transplantation, respectively. The central nervous system was the most common site (35.3%, 12/34). Overall survival was similar between patients with and without central nervous system lesions (P=0.676). Of all of the cases, 23.5% (8/34) were detected through cancer screening. Importantly, patients with screening-detected post-transplant lymphoproliferative disorder had better overall survival than those with the disorder who had been symptom detected (P=0.0215). Overall survival was significantly reduced in patients who developed the disorder compared with those who did not (P=0.0001). Post-transplant lymphoproliferative disorder was more likely to occur in the late post-transplantation period, which showed that long-term medical examination for transplant recipients is required. Based on our findings, we propose vigilant, long-term, cancer screening in kidney transplant recipients.

Identifying the most vulnerable areas for the occurrence of new cases and deaths related to cervical cancer in the city of Recife, Brazil: See to act.

e13628 Background: Cervical cancer (CC) is the second most incident and the most deadly among women from the Northeast’S Brazil and RECIFE-Pernambuco and the third most incident in Brazil. The occurrence of CC expresses a reality of inequality and inequity and should be understood not only as an oncological indicator, but essentially as an indicator of social vulnerability and health care needs. Its distribution occurs heterogeneously. Methods: Determine the geolocation of areas of greatest risk of occurrence of SC from the social and health determinants Considering the high incidence and mortality related to cervical cancer between 2006-2015, in the city of Recife, we used the spatialization technique to identify the most vulnerable territories for our intervention in the city of Recife. Results: 3,844 Cervical Cancer notifications AND 276 OBITUATIONS registered in the period 2006-2015 and the number of deaths in the period from 2009 to 2018, as a result, there are five areas of high influence. from spatialization, the heat zone generated by the 47 deaths that occurred in the north of the city of Recife WAS DETERMANED. Regarding the cytopathological supply, the ratio in 2018 was 0.37, being below the state average, which is 0.41. With a deficit of 45,041 screening cytopathological exams in the age group 25-64 years.the III Health Region was identified, based on the analysis of information from the State Health Secretary, which shows to be one of the areas of great social vulnerability, since 63% of the 22 municipalities that make up this health region and its population is in extreme poverty, according to IBGE (2010). Conclusions: The occurrence of deaths and new cases of cervical cancer in the city of Recife occurs geographically unequally and is associated with indicators of social vulnerability. IS IT POSSIBLE to identify a priority region to intensify public actions for prevention and early diagnosis. A challenging scenario has been found and must be actively addressed.

Diabetes mellitus u staršího komplikovaného pacienta

Care of the elderly diabetic patients requires a special approach. What must be considered is not only individualiza-tion, and in more fragile elderly patients easing the targets for long-term compensation of diabetes, but also appropriate antidiabetic therapy needs to be chosen. Most patients suffer from polymorbidity and are at a greater risk for occurrence and consequences of hypoglycemia and cognitive impairment. The treatment procedure for sturdy elderly patients with diabetes is not any different from younger patients, while appropriate drugs for fragile patients are gliptins, possibly in combination with a long-term insulin analogue. Key words: antidiabetic therapy - complications - diabetes mellitus - level of robustness - old age.

Seismic intensity zoning and earthquake risk mapping in Iraq

The recently published Iraqi earthquake data file over the period 1905–1984 is used to derive a local Io-Msformula. This is then combined with a local intensity attenuation relationship to compile the observed Io(MM) zoning map for Iraq. Earthquake risk is calculated using the log N (Ms)relation for selected design magnitudes and periods and is mapped as the (%) probability of occurrence using a 0.5 deg latitude/longitude grid system. It is observed that the intensity zones and contour distributions are highly influenced by the presence of large magnitude shocks while risk maps reveal the Tauros seismogenic zone as having a greater risk of occurrence than the Zagros zone. The compiled zoning maps are intended for the use of local practising engineers for earthquake-resistant design procedures that are currently being adopted in the country.