High Incidence Research Articles

Increased Risk of Fracture after Traumatic Amputation: A Nationwide Retrospective Cohort Study.

The physiological changes and alterations in gait following amputation may increase the risk of fractures. However, there is insufficient research on fracture risk in amputees. Therefore, this study intended to analyze whether the risk of new fractures increases after traumatic amputations. This population-based, retrospective cohort study used data from the Korean National Health Insurance System database. The study included 19,586 participants who had undergone an amputation and 76,645 matched controls. The incidence of any fracture and site-specific fractures (vertebral, hip, and others) according to amputation site(s) and severity of disability due to amputation were evaluated using Cox proportional hazard regression analysis. During the mean follow-up of 4.2 years, amputees had a higher incidence rate (IR) of any fracture (adjusted HR [aHR] 1.47, 95% CI 1.36-1.60), vertebral fracture (aHR 1.63, 95% CI 1.44-1.85), hip fracture (aHR 1.85, 95% CI 1.39-2.46), and other fracture (aHR 1.34, 95% CI 1.20-1.49) compared to that of controls. In the presence of disability, the risks were further increased and were highest among amputees with severe disabilities. All fracture risks were higher in amputees than they were in controls, regardless of lower limb or upper limb amputation. This cohort study demonstrated that traumatic amputees experienced higher incidence of all fractures than did individuals without amputations, and this risk increases with severity of disability. This finding underscores the importance of early screening and lifestyle interventions to address fracture risk in traumatic amputees.

Assessment and Empirical Treatment of Chronic Abdominal Pain from Suspected Helicobacter Pylori Infection In a Remote Setting

The prevalence of Helicobacter Pylori (H. Pylori) remains globally high, with an estimated 50% of the words population believed to be infected. Despite the continually high incident rates of infection 90% of those infected remain asymptomatic. H.Pylori is a gram-negative, microaerophilic bacteria, mostly found in stomach of affected individuals that causes inflammation and ulceration. Definitive routes of transmission and subsequent infection are still debated. The most likely mechanism of transmission is thought to be intrafamilliar, this encapsulates fecal-oral, gastric-oral, oral-oral and sexual vectors. Contaminated foods and water sources are also highly likely mechanisms of transmission. Therefore in developing countries with poor sanitation, potentially contaminated water sources and regions with social-economic hardship experience increased symptomatic cases of H.Pylori.

Deregulation of MMP-2 and MMP-9 in laryngeal cancer: A retrospective observational study.

Laryngeal carcinoma (LC) is reported to have a higher incidence rate among all types of head and neck cancers around the globe. Mechanisms resulting in the pathogenesis of LC are complicated due to involvement of invasion and metastasis and there is a need to understand this complicated multistep process. Numerous molecules including matrix metalloproteinases (MMPs) are involved in regulating metastatic mechanisms. Furthermore, activation and expression of different classes of MMPs have been observed in multiple pathological and physiological events including inflammation, invasion, and metastasis. Among all members of MMPs, matrix metalloproteinases-2 (MMP-2), and matrix metalloproteinases-9 (MMP-9) have been frequently reported to correlate with tumor pathogenesis. The present study is designed to check the involvement of MMP-2 and MMP-9 in LC pathogenesis. 184 laryngeal tumor samples along with adjacent uninvolved healthy sections were collected to check the expression deregulation of the above-mentioned gene in LC using real-time PCR and immunohistochemistry (IHC). Real-time PCR and IHC analyses showed the significant upregulation of MMP-2 (P < .0001) and MMP-9 (P < .0001) genes in laryngeal tumors compared to controls. Spearman correlation showed the positive correlation of expression deregulation of selected MMPs with advanced TNM stage [MMP-2, (P < .0001); MMP-9, P < .0001] and smoking status [MMP-2 (P < .0001); MMP-9 P < .0001] in laryngeal pathogenesis. Receiver operating curve (ROC) analysis showed the good diagnostic/prognostic value of said markers in laryngeal cancer patients. The present study showed that significant upregulation of selected MMPs was found associated with an increased risk of laryngeal cancer and can act as good diagnostic markers for the detection of said disease.

Microbial keratitis in the subtropical region of Korea: a comprehensive 12-year retrospective review at a single referral center

ObjectivesTo investigate the epidemiological characteristics and clinical outcomes of culture-proven bacterial and fungal keratitis at a single tertiary referral centre on Jeju Island, South Korea.DesignA retrospective study design.SettingData from a...

Myxoinflammatory fibroblastic sarcoma of the liver: Case report and literature review.

Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare low-grade malignant soft tissue sarcoma that primarily affects the distal extremities in adults, with the highest incidence in patients in their 40s and 50s. It has a high local recurrence rate and a low metastasis rate. Although MIFSs have been documented in other sites, an MIFS in the liver is highly unusual. Herein, we present a case of a patient with hepatic MIFS. The patient was a 58-year-old Chinese man with abdominal pain as the primary symptom. Abdominal computed tomography and magnetic resonance imaging revealed a mass in the right posterior lobe of the liver. The patient underwent surgical excision, and the excised specimen was identified as MIFS. Three years later, the patient returned to our hospital for abdominal pain. Computed tomography and magnetic resonance imaging revealed a mass in liver segments 2/3/4. Postoperative pathological examination of the tumor revealed the recurrence of MIFS. The patient underwent surgical resection of the MIFS. The patient received multiple pirarubicin-based chemotherapy treatments and an ALK inhibitor (anlotinib) within 6 months after surgery, but the tumor recurred. MIFS can not only occur in the proximal limbs, trunk, head, and neck but can also affect the abdominal organs. Surgical resection remains the primary treatment option for MIFS in the absence of any contraindications. Because the recurrence rate of MIFS is high, meticulous long-term monitoring is required.

Burden and Patterns of Electric Scooter-Related Injuries: Insights From 2 Polish Emergency Departments.

BACKGROUND The widespread adoption of electric scooters (e-scooters) as a mode of urban transportation has led to a notable upsurge in e-scooter-related injuries globally. Variations in e-scooter regulations across countries contribute to differences in injury patterns. This study sought to investigate the healthcare burden posed by e-scooter-related injuries on emergency departments (EDs) in Poland, and to delineate the epidemiological and clinical features of these injuries. MATERIAL AND METHODS Medical records of patients who presented to 2 distinct EDs - in Poznań and Bydgoszcz, Poland - with injuries directly linked to e-scooter use were collected and retrospectively analyzed. RESULTS A total of 633 patients were admitted to the EDs due to e-scooter injuries during the study period, and 413 of these patients were further analyzed. The majority were males (64.65%), with a median age of 27 years. Most admissions occurred in the afternoon and nighttime (71.94%), with a higher incidence in the summer (46.73%). Falls were the most frequent mechanism of injury (74.09%), with the head and upper and lower extremities being the most frequently affected locations (36.08%, 29.78%, and 21.07%, respectively). Twelve patients (2.91%) confirmed recent alcohol consumption. Hospitalization costs were higher in cases involving alcohol use and among males. CONCLUSIONS The findings of this study underscore the significant strain exerted by e-scooter-related injuries on EDs in Poland. Injuries, notably to the head and limbs, carry significant long-term implications and strain healthcare resources. Collaboration with policymakers is crucial to ensure the safety of e-scooter users and appropriate healthcare resource allocation.

Biliary complications associated with weight loss, cholelithiasis and choledocholithiasis.

Biliary complications like cholelithiasis and choledocholithiasis are more common in bariatric surgery patients due to obesity and rapid weight loss. Patients with a body mass index > 40 face an eightfold risk of developing cholelithiasis. Post-bariatric surgery, especially after laparoscopic Roux-en-Y gastric bypass (LRYGB), 30% of patients develop biliary disease due to rapid weight loss. The aim of this review is to analyze the main biliary complications that occur after bariatric surgery and its management. A review of the literature was conducted mainly from 2010 up to 2023 with regard to biliary complications associated with bariatric patients in SciELO, PubMed, and MEDLINE. Patients undergoing LRYGB have a higher incidence (14.5%) of symptomatic calculi post-surgery compared to those undergoing laparoscopic sleeve gastrectomy at 4.1%. Key biliary complications within 6 to 12 months post-surgery include: Cholelithiasis: 36%; Biliary colic/dyskinesia: 3.86%; Acute cholecystitis: 0.98%-18.1%; Chronic cholecystitis: 70.2%; Choledocholithiasis: 0.2%-5.7% and Pancreatitis: 0.46%-9.4%. Surgeons need to be aware of these complications and consider surgical treatments based on patient symptoms to enhance their quality of life.

Global burden of skin and subcutaneous diseases and its association with socioeconomic status in children and adolescents: an analysis of the Global Burden of Diseases Study 2019.

Skin and subcutaneous diseases are one of the most common problems affecting the health of children and adolescents. The purpose of this study was to investigate the burden of skin and subcutaneous diseases among children and adolescents and its association with socioeconomic status. Data was obtained from the Global Burden of Disease Study 2019. The number of cases, incidence rate, number of deaths, and death rate in 204 countries and territories from 1990 to 2019 were extracted and stratified by age, sex, and socioeconomic status. In 2019, the global incidence and death rates of skin and subcutaneous diseases in children and adolescents were 57966.98 (95% Uncertainty Interval [UI] 53776.15 to 62521.24) per 100,000 and 0.21 (95% UI 0.13 to 0.26) per 100,000, respectively. From 1990 to 2019, the global incidence rate increased by 5.80% (95% UI 4.82-6.72%) and the death rate decreased by 43.68% (95% UI 23.04-65.27%). The incidence and death rates were negatively correlated with socioeconomic status. Incidence rates were not different between females and males, but death rates were higher among females than males. The highest incidence and death rates were found in the 1-4-year age group and < 1-year age group, respectively. The global burden of skin and subcutaneous diseases in children and adolescents was characterized by regional imbalances. The global burden of skin and subcutaneous diseases in children and adolescents from poorer regions requires more attention. This study provides strong evidence for global policymaking for childhood and adolescent diseases.

Prediction of the Cause of Glaucoma Disease Identified by Glaucoma Optical Coherence Tomography Test in Relation to Diabetes and Hypertension at a National Hospital in Seoul: A Retrospective Study.

Glaucoma remains the primary cause of long-term blindness. While diabetes mellitus (DM) and hypertension (HTN) are known to influence glaucoma, other factors such as age and sex may be involved. In this retrospective study, we aimed to investigate the associations between age, sex, DM, HTN, and glaucoma risk. We employed optical coherence tomography (OCT) conducted using a 200 × 200-pixel optic cube (Cirrus HD OCT 6000, version 10.0; Carl Zeiss Meditec, Dublin, CA, USA). Effects obscured by low-test signals were disregarded. Data were amassed from 1337 patients. Among them, 218 and 402 patients had DM and HTN, respectively, with 133 (10%) exhibiting both. A sex-based comparison revealed slightly greater retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness in females. Patients without DM and HTN were predominantly in their 50 s and 60 s, whereas DM and HTN were most prevalent in those in their 60 s and 70 s. Both RNFL and GCIPL thicknesses decreased with advancing age in most patients. The study revealed that older individuals were more prone to glaucoma than younger individuals, with a higher incidence among patients with DM and HTN and reduced RNFL and GCIPL thicknesses. Furthermore, early detection before advancing age could furnish valuable preventive insights.

Global insights into keloid formation: An international systematic review of regional genetic risk factors and commonalities.

Keloid disorder is a morbid and disfiguring benign fibroproliferative disease with a higher incidence in groups with darker skin pigmentation. Predicting keloidogenesis in patients is difficult with treatment primarily aimed at preventing further scar expansion and improving aesthetics without addressing their unknown underlying pathophysiology. We aimed to identify potential genetic predispositions to keloid scarring in the literature. A search was conducted on 21 August 2023, by the first and second authors independently from 1985 to August 2023 using PubMed, MEDLINE, Embase, Web of Science, Scopus and CINAHL. The following MeSH terms were used: 'Keloid', 'Risk' and 'Genetic'. Two researchers independently searched for studies based on titles and abstracts and screened filtered articles by reviewing full text. If no agreement could be reached, a third senior author designated whether the article should be included. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement as the basis of our organisation. Human studies with genetic analysis to determine an association of a protein or gene to keloidogenesis were selected for inclusion. Studies in languages other than English, reviews, conference articles, and book chapters were excluded. Fifty studies met inclusion criteria. The human leukocyte antigen (HLA) system was broadly implicated, and the DRB1*15 allele was associated with an increased risk of keloid in three separate ethnic groups. Some HLA Class I alleles were associated with keloid in one population but not in others. Additionally, polymorphisms in the E3 ubiquitin-protein ligase (NEDD4) signal cascade and vitamin D receptor (VDR) have been implicated in diverse groups. No current genetic test can predict keloid risk. Our review identified candidate predisposing genes, including NEDD4, VDR and components of the HLA system. Further studies in heterogeneous populations are needed to identify reliable screening targets.

Oral administration of oligo fucoidan improves the survival rate, quality of life, and immunity in patients with lung cancer.

Lung cancer, the most commonly diagnosed cancer globally, has the highest incidence and mortality rates in Taiwan. It can be divided into two types. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of lung cancers, which is further divided into adenocarcinoma, squamous cell carcinoma, and large cell lung cancer accounting for approximately 40%, 25%, and 15% of NSCLC cases, respectively. Small cell lung cancer accounts for approximately 15% of lung cancers. Early systemic therapy NSCLC was based on chemotherapy, and immunotherapy is currently under development. Fucoidan, from brown seaweed extracts, shows promise in mitigating radiation-induced lung fibrosis in animal studies, suggesting its potential as an adjuvant for radiation therapy-related lung fibrosis in lung cancer patients. However, the clinical utility of such adjuvant therapy in lung cancer treatment remains uncertain. The purpose of this study was to investigate the effects of oral administration of oligo-fucoidan on the survival rate, quality of life, and immunity of patients with lung cancer. Subjects with Non-small cell lung cancer aged between 20 and 80 were collected from outpatient clinics, divided into control group (n = 7): conventional therapy and fucoidan group (n = 13): received conventional therapy+ oral supplementation of oligo-fucoidan (550 mg × 4 tablets). Data were collected before the study, at weeks 4, 12, and 24 during the study, and to collect 20 ml of peripheral blood, for analysis biochemical data, liver and kidney function, lymphocyte population, inflammation cytokines, and using EORTC QLQ-C30 questionnaire to assess quality of life. The survival rates of the subjects in the control and fucoidan groups were 20% and 28.6%, respectively. During the study, patients in the fucoidan group experienced a better quality of life than those in the control group, but this difference lacked statistical significance. Oligo-fucoidan increases the CD19 lymphocyte population. The patients in the fucoidan group also had Lower inflammatory cytokine. Oligo-fucoidan holds promise as an adjuvant therapy to enhance the survival rate, quality of life, and immune function in patients with lung cancer.

P-804 Smchd1 is a key regulator of epigenetic cellular memory induced by morphine in mouse embryonic stem cells (mESC)

Abstract Study question Can morphine induce stable epigenetic changes that persist mitotically in mESC? Summary answer SMCHD1 is a key regulator of epigenetic cellular memory induced by morphine, whose deregulation can be memorized by mESC and upon embryo development. What is known already Epigenetic cellular memory induced by environmental factors implies the existence of mitotically heritable changes that influence gene expression without altering DNA sequence, leading to the propagation of heritable changes in phenotype. X chromosome inactivation (XCI) is an important epigenetic process, which takes places during embryo development and is maintained in the adulthood. Since XCI is part of normal development, changes induced by environmental factors might affect embryo development and lead to health problems. As morphine can easily pass through the placental barrier and reach the embryo, our aim is to elucidate whether morphine causes epigenetic regulation on XCI process. Study design, size, duration Epigenetic cellular memory induced by environmental factors implies the existence of mitotically heritable changes that influence gene expression without altering DNA sequence, leading to the propagation of heritable changes in phenotype. To evaluate if morphine can induce cellular epigenetic memory, we analyzed the dynamic epigenetic changes over the time in the absence of morphine. For that purpose, OCT4-reported mESCs were chronically treated with morphine during 24h (10-5 mM) Participants/materials, setting, methods • Transcriptomic analysis by RNA-Sequencing and gene expression validation by qRT-PCR. • Epigenetic analysis by H3K27me3 ChIP-Sequencing and WGBS-Sequencing. • Smchd1 gene silencing by Crisper-Cas9. Main results and the role of chance Morphine induced cellular epigenetic memory upon embryo development. mESCs can memorize morphine exposure and induces transcriptional changes that can persist over the time, even in the absence of morphine. RNA-seq has shown that morphine chronic treatment produces a transcriptional deregulation of 932 genes in P1 just after the treatment and this amount increased after treatment withdrawal (1196 genes, P2 and 2138 in P3). Integrative analyses between P1, P2 and P3 identifies Smchd1 gene as a potential regulator of epigenetic cellular memory induced by morphine. Crisper-Cas9 silencing analyses confirmed that Structural maintenance of chromosomes flexible hinge domain-containing 1 (Smchd1), an architectural factor critical for X-chromosome inactivation (XCI), is a morphine-sensitive target gene. Morphine reduced the gene expression of Smchd1 in mESC at different time points, which is consistent with an increase of H3K27me3 and DNA methylation at promoter. Morphine alters normal X chromosome wide silencing. Our results identified Smchd1 a key regulator of epigenetic cellular memory induced by morphine, whose deregulation can be memorized by the cell, providing an epigenetic mechanism that is maintained into cell-to-cell memory and cell differentiation process, which might cause diseases or health problems during the adulthood. Limitations, reasons for caution To perform the in-vitro analysis in mouse Wider implications of the findings Our results provide insights into the epigenetic mechanisms induced by morphine and establish the bases to understand how environmental factors can cause epigenetic changes that cause health problems or diseases, since a skewed XCI pattern is behind the higher incidence on different neurological diseases such as Alzheimer or Autism Trial registration number not applicable

Global and regional seroprevalence, incidence, mortality of, and risk factors for scrub typhus: A systematic review and meta-analysis

ObjectivesScrub typhus is underdiagnosed and underreported but emerging as a global public health problem. We aimed to provide the first comprehensive review on the seroprevalence, incidence, mortality of and risk factors for scrub typhus. MethodsWe searched PubMed, Scopus, Web of Science, China National Knowledge Infrastructure and other databases. Trended incidence and median mortality were calculated and pooled seroprevalence and risk factors for scrub typhus were evaluated using the random-effects meta-analysis. ResultsWe included 663 articles from 29 countries/regions. The pooled seroprevalence was 10.73% (95%CI 9.47-12.13%) among healthy individuals and 22.58% (95%CI: 20.55%-24.76%) among febrile patients. Mainland China reported the highest number of cases and South Korea and Thailand had the highest incidence rates. Median mortalities were 5.00% (range: 0.00-56.00%) among hospital inpatients, 6.70% (range: 0.00-33.33%) among patients without specified admission status and 2.17% (range: 0.00-22.22%) among outpatients. The significant risk factors included agricultural work, specific vegetation exposure, other outdoor activities, risky personal health habits, and proximity to rodents, livestock, or poultry. ConclusionsOur comprehensive review elucidates the significant yet variable burden of scrub typhus across different regions, underscoring its emergence as a critical public health concern globally.

Evaluation of the Immune Response within the Tumor Microenvironment in African American and Non-Hispanic White Patients with Non-Small Cell Lung Cancer.

African Americans have higher incidence and mortality from lung cancer than non-Hispanic Whites, but investigations into differences in immune response have been minimal. Therefore, we compared components of the tumor microenvironment among African Americans and non-Hispanic Whites diagnosed with non-small cell lung cancer based on PDL1 or tertiary lymphoid structure (TLS) status to identify differences of translational relevance. Using a cohort of 280 patients with non-small cell lung cancer from the Inflammation, Health, Ancestry, and Lung Epidemiology study (non-Hispanic White: n = 155; African American: n = 125), we evaluated PDL1 tumor proportion score (<1% vs. ≥1%) and TLS status (presence/absence), comparing differences within the tumor microenvironment based on immune cell distribution and differential expression of genes. Tumors from African Americans had a higher proportion of plasma cell signatures within the tumor microenvironment than non-Hispanic Whites. In addition, gene expression patterns in African American PDL1-positive samples suggest that these tumors contained greater numbers of γδ T cells and resting dendritic cells, along with fewer CD8+ T cells after adjusting for age, sex, pack-years, stage, and histology. Investigation of differential expression of B cell/plasma cell-related genes between the two patient populations revealed that two immunoglobulin genes (IGKV2-29 and IGLL5) were associated with decreased mortality risk in African Americans. In the first known race-stratified analysis of tumor microenvironment components in lung cancer based on PDL1 expression or TLS status, differences within the immune cell composition and transcriptomic signature were identified that may have therapeutic implications. Future investigation of racial variation within the tumor microenvironment may help direct the use of immunotherapy.

Introduction to the database “efficacy of different treatment modalities for lower respiratory tract infections in children”

AbstractThis study aimed to establish a registry database of different treatment modalities for lower respiratory tract infections (LRTIs) in Chinese children, thereby filling gaps in knowledge on clinical characteristics, treatment modalities, and rational drug use in relation to LRTIs in Chinese children, and providing large amounts of continuous, complete, scientific, and objective clinical data, and an information exchange platform. Multicenter data from these children's clinical visits were collected, pooled, and analyzed using medical informatics and statistical techniques to explore their potential value. The database was preliminarily established and a real‐world study cohort was constructed based on a total of 4805 patients registered in this database. Pneumonia was identified as the most common type of LRTIs (72.44%), followed by acute bronchitis (20.71%). The mean age of the enrolled children with LRTIs was 3.26 ± 2.84 years, and boys accounted for 59.21% of the samples. Among the enrolled children, pneumonia and acute bronchitis had the highest incidence in children aged 1–3 years (27.44%) and those aged 3–6 years (34.16%), respectively. In this national, multicenter, observational database of LRTIs in children, the real‐world characteristics and treatment modalities for LRTIs in Chinese children are elucidated. This database will help improve the research efficiency of clinicians and facilitate the exploration of underlying clinical patterns in real‐world medical big data.

Improvement and exacerbation of multiple disparities in sexually transmitted infections among children and adolescents aged 6-22 years: An analysis of national surveillance data from 2013 to 2021.

To investigate the progress of disparities in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), gonorrhea, and syphilis among children and adolescents aged 6-22 years in China during 2013-2021. A total of 614 325 cases data were extracted from the Chinese Information System for Infectious Diseases Control and Prevention during 2013-2021. Puberty health education data were drew from the Student Health Surveillance in 2021. Disparity patterns and average annual percentage changes (AAPCs) in sexually transmitted infections (STIs) incidence or new cases in China were examined using descriptive statistics and joinpoint regression. The incidence across 345 cities was stratified by gross domestic product (GDP). Between 2013 and 2021, there were 614 325 reported cases of HIV/AIDS, gonorrhea, and syphilis among children and adolescents aged 6-22, with an annual average incidence of 24.0967 per 100 000. The expansion of HIV/AIDS has halted, yet the surge in gonorrhea and syphilis remains notably pronounced. The ratio of male to female AIDS incidence increased from 2.75 (2.60, 2.90) to 7.13 (6.68, 7.62), but that of syphilis changed from 0.33 (0.32, 0.34) to 0.56 (0.55, 0.57). Students and out-of-school individuals aged 13-15 experienced a notably high increase in STI cases, surpassing other age groups, with an average annual percentage increase of 29.2% and 26.3%, respectively. Nonstudents consistently had a higher incidence rate than students, with an IRR reaching 31.80 (31.24, 32.37) in 2021. A noticeable clustering pattern of new cases emerged in the southeastern region of the Heihe-Tengchong line, extending inland from the coastal areas. Districts and counties with lower rates of puberty sexual health education tended to have higher average STI incidence rates. At the prefecture and city levels, there was a noticeable upward trend on average STI incidence rates in cities with per capita GDPs. Strategies to address those disparities include promoting equitable health education, and widespread sexual health education, particularly in areas with limited access to education and experiencing rapid economic development. The effectiveness of sexual health education intervention needs to be further evaluated in well-designed studies.

Caracterização dos acidentes por mordeduras por serpentes na província de Benguela, período 2019 – 2021

Introduction: Snakebites are a public health problem affecting tropical countries in Africa, Asia, and Latin America. In Angola there are no rigorous statistics or scientific studies that allow us to know the situation of the country. Objective: to characterize snakebite accidents in Benguela province, in the period 2019-2021. Material and Method: Observational, descriptive, cross-sectional, and prospective study. Universe made up of the total number of families in the municipalities with the highest incidence: Cubal, Lobito, Caimbambo and Chongoroi. The sample size was calculated with a 95% confidence level for a total of 124 households, represented by 1014 people. The residences were selected by simple random sampling. A structured interview was given to the head of the family, with prior informed consent. Data were analyzed in SPSS through absolute frequencies and percentages. Results: Of the heads of household, 73.3% are men, 76.6% work in the fields and 56% had primary education. Of the total number of people, 2.6% were bitten by snakes (26 people) and 3 died. Of the survivors, 13% had physical sequelae. Regarding knowledge, 64.5% identified it as the place with the highest incidence at home, 33.8% from 6 pm to 12 pm, 48.3% in the summer season, 100% applied traditional treatments, 94.4% correctly identified at least one, and 70.9% recognized bitis arietans. Regarding prevention measures, 49.1% do not know, although of the remaining 54.8% consider it better to wear shoes or boots. Conclusion: Angola needs to continue and increase community education programs to alleviate human suffering.

AN EXPLORATORY STUDY ON CRIME AGAINST WOMEN IN STATES OF WESTERN AND NORTHERN REGIONS OF INDIA

The paper discussed the crimes against women in states of western and northern regions of India. It has found that Uttar Pradesh, Rajasthan and Maharashtra has higher incidences of crimes against women then other states in the regions. Goa, Himachal Pradesh and Uttarakhand has comparatively lower incidences of crimes against women. Uttar Pradesh has the highest incidences and victims of SLL crimes against women, followed by Maharashtra and Rajasthan On the other hand, least incidences and victims of such crimes is reported in Goa preceded by Himachal Pradesh and Punjab. Uttar Pradesh also has the highest incidences and victims of total crime against women (IPC+SLL) followed by Maharashtra and Rajasthan. On the other hand, least incidences and victims of total crime against women (IPC+SLL) reported in Goa preceded by Himachal Pradesh and Uttarakhand. Therefore, Governments of the concern states should implement proper policies and regulations for minimizing the incidences of crime against women.

The incidence of pleural infections in Finland

BackgroundThe incidence of pleural infections appears to be increasing in Western countries for unclear reasons. The aim of the study was to describe the incidence and treatment patterns of pleural infections in Finland over three decades. MethodsData regarding each treatment episode for pleural infections in the Finnish special medical care between January 1994 and December 2016 was obtained from a national database and compared to the demographics of Finnish residents obtained from the national census bureau. The annual incidence rates, type of treatment given, as well as the lengths of the hospitalization were analyzed. ResultsA total of 28,463 episodes were reported, of which 55% were in-patient episodes. Of these, 76% concerned males, and the median age of patients was 60 (interquartile range 49-70) years. The overall incidence of pleural infections was 23.4 per 100.000 patient-years, with a male-to-female -ratio of 3.3:1. The annual incidence rates increased throughout the study period with an average annual percentage change of +11.4% (95% CI ±7.4%). The highest incidence rates (>200 per 100.000 patient-years) were observed in men aged 80 or more. Altogether 88% of patients were treated conservatively. The proportion of patients treated by mini-invasive surgery significantly increased during study period (0-5.9%, p<0.001) and was associated with shorter hospitalization (median 6 [interquartile range 4-12] days) than open surgery (median 7 [4.5-13] days) (p<0.001). ConclusionThe incidence of pleural infections has increased significantly over the previous decades in Finland and appears to be higher than previously reported, particularly in elderly men.

Predictors and weight impact of postbariatric hypoglycemia after Roux-en-Y gastric bypass surgery: a prospective observational cohort study

BackgroundPostbariatric hypoglycemia (PBH) is a challenging condition affecting quality of life of patients after bariatric surgery. However, its incidence and predictive factors remain debated. ObjectivesTo determine the incidence of PBH, identify predictors of PBH and assess its association with weight trajectory after bariatric surgery. SettingUniversity Hospital. MethodsProspective observational cohort study including 222 nondiabetic patients who underwent Roux-en-Y gastric bypass between 2014 and 2021, had an oral glucose tolerance test (OGTT) and/or A1C (glycated hemoglobin) measurement prior to surgery and were followed for at least 12 months. Diagnosis of PBH was made when symptoms of hypoglycemia were accompanied by a postprandial plasma glucose level < 3.9 mmol/l or a glycemia < 3.9 mmol/l during continuous glucose monitoring, with resolution of symptomatology after carbohydrate consumption. Univariable and multivariable logistic regression analyses were performed to identify factors associated with PBH. ResultsOut of 222 patients, 71 (32%) were diagnosed with PBH. The highest incidence rate was observed at 2 years postbariatric surgery with a cumulative incidence of 26.5%. Predictive factors for higher risk of PBH were younger age at surgery (OR = .97; 95% CI: .94–.99; P = .049) and early dumping syndrome (OR = 3.05; 95% CI: 1.62–6.04; P = .0008). In multivariable logistic regression, higher glycemia at 2 hours during preoperative OGTT was associated with lower risk of PBH (OR = .8; 95% CI: .63–.98; P = .04). PBH was not associated with weight trajectory after surgery in our cohort. ConclusionsYounger age at time of surgery and lower blood glucose at 120 minute during preoperative OGTT are risk factors for PBH. Early dumping syndrome is significantly associated with PBH and could be used as a red flag to help identify patients at risk of PBH.