High Prevalence Of Disease Research Articles

Connecting Past to Present: Does Historical Redlining Affect Current Life Expectancy?

Previous research has documented a strong relationship between currently living in the redlined zones of the 1930s and suffering from a higher prevalence of disease. However, little is known about the relationship between historical redlining, modern-day redlining, and current resident health outcomes. This paper aimed to simultaneously model the associations between both historical redlining and modern-day redlining on current health outcomes. In this paper, we used structural equation modeling to uncover relationships between current and historical redlining practices and modern-day life expectancy, exploring two levels of potential mediating factors: (1) racial segregation and structural racism; and (2) mediating health outcomes. We analyzed data from 11,661 census tracts throughout the United States using historical redlining data from 1940, modern redlining data from 2010 to 2017, racial segregation and structural racism indices from 2010 to 2019, health outcome data from 2021 to 2022, and life expectancy data from 2010 to 2015. Historical redlining was measured using Home Owners' Loan Corporation (HOLC) ratings, which ranged from 1.0 for favorable neighborhoods ("greenlined") to 4.0 for unfavorable ("redlined") neighborhoods. Modern-day redlining was measured using Home Mortgage Disclosure Act (HMDA) data, which were transformed into four quartiles, ranging from level 1 (low mortgage rejection rates) to level 4 (high mortgage rejection rates). We found a significant relationship between historic redlining and current life expectancy, with average life expectancy decreasing steadily from 80.7 years in HOLC 1 tracts to 75.7 years in HOLC 4 tracts, a differential of 5.0 years between the greenlined and redlined tracts. We also found a significant relationship between modern-day redlining and current life expectancy, with average life expectancy decreasing steadily from 79.9 years in HMDA 1 tracts to 73.5 years in HMDA 4 tracts, a differential of 6.4 years. In the structural equation model, historical redlining had a total effect of decreasing life expectancy by 1.18 years for each increase of one in the HOLC rating. Modern-day redlining had a total effect of decreasing life expectancy by 1.89 years for each increase of one in the HMDA quartile. This paper provides new evidence that the legacy of redlining is not relegated to the history books but rather is a present and pressing public health issue today.

Developing a multi-center registry of peripheral artery disease using natural language processing: unlocking the power of the electronic health record

Abstract Background Although peripheral artery disease (PAD) is common and associated with a high risk of mortality, contemporary PAD research remains limited due to poor accuracy of diagnosis codes in the electronic health record (EHR). We previously developed and validated a novel natural language processing (NLP) algorithm that can extract ankle brachial index (ABI) and toe-brachial index (TBI) values from clinical documents and identify patients with PAD with high accuracy (positive predictive value 92.4%). Purpose Scale the NLP system for developing a nationwide registry of PAD in the Veterans Health Administration (VHA), the largest integrated health system in the U.S. that provides care to ~9 million Veterans across 130 sites. Describe the baseline characteristics and mortality outcomes among participants and identify predictors of long-term mortality. Methods A total of 1,182,025 documents from vascular and radiology procedures during 2013-2020 were processed by the NLP system. After excluding non-ABI vascular studies, patients with a known diagnosis of PAD prior to 2015, patients younger than 40 years of age, and those who do not regularly follow-up in the VHA, we identified 107,711 patients with newly diagnosed PAD during 2015-2020. Patients were followed longitudinally using the VA’s electronic health record data. The primary outcome was all-cause mortality. We used Cox proportional hazards regression to examine predictors of long-term mortality. Results The mean age was 70.5 years; 97.3% were males, and 18.5% were of Black race. The mean ABI value was 0.78 (SD: 0.26) and the mean TBI value was 0.51 (SD: 0.19). There was a high prevalence of hypertension (83.6%), heart failure (20.8%), diabetes (53.6%), renal failure (22.1%) and chronic obstructive pulmonary disease (32.4%, Table 1). At 1-year, 9.6% of patients had died and this proportion increased to 25.4% at 3 years. Although nearly all patient variables were significantly associated with mortality, older age, severe PAD at diagnosis, diabetes, heart failure, renal failure and COPD were the strongest predictors of long-term mortality. Black race was associated with lower hazard of long-term mortality. Conclusions Using a previously validated novel NLP algorithm that extracts ABI and TBI values from clinical documents, we have successfully developed a registry of newly diagnosed PAD in the VHA. Ongoing studies from our cohort will yield important insights into the association between clinical management of PAD and clinical outcomes, with the goal of identifying opportunities for improving care.

Real-world analysis of transcatheter aortic valve replacement in patients with prostate cancer and severe aortic stenosis

Abstract Background Patients with prostate cancer have a high prevalence of cardiovascular disease, including degenerative heart valve diseases such as aortic stenosis. It is not uncommon in clinical practice to perform transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis and active prostate cancer. Still, the prognosis after this procedure in this population is not well known. Purpose To evaluate 1-year and 3-year survival rates after TAVR in patients with prostate cancer who have undergone TAVR when compared with patients without active cancer. Methods Data were extracted from electronic medical records of a large multinational collaborative network (TriNetX) that currently englobes 113 healthcare organizations worldwide with more than 100 million patients. Patients aged 18 years or older with prostate cancer documented up to 12 months before TAVR as well as controls undergoing TAVR without oncologic history before the proceeding were included. The survival analysis for 1 year and 3 years was performed with Kaplan Meier survival plots and log-rank test. Propensity score matching, using clinical and demographic variables, was performed to pair the cohorts. Results From a cohort of 26,656 men who had undergone TAVR, we identified 1,040 with prostate cancer diagnosed up to 1 year before TAVR ( prostate cancer group) and 20,231 patients without oncologic history before TAVI (control group). After propensity score matching, analyzing 1,040 patients in each group, the 1-year and 3-year survival probabilities were not different between the prostate cancer group versus the control group ( 89.5% vs 88.9%, log-rank test P=0.70 and 72.6% vs 68.7%, log-rank test P=0.22, respectively). Considering a subgroup of patients with metastatic prostate cancer ( n=229) under androgen deprivation therapy vs the control group ( n =229), we have also not observed a survival difference between the two groups at 1-year and 3-year follow-up ( 88.1 vs 89.1%, log-rank test P=0.69 and 58.7% vs 67.4%, log-rank test P=0.25). Conclusions In this real-world analysis, patients with prostate cancer and severe aortic stenosis who underwent TAVR, including patients with metastatic disease, the 1-year and 3-year survival rates were not significantly different when compared to patients without oncologic hystory who underwent TAVR.

Electrocardiographic criteria for the diagnosis of left ventricular hypertrophy in patients with severe aortic stenosis

Abstract Introduction There is a lack of data regarding the performance of current electrocardiographic (EKG) criteria for left ventricular hypertrophy (LVH) in patients with severe aortic stenosis (AS). Purpose To test the performance of the current EKG scores to diagnosis LVH in AS patients, and also to compare the performance of a new proposed score. Methods The present study evaluated 80 patients with severe AS that underwent cardiac magnetic resonance to diagnose LVH, defined as left ventricular indexed mass of 95 g/m² for female and 115 g/m² for male patients. The EKG criteria used for left ventricular hypertrophy were Sokolow-Lyon criteria, Romhilt-Estes point score system, Cornell voltage criteria and Peguero-Lo Presti criteria. Results Among the 80 patients included in analysis, 58.7% were male and the mean age was 64±8 years. There was a high prevalence of comorbidities, highlighting diabetes (32.5%), hypertension (67.5%), atrial fibrillation (5.0%) and coronary artery disease (11.3%). Regarding echocardiogram, the median left ventricle ejection fraction was 64 (56-68)% and the median indexed aortic valve area was 0.43 (0.35-0.49) cm²/m². Cardiac magnetic resonance analysis demonstrated a mean left ventricle mass of 168±55g, and the LVH incidence was 26.3%. Regarding EKG, Strain pattern was found in 49.1% of the patients, Cornell voltage criteria was positive in 51.3%, Sokolow-Lyon criteria in 51.3%, Romhilt-Estes point score system in 42.5% and Peguero-Lo Presti criteria in 61.3%. Discriminative capacity of electrocardiographic criteria for LVH is shown in Figure 1. Peguero-Lo Presti score had the best diagnostic accuracy in the overall population and in male sex (AUC 0.776), while Cornell voltage criteria had the best diagnostic accuracy in female patients (AUC 0.776). Based on linear regression model, the proposed score was created to predict LVH at cardiac magnetic resonance: 48 + (1.3 x Deepest S wave) + (0.5 x S wave in V1 or V2 plus R wave in V5). The proposed score cutoff value of 90.5 mm had a sensitivity of 0.765 and specificity of 0.707 (for male sex: 0.769 and 0.655, respectively; for female sex: 0.750 and 0.759, respectively). Compared to the scores described in the literature, the proposed score had the best area AUC for the overall population (Figure 1), for female and male patients (AUC 0.796, 0.819 and 0.780, respectively). Conclusion In patients with severe AS, the proposed score had the best diagnostic accuracy compared to the scores described in the literature for LVH identification, followed by Peguero-Lo Presti score, even when analyzed based on gender. Besides, the proposed score had also acceptable sensitivity and specificity for LVH detection.AUC of electrocardiographic scores.

Integrated Care in Parkinson’s disease: e-training for multidisciplinary team members

Abstract Background Parkinson’s is a high prevalence disease worldwide and training in Integrated Care (IC) for professionals in this field is an obvious need. The SUPER training course is focused on integrated care applied to Parkinson’s disease (PD) and aimed at social and health professionals. Both the content and the training methodology have been co-designed with people living with PD, relatives/caregivers and professionals from Spain and Italy. The course comprises3 training modules (10 units), alongside self-assessment questions, as well as case studies. Accessible open access via an e-learning platform. It is available in English, Spanish, Italian and French enhancing its applicability and transferability. Objectives The SUPER e-training course aims to equip members of multidisciplinary teams with knowledge, skills and competencies in IC applied to PD. Results The course was validated with 89 socio-health professionals in Spain and Italy (M age = 37.28; 75.28% women), who completed a questionnaire assessing the usefulness and quality of the training modules and the platform, as well as an overall evaluation of the training in terms of quality and impact. According to the them: the training could improve the quality of care offered to people living with PD; it is expected to heighten interest in IC, while also introducing novel and invaluable elements. Conclusions This course is useful to train professionals of different profiles (and European contexts) on IC in PC, increasing their knowledge and skills and improving the provision of care to people living with PD. The SUPER multilingual course is an innovative tool because it has been designed from a bottom-up approach and makes available to any professional a free training that can be taken online at any time. Key messages • SUPER training course equips professionals from a holistic, multidisciplinary and person-centred approach to PD. • This multilingual tool aids diverse professionals in social & health care.

Substance use and lifestyle risk factors for somatic disorders among psychiatric patients in Greenland

ABSTRACT Patients with psychotic disorders exhibit elevated mortality and morbidity rates compared to the general population primarily due to comorbid somatic diseases. This study aims to describe the prevalence of selected risk factors and somatic disorders among psychiatric patients with a diagnosis of psychotic disorder. Material and methods: Data were retrieved from Greenland’s nationwide electronic medical record. The study population consists of 104 patients diagnosed with a psychotic disorder, encompassing schizophrenia or schizotypal and delusional disorders, residing in Nuuk. The study population comprised 104 patients (68 males and 36 females) with a mean age of 40 years. More than 80% were daily smokers, and 68% had harmful use of cannabis. More than half had dyslipidemia (any imbalance in lipids), while over a quarter were classified as obese with body mass index of 30 kg/m2 or higher. Eighteen percent had hypertension, and six percent suffered from diabetes. This study revealed a notable prevalence of risk factors for somatic diseases, particularly smoking and cannabis use among patients with schizophrenia in Nuuk, indicating that a high prevalence of somatic diseases might be expected as the population gets older and the risk of developing somatic diseases becomes greater. Increased focus on monitoring and preventing those as part of the health care is recommended.

The heart of the matter: a re-iteration of the role of the social determinants of health in addressing health inequity in Central Australia.

The persisting life-expectancy 'gap' between First Nations and non-First Nations Australians is fundamentally driven by the social determinants of health. These include income and social protection, access to adequate housing and food security, among others. These factors are particularly prominent in Central Australia. Inadequate housing has led to some of the highest rates of Streptococcus pyogenes infection in the world, which in turn drives an extremely high prevalence of rheumatic heart disease. Food insecurity and inadequate social protection manifesting as energy insecurity result in inadequate nutrition and have resulted in a huge burden of diabetes in Central Australia. These factors, combined with social exclusion, racism and the pervasive effect of colonisation, also drive a high rate of alcohol misuse. Only by prioritising equity in these 'social determinants' and emphasising the importance of First Nations leadership in formulating and implementing solutions will health inequity be addressed.

Public measures to reduce the consumption of added sugars and their impact on the occurrence of oral diseases: an integrative literature review

The consumption of added sugars has increased globally, influencing the high prevalence of chronic non-communicable diseases (NCDs), including oral diseases such as tooth decay and periodontitis, highlighting the need for effective public policies to control the consumption of sugary products. This work aimed to identify whether external public interventions to reduce the consumption of sugary products impact the occurrence of chronic oral diseases, being an integrative literature review. The electronic search was carried out in the SciELO, Cochrane and PubMed databases, using the English descriptors “sugar sweetened drink”, “sugar, public health” and “oral health” and their Portuguese counterparts. The application of taxes on sugary products, especially drinks, was the most investigated public measure, showing a positive effect on caries control. However, more studies are needed to draw concrete conclusions about its effectiveness in preventing and controlling periodontitis. Although taxation is effective for cavities, public policies that facilitate access to a healthy diet for the vulnerable population

Empowering Early Career Researchers: The Jackson Heart Study Smith Scholars Program.

The University of Mississippi Medical Center Graduate Training and Education Center houses the Robert E. Smith, MD, Scholars Program, a two-year certificate program that equips predoctoral trainees from five Mississippi universities with advanced research skills in cardiovascular epidemiology. Funded by the National Heart, Lung, and Blood Institute (NHLBI), the program focuses on addressing health disparities, minority health, and health inequities in underserved communities. Trainees receive mentorship, career coaching, and a $7,500 annual stipend, building a foundation for postdoctoral opportunities and expanding professional networks. The Smith Scholars Program emphasizes population health and provides interdisciplinary training in areas such as biostatistics, scientific communication, and cardiovascular health. It is uniquely positioned to address systemic challenges, particularly in Mississippi, a state with high cardiovascular disease prevalence and limited research funding. The program's regional advantage and its partnership with the Jackson Heart Study offer scholars exposure to health disparities in Black/African American communities, preparing them to contribute to innovative, community-based research. Additionally, it fosters collaborative science, enabling participants to overcome academic barriers and engage with large-scale health equity research efforts. The Smith Scholars Program has been instrumental in shaping the career trajectories of its participants, facilitating their transition to postdoctoral positions and independent research roles.

Somatic coliphages as bioindicators of contamination in Lake Guamuez, Colombia

Lake Guamuez is the second largest lake in Colombia and economically supports hundreds of families in the area. The main activities carried out in the region have focused on tourism, agriculture, livestock, and rainbow trout production; however, these activities have been associated with contamination of the lake. This research aimed to evaluate the water quality of Lake Guamuez using somatic coliphages (SCs) as bioindicators. For this purpose, periodic sampling was carried out for six months at 9 strategic points of the lake. For the detection of SCs, the method described in 9211 D of the Standard Methods for the Examination of Water and Wastewater was used. The genomic variability and presence of virulence genes in the isolated SCs were determined. Water contamination in the lake is evident, and the SCs titer is greater in areas with a high flow of anthropogenic activities. An important degree of genetic diversity and a high prevalence of virulence genes could be observed among the SCs analyzed. The results when compared with guidelines and water quality standards from various countries, showed concentrations of SCs higher than those allowed. The high prevalence of gastrointestinal diseases in the region suggests a link to water contamination.

Atherosclerotic Cardiovascular Disease (ASCVD) in Rheumatoid Arthritis (RA)—Indian Perspective

Reduced life expectancy in rheumatoid arthritis (RA) has been recognised since the 1950s, with standardised mortality rates (SMRs) of 1.41 for females and 1.08 for males. Extensive studies worldwide, including in India, have attributed this to a high prevalence of atherosclerotic cardiovascular disease (ASCVD) in RA. The increased ASCVD risk in RA and other inflammatory rheumatic and musculoskeletal diseases (I-RMDs) is influenced not only by conventional ASCVD risk factors (such as hypertension, diabetes mellitus, obesity, smoking, physical inactivity, and family history) but also by the degree and duration of systemic inflammation, as indicated by high-sensitivity C-reactive protein (hs-CRP) levels. Therefore, preventing ASCVD in RA and other I-RMDs has become a critical responsibility for rheumatologists. A two-pronged strategy is recommended: (a) strict lipid control and (b) stringent management of systemic inflammation, measured by hs-CRP levels. This article summarises the Lipid Association of India (LAI) guidelines for preventing ASCVD in RA and other I-RMDs, which can be implemented by specialist rheumatologist-nurse-led teams in rheumatology clinics and departments.

Gingival inflammation and leukocyte-endothelium cell interactions in women with polycystic ovary syndrome.

Given the link between chronic inflammation and periodontal pathologies and increased cardiovascular risk, this study aims to investigate if gingivitis exacerbates the inflammatory response and subclinical atherosclerotic markers in women with polycystic ovary syndrome (PCOS). For this case-control study, women were assigned to three groups: two PCOS groups (with and without gingivitis) and a control group. Anthropometric and biochemical variables were determined, along with periodontal parameters (probing pocket depth [PPD], clinical attachment level [CAL], bleeding on probing [BOP], plaque index, calculus index, and tooth loss), systemic and neutrophil inflammatory markers (tumor necrosis factor alpha [TNFα], C-reactive protein [CRP], and c-Jun N-terminal kinase [JNK]), systemic oxidative stress mediators (myeloperoxidase [MPO] and glutathione), soluble cellular adhesion molecules, and neutrophil-endothelium cell interactions (rolling flux, velocity, and adhesion). Of 104 women recruited, 68 had PCOS, 24 of whom presented gingivitis, and 36 were controls. PCOS patients presented altered sexual hormone, lipid, and carbohydrate profiles. Levels of systemic inflammatory markers, MPO, and soluble platelet selectin (sP-selectin) were higher, and glutathione levels were lower in PCOS patients. BOP, plaque, and calculus index values were higher in PCOS patients with gingivitis. Neutrophils from PCOS patients showed increased JNK and decreased adhesion under flow conditions, with reduced rolling velocity and increased rolling flux and cellular adhesion, all of which were more pronounced in those with gingivitis. BOP was independently associated with rolling velocity, rolling flux, and cellular adhesion. Neutrophils of PCOS patients with gingivitis exhibit hyperactivity, promoting interaction with the endothelium and potentially contributing to atherosclerotic disease. Currently, there is a high prevalence of diseases that affect tooth-supporting tissues (periodontal diseases) and negatively influence the oral health and quality of life of the adult population. These pathologies lead to movement of the teeth and impairment of chewing function, eventually resulting in the loss of teeth. In recent years, the concept of periodontal medicine has arisen and consists of studying how periodontal diseases can influence our general inflammatory system and how systemic inflammatory pathologies can affect our oral health. In the present study, we evaluate a group of women with polycystic ovary syndrome (PCOS), a condition characterized by alterations of sex hormones and lipid profile and weight gain (body mass index). Our results show a high prevalence of gum inflammation among women with PCOS, which affects the interaction of their leukocytes and endothelial cells. The leukocytes of these women are hyper-responsive, presenting greater endothelial adhesion, lower flow velocity and enhanced rolling compared to those in a PCOS group without gum inflammation or controls. This study has generated a new line of research to analyze how neutrophils from patients with gingivitis exhibit hyperactivity, which promotes their interaction with the endothelium, thus contributing to the development of atherosclerotic disease.

Estimated GFR Decline is Causally Associated with Acute Pulmonary Embolism: A Nested Case-Control and Mendelian Randomization Study.

Renal dysfunction is highly prevalent among patients with pulmonary embolism (PE). This study combined population-based study and Mendelian randomization to observe the relationship between renal function and PE. A nested case-control study were performed using data of PE patients and controls were from two nationwide cohorts, the China pUlmonary thromboembolism REgistry Study (CURES) and China Health and Retirement Longitudinal Survey (CHARLS). Baseline characteristics were balanced using propensity score matching and inverse probability of treatment weighting. Restricted cubic spline models were applied for the relationship between estimated glomerular filtration rate (eGFR) decline and the risk of PE. Bidirectional two-sample Mendelian randomization (MR) analyses were performed using Genome-wide association study summary statistics for eGFR involving 1,201,909 individuals and for PE from the FinnGen consortium. The nested case-control study including 17,547 participants (6,322 PE patients) found that eGFR distribution was significantly different between PE patients and controls (P<0.001), PE patients had a higher proportion of eGFR<60 mL/min/1·73 m2. eGFR below 88 mL/min/1·73 m2 was associated with a steep elevation in PE risk. MR analyses indicated a potential causal effect of eGFR decline on PE (OR=4·26, 95%CI 2·07-8·79), with no evidence of horizontal pleiotropy and reverse causality. Our findings support the hypothesis that renal function decline contributes to an elevated PE risk. Together with the high prevalence of chronic kidney diseases globally, there arises the necessity for monitoring and modulation of renal function in effective PE prevention.

Comprehensive Tuberculosis Screening and Treatment at a Prison in Central Papua Province, Indonesia.

Incarcerated people have been reported to have higher rates of tuberculosis (TB) than the general population. However, TB is rarely reported among incarcerated people in correctional facilities in Mimika District, in Central Papua Province of Indonesia. This study aims to describe the outcomes of comprehensive screening and treatment of TB disease and latent TB infection (LTBI) within a prison in Mimika. In response to a newly reported case of TB within a prison, a facility-wide comprehensive screening and treatment program was carried out for both TB disease and LTBI between September 2021 and June 2022. We evaluated the outcomes of the screening intervention, including the number of people found to have TB and LTBI and the number and proportion of people who started and completed TB-preventive treatment at the facility. A total of 403 incarcerated people and facility staff participated in the comprehensive screening program. Ten participants were found to have TB disease, all of whom commenced treatment. LTBI was detected in 256 (64%) participants, 251 (98%) of whom completed TB-preventive treatment. Comprehensive screening revealed a high prevalence of TB disease and LTBI in this prison. Completion of treatment for TB disease and latent TB infection was high. These outcomes suggest a role for routine search-treat-prevent strategies for TB in this setting.

Population Health Implications of Medicaid Prerelease and Transition Services for Incarcerated Populations.

As states expand prerelease and transition services for incarcerated individuals under the Medicaid Reentry Section 1115 Demonstration Opportunity, we sought to systematically inform Medicaid state and plan administrators regarding the population size and burden of disease data available on incarcerated populations in both jails and prisons in the United States. We analyzed data on eligibility criteria for new Medicaid prerelease and transition services based on incarceration length and health conditions across states. We estimated the potentially eligible populations in prisons and jails, considering various incarceration lengths and health status requirements. We also compared disease prevalence in the incarcerated population with that of the existing civilian Medicaid population. We found that rural and smaller states would experience a disproportionately large proportion of their Medicaid populations to be eligible for prerelease and transition services if new Medicaid eligibility rules were broadly applied. Self-reported psychological distress was notably higher among incarcerated individuals compared with those currently on Medicaid. The prevalence rates of previously diagnosed chronic hepatitis C and kidney disease were also much higher in the incarcerated population than the existing civilian Medicaid population. We estimated large volumes of potentially Medicaid-eligible entrants as coverage policy changes take effect over the coming years, particularly impacting smaller and more rural states. Our findings reveal very high disease prevalence rates among the incarcerated population subject to new Medicaid coverage, including specific chronic, infectious, and behavioral health conditions that state Medicaid programs, health plans, and providers may benefit from advanced planning to address.

Anatomical and Computed Tomography Study of the Mandible of the Patagonian Huemul (Hippocamelus bisulcus): Ecological and Clinical Insights.

Given the high prevalence of skeletal and mandibular diseases in the Patagonian Huemul, comprehensive anatomical studies are essential to understand the impact of nutritional deficiencies and support conservation efforts. The aim of this study is to provide a detailed anatomical characterisation of three exhumed mandibles of Patagonian huemul (Hippocamelus bisulcus) through three-dimensional reconstructions obtained from computed tomography data and semi-automatic segmentation, documenting their distinctive features. The findings revealed distinctive features in the mandible, consistent with the browsing habits of herbivores, such as a robust coronoid process, a wide and deep pterygoid fossa, a significantly lower mandibular condyle compared to other deer species and a unique configuration of the mandibular canal with a curved caudal portion and a straight rostral portion. These anatomical adaptations are likely related to the species' feeding habits and behaviour. The study also addressed the challenges of researching an endangered species, given that access to biological material is restricted by strict regulations in Chile and Argentina. These restrictions limited the available sample size and hindered the acquisition of additional specimens, which could affect the generalisation of the results. Despite these limitations, the research provides valuable anatomical insights that are fundamental for the biology, clinical practice and management of specimens. In conclusion, the mandibles of both juvenile and adult Patagonian huemul demonstrate distinctive features characteristic of browsing herbivores. The findings can serve as a basis for future comparative studies on mandibular anatomy and function in this endangered deer species as well as in other herbivorous deer.

Paediatric staphyloma classification: new perspectives via ultrawide field three-dimensional swept-source optical coherence tomographic angiography

AimTo employ ultrawide field three-dimensional swept-source optical coherence tomographic angiography (UWF 3D SS-OCTA) modality, integrating novel strategies, posterior eye curvature maps and posterior eye height maps, in characterising the features...

Utility of ultra-portable ultrasound devices for the risk-stratification of thyroid dysfunctions in an emergency setting.

We previously showed that the rapid TSH (rTSH) screening is able to detect a high prevalence of thyroid diseases in patients presenting to the Emergency department (ED), with a 7% prevalence of undiagnosed thyroid dysfunctions. The purpose of the present study is to implement our diagnostic flow-chart for thyroid dysfunctions in the ED with a rapid point-of-care thyroid ultrasound (rPOCUS). rPOCUS was performed by an app-based mobile ultrasound device (Lumify® by Philips Healthcare) in patients with suppressed rTSH undergoing urgent procedures requiring iodinate contrast media. Our results suggest that rPOCUS is cost- and time-effective for the management of patients with a newly diagnosed hyperthyroidism requiring urgent iodinated contrast media or amiodarone administration. Moreover, this handled US scanner avoided rTSH measurement in patients found to have a normal thyroid gland, and detected some incidental findings (nodules, heterogeneous echotexture), which would lead to further diagnostic investigations. We demonstrate, for the first time, that rPOCUS greatly improves the management of patients attending the ED, including the prompt characterization and correct treatment of hyperthyroidism, and the prevention of iodine-induced thyrotoxicosis.

12217 Exploring Thyroid-stimulating Hormone As A Potential Cardiovascular Disease Risk Marker In Euthyroid Individuals

Abstract Disclosure: A.P. Neto: None. H. Lucchesi: None. C.C. Silva Janovsky: None. I. Bensenor: None. L.S. Ward: None. L.L. Cunha: None. Previous studies have suggested that TSH levels may predict longevity primarily in elderly individuals. Aging is associated with a high prevalence of cardiovascular and metabolic diseases that reduce survival. However, the relationship between serum TSH levels and these conditions, especially traditional cardiovascular risk markers, remains poorly explored. We employed data from the longitudinal multicenter cohort study ELSA-Brasil, which includes workers from five Brazilian Universities, to evaluate thyroid function in 8,452 participants aged between 34 and 75 years, classified as euthyroid and followed for 8.9 ± 0.6 years. The participants were evaluated for the presence of diabetes, hypertension, angina, peripheral arterial disease, and cardiovascular mortality. Additionally, we measured cardiovascular markers, including global cardiovascular risk score, HbA1c, microalbuminuria (mg/dl), LDL levels, and triglyceride levels. Statistical analysis was used to compare TSH levels with clinically relevant outcomes and classical cardiovascular risk markers. We observed that higher TSH levels correlated negatively with global cardiovascular risk (Spearman rank -0.023, p-value=0.038), microalbuminuria (Spearman rank -0.055, p&amp;lt;0.000), and HbA1c (Spearman rank -0.041, p&amp;lt;0.000). However, TSH levels were positively correlated with hypertriglyceridemia (Spearman rank +0.125, p&amp;lt;0.000) but had no relationship with LDL (p &amp;gt;0.05). The appraisal of cardio-metabolic diseases showed that individuals without diabetes had higher TSH levels (1.79 mIU/L, IQR 1.07) than individuals with diabetes (1.71 mIU/L, IQR 1.07). Patients with arteriosclerosis diseases, such as coronary and peripheral arterial disease, had lower TSH levels (1.66, IQR 0.98 and 1.67, IQR 0.94, respectively) than those who did not have these comorbidities (1.79, IQR 1.07, and 1.79, IQR 1.07). Furthermore, TSH levels did not correlate with the incidence of hypertension (p &amp;gt;0.05). Finally, we divided the population into two groups: higher and lower TSH levels based on the median TSH levels (1.78 mIU/L, IQR 1.06). The Kaplan-Meier curve did not show a difference between these groups (p=0.758) in survival after cardiovascular events (08 events in total) during follow-up. In conclusion, our results suggest that higher serum TSH levels in euthyroid individuals are associated with a lower prevalence of metabolic and cardiovascular disease. However, the relatively short observation duration and low frequency of cardiovascular events in our cohort made it difficult to statistically analyze several endpoints, such as survival. Further investigation is necessary to completely understand whether TSH is a cardiovascular risk indicator. Presentation: 6/2/2024

Monogenic Kidney Diseases in Adults With Chronic Kidney Disease (CKD).

According to current evidence, every 10th to 11th adult with chronic kidney disease (CKD) has a monogenic disease of the kidney. This review is based on reported studies in which molecular genetic diagnostic techniques were used to investigate monogenic kidney diseases in adults with CKD. The studies were identified by a selective literature search using predefined criteria. In 12 selected studies, diagnostic variants of 179 different genes were identified in 1467 out of 6607 study participants with CKD (22.2%). More than 60% of these variants affected 8 genes (PKD1, PKD2, COL4A3, COL4A4, COL4A5, UMOD, MUC1, HNF1B). Three diseases are associated with these genes: autosomal dominant polycystic kidney disease (ADPKD), Alport syndrome, and autosomal dominant tubulo-interstitial kidney disease (ADTKD). Physicians treating patients with CKD should be alert to the presence of any red flags, such as onset at a young age, a positive family history, or hematuria of unknown cause. When a genetic etiology is suspected, a specialized work-up is indicated, often including a molecular genetic investigation. A positive genetic finding usually leads to a modification of the patient's specific diagnosis and/or treatment. Awareness of the high prevalence of monogenic kidney diseases in adults with CKD and alertness to their suggestive clinical features are crucial for the timely initiation of targeted diagnostic testing. The molecular genetic identification of these diseases is a prerequisite for appropriate patient management.