Peak Incidence Research Articles

Osteopathic correction as part of complex treatment of patients with irritable bowel syndrome

Introduction. According to WHO data from 15 to 20 % of patients seeking gastroenterological care suffer from irritable bowel syndrome. The peak incidence is at the age of 30–40 years and is a frequent cause of disability due to the development of pain syndrome with localisation in the abdomen and changes in stool frequency in the absence of organic pathology. Low effectiveness of treatment of this disease is associated not only with multifactorial formation of gastrointestinal tract dysfunction and the lack of a single standard of therapy, but also with low adherence of patients to treatment due to polypragmasy and the need for long-term use of medications against the background of stressors, urbanisation, low motor activity and changes in diet and diet quality. All this puts before clinicians the task of searching for and including new non-medication methods of treatment of patients with this nosology, which predetermined the purpose of this study.The aim of the study was to investigate the effect of including osteopathic correction in the complex treatment of patients with irritable bowel syndrome on the course of this disease.Materials and methods. A prospective randomised controlled study, conducted between January 2022 and March 2023 at the outpatient clinic of FBUZ MSCh № 32 FMBA of Russia in Zarechny, Sverdlovsk region, included 64 patients of both sexes with an established diagnosis of irritable bowel syndrome. All participants of the study were divided into two comparable groups - main and control groups of 32 people each. Patients of the main group along with standard drug therapy received osteopathic correction, patients of the control group received only drug therapy according to clinical recommendations in gastroenterology. At the end of the treatment course the osteopathic status and the degree of pain syndrome severity were evaluated in patients of both groups.Results. In patients with irritable bowel syndrome the most frequently diagnosed were somatic dysfunctions of global and regional level. Somatic dysfunctions of the global (psychovisceral dysfunction — 23,4 %, rhythmogenic cranial dysfunction — 17,2 %, global biomechanical dysfunction — 6,3 %) and regional levels (lumbar region: visceral component — 35 %, somatic component — 29,7 % and thoracic region: somatic component — 37,4 %) were determined as dominant. The inclusion of osteopathic correction in the complex treatment of patients with irritable bowel syndrome resulted in a statistically signifi cant (p<0,05) decrease in the severity of pain syndrome with localisation in the abdomen.Conclusion. As part of the complex treatment of patients with irritable bowel syndrome, osteopathic correction in combination with the use of standard drug therapy contributes to a signifi cantly more signifi cant reduction in the severity of pain syndrome compared to the use of pharmacological treatment alone in this category of patients.

Epidemiological Characteristics and Risk Factors for Coronary Artery Lesions in Kawasaki Disease: A Five-Year Study in Xuzhou of 1082 Cases

Background: Kawasaki disease (KD) is a major cause of childhood vasculitis and a common cause of acquired heart disease in children worldwide. This study sought to investigate the epidemiological characteristics of KD and to analyze the risk factors associated with KD complications, particularly coronary artery lesions (CALs). Methods: The medical records of children diagnosed with KD in Xuzhou from January 1, 2016, to December 31, 2020, were reviewed retrospectively. Categorical variables were analyzed using the Chi-square test, while unpaired Student's t-tests or the Mann–Whitney U test were employed for continuous data. Univariate and multivariable logistic regression analyses were conducted to identify risk factors of KD- associated CALs. Results: Of the 1082 children enrolled, the male-to-female ratio was 1.7:1. The age at diagnosis ranged from 1 to 127 months, with a median of 17 months. Seasonal variation was observed, with a peak incidence noted in summer (27.5%). CALs were identified in 292 cases (27.0%), detailed as follows: transient dilation (17.4%), mild dilation (4.0%), small aneurysms (2.9%), medium-sized aneurysms (1.9%), and giant aneurysms (0.8%). Independent risk factors for CALs included male gender, longer fever duration before intravenous immunoglobulin (IVIG), and elevated levels of leukocytes, C-reactive protein, creatine kinase-muscle/brain (CK-MB), and interleukin-6 (IL-6). Conclusions: Male gender, elevated levels of fever duration before IVIG, leukocytes, C-reactive protein, CK-MB, and IL-6 were predictive risk factors of CALs. These findings underscore the need for increased clinical awareness and targeted interventions to mitigate the risk of CALs in children affected by KD.

Serial Paediatrics Omics Tracking in Myalgic Encephalomyelitis (SPOT-ME): protocol paper for a multidisciplinary, observational study of clinical and biological markers of paediatric myalgic encephalomyelitis/chronic fatigue syndrome in Australian adolescents aged 12–19 years

IntroductionMyalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disabling condition that can affect adolescents during a vulnerable period of development. The underlying biological mechanisms for ME/CFS remain unclear and have rarely...

The impact of cognitive bias about infectious diseases on social well-being.

We investigate the relationship between bias, that is, cognitive distortions about the severity of infectious disease and social well-being. First, we establish empirically the existence of bias and analyze some of its causes; specifically, during the COVID-19 pandemic. Second, we derive an integrated economic-epidemiological differential equation model from an agent-based model that combines myopic rational choice with infectious disease dynamics. Third, we characterize axiomatically a model of an ethical, impartial, eudaemonistic and individualist observer. We prove that such an observer evaluates the state of society (social welfare or social well-being) according to the utilitarian principle. We show numerically that while increased risk-perception indeed improves epidemiological outcomes such as peak of infections and total incidence, the impact on social well-being is ambiguous. This result urges to look beyond cases and deaths. We also discuss problematic aspects of the simplified utilitarian principle. Finally, we point out three possible future research directions and highlight some critical issues that arise in the normative direction.

Trends and projections of Hepatitis A incidence in eastern China from 2007 to 2021: an age-period-cohort analysis.

This study aimed to analyze the trends in Hepatitis A incidence associated with age, period, and birth cohorts from 2007 to 2021 in Jiangsu Province, China, and projects the future burden through 2031. Data on Hepatitis A cases in Jiangsu Province from 2007 to 2021 were obtained from the National Notifiable Disease Reporting System. Joinpoint regression analysis identified significant changes in incidence trends. The age-period-cohort model assessed the effects of age, period, and cohort on Hepatitis A incidence rates. Projections for 2022-2031 were generated using the Bayesian age-period-cohort model. From 2007 to 2021, Hepatitis A incidence in Jiangsu Province significantly declined, with an average annual percent change (AAPC) of -10.77%. The decline was more pronounced in males (AAPC = -12.87%) compared to females (AAPC = -7.46%). The overall net drift was -10.61% (95% CI: -11.14% to -10.07%), the net drift for males was -12.77% (95% CI: -13.40% to -12.13%), which was higher than that for females at -7.27% (95% CI: -7.93% to -6.60%). The local drift indicates the incidence of hepatitis A decreased gradually, with the rate of decline slowing in the later period. Descriptive analysis revealed the highest incidence of Hepatitis A cases in the 40-59 age group, while age-period-cohort analysis indicated higher incidence rates in younger individuals. The cohort effect showed a continuous decline from the earliest cohort in 1923-1927 (Overall RR = 64.93, 95% CI: 42.55 to 99.07) to the most recent cohort in 1993-1997 (Overall RR = 0.008, 95% CI: 0.004 to 0.01). But Bayesian age-period-cohort model projections for 2022-2031 suggest that incidence rates will remain low, though they may slightly increase by 2031, with peak incidence shifting to the 60-64 age group. The incidence of Hepatitis A in Jiangsu Province has significantly decreased from 2007 to 2021, primarily due to public health measures and vaccination programs. Future efforts should focus on maintaining vaccination coverage and improving sanitation and hygiene practices to sustain these achievements.

Incidence of Neoplasms in Endemic Fight Agents: Results of a Retrospective Cohort.

The aim of the study is to measure cancer's incidence in endemic fight agents in a Brazil's Northeast state. This is a historical cohort with 1053 endemic fight agents. A survival analysis was performed using Kaplan-Meier method. The overall neoplasm incidence rate has been 5508 cases per 105, and 4843 cases per 105 when nonmelanoma skin tumors were excluded. The increase in incidence of neoplasms occurred in 2019 and has conferred a risk of neoplasms 20 times higher than the national and state incidence. We believe in an occupational factor for these results: the chronic exposure to insecticides used in public health campaigns. The peak incidence of neoplasms, in 2019, may corroborate with long induction period of these compounds, in addition to consistency with specialized literature.

Treatment Options for IDH-Mutant Malignant Gliomas.

As the peak incidence of isocitrate dehydrogenase (IDH)-mutant gliomas is amongst young adults, there is a need to balance tumor control with long term side effects of therapy. Following initial clinical presentation and acquisition of contrasted diagnostic imaging, tissue diagnosis is essential in suspected diffuse glioma. Depending on the location and extent of disease, maximal surgical resection is preferred both for histologic diagnosis and initial therapy. Partial resection or biopsy alone is considered when the tumor cannot be completely resected or if there are clinical reservations regarding a more significant operation. The classification of diffuse glioma has evolved over time, with histopathology and molecular marker status guiding discussions of prognosis and postoperative management. In patients with IDH-mutant grade 2 glioma and low-risk features, observation with active surveillance is generally recommended following a gross total resection. For those with high-risk features, which historically included age > 40years or subtotal resection, adjuvant chemotherapy and radiation therapy are generally recommended, however decisions for adjuvant therapy pose challenges as many of the landmark historical trials guiding adjuvant therapy were performed prior to the molecularly defined era. This is an area where multiple clinical trials are ongoing and hold promise to inform treatment paradigms, including recent data on the use of IDH-mutant inhibitors in grade 2 tumors with recurrent or residual disease. For IDH-mutant grade 3 and 4 glioma, adjuvant chemotherapy and radiation are recommended for all patients after initial resection.

Trend of hand, foot and mouth disease before, during, and after China's COVID control policies in Zhejiang, China.

To describe the trends in the incidence of hand, foot and mouth disease (HFMD) before, during, and after China's Coronavirus Disease (COVID) control policies, and to interpret the influence on HFMD incidence at different control stages in Zhejiang Province. We collected data on HFMD cases in Zhejiang between 2014 and 2023. We compared the constituent ratios of cases at different COVID control stages by sex, age, child groups, and pathogens and weekly seasonal indices to observe seasonal variations in the incidence of HFMD. An interrupted time-series segmented regression analysis was applied to estimate the influence on HFMD incidence at different control stages. Stratified and sensitivity analyses were conducted to validate the findings. A considerable proportion of cases occurred among children living separately. The proportions of children in kindergartens or nurseries and children aged 2-4 years were relatively low at the strict control stage compared to the other three stages. Enteroviruses other than enterovirus 71 and coxsackie virus A16 were the dominant HFMD pathogens, and the proportion showed an increasing trend. The usual spring-summer peak in HMFD incidence did not occur in 2020, and the periodicity of the biennial peak was disrupted for a year. The summer peak in 2023 was higher than that in the other years, and was delayed by 3 weeks. The trend changes in weekly HFMD cases during the strict control and regular control stages were - 15% (IRR: 0.85, 95% CI: 0.81-0.89) and 17% (IRR: 1.17, 95% CI: 1.12-1.23), respectively. However, the change was not statistically significant during the reopening stage (IRR: 1.41, 95% CI: 0.34-5.88). The expected number of cases increased by 1.12 times (95% CI: 243.17, 53.45%) during the reopening stage compared to what would have occurred if the zero-COVID policy had continued in 2023. Non-pharmaceutical interventions (NPIs) for COVID-19 control can mitigate HFMD. However, after the dynamic zero-COVID policy ended, the HFMD incidence returned to historical levels. Strict NPIs such as traffic restrictions and kindergarten closures cannot be sustained long-term. NPIs such as improving personal hygiene for routine prevention are highly recommended.

Municipal secondary-treated effluent data seem to be a suitable source of information for human viral trends

Employing a long-time series of municipal wastewater samples collected in 2020, the present study aims to confirm whether the appearance of SARS-CoV-2 influences the environmental load and behaviour of both JC Virus and Norovirus, determine the ability of the selected wastewater treatment plant (WWTP) to remove viral genomes, and assess if secondary-treated effluent data is somehow related to the incidence of the viral diseases reported by the local hospital. From the 11 raw influent and 52 secondary-treated effluent samples tested, JC Virus data present an occurrence frequency of 100 %, showing two different abundance patterns along the year, before and after the appearance of SARS-CoV-2. The constant detection of JC nucleic acids in wastewater reinforces the idea that urine is responsible for transmitting this virus. The Norovirus genogroup (G) II was detected more frequently than GI, both in influents and effluents, and their characteristic incidence peaks were not observed in late 2020. Regarding SARS-CoV-2 RNA, it appeared only in 5.8 % of the effluents, possibly due to the iron dosing used by the WWTP to reduce both phosphorus and organic matter concentrations in order to meet the requirements of European legislation, and/or the pre-filtration laboratory step which neglected the possibility of viral association with the solid fraction. The results suggest a poor performance of the WWTP, since Log removal values below 1.8 were determined. We were able to trace the development of local Norovirus outbreaks in the effluent samples to some extent, suggesting that secondary-treated effluents may be used to monitor human viruses by following viral nucleic acid levels.

STUDY OF HUMAN LEPTOSPIROSIS IN A TERTIARY CARE HOSPITAL, VISAKHAPATNAM

Objective: Prevalence of leptospirosis in humans is found in an alarming number in recent times. This endemic zoonotic disease is widespread and potentially fatal. It is usually seen in areas with poor socioeconomic conditions, water stagnation, garbage accumulation, which becomes breeding sites for the rodents. Infection may turn epidemic during monsoon. Reservoir of infection is rat scientifically named as Rattus rattus and infection results from direct or indirect exposure to host animals that carry the pathogen in their renal tubules and shed pathogenic leptospires in their urine. The main objective of this study was to estimate the seropositivity of leptospirosis in patients presenting with undifferentiated acute febrile illness for 5 to 7 days during one year period from February 2023 to February 2024 in a tertiary care hospital, Visakhapatnam, India. Methods: A total of 279 blood samples received from suspected cases of leptospirosis were subjected to IgM ELISA. Results: Out of total 279 cases, 20 were positive for leptospirosis (OD ratio ≥1.00). All the positive cases presented with a fever more than 99.5°F, chills and headache with elevated serum procalcitonin levels. Peak incidence of cases was recorded during July and August 2023. Conclusion: Seroprevalence of human leptospirosis in this study was found to be 7.2%.

BN SO44 - Is routine histological analysis of excised gallbladders necessary?

Abstract Background Gallbladder cancer is rare representing <1% of annual cancer diagnoses in the UK. It is more common in females (2.4/100,000 vs 1/100,000) with a peak age incidence of 85–89-years. Our trust routinely histologically analyses all resected gallbladders, over 1000 per year, regardless of indication. Our pathologists estimate that each specimen costs £75 to analyse, reflecting an annual cost of over £80,000. A 2021 systematic review suggested selective histological analysis is safe, reduces laboratory burden and costs. We aimed to assess our centre’s cholecystectomy specimens to ascertain the incidental gallbladder cancer diagnoses and explore the possibility of selective analysis. Method A retrospective search of our pathology database was carried out for the terms “cancer” and “gallbladder” from 2015 to 2018 inclusive. After exclusion of non-gallbladder primary cancers, all selected cases electronic notes were retrospectively reviewed. The primary outcome was the incidental findings of gallbladder cancer. Secondary outcomes were the indications for surgery, intraoperative findings, histological macroscopic description, final diagnosis and further management where applicable. Results We identified 4421 gallbladder specimens of which 12 (0.27%) identified cancer. The ratio of female to male diagnoses was 5:1 and the median age was 73.5 years. Of the 12 cancers, 7 (0.16%) of these were incidental findings, with 5 having surgery for symptomatic gallstones and 2 for gallbladder polyps. The 5 symptomatic gallstones patients all had grossly abnormal macroscopic appearances of the serosa, dense adhesions or exudate; all were confirmed as gallbladder adenocarcinoma. Three patients were fit enough for limited liver resection. Conclusion Our results demonstrate that across four years the rate of incidental gallbladder adenocarcinoma diagnosed by cholecystectomy was 0.16%. In all non-polypoidal cases (0.11%), the gallbladder was macroscopically abnormal. This suggests that with careful criteria, selective gallbladder histological analysis may reduce laboratory burden and therefore costs associated with elective gallbladder surgery. With increasing emphasis to improve efficiency and rationalise healthcare spending, our results suggest that selective histological analysis may be safe and effective. However, given the consequences of missing a cancer diagnosis it would require a larger scale multi centre study to support a move in this direction.

Red Breast Syndrome—Where Has It Gone?

Background Red breast syndrome (RBS) has been noted in past literature as a possible complication of implant-based breast reconstruction (IBBR) with the use of acellular dermal matrices (ADMs). Since its first appearance in 2009, RBS has drawn growing medical attention with reported incidence ranging from 7%–9%. There has been a noted decrease in the emergence of RBS despite its inclusion among the analyzed complications in a number of studies. This systematic review aims to evaluate the trend in reported RBS incidence over time and appropriately determine an accurate incidence of RBS from reported literature since the emergence of the phenomena. Methods A systematic literature review was performed in July 2023 that analyzed the incidence of RBS among retrospective cohort studies on complication rates of IBBR with ADM. Patient demographics, RBS incidence rates, and all-cause complications were captured. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines and Methodological Index for Nonrandomized Studies criteria was used to assess study quality. Results From 2009 to 2023, a total of 48 studies (n = 6251) met inclusion criteria of which 35 studies from 2017 to 2023 were not already included in a prior systematic review (n = 5246). The mean incidence of RBS in the unreported studies was 2.88% with a weighted mean of 3.22%. Analysis of the trend in RBS over time shows an increasing reported incidence rate from 2009 with a peak in incidence between 2016 and 2017, followed by a steady decline through 2022. Twenty-six of the studies were published from 2016 to 2019. Conclusions The incidence of RBS among prior studies and systematic reviews has fluctuated significantly since its initial emergence in 2009. Reported incidence rates have been on the decline since 2018 with a true weighted incidence of 3.22% from analysis of recent reported studies. Potential causes for the decline in incidence include practice changes in ADM preparation, changes in the ADM brand used for IBBR, and improved categorization of RBS compared to cellulitis/infection. Despite more robust criteria for diagnosis, no consensus for management has yet been established.

Abstract 4142796: Hospital Admission Rates for Peripartum Cardiomyopathy Follow Influenza Seasonal Peaks

Background: Peripartum cardiomyopathy (PPCM) is defined as a dilated form of cardiomyopathy that occurs within the last month of pregnancy and up to 5 months postpartum. Previous studies have shown that PPCM more often occurs in the Southern United States compared to other geographic locations. Although the etiology of PPCM is likely multifactorial, viral infections may account for up to a third of those cases. We aimed to examine the association of PPCM to active influenza infection in the Southern United States. Methods: National Inpatient Sample 2016-2021 was queried to identify women admitted with PPCM with (group A) and without (group B) concurrent influenza infection in the Southern United States. Results: A total of 13540 women were admitted with PPCM, of whom 3511 (35%) had concurrent influenza infection. Group A PPCM followed a seasonal pattern with peak incidence in winter (62%) followed by spring (25%), fall (13%) and summer (0) [p<0.001]. Group A was older (mean age 33.6 -vs- 31.9), more often obese (16.8% -vs- 11.2%, p=0.011), had a smoking history (38.2% -vs- 26.1%, p<0.001), had higher Charlson comorbidity severity indexes (25.3% -vs- 17.2%, p=0.020), and had longer length of stay (6.1 -vs- 5.5). Group A also had higher rates of preexisting hypertension (15.3% -vs- 13.1%, p=0.011) and depression (18.8% -vs- 8.6%, p<0.001, OR 0.125 p-0.285), but similar rates of preeclampsia. In hospital mortality was not statistically significantly different between the two groups (1.8 -vs- 1.6%, p=0.067). Conclusion: PPCM appears to follow a seasonal trend in incidence similar to influenza in the Southern United States. Influenza infection may account for some cases of PPCM in that region and may be associated with adverse in-hospital outcomes.

Epidemiological and clinical characteristics of respiratory syncytial virus infections in children in Jiangsu Province, 2014-2023

Objective: To analyze the epidemiological and clinical characteristics of respiratory syncytial virus (RSV) infection in children in Jiangsu Province from 2014 to 2023. Methods: The acute respiratory infection cases in children aged 0-14 years were selected from outpatient/emergency or inpatient departments in 2 surveillance sentinel hospitals, respectively, in Nanjing, Suzhou and Taizhou of Jiangsu from 1 July 2014 to 31 December 2023, and RSV nucleic acid test was conducted and the intensity of the RSV infection was accessed by WHO influenza epidemiological threshold method, and case information and clinical data were collected. χ2 test was used to compare the differences between groups, and the Bonferroni method was used for pairwise comparisons between groups. Results: In 4 946 cases of acute respiratory infections, the RSV positive rate was 8.21% (406/4 946), and the age M(Q1,Q3) of the cases was 1 (0, 3) years. The RSV positive rate was 10.92% (258/2 362) during 2014-2019 and 6.06% (118/1 948) during 2019-2023, the difference was significant (χ2=31.74, P<0.001). RSV infection mainly occurred from October to March during 2014-2019, with the incidence peak in December and moderate or higher intensity. The seasonality of RSV infection was not obvious during 2019-2023, with low intensity. The RSV positive rate was highest in children in age group 0- years (17.85%, 151/846), and the positive rate declined gradually with age (χ2=184.51, P<0.001). The RSV positive rate was higher in inpatient cases (9.84%, 244/2 480) than in outpatient/emergency cases (6.57%, 162/2 466) (χ2=17.54, P<0.001). In the 155 RSV infection cases with complete clinical data, the clinical symptoms mainly included cough (99.35%, 154/155), fever (55.48%, 86/155), and shortness of breath (45.16%, 70/155). In the cases aged <6 months, the proportion of those with fever was low, but the proportion of those with shortness of breath, transferred to intensive care units, and receiving oxygen therapy were higher (all P<0.05). Children aged <6 months and those with underlying diseases were more likely to have severe RSV infection (all P<0.05). Conclusions: RSV infection in children in Jiangsu Province showed seasonal prevalence in winter from 2014 to 2019. Since 2020, the seasonal characteristics of the epidemic have changed, the epidemic period has been dispersed and the epidemic intensity has decreased. Infants <1 year old were at high risk for RSV infection, and those <6 months old and with underlying diseases might have severe infection.

Association of greening bacterium with fruit morphological disorder ‘Waywar’ in monsoon cropping of Nagpur mandarin (Citrus reticulata Blanco) grown in central India

Abstract In the Vidarbha region of Maharashtra and the surrounding parts of central India, Waywar (citrus greening bacterium) fruit disorder, also known as wasteful fruit disorder, is a common manifestation of Nagpur mandarin fruit. In Vidarbha, the condition is also known as cock bund, while in China, it is called ‘Red Nose.’ According to early research, this condition is caused by abiotic stress factors, such as poor nutrition, too much moisture in the root zone, and other incorrect cultural practices. Recent research, however, has unequivocally shown that Candidatus Liberobacter asiaticus, the citrus greening bacterium, is responsible for this illness. When compared to normal growing fruits (0.82–0.89), the length to diameter ratio of Waywar fruits at the peak of incidence was reported in the range of 0.95–1.09, indicating their oblong shape. Premature Waywar fruits had higher acidity levels (1.75 to 2.04%) than normal fruits (1.65 to 2.03%) and produced seeds that were not viable. The cultural treatments applied to reduce the ill effects of the disorder improved the physico-chemical characteristics of Nagpur mandarin fruit at the time of harvesting. When compared to the untreated control, foliar spraying with growth regulators 2,4-D (15 ppm) and GA3 (15 ppm) enhanced the amount of fruit retained per plant at harvest. The critical fruit quality parameters like TSS (10.10%) and vitamin C (39.37 mg/100 ml) were highest in GA3 treated fruits. Maximum TSS/Acid ratio (14.00) and minimum acidity (0.69%) were noted with phosphorus applied at three times the RDF level at harvest.

Impact of Climate Variability and Interventions on Malaria Incidence and Forecasting in Burkina Faso.

Malaria remains a climate-driven public health issue in Burkina Faso, yet the interactions between climatic factors and malaria interventions across different zones are not well understood. This study estimates time delays in the effects of climatic factors on malaria incidence, develops forecasting models, and assesses their short-term forecasting performance across three distinct climatic zones: the Sahelian zone (hot/arid), the Sudano-Sahelian zone (moderate temperatures/rainfall); and the Sudanian zone (cooler/wet). Monthly confirmed malaria cases of children under five during the period 2015-2021 were analyzed using Bayesian generalized autoregressive moving average negative binomial models. The predictors included land surface temperature (LST), rainfall, the coverage of insecticide-treated net (ITN) use, and the coverage of artemisinin-based combination therapies (ACTs). Bayesian variable selection was used to identify the time delays between climatic suitability and malaria incidence. Wavelet analysis was conducted to understand better how fluctuations in climatic factors across different time scales and climatic zones affect malaria transmission dynamics. Malaria incidence averaged 9.92 cases per 1000 persons per month from 2015 to 2021, with peak incidences in July and October in the cooler/wet zone and October in the other zones. Periodicities at 6-month and 12-month intervals were identified in malaria incidence and LST and at 12 months for rainfall from 2015 to 2021 in all climatic zones. Varying lag times in the effects of climatic factors were identified across the zones. The highest predictive power was observed at lead times of 3 months in the cooler/wet zone, followed by 2 months in the hot/arid and moderate zones. Forecasting accuracy, measured by the mean absolute percentage error (MAPE), varied across the zones: 28% in the cooler/wet zone, 53% in the moderate zone, and 45% in the hot/arid zone. ITNs were not statistically important in the hot/arid zone, while ACTs were not in the cooler/wet and moderate zones. The interaction between climatic factors and interventions varied across zones, with the best forecasting performance in the cooler/wet zone. Zone-specific intervention planning and model development adjustments are essential for more efficient early-warning systems.

Case of delayed diagnosis of combined urogenita and pulmonary tuberculosis in a patient with abnormal uterine bleeding

According to the World Health Organization tuberculosis remains a global health issue for both adult and pediatric populations worldwide. Among women the peak incidence occurs during the active reproductive age, with pregnant women being 1.5–2 times more likely to be affected and experience more severe symptoms than non-pregnant women. In the Altai Region, the epidemiological situation of tuberculosis is characterized by instability, with the incidence rate among women reaching30.5 per 100 000 of the corresponding population in 2022. Delayed diagnosis and treatment can lead to serious complications, including fatal outcomes for both mother and fetus. This article describes a clinical observation of a case of urogenital and pulmonary tuberculosis diagnosed three months after premature abdominal delivery. The course of pregnancy was complicated by acute pleuritis at 13–14 weeks, however, negative results of bacteriological culture of pleural fluid led to the absence of specific tuberculosis treatment and the development of chronic subcompensated placental dysfunction. Three months after delivery, a 34-year-old patient was admitted to the gynecological department of the emergency hospital with abnormal uterine bleeding. The diagnosis was confirmed by histopathology of an endometrial sample revealing tuberculous granulomas without caseous necrosis with epithelioid giant cells of Pirogov – Langhans. Subsequently, generalized tuberculosis was diagnosed in the preterm infant. The negative impact of undiagnosed combined urogenital and pulmonary tuberculosis on the course and outcome of pregnancy is demonstrated, including the development of anemia, placental dysfunction, preterm delivery, puerperal complications, and adverse perinatal outcomes.

Paediatric oral and maxillofacial biopsies: A retrospective institutional archival study.

This is a retrospective cross-sectional study of oral and maxillofacial biopsies in paediatric population, up to 16 years of age from 1991 to 2021. This study aimed to investigate the frequency, demographic and clinicopathological characteristics of paediatric biopsies according to the diagnosis categories of the main tertiary centre in Malaysia. A total of 17294 histopathological reports from Diagnostic Oral Pathology Unit between 1991 and 2021 were retrieved. One thousand eleven histopathological reports that fulfilled the inclusion and exclusion criteria were included. Information of interest was extracted from histopathological reports. The lesions were categorised into 10 diagnosis categories. Descriptive and correlation analysis were performed. Paediatric oral and maxillofacial biopsies accounted for 5.9% of the total biopsies received. The peak incidence of diagnosis was in age range of 12 to 16 years old and mean age of 11.6 years old (±3.5), with female preponderance. The most common category of diagnosis was salivary gland pathology with mucocele (30%) being the most frequently diagnosed lesions. Lip and labial mucosa were the commonest site of occurrence. Specimen sizes smaller than 1 cm were the most common specimen diameter with mean size of 1.6 cm (±1.5). Age, site of occurrence and specimen size were statistically significant (P < 0.05) with paediatric oral and maxillofacial biopsies. This is a large-scale study of paediatric oral and maxillofacial biopsies of a tertiary centre over three decades. We hope this data is useful for chairside assessment and aids in diagnosis making.

Epidemiology of HIV infection in penal system institutions

Aim. To assess the medical and statistical indicators of the health status of persons with the disease caused by the human immunodeficiency virus (HIV), among suspects, accused, and convicts held in institutions of the penal system. To develop proposals for improving work in the field of countering the spread of HIV infections. Materials and methods. The structure and dynamics of morbidity and mortality from HIV infection in penal institutions from 2014 to 2022 was analyzed using official statistical data. Calculations were carried out using MS Excel application packages and the R software environment version 3.6.2.Results. The peak HIV incidence in penal system institutions was recorded in 2015, followed by its gradual decrease by 2020. HIV mortality decreased by 52.1% since 2014, amounting to 84.6 per 100,000 people in 2022. The mortality rate of people living with HIV (PLHIV) decreased by 61.5% in 2014. This dynamics showed a decreasing trend starting from 2015. The antiretroviral therapy coverage in this group of patients reached a maximum value of 94.5% by 2022. Conclusions. The HIV mortality and mortality rates during the study period show a downward trend. The antiretroviral therapy coverage in 2022 reached a historic maximum. However, this does not exclude the low adherence of patients to treatment, which indicates the need to develop new methods of sanitary education and therapeutic and preventive work in penal system institutions.

Time trends in incidence of pilonidal sinus disease from 1996 to 2021: A Danish population-based cohort study.

Pilonidal sinus disease (PSD) is a common condition, but no data on disease occurrence exist outside highly selected settings. The aim of this study was to assess time trends in the incidence of PSD in a nationwide setting. Using data from nationwide Danish registries, we identified 48 247 patients recorded with diagnostic or surgical procedure codes representing PSD between 1996 and 2021. We stratified by sex and computed the age-adjusted and age-specific incidence rate, comparing 5-year intervals with the incidence rate ratio (IRR). The overall incidence of PSD increased from 26.1 to 39.6/100 000 person-years (PY) from the period 1996-2000 to the period 2016-2021 (IRR 1.52, 95% CI 0.78-2.94). The incidence increased from 35.8 to 56.9/100 000 PY (IRR 1.59, 95% CI 0.52-4.89) in male patients and from 16.4 to 22.5/100 000 PY (IRR 1.37, 95% CI 0.68-2.76) in female patients. The peak of age-specific incidence was 215.7/100 000 PY (95% CI 206.1-245.4) among 20-year-old men and 107.9/100.000 PY (95% CI 100.0-114.0) among 18-year-old women. Over the study period, the median age at first hospital contact decreased from 27 years [interquartile range (IQR) 22-34 years) to 25 years (IQR 20-34 years) in men but remained stable around 23 years (IQR 18-32 years) in women. However, for both sexes, the highest increase in incidence was seen in early adolescence. The incidence of PSD has increased significantly over the last decades. The increase is driven primarily by men and boys, with the highest increase in incidence seen in early adolescence. The increased burden of disease is not reflected in the literature, and more studies are warranted to understand the drivers of this development.