Life Expectancy Research Articles

The effect of drugs and guns on life expectancy in the United States, 2000–2020

ObjectivesThis study estimated the effect of changing trends in drug- and firearm-related mortality on life expectancy in the U.S. over the last two decades. Study designRetrospective cross-sectional study. MethodsWe used national vital registration data from CDC WONDER, stratified by sex, to estimate the mortality rate due to accidental and intentional poisoning (ICD Codes X40-X49, X60-X69, Y10-Y19 and X85), and firearm deaths (ICD codes W32-W34, X72-X74, X93-X95, Y22-Y24) for the period 2000–2020. We applied standard life table methods to all cause mortality rates with and without these mortality causes to estimate the life expectancy at each age over this period. ResultsIn 2020, mortality due to drugs and firearms combined reduced male life expectancy by1.67 years compared to 0.67 years in 2000, and without the effect of these two causes of death, male life expectancy in 2019 would have been 78.02 years. For women, drugs and firearm-related mortality reduced life expectancy by 0.20 years in 2000 and 0.63 years in 2020, and female life expectancy would have been 82.25 years in 2019 without the retarding effect of these two preventable causes. ConclusionsDrug- and firearm-related deaths have increased so rapidly, especially among younger populations, that life expectancy at birth is significantly reduced by these causes of death. Without urgent action to tackle these preventable causes of death, US life expectancy will continue to stagnate and may even decline, even without the effect of COVID-19.

Impact of age at HBsAg seroclearance on hepatic outcomes and life expectancy in men with chronic HBV infection based on multi-state modeling of the natural history.

The effects of age at HBsAg seroclearance on clinical outcomes and survival in chronic hepatitis B (CHB) have not been adequately assessed. We evaluated the impact of age at HBsAg seroclearance on long-term outcomes, along with how coexisting factors modified risks and life expectancy in CHB patients. We used multi-state modeling approach to examine transitions through the CHB continuum in a longitudinal cohort study of male civil servants recruited in 1989-1992. Hepatic outcomes and deaths were identified by clinical evaluation and linkage with national health databases. Four sets of risk factors (CHB-related, metabolic, lifestyle, and genetic factors) were assessed. Of 2551 HBsAg carriers, with follow-up until 2021 or death, 695 achieved HBsAg seroclearance, 490 developed cirrhosis (88 decompensated), 252 developed hepatocellular carcinoma (HCC), and 652 died. The cumulative rates for HCC were 1.1% and 1.5% at 10years after HBsAg seroclearance, respectively, for patients achieving seroclearance at age 50 and 60; correspondingly, the rates for cirrhosis were 2.3% and 3.0%. Developing HBsAg seroclearance was associated with a reduced risk of cirrhosis (HR = 0.37, 95% CI 0.15-0.92) but not HCC. Patients experiencing HBsAg seroclearance lived longer years free of major liver diseases than HBsAg-persistent patients, and achieving seroclearance at age 50 (vs 60) led to a greater increase in the disease-free life expectancy. However, obesity and smoking were associated with adverse hepatic outcomes and loss of the disease-free life expectancy following HBsAg seroclearance. Our findings highlight the benefit of earlier HBsAg seroclearance for gains in disease-free life expectancy and the impact of obesity and smoking on loss of the life years free of major liver diseases following HBsAg seroclearance.

Impacts of PM2.5 exposure near cement facilities on human health and years of life lost: A case study in Brazil

Cement factories significantly contribute to atmospheric pollution by generating fine particulate matter (PM2.5), which can potentially increase the mortality risk. The lack of information on the health impacts of PM2.5 pollution from cement operations in Brazil prompted this investigation. We used corrected PM2.5 measurements from low-cost sensors from March 2021 to October 2022 in Rio Branco do Sul, city in the southern region of the country and home to Latin America's largest cement plant, to assess exposure data. Disability-adjusted life years (DALY) method was applied to estimate the years of life lost (YLL) and cost estimate due to deaths from non-accidental causes, cardiovascular and respiratory diseases. The total YLL attributable to PM2.5 concentration was estimated by calculating the attributable fraction (AF) through relative risk. We also collected PM2.5 using a Harvard impactor to evaluate health risks from toxic metals components. During the study period, the analysis of chemical characterization of PM2.5 showed enrichment factors for most elements and the possible influence of the calcination process facilities on the PM2.5 levels. The mean concentration of PM2.5 exceeded the annual WHO air quality guideline (AQG) level, accounted for 3.5%, 4.7%, and 4.3% of total YLL from all causes, cardiovascular, and respiratory diseases, which corresponded to 0.23 (95% CI: 0.17–0.26), 0.06 (95% CI: 0.05–0.07) and 0.03 (95% CI: 0.01–0.06) years loss in life expectancy, respectively. An indirect health cost attributable to PM2.5 resulted in US$ 1.4 million, equivalent to about 3.5% of the total local annual health costs in Rio Branco do Sul, underscoring the significant financial burden of PM2.5 exposures. The greatest economic loss was found in the male age group of 40–69 years and among those with cardiovascular disease, rather than those with respiratory disease. Despite this, the carcinogenic and non-carcinogenic risks from inhalation of hazardous elements were within safe ranges. This work demonstrated PurpleAir's potential for air quality and public health applications. Our findings indicate health and economic benefits from reducing PM2.5 levels by adopting WHO air pollution standards. The results can guide policies toward delivering more effective health care.

Humans without a sense of smell breathe differently

Olfaction may play a restricted role in human behavior, yet paradoxically, its absence in anosmia is associated with diverse deleterious outcomes, culminating in reduced life expectancy. The mammalian nose serves two purposes: olfaction and breathing. Because respiratory patterns are impacted by odors, we hypothesized that nasal respiratory airflow may be altered in anosmia. We apply a wearable device that precisely logs nasal airflow for 24-hour-long sessions in participants with isolated congenital anosmia and controls. We observe significantly altered patterns of respiratory nasal airflow in anosmia in wake and in sleep. These differences allow classification of anosmia at 83% accuracy using the respiratory trace alone. Patterns of respiratory airflow have pronounced impact on health, emotion and cognition. We therefore suggest that a portion of the deleterious outcomes associated with anosmia may be attributed to altered patterns of respiratory nasal airflow rather than a direct result of lost odor perception per se.

Tap Water Shorts the Lifespan of Mice with Prolonged Exposure to Fractionated γ-Radiation

Assessing the role of social factors in the formation of radioresistance in chronic exposure and finding ways to increase it are important for understanding the mechanisms of the damaging effects of radiation and developing practical methods for reducing radiation risk in professionals exposed to ionizing radiation and patients undergoing radiation therapy. In this work, we investigated the ability to influence the lifespan of animals exposed to γ-radiation fractionally for a long time by replacing drinking water from tap water to distilled water. Female ICR mice (CD-1) were exposed to total 60Co γ radiation weekly in fractions for 33 weeks starting at 9 weeks of age. The dose of a single irradiation was 50 mGy, the average dose rate was 2 mGy/sec. The total radiation dose was 1.65 Gy. Control non-irradiated mice and irradiated animals were divided into 2 groups. The first received tap water, and the second received distilled water throughout the experiment. Non-irradiated animals kept on tap water showed a statistically insignificant (log-rank test, p = 0.483) reduction in average life expectancy compared to mice kept on distilled water. In animals after exposure to 60Co γ-radiation, a statistically significant (p = 0.0013) decrease in life expectancy was noted when kept on tap water and statistically insignificant (p = 0.1511) when kept on distilled water. Tap water and irradiation showed a clear synergy with a combined effect on the body of mice, expressed in a more than threefold decrease in the period of post-radiation shortening of life expectancy. Distilled water reduced the rate of death of irradiated animals and modified the rate of death of non-irradiated animals. Our data demonstrate that the reduction in life expectancy of mice kept on tap water caused by long-term fractionated irradiation can be reduced when animals are kept on distilled water.

Association between delay in diabetes development and mortality in people with obesity: Up to 33 years follow-up of the prospective Swedish Obese Subjects study.

Life expectancy is reduced in people with obesity and is further reduced in those with concomitant type 2 diabetes. The aim of the study was to assess whether a 2-year delay in diabetes development influences life expectancy in people with obesity. Participants from the Swedish Obese Subjects study without diabetes at baseline and known diabetes status at the 2-year follow-up were included: bariatric surgery (n = 1471) and usual obesity care (n = 1392). Median follow-up was 26.1 years (interquartile range: 22.7-28.7 years). The Swedish Cause of Death Register, case sheets and autopsy reports were assessed to determine the direct cause of death. Analyses were adjusted for preselected risk factors: inclusion year, sex, baseline age, body mass index (BMI) and smoking. Across both study arms, 146 participants were newly diagnosed with type 2 diabetes at the 2-year examination, whereas 2717 remained diabetes-free. Most participants diagnosed with diabetes (n = 140) were from the usual care control group. During the follow-up, there were 18.3 deaths per 1000 person-years (95% confidence interval [CI]:14.1-23.9) in the group with diagnosed diabetes at the 2-year follow-up and 10.9 deaths per 1000 person-years (95% CI:10.2-11.8) in the group that remained diabetes-free (adjusted hazard ratio [HRadj] 1.60, 95% CI: 1.19-2.15, p = 0.002). The adjusted median life expectancy in the diabetes group was 3.7 years (95% CI: 1.4-6.0, p = 0.002) shorter than in the diabetes-free group. Specifically, cardiovascular mortality was higher in the group with diabetes (adj sub-hazard ratio [sub-HR] 1.74 [95% CI: 1.09-2.77], p = 0.021). A 2-year delay in diabetes development may be linked to increased life expectancy, possibly due to a reduction in cardiovascular mortality. Future studies should confirm these findings.

Fostering economic growth in Somalia: the role of life expectancy and environmental degradation

Economic growth is a primary objective for countries worldwide since it has a pivotal impact on enhancing living standards, alleviating poverty, and promoting general societal well-being. Hence, this study examines the connection between life expectancy, environmental pollution, and economic growth in Somalia by using time-series data from 1990 to 2020. The study employs the autoregressive distributed lag (ARDL) bound test and fully modified ordinary least squares (FMOLS) method. The empirical results of the bound test indicate that life expectancy is statistically significant and positively affects economic growth in the long run. However, it does not significantly affect economic growth in the short run. Furthermore, environmental pollution does not significantly impact economic growth in the long run but enhances it in the short run. The study indicates that life expectancy improves economic growth. Based on the empirical evidence, the study provides several policy implications, including public health initiatives, health-related infrastructure, and sustainable environmental practices, which are recommended.

On the Road Safety: Gender Differences in Risk-Taking Driving Behaviors Among Seniors Aged 65 and Older.

Background/Objectives: Life expectancies have increased in most countries, leading to a higher accident rate among older drivers than their younger counterparts. While numerous studies have analyzed the decline in cognitive abilities and physical limitations as contributing factors, there are other considerations. For instance, younger male drivers tend to take more risks than younger female drivers. However, there is a lack of research and evidence regarding the role of gender in risk-taking among individuals over 65. Given this gap, our current study aims to investigate the relationship between gender and risk propensity in this particular age group. The primary goal was to determine if driving experience affects the gender gap in risk attitude; Methods: We studied risk behavior in both car drivers and pedestrians. Our sample included 200 individuals (101 women), all over 65, with the same weekly driving times. After a brief demographic and anamnestic interview, they completed the Driver Road Risk Perception Scale (DRPS) and the Pedestrian Behavior Appropriateness Perception Scale (PBAS) questionnaires. They also provided information about traffic violations and road crashes; Results: Our research revealed that older male drivers continue to tend to risky behavior, highlighting the need for targeted interventions to improve risk awareness, especially among older men; Conclusions: Our findings suggest that road safety messages should specifically target male drivers as they are less likely to view responsible driving actions, such as observing speed limits, as desirable.

Research Progress in the Medicine-Food Dual Use of Astragalus for Gastrointestinal Tumors.

Gastrointestinal tumors have a major impact on human life expectancy and quality of life and are a major cause of personal and social hygiene stress. Gastrointestinal tumors are the main cause of cancer-related death, and the main treatment methods are surgery, radiotherapy, and chemotherapy. However, they also cause great damage to the body and have a poor prognosis after surgery. Therefore, we urgently need safe and effective drugs to intervene in gastrointestinal tumors. In recent years, Traditional Chinese Medicine has been widely used in tumor treatment as a complementary and alternative therapy. Astragalus membranaceus is one of the main herbal medicines with tonic effect and one of the important components of many antitumor herbal compounds. Astragalus polysaccharides, saponins, and flavonoids are the main active components of Astragalus, all of which have antitumor effects. In this article, we studied the mechanism of action of Astragalus and its active ingredients in the intervention of gastrointestinal tumors in recent years and suggested a new approach for the study of Astragalus intervention in gastrointestinal tumors from the perspective of the homology of medicine and food.

Rebooting the Adaptive Immune Response in Immunotherapy-Resistant Lung Adenocarcinoma Using a Supramolecular Albumin.

Despite the availability of immune checkpoint inhibitors (ICBs) significantly prolonging the life expectancy of some lung adenocarcinoma (LUAD) patients, their implementation and long-term effectiveness are hampered by the growing issue of acquired resistance. Herein, the bioinformatics analysis of immunotherapy-resistant LUAD patients and the system analysis of Anti-PD1-resistant mice models once again validate that the resistance-associated Wnt/β-catenin pathway offers a promising avenue for ICB sensitization. Consequently, a mild and convenient self-assembly between albumin and carnosic acid (CA), a Wnt inhibitor is employed, to develop a supramolecular albumin known as ABCA, serving as a reactivator for ICB. As anticipated, ABCA effectively suppress the Wnt/β-catenin cascade in vitro and leads to significant inhibition of cell proliferation while promoting apoptosis. Most notably, ABCA restores the anticancer efficacy of Anti-PD1 in immunotherapy-resistant LUAD orthotopic allografting mice models by reinvigorating the adaptive immune response mediated by T lymphocytes. Furthermore, ABCA exhibits minimal adverse effects during treatment and high-dose toxicity tests, underscoring its excellent potential for clinical translation. Collectively, the present work possesses the potential to provide innovative perspectives on the advancement of optimized immunotherapies targeting drug resistance, while also presenting a promising avenue for translating Wnt inhibitors into immunotherapeutic drugs for their clinical application.

Variation in Morphological Characteristic and Growth Rate of Isolated Dikaryotic Ganoderma boninense Mycelia on Nutrient Medium and Rubberwood Block: A Cue for Their Virulency

Undeniably, the formation of new Ganoderma variants within the plantation rapidly declines the life expectancy of oil palm trees. The produced variants induce severe infection on the palm, largely impeding disease management approaches to prevent infection. Selection of the high virulent of Ganoderma spp. affiliated with stem rot disease is crucial for assessing the planting material to identify either resistant or tolerant oil palm cultivars and optimise treatment strategies in line with species varieties. So far, the genetic diversity and virulency of these Ganoderma species in the IOI Group estate have not yet been explored. About seven basidocarps were collected from Ganoderma-infected palms and identified as Ganoderma boninense. The cultural traits of these nine isolates, including P4.1E and PER71 showed distinct phenotypical variations on potato dextrose agar (PDA). Though sequence analysis revealed four PM09C isolates were 100 per cent identical, incompatible reactions were observed among isolates, similar to other isolates from different fields. The mycelia rate expansion on the nutrient medium had a significantly correlated relationship to the disease incidence (DI) (r = 0.750), disease severity index (DSI) (r = 0.690) and death rate (DR) (r = 0.732). Overall, these findings contribute to the understanding of Ganoderma species in the estate and provide valuable insights for developing targeted management strategies in evaluating tolerant planting material for future replanting. Keywords: Ganoderma, oil palm, basal stem rot, genetic diversity, virulency.

Global variations in elderly cancer mortality pattern in 2020 & prediction to 2040: A population-based study

Background & objectives Cancer contributes to decreasing life expectancy, especially in low- and middle- income countries (LMIC) and countries in transition where resources for diagnosis and care are limited. As the world population is ageing, and by 2050, two-thirds of the population in LMIC will be elderly, the greater impact of cancer on the expectation of life in years at a given age of an adult will be seen in these countries. Methods Estimated cancer mortality for older adults (60 yr or above) was estimated using statistics available on Globocan 2020 platform (gco.iarc.fr). This platform provided the number of deaths and age‐standardized truncated mortality rates (per 100,000) by sex and continent. We calculated the projected cancer deaths in 2040 by applying the projection model, considering a stable rate. Results Globally, with an estimated 7.5 million deaths, cancer deaths in older population represented a total of 71.2 per cent of all cancer-related deaths. The truncated age-adjusted mortality rate among the older population (both sexes) was estimated as 615.1 deaths per 100,000 and the mortality rate was 62.6 per cent higher in elderly (60 yr or above) males as compared to elderly females. The overall future cancer death among the elderly was estimated to increase from 7.05 to 12.7 million deaths, representing a total 80.2 per cent increase in deaths by 2040. Interpretation & conclusions The projected mortality increase will challenge existing healthcare systems, especially in lower or lower medium-income countries where resources are limited. Elderly patients are at an elevated risk of adverse outcomes due to the high prevalence of co-morbid conditions. Geriatric oncology will play an important role in the coming years to ensure the overall health and well-being of elderly patients, which needs to be supported by good stratified data on elderly cancer.

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.

A Survey on Computational Methods in Drug Discovery for Neurodegenerative Diseases.

Currently, the age structure of the world population is changing due to declining birth rates and increasing life expectancy. As a result, physicians worldwide have to treat an increasing number of age-related diseases, of which neurological disorders represent a significant part. In this context, there is an urgent need to discover new therapeutic approaches to counteract the effects of neurodegeneration on human health, and computational science can be of pivotal importance for more effective neurodrug discovery. The knowledge of the molecular structure of the receptors and other biomolecules involved in neurological pathogenesis facilitates the design of new molecules as potential drugs to be used in the fight against diseases of high social relevance such as dementia, Alzheimer's disease (AD) and Parkinson's disease (PD), to cite only a few. However, the absence of comprehensive guidelines regarding the strengths and weaknesses of alternative approaches creates a fragmented and disconnected field, resulting in missed opportunities to enhance performance and achieve successful applications. This review aims to summarize some of the most innovative strategies based on computational methods used for neurodrug development. In particular, recent applications and the state-of-the-art of molecular docking and artificial intelligence for ligand- and target-based approaches in novel drug design were reviewed, highlighting the crucial role of in silico methods in the context of neurodrug discovery for neurodegenerative diseases.

Clinical case of a live-born child with triploidy

Theoretical data on etiopathogenesis, clinical manifestations of triploidy, life expectancy of children in case of live-birth with this chromosomal anomaly are presented. A clinical case of a triploidy in a child is described. The girl was born from the first pregnancy from young healthy parents. Parents are not close relatives. Pregnancy was complicated with anemia, recurrent threats of miscarriage, progressive lack of water, progressive violation of uteroplacental blood flow and delay in fetal development. A congenital heart defect was diagnosed prenatally. The girl was born at 38 weeks of pregnancy with low indicators of physical development by caesarean section. Multiple developmental anomalies and malformations were revealed after birth. Combined congenital heart disease was confirmed by instrumental examination. Karyotyping revealed karyotype 69, ХХХ. Dynamic observation revealed that the child's age-related skills were not formed. Epileptic seizures occurred from the age of 4 months. The seizures had a status course. Surgical correction of congenital heart disease was performed in two stages: at 4.5 months and at 9.5 months in this patient. A fatal outcome occurred with an increase in multiple organ failure at the age of 10 months. The features of the clinical case, the possibilities of prenatal diagnosis of triploidy are analyzed.

Multi-Class Detection of Neurodegenerative Diseases from EEG Signals Using Lightweight LSTM Neural Networks.

Neurodegenerative diseases severely impact the life of millions of patients worldwide, and their occurrence is more and more increasing proportionally to longer life expectancy. Electroencephalography has become an important diagnostic tool for these diseases, due to its relatively simple procedure, but it requires analyzing a large number of data, often carrying a small fraction of informative content. For this reason, machine learning tools have gained a considerable relevance as an aid to classify potential signs of a specific disease, especially in its early stages, when treatments can be more effective. In this work, long short-term memory-based neural networks with different numbers of units were properly designed and trained after accurate data pre-processing, in order to perform a multi-class detection. To this end, a custom dataset of EEG recordings from subjects affected by five neurodegenerative diseases (Alzheimer's disease, frontotemporal dementia, dementia with Lewy bodies, progressive supranuclear palsy, and vascular dementia) was acquired. Experimental results show that an accuracy up to 98% was achieved with data belonging to different classes of disease, up to six including the control group, while not requiring particularly heavy computational resources.

Modern etiotropic therapy of chronic viral hepatitis B

Chronic viral hepatitis B (CHB) is a significant global health problem. The biological characteristics of the hepatitis B virus, which causes this disease, significantly impede the achievement of complete virus elimination in most patients. In this regard, the rational choice of drugs and antiviral therapy regimens is crucial for increasing life expectancy and improving the quality of life in patients with CHB. The purpose of this literature review is to identify current approaches and trends in etiotropic therapy for CHB.Materials and methods. The review uses data published in domestic and foreign scientific journals, clinical guidelines, regulatory documents, and Internet resources.Results. Currently, the most effective means of etiotropic therapy for CHB are interferons (standard interferon alpha, pegylated interferons alpha-2a and alpha-2b), as well as first-line nucleoside/nucleotide analogs (entecavir, tenofovir) and second-line analogs (lamivudine, telbivudine, adefovir). The choice of a specific drug is determined by the patient's clinical condition, preferences, availability, and cost of treatment. Despite certain limitations of current etiotropic therapies for CHB, their use can significantly increase patients' life expectancy and improve their quality of life.

Coping strategies associated with art adherence among older adults living with HIV, South Carolina

ABSTRACT People living with HIV/AIDS (PLWH) are living longer due to improvements in HIV care including antiretroviral therapy (ART). Even though ART improves HIV prognosis and life expectancy, its adherence is hindered by many factors. As the population of older adults living with HIV (OALH) continues to increase, it is important to understand the psychosocial factors that are associated with living with HIV to improve ART adherence. The aim of this study was to determine the association between coping strategies and ART adherence. Data were obtained from 91 OALH at an immunology clinic in Columbia, South Carolina via purposive sampling. The participants were at least 50 years or older and living with HIV. Coping was assessed using the Brief COPE Inventory. Crude and adjusted linear regression models, controlling for age, race, gender, and were used to determine the association between coping strategies and ART adherence. Subgroup analyses were done to determine if the association between coping and ART adherence varied by gender. The analyses were conducted in SAS version 9.4. The mean difference in ART adherence was statistically significant for race (p = 0.0292). There was a statistically significant association between religion and ART adherence (β = −0.718, p = 0.024). Males who use venting as a coping mechanism had higher ART adherence (β = 1.227, p = 0.048), and males who use behavioral disengagement had lower ART adherence (β = -1.624, p = 0.003) after adjusting for age and race. OALH who use religion as a coping strategy were less likely to adhere to ART treatment. Venting and behavioral disengagement tend to be associated with ART adherence among men. Qualitative research is needed to delve deeper into the relationship between religious coping and ART adherence, especially among OALH.

Prognostic factors and outcomes of chronic limb threatening ischaemia in patients post kidney transplant: a systematic review

BackgroundKidney Transplantation (KT) is widely recognized as the optimal treatment for patients with End Stage Renal Disease (ESRD), improving not only life expectancy but also quality of life. Undetected peripheral arterial disease (PAD) in patients undergoing KT may lead to lower limb ischaemic ulceration and gangrene which is associated with an increased mortality rate. If undiagnosed and untreated this may lead to limb loss and graft failure. This review aims to evaluate the current evidence related to the prognosis of chronic limb-threatening ischemia (CLTI) in patients with a KT.MethodsWe conducted a systematic review of the literature in PubMed and MEDLINE, the Cochrane database of systematic reviews, Elsevier, Web of Science, and CINAHL using relevant search keywords to identify the prognosis and progression of CLTI in patients with a KT. Outcomes of interest were CLTI and progression rate in terms of haemodynamic measurement. This systematic review adhered to the guidelines set forth by the Cochrane Collaboration. The study design, population selection, and follow-up time frame were outlined in accordance with the PRISMA guidelines.ResultsStudies have shown a decline in the ankle-brachial index (ABI) post-KT, indicating vascular deterioration. Surgical interventions and amputations are more likely, particularly on the ipsilateral side of KT. The infrapopliteal artery is the most compromised in this cohort. A low ABI was found to be an independent predictor of graft failure, doubling the risk of mortality post-KT. Quality of evidence was observed to be low primarily due to confounding and selection bias.ConclusionsThe available evidence regarding the prognosis of CLTI in individuals with KT is limited to a small number of studies offering predominantly low-quality evidence and conflicting results pertaining to PAD and its progression into CLTI. Further research is required on CLTI prognosis and progression among KT recipients.

Evolving trends in oral cancer burden in Europe: a systematic review

IntroductionOral cavity cancer (OCC), primarily oral squamous cell carcinoma (OSCC), is a growing concern in Europe, particularly among younger populations. Preventable lifestyle factors and social determinants of health contribute significantly to the disease burden. Limited access to healthcare and delayed diagnoses further complicate treatment and reduce survival rates.MethodsThis systematic literature review adhered to PRISMA guidelines to explore trends in OSCC epidemiology, etiology, diagnosis, treatment, and survival across Europe. A comprehensive search strategy using PubMed, GLOBOCAN data, and the EUROCARE-5 study identified relevant articles focusing on human populations in Europe with a primary interest in OSCC epidemiology. Only peer-reviewed publications in English with full-text access were included.ResultsThis study investigated the burden of OSCC across Europe, revealing variations in incidence, mortality, and prognosis. Eastern and Central Europe displayed the highest burden. Males exhibited a significantly higher risk compared to females. Age-related disparities existed in life expectancy and time to achieve favorable outcomes. HPV emerged as a growing risk factor for oropharyngeal cancer. Public health strategies should target modifiable risk factors and improve early detection.ConclusionThis review reveals concerning disparities in European OSCC. Region, sex, and age all influence burden and prognosis. Future research should focus on controlling risk factors and personalized medicine to optimize treatment. This will lead to a Europe with reduced OSCC incidence and demonstrably better patient outcomes.