Multicenter Epidemiological Study Research Articles

Inhaled antiseptics and inhaled antiviral non-prescription drugs in the prevention of ARVI, in particular COVID-19: an epidemiological study

BACKGROUND. The article presents the results of a continuous, cross-sectional, non-interventional, multicenter retrospective epidemiological study, which included cases of 3443 participants. Questionnaires and rapid test for antibodies to SARS-CoV-2 were used to collect data.
 OBJECTIVE. To determine the relationship between the systematic use of additional drugs for the prevention of COVID-19, including inhaled antiseptics and inhaled antiviral drugs, separately and in combination with other drugs, and the risk of developing of coronavirus disease (COVID-19).
 RESULTS AND DISCUSSION. 396 participants (11.8 %) took inhaled antiseptics in any period since March 2020, and 410 participants (12.2 %) took inhaled antivirals. A statistically significant protective relationship between episode of COVID-19 when taking inhaled antiseptics and inhaled antiviral drugs (risk ratio 0.901; 95 % confidence interval 0.856-0.948) was determined.
 CONCLUSIONS. The use of inhaled antiseptics and inhaled antiviral drugs as additional methods of prevention of COVID-19 has shown a statistically significant effect not only on reducing the risk of COVID-19, but different combinations of inhaled antiseptics or inhaled antiviral drugs with other drug groups as additional methods of preventing COVID-19 had a statistically significant protective relationship with the episode of the disease, with the severity of COVID-19 and with the need for hospitalization.

A Multicentric Prospective Study on Maxillofacial Trauma Due to Road Traffic Accidents: The World Oral and Maxillofacial Trauma Project

Abstract The purpose of this prospective multicenter study was to analyze the epidemiology, patterns, and management of maxillofacial fractures due to road traffic accidents (RTAs) worldwide. Between Monday September 30, 2019 and Sunday October 4, 2020,1066 patients with RTAs related fractures were admitted to 14 maxillofacial surgery departments. The following data were analyzed: age, gender, mechanism of injury, alcohol or drug abuse at the time of trauma, maxillofacial fracture site, facial injury severity scale (FISS) score, associated injuries, day and month of trauma, time of treatment, type of treatment and length of hospital stay. Data were analyzed using bivaried and multivaried statistical analysis. Eight hundred seventy patients were male, and 196 were female. The most common mechanism of injury was motorcycle accidents (48%). More than half of the patients had fractures of the middle third of the maxillofacial skeleton. In total, 59% of the study sample underwent open reduction internal fixation. The median facial injury severity scale (3 points) and the medial hospital stay (3 days) were significantly lower in patients with seatbelts and helmet (P < 0.001). This first prospective, multicenter epidemiological study shows that motorcycle accidents are the leading cause of RTAs related fractures, mostly in young males. Particularly in Australia and Europe, the incidence of RTAs was significantly lower. Moreover, this study found that the severity of maxillofacial lesions was significantly higher in patients without safety devices, with consequent longer hospital stay demonstrating the efficacy of road safety policies in preventing maxillofacial injury.

Arterial stiffness measured according to the cardio-ankle vascular index in the persons with pre-diabetes and diabetes mellitus in the population sample of the Russian Federation

Abstract Aims To study the characteristics of the cardio-ankle vascular index (CAVI) and predictors of increased arterial stiffness in patients with carbohydrate metabolism disorders (CMD). Methods A cross-sectional study was conducted within the framework of the multicenter epidemiological study “Epidemiology of cardiovascular diseases and their risk factors in the Russian Federation” (ESSE-RF) from March to October 2013. The object was a random population sample of the adult male and female population of the Kemerovo region (Western Siberia, Russia) aged of 25–64 years. The standard protocol of the ESSE-RF has been expanded with investigation of peripheral arteries wall stiffness (VaSeraVS-1000, Fukuda Denshi, Japan) with automatic CAVI calculation. A total of 1617 subjects were divided into three groups: group 1 – patients with type 2 diabetes mellitus (n=272), group 2 – patients with pre-diabetes (n=44), group 3 –without any confirmed CMD (n=1301). Results A trend for the similarity of clinical, instrumental (including arterial stiffness measured by CAVI) and laboratory characteristics in patients with type 2 diabetes and prediabetes was revealed, with a significant difference from patients without CMD. A direct correlations of CAVI with age (p<0.001), male gender (p<0.001), type 2 diabetes (p<0.001), prediabetes (p=0.002), visceral obesity (p<0.001), level of total cholesterol (p<0.001), triglycerides (p<0.001), low density lipoprotein cholesterol (p<0.001), and inverse correlations of CAVI with the glomerular filtration rate (GFR) using the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formula (p<0.001) were revealed in the general sample. Further, the patients were divided into 2 groups - with disorders of carbohydrate metabolism (prediabetes and diabetes) and normoglycemia, and in each group, predictors of increased arterial stiffness (pathological CAVI) were analyzed. According to the results of multivariate regression analysis in both groups, age, arterial hypertension, systolic and diastolic blood pressure, and a decrease in GFR CKD-EPI were predictors of pathological CAVI (Table). Male gender became a predictor of increased arterial stiffness only among patients with normoglycemia, and there was no effect among patients with CMD (Table). Conclusions An increase in CAVI is associated with diabetes mellitus 2, prediabetes, increasing age, systolic and diastolic blood pressure and decreased GFR. An increase in arterial stiffness occurs already in the prediabetes stage. Identifying of prediabetes is important because prediabetes and type 2 diabetes are similar in many ways. Funding Acknowledgement Type of funding sources: None. Correlations of CAVIPredictors of pathological CAVI

Epidemiology of pediatric hand surgery emergencies. Retrospective study of 245 patients seen over 10 months in two referral centers

BackgroundThe primary objective of this retrospective study was to analyse the epidemiology and assess the characteristics of all paediatric hand injuries requiring emergent surgery. HypothesisPaediatric hand emergencies that require surgical treatment have a specific epidemiological distribution. MethodsWe conducted a multicentre retrospective descriptive epidemiological study of surgical paediatric hand emergencies seen over 10 consecutive months. ResultsWe included 245 patients between the 1st of January and the 31st of October 2016. Irrespective of age, most injuries (69%) occurred at home; 11% (n=26) occurred at school and 4% in a sports centre. Overall, most injuries involved the dorsal aspect and affected the fingers more often than the hand. The most common lesion was crush injury of a distal phalanx (36% of cases). Door guards were in use in only 9% of homes (n=8), and mean age of the patients in this group was 5 years Paronychia/acute infections accounted for 27% of cases. Wounds of the hands of fingers made up 23% of cases, with the palmar aspect being involved in 70% of cases. The wound was often due to the use of a sharp-edged object. Fractures/dislocations accounted for 12% of cases and bites or scratches for 2%. DiscussionThis study showed that the most common hand injuries requiring emergent surgery in a paediatric population are crush injuries of the fingertip such as door-crush injuries, which most often occur at home. Reinforcing prevention strategies should be the main priority in order to decrease the incidence of hand lesions in children. Raising awareness among parents and improving the education of the public could significantly decrease the incidence of these injuries. Level of evidenceIV; retrospective cohort.

Comparisons of Treatment for HER2-Positive Breast Cancer between Chinese and International Practice: A Nationwide Multicenter Epidemiological Study from China.

Objective To better understand the status of medical treatment for human epidermal growth factor receptor 2 (HER2)-positive breast cancer and the differences between the Chinese and the international clinical practice. Methods This was a retrospective, nationwide, multicenter, epidemiological study of advanced breast cancer patients from China. Between January 01, 2012, and December 31, 2014, a total of 3649 patients, covering 7 geographic regions and 21 institutions, participated in this series of studies. HER2-positive breast cancer was selected among the group and adopted into this study. In comparison, we summarized the demographics and clinical characteristics of HER2-positive breast cancer from the Surveillance, Epidemiology, and End Results (SEER) database. Results A total of 918 patients diagnosed as HER2-positive breast cancer patients were included. The median age at diagnosis was 46 years (ranging, 23 to 78) with a single-peak incidence. The proportions of stages II–IV at diagnosis and distance metastasis in viscera were more than half of the participants. In comparison, the prevalence of estrogen or progesterone receptor-positive expression and luminalB subtype was relatively lower than that of the United States. The receipt of chemotherapy was fairly higher, while the usage of targeted therapy was seriously insufficient. Tumor size was in significantly positive associations with the duration of targeted therapy (Kendall's correlation coefficient = 0.3, P < 0.0001), while no prohibitive variables among clinical characteristics were detected. Conclusion Our study suggested that HER2-positive breast cancer patients were characterized as a younger trend, a lower prevalence of hormonal receptor (HR)-positive expression, and less accessible to anti-HER2 targeted therapy with insufficient duration over the past few years in China. Concerted efforts should be exerted for promising survival benefits in the future. The trial registration number is https://clinicaltrials.gov/ct2/show/NCT03047889.

Profile, treatment patterns, and influencing factors of anthracycline use in breast cancer patients in China: A nation‐wide multicenter study

BackgroundAnthracycline‐based chemotherapy (ABC) is one of the standard therapies against breast cancer. However, few guidelines are currently available to optimize the use of ABC. Therefore, the present analysis aimed at determining the profile and treatment patterns of ABC and the association of clinicopathological characteristics with ABC selection.MethodsWe retrospectively analyzed the data of a nation‐wide multicenter epidemiological study, which collected the medical records of breast cancer patients receiving chemotherapy in different settings from seven geographic regions in China (NCT03047889).ResultsIn total, 3393 patients were included, with 2917 treated with ABC. Among them, 553 (89.8%), 2165 (81.7%), and 814 (25.7%) were subjected to ABC as neoadjuvant, adjuvant, and advanced chemotherapy, respectively. The most frequently used regimens were anthracycline‐taxane‐based combinations for neo‐ and adjuvant chemotherapy, along with taxanes and oral fluorouracils for the palliative stages. In the overall cohort, patients aged < 40 or 40‐65 (p < 0.001), in premenopause (p < 0.001), without comorbidities (p = 0.016), with invasive ductal carcinoma (p= 0.001), high lymph node involvement (p < 0.001), in the pTNM stage II, III, or IV versus stage I (p < 0.001), subjected to mastectomy (p < 0.001) or subjected to sentinel lymph node biopsy combined with axillary lymph node dissection (p = 0.044), or with a decreased disease‐free survival (p < 0.001) were more likely to be recommended to ABC.ConclusionTaken together, ABC remained the mainstay of breast cancer treatment, especially in neo and adjuvant therapy. ABC was mainly used as a combination therapy, and the correlation between influencing factors and ABC choice varied during different settings, indicating the preference and different perspectives of medication considered by medical oncologists regarding the use ABC in China.

A multicentric clinical and epidemiological study of chronic and recurrent dermatophytosis in India.

There has been an alarming increase in the prevalence of chronic, recurrent and steroid modified dermatophytosis of the glabrous skin in the recent years in India. There is paucity of literature on the magnitude of this major public health problem. To estimate the prevalence of dermatophytosis and clinico-epidemiological features of chronic and recurrent dermatophytosis (CRD) across India and to evaluate the associated risk factors. This is a multicentric descriptive cross-sectional study conducted in 13 centres situated across India in two phases during dry and rainy seasons. All consecutive patients presenting with dermatophytosis were screened during the study period of 14 consecutive working days. Patients with CRD of the glabrous skin as per the case definition were included after exclusion of isolated hair and nail infections. Demography, clinical findings and results of potassium hydroxide wet mount were recorded. A total of 41,421 patients were screened, out of which 7174 (17.31%) patients had glabrous dermatophytosis. CRD was observed in 1999 (27.86%) patients with 78.08% and 21.95% of chronic and recurrent dermatophytosis, respectively. Family history was present in 50.03% of patients. History of sharing of fomites was present in 50.37% of them. Synthetic tight clothes were worn by 43.47%, while 50.9% gave history of misuse of topical corticosteroid creams. Multiple site involvement was common (69.58%) with tinea cruris (79.99%) and tinea corporis (75.69%) being the most common clinical types. CRD is associated with sharing of fomites, topical corticosteroid misuse and involvement of multiple sites.

Frequency of Sexual Problems and Related Psychosocial Characteristics in Cancer Patients-Findings From an Epidemiological Multicenter Study in Germany.

BackgroundMultimodal cancer treatments are often associated with sexual problems. Identifying patients with sexual problems could help further elucidate serious issues with their sexuality and thus promote or maintain patients’ sexual health. We aimed to assess the occurrence of sexual problems in patients across different tumor locations and to explore associated sociodemographic, medical and psychosocial factors.MethodsWe included 3,677 cancer patients (mean age 58 years, age range 18–75 years, 51.4% women) from a large epidemiological multicenter study in Germany on average 13.5 months after cancer diagnosis. The occurrence and frequency of sexual problems were assessed via a binary item on the problem checklist of the Distress Thermometer (DT). Controlled associations of these problems with sociodemographic, medical and psychosocial factors including distress (DT), anxiety (GAD-7), depression (PHQ-9), quality of life (EORTC-QLQ-C30), and social support (SSUK-8) are analyzed using logistic regression analysis.ResultsWe found that 31.8% of patients reported sexual problems, with a significant higher proportion in men (40.5%) compared to women (23.7%), OR 2.35, 95% CI [1.80–3.07] and a higher proportion in patients with a partner (35.6%) compared to those without a partner (3.5%), OR 2.83, 95% CI [2.17–3.70]. Tumor location was associated with occurrence of sexual problems: patients with cancer, affecting the male genital organs had the highest chance for sexual problems, OR 2.65, 95% CI [1.18–3.95]. There was no significant difference in the occurrence of sexual problems between age groups OR 0.99, 95% CI [2.13–3.53] and type of therapy (e.g., operation OR 0.91, 95% CI [0.72–1.15]). Sexual problems were further associated with elevated levels of anxiety, OR 1.05, 95% CI [1.02–1.10], less social support, OR 0.93, 95% CI [0.90–0.97] and lower quality of life in terms of impaired functioning (e.g., social function, OR 0.99, 95% CI [0.99–1.00]).ConclusionsSexual problems are commonly reported by patients. Male patients and those living with a partner are more likely to report sexual problems. Sexual problems are associated with different aspects of well-being. The findings imply the practical relevance to screen for sexual problems among patients and identified groups that should be particularly monitored.

Systematic review of the epidemiological characteristics of inhalation injury in burn patients in China

Objective: To study the epidemiological characteristics of inhalation injury in burn patients in China. Methods: The systematic review method was performed. Chinese Journal Full-text Database, Wanfang Database, and Chinese Biomedical Literature Database were searched with the Chinese search terms of ", , ", and PubMed and Embase were searched with the search terms of "burns, inhalation injury" to retrieve the collected retrospective studies on the epidemiological characteristics of inhalation injury in burn patients in China from the establishment of each database to January 2019. Data were extracted from the included articles, including the first author, study institution, study period, study subjects, number of burn patients, incidence of inhalation injury, and gender, age, causes of injury, mortality, and causes of death in patients with inhalation injury. Results: A total of 24 articles were included in this study with the first authors being from multiple research institutions across the country. The articles reported single or multi-center epidemiological studies with statistics on the incidence of inhalation injury in burn patients or severe burn patients admitted to key burn treatment institutions in many provinces/cities in China from 1958 to 2016. The number of burn patients included was 103-64 320 cases in the studies, and the incidence of inhalation injury in hospitalized burn patients ranged from 4.89% to 11.28%, with no obvious trend. The incidence of inhalation injury in severe burn patients was still high, from 19.09% to 32.38% as most articles reported. The number of men with inhalation injury was larger than that of women, with a male-to-female ratio of 1.61 ∶1.00-4.95 ∶1.00; young and middle-aged people were the high-risk population, and flame burn was the main cause of injury. The mortality of patients with inhalation injury was 5.17%-58.67%, of which the mortality was 5.17%-24.75% since 2000, in accordance with reports from hospitals in various regions that the mortality in the later period decreased significantly compared with the previous period. The causes of death in patients with inhalation injury included upper respiratory tract obstruction, sepsis, respiratory failure, and severe pulmonary infection. Conclusions: From 1958 to 2016, there is no obvious trend in the incidence of inhalation injury among burn patients in China; the incidence of inhalation injury is high in young and middle-aged males, and the main cause of inhalation injury is flame burn. The mortality of inhalation injury generally decreased since 2000 compared with the previous period.

Epidemiology of Myopia in Children of the Russian Federation and Analysis of Its Control Methods

The increasing prevalence of myopia is observed all over the world, and Russia is no exception. In this regard, obtaining new data on its epidemiology among children and assessing methods of its control in real clinical practice are highly topical matters.Purpose. The purpose of this work was to assess the current issues of the epidemiology and treatment of progressive myopia in children in various regions of the Russian Federation.Materials and methods. We conducted a prospective multicenter epidemiological observational questionnaire study. This study involved 106 doctors from 53 regions of Russia and 2931 parents of myopic children.Results. 50% of the surveyed doctors noted that the manifestation of myopia is diagnosed in children aged 10–12 years, while 43% noted the same in children aged 7–9 years. According to 74.5% of doctors, the degree of the newly diagnosed myopia ranges from –1.25 to –3.00 diopters, 25.5% of doctors reported that it is below –1.0 diopters. The majority of doctors (73.6%) assess accommodation in myopic children, considering it one of the progression factors. 52.9% of ophthalmologists prescribe optical correction in cases when monocular distance visual acuity amounts to 0.6 (decimal scale) or lower values, while 29.2%, 16% and 1.9% of the surveyed ophthalmologists prescribe optical correction in cases when monocular distance visual acuity amounts to 0.7, 0.8 and 0.9 respectively.The following optical methods for juvenile myopia control are recommended by the doctors: orthokeratology contact lenses (53.8%), spectacles for full correction (51.9%), peripheral defocus-inducing (bifocal) soft contact lenses (18.9%), while 4.7% of the surveyed doctors utilized other methods of myopia control, which were not indicated in the questionnaire.Conclusion. In most cases, manifestation of myopia is diagnosed in children aged 7–12 years. Its degree ranges from –1.25 to –3.0 diopters, which indicates its late diagnosis; optical correction is prescribed mainly in cases when monocular distance visual acuity is 0.6 or lower; most ophthalmologists assess accommodation in myopic children, considering it a progression factor. As methods of myopia control, doctors utilize optical correction, device-assisted therapy and pharmacological treatment of accommodative disorders, while parents prefer methods that require minimum time expenditures.

Dispositif intra-utérin au cuivre (DIUc) : comparaison de la tolérance et de l’efficacité chez des nullipares et des multipares sur 6 mois

IntroductionThe copper-containing intra-uterine device IUD (cIUD) is a non-hormonal, effective, long-acting method of contraception, which is not widely used in nulliparous patients in France. The objectives of the study are to compare the safety of the cIUD by the rate of continuation at 6 months between nulliparous and parous patients, and to assess the complications and side effects at insertion and during follow-up.Material and method This is a multicenter prospective epidemiological study with follow-up for 6 months. The adult patients were included in Nantes from February 2019 to October 2019 during the insertion of a IUD in different centers: the student health service (SUMPPS) (Nantes), the Clotilde de Vautier center in the Clinic Jules Verne (Nantes) and in the gynecological offices of the city of Nantes. ResultsA total of 94 patients were included during the insertion of the cIUD. At 6 months, 77 patients answered the second questionnaire, 49 patients were nulliparous and 28 were parous. The pain on insertion was greater in nulliparous patients with a VAS of 6.5±2.4 (0–10) versus 3.9±2.2 (0–8) for multiparous patients (P<10−4). The 6-month continuation rate for the cIUD was 92.8% for 83.4% for nulliparous patients, and parous patients with no significant difference (P=0.25). Expulsion was the only complication found with 12.2% in nulliparous and 3.5% in parous (P=0.40). Otherwise, 64% of the patients observed heavy bleeding than before without difference with the parity, and 72% of the nulliparous declared to have dysmenorrhea requiring the use of analgesics, against 47% of the parous (P=0.025). The nulliparous were very satisfied or satisfied for 89% in daily life and 96% of them in sex life, without difference compared to parous (97% and 100% respectively). ConclusionThere is no difference in the rate of continuation at 6 months between nulliparous and parous. Nulliparous complained more often of dysmenorrhea in comparison to the period before the cIUD. The satisfaction rates were comparable.

Pervasive but Neglected: A Perspective on COVID-19-Associated Pulmonary Mold Infections Among Mechanically Ventilated COVID-19 Patients.

Background: Recent studies from multiple countries have shown a high prevalence of coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) among severely ill patients. Despite providing valuable insight into the clinical management of CAPA, large-scale prospective studies are limited. Here, we report on one of the largest multicenter epidemiological studies to explore the clinical features and prevalence of COVID-19-associated pulmonary mold infections (CAPMIs) among mechanically ventilated patients.Methods: Bronchoalveolar lavage (BAL) and serum samples were collected for culture, galactomannan (GM), and β-D-glucan (BDG) testing. Patients were classified as probable CAPMI based on the presence of host factors, radiological findings, and mycological criteria.Results: During the study period, 302 COVID-19 patients were admitted to intensive care units (ICUs), among whom 105 were mechanically ventilated for ≥4 days. Probable CAPMI was observed among 38% of patients (40/105), among whom BAL culture of 29 patients turned positive for molds, while galactomannan testing on BAL (GM index ≥1) and serum (GM index >0.5) samples were positive for 60% (24/40) and 37.5% (15/39) of patients, respectively. Aspergillus (22/29; 75.8%) and Fusarium (6/29; 20.6%) constituted 96.5% of the molds isolated. Diaporthe foeniculina was isolated from a COVID-19 patient. None of the patients who presented with CAPMI were treated with antifungal drugs.Conclusion: Despite being prevalent, the absence of appropriate antifungal treatment highlights that CAPMI is a neglected complication among mechanically ventilated COVID-19 patients admitted to ICUs. CAPMI can be caused by species other than Aspergillus.

Impact of the COVID-19 pandemic on orthopedic fracture characteristics in three hospitals in Turkey: A multi-center epidemiological study

Objectives The aim of this study was to evaluate the impact of novel coronavirus-2019 (COVID-19) on the epidemiological characteristics of orthopedic fractures. Patients and methods A total of 2,960 patients (1,755 males, 1,205 females; mean age: 39.6 years; range, 1 to 98 years) with orthopedic fractures were included in the study: 552 patients during the pandemic period (March 10th and July 1st, 2020) and 1,158 control patients in the same period 2019 and 1,250 control patients in 2018. Epidemiological characteristics, injury mechanisms, fracture locations and treatment details of the patients were analyzed and compared between 2018, 2019 and 2020 for adult and pediatric populations.Results Of a total of 552 patients, 485 were adults and 67 were pediatric patients. In the control groups, of 1,158 patients (2019), 770 were adults and 378 were pediatric patients and, of 1,250 patients (2018), 857 were adults and 393 were pediatric patients. The proportion of proximal femur and hand fractures significantly increased during the pandemic period (p=0.025 and p=0.038, respectively). The most frequent surgical indication in the pandemic period was proximal femoral fracture. The proportion of home accidents as an injury mechanism significantly increased in the pandemic period compared to 2018 and 2019 (48.5% vs. 18.6% and 20.6%, respectively; p=0.000). The proportion of female pediatric patients significantly increased during the pandemic period compared to 2018 and 2019 (44.8% vs. 25.4% and 27.2%, respectively, p=0.004). The proportion of forearm fractures (p=0.001) also increased, and the proportion of tibia-fibula fractures (p=0.03) decreased. The most frequent surgical indication in pediatric patients was distal humeral fracture in both groups. Conclusion During the pandemic period, proximal femoral fractures in the elderly remained a concern. In-home preventative strategies may be beneficial to reduce the incidence of hip fractures in the elderly.

Multicenter Epidemiologic Study of Coronavirus Disease-Associated Mucormycosis, India.

During September–December 2020, we conducted a multicenter retrospective study across India to evaluate epidemiology and outcomes among cases of coronavirus disease (COVID-19)–associated mucormycosis (CAM). Among 287 mucormycosis patients, 187 (65.2%) had CAM; CAM prevalence was 0.27% among hospitalized COVID-19 patients. We noted a 2.1-fold rise in mucormycosis during the study period compared with September–December 2019. Uncontrolled diabetes mellitus was the most common underlying disease among CAM and non-CAM patients. COVID-19 was the only underlying disease in 32.6% of CAM patients. COVID-19–related hypoxemia and improper glucocorticoid use independently were associated with CAM. The mucormycosis case-fatality rate at 12 weeks was 45.7% but was similar for CAM and non-CAM patients. Age, rhino-orbital-cerebral involvement, and intensive care unit admission were associated with increased mortality rates; sequential antifungal drug treatment improved mucormycosis survival. The COVID-19 pandemic has led to increases in mucormycosis in India, partly from inappropriate glucocorticoid use.

Vitamin D deficiency in Russia: the first results of a registered, non-interventional study of the frequency of vitamin D deficiency and insufficiency in various geographic regions of the country

ОБОСНОВАНИЕ. В Российской Федерации отсутствуют широкомасштабные одномоментные многоцентровые эпидемиологические исследования, оценивающие распространенность дефицита и недостаточности витамина D в различных географических широтах. Недостаточный уровень солнечной инсоляции и неадекватное содержание витамина D в продуктах питания диктуют необходимость изучения эпидемиологической структуры низкого статуса витамина D в России.ЦЕЛЬ. Оценить частоту дефицита и недостаточности витамина D среди населения, проживающего в регионах Российской Федерации, расположенных в широтах от 45° до 70°.МАТЕРИАЛЫ И МЕТОДЫ. Проведен первый этап российского многоцентрового неинтервенционного регистрового исследования по методу «поперечных срезов» с марта 2020 по май 2020 гг.РЕЗУЛЬТАТЫ. В регионах РФ, которые представляют собой репрезентативную с географической точки зрения выборку с высоким риском развития низкого уровня витамина D, его дефицит отмечен в 55,96%, а уровень дефицита и недостаточности регистрируется в 84,01%.ЗАКЛЮЧЕНИЕ. Пристальное внимание к широкому масштабу проблемы дефицита и недостаточности витамина D в РФ будет способствовать прогрессивному формированию различных образовательных и профилактических программ, необходимых для укрепления здоровья и улучшения качества жизни населения.

Screening of the college students at clinical high risk for psychosis in China: a multicenter epidemiological study

BackgroundTo investigate a 3-stage screening procedure and explore the clinical features of subjects at Clinical High Risk (CHR) for psychosis in a representative sample of Chinese college students.MethodsAn epidemiological survey of the prevalence of the CHR syndrome in Chinese college students that was selected by stratified random sampling from Shanghai, Nanjing and Nanchang cities was done following a 3-stage procedure. Participants were initially screened with the Prodromal Questionnaire-brief version (PQ-B), and whose distress score of PQ-B exceeded 24 would be invited to a telephone assessment using the subscale for positive symptoms of the Scale of Prodromal Symptoms (SOPS)/Structured Interview for Prodromal Syndromes (SIPS). Lastly, participants who scored 3 or higher in any item of the subscale would be administered with the SIPS interview conducted by trained researchers to confirm the diagnosis of CHR syndrome.ResultsTwenty-three thousand sixty-three college students completed the survey during September 2017 to October 2018. Seventy-two students were diagnosed as CHR subjects, and the detection rate in the total sample was 0.3%. The peak age range for the first diagnosis of CHR was 17 to 20 years. Thirteen and forty-six were set as the cutoff points of PQ-B total score and distress score to balance the greatest sensitivity and specificity. Binary logistic regression revealed that 8 items in PQ-B showed significant distinction for detecting CHR subjects.ConclusionsThe 3-stage screening method can be utilized in the detection of CHR subjects for psychosis in the general population, during which delusional ideas, perceptual abnormalities and suspiciousness deserve great attention.

Histopathological Correlation (World Health Organization Classification) of Meningiomas and Their Anatomical Localization: A Multicenter Epidemiological Study in Mexico

To determine the epidemiology of the localization and histological type of meningiomas in the Mexican population and the distribution of the different histological patterns and their relationship to tumor localization and patient demographics. A retrospective analysis was performed in 5 hospitals in Mexico from 2009 to 2019. For qualitative variables, mean values were compared using Pearson χ2 test for the correlation between location and histological pattern as well as the clinical presentation and the patient's sex. Student t test was performed for age and its correlation with location and histology. Analysis of 179 patients revealed significant differences in histopathological pattern, patient sex, and tumor location. No significant differences were found for age or clinical presentation in association with any specific histological pattern. There was a correlation between the histology of the 15 histopathological varieties of meningiomas and the predilection site of appearance as well as certain demographic aspects, such as sex. This study lays the foundation for future studies in Mexico on the differentiation and typing of meningiomas regardless of the histological grade to which they belong, as the exact behavior of these tumors, including grade I tumors, remains unknown to date.

Association of smoking with coronary artery disease depending on other cardiovascular risk factors

Aim . To study the possibility of the presence of coronary artery disease (CAD) depending on the smoking status, as well as to estimate the association of smoking with other traditional risk factors in residents of Kemerovo region aged 25 –64 years. Materials and methods. We analyzed the results of the multicenter epidemiological study “Epidemiology of cardiovascular diseases and their risk factors in the Russian Federation” in Kemerovo region obtained from a random sample of 1,599 subjects aged 25–64 years. Besides the smoking status, the following parameters were analyzed: gender, age, education, diabetes mellitus (DM) and arterial hypertension (AH) history, hypercholesterolemia, hypertriglyceridemia, high level of low-density lipoproteins, low level of high-density lipoproteins (HDL), hyperglycemia, obesity, alcohol abuse, and depression. Results. Three groups were formed depending on the smoking status: group 1 included 484 (30.3%) current smokers, group 2 had 317 (19.8%) former smokers and group 3 had 798 (49.9%) individuals who had never smoked. The groups did not differ in the prevalence of CAD. When determining the rank significance of the impact of risk factors on the possibility of CAD development in the overall population, it was revealed that the age affected the risk of CAD the most, while smoking and low HDL had minimal impact. The impact of the smoking factor on CAD was higher in the representatives of the older age group; however, even in the subjects aged ≥ 50 years, the smoking factor was not the leading one and followed DM, hypertriglyceridemia, depression, and obesity. The possibility of CAD development in smokers, as opposed to individuals who had never smoked, increased when smoking was accompanied by hypercholesterolemia, hypertriglyceridemia, male sex, lack of higher education, depression, and age of ≥ 50 years. The possibility of CAD development in former smokers as opposed to nonsmokers increased when smoking was accompanied by hyperglycemia. Conclusion . Smoking is not the primary risk factor in CAD detection in the studied sample. In the presence of additional risk factors, the impact of smoking on the possibility of CAD detection increases.

SOLLID - a single centre study to develop methods to investigate the effects of low radiation doses within nuclear medicine, to enable multicentre epidemiological investigations.

There is continuing debate concerning the risks of secondary malignancies from low levels of radiation exposure. The current model used for radiation protection is predicated on the assumption that even very low levels of exposure may entail risk. This has profound implications for medical procedures involving ionising radiation as radiation doses must be carefully monitored, and for diagnostic procedures are minimised as far as possible. This incurs considerable expense. The SOLLID study (ClinicalTrials.gov Identifier: NCT03580161) aims to develop the methodology to enable a large-scale epidemiological investigation of the effect of radiopharmaceutical administrations to patients undergoing diagnostic nuclear medicine procedures. Patients will undergo a series of scans in addition to that acquired as standard of care to enable the radiation doses delivered to healthy organs to be accurately calculated. Detailed analysis will be performed to determine the uncertainty in the radiation dose calculations as a function of the number and type of scans acquired. It is intended that this will inform a subsequent long-term multicentre epidemiological study that would address the question definitively. Secondary aims of the study are to evaluate the range of absorbed doses that are delivered from diagnostic nuclear medicine procedures and to use current risk models to ascertain the relative risks from these administrations.

Modeling multi-level survival data in multi-center epidemiological cohort studies: Applications from the ELAPSE project

BackgroundWe evaluated methods for the analysis of multi-level survival data using a pooled dataset of 14 cohorts participating in the ELAPSE project investigating associations between residential exposure to low levels of air pollution (PM2.5 and NO2) and health (natural-cause mortality and cerebrovascular, coronary and lung cancer incidence). MethodsWe applied five approaches in a multivariable Cox model to account for the first level of clustering corresponding to cohort specification: (1) not accounting for the cohort or using (2) indicator variables, (3) strata, (4) a frailty term in frailty Cox models, (5) a random intercept under a mixed Cox, for cohort identification. We accounted for the second level of clustering due to common characteristics in the residential area by (1) a random intercept per small area or (2) applying variance correction. We assessed the stratified, frailty and mixed Cox approach through simulations under different scenarios for heterogeneity in the underlying hazards and the air pollution effects. ResultsEffect estimates were stable under approaches used to adjust for cohort but substantially differed when no adjustment was applied. Further adjustment for the small area grouping increased the effect estimates’ standard errors. Simulations confirmed identical results between the stratified and frailty models. In ELAPSE we selected a stratified multivariable Cox model to account for between-cohort heterogeneity without adjustment for small area level, due to the small number of subjects and events in the latter. ConclusionsOur study supports the need to account for between-cohort heterogeneity in multi-center collaborations using pooled individual level data.