Prevalence In General Population Research Articles

An international comparison of HIV prevalence and incidence in blood donors and general population: a BEST Collaborative study.

Efficiency in mitigating HIV transmission risk by transfusion may vary internationally. We compared HIV prevalence and incidence in blood donors across different jurisdictions in relation to those rates in the general population and differences in deferral practices. Data from 2007 to 2016 were collected in Australia, Brazil (São Paulo), Canada, England, France, Italy, Ireland, Japan, the Netherlands, New Zealand, Norway, Spain (Basque Country), USA (Vitalant) and Wales. For each country/region, the number of HIV antibody-positive donations and nucleic acid testing (NAT)-only-positive donations was broken down according to first-time or repeat donor status, along with the relevant denominators. There is a modest correlation between HIV prevalence among first-time donors and HIV prevalence in the general population. However, rates of HIV-positive donations in repeat donors, a proxy for incidence, do not correlate with incidence rates in the general population. Rates in donors from Italy and Basque Country, where deferral criteria for men having sex with men are less stringent, are higher compared with most other jurisdictions. Rates of NAT-only-positive donations are extremely low and do not differ significantly after adjustment for multiple comparisons. Donor HIV rates are only weakly associated with those observed in the general population. Countries with less stringent deferral criteria have higher HIV rates in their donor population, but the rates remain very low.

Higher prevalence of Concomitant Hyperparathyroidism in African American Patients Undergoing Thyroid Surgery

BackgroundHyperparathyroidism (HPT) occurs in about 1% of the general population. Previous studies have suggested that the incidence is higher in those patients with thyroid disease who are undergoing thyroid surgery. The study purpose was to examine the incidence of concomitant HPT in patients already undergoing a thyroid procedure and to identify risk factors. Materials and methodsA prospective database of all patients who had thyroidectomy by the endocrine surgery team was reviewed between August 2012 and April 2020. Per institutional protocol, all patients having thyroid surgery were screened for concomitant hyperparathyroidism. ANOVA/T-Test and Chi-square were conducted to compare those with and without hyperparathyroidism. ResultsThe median age was 43 and 79% were female. Of the 481 patients undergoing thyroidectomy, 31 (6%) had HPT. The mean preoperative calcium and parathyroid hormone levels were 10 ± 0 mg/dL and 67 ± 5 pg/mL, respectively. When comparing the groups, patients with concomitant HPT were older (53 ± 4 versus 42 ± 1 y, P = 0.005). African American race was a significant risk factor for concomitant HPT. While African Americans represented only 29% of those undergoing surgery, 58% of those with concomitant HPT were African American (P = 0.007). ConclusionIn patients having thyroid surgery, concomitant HPT was present in 6% of the population, higher than estimated general population prevalence. While we understand that primary HPT incidence increases with age, to our knowledge, this is the first report to document that African Americans are at a higher risk for concomitant HPT with thyroid disease. Thus, routine screening for hyperparathyroidism in patients undergoing thyroid surgery, especially in vulnerable populations, such as the older and African American population, is beneficial.

Hepatitis C viraemic and seroprevalence and risk factors for positivity in Northwest Cambodia: a household cross-sectional serosurvey

BackgroundDespite a dramatic reduction in HCV drug costs and simplified models of care, many countries lack important information on prevalence and risk factors to structure effective HCV services.MethodsA cross-sectional, multi-stage cluster survey of HCV seroprevalence in adults 18 years and above was conducted, with an oversampling of those 45 years and above. One hundred forty-seven clusters of 25 households were randomly selected in two sets (set 1=24 clusters ≥18; set 2=123 clusters, ≥45). A multi-variable analysis assessed risk factors for sero-positivity among participants ≥45. The study occurred in rural Moung Ruessei Health Operational District, Battambang Province, Western Cambodia.ResultsA total of 5098 individuals and 3616 households participated in the survey. The overall seroprevalence was 2.6% (CI95% 2.3–3.0) for those ≥18 years, 5.1% (CI95% 4.6–5.7) for adults ≥ 45 years, and 0.6% (CI95% 0.3–0.9) for adults 18–44. Viraemic prevalence was 1.9% (CI95% 1.6–2.1), 3.6% (CI95% 3.2–4.0), and 0.5% (CI95% 0.2–0.8), respectively. Men had higher prevalence than women: ≥18 years male seroprevalence was 3.0 (CI95% 2.5–3.5) versus 2.3 (CI95% 1.9–2.7) for women. Knowledge of HCV was poor: 64.7% of all respondents and 57.0% of seropositive participants reported never having heard of HCV.Risk factor characteristics for the population ≥45 years included: advancing age (p< 0.001), low education (higher than secondary school OR 0.7 [95% CI 0.6–0.8]), any dental or gum treatment (OR 1.6 [95% CI 1.3–1.8]), historical routine medical care (medical injection after 1990 OR 0.7 [95% CI 0.6–0.9]; surgery after 1990 OR 0.7 [95% CI0.5–0.9]), and historical blood donation or transfusion (blood donation after 1980 OR 0.4 [95% CI 0.2–0.8]); blood transfusion after 1990 OR 0.7 [95% CI 0.4–1.1]).ConclusionsThis study provides the first large-scale general adult population prevalence data on HCV infection in Cambodia. The results confirm the link between high prevalence and age ≥45 years, lower socio-economic status and past routine medical interventions (particularly those received before 1990 and 1980). This survey suggests high HCV prevalence in certain populations in Cambodia and can be used to guide national and local HCV policy discussion.

Prevalence, incidence and residual risk of transfusion transmitted viruses (HBV, HCV and HIV infections) in Lithuanian blood donors from 2004 to 2018: The incidence/window-period model study.

IntroductionEstimation of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transfusion risk in blood donors is essential for monitoring the safety of the blood supply and the impact of new screening tests. Due to improvements in donor selection and continuing progress in screening assays, residual risk of virus transmission has significantly decreased over the past years. It is not practical and sometimes even not possible to measure residual risk in blood donors directly and mathematical models are used. The aim of this study was to calculate the prevalence, incidence rates of HBV, HCV and HIV infections and analyse evolution of their transmission residual risk from 2004 to 2018 at the National Blood Center of Lithuania.Materials and methodsData from the archives of the National Blood Center of Lithuania from 2004 to 2018 was retrospectively analysed. The residual risk was calculated for each virus and year by applying the incidence/window-period model suggested by World Health Organization. For the analysis of the residual risk yearly trends a linear regression was used.ResultsA total of 754,755 blood donors and 1,245,568 donations were included in the analysis and represented a 2.06 donations per donor over 15 years. Average residual risk for HBV, HCV and HIV respectively was 570.04, 807.14 and 35.72 per 1,00,000 donations. During the study period, there was statistically significant downward trend in the residual risk for every analysed virus.DiscussionResidual risk of virus transmission has been steadily decreasing over past 15 years in Lithuanian donors, but the current risk remains quite high. It is difficult to establish how much the risk is affected by statistical assumptions or virus prevalence in general population. However, results of this study indicate the need of the population screening program of transfusion transmitted viruses.

Permanent childhood hearing impairment in infants admitted to the neonatal intensive care unit: nested case-control study.

The prevalence of permanent childhood hearing impairment (PCHI) in infants admitted to a neonatal intensive care unit (NICU) is higher than that in the general population. Our study objective was to identify risk factors associated with PCHI in infants who required admission to the NICU for more than 48 h. We performed a case-control study, including infants of all gestational ages who were admitted to NICU for more than 48 h and who underwent newborn hearing screening between 2005 and 2019. Infants admitted to NICU and diagnosed with PCHI by formal audiology were classified as "cases". The "controls" were infants who were admitted to NICU and did not have PCHI. Cases and controls (1:4) were matched based on their birth gestation, birthing place, and treating NICU. The prevalence of PCHI in infants admitted to NICU was 6.3% as compared with our general population prevalence of 0.25%. There were 77 cases and 269 controls during the study period. The median age at diagnosis of PCHI in these infants was 132 days (interquartile range 75.5-518.5). Using regression analysis, "any ventilation episodes", presence of seizures, and major congenital anomalies were significantly associated with PCHI in infants of all gestational ages. There were higher prevalence of PCHI in preterms (<32 weeks) who received furosemide and lower prevalence with antenatal use of magnesium sulphate.Conclusions: In our study, the prevalence of hearing loss was high in infants admitted to NICU. Gestation-specific risk factors identified in this case-control study would help in counselling of parents. What is Known: •In the UK, 1-2/1000 infants are born with hearing loss and infants admitted to the neonatal unit for 48 h or more have increased prevalence of hearing loss(1 in 100 live births). •Identification of risk factors in infants admitted to neonatal unit would help with risk stratification and further management. What is New: •In our study, infants admitted to the neonatal unit had higher prevalence of hearing loss (6.3 in 100 live births). •In infants across all gestational age "any ventilation episodes", presence of seizures, and severe congenital anomalies were associated with a statistically significant increase in prevalence of hearing loss. Higher prevalence of hearing loss was noted in preterm infants (<32 weeks) who received furosemide treatment and lower prevalence was noted with antenatal use of magnesium sulphate.

CLARITY: Co-occurrences in achondroplasia-craniosynostosis, seizures, and decreased risk of diabetes mellitus.

Achondroplasia is the most common disproportionate short statured skeletal dysplasia with a prevalence of approximately 1:20,000-30,000. We created the largest database to date of a historical cohort of 1374 patients with achondroplasia (CLARITY-aChondropLasia nAtuRal hIsTory studY). This cohort was queried for the presence of unrecognized or under-recognized features associated with achondroplasia. Craniosynostosis was found to co-occur with achondroplasia in 9 (0.65%) patients in this cohort, which is much higher than the general population prevalence of 3.1-7.2 per 10,000. In addition, 27 patients had seizures (2.0%), an apparent excess as compared to the general population. Only two people had diabetes despite a high rate of adult obesity. This report documents for the first time an increased prevalence of craniosynostosis in persons with achondroplasia, and adds support to previous observations of an apparently higher than expected prevalence of seizures and lower prevalence of diabetes mellitus.

Prevalence of MYOC risk variants for glaucoma in different populations.

To assess the clinical relevance of myocilin (MYOC) gene variants as risk factors for glaucoma in literature and to estimate their prevalence in different populations. We reviewed the literature for published MYOC variants in glaucoma patients and estimated their prevalence in general population using gnomAD and BRAVO databases. We used several bioinformatics tools and the criteria of the American College of Medical Genetics and Genomics (ACMG) to assess the pathogenicity of the variants. We evaluated the carrier frequency of the variants in gnomAD, including its subpopulations. We found 13 missense and 5 loss-of-function (LOF) reported variants in MYOC that were both probable pathogenic or risk variants and listed in gnomAD. Six likely pathogenic missense variants were p.(Cys25Arg), p.(Gln48His), p.(Gly326Ser), p.(Thr353Ile), p.(Thr377Met) and p.(Gly399Val). They were most prevalent in East and South Asia (frequency, 0.92% and 0.81%, respectively). The most common missense variants were p.(Thr353Ile) (0.91% in East Asia) and p.(Gln48His) (0.79% in South Asia). Five LOF variants were p.(Arg46Ter), p.(Arg91Ter), p.(Arg272Ter), p.(Gln368Ter) and p.(Tyr453MetfsTer11). We considered these glaucoma risk variants. They were most prevalent in the East Asian and the Finnish population (0.93% and 0.33%, respectively). Pathogenic MYOC variants appear to be population-associated. Our results highlight allelic heterogeneity of MYOC variants in open-angle glaucoma. Many of the probable pathogenic variants are over-represented in some of the populations causing doubt of their status as monogenic disease-causing variants.

Serological diagnosis and prevalence of HIV-1 infection in Russian metropolitan areas

BackgroundHIV infection is a major health problem in Russia. We aimed to assess HIV prevalence in different population groups and to compare the characteristics of 4th generation immunoassays from Abbott, Bio-Rad, Vector-Best, Diagnostic Systems, and Medical Biological Unit.MethodsThe study included 4452 individuals from the general population (GP), 391 subjects at high risk of HIV infection (HR) and 699 with potentially interfering conditions. HIV positivity was confirmed by immunoblot and by HIV RNA, seroconversion and virus diversity panels were also used. HIV avidity was employed to assess recent infections.ResultsThe prevalence in GP was 0.40%, higher in males (0.62%) and in people aged < 40 years (0.58%). Patients attending dermo-venereal centers and drug users had a high prevalence (34.1 and 58.8%). Recent infections were diagnosed in 20% of GP and in 4.2% of HR. Assay sensitivity was 100% except for one false negative (99,54%, MBU). Specificity was 99.58–99.89% overall, but as low as 93.26% on HR (Vector-Best). Small differences on early seroconversion were recorded. Only the Abbott assay detected all samples on the viral diversity panel.ConclusionHIV infection rate in the high-risk groups suggests that awareness and screening campaigns should be enhanced. Fourth generation assays are adequate but performance differences must be considered.

Smoking, diabetes mellitus, and obesity as risk factors of gastroesophageal reflux disease and extraesophageal symptoms of gastroesophageal reflux disease: A case-control study

Background: Gastroesophageal reflux disease (GERD) is a spectrum of disease usually producing symptoms of heartburn and acid regurgitation. Its prevalence in general population is about 12–17% worldwide. There are many suggested risk factors for GERD. Aim and Objective: This study was conducted to find out whether smoking, diabetes mellitus (DM), and obesity are risk factors of GERD and to find out the extraesophageal symptoms of GERD. Materials and Methods: This is a case–control study matched for age done in 46 GERD patients who were cases and 92 subjects with dyspepsia who were not having GERD as controls. The statistical analysis was done to find out proportions and odds ratio (OR) with 95% confidence interval (CI). Results: Most of the study subjects were in the age group of 40–49 years. About 59% were males. About 14% were smokers and 25% were diabetics. OR for smoking, DM, and obesity was 3.706, 5.571, and 3.618, respectively. About 28% of the GERD patients had easy tiredness. Conclusion: In this study, smoking and DM were found to be the risk factors of GERD based on OR with 95% CI. The most frequent extraesophageal symptom among GERD patients was found to be tiredness.

Large-Scale Screening in General Population Children for Celiac Disease with a Multiplex Electrochemiluminescence (ECL) Assay.

Background Autoimmunity Screening for Kids (ASK) study was launched to screen general population children for type 1 diabetes (T1D) and celiac disease (CD). Methods A total of 23,319 children from general population were screened. A high throughput multiplex electrochemiluminescence (ECL) assay to screen multiautoantibodies in a single well was applied, parallel with a standard radiobinding assay (RBA). All children with any positive autoantibodies in screening were revisited within one month for confirmation and followed every 6 months. Results Among 23,319 children, 2.6% (606/23,319) of children were tested positive for TGA. Multiplex ECL assay detected more TGA (584/23,319) in the initial screening than RBA (490/23,319, p = 0.004) and was able to detect TGA earlier than RBA in a subset of children by 0.8 to 34.8 months. Prevalence of TGA by either ECL or RBA in children with islet autoantibodies was found significantly higher than overall prevalence in general population screened. Conclusions A multiplex ECL assay was more sensitive than standard RBA by identifying more TGA positivity and detecting TGA earlier in general population screening. It also provides a high efficient tool with its unique advantage of multiplexing measurements to screen for multiple autoimmune diseases simultaneously in general population.

Characterization of the metabolomic profile by 1H-nuclear magnetic resonance spectroscopy in the DI@BET.ES study

Background and Aims: The [email protected] study is the first national study to evaluate Diabetes Mellitus (DM) prevalence in Spanish general population. The current study describes a metabolomic analysis based on 1H-Nuclear Magnetic Resonance (1H-NMR) spectroscopy of the [email protected] population.

Prevalence of depression, anxiety and stress in china during COVID-19 pandemic: A systematic review with meta-analysis.

The novel coronavirus disease which is believed to have initially originated in Wuhan city of China at the end of 2019 was declared as pandemic by March 2020 by WHO. This pandemic significantly impacted the mental health of communities around the globe. This project draws data from available research to quantify COVID-19 mental health issues and its prevalence in China during the early period of the COVID-19 crisis. It is believed that this pooling of data will give fair estimate of the effects of the COVID-19 pandemic on mental health. We conducted this study in accordance with PRISMA guidelines 2009. The protocol for this review is registered and published in PROSPERO (CRD42020182893). The databases used were Pubmed, Medline, Google scholar and Scopus. The studies were extracted according to pre-defined eligibility criteria and risk of bias assessment was conducted. The Meta-analysis was done using OpenMeta [analyst]. Total of 62382 participants in nineteen studies fulfilled the eligibility criteria. Stress was the most prevalent (48.1%) mental health consequence of Covid-19 pandemic, followed by depression (26.9%) and anxiety (21.8%). After performing subgroup analysis, prevalence of depression and anxiety in both females and frontline health care workers were high as compared to the prevalence in general Chinese population. The prevalence of depression and anxiety is moderately high whereas pooled prevalence of stress was found to be very high in Chinese people during this Covid-19 crisis.

Thrombocytopenia and Anemia Among Patients with Cerebral Palsy: A Big-Data Analysis

Title: Thrombocytopenia and Anemia among patients with Cerebral Palsy: A big-data analysis Introduction : The incidence of thrombocytopenia and anemia in patients with cerebral palsy (CP) is not well reported in the medical literature . Patients with CP, particularly those with the most severe phenotypes, may be repeatedly exposed to medications and infections associated with blood dyscrasias. The aim of this study was to assess the the prevalence of thrombocytopeniaand anemia in patients with CP comparing it to the general population. We also compared the prevalence of hospitalizations between patients with CP, with and without these blood dyscrasias. Methods: Utilizing a commercial database (Explorys Inc, IBM), we identified a cohort of patients diagnosed with CP based on the Systematized Nomenclature of Medicine-Clinical Terms. We calculated the overall prevalence rate of diagnosis of CP, described age, and gender-based prevalence rates of CP, and identified associated diagnoses of thrombocytopenia and anemia associated with CP. Explorys is a largereservoir of de-identified, HIPAA-compliant aggregated data of more than 63 million unique patients. First we compared the incidence of thrombocytopenia and anemia between patients with CP and the general population. To generate a cohort of patients representative of the general population, a cohort of patients with any coded disease was pooled except for CP. Moreover, relevant covariates including hospitalization, use of antiepileptic drugs (AED), infections, age, and gender were recorded and will be included in a multivariate analysis. We further sub-grouped patients with CP based on diagnoses of wheelchair dependency and AED exposure as markers of morbidity and risk for blood dyscrasias respectively. Results: We identified 49,492,350 unique patients of whom 93,850 were patients with CP. The prevalence of thrombocytopenia was higher in patients with CP than in the general population (Table 1; 4.91% vs 1.76%, RR 2.8, p&amp;lt;0.0000001). The same case was also noted for anemia (24,4% vs 11,4%, RR 2.1, p&amp;lt;0.0000001). When comparing the baseline characteristics of the two populations it seems that patients with CP are less aged compared to the general population (prevalence of patients &amp;gt;65 yoa , 53% vs 28%). Moreover, the infection rate in patient with CP surpasses that of the general population (infectious disease prevalence 93% vs 77%). On subgroup analysis, wheelchair dependence,AED exposure and any infectious process in patients with CP are risk factors for both anemia and thrombocytopenia. Nonetheless, an infectious process seems to be a stronger risk factor for both thrombocytopenia and anemia compared to AED exposure and wheelchair dependence (WD). More specifically the RR for thrombocytopenia in patients with CP is 7.4 compared to 4.8 and 2.4 for AED exposure and WD respectively. The same pattern is noticed for anemia (RR 4.7 vs 2.6 vs 1.8, p&amp;lt;0.001).Finally, we compared the total hospitalization rate in the past 5 years between patients with CP and with or withoutthrombocytopenia, anemia and cytopenia (defined as thrombocytopenia and anemia). Higher hospitalizations rates were found for patients with CP and with any of the above defined blood cell dyscrasias (Relative risk for hospitalization for patients with CP and thrombocytopenia/anemia/cytopenia vs without, RR 10/9/12.5, P&amp;lt;0.001). Discussion: Our study using large, aggregated data from Explorys demonstrates there is a higher prevalence of thrombocytopenia and anemia in patients with CP. In our cohort, patients with CP with thrombocytopenia and/or anemia were more likely to be hospitalized. Further research is needed to confirm this observed association and to clarify the mechanism of the relationship between CP and cytopenias. Disclosures Ahuja: Genentech: Consultancy, Honoraria; Sanofi Genzyme: Consultancy, Honoraria; XaTek, Inc.: Consultancy, Patents &amp; Royalties, Research Funding.

Time trends in the relation between the achieved education and the cardiovascular risk factors prevalence and control in general population and in persons with coronary heart disease

Abstract Background Achieved education is the most consistent and powerful socioeconomic status index and the differences in cardiovascular mortality (CV) according to achieved education in the Czech Republic are over a long period among most pronounced in Europe. Higher prevalence of CV risk factors in less educated is the major factor behind their higher CV morbidity and mortality. Purpose To analyse the changes in prevalence and control of CV risk factors according to achieved education in general population and in patients with stable CHD and their impact on CV mortality. Methods Based on data of 15 590 persons from 7 cross sectional epidemiological surveys carried through the Czech MONICA and post-MONICA project in 1985–2018 in identical 6 districts of the Czech Republic (general population) and on data of 2129 patients from 5 independent descriptive surveys of the Czech EUROASPIRE study in 1995–2018 (patients with stable CHD) time trends of major CV risk factors and their control in respondents with basic, secondary and university education were compared. Results The persons from general population as well as patients with CHD with higher education had consistently lower BMI and lower prevalence of obesity, the differences increased in due time (p&amp;lt;0,001), the prevalence of obesity increased in all educational strata (p&amp;lt;0,001). The total and non-HDL cholesterol were higher in lower educational population strata (p&amp;lt;0,01), but not in CHD patients, there was a very pronounced continuous decrease in all educational strata (p&amp;lt;0,001 for trend). Population systolic and diastolic blood pressures and prevalence of hypertension were higher in men and women with basic education (p&amp;lt;0,01) and decreased during the analysed period (p&amp;lt;0,001). In CHD patients the blood pressure was higher only in women. The prevalence of smoking was higher in men with basic education and decreased in all educational strata (p&amp;lt;0,0001), in women the prevalence of smoking increased in women with basic and decreased in women with secondary and university education (p&amp;lt;0,0001), in CHD patients the prevalence of smoking was lower and did not differ according to education. Prevalence of diabetes and of sedentary life style increased and was more prevalent in general as well as in CHD population in persons with lower education. Conclusion CV risk gradient in general population and in CHD patients decreased with level of education achieved, was present during the whole analysed period and became more pronounced in the 2016–18 survey. The education based differences were more pronounced in factors influenced by lifestyle (BMI, smoking) and less in factors influenced also by medical therapies (blood pressure, cholesterol levels). The impact on CV mortality is to be expected more pronounced in general CV prevention and less in already treated population. Observation of healthy life style remains a basic problem in CV prevention, particularly in persons with elementary education. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Agency for Medical Research, Ministry of Health of the Czech Republic

Non-communicable disease risk factors among a cohort of mine workers in Mongolia

Abstract Background Prevalence of non-communicable diseases (NCD) are growing among working populations globally. The World Health Organization (WHO) estimates NCD are responsible for 80% of all premature deaths (Lancet, 2016). The purpose of this study is to determine baseline level of NCD and risk factors among mine workers and to identify intervention strategies based on results. The collected results will be compared with a NCD study on the general population of Mongolia. Methods A cross sectional design was used for this study. 684 employees were randomly recruited to the study. We utilised WHO questionnaire to collect anthropogenic measurements, health behaviours, alcohol consumption, smoking, NCD and work related information.. The study focused on four (4) key risk factors of hypertension, obesity, drinking habits and smoking habits. These factors are key contributors to NCD and decreased life expectancy. Results Results of the study showed prevalence's of hypertension 12.9%, obesity 64.1%, alcohol users 22.1% and smokers 38.8%. The general population prevalence's are 27.5%, 56.8%, 15.5% and 24.8% respectively. Differences between gender in the study cohort for smoking rate (men = 43.3%, women = 8.9%), alcohol consumption (men = 29.9%, women = 16.1%) and central obesity (men = 78.3%, women = 35.1%) were statistically significant (p &amp;lt; 0.05). Conclusions Prevalence of arterial hypertension for the mine worker cohort was lower than general population, however, obesity, drinking and smoking rates were higher. The study findings allow us to target intervention strategies to mitigate the risk of NCD development in the future. Key messages Understand the risk factors and control measures available to mitigate the risk of the development of NCD. Comparison of the mine site cohort with the general population to understand similarities and differences.

Body mass index and obesity in Italy: results of CUORE Project-Health Examination Survey 2018-2019

Abstract Background The WHO Global Action Plan for the Prevention of Non-Communicable Disease (WHO-NCD) recommends to halt the rise of obesity by 2025. Obesity is largely preventable. This preliminary analysis aims to assess mean level of BMI and prevalence of obesity in the Italian general adult population using the data collected within the CUORE Project to investigate if Italy can meet the WHO-NCD target. Methods Within the health examination survey conducted in 2018-2019, mean level of BMI and prevalence of obesity (BMI &amp;gt; =30 kg/m2) and overweight (25 &amp;lt; =BMI&amp;lt;30 kg/m2) were assessed in representative random samples of resident population, aged 35-74 years, stratified by age and sex (822 men and 869 women), from 8 Italian Regions in Northern, Central and Southern Italy. Weight and height were measured using standardized methods. A standardized questionnaire was used to collect data on educational level that was used as a proxy of socio-economic status. The survey is funded by the Italian Ministry of Health-CCM. Results In this preliminary analysis, mean level of BMI was 26.8 kg/m2 (95% C.I. 26.5-27.1) in men and 25.9 kg/m2 (25.6-26.3) in women. Prevalence of obesity was 19% (16-22) in men and 22% (19-25) in women; prevalence of overweight was 45% (41-48) in men and 28% (25-31) in women. Obesity resulted significantly higher in persons with lower educational level (primary or middle school) vs those with higher education: 26% (20-31) vs 16% (13-19) in men and 33% (27-38) vs 17% (14-20) in women. Both in men and women prevalence of obesity was significantly higher in the Southern regions. Conclusions Preliminary data show that more than half of Italian adults are overweight/obese. However, in comparison to BMI measured in the CUORE Project 10 years earlier, the prevalence of people at normal weight is increasing, moving in the direction of the WHO-NCDs obesity target. Preventive actions at community level should be more incisive in the population at low socio-economic level. Key messages Mean BMI and prevalence of obesity in the Italian general adult population are still high. If confirmed, in the last ten years an increase of normal weight prevalence in the Italian general adult population seems to be occurred.

Chronic inflammatory demyelinating polyneuropathy associated with diabetes: a European multicentre comparative reappraisal

IntroductionThe association between chronic inflammatory demyelinating polyneuropathy (CIDP) and diabetes is uncertain despite important diagnostic and management implications.MethodsWe retrospectively analysed two European cohorts, totaling 257 patients with ‘definite’ or ‘probable’...

Assessing the susceptibility to acute respiratory illness COVID-19-related in a cohort of multiple sclerosis patients

IntroductionItaly has been the first European country severely affected by the COVID-19 pandemic. ObjectiveTo analyze the incidence of the clinical presentations suggestive for COVID-19 infection among patients with Multiple Sclerosis in the province of Lecco, in the North Italy, the closest province capital to Bergamo. To describe the association of demographics, clinical characteristics, and use of DMTs categories with the risk of contracting the disease. MethodsWe telephonically interviewed all the 275 MS patients followed in the MS center. The collected data included recent contact with a patient with COVID-19 diagnosis or a subject with respiratory symptoms and the developing of COVID-19 symptoms or a confirmed diagnosis. Results15 out of 275 patients reported symptoms suggestive for COVID-19 infection, only one of them with PCR-confirmed diagnosis. No one of them presented severe symptoms or needed hospitalization. Using a multivariable logistic regression model, the only factor associated with being in the COVID-suspect group was the report of a recent contact with a patient with a COVID-19 diagnosis. ConclusionsThe prevalence of COVID-19 within MS patients seems to resemble the prevalence in general population. The lack of associations with other factors assessed, including DMTs, may reflect a lack of statistical power. Larger population studies are needed to explore the correlation between different disease-modifying therapies and COVID-19 course.

A Simple Bayesian Method for Evaluating Whether Data From Patients With Rheumatic Diseases Who Have Been Under Chronic Hydroxychloroquine Medication Since Before the COVID-19 Outbreak Can Speak to Hydroxychloroquine's Prophylactic Effect Against Infection With SARS-CoV-2.

No vaccine against infection by SARS-CoV-2 yet exists. Treatment by hydroxychloroquine (HCQ) medication, among others, has been proposed. However, prophylactic HCQ medication has been little evaluated. We propose to use data from patients with rheumatic diseases (RA, SLR) who have been chronically taking HCQ medication since before the COVID-19 outbreak (hereafter: HCQpa), in order to evaluate the potential of HCQ for preventing infection with SARS-CoV-2. This can be achieved with relative ease by considering whether COVID-19 prevalence is significantly lower in HCQpa than in the general population (i.e., all people that are not HCQpa). Even if COVID-19 prevalence is truly significantly lower in HCQpa, some HCQpa may still present with COVID-19 (lower prevalence does not mean a prevalence of zero). However, given a value for COVID-19 prevalence in the general population and a number of available HCQpa, one may compute the maximum number of HCQpa for that total number of HCQpa considered that can have COVID-19 in order to still be able to conclude a lower COVID-19 prevalence in HCQpa (i.e., if there is one more case of COVID-19 than that maximum number, the COVID-19 prevalence in the HCQpa cannot be said to be lower than in the general population). Because the COVID-19 prevalence in the general population is not known with precision, we will consider different general population prevalence values. Among these contemplated prevalence values, one is derived from the official total number of confirmed cases, others by computing the total number of cases from the number of fatal COVID-19 cases so far and considering different case fatality rates per total cases. Our analyses show that systematic testing for COVID-19 in as few as 5,000 HCQpa is all that is needed for a test of whether HCQ has a prophylactic action against COVID-19, even for a COVID-19 prevalence value as low as 250 per 100,000, provided that test sensitivity is at least equal to its specificity. For higher COVID-19 prevalence values, the number of HCQpa needed is even lower.

Air pollution and psychiatric disorders: Current and future challenges.

The recent article of Khan et al.1 opens a new field of research in bipolar disorders and other psychiatric disorders, which can give clues for a better understanding of their pathophysiology. These authors provide an analysis of two large national datasets, highlighting the issue of air pollution as a risk factor for major psychiatric disorders. The authors show the influence of different environmental factors, including air pollution characteristics, on the general population prevalence of four psychiatric disorders (bipolar disorder, major depression, schizophrenia, and personality disorders taken as a whole) in Denmark and the USA. Their results show that poor air quality is associated with an elevated prevalence of bipolar disorders both in US and Denmark, and with elevated prevalence of schizophrenia, major depression and personality disorders also being associated with poor air quality in Denmark.