Female Prevalence Rates Research Articles

Long-term trends in the burden of nasopharyngeal carcinoma in China: A comprehensive analysis from 1990 to 2021 and projections to 2030 based on the global burden of disease study 2021

Background and PurposeNasopharyngeal carcinoma (NPC) is a significant public health issue in China, with distinctive epidemiological characteristics and evolving trends. This study aims to analyze long-term trends in NPC burden from 1990 to 2021 and provide projections. Materials and MethodsData from the Global Burden of Disease (GBD) database (1990–2021) was utilized to evaluate NPC metrics, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Joinpoint regression identified significant changes over time. Age-period-cohort (APC) analyses assessed the effects of age, period, and cohort. A decomposition analysis identified factors influencing changes in NPC incidence, prevalence, and DALYs. Projections were made for future trends up to 2030. ResultsIn 2021, NPC significantly impacted China, with males experiencing higher incidence (5.16 per 100,000) and mortality rates (2.32 per 100,000) than females. NPC prevalence was 342,477 cases, with males accounting for 260,164. DALYs totaled 982,657, predominantly affecting males. From 1990 to 2021, the age-standardized incidence rate (ASIR) in China decreased from 4.64 to 3.42 per 100,000, while globally it declined from 1.74 to 1.38 per 100,000. Between 1990 and 2021, trends showed an initial decline in ASIR and age-standardized prevalence rate (ASPR), followed by a steady increase from 2006 onwards, with males experiencing more significant rises. Mortality rates showed a general downward trend, yet males remained disproportionately affected. Comparative global data indicated that while NPC metrics are declining worldwide, the burden remains higher in China. Decomposition analysis highlighted aging and population growth as major contributors to the NPC burden. Bayesian age-period-cohort (BAPC) projections indicated a continuing rise in age-standardized incidence and prevalence rates for both males and females up to 2030. ConclusionsThe burden of NPC in China remains significant, particularly among the male population. Despite declining mortality rates, the increasing prevalence suggests that more people are living with NPC. Targeted public health interventions are urgently needed to address these gender-specific trends and reduce the disease burden.

A Dual Diagnosis of Myasthenia Gravis and Sjogren’s Syndrome in a Hispanic Patient: A Case-based Discussion of Clinical Findings, Therapeutic Implications, and Culturally Competent Care

The co-occurrence of myasthenia gravis (MG) and Sjogren's syndrome (SS) in a young, Hispanic, female patient underscores the diagnostic and therapeutic complexities inherent in autoimmune disorders. MG, a rare neuromuscular disorder characterized by autoantibodies impairing neuromuscular transmission, leads to variable muscle weakness and fatigue, notably affecting ocular and bulbar muscles. SS, an autoimmune condition with systemic manifestations, primarily affects secretory glands, resulting in symptoms such as xerostomia and xerophthalmia. Both conditions have higher prevalence rates in females, with MG particularly affecting young women under 40. Herein we present a case report and case-based discussion on diagnostic and management challenges of these two autoimmune conditions while highlighting issues specific to the Hispanic and underrepresented populations. Our goal is to highlight the intricate interplay between these two autoimmune pathologies to allow for more rapid recognition and reduce delay in diagnosis.

Evaluation of an Updated Gene Panel as a Diagnostic Tool for Both Male and Female Infertility.

In recent years, an increasing number of genes associated with male and female infertility have been identified. The genetics of infertility is no longer limited to the analysis of karyotypes or specific genes, and it is now possible to analyse several dozen infertility genes simultaneously. Here, we present the diagnostic activity over the past two years including 140 patients (63 women and 77 men). Targeted sequencing revealed causative variants in 17 patients, representing an overall diagnostic rate of 12.1%, with prevalence rates in females and males of 11% and 13%, respectively. The gene-disease relationship (GDR) was re-evaluated for genes due to the addition of new patients and/or variants in the actual study. Five genes changed categories: two female genes (MEIOB and TBPL2) moved from limited to moderate; two male genes (SOHLH1 and GALNTL5) moved from no evidence to strong and from limited to moderate; and SEPTIN12, which was unable to classify male infertility, was reclassified as limited. Many infertility genes have yet to be identified. With the increasing integration of genetics in reproductive medicine, the scope of intervention extends to include other family members, in addition to individual patients or couples. Genetic counselling consultations and appropriate staffing will need to be established in fertility centres. Trial registration number: Not applicable.

SADARI (Periksa Payudara Sendiri) : Pengetahuan dan Perilaku Remaja kota dan Desa di Provinsi Papua

Breast cancer is still a serious problem in both developed and developing countries. Cancer is the highest cause of death in the world. In Indonesia, breast cancer is also the type of cancer that contributes the highest to the female cancer prevalence rate. The low level of early detection efforts by self-examination of the breasts and clinical breast examinations is the cause of the increase in breast cancer. Leading to an increase in the death rate. The aim of this research is to identify knowledge and behavior of BSE (breast self- examination) among urban and rural teenage girls in Papua Province. This research method uses a cross sectional study design. The sample in this study was 185 urban and rural teenage girls. Data analysis used the Mann Whitney U statistical test to see differences in BSE knowledge and behavior in urban n rural teenage girls. The research results showed that the majority of urban teenage girls’ knowledge level was in the high category, while the majority of rural teenage girls were in the low category. While the behavior of urban teenage girls tended to be more obedient in doing BSE (breast self- examination) compared to rural teenage girls. Bivariate analysis show that there is a difference in the level of knowledge between urban and rural teenage girls regarding BSE (breast self- examination) with a p-value (0,000) < 0,05 and there is also difference in BSE (breast self- examination) behavior among urban and rural teenage girls with p-value (0.016)<0.05.

Tobacco Prevalence and Economic Growth: Evidence from Low and Lower-Middle-Income Countries

ABSTRACT: The economic costs of tobacco use are substantial particularly in developing countries. While much has been written on healthcare costs from tobacco use related diseases, little is known on the macro-economic impacts of tobacco-related productivity loss. The objective of the current research is to understand the macroeconomic burden of tobacco use in developing countries. Using World Bank's development indicators database for 44 low-and lower-middle-income countries, most of which are African, this paper assesses the relationship between tobacco consumption and economic growth. Specifically, using the fixed effect regression approach, we examined whether tobacco prevalence affects long-run growth rate in the real gross domestic product (GDP) per capita. We adopted an empirical framework from the growth literature by including the national tobacco prevalence rate as one of the determinants of long-run growth in the real GDP per capita. The tobacco prevalence rate varies across countries ranging from 5% in Ethiopia to almost 50% in Myanmar. The prevalence rate is much higher among males than females in almost all countries, with Myanmar males having above 70%. The regression results indicate the existence of a statistically significant negative relationship between the prevalence of tobacco and economic growth after controlling for other determinants of growth, including the initial level of GDP per capita, gross fixed capital formation, trade, resource revenues, institutional quality, a human capital indicator, and infrastructure capacity. A 1% increase in the total tobacco prevalence rate reduces the economic growth rate by almost 2%, all else equal. These findings are robust even after running separate models for male and female tobacco prevalence rates. The results on the other determinants of growth are consistent with the previous empirical studies on economic growth in the context of developing countries. The findings of this study provide additional support to the existing body of empirical economic research on the role of better health, as a form of human capital, in increasing economic output. Thus, actively targeting tobacco control interventions, both in and outside of the workplace, can likely improve workers' productivity and hence economic growth.

DIAGNOSTIC PATTERNS OF AGE-RELATED MACULAR DEGENERATION.

To characterize prevalence estimates by race, age, sex, and comorbidity (diabetes and hypertension) within the Medicare beneficiary demographic. In this US population-based retrospective cohort analysis, the Vision and Eye Health Surveillance System was analyzed for a 100% sample of Medicare Fee-For-Service beneficiary populations of Asians and non-Hispanic Whites between 2014 and 2018. Exclusionary criteria included beneficiaries younger than 40 years. Prevalence rate ratios, defined as prevalence rate for Asians divided by prevalence rate for non-Hispanic Whites, were calculated using multivariate negative binomial regression or Pearson-scaled Poisson regression, stratified by age, sex, and comorbidity. A total of 21,892,200 Medicare beneficiaries fulfilled the inclusionary criteria in 2018. Of the entire cohort, 3.2% of the beneficiaries (N = 714,500) were Asian. For beneficiaries aged 40 to 64 years, Asian male (prevalence rate ratios 1.73, 95% confidence interval 1.64-1.83, P < 0.0001) and female (prevalence rate ratios 1.34, 95% confidence interval 1.28-1.41, P < 0.0001) beneficiaries had an increased prevalence rate of all age-related macular degeneration relative to non-Hispanic Whites. Significant time-wise increases in prevalence rate ratios were observed within several age groups, sexes, and comorbidities (race-time interaction coefficients P < 0.05 ). This analysis highlights increased age-related macular degeneration prevalence estimates within the Asian American demographic relative to non-Hispanic Whites. Furthermore, specific Asian subpopulations are experiencing accelerated prevalence rates over time.

Spatiotemporal patterns of drug use disorder in Sweden assessed using population-based registries

BackgroundDrug Use Disorder (DUD) is a major contributor to world-wide morbidity and mortality. The extensive national registers in Sweden provide the basis for a study of spatial and temporal patterns of DUD onset and recurrence in Sweden from 2001–2015.MethodsTo identify patterns of DUD over space, time and gender for Swedish individuals aged 15–35, space–time clustering using SaTScan was applied. We used yearly information on residential locations in Demographic Statistical Areas (DeSO) for all of Sweden. The clustering analysis used a Poisson probability model and a null hypothesis that the expected number of cases in each DeSO was proportional to the population size of DeSOs. As SaTScan results can be unstable, steps were taken to determine stable clusters and to refine and optimize cluster size. Results for each gender-register combination were compared to the results of spatial clustering using Gi* statistics. The space–time scanning model was also run with an adjustment for neighborhood socioeconomic status to determine DUD prevalence as it relates to education, income, unemployment and receipt of social welfare.ResultsDUD prevalence increased over time. Males yielded more significant clusters than females for both criminal and medical registers. Female DUD prevalence rates increased over time, especially after 2012. Higher correlations in DUD rates existed across the two registers than across gender. Male clusters were present from 2004 onwards while female–criminal clusters appeared after 2007, and female–medical clusters not until 2010. By 2013, clusters existed for all gender–register combinations. Male–criminal clusters were concentrated in Stockholm, Göteborg and Malmö as were male and female-medical clusters. Neighborhood SES was more highly related to the distribution of criminal than medical DUD clusters. A persistent gap in core clusters was identified in Stockholm in an area with notably high SES.ConclusionsPersistent hotspots of DUD in Sweden were confirmed as well as new and emerging hotspots, especially in Stockholm, Göteborg and Malmö. Higher correlations existed in DUD rates across registers than across gender. The findings are useful for monitoring the current drug problem and for identifying drivers underlying patterns of spread and important causal pathways to DUD.

Sex differences in longitudinal changes of episodic memory-related brain activity and cognition in cognitively unimpaired older adults with a family history of Alzheimer’s disease

Episodic memory decline is an early symptom of Alzheimer’s disease (AD) – a neurodegenerative disease that has a higher prevalence rate in older females compared to older males. However, little is known about why these sex differences in prevalence rate exist. In the current longitudinal task fMRI study, we explored whether there were sex differences in the patterns of memory decline and brain activity during object-location (spatial context) encoding and retrieval in a large sample of cognitively unimpaired older adults from the Pre-symptomatic Evaluation of Novel or Experimental Treatments for Alzheimer’s Disease (PREVENT-AD) program who are at heightened risk of developing AD due to having a family history (+FH) of the disease. The goal of the study was to gain insight into whether there are sex differences in the neural correlates of episodic memory decline, which may advance knowledge about sex-specific patterns in the natural progression to AD. Our results indicate that +FH females performed better than +FH males at both baseline and follow-up on neuropsychological and task fMRI measures of episodic memory. Moreover, multivariate data-driven task fMRI analysis identified generalized patterns of longitudinal decline in medial temporal lobe activity that was paralleled by longitudinal increases in lateral prefrontal cortex, caudate and midline cortical activity during successful episodic retrieval and novelty detection in +FH males, but not females. Post-hoc analyses indicated that higher education had a stronger effect on +FH females neuropsychological scores compared to +FH males. We conclude that higher educational attainment may have a greater neuroprotective effect in older +FH females compared to +FH males.

Significantly different roles of economic affluence in sex-specific obesity prevalence rates: understanding more modifications within female body weight management

Socioeconomic status has been associated with obesity prevalence increase in both males and females worldwide. We examined the magnitude of the difference between the two relationships and explored the independence of both relationships. Country specific data on gross domestic product (GDP) per capita, sex-specific obesity prevalence rates, urbanisation, total calories availability and level of obesity, genetic background accumulation (measured by the Biological State Index, Ibs) were obtained for 191 countries. Curvilinear regressions, bivariate and partial correlations, linear mixed models and multivariate linear regression analyses were used to examine the relationship between GDP and obesity prevalence rates in males and females respectively. Fisher’s r-to-z transformation, F-test and R2 increment in multivariate regression were used to compare results for males and females. GDP significantly correlated with sex-specific obesity prevalence rates, but significantly more strongly with male obesity prevalence in bivariate correlation analyses. These relationships remained independent of calories availability, Ibs and urbanization in partial correlation model. Stepwise multiple regression identified that GDP was a significant predictor of obesity prevalence in both sexes. Multivariate stepwise regression showed that, when adding GDP as an obesity prevalence predictor, the absolute increment of R2 in male fit model (0.046) was almost four (4) times greater than the absolute increment in female model fit (0.012). The Stepwise analyses also revealed that 68.0% of male but only 37.4% of female obesity prevalence rates were explained by the total contributing effects of GDP, Ibs, urbanization and calories availability. In both Pearson’s r and nonparametric analyses, GDP contributes significantly more to male obesity than to female obesity in both developed and developing countries. GDP also determined the significant regional variation in male, but not female obesity prevalence. GDP may contribute to obesity prevalence significantly more in males than in females regardless of the confounding effects of Ibs, urbanization and calories. This may suggest that aetiologies for female obesity are much more complex than for males and more confounders should be included in the future studies when data are available.

Intestinal parasitic infection among mentally handicapped students in the Islamic Republic of Iran.

Intestinal parasitic infections are among the most common public health problems in populations with poor hygiene. Consequently, mental retardation increases the risk of infection. The aim of this study was to investigate the prevalence of intestinal parasitic infections among mentally disabled young people in Hamadan, western Islamic Republic of Iran. This descriptive cross-sectional study was conducted on 318 students in 9 special schools in 2017. Triplicate faecal specimens for each student were subjected to stool analysis using direct wet mount, sedimentation concentration, and permanent staining technique. Chi-squared or Fisher's exact test were used for statistical analysis. Out of 318 students, 135 (42.5%, 95% CI: 37.1-47.9) were infected with intestinal parasites. Prevalence rates for females and males were 45.2% (61/135) and 40.4% (74/183) respectively. Protozoan infections (42.5%, 135) were more numerous than helminthiasis (0.6%, 2). Blastocystis hominis (28%, 89) was the most common parasite, followed by Giardia lamblia (9.7%, 31), Entamoeba coli (9.1%, 29) and Trichomonas hominis (6%, 19). The high prevalence rate of intestinal protozoan infection reflects poor personal hygiene among the students and inappropriate environmental conditions. Therefore, specific public health measures are required for the mentally handicapped students in special schools.

Prevalence of Chronic Fatigue Syndrome (CFS) in Korea and Japan: A Meta-Analysis.

Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term disabling illness accompanied by fatigue unsolved by rest. However, ME/CFS is a poorly understood illness that lacks a universally accepted pathophysiology and treatment. A lack of CFS-related studies have been conducted in Asian countries. This study aimed to estimate and compare the prevalence of ME/CFS in Korea and Japan and conducted a meta-analysis. Methods: We searched PubMed, EMBASE, Cochrane, and KMBASE for population-based prevalence studies of the two countries and synthesized the data according to the Fukuda case definition. Results: Of the eight studies (five in Korea, three in Japan) included, the total prevalence rate of Korean studies was 0.77% (95% CI 0.34–1.76), and 0.76% (95% CI 0.46–1.25) for the Japanese studies. The prevalence rate in females was approximately two-fold higher than males in Korean studies (1.31% female vs. 0.60% male), while the gender difference was less obvious in Japanese studies (0.76% female vs. 0.65% male). Conclusions: Further epidemiology studies on the female ME/CFS prevalence rate between countries may be required.

Pregnancy Outcomes in Patients With Adult-Onset Still's Disease: A Cohort Study From China.

Objective: Adult-onset Still's disease (AOSD) is an autoinflammatory disease with a higher prevalence rate in young females. The purpose of this study is to investigate whether AOSD has an adverse impact on pregnancy outcomes, or conversely exacerbated by pregnancy.Methods: The outcomes of 191 pregnancies were evaluated in 86 female patients with AOSD. The generalized linear mixed model and propensity score matching method were conducted to evaluate the influence of AOSD on pregnancy outcomes. A dependent sample sign test was applied to assess the impact of pregnancy on the relapse of AOSD.Results: The results showed that the post-AOSD group had a lower proportion of normal delivery (25.0 vs. 52.4%, p = 0.036) and a higher proportion of spontaneous abortion (STA) (18.8 vs. 0.6%, p = 0.002) compared with the pre-AOSD group. Moreover, pregnancy after being diagnosed with AOSD was a significant high risk factor of STA (adjusted OR = 4.577, 95% CI: 4.166–845.119; p = 0.003). Disease flare upon conception was observed in one of 16 post-AOSD pregnancies (p = 1.000). There were 11 patients with new-onset AOSD during gestation or postpartum, among which five (45.4%) evolved into the polycyclic course.Conclusions: AOSD patients might suffer from a higher risk of STA, however, pregnancy might not be related with the exacerbation of diagnosed AOSD. New-onset AOSD during gestation or postpartum tend to evolve into the polycyclic course.

County-level factors affecting Latino HIV disparities in the United States.

To determine which county-level social, economic, demographic, epidemiologic and access to care factors are associated with Latino/non-Latino White disparities in prevalence of diagnosed HIV infection. We used 2016 county-level prevalence rates of diagnosed HIV infection rates for Latinos and non-Latino Whites obtained from the National HIV Surveillance System and factors obtained from multiple publicly available datasets. We used mixed effects Poisson modeling of observed HIV prevalence at the county-level to identify county-level factors that explained homogeneous effects across race/ethnicity and differential effects for Latinos and NL-Whites. Overall, the median Latinos disparity in HIV prevalence is 2.4; 94% of the counties have higher rates for Latinos than non-Latinos, and one-quarter of the counties' disparities exceeded 10. Of the 41 county-level factors examined, 24 showed significant effect modification when examined individually. In multi-variable modeling, 11 county-level factors were found that significantly affected disparities. Factors that increased disparity with higher, compared to lower values included proportion of HIV diagnoses due to injection drug use, percent Latino living in poverty, percent not English proficient, and percent Puerto Rican. Latino disparities increased with decreasing percent severe housing, drug overdose mortality rate, percent rural, female prevalence rate, social association rate, percent change in Latino population, and Latino to NL-White proportion of the population. These factors while significant had minimal effects on diminishing disparity, but did substantially reduce the variance in disparity rates. Large differences in HIV prevalence rates persist across almost all counties even after controlling for county-level factors. Counties that are more rural, have fewer Latinos, or have lower NL-White prevalence rates tend to have higher disparities. There is also higher disparity when community risk is low.

A DNA Sequence Analysis of Helicobacter pylori in Jeddah City, Western Saudi Arabia

Helicobacter pylori are the type of Gram-negative bacteria which colonize the mucous lining of the human stomach. These bacteria have two major virulence factors: (vacuolating cytotoxin A gene) and (cytotoxin-associated A gene). This study aimed to provide data to determine the prevalent virulence factors (vacA and cagA genes) in Jeddah city, western Saudi Arabia, by sequence analysis. This study included 60 patients with symptoms similar to H. pylori infection. H. pylori were identified by using the 16s rRNA sequence. Then, the screening for specific genes in H. pylori (vacA and cagA) was done by using automated DNA sequencing analysis, and the DNA sequences were compared by BLAST and sequence alignment of the vacA nucleotides that are present in all H. pylori strains using those already reported in GeneBank from various studies. Results indicated that H. pylori infection was detected in 13.3%, while 86.7% were negative samples in our study patients. Interestingly, the vacA gene was found in 8.3%, while the cagA gene was not appear in patient. Also, the female prevalence rate was higher than males (11.7% female versus 1.7% males), and the highest infection was between age 40-49 by 6.7%. In conclusion, this study revealed that the vacA gene was spread in the patients infected with H. pylori in Jeddah, while the cagA gene was not appear in any isolate.

Prevalence, seasonal and geographical distribution of parasitic diseases in dogs in Plateau State Nigeria: a 30-year retrospective study (1986-2015).

Parasitic diseases of dogs are now major economic and public health issues in Nigeria due to indiscriminate reproduction of dogs, lack of appropriate policies on pet ownership and diseases control as well as inadequate veterinary care. In order to understand the prevalence, seasonal variation and distribution of parasitic diseases of dogs in this region of Nigeria, the present study conducted a 30-year retrospective analysis in the referral veterinary centre, Vom, and analysed data using the Chi square test and the factor analysis. Of the 26,844 dogs handled between January 1986 and December 2015, 17,663 (65.8%) had different parasitic diseases. Yearly distribution of parasitic diseases varied significantly (p < 0.0001) and ranged between 52.0 and 85.4%. Age, seasonal and disease specific prevalence rates ranged between 2.8 and 80.5%. Prevalence rates in females 78.2% (95% CI 77.6-78.9) and indigenous breed 70.0% (95% CI 69.2-70.7) were significantly higher (p < 0.0001) from those of the males 47.2% (95% CI 46.2-48.1) and exotic breeds of dogs 60.7% (95% CI 59.8-61.6), respectively. Ancylostomosis was the most prevalent (15.9%) disease while Barkin Ladi recorded the highest regional prevalence. It is pertinent to enact appropriate disease control policies and observe control programmes including vector control and improved hygiene to curtail the economic and public health threats associated with these diseases.

Female representation in clinical trials leading to FDA cancer drug approvals for gastrointestinal (GI) cancers between 2008 to 2018.

809 Background: Proportionate representation of women in health research is an area for improvement. This study aims to assess the representation of women in gastrointestinal (GI) cancer clinical trials leading to FDA cancer drug approvals over the past 10 years. Methods: FDA cancer drug approvals between 07/2008-06/2018 were identified and trial reports supporting approvals sourced. The ratio of female to male (F:M) enrollment was compared with F:M cancer incidence in the U.S., and U.S. cancer prevalence and mortality. Results: Although F:M enrollment for all 229 trials leading to FDA cancer drug approvals in this period was similar to overall F:M cancer incidence in the U.S. (0.89 vs 0.86; Odds Ratio for female enrollment (OR) 1.05, 95% Confidence Interval (CI) 1.03-1.06, P&lt;0.0001), in 17 trials that led to drug approvals in GI cancers there was lower F:M trial enrollment compared to cumulative U.S. incidence at those tumor sites (0.55 vs 0.79, OR 0.71, 95% CI 0.68-0.74, P&lt;0.0001). F:M enrollment and U.S. incidence by the main GI tumor sites where approvals occurred is shown in Table. Female enrollment rates were also lower than U.S. female cancer mortality and prevalence rates in these tumor sites (P&lt;0.0001 for all). Female enrollment in GI trials fell between 2008-2013 and 2014-2018 (38 vs 33%, OR 0.80, 95% CI 0.74-0.87, P&lt;0.0001). Conclusions: Although disparity in female enrollment may be improving across combined FDA cancer drug approval trials, underrepresentation of females has persisted in GI cancer trials when compared to F:M cancer incidence, prevalence and mortality in the U.S. More work is required to determine the drivers of this disparity, in order to mitigate it. [Table: see text]

Intestinal parasites in Meche community in relation to their socio-economic status

Background and Objectives: Intestinal parasites still establishes one of the important causes of public health problem in world, especially in developing countries like Nepal. The aim of the study is to determine the prevalence of intestinal parasites in Meche community of Jalthal Village Development Committee of Jhapa district in relation to their socio-economic status. &#x0D; Material and Methods: Study was carried out during June to July 2017 in Meche community of Jalthal Village Development Committee of Jhapa district. A total of 150 human stool samples were randomly collected and examined using direct smear and concentration methods (sedimentation and flotation technique). &#x0D; Results: Among total samples the prevalence of intestinal parasites in Meche community was 27.33%. Prevalence rate in females were higher 32.47% than in males 21.91%. There was no significant difference in the distribution of parasites between male and female (χ2=1.6022, df=1, p value=0.2056). The prevalence of the parasites was maximum in the age group 21- 40 years (47.22%). Altogether 5 species of the intestinal parasites were detected. Among them Ascaris lumbricoides (19.33%) topped the list followed by Taenia solium (2.67%), Hookworm (2.67%), Entamoeba coli (2.67%) and Trichuris trichiura (2%). &#x0D; Conclusion: The high prevalence of infection in community seems directly related to un-hygienic living condition, unsafe drinking water, unhygienic food, lack of health education, poor sanitary condition and low socio-economic status help to increase the burden of the infection in the community.

733P - Biliary tract cancers in Portuguese families with BRCA gene mutation: A retrospective study

BackgroundBiliary tract cancers (BTCs) are rare. They are clinically and pathologically heterogeneous and associated with a poor prognosis. BRCA 1/2 are tumor suppressor genes responsible for a high number of hereditary breast and ovarian cancers. BRCA2 mutations are also associated with higher risk of other cancers, including prostate and pancreatic cancers. BTC-associated with BRCA mutation is still unclear. In this study, we analyzed the frequency and characteristics of BTCs in confirmed BRCA Portuguese families. MethodsRetrospective analysis of all BRCA1/2 families registered in our multidisciplinary program since January 2000 was performed. All cases of BTCs, on the mutated side of the family were included. ResultsFrom 513 BRCA1/2 families, 187 were BRCA1 and 325 BRCA2. BRCA2 c.156_157insAlu - the Portuguese founder mutation - was observed in 101 families. We identified BTCs in seven BRCA2 families, five of which were c.1567_157insAlu. Overall, 7 cases of BTCs were identified (5 with pathological confirmation): 5 BRCA2 carriers and 2 first-degree relatives of BRCA2 carriers. Median age at diagnosis was 63 years, with male and female prevalence rates of 57% and 43%, respectively. Two cases of BTC were diagnosed in two female survivors of breast cancer. One female survivor of BT developed peritoneal carcinoma after prophylactic salpingo-oophorectomy. All BRCA2 families revealed a heterogeneous phenotype: 5 out of 7 families have aggregation to pancreatic and/or stomach cancers. Four patients died, three from BTC disease progression and one from peritoneal carcinoma. The other 3 patients are alive without relapse. ConclusionsBRCA-associated BTCs are uncommon. Surveillance and prophylactic surgery reduces the risk of death from breast and ovarian cancer in BRCA2 carries allowing the diagnosis of other type of cancer during the follow-up, such as BTCs. Therefore, it is crucial the development of surveillance protocols for gastrointestinal tumours. Diagnosis of BTC-associated germline BRCA mutations might have clinical implications, expanding roles in treatment planning and allowing application of targeted therapies. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

Analysis of influencing factors and causes of death in elderly residents with non-alcoholic fatty liver disease

Objective: To understand and analyze the incidence rate, risk factors, independent risk factors and the causes of death in elderly population with non-alcoholic fatty liver disease (NAFLD). Furthermore, analyze the relationship between metabolic syndrome (MS) and mortality rate in patients with NAFLD to provide evidence for the prevention and control of NAFLD in the elderly population. Methods: A total of 7 619 elderly people aged over 60 years, and local household registered in Kunshan city, Jiangsu province in 2016 were included as subjects to analyze the incidence rate, influencing factors and causes of death in patients with NAFLD and the relationship between MS and mortality rate in patients with NAFLD. According to different data, using Kruskal-Wallis H test, analysis of variance, t-test, chi-square test or logistic regression analysis were performed. Results: The prevalence of NAFLD was14.10% (1 074/7 619) among the elderly over 60 years in Kunshan city, Jiangsu province in 2016, and the female prevalence rate was significantly higher than that of males (P < 0.05). When the body mass index (BMI) was < 32 (kg/m(2)), the prevalence of NAFLD increased with the increase of BMI index. When BMI was 18.5-23.9 kg/m2, 24-27.9 kg/m(2) and > 32 kg/m(2), the prevalence of NAFLD was significantly higher in females than males (P < 0.05). There was no significant difference in prevalence between males and females with BMI <18.5 kg/m(2) and 28~31.9 kg/m(2) (P > 0.05). BMI gradually decreased (P < 0.05) with the increase of age, and the incidence of NAFLD showed a downward trend (P < 0.05). An independent risk factors for NAFLD (P < 0.01) were gender (OR = 0.616), age (OR = 0.970), waist circumference (OR = 1.065), triglycerides (OR = 1.162), BMI (OR = 1.238), and diastolic blood pressure (OR = 1.012). The probability of NAFLD combined with three and four kinds of MS was significantly higher than control group (P < 0.05). Subjects' mortality rate during the follow-up period was 1.94%, 2.23% in the NAFLD group, and 1.89% in the control group. Average life expectancy was 75.58 years in NAFLD group and 78.68 years in the control group. All deaths in NAFLD groups were associated with MS, and 70.83% combined with three or more MS. The primary cause of death in NAFLD group was tumors (37.5%), followed by cardiovascular disease (16.67%) and three cases died directly from MS. Conclusion: The prevalence of NAFLD in the elderly population in Kunshan city, Jiangsu province is relatively low, which may be associated with local diet and high-intensity workouts. MS disorders represented by obesity and diabetes mellitus are closely associated to the onset of NAFLD. Obesity is the most important risk factor for the incidence of NAFLD in the local elderly population over 60 years old. However, the risk of NAFLD should not be neglected in people with normal BMI, especially in aged women, and the weight control should be the most important means to prevent and control NAFLD. NAFLD may increase mortality rate and reduce life expectancy in the elderly population. The main reason to cause death in the elderly with NAFLD is cardiovascular disease and malignant tumors. Simultaneously, multiple MS development may increase the death rate in elderly with NAFLD.

Sex differences in adolescent physical aggression: Evidence from sixty-three low-and middle-income countries.

A great deal of research shows that adolescent and adult males are more likely to engage in physical aggression and violence than females are. However, few studies have examined cross‐cultural variation in sex differences, particularly among low‐ and middle‐income countries [LMICs]. Based on social role and sexual selection theories, we derived two hypotheses regarding possible variations in sex differences across societal contexts: 1) sex differences increase with societal gender polarization (social role theory) and 2) sex differences are exacerbated in societies where socio‐economic opportunities are scarce, unequal, or insecure (prediction derived from sexual selection theory). The current study examined the prevalence of and variation in sex differences in physical aggression, as measured by frequent fighting, among 247,909 adolescents in 63 low‐ and middle‐income countries. The results show that, overall, males were over twice as likely (OR = 2.68; 95% CI = 2.60–2.76) to report frequent fighting in the past 12 months than females. However, sex differences vary significantly across LMICs, wherein countries with higher female prevalence rates have smaller sex differences in frequent fighting. Contrary to expectations derived from social role theory, sex differences in physical aggression decrease as societal gender inequality increased. In regards to sexual selection theory, we find no evidence that sex differences in frequent fighting varies according to societal rule of law or income inequality.