Proportion Of Persons Research Articles

Vericiguat on C-reactive Protein Level and Prognosis in Patients with Hypertensive Heart Failure.

Hypertensive heart failure (HHF) has a high incidence and poor prognosis. This article evaluated the efficacy and safety of Vericiguat in HHF and analyzed the relationship between C-reactive protein (CRP) levels and patient prognosis. 110 HHF patients were divided into Placebo and Vericiguat groups. Cardiac function was assessed by echocardiography and 6-minute walk test (6MWT). Blood samples were collected to detect the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), endothelin (ET-1), nitric oxide (NO), and CRP. Left ventricular end systolic diameter (LVESD) and left ventricular end diastolic dimension (LVEDD) were reduced, the left ventricular ejection fraction (LVEF) and 6MWT were increased, and the serum levels of NT-proBNP, cTnI, ET-1, NO, and CRP were decreased in Vericiguat group as against Placebo group; The total effective rate was 76.4% in Placebo group and 92.7% in Vericiguat group (P < 0.05). The adverse reaction rate was 10.9% and 9.1% (P > 0.05). The proportion of persons with poor prognosis and no improvement of cardiac function in patients with highly expressed CRP before treatment was higher as against patients with low expression of CRP (P < 0.05). Highly expressed CRP is an independent risk factor for poor prognosis. Vericiguat is safe and effective in improving cardiac function in HHF patients.

#1396 Anxiety level in kidney transplant recipients with adverse cardiovascular events

Abstract Background and Aims Kidney transplantation is the most cardioprotective method of renal replacement therapy and it has a positive effect on the psycho-emotional state of patients. However, kidney transplant recipients have a higher cardiovascular risk and a higher prevalence of anxiety and depression than people in the general population. The aim of the study was assessment of anxiety levels and the quality of life of kidney transplant recipients preceding adverse cardiovascular events. Method The study included 154 kidney transplant recipients. 54 (35.1%) of them had adverse cardiovascular events (acute coronary syndrome, complicated hypertensive crisis or rhythm disturbance) for three years of observation. The comparison group was 100 (64.9%) recipients without cardiovascular complications during the observation period. The study groups were comparable by age, gender, graft function and traditional cardiovascular risk factors. Results The average level of situational anxiety of kidney transplant recipients was 39 ± 7, the level of personal anxiety—43 ± 8. The structure was dominated by recipients with moderate personal anxiety—55.2% (n = 85) and moderate situational anxiety—66.9% (n = 103). However, the proportion of persons with high personal anxiety was quite high—40.9% (n = 63). The structure of anxiety levels had no significant differences depending on subsequent cardiovascular complications. Nevertheless, kidney transplantation recipients with adverse cardiovascular events had higher previous level of situational anxiety than recipients without cardiovascular events—41 ± 7 versus 38 ± 7, p &amp;lt; 0.05. During the study kidney transplant recipients were asked to rate their quality of life on a scale of 1 to 10. Recipients with subsequent adverse cardiovascular events had a lower subjective quality of life than recipients without cardiovascular complications—7 (6-8) versus 8 (7-8), p &amp;lt; 0.01. Conclusion Based on the study it was found that recipients with adverse cardiovascular events in the late postoperative period are characterized by a higher level of situational anxiety and a lower quality of life before these complications.

ETHNOCULTURAL COMPLEXITY OF THE POPULATION OF CHUVASHIA ACCORDING TO THE 2020 CENSUS

The relevance of the study is determined by new approaches in the official accounting of the nationality of Russian citizens. A decreasing number of representatives of the main ethnic groups both in Russia and in its individual regions increases the attention paid to the problems of ethnocultural development and interethnic relations. The publication of the 2020 census materials caused a mixed reaction to its organization and individual results. The purpose of the article is to analyze the census materials on the national composition of the population, an attempt to count citizens who have declared their difficult ethno–cultural choice. The reasons for the noticeable difference between the materials of sociological surveys and population census data are considered. Materials and methods. The article analyzes the published data of the 2020 population census, in particular, the data contained in the fifth volume of the national census 2020 results “National composition and language proficiency” for Russia in general and for the Chuvash Republic in particular. In addition, the “Methodological explanations” to the census materials were studied, as well as a number of regulatory documents. According to the table “Population’s answers to the question “Your nationality”, information was calculated on the number of people who chose a difficult answer to the question of nationality. Study results. The census materials showed that the number of individual ethnic groups of Chuvashia, representing the old-age population (except the Russians), decreased during the inter-census period. This process was determined not by the natural and mechanical movement of the population, but by the change of ethnic identity. The increase in the number and proportion of persons who did not indicate their ethnicity occurred both due to refusal to answer the question and due to a negative answer about specific nationality. In addition, in Chuvashia, the proportion of citizens whose information was obtained from administrative documents (gender and age) has increased significantly. The number of citizens who declared a complex ethnic identity was about 0.2% of those who named their ethnicity. This indicator lags far behind the data obtained in the course of sociological surveys. Conclusions. It follows from the above materials that the residents of Chuvashia were more loyal to the issue of their nationality compared to the citizens of Russia. The choice of a complex variant of ethnicity was not massive, but it also differed from a similar process in Russia as a whole. For example, in the republic, more often than in the country, the Russians, the Tatars, the Mordvins and the Ukrainians chose a difficult variant of nationality. The opposite picture was typical for the Chuvash; the Tatars living in Russia and Chuvashia had the same indicators of ethnocultural complexity. For the majority of the population, the definition of their ethnic identity did not cause any particular difficulties, but at the same time, both difficulties and a desire to distance themselves from such self-determination were noted in this process.

Features of changes in the age structure of newly diagnosed chronic hepatitis C in the Samara region

The urgency of the problem of chronic hepatitis C (HCV) is determined by the increasing incidence and severe consequences of infection in the form of cirrhosis and liver cancer. In the Russian Federation, the epidemiological situation of viral hepatitis is characterized by a relatively high incidence and mortality associated with hepatitis C, which determines the need to search for contingents for which it is necessary to purposefully carry out preventive and anti-epidemic measures. The aim of the work is to conduct a comparative analysis of the incidence of chronic hepatitis C in the Samara region in 1997–2021 and to characterize the dynamics of changes in the age composition of patients with chronic hepatitis C. To analyze the incidence of newly diagnosed chronic hepatitis C in the Russian Federation and the Samara Region, data from official statistics of the Federal Service for Supervision of Consumer Rights Protection and Human Well-being, the Office of the Federal Service for Supervision of Consumer Rights Protection and Human Well-being in the Samara Region were used. The study established a significant contribution of HCV to the structure of newly diagnosed chronic hepatitis and high incidence rates both in the Russian Federation and in the Samara region. In the studied region, the presence of changes in the contribution of various age groups to the structure of HCV cases over the years was revealed, expressed in an increase in the proportion of persons under the age of 2 years, 30–39 years and 60 years and older and a decrease in the proportion of adolescents 15–19 years and children 7–10 and 11–14 years. The identified features allow us to outline directions for adjusting preventive and anti-epidemic measures aimed at reducing the burden of HCV in the region.

A Rasch analysis of the Danish version of the occupational balance questionnaire (OBQ11)

Background OBQ11 was developed in a Swedish context. To evaluate occupational balance, accurate self-rating instruments in the native language are needed. Aim The aim was to investigate the measurement properties of the Danish version of OBQ11, using the Rasch analysis. Method Data for the analysis of the Danish version of OBQ11 (OBQ11-DK) was gathered online, and all full data records (n 366) were included in the analysis. Results Three items showed non-significant marginal under- or overfit, suggesting a degree of misfit between the data and the Rasch model. Unidimensionality was not reached, though, since the proportion of persons with different estimates were more than 5% and thus the OBQ11-DK cannot be said to assess a person’s perception of occupational balance. Conclusion The present version of the OBQ11-DK shows the need for further development and testing and is not tested for test/retest or in clinical samples. The results and small number of items may after modifications and further studies make it feasible to implement OBQ11-DK into settings where the measuring of occupational balance is needed.

Bias and Accuracy of Glomerular Filtration Rate Estimating Equations in the US

There is increasing concern that continued use of a glomerular filtration rate (GFR) estimating equation adjusted for a single racial group could exacerbate chronic kidney disease-related disparities and inequalities. To assess the performance of GFR estimating equations across varied patient populations. PubMed, Embase, Web of Science, ClinicalTrials.gov, and Scopus databases were systematically searched from January 2012 to February 2023. Inclusion criteria were studies that compared measured GFR with estimated GFR in adults using established reference standards and methods. A total of 6663 studies were initially identified for screening and review. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 2 authors independently extracted data on studies that examined the bias and accuracy of GFR estimating equations. For each outcome, a random-effects model was used to calculate pooled estimates. Data analysis was conducted from March to December 2023. The primary outcomes were bias and accuracy of estimated GFRs in Black vs non-Black patients, as well as in individuals with chronic conditions. Bias was defined as the median difference between the measured GFR and the estimated GFR. Accuracy was assessed with P30 (the proportion of persons in a data set whose estimated GFR values were within 30% of measured GFR values) and measures of heterogeneity. A total of 12 studies with a combined 44 721 patients were included. Significant heterogeneity was found in the bias of various GFR estimation equations. Race-corrected equations and creatinine-based equations tended to overestimate GFR in Black populations and showed mixed results in non-Black populations. For creatinine-based equations, the mean bias in subgroup analysis was 2.1 mL/min/1.73 m2 (95% CI, -0.2 mL/min/1.73 m2 to 4.4 mL/min/1.73 m2) in Black persons and 1.3 mL/min/1.73 m2 (95% CI, 0.0 mL/min/1.73 m2 to 2.5 mL/min/1.73 m2) in non-Black persons. Equations using only cystatin C had small biases. Regarding accuracy, heterogeneity was high in both groups. The overall P30 was 84.5% in Black persons and 87.8% in non-Black persons. Creatinine-based equations were more accurate in non-Black persons than in Black persons. For creatinine-cystatin C equations, the P30 was higher in non-Black persons. There was no significant P30 difference in cystatin C-only equations between the 2 groups. In patients with chronic conditions, P30 values were generally less than 85%, and the biases varied widely. This systematic review and meta-analysis of GFR estimating equations suggests that there is bias in race-based GFR estimating equations, which exacerbates kidney disease disparities. Development of a GFR equation independent of race is a crucial starting point, but not the sole solution. Addressing the disproportionate burden of kidney failure on Black individuals in the US requires an enduring, multifaceted approach that should include improving diagnostics, tackling social determinants of health, confronting systemic racism, and using effective disease prevention and management strategies.

An estimate of the need for continuous glucose monitoring in type 2 diabetes with intensive insulin treatment in secondary healthcare.

To estimate the proportion of persons with type 2 diabetes (T2DM) receiving intensive insulin treatment in the secondary healthcare who could be candidates for continuous glucose monitoring (CGM), based on different HbA1c criteria. For comparison, the results are also presented as proportion of persons with type 1 diabetes (T1DM) in the same region. In the Central Denmark Region, we identified all persons with T1DM (n = 6179) and T2DM (n = 4315) who had a minimum of one contact to a diabetes outpatient clinic from September 2021 to September 2022. Insulin regimen and HbA1c measured after a minimum of 2 months with a stable insulin regimen were retrieved from the healthcare administrative electronic platform used in the region. The numbers of persons with T1DM and T2DM with HbA1c meeting the criteria were 5145 and 3090, respectively. The fraction of T2DM with basal-bolus insulin was 35.3%, and the fraction with basal-bolus insulin and HbA1c >53 (7%) mmol/mol or >58 (7.5%) mmol/mol was 20.5% and 16.6%, respectively. These proportions correspond to 19.4%, 14.4% and 11.7% of the persons with T1DM in the same geographical area. The proportion of persons with T2DM in secondary healthcare undergoing intensive insulin treatment who could be candidates for CGM corresponded to only a minor fraction of persons with T1DM in the same region, irrespective of any HbA1c criteria applied.

A randomized trial evaluating the utility of non-targeted biopsies for colorectal neoplasia detection in adults with inflammatory bowel disease: a pilot study protocol

BackgroundPersons with inflammatory bowel diseases are at increased risk of developing colorectal cancer and require frequent colonoscopy surveillance. Guidelines recommend taking 30 to 40 non-targeted biopsies throughout the colorectum to detect “invisible” neoplasia in this setting, despite a lack of evidence supporting this practice. We sought to assess the utility of this practice through a randomized controlled trial. We first propose an internal pilot study to assess recruitment potential, protocol adherence and data capture to guide the full trial.MethodsWe have designed a multi-centre, parallel-group, non-inferiority randomized controlled trial to test the utility of non-targeted biopsies as an adjunct to colonoscopy surveillance for neoplasia detection in persons with inflammatory bowel disease involving the colorectum in routine clinical practice. Participants are randomized 1:1, stratified by study site, to either standard of care high-definition white-light colonoscopy with 32 to 40 non-targeted biopsies of non-neoplastic-appearing mucosa along with a sampling of abnormal-appearing mucosa (control group) or modified colonoscopy with targeted sampling alone (intervention group). The primary outcome for the full trial will be the proportion of persons with ≥ 1 neoplastic focus detected during colonoscopy. For the pilot phase, we will assess the feasibility of recruiting a minimum of 15% of the estimated sample size within 1 year, under identical conditions as the full trial, while maintaining ≥ 90–95% rate of protocol adherence and data capture. These participants will contribute data to the full trial. The trial is being conducted at 12 centres across Canada, with a total sample size of 1952 persons.DiscussionsThe trial protocol has been approved by the ethics committees of all participating sites, and the pilot study has received funding through the Canadian Institutes of Health Research (PJT 159607). If feasibility metrics are met during the pilot phase, we will complete the full trial. The trial outcomes will contribute to update the practice guidelines in this area.Trial registrationClinicalTrials.gov, NCT04067778.

Inconsistencies in self-reported diabetes in a large panel study: the Survey of Health, Ageing and Retirement in Europe (SHARE)

BackgroundThe validity of self-reported chronic conditions has been assessed by comparing them with medical records or register data in several studies. However, the reliability of self-reports of chronic diseases has less often been examined. Our aim was to assess the proportion and determinants of inconsistent self-reports of diabetes in a long panel study.MethodsSHARE (Survey of Health, Ageing and Retirement in Europe) includes 140,000 persons aged ≥ 50 years from 28 European countries and Israel. We used data from waves 1 to 7 (except wave 3) collected between 2004 and 2017. Diabetes was assessed by self-report. An inconsistent report for diabetes was defined as reporting the condition in one wave, but denying it in at least one later wave. The analysis data set included 13,179 persons who reported diabetes, and answered the question about diabetes in at least one later wave. Log-binomial regression models were fitted to estimate crude and adjusted relative risks (RR) with 95% confidence intervals (CI) for the associations between various exposure variables and inconsistent report of diabetes.ResultsThe proportion of persons with inconsistent self-reports of diabetes was 33.0% (95% CI: 32.2%—33.8%). Inconsistencies occurred less often in persons taking antidiabetic drugs (RR = 0.53 (0.53—0.56)), persons with BMI ≥ 35 kg/m2 versus BMI < 25 kg/m2 (RR = 0.70, (0.64—0.77)), and poor versus excellent subjective health (RR = 0.87 (0.75—1.01)). Inconsistencies occurred more often in older persons (RR = 1.15 (1.12—1.18) per 10 years increase of age), and persons not reporting their age at diabetes onset (RR = 1.38 (1.31—1.45)).ConclusionIn SHARE, inconsistent self-report of diabetes is frequent. Consistent reports are more likely for persons whose characteristics make diabetes more salient, like intake of antidiabetic medication, obesity, and poor subjective health. However, lack of attention in answering the questions, and poor wording of the items may also play a role.

Влияние вакцинации против гриппа, пневмококковой инфекции и SARS-CoV-2 на заболеваемость и тяжесть течения COVID‑19 у медицинских работников отдельного учреждения (эпидемиологические исследования)

Objective. To study the effect of influenza, pneumococcal and SARS-CoV-2 vaccination on the incidence and severity of COVID-19 course in health care workers. Patients and Methods. We examined 547 health care workers divided into group 1 (no history of influenza and pneumococcal vaccination, n = 281) and groups vaccinated between August and October 2020 (before SARS-CoV-2 epidemic II): Group 2 against influenza (n = 98), Group 3 against pneumococcal infection (n = 60), and Group 4 against influenza and pneumococcus (n = 108). Between March and August 2021 (before the SARS-CoV-2 epidemic III outbreak), 98.6% of all employees were vaccinated against COVID-19. We compared COVID-19 incidence rates during Periods II and III epidemic rises (2020–2022) as a function of influenza and pneumococcal vaccination. Results. It was found that with combined vaccination against influenza and pneumococcal infection in the group of medical workers at high risk of infection, the risk of COVID-19 morbidity within 4–5 months was 2 times lower (1.6% vs. 13.2%, p &lt; 0.05) compared to the unvaccinated. Comparative data on COVID-19 incidence in the II and III periods of epidemic rises showed that COVID-19 in medical workers in the III period was registered 36.1% lower in comparison with the index in the II period – 11.2 and 7.1%, respectively (p &lt; 0.05). We found that when comparing II and III periods of epidemic rises among medical workers, the proportion of persons with COVID-19 with moderate forms of disease who received combined vaccination against influenza and pneumococcal infection decreases more than 2-fold (p &lt; 0.05), including in the category with a high risk of infection. Conclusion. The presented data indicate a positive effect of combined vaccination against pneumococcal infection and influenza on the incidence and severity of COVID-19. The proposed approach can be used in public health practice as a method of nonspecific prevention of COVID-19 and other acute respiratory viral infections. Key words: influenza vaccine, pneumococcal vaccine, combined vaccination, epidemic rise, COVID-19

Активность теломеразы, гиперлипидемия и особенности атеросклеротического поражения брахиоцефальных артерий у бессимптомных пациентов трудоспособного возраста с субклиническим гипотиреозом

Aim. To study telomerase activity, lipidemia and to assess the severity of atherosclerotic lesions of the brachiocephalic arteries in asymptomatic patients of working age with subclinical hypothyroidism. Design. A cross-sectional cohort study. Materials and methods. Data on 131 patients of working age (32 men and 99 women) with different hormonal status of the thyroid gland (thyroid) without clinical signs of chronic cerebral circulatory insufficiency were analyzed. Based on the assessment of the hormonal status of the thyroid gland, 2 groups of patients were formed: 87 with laboratory-confirmed hypertension (thyroid-stimulating hormone level &gt; 4.0 mMU/l with normal characteristics of free fractions of thyroid hormones) and 44 patients without thyroid dysfunction. The groups formed were comparable in age, gender composition, presence and severity of hypertension, aggravated family history of early cardiovascular events, and smoking. All patients underwent ultrasound examination of the brachiocephalic arteries, determination of the lipid spectrum and telomerase concentration. The processing of the obtained data was carried out using statistical packages Excel, Statistica v. 10.0. The data obtained were interpreted as reliable, and the differences between the indicators were considered significant when the error-free prediction value was equal to or greater than 95% (p &lt; 0.05). Results. In the group of people with hypothyroidism, the proportion of people with multivessel atherosclerotic lesion was higher (34.5% (n = 30) vs. 13.6% (n = 6) (χ2 = 6.37; p &lt; 0.05)), one or a combination of several signs of instability of atherosclerotic plaque (41.4% (n = 36) vs. 18.2% (n = 8) (χ2 = 7.05; p &lt; 0.01)). In patients with subclinical hypothyroidism, precerebral atherosclerosis occurs against the background of atherogenic type IIa secondary hyperlipidemia (67.8% (n = 59) vs. 34.1% (n = 6) (χ2 = 13.52; p &lt; 0.001) in combination with insufficiency of antiatherogenic high density lipoproteins (74.7% (n = 65) vs. 45.5% (n = 20) (χ2 = 10.98; p &lt; 0.001)), lower values of telomerase concentration in comparison with the group of people without thyroid dysfunction: (8.2 (7.4–9.5) vs. 10.8 (10.1–12.2) ng/ml (p &lt; 0.001)). The relationship between the level of telomerase activity (r = –0.72; p &lt; 0.05) and the presence of subclinical hypothyroidism, atherosclerotic lesions of the precerebral bed in patients (r = –0.33; p &lt; 0.05) was established. Conclusion. In clinically healthy patients of working age with newly diagnosed, medically uncorrected subclinical hypothyroidism, the proportion of persons with ultrasound signs of multivessel atherosclerotic lesions of the brachiocephalic arteries is higher, and precerebral atherosclerosis occurs against the background of atherogenic type IIa secondary hyperlipidemia in combination with insufficiency of antiatherogenic high density lipoproteins, lower values of telomerase activity in comparison with the group of persons without thyroid dysfunction. Etiopathogenetic mechanisms of "early vascular aging", the criteria for stratification of risk groups for atherosclerosis-associated cardiovascular disease, the choice of diagnostic algorithms for visualizing preclinical stages of atherogenesis, and timely antiatherogenic tactics in asymptomatic patients with comorbid thyroid pathology require further study. Verification of a stenosing hemodynamically significant or non-hemodynamically significant atherosclerotic lesion of the coronary basin, regardless of the clinical component, is a factor of high cardiovascular risk requiring immediate correction of hyperlipidemia. Keywords: thyroid gland, hypothyroidism, hyperlipidemia, atherosclerosis, precerebral (brachiocephalic) arteries, telomerase activity, comorbid pathology.

HIV Testing and Preexposure Prophylaxis Prescriptions Among U.S. Commercially Insured Transgender Men and Women, 2014 to 2021.

Transgender persons are disproportionately affected by HIV, but preexposure prophylaxis (PrEP) use has been low in this population. Clinical encounters for gender-affirming hormone therapy (GAHT) provide opportunities for HIV prevention. To estimate the number of commercially insured transgender women (TGW) and transgender men (TGM) in the United States and their use of HIV prevention services. Retrospective analysis of secondary data. Merative MarketScan commercial databases from 2014 to 2021. TGW and TGM, defined as those with transgender-related diagnoses and prescriptions for feminizing or masculinizing GAHT. HIV testing and PrEP use. A substantially increasing trend was observed in the prevalence of transgender-related diagnosis codes from 2014 to 2021 and in the proportion of persons who used GAHT. The increases were driven by persons aged 18 to 34 years. In 2021, among 10 613 TGW with a test for or a diagnosis of a sexually transmitted infection (STI) in the previous 12 months, 61.1% had an HIV test; among those, 20.2% were prescribed PrEP. Among 4184 TGM with STI risk, 48.3% had an HIV test; among those, 10.2% were prescribed PrEP. The prevalence of TGW and TGM who had a test for or a diagnosis of an STI, had an HIV test, and were prescribed PrEP increased substantially from 2014 to 2021. The findings represent only persons with commercial health insurance who sought health care services for GAHT. It is important to identify transgender persons to monitor their receipt of HIV prevention services. Encounters for GAHT provide opportunities to offer HIV prevention and other prevention services. Many HIV prevention opportunities were likely missed at clinical encounters for GAHT. None.

Increasing age of multiple sclerosis onset from 1920 to 2022: a population-based study

ObjectiveTo study the age at onset of relapsing–remitting multiple sclerosis (RRMS) during the past century.MethodsThis is a population-based cohort study of persons diagnosed with RRMS in Hordaland, Møre, and Romsdal counties, Western Norway, from 1920 to 2022. Individual patient data were available and assessed from previously conducted prevalence and incidence studies in addition to hospital records up until October 31, 2022. Participants were categorized according to onset period and analyzed for temporal trends in age at onset, time from onset to diagnosis, and distribution of onset over time.ResultsWe identified 3364 persons with confirmed RRMS. The mean age at onset significantly increased (p < 0.001) throughout the study period, despite a decrease in time from symptom onset to diagnosis (p < 0.001). The proportion of persons with MS onset after 50 years of age increased from 2.6% before 1970 to 11.9% after 2010. We also found a trend toward a bimodal distribution of age at onset that peaked at around 30 years and 40–45 years of age in the latest period.ConclusionAge at onset of MS significantly increased throughout the study period. This was mainly due to an increasing number of persons with MS, predominantly female, experiencing onset after 40–45 years of age. This bimodal distribution could indicate different susceptibility periods of MS or changes in exposure to risk factors during the observation period.

High quality of diabetes care in Greenland since the launch of Steno Diabetes Center Greenland 2020 - geographical disparities need attention

ABSTRACTThe aim of this study was to estimate the prevalence of diagnosed diabetes in Greenland and evaluate quality of care according to sex, region and healthcare unit within regions. Data on all inhabitants registered with diabetes were extracted from the electronic medical record. We found a crude prevalence of diagnosed diabetes in the population aged ≥ 20 years to be 4.7%, and the prevalence of diabetes standardised to the WHO world population was 4.0%. Compared to males, a significantly higher proportion of females had mean glycated haemoglobin (HbA1c) level below 7% (68.9% vs. 57.5%) and blood pressure below 140/90 mmHg (83.4% vs. 73.5%). Regarding healthcare unit within regions, quality of care was higher in regional cities compared to smaller cities, concerning proportion of persons having blood pressure measured regularly (86.0% vs. 71.7%), urine tested for albuminuria (70.6% vs. 51.2%), receiving eye examination (86.9% vs. 79.5%) and foot examination (87.9% vs. 79.4%). In conclusion, the prevalence of diagnosed diabetes in Greenland is the highest reported yet. The overall quality of diabetes care was high and significantly improved compared to 2018. We observed geographical inequality in diabetes care and improvements in the quality of care in specific remote locations are necessary to minimise health care disparities.

The register as a tool for researching trends in phlebological care for the population of a large industrial center of Russia

Introduction. The Russian Phlebological Register began work in 2016 under the patronage of the Association of Phlebologists of Russia. The creation of a phlebological register in a separate municipal center of the country complements and enriches national plans. Aim. Тo investigate the trends in the organization of medical care to the population with chronic venous diseases (CVD) of a large industrial center using the phlebological register over the past 20 years. Materials and methods. The data of municipal and private medical institutions of Ekaterinburg from 2003 to 2022 are analyzed. Data on municipal hospitals (MHs) are provided by the TFOMS of the Sverdlovsk region. Data on private medical centers (PMCs) are obtained by exporting them from the electronic databases of each center. The statistics of phlebectomies (PhE), outpatient minimally invasive interventions and procedures are summarized. Results. Over the entire period of time, the number of classical phlebectomies in MHs decreased by 4 times – from 2300 (2003) to 587 (2022). At the same time, the development of minimally invasive procedures on the main veins in the PMCs increased from 313 (2003) to 4364 (2022). This made it possible to double the coverage of patients suffering from CVD with specialized medical care. In the structure of patients operated in MHs, the proportion of persons with severe chronic venous insufficiency (CVD C4–6) significantly decreased. The number of patients with superficial thrombophlebitis had a steady downward trend: the first 5 years (2003–2007) – about 200 PhE/year, then 5 years (2008–2012) – about 120 PhE/year, and from 2013 to 2022 &lt; 100 PhE/year. Discussion. Private medical centers have consistently introduced the latest technologies, but endovasal laser coagulation remains the leader. Conclusion. The analysis of the register revealed a number of systemic changes in the organization of phlebological care.

Evolution of herd SARS-CoV-2 humoral immunity in the Republic of Belarus

Background. The course of the COVID-19 epidemic process depends on population immunity which prevents pathogen spread. Aim: to study an evolution of SARS-CoV-2 humoral immunity in the Belarusian population rela- tive to COVID-19 pandemic dynamics.&#x0D; Materials and methods. The work was carried out according to a methodology for assessing herd immunity developed by Rospotrebnadzor (Russia) and the Belarusian Ministry of Health involving the St. Petersburg Pasteur Institute (SPPI) by taking into account the WHO recommendations. The study was approved by the Bioethics Committee of Belarus and the SPPI Bioethics Committee. Participant selection was carried out by ques- tionnaire using a cloud (internet server) service. To monitor herd immunity, a cohort of 4661 subjects (involved at all stages of seromonitoring) was formed from the total volunteer group. Study subjects were randomized into groups based on age (117, 1829, 3039, 4049, 5059, 6069, 70+ years), geographic region, and occupation. For the detection of antibodies (Abs) against SARS-CoV-2 nucleocapsid (Nc) and S glycoprotein receptor-binding domain (RBD), rel- evant assay systems were used according to the manufacturers instructions. A four-stage study was conducted according to a unified scheme.&#x0D; Results. At stage 1 (pandemic month 15), herd immunity was mainly accounted for by Nc+RBD+ Ab status alone. By stage 2 (4 months later), its specific proportion decreased by 1.2-fold, whereas percentage of subjects solely bearing RBD-specific Abs increased by 1.7-fold. At stages 3 and 4 (9 and 19 months after the onset) vs. stage 2, percent- age of subjects with RBD+Nc decreased by 3.5%; the proportion of persons with Nc+RBD Abs increased by 1.5-fold.&#x0D; The most important contributor in herd immunity turned out to be due to population vaccination, with coverage reaching 70% by stage 4. Among vaccines, compared with whole-virion, inactivated BIBP-CorV vaccine the Sputnik V and Sputnik Light vector were used most often.&#x0D; Conclusion. The evolution of herd SARS-CoV-2 humoral immunity included a series of changes in circulating Ab levels (Nc, RBD). The hybrid immunity formed helped to reduce the incidence of COVID-19 to sporadic level.

The pattern of online health information-seeking behavior before and during the COVID-19: An online cross-sectional survey among Nigerians

Objectives: To evaluate alterations in the behavioral pattern of people looking for health information online in Nigeria. Material and Methods: Using a Google form that included a consent form and a data collection tool, 206 internet users participated in this online descriptive cross-sectional survey. From April 22 through May 31, 2022, the Google form’s link was shared on social media with all eligible participants. Descriptive statistics of frequency and percentage were used to summarize the data, which was represented as a bar chart. Results: Respondents within the age range of 20-29 years (82.5%) predominated in the study and were mostly Male (63.1%). The proportion of persons with internet access had gone up slightly from 98.5% to 99.5%, but internet usage remained the same (99% Vs 99%), however, a decrease in the frequency of using the internet always (56.3% Vs 48.5%) was observed. During COVID-19, there was a rise in the percentage of people obtaining health information online (87.4% vs. 96.6%). Conclusion: Albeit a slight decrease in using the internet during the COVID-19 era, however, there was an increase in online seeking behavior.

Breath of fresh insight: unraveling the evolution of our understanding of cystic fibrosis pulmonary exacerbations.

Pulmonary exacerbations are critical events with significant negative impacts in persons with cystic fibrosis, but their diagnosis and management are highly variable. Highly effective modulator therapies have greatly improved health and reduced exacerbation events, but have also reshaped how they present. This review discusses the complexities of the diagnosis and management of pulmonary exacerbations as well as the emerging work and evidence in this area. The shifting epidemiology and our understanding of risk factors for pulmonary exacerbations are discussed. As symptoms may be more subtle in the modulator context, novel technologies including studies of remote monitoring are presented. The continued relevance of pulmonary exacerbations, the heterogeneity in their management, as well as current and forthcoming clinical trials to optimize treatment approaches are detailed. In spite of the dramatic reductions in pulmonary exacerbations, airway infections persist, a proportion of persons with cystic fibrosis either on or off modulator therapies continue to experience exacerbation events, and long-term data is lacking. Innovative approaches and studies will be crucial to enable standardized and generalizable strategies to improve outcomes in persons with cystic fibrosis.

Diabetes in a hospital cohort of persons living with HIV: a descriptive and comparative study in French Guiana

BackgroundIn French Guiana (population 294,000) the prevalence of type 2 diabetes (10%) and of HIV(1.1%) are very high. Our objective was to determine the prevalence of diabetes and its complications in a HIV cohort.Materials and methodsWe enrolled HIV-infected persons followed in Cayenne, Kourou, and Saint Laurent du Maroni hospitals between January 1, 1992 and December 31, 2021 in the French Hospital Database for HIV (FHDH) a national database compiling data from all French regions.ResultsThere was no difference of diabetes prevalence between men (8.2%) and women (8.8%), P = 0.4. Patients with diabetes were older (56 years ± 13.4) than those without diabetes (44.7 years ± 13.6) and prevalence increased with age. The proportion of persons with diabetes was greater among virologically suppressed persons (10%) than those with a detectable viral load under antiretroviral treatment (5.8%). Persons with diabetes had substantially greater CD4 counts at diagnosis than persons without diabetes. The majority of macro and microvascular complications were observed in people with diabetes. Persons with diabetes and HIV were significantly less likely to have had AIDS (1.6 versus 2.2 per 100 person-years, respectively). Overall, 374 persons living with HIV of 4167 had died (9%) the proportion of persons with diabetes among the dead was greater than those who did not die 11.7% versus 8.1%, respectively, p = 0.017. However, persons with diabetes were older and hence died older, 62.3 years (SD = 1.9) for deceased persons with diabetes versus 50.4 years (SD = 0.8), P < 0.0001. However, using Cox regression to adjust for age, initial CD4 count, country of birth there was no significant difference in the Hazard for death between persons with diabetes and persons without diabetes (aHR = 0.99, 95%CI = 0.65–1.5), P = 0.9.ConclusionsThe prevalence of diabetes in our HIV cohort was high. Persons with diabetes had greater CD4 counts, earlier care, and greater virological suppression than persons without diabetes. There were no significant differences between persons with diabetes and without diabetes in terms of survival.

Подходы к интегральной оценке эффективности первичных профилактических мероприятий для принятия управленческих решений

Standard indicators currently used to evaluate efficiency of various prevention measures do not determine the impact of these measures on public health indicators and achievement of target results. P u r p o s e of this study is to develop approaches of integral assessment efficiency evaluation of public health system primary prevention measures. M a t e r i a l s a n d m e t h o d s . The analysis was conducted in Omsk region municipal districts during the period from 2018 to 2022. The materials for this research were data from reporting forms of federal sectoral monitoring, morbidity of the population data, information about prevention measures volume and quality. The method of integral efficiency assessment was used. This method is based on arithmetic mean of the selected general indices of measures that include individual indices of public health measures efficiency. Efficiency assessment of measures aimed at population alcohol consumption reduction is used as an example. R e s u l t s . Individual indices that evaluate retail alcohol sales rate, the proportion of persons with risk factors, their involvement in dispensary supervision, involvement of the population in preventive measures, were created to assess the overall index of measures aimed at alcohol consumption reduction. Individual indices are presented with baseline and target values. The analysis of the dynamics of actual indicators of the volume of alcohol consumption reduction measures is given. Integral index of prevention measures efficiency is the arithmetic mean of the general indices, including six components of primary prevention of chronic non-communicable diseases that have a significant impact on public health indicators, including: tobacco consumption reduction, obesity prevalence, proportion of the population with physical activity increase, rational nutrition, healthy lifestyle. The closer the integral index is to the value of 1, the more effective preventive measures are. The integral index of primary prevention measures efficiency in Omsk in 2022 is at 0,46 points. C o n c l u s i o n . Implementing the integral efficiency assessment method allowed to use unified approach in evaluation of the current primary prevention of chronic non-communicable diseases measures model, to conduct a comparative evaluation of measures aimed at strengthening public health in Omsk region municipal districts, showed the direction of additional measures to improve the efficiency of the process as a whole.