Death Rate Research Articles

Pattern of burden cancer breast and relationshipin to human development index in Iran 2009 to 2019: an observational study based on the Global Burden of Diseases

ObjectiveBreast cancer is one of the most common cancers in women worldwide. This study aims is to investigate the burden of breast cancer in Iran and its relationship with the Human Development Index (HDI) during 2009 to 2019.Study designThe present study is an observational study in Iran during the years 2009 to 2019. Data related to the incidence, mortality, Years of Life with Disability (YLD), Years of Life Lost (YLL) and Disability-Adjusted Life-Years (DALY) of breast cancer in Iran were extracted from the Global Burden of Disease 2019 (GBD-2019) website. Correlation tests are used to check the relationship between these indicators and the human development index.ResultsThe highest incidence rate of breast cancer in 2019 is related to the provinces of Gilan (29 per 100,000) and Tehran (28.55 per 100,000) and the highest rate of death from breast cancer is related to the provinces of Gilan (10.71 per 100,000). and Semnan (9.97 in 100,000). The results showed that there is a positive and significant correlation between DALY (r = 0.626, P < 0.0001), YLL (r = 0.611, P < 0.0001) and, YLD (r = 0.773, P < 0.0001) breast cancer with HDI index. There is a positive and significant correlation between the incidence (r = 0.794, P < 0.0001) and mortality (r = 0.503, P = 0.003) of breast cancer with the HDI index.ConclusionsConsidering that a positive correlation was observed between the incidence and burden of breast cancer and the human development index in the country, it is suggested to implement preventive measures such as public education programs to reduce the incidence and burden of breast cancer and the necessity of screening programs in areas with low human development index. It confirms the diagnosis of disease cases.

Health service utilization, substance use treatment response, and death in patients with opioid use disorder and comorbid hepatitis C findings from prospective cohort study with administrative database linkage

BackgroundAmong patients with opioid use disorder (OUD), high rates of overdose and death have been reported in subgroups with Hepatitis C Virus (HCV). Evidence on the comorbid effect of HCV on clinical and substance use trajectories has been limited by small sample sizes, short follow-up, and heavy reliance on administrative data which lacks granularity on important prognostic factors. Additionally, few studies include populations on substance use treatment. AimTo establish the impact of HCV exposure (antibody positivity) on health care utilization patterns, substance use treatment response, and death in a cohort of patients with OUD on opioid agonist therapy (OAT). MethodsThis multi-center prospective cohort study recruited adult patients with OUD on OAT from 57 substance use treatment centers in Ontario, Canada. The study collected substance use outcomes, and classified patients with ≥50 % positive opioid urine screens over one year of follow-up as having poor treatment response. Additional data obtained via linkage with ICES administrative databases evaluated the relationship between HCV status, healthcare service utilization, and death over 3 years of follow-up. Multiple logistic regression models established the adjusted impact of HCV on various outcomes. ResultsAmong recruited participants (n = 3430), 44.10 % were female with a mean age of 38.64 years (Standard deviation: 10.96). HCV was prevalent in 10.6 % of the cohort (n = 365). Methadone was used most often (83.9 %, n = 2876), followed by sublingual buprenorphine (16.2 %, n = 554). Over the three-year follow-up, 5.3 % of patients died (n = 181). Unadjusted results reveal rates of hospitalization (all-cause, mental-health related, critical care) and emergency department visits (mental health-related), were significantly higher among HCV patients. Associations diminished in adjusted models. Active injection drug use exhibited the highest predictive risk for all outcomes. ConclusionA high degree of acute physical and mental illness and its resulting health service utilization burden is concentrated among patients with OUD and comorbid HCV. Future research should explore the role for targeted interventions and how best to implement integrated healthcare models to better address the complex health needs of HCV populations who inject drugs.

Evaluating Pericardiectomy Outcomes and Determinants; an 8-Year Retrospective Study at Tertiary Teaching Hospitals in Ethiopia

&amp;lt;i&amp;gt;Background&amp;lt;/i&amp;gt;: Constrictive pericarditis has a variety of etiologies which leads to severe symptoms and heart failure which affects the quality of life. So far the main modality of treatment is pericardiectomy. &amp;lt;i&amp;gt;Objective&amp;lt;/i&amp;gt;: The aim of this research was to know pericardiectomy outcomes and determinants among constrictive pericarditis patients who were operated at Tikur Anbessa Specialized Hospital from 2014 - 2022. &amp;lt;i&amp;gt;Methods&amp;lt;/i&amp;gt;: A retrospective study was done among 65 patients. Data was presented using frequencies with percentages, mean (±standard deviation) and/ or median (interquartile range) as required. Perioperative mortality and complications were summarized using incidence density with 95% confidence interval (CI). &amp;lt;i&amp;gt;Result&amp;lt;/i&amp;gt;: Most patients were in their 20s (53.8%) and where male are (84.6%). The commonest presenting symptom was shortness of breath (100%), fatiguability (96.9%), and coughs (66.2%). The median time of presentation was 12.3 months (IQR, 7.0-25.5). There were also cases with clinical symptoms of tuberculosis (13.8%). The etiology of constrictive pericarditis was infectious in 83.1% of cases. The mean length of surgery was 3.3 ± 0.6 hours. The median duration of hospital stay is 9.0 days (IQR, 7.0-12.0). The incidence rate (IR) of perioperative death was 7.9 per 1000 person-days (PD) of observation (94% CI = 3.3 – 19.2) and the incidence rate of complication was 4.8 per 1000 PD (95% CI = 1.5 -14.9). &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: Pericardiectomy is the best treatment for patients with constrictive pericarditis. The majority of patients had a good outcome, with an improvement in symptoms and functional status. The mortality rate was low, and the complication rate was acceptable. However, this study is based on relatively small sample size, and it is a retrospective study from a single center. Hence, further prospective studies are needed to confirm the findings of this study.

Predictors of Pandemic Impact in a Rural Community: Survey Results from a Community Partnership to Support Health and Well-Being.

Rural communities have struggled to fight the COVID-19 pandemic. Despite slower spread at the start of the pandemic in these areas, by 2021, they experienced higher death and hospitalization rates compared with urban areas. Increased mental health issues including stress, depression, and anxiety were also reported in rural areas following the start of the pandemic. Young people in these communities were significantly impacted by COVID-19, reporting increased stress and mental health issues. To examine the effects of COVID-19 on these local rural communities, authors conducted a survey in coordination with their community partners. The survey was completed by 119 participants across three rural counties and included 69 questions from the Pandemic Stress Index and the World Health Organization COVID-19 Rapid Quantitative Assessment Tool. Authors' results indicated that age, depression, and anxiety were predictors of higher self-reported COVID-19 impact. The strongest predictor of high pandemic impact in the sample was the combination of depression and anxiety symptoms. Authors used these results to inform their partners about the need for increased mental health services that are tailored for young adults in their communities. More research is needed to determine which services will be most beneficial and how to best reach those in need. Social workers in both public health and mental health settings are poised to help.

Incidence trends of gastric cancer in the United States over 2000-2020: A population-based analysis.

Gastric cancer ranks among the top cancers in terms of both occurrence and death rates in the United States (US). Our objective was to provide the incidence trends of gastric cancer in the US from 2000 to 2020 by age, sex, histology, and race/ethnicity, and to evaluate the effects of the COVID-19 pandemic. We obtained data from the Surveillance, Epidemiology, and End Results 22 program. The morphologies of gastric cancer were classified as adenocarcinoma, gastrointestinal stromal tumor, signet ring cell carcinoma, and carcinoid tumor. We used average annual percent change (AAPC) and compared pairs using parallelism and coincidence. The numbers were displayed as both counts and age-standardized incidence rates (ASIRs) per 100000 individuals, along with their corresponding 95% confidence intervals (CIs). Over 2000-2019, most gastric cancers were among those aged ≥55 years (81.82%), men (60.37%), and Non-Hispanic Whites (62.60%). By histology, adenocarcinoma had the highest incident cases. During the COVID-19 pandemic, there was a remarkable decline in ASIRs of gastric cancer in both sexes and all races (AAPC: -8.92; 95% CI: -11.18 to -6.67). The overall incidence trends of gastric cancer were not parallel, nor identical. The incidence of gastric cancer shows notable variations by age, race, and sex, with a rising trend across ethnicities. While the overall incidence has declined, a noteworthy increase has been observed among younger adults, particularly young Hispanic women; however, rates decreased significantly in 2020.

Factors Associated with Newborn’s Survival: A Cross-Sectional Study at two Districts of Bihar

Family Participatory Care (FPC) is a relatively new concept adopted in SNCUs in India. Its effect on survival outcomes of sick newborns has not been studied much. As such newborn mortality studies are rare due to their large sample scale requirement. This is one of the few studies which have been conducted using primary data on this subject in India. In our study, we have found similar causes of death among newborns as published by renowned studies. Study findings highlighted that FPC may reduce newborn mortality by reducing the length of stay at the facility, newborn growth, and survival outcome of sick neonates, especially Kangaroo mother care and exclusive breastfeeding are key components of FPC, and help in reducing newborn deaths. Objectives: Family Participatory Care (FPC), a cost-effective innovation implemented in Special Newborn Care Units (SNCUs) where vulnerable newborns are treated, is a well-established concept akin to Family Centered Care (FCC) in developed nations. The study aims to assess the impact of FPC on the survival rates of sick neonates in SNCUs. The study explored the factors associated with the care of sick neonates after discharge from SNCU that adapted FPC and that did not adapt FPC. Methods: A multistage random sampling method was used to examine sick neonates and newborns discharged from Special Newborn Care Units (SNCUs) in selected districts of Bihar namely Nalanda SNCU with Family Participatory Care (FPC) and Vaishali SNCU without FPC. Findings: The study found a notable variance in the rate of newborn mortality between the district implementing Family Participatory Care and the district that did not implement FPC, with the former experiencing nearly double the rate of newborn deaths. 11 key factors (maternal, household, family support, newborn health-related) attributing towards newborn survival status were identified in this study. Novelty: Family Participatory Care (FPC) is a relatively new concept in India, and this is one of the few studies that have been conducted on this subject. Keywords: Neonatal death, Family Participatory Care, Newborn Survival, Newborn Care, Family participation in Newborn care

Prediction and Diagnosis of Breast Cancer using Machine Learning Techniques

Introduction: One of the most common types of cancer and a significant contributor to the high death rates among women is breast cancer. It usually occurs in women. It is crucial to acquire a diagnosis early in order to kill cancer from becoming worse. Objective: The traditional diagnosing procedure takes more time. A fast and useful option can apply Machine Learning Technique (MLT) to identify illnesses. However new technology creates a variety of high-dimensional data kinds particularly when it comes to health or cancer data. Methods: Data classification techniques like Machine Learning are efficient. Particularly in the medical field where such techniques are often utilised to make decisions via diagnosis and analysis. Using Wisconsin Breast Cancer Dataset, the proposed research was carried out (WBCD). Some of these issues may be solved using the feature selection approach. Results: This research analyses the classification accuracy of different MLT: Logistic Regression, Support Vector Machine, and K-Nearest Neighbour. According to experiment results, SVM has the best accuracy of all algorithms, at 97.12%. Conclusion: The mentioned prediction models are based on several supervised MLT. Tenfold cross validation is applied. Additionally, author also proposed a Flow chart of breast Cancer using MLT.

Perforin-2 is dispensable for host defense against Aspergillus fumigatus and Candida albicans.

Aspergillus fumigatus is the leading cause of invasive aspergillosis (IA), which is associated with significant mortality, particularly in immunocompromised patients such as those with acute leukemia or undergoing hematopoietic stem cell transplants, where death rates reach 40-50% despite standard care. Treatments for IA remain limited and resistance to antifungals is emerging, leading the World Health Organization to recently classify A. fumigatus as a critical priority fungal pathogen. A greater understanding of how the immune system clears A. fumigatus could lead to host-directed therapies that could complement our current armamentarium of antifungal drugs and improve patient outcomes. Our findings reveal that perforin-2 is not essential for antifungal immunity against A. fumigatus in otherwise immune-competent mice and underscore the necessity of using co-housed littermate controls to avoid confounding factors in immunological studies.

Endovascular thrombectomy versus medical management for patients with large vessel stroke and infective endocarditis

BackgroundThe safety and efficacy of endovascular thrombectomy (EVT) for large vessel occlusion (LVO) strokes associated with infective endocarditis (IE) compared with medical management (MM) is unclear.MethodsIn this nationwide analysis of...

Beneficial effects of extravascular lung water index-guided volum management in patients with cardiogenic shock

Objective: To evaluate the role of volume management guided by extravascular lung water index(EVLWI) in improving the clinical outcomes and cardiac function for patients with cardiogenic shock. Methods: This study was a single-center, prospective cohort study. Patients with cardiogenic shock admitted to the Department of Cardiovascular Medicine, Shanghai East Hospital from July 2022 to December 2023 were enrolled. Patients were matched 1∶1 by propensity score and divided into EVLWI group and control group. In the control group, the volume management strategy was determined by the attending physician based mainly on conventional factors, including clinical features, biochemical assessments, and certain blood pressure measurements. In EVLWI group, the volume management plan was formulated by integrating conventional factors with EVLWI derived from pulse index continuous cardiac output (PiCCO) monitoring. Baseline clinical data, in-hospital treatment, and hemodynamic data were collected. Major adverse cardiovascular events and cardiac function related parameters were compared at 30 d after treatment between the two groups. Baseline EVLWI levels were compared between the non-survivors and the survivors in the EVLWI group. The receiver operating characteristic curve was plotted to assess the accuracy of baseline EVLWI and central venous pressure in predicting all-cause mortality at 30 d after treatment in patients with cardiogenic shock, and subgroup analysis was performed according to ischemic/non-ischemic etiology and with/without use of inotropic drugs. Kaplan-Meier curve was used for survival analysis, with log-rank tests comparing all-cause mortality, cardiac death, and readmission rate for heart failure at 30 d after treatment. Results: A total of 200 patients with cardiogenic shock were enrolled, aged (71.35±12.82) years, 144(72%) males, EVLWI group and control group 100 patients each. Compared with the control group, EVLWI group had lower all-cause mortality (16%(16/100) vs. 42%(42/100), log-rank P<0.01), cardiac death (14%(14/100) vs. 34%(34/100), log-rank P<0.01), and readmission rate for heart failure (4%(4/100) vs. 12%(12/100), log-rank P=0.03) at 30 d after treatment. Subgroup analysis showed that EVLWI-guided volume management was associated with lower all-cause mortality at 30 d after treatment in patients with cardiogenic shock of ischemic or non-ischemic etiology and with or without inotropic drugs (all P<0.05). In EVLWI group, baseline EVLWI levels were higher in non-survivors than those in survivors [(15.99±6.47) ml/kg vs.(9.75±2.55) ml/kg, P<0.01]. The baseline EVLWI could predicting all-cause mortality at 30 d after treatment in patients with cardiogenic shock, with an area under the receiver operating characteristic curve of 0.84 (95%CI: 0.75-0.94, P<0.01), while the baseline central venous pressure had no predicting value (AUC=0.54, 95%CI: 0.40-0.69, P=0.60). The optimal cutoff value of EVLWI in pridicting all-cause mortality at 30 d after treatment in patients with cardiogenic shock was >10.3 ml/kg. With the optimization of hemodynamic parameters, left ventricular ejection fraction was improved in EVLWI group, and serum levels of N-terminal pro-brain natriuretic peptide, creatinine, alanine aminotransferase and lactic acid were decreased (all P<0.05). Conclusion: EVLWI-guided volume management exerts a beneficial effect on therapeutic decision-making and improves clinical outcomes and cardiac function in patients with cardiogenic shock.

Target and Gene-Based Therapeutic Strategies against Pancreatic Cancer: Current and Future Prospects.

Despite tremendous advancements in knowledge, diagnosis, and availability of both traditional and innovative treatments, pancreatic cancer remains a dangerous disease with a high death rate and dismal prognosis. The traditional strategy in adjuvant and palliative settings is still cytotoxic chemotherapy predicated on the purine derivative gemcitabine; nevertheless, there is an increasing need for new medicines that target the primary molecular pathways and pathophysiological abnormalities implicated. There is now just a tiny amount of evidence of therapeutic benefit when the targeted drug erlotinib is added to the conventional gemcitabine treatment. In preclinical and clinical trials, novel medications targeting mTOR, NF-κB, and proteasome, including the enzyme histone deacetylase, are currently being studied alongside the well-established monoclonal antibody treatments and small-molecule protein tyrosine kinase inhibitors. These novel medications may change the negative natural progression of this illness in conjunction with gene therapy and immunotherapy, both of which are undergoing clinical study. In this regard, leveraging miRNA manipulation to combat cancer is appealing due to its promise to deliver personalized treatment tailored to an individual's distinct gene or miRNA expression profile. Preclinical studies involving animals have showcased the effectiveness of miRNA-based therapies, with several of these treatments now progressing into human clinical trials for various malignancies and other medical conditions. This review describes the important developments of targeted therapeutics that are associated with pancreatic cancer and the discoveries which can help in dealing with this fatal malignancy in a more significant manner.

A Correlation Study that Reveals the Relationship Between Countries’ GDP, Frequency of Access to Clean Fuel, Level of PM2.5, and Death Rate Related to Air Pollution

A Correlation Study that Reveals the Relationship Between Countries’ GDP, Frequency of Access to Clean Fuel, Level of PM2.5, and Death Rate Related to Air Pollution

Investigation of Toxicity of the Combined Exposure of Microplastics and Arsenic (III) on Clams

Introduction: Microplastics is a new type of global pollutant that can absorb pollutants in the environment and enter the food chain. Arsenic (As) is a kind of heavy metal element, and its pollution to the environment has been concerned. Nowadays, the threat of both to Marine ecology is gradually increasing, and people are paying more attention to the harm of microplastics and heavy metal pollution to human health. Method: The aim of this paper is to study the adsorption of arsenic by microplastics and the toxic effects of the combination of the two on clams. The toxicity effects of microplastics and As (III) on clams were determined by joint toxicity test. The fatality rates caused by microplastics polypropylene (PP), polyethylene (PE), polystyrene (PS), polyvinyl chloride (PVC) and polymethyl methacrylate (PMMA) with concentrations between 10 mg/L and 500 mg/L adsorbed with As (III) in first 48 h were 0-30.0%, 0-10.0%, 0-30.0%, 0-15.0% and 0-50.0% (larval clams); 0-35.0%, 0-25.0%, 0-30.0%, 0-50.0% and 0-15.0% (adult clams), respectively. Results: Compared with the group of As (III) alone, the fatality rates caused by PP, PE, PS, PVC and PMMA after 48 h increased dramatically to 80%, 62%, 40%, 60% and 70% (larval clams); 85%, 72%, 40%, 72% and 65% (adult clams), respectively. Conclusion: The death rate of clams was proportional to the input of microplastic particles containing As (III), that is, the higher the concentration used, the higher the fatality rates and the faster the death rates of clams.

Pseudorabies Virus UL4 protein promotes the ASC-dependent inflammasome activation and pyroptosis to exacerbate inflammation.

Pseudorabies virus (PRV) infection causes systemic inflammatory responses and inflammatory damages in infected animals, which are associated with the activation of inflammasome and pyroptosis in infected tissues. Here, we identified a critical function of PRV non-structural protein UL4 that enhanced ASC-dependent inflammasome activation to promote pyroptosis. Whereas, the deficiency of viral UL4 was able to reduce ASC-dependent inflammasome activation and the occurrences of pyroptosis. Mechanistically, the 132-145 aa of UL4 permitted its translocation from the nucleus to the cytoplasm to interact with cytoplasmic ASC to promote the activation of NLRP3 and AIM2 inflammasome. Further research showed that UL4 promoted the phosphorylation levels of SYK and JNK to enhance the ASC phosphorylation, which led to the increase of ASC oligomerization, thus promoting the activation of NLRP3 and AIM2 inflammasome and enhanced GSDMD-mediated pyroptosis. In vivo experiments further showed that PRV UL4 (132DVAADAAAEAAAAE145) mutated strain (PRV-UL4mut) infection did not lead to a significant decrease in viral titers at 12 h. p. i, but it induced lower levels of IL-1β, IL-18, and GSDMD-NT, which led to an alleviated inflammatory infiltration and pathological damage in the lungs and brains, and a lower death rate compared with wild-type PRV strain infection. Taken together, our findings unravel that UL4 is an important viral regulator to manipulate the inflammasome signaling and pyroptosis of host cells to promote the pathogenicity of PRV, which might be further exploited as a new target for live attenuated vaccines or therapeutic strategies against pseudorabies in the future.

On-Pump or Off-Pump Impact of Diabetic Patient Undergoing Coronary Artery Bypass Grafting 5-Year Clinical Outcomes.

For diabetic patients undergoing coronary artery bypass grafting (CABG), there is still a debate about whether an off-pump or on-pump approach is advantageous. A retrospective review of 1269 consecutive diabetic patients undergoing isolated, primary CABG surgery from January 1, 2013 to December 31, 2015 was conducted. Among them, 614 received non-cardiopulmonary bypass treatment during their operation (off-pump group), and 655 received cardiopulmonary bypass treatment (on-pump group). The hospitalization outcomes were compared by multiple logistic regression models with patient characteristics and operative variables as independent variables. Kaplan-Meier curves and Cox proportional-hazard regression models for mid-term (2-year) and long-term (5-year) clinical survival analyses were used to determine the effect on survival after CABG surgery. In order to further verify the reliability of the results, propensity-score matching (PSM) was also performed between the two groups. Five-year all-cause death rates were 4.23% off-pump vs. 5.95% on-pump (p = 0.044), and off-pump was associated with reduced postoperative stroke and atrial fibrillation. These findings suggest that off-pump procedures may have benefits for diabetic patients in CABG.

Cost-effectiveness analysis of direct oral anticoagulants versus low-molecular-weight heparin and no thromboprophylaxis in primary prevention of cancer-associated venous thromboembolism in China.

Cancer-associated venous thromboembolism (CAVTE) is a preventable, life-threatening complication with a considerable morbidity and mortality. Primary venous thromboembolism (VTE) prophylaxis is currently recommended; however, the health and economic benefits have not been evaluated and compared in China. This study aimed to assess and compare the cost-effectiveness of anticoagulants in primary CAVTE prevention among cancer patients in China. A Markov model with a 5-year horizon was established to evaluate the costs and effectiveness of direct oral anticoagulants (DOACs) compared to low-molecular-weight heparins (LMWHs) and no prevention in primary prophylaxis of CAVTE in China. Key clinical outcomes were obtained from the available clinical trials, comparing DOACs (rivaroxaban and apixaban) with LMWHs or with no thromboprophylaxis. Utility and the cost inputs were all obtained from the published literature or local data with public sources. The total costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were estimated as the main endpoints of the modal for each strategy. The assessment of uncertainty was performed involving deterministic sensitivity analysis and probabilistic sensitivity analysis (PSA). Impact of time horizon, generic drug price, and individual DOACs were assessed in scenario and subgroup analyses. Primary prophylaxis using DOACs were projected to yield 1.866 QALYs at a cost of $3,287.893, resulting in the ICERs of $12,895.851 (DOACs vs. no-thromboprophylaxis) and $43,613.184/QALYs (LMWHs vs. DOACs). Sensitivity analysis revealed that ICER was sensitive to the VTE and bleeding risk, drug cost of anticoagulants, self-payment ratio, and overall death rate of cancer. Probabilistic sensitivity analysis showed that DOACs and LMWHs had a 48% and 45% probability of being cost-effective at a 5-year time horizon, respectively. When the time horizon extended to 10 years, DOACs achieved a cost-effective probability of 43%. Among individual DOACs, apixaban was found to be the preferred strategy in VTE prevention due to its incremental health gain with an acceptable cost increase. Primary thromboprophylaxis with DOACs was cost-effective in cancer patients at a willing-to-pay (WTP) threshold of $37,125.24/QALY in China. Cancer death rate, risk of VTE and major bleeding, and the drug cost assumed greater relevance and importance in the decision-making process for primary thromboprophylaxis in cancer.

Factors That Impact Effective Public Health Communication With Michigan’s Latinx Population in the Context of COVID-19

The far-reaching impact of the COVID-19 pandemic on Latinx communities is well-documented. This population has higher rates of COVID-19 infection and death compared with non-Latinx White Americans mainly due to long-standing problems related to Social Determinants of Health. Communication about issues such as health threats and safety measures are a vital part of public health, and need to be appropriate to the population of focus. To understand the effectiveness of public health communication to Latinx communities in Michigan during the COVID-19 pandemic, semi-structured interviews ( n = 16) and three focus groups ( n = 24 participants) were conducted virtually in 2021 across counties in Michigan deeply impacted by COVID-19: Washtenaw, Kent, Genesee, and Wayne. Participants shared some facilitating factors that supported effective health communication during the pandemic for their communities. For instance, in their experiences, religious and community leaders were especially effective in communicating information about the pandemic. They also expressed issues with English often being the only language of official communication; the need for bilingual options; and, the need for multiple channels of communication to reach as many people as possible. Participants also highlighted their concerns about inconsistent government communication and politicizing messages as a hindering factor that impacted effective health communication within their communities. Lessons from successes and failures experienced during the COVID-19 pandemic are vital to improving health outcomes for marginalized communities during public health crises. Future responses must ensure that public health communication is appropriate and effective for Latinx communities to better protect them.

Some risk factors for recurrent ischemic stroke caused by middle cerebral artery damage

Background and Purpose: Recurrent ischemic stroke due to damage to the middle cerebral artery causes deterioration of neurological function and increases the rate of disability, death, and treatment costs many times compared to the first ischemic stroke. Assessing risk factors plays an extremely important role in preventing recurrent ischemic stroke. We have discuss some risk factors for recurrent ischemic stroke caused by middle cerebral artery damage. Research subjects and methods: Cross-sectional descriptive study on 77 patients with recurrent ischemic stroke due to middle cerebral artery damage at the Neurology Center - Bach Mai Hospital from July 2021 to August 2022. Summary of review: There were 22 female patients and 55 male patients with an average age of 65 ± 11 years old, predominantly in the age group of 61 - 70 years old (making up 44.2% of the total). The majority of patients experienced their first recurrence (64.9%). The timeframe between the most recent ischemic stroke and the recurrent event ranged from 12 months to 5 years, with the highest occurrence rate at 33.8%. Hypertension has the highest rate among risk factors (88.3%); Hyperlipidemia follows as the second leading risk factor (49.4%). Patients with recurrent ischemic stroke caused by middle cerebral artery damage showed limited effectiveness in recurrence prevention treatment: 68.8% did not adhere to antiplatelet medication or had recently stopped taking them. 81.8% did not consistently receive statin treatment as prescribed. There is a significant difference in clinical recovery levels based on the mRS among patients with and without hypertension (p=0.023); with and without hyperlipidemia (p=0.044); among patients receiving regular and irregular antithrombotic therapy (p &lt; 0.005); among patients receiving regular and irregular statin therapy (p = 0.01). Conclusion: Our research indicates that recurrent ischemic stroke resulting from middle cerebral artery damage presents a higher number of risk factors, and the efficacy of recurrence prevention treatment is suboptimal.

Multisymptom Burden in Cancer Survivors: Benefits of Physical Activity

ABSTRACT In contrast with other leading causes of mortality, the cancer death rate in the United States continues to decline, reflecting improvements in prevention, screening, and treatment. Despite these advances, there has been limited development of strategies to counter the unwanted and debilitating effects associated with cancer and its treatments. Indeed, syndromes including cachexia, cardiotoxicity, fatigue, and mucositis among others plague cancer survivors, leading to poor life quality and premature mortality. The systemic nature of these impairments creates a strong rationale for treatment strategies to mitigate syndromes affecting cancer survivors. Currently, however, there are limited treatments approved by the US Food and Drug Administration to counter the debilitating side effects of cancer and cancer treatments. In noncancer clinical populations, physical activity is a well-established strategy to increase muscle mass, improve cardiovascular health, enhance energy levels, and promote gut health. Although physical activity programs are widely encouraged for cancer survivors, researchers are just beginning to understand the physiological basis of their positive effects and how they can be maximized for different cancer populations and treatments. This graphical review describes the benefits of physical activity and associated mechanisms for ameliorating select side effects of cancer and its therapeutics.

Hemoperitoneum: Frequency, Management and Prognostic Factors in the General Surgery Department Hospital National Ignace Deen, CHU de Conakry, Guinea

&amp;lt;i&amp;gt;Aim&amp;lt;/i&amp;gt;: To report our experience in the management of haemoperitoneum in the general surgery department of the Ignace Deen National Hospital. &amp;lt;i&amp;gt;Patients and methods&amp;lt;/i&amp;gt;: This was a retrospective descriptive and analytical study, covering a period of 5 years, from January 2017 to December 2021, carried out in the general surgery department of the Ignace Deen National Hospital. All records of patients admitted for hemoperitoneum were included. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: During the five (5) years, 120 cases of hemoperitoneum were collected, representing 1.1% of all abdominal surgical emergencies. The mean age of the patients was 24 ± 16.83 years. The patients were predominantly male, with a sex ratio M/F: 1,05. The average admission time was 32.1 hours. Haemoperitoneum was traumatic in 58.33% of cases. Road traffic accidents accounted for 35.83% of cases. Treatment was surgical in 81 patients (69.23%). The main anatomopathological lesions found were: rupture of ectopic pregnancy (33.33%), rupture of the spleen (17.5%). The procedures performed were: salpingectomy (61.72%), splenectomy (23.45%). The prognostic factors were: age greater than 30 years, admission time greater than 48 hours, large haemoperitoneum. Post-operative management was straightforward in 92.50% of cases with a death rate of 4.17%. &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: Hemoperitoneum is a frequent occurrence in the department. Treatment was surgical with hemostasis, salpingectomy and splenectomy. Prognostic factors were age, admission time and quantity of hemoperitoneum.