Retrospective Epidemiological Study Research Articles

Cardiovascular mortality rate between 2018 and 2022 in Kyrgyz Republic

Abstract Background Cardiovascular diseases (CVD) are the number one cause of death in low- and middle-income countries (LMICs), including Kyrgyz Republic. According to official statistics, CVD ranks first in the structure of overall mortality, accounting for more than half (52.1% according to 2022 data) of all deaths. Purpose to analyze the cardiovascular mortality rate in the Kyrgyz Republic, from 2018 to 2022. Methods Medical and statistical information on mortality from CVD in the population was obtained from the Centre for Electronic Health (CEH) of the Ministry of Health. To conduct a comparative analysis, relative indicators per 100 thousand population were calculated. A retrospective epidemiological study of mortality from CVD including different nosological forms over period for 2018–2022 was conducted, calculating the rate of increase (decrease). An analysis of the epidemiological situation of the disease in nine administrative-territorial units of the Kyrgyz Republic was also carried out with the calculation of the average 5-year mortality ratefor the period from 2018 to 2022. Results Despite the decrease in morbidity, a high proportion of mortality from CVD remains in all years, more than 50%. In terms of the percentage indicator for recent years, all this time it has maintained the highest position, in contrast to diseases of other organs and systems. In the last decade, from 2012 until 2020, there was a gradual decrease in the mortality rate. Since 2020, we have seen a sharp increase in the CVD mortality rate per 100 thousand population by 19.6% compared to 2018, by 19.4% since 2019, which is associated with the influence of Covid-19 pandemic, in 2021 this indicator amounted to 297.6 cases, in 2022 - 234.5. The main contribution to population death from CVD is made by coronary heart disease (65.90%), including acute myocardial infarction, cerebrovascular diseases (21.4%), arterial hypertension (5.9%). If we analyze the mortality rate from CVD by nine administrative-territorial units, the highest rates in 2022 are observed in the Chui and Talas regions, 291.9 and 266.3 per 100 thousand population respectively; the lowest in the Osh region (207.3), Osh city (196.1) and Bishkek (208.6), which is explained by the better organization of health services in these areas. Conclusion CVD remains the main cause of mortality in the population of the Kyrgyz Republic. Although over the past year there has been a good decline in this indicator, in almost all regions, particularly the greatest successes have been achieved in Naryn and Issyk-Kul regions. In connection with the above, there is requirement for a clear identification of priorities when determining the strategy of treatment and preventive interventions. It is necessary to create an effective National system of care for patients with CVD with a focus on emergency cardiac care and prevention issues.

Characteristics of the Cohort of Personnel of the Sublimate Production of the Siberian Chemical Plant Involved in Working with Plutonium-239

239Pu has the property of initiating radiogenic diseases in workers who come into contact with it during their professional activities. To study adverse medical and biological effects and to study in detail the potential consequences of plutonium exposure on the body of personnel at nuclear energy facilities, it is necessary to form a cohort of people involved in working with this isotope. The purpose of the study is to form and characterize a cohort of Siberian Chemical Plant sublimation production employees involved in working with 239Pu in the period 1953–2000. The source of information for forming the cohort was the database of the regional medical and dosimetric register of the population of closed administrative-territorial formation Seversk and the personnel of the Siberian Chemical Plant, containing personal, dosimetric, medical and biological information regarding all current and former employees of the Siberian Chemical Plant (about 65,000 people) since the founding of the enterprise till now. As part of this work, a cohort of sublimation production employees involved in working with 239Pu 9 in 1953–2000 was formed (1,052 people, 577 men and 475 women). The dosimetric, medical and biological characteristics of workers included in the sublimation production cohort are given. The created sublimation production cohort will make it possible to conduct comprehensive retrospective and prospective epidemiological studies to assess the morbidity and mortality of nuclear energy facilities employees, as well as to draw scientifically based conclusions regarding the role of 239Pu in the initiation of the most important socially significant non-infectious diseases (for example, malignant neoplasms, diseases of the circulatory system etc.) and mortality from these diseases. The scientific data obtained as a result of this study will make it possible to determine the main directions for organizing a system for assessing risks to the health of personnel at sites for the decommissioning of nuclear facilities and the formation of a set of measures aimed at improving the health-saving system of nuclear facilities employees and extending their working longevity.

Short-Term Outcomes and Complications of Premature Infants with a Birth Weight ≤ 1500g

prognosis of a premature infant is correlated with the conditions of medical care, both during and after birth, as well as the quality of the environment they are welcomed into. Objective: The aim of our study is to highlight the complications and outcomes of premature infants with a birth weight ≤ 1500g, by identifying the factors of morbidity and mortality, and then comparing our results with other studies. Materials and Methods: This is a retrospective descriptive, epidemiological, clinical, therapeutic, and developmental study conducted over a two-year period, from June 1, 2019, to June 30, 2021, in the neonatology and neonatal resuscitation unit at CHU HASSAN II of Fès. Results: We reported a mortality rate of 54% among the newborns, with the main causes of death being alveolar hemorrhage (43.41%), septic shock (29.45%), and severe respiratory distress (20.93%). The main complications and conditions observed during the hospital stay were: hyaline membrane disease (35.26%), alveolar hemorrhage (26.14%), patent ductus arteriosus (14.93%), hemodynamic instability (56.01%), electrolyte imbalances (44.81%), neonatal jaundice (54.77%), anemia (46.05%), thrombocytopenia (54.77%), apnea of prematurity (51.81%), intraventricular hemorrhage (12.86%), and neonatal infection (85.89%). Conclusion: The results of our study serve as a wake-up call for the necessity of implementing a management and prevention plan to improve the prognosis of premature infants with a birth weight ≤ 1500g.

Povezanost med vročinskimi valovi in obiski na Internistični prvi pomoči Univerzitetnega kliničnega centra Ljubljana v obdobju 2013–2017

Background: Heatwaves have a severe impact on the number of deaths and emergency department visits, making them the most hazardous natural disaster due to climate change in many regions of the world. Our aim was to assess the short-term association between emergency department visits and heat waves from 2013 to 2017 to see whether any difference in the number of visits occurred at the Emergency Department in Ljubljana University Medical Centre during that period. Methods: The design of our study is a retrospective cross-sectional epidemiologic study. We estimated relative risks (RR) for a number of ED visits during heatwave days and reference period days for the observed diagnoses (all causes, diseases of the circulatory system, respiratory system, endocrine diseases, diseases of the digestive system and genitourinary diseases) sex, and age (from 19 to 74 years old, 75 years old and older), as well as 99.6% confidence intervals (CI) and excess ED visits in percent (%) associated with heatwaves occurring in the years from 2014 to 2017. Data were analyzed for the patients arriving at the Emergency Department of the Ljubljana University Medical Centre during summer time, from May to September. The region covers around 550,000 people and is considered an urban and rural area. Results: The results of our study showed that there was no statistically significant increase in number of ED visits during heatwaves for all causes in all observed years. We noticed even statistically significant protective phenomena between heatwaves and the number of ED visits. These happened in the years 2015 and 2017 for both sexes and circulatory system diseases, in 2016 for men, circulatory system diseases, and in 2015 for respiratory system diseases. We showed a statistically significant association between heatwaves and the number of visits in the ED for endocrine diseases in 2013. Conclusion: Despite the increased heat load in the last observed years, the number of ED visits in Ljubljana has remained stable or even decreased. Further studies on how each intervention affects the behavior of the observed population are needed to clarify whether public health measures and inter-sectoral cooperation impact the number of ED visits.

Increased resistance rates of extended-spectrum β-lactamase-producing Enterobacterales isolated from blood cultures in Brazil

This study aimed to identify and evaluate the antimicrobial susceptibility profile of extended-spectrum β-lactamase (ESBL)-producing Enterobacterales isolated from blood cultures of patients with suspected sepsis. This retrospective cross-sectional epidemiological study was performed for four years (2015 to 2018) by accessing the medical records of patients diagnosed with bloodstream infections in two tertiary public hospitals in Brazil. Culture results and susceptibility tests of bacterial strains isolated from blood samples were analyzed. During four years, 2,263 blood culture exams were performed, and Enterobacterales were isolated in 694 (30.7%) samples. The disk approximation test detected ESBL production in 171 (24.6%) of the 694 isolated Enterobacterales (p<0.05), with 125 (73.1%) corresponding to Klebsiella spp., 28 (16.2%) to Escherichia coli, eight (4.6%) to Enterobacter spp., five (2.9%) to Serratia spp., three (1.7%) to Proteus spp., and two (1.2%) to Citrobacter spp. All tested antibiotics demonstrated low susceptibility (2.9% to 26.9%). The classes of monobactams, cephalosporins, and penicillin showed high resistance indices. The evaluated Enterobacterales isolates exhibited expressive antimicrobial resistance to drugs commonly used as empirical treatment in bloodstream infections. The findings reinforce the relevance of assessing the bacterial antimicrobial susceptibility profile, as it drives antibiotic therapy, potentially detecting multiresistance cases.

Retrospective epidemiological study of the width of maxillary diastema in patients from northeastern Bulgaria.

A maxillary diastema (MD) is identified when the gap between the central incisors exceeds 0.5 mm. It poses an a and phonetic concern, often seen in mixed dentition and occasionally continuing into permanent dentition.

Risk assessment and transmission of fluoroquinolone resistance in drug-resistant pulmonary tuberculosis: a retrospective genomic epidemiology study

Fluoroquinolone resistance is a major challenge in treating Multidrug-Resistant Tuberculosis globally. The GenoType MTBDRsl Ver 2.0, endorsed by the WHO, was used to characterize fluoroquinolone resistance. The fluoroquinolone resistance rates in the MDR-TB, Rifampicin-Resistant TB, and non-MDR-TB were 33%, 16.5%, and 5.4%, respectively. The most common mutation found in fluoroquinolone-resistant isolates was D94G (49.5%) in the gyrA gene. Of the 150 MDR-TB isolates, the prevalence of Extensively Drug-Resistant Tuberculosis and pre-XDR-TB was 1.33% and 30%, respectively. Among the 139 RR-TB isolates, pre-XDR-TB prevalence was 15.8%. The fluoroquinolone resistance rates were 5.12% among the 1230 isoniazid-monoresistant isolates. The study found that MDR-TB and RR-TB have higher risk of fluoroquinolone resistance than non-MDR tuberculosis. Rifampicin-resistant isolates with a mutation at codon S450L have a higher risk (RR = 12.96; 95%CI: 8.34–20.13) of developing fluoroquinolone resistance than isolates with mutations at other codons in the rpoB gene. Isoniazid-resistant isolates with a mutation at codon S315T have a higher risk (RR = 2.09; 95%CI: 1.25–3.50) of developing fluoroquinolone resistance. The study concludes that rapid diagnosis of fluoroquinolone resistance before starting treatment is urgently needed to prevent the spread and increase of resistance and to achieve better treatment outcomes in areas where it is higher.

Molecular detection using hybridization capture and next-generation sequencing reveals cross-species transmission of feline coronavirus type-1 between a domestic cat and a captive wild felid.

Feline coronavirus (FCoV) is highly prevalent in domestic cats worldwide and has also been reported in wild felids, including endangered species, in which it has caused substantial population declines. Characterizing the genetic diversity of FCoV is crucial due to recent reports of novel pathogenic recombinant variants causing high mortality in feral cats in Cyprus. In this retrospective molecular epidemiology study, we used archived samples collected in a zoological institution in the U.S. in which a domestic and a wild felid succumbed to FCoV. Using hybridization capture (HC) and next-generation sequencing, we show for the first time that FCoV can be naturally transmitted between domestic and wild felids. We demonstrate the efficacy of HC for detecting and sequencing the whole genome of FCoV, which is essential to characterize its different genotypes.

Transmission dynamics of tuberculosis in a high-burden area of China: An 8-year population-based study using whole genome sequencing

ObjectivesThis study investigated the transmission patterns of tuberculosis (TB) and its associated risk factors in Hunan province to inform the development of prevention and control strategies in the region. MethodsAn 8-year retrospective population-based genomic epidemiological study was conducted. Genomic clusters were defined using distance thresholds of 12-single-nucletide-polymorphisms. Risk factors associated with TB transmission were analyzed using logistic regression model. Kernel Density analysis was used to locate hotspots where transmission occurred. ResultsAmong 2649 TB cases included in this study, 275 clusters were identified, with an overall clustering rate of 24.7% (654/2649). Nearly 95% (620/654) of clustered strains were isolated from the same county. Of the 275 clusters, 23 (8.4%, 23/275) had differences in drug-resistant profiles, with FQs resistance mutations occurring most frequently (52.2%, 12/23). Multivariate analysis identified male TB patients, those aged 30-60 years, ethnic minorities, nonfarmers, retreated TB patients, and individuals infected with MDR/RR-TB as independent risk factors for TB transmission (P < 0.05). Kernel density analysis showed that among the 5 drug-resistant surveillance sites, Leiyang had the highest clustering rate, followed by Yongshun, Qidong, Hecheng, and Taojiang. ConclusionRecent transmission in the region is predominantly occurring within counties. The risk factors related to TB transmission and the hotspots where transmission occurs can provide a scientific basis for the formulation of targeted TB prevention and control strategies.

Profiling IgG and IgA antibody responses during vaccination and infection in a high-risk gonorrhoea population

Development of a vaccine against gonorrhoea is a global priority, driven by the rise in antibiotic resistance. Although Neisseria gonorrhoeae (Ng) infection does not induce substantial protective immunity, highly exposed individuals may develop immunity against re-infection with the same strain. Retrospective epidemiological studies have shown that vaccines containing Neisseria meningitidis (Nm) outer membrane vesicles (OMVs) provide a degree of cross-protection against Ng infection. We conducted a clinical trial (NCT04297436) of 4CMenB (Bexsero, GSK), a licensed Nm vaccine containing OMVs and recombinant antigens, comprising a single arm, open label study of two doses with 50 adults in coastal Kenya who have high exposure to Ng. Data from a Ng antigen microarray established that serum IgG and IgA reactivities against the gonococcal homologs of the recombinant antigens in the vaccine peaked at 10 but had declined by 24 weeks. For most reactive OMV-derived antigens, the reverse was the case. A cohort of similar individuals with laboratory-confirmed gonococcal infection were compared before, during, and after infection: their reactivities were weaker and differed from the vaccinated cohort. We conclude that the cross-protection of the 4CMenB vaccine against gonorrhoea could be explained by cross-reaction against a diverse selection of antigens derived from the OMV component.

Relationship between persistence with topical antiglaucomatous prescription and patient socioeconomic status at a tertiary university hospital in Jerez de la Frontera (Spain).

To study the relationship between socioeconomic status and persistence with topical antiglaucomatous medication. A retrospective epidemiological observational cohort study was conducted with a sample of 1563 patients. The main dependent variable was persistence (medication possession ratio), the independent variable was socioeconomic status (deprivation index). Additional independent variables were used for multivariate analysis: individual health card index, sex, age, pharmacological group, number of eye drops, preservatives, diagnosis and concurrent medications. Bivariate statistical analysis was obtained using non-parametric tests. Logistic regression was used for multivariate analysis. The level of statistical significance was set at p < 0.05. We obtained data showing greater persistence in the groups with a higher socioeconomic level (deprivation index 1 and 2), with medication possession ratio values of 79.97 and 75.30, respectively) as opposed to the groups at lower socioeconomic levels (deprivation index 4 and 5, with medication possession ratio values of 73.75 and 69.85, respectively. Logistic regression corroborated this difference, reaching a significant value (no persistence in deprivation index group 5 versus 1) with OR = 1.62; 95%CI: 1.13-2.31. Additionally, lower persistence was detected in males, under 60 years of age, undergoing treatment with alpha-agonists, and in patients with ocular hypertension. Low socioeconomic status of the patient was significantly associated with decreased persistence with topical antiglaucomatous therapy.

Retrospective epidemiological study over 8‐year period on zygomatic complex fractures: A single centre experience

AbstractObjectivesThe purpose of this study was to do a retrospective analysis of patients with zygomatic fractures who were treated at the Department of Maxillofacial Surgery, Regional University Hospital of Perugia, Italy, between 2016 and 2023.Materials and MethodsPatients were evaluated based on various parameters including age, sex, aetiology, symptoms, comorbidity, clinical findings, zygomatic fracture type, other facial fractures, treatment, waiting time before the operation, complications and sequelae. In the period described, we had 123 cases of zygomatic fractures requiring surgical intervention.ResultsAmong the patients, 101 were male (82.1%) and 22 were female (17.9%). The average age of the patients was 48.65 years (ranging from 7 to 94 years).The leading cause of these fractures was sports‐related injury (n = 32; 26.01%), and isolated zygomatic bone fractures were the most frequent (72.43%). The most common clinical signs and symptoms were pain, depression of the facial profile, difficulty in chewing, limitation of the buccal opening, difficulty in protrusion movements and mandibular lateralization. Ninety‐six per cent of patients underwent surgery under general anaesthesia, with open reduction and internal fixation.ConclusionsThe successful and effective management of zygomatic fractures requires a solid understanding of its anatomy, pathophysiology and related biomechanical structures and forces. The continuous research in epidemiology, aetiology, materials and techniques will further refine our treatments which are nowadays more and more customized according to the type of trauma.

MORTALITY ANALYSIS IN BLUNT COMBINED TRAUMA AND POLYTRAUMA

Introduction. Modern traumatism from the standpoint of clinical epidemiology meets the classification criteria of a global pandemic. Important factors triggering the global clinical and epidemiological picture are the unsatisfactory state of prevention of all types of injuries in developing countries, traffic injuries in industrialized countries and the progressively increasing number of armed conflicts. The aim of the study. To conduct a comparative clinical and epidemiological analysis of mortality in blunt combined trauma and polytrauma. Materials and methods. A retrospective single-center cohort 10-year clinical and epidemiological study of 933 fatal clinical cases of blunt combined trauma on the basis of polytrauma department of the Kyiv City Clinical Emergency Hospital has been conducted. Clinical diagnoses and forensic medical conclusions were transformed into Hannover Polytrauma Score scale codes. The clinical and epidemiological experiment was based on the clustering of the research array according to the severity of the injury. Results. As a result of the clinical and epidemiological experiment, 5 stable clusters which can be characterized as separate randomized clinical-epidemiological groups were obtained. Clinical profile was determined by the dominant injury: cluster-1 (patients with an extremely severe thoracic profile), cluster-2 (patients with a severe thoracic profile), cluster-3 (patients with an extremely severe abdominal profile), cluster-4 (patients with a severe neurosurgical profile), cluster-5 (patients with an extremely severe neurosurgical profile). Conclusions. Lethal blunt combined injury has a clear hierarchical structure based on the severity of the injury and the presence of dominant damage to the corresponding anatomical and functional area. The results obtained during the current study indicate the need to find new technological approaches to the treatment of extremely severe injuries, as well as treatment and prevention of the development of complications of severe injuries in order to reduce mortality in polytrauma.

Analysis of the Causes and Conditions for the Formation of a High Incidence of Acute Respiratory Infections in the Population of the Altai Krai (Part 2. Environmental factors, diagnosis of coxiellosis and tick­borne rickettsiosis)

Relevance. Altai Krai (AK) is one of the least prosperous subjects of the Russian Federation in terms of the incidence of acute respiratory infections (ARI). Results of studying long-term and intra-annual dynamics of the incidence of ARI and community-acquired pneumonia (CAP) in various population groups of the AK in 2011–2021 led to a conclusion about possible connection between the characteristics of the epidemic process of ARI and environmental factors, primarily air pollution, as well as the widespread distribution of natural and atropurgic foci of tick-borne transmissible and zoonotic infections in the territory of the AK, along with the problems of diagnostics. Aim. Assessment of the possible influence of environmental factors on the formation of a high level of registered incidence of ARI in the Altai Territory, as well as diagnostics of some natural focal and zoonotic infections with fever and respiratory symptoms. Materials and methods. A retrospective epidemiological study was conducted based on annual and monthly official statistical reporting during 2011–2021 about the morbidity of the population, demographic and environmental features of the territory of the AK for each of the municipalities (MU), the average long-term incidence rates of ARI, VBP, tuberculosis, Siberian tick typhus (STT), ixodid tick-borne borreliosis, tick-borne viral encephalitis were calculated; appeals of the population regarding tick bites; population density and annual average sulfur dioxide (SO2) emissions. Pearson correlation coefficient was used to assess the strength of the relationship between the analyzed indicators; and seasonality coefficients and the method of trend-seasonal decomposition were used to assess the intra-annual dynamics of the incidence of ARI and CAP (for the period 2011-2019). To study seroprevalence of antibodies to C. burnetii, R. sibirica and SARS-CoV-2 in febrile patients with symptoms of ARI blood samples were collected in October 2022 from ten rural districts of the AK. Results and discussion. It was established that there was a significant direct correlation between the incidence of ARI and the amount of SO2 emissions into the atmosphere (r = 0.61, p &lt; 0.001), as well as between the incidence of ARI and population density (r = 0.53, p &lt; 0.001). The largest share (69%) of the total number of ARI cases in the Altai Territory in 2011–2021 was attributed to the cities of Barnaul, Biysk, Rubtsovsk, Zarinsk and Novoaltaisk, which are characterized by maximum SO2 emissions and population density. An additional contribution (8% total) to the incidence of ARI in the Altai Territory was attributed to 7 rural areas with the highest levels of SO2 emissions. Regardless of the ranking for the incidence of ARI and CAP, in 9 out of 10 areas selected for the study, patients had both anamnestic and diagnostic titers of antibodies to C. burnetii and/or R. sibirica. At the same time, coxiellosis cases in these areas were not registered for 12 years, and the number of cases of STT was much less than the probable number based on the proportion of patients which were seropositive to R. sibirica and had symptoms of ARI. IgM to SARS-CoV-2 were detected in 5 out of 203 examined samples, IgG – in 188 out of 203 examined samples, moreover 13.8% of samples had 118 to 499 BAU/ml, 40.9% of samples had 500 to 5000 BAU/ml, and the rest of samples had more than 5000 BAU/ml. Conclusion. Among all the variables analyzed in the study, the greatest role in the formation of the high level of registered incidence of ARI in the AK for many years belong to the high level of air pollution with SO2 emissions, high population density and, especially, their combination. Underdiagnosis of tick-borne rickettsioses and coxiellosis is of particular importance due to the unavailability of test kits for laboratory verification. Starting from 2020, a new coronavirus infection made some contribution to the registered incidence of ARI.

A four-year Retrospective Epidemiological Study on Hanging at A Tertiary Care Hospital of Western Maharashtra

A four-year Retrospective Epidemiological Study on Hanging at A Tertiary Care Hospital of Western Maharashtra

Invasive Fungal Sinusitis and Its Orbital Morbidity in Pediatric Population: A Strategic Treatment Algorithm and Outcomes.

Invasive fungal sinusitis, particularly mucormycosis, presents a significant clinical challenge, especially in pediatric populations. This retrospective epidemiologic study aimed to investigate the clinical characteristics, risk factors and outcomes associated with this rare but severe condition, with a focus on orbital morbidity. Clinical data of 12 pediatric patients diagnosed with invasive fungal sinusitis between 2021 and 2023 were retrospectively analyzed. Diagnosis involved microbiological and histopathologic examinations, alongside radiologic imaging. Treatment comprised surgical intervention and antifungal therapy, with a detailed evaluation of orbital involvement. Statistical analysis included descriptive statistics and logistic regression. Predominantly affecting males, the median age of the patients was 8 years. Common symptoms included orbital swelling and impaired vision. Imaging revealed characteristic features of invasive fungal sinusitis, including fat stranding and bone erosions. Orbital involvement was extensive, with poor visual outcomes observed in several cases. Surgical debridement and antifungal therapy, including transcutaneous retrobulbar Amphotericin B, were administered. Risk factors associated with poor orbital outcomes included duration of diabetes and glycated hemoglobin levels. Mortality rate stood at 22.2%. Early diagnosis, aggressive surgical intervention and combined antifungal therapy are essential for improving outcomes. Timely intervention showed stabilization of the orbital disease and better outcomes in pediatric patients. Further research with larger sample sizes is warranted to better understand and address this serious condition.

EPID-07. INCIDENCE OF PAEDIATRIC BRAIN TUMORS IN AN ITALIAN REGIONAL COHORT: AN EPIDEMIOLOGICAL STUDY FROM 2012 TO 2023

Abstract BACKGROUND Central nervous system (CNS) tumors are the most common solid cancer in children, second only to leukaemia. METHODS We conducted a retrospective epidemiological study of primary CNS tumors diagnosed in children up to 16 years of age between 2012 and 2023, in order to estimate the incidence in a regional cohort of 1,2 million inhabitants (Northeastern Italy). Only primitive lesions were enrolled, relapses were excluded. RESULTS Over a period of twelve years, 100 new diagnoses were made (44% Female, 56% Male) with a mean age of 8,92 years (range 0-16 years) at time of onset. In terms of location, we recorded an equal number of supratentorial and subtentorial diagnoses (50% vs 50%). A time-series analysis was performed to verify possible variations in the incidence rate of brain tumors over years, and no significant change was described (R2 0.301, p=0.06). However, after 2017 a significant increase was noted (R2 0.725, p=0.015), as the incidence of new diagnosis quite doubled, from 3.16 in 2018 (95%CI 3.15-3.17) to 5.59 in 2023 (95%CI 5.57-5,61). Data were therefore divided in two groups: 2012-2017 (group 1), and 2018-2023 (group 2). There were no differences in terms of gender or age. The number of low-grade (LG) and high-grade (HG) diagnosis were compared: HG tumors, including high grade glioma, ependymoma and medulloblastoma, were significantly higher in the group 2 than group 1 (27/50, 54% vs 6/43, 14%, p&amp;lt;0.001). CONCLUSIONS In childhood, CNS tumors incidence has been fairly stable in the last twelve years in our regional cohort, but a recent concern of an increased rate of high-grade diseases emerged according to our data. In case of a confirmation of this trend, further analysis will be required in order to understand the reason.

Epidemiological analysis of hospitalization of the elderly in Brazil between 2019 and 2023

Brazil has seen an increase in the elderly population as a result of falling mortality rates. Associated with the ageing process, there is an increased risk of developing comorbidities, which is why the health system has found it difficult to keep up with the rapid demographic transition and support this more fragile section of the population. The aim of this study was to describe the epidemiological aspects of hospitalization of the elderly in Brazil. This is a retrospective epidemiological study, with a quantitative approach, which used data from the Hospital Information System and the Unified Health System, made available by the Department of Informatics of the Unified Health System, for the period 2019 to 2023. The variables analyzed were: type of care, gender, race, reason for hospitalization, cause of death and region with the highest incidence. 16,779,162 elderly people were admitted to hospital units: 78% (n= 16,069,729) were admitted as emergencies. Of these individuals, 51% (n= 8,595,199) were male and 41% (n= 6,892,500) were white. Initially, 21% (n= 3,485,803) were hospitalized for diseases related to the circulatory system, but the main cause of death was pneumonia, which accounted for 7% (n= 1,195,048) of these patients, and was most prevalent in the southeast region with 508,696 deaths. Hospitalizations of the elderly in Brazil are on the rise, and epidemiological characteristics, a reduction in the number of public investments and social factors are determining factors in this variation. The main related diseases are those affecting the cardiovascular and respiratory systems, accounting for almost half of the deaths in this age group. The increase in the number of hospitalizations demonstrates the need to formulate public policies to improve the quality of life of the elderly population.

Retrospective Cross-Sectional Epidemiological Study of Human Papillomavirus-Associated Precancers and Anogenital Warts in Patients Attending Specialized Clinics in Russian Federation

Background. In Russia, there are no country level registries on HPV-associated pre-cancers (cervical intraepithelial neoplasia, CIN; vulvar intraepithelial neoplasia, VIN; vaginal intraepithelial neoplasia, VaIN; anal intraepithelial neoplasia, AIN; penile intraepithelial neoplasia PIN) and anogenital warts (AWs) and no national-level cervical cancer screening program. Aims — the aim of this study was to assess the proportion of patients with CIN, VIN, VaIN, AIN, PIN and AWs diagnosis in the clinical settings in Russia. Methods. This study was a non-interventional retrospective multi-center chart-review study in 28 investigational sites representing 21 Federal subjects of 6 Federal Districts of Russia. Medical charts of adult men and women visited gynecology, sexual health, dermatovenerology or urology services between 1 Jan 2000 — 31 Dec 2019 were reviewed. Data were abstracted, using a standardized approach, on patient demographic characteristics, presence or absence of pre-cancers and AWs diagnoses, method of diagnosing pre-cancer and HPV infection, and grade of neoplasia. Results. A total of 11 520 patients (1732 male and 9788 female) were included in the analysis. The overall proportion of patients with HPV-associated precancers and AWs was 10.8%. By service type, cases of HPV-associated conditions were revealed most often in dermatological departments (14.5%) and gynecological hospitals (13.8%). CIN detection rate in Russian clinical settings increased over the 20-years from 3.2 to 11.1% and was higher in gynecological in-patient departments compared to out-patient departments (12.5 and 5.2% respectively). The number of non-cervical precancers (VIN, VaIN, AIN, PIN) cases were very low (the detection rate was less than 1%). The frequency of HPV type 16 and 18 detection increased from 0.6 to 4.8%, and from 0.2 to 1.9%, respectively, for the 20-years period. Conclusions. Our study suggested high level of HPV-related pre-cancer and AW disease burden as well as presence of high-risk HPV types. Preventive strategy through effective national HPV immunization program would be beneficial to reduce HPV-related disease burden in Russia.

Descriptive epidemiology study of hand injuries sustained in Gaelic football referred to a hand therapy service over 1 year

ObjectivesGaelic football requires ball handling, such as bouncing, fist passing and catching. To date, no research has examined the types of injuries sustained to the hand in this sport. This...