Risk Population Research Articles

Prevalence of oral submucous fibrosis across diverse populations: a systematic review and meta-analysis

Purpose The aim is to offer a comprehensive overview of oral submucous fibrosis (OSF) prevalence and explore its epidemiological characteristics across various demographic groups and geographical locations, thereby helping the formulation of public health management policies. Methods Studies reporting OSF prevalence were identified from electronic databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via PubMed, EMBASE via OVID, and Web of Science. Pooled prevalence and quality assessment using the New-Ottawa Scale were conducted. Two reviewers screened and selected records, assessed quality, and independently extracted data. This systematic review and meta-analysis followed the PRISMA guidelines and was registered on PROSPERO (CRD42024532975). Results Sixty-three studies, encompassing 11,434 cases in a total population of 769,860, reported OSF prevalence. The majority of studies (forty-one) were from India. The pooled prevalence of OSF across all populations was 3.0% (95% CI [2.8–3.2]%). In non-risk populations, risk populations, and consecutive dental patients, the pooled prevalence stood at 2.4% (95% CI [2.1–2.6]%), 4.5% (95% CI 3.5-5.6%), and 5.6% (95% CI [3.8–7.5]%), respectively. Subgroup analysis by age, sex, and geographical region revealed higher prevalence rates among those aged 50 and above (4.2%, 95% CI [3.0–5.4]%), males (3.3%, 95% CI [2.9–3.7]%), and in India (4.0%, 95% CI [3.7–4.3]%). As the exposure to risk factors exceeded 50% in the surveyed population, the prevalence of OSF notably increased. Most studies met satisfactory quality standards. Conclusions Our research findings reveal a comprehensive prevalence of OSF across all populations at 3.0% (95% CI [2.8–3.2]%). And, existing evidence indicates a relatively low prevalence of OSF associated with tobacco, alcohol, and Areca (betel) nut use. However, further large-scale studies are recommended to validate these findings. Understanding the prevalence and distribution patterns of OSF may assist in healthcare intervention planning and alleviate the oral cancer burden associated with OSF.

The association of serum albumin with 28 day mortality in critically ill patients undergoing dialysis: a secondary analysis based on the eICU collaborative research database

BackgroundThe relationship between serum albumin and prognosis in critically ill patients has been studied, however, there is a paucity of exploration into non-linear relationships, particularly in critically ill patients undergoing dialysis. This study intends to investigate the association between serum albumin (ALB) and 28 day mortality in critically ill patients undergoing dialysis.MethodsWe conducted a multi-center retrospective cohort study of patients undergoing dialysis by utilising data from the eICU Collaborative Research Database from 208 distinct ICUs across the United States between 2014 and 2015. The study focused on mortality within 28 days of ICU admission. We employed univariate analysis, multi-factor logistic regression, subgroup analysis, curve-fitting, and threshold effect analysis to examine the correlation between ALB levels and 28 day mortality.ResultsAmong the 2,315 patients with a median age of 63 years, 205 (8.86%) died within 28 days of ICU admission. When ALB level was < 2.7 g/dL, the mortality decreased with an adjusted odds ratio (OR) of 0.34 (95% CI 0.22–0.51, P < 0.0001) for every 1 increment in the ALB. However, no significant mortality changes were observed when ALB levels were at or above this threshold.ConclusionOur study identifies a nonlinear dose–response relationship between serum ALB levels and 28 day mortality in critically ill patients undergoing dialysis, with a specific turning point observed. This finding underscores a significant negative correlation between ALB levels and mortality risk, with lower ALB levels being associated with higher mortality risk in this particular population.

Genetic variants in BDNF (rs6265 and rs11030119) and stroke susceptibility: a case-control analysis in South India

Background Stroke occurs when the blood supply to part of the cerebral cortex is blocked, depriving it of oxygen and glucose, leading to cell death. It is a multifactorial disorder influenced by genetic, vascular, and environmental factors. Aim This study investigated the association between two polymorphisms of the brain-derived neurotrophic factor (BDNF) gene, rs6265 and rs11030119, and stroke risk in a South Indian population. Subjects and Methods The study included 163 stroke cases and 160 healthy controls. Genomic DNA was extracted, and genotyping of rs6265 and rs11030119 polymorphisms was done using ARMS-PCR. Allelic and genotype frequencies were calculated, and odds ratios (OR) with 95% confidence intervals (CI) were determined using SPSS version 21.0. Results The rs6265 polymorphism was significantly associated with stroke risk, with the GG genotype more frequent in controls (OR 1.79, 95% CI 1.05–1.76, p = 0.01). The rs11030119 polymorphism showed a positive association, with the AA genotype more prevalent in cases (OR 2.70, 95% CI 1.34–5.44, p = 0.003). Conclusion This study suggests an association between BDNF polymorphisms (rs6265, rs11030119) and stroke risk in a South Indian population. Further research in larger populations is necessary to confirm these findings and explore the mechanisms involved.

Relationship between physical activity, body posture and morbidity risk in the elderly population

Background Physical activity plays a crucial role in the health and well-being of older adults, positively influencing various aspects of their quality of life. This study aims to explore the relationship between physical activity and body segments, as well as the risk indices of non-communicable chronic diseases in healthy elderly individuals. Methods The analyzed variables include weekly physical activity, the Postural Correction Index (PCI), measured using the system developed by Portland State University (PSU), and predictors of non-communicable chronic diseases assessed through body mass index (BMI) and waist-to-hip ratio. Results The results reveal a moderate positive relationship between physical activity and the PCI (r=0.45; p≤0.05), with significant correlations in specific components of the PCI, such as thoracic depression (r=0.51; p&lt;0.01), anteroposterior shoulder alignment (r=0.51; p&lt;0.01), and upper back (r=0.53; p&lt;0.001). Conclusions It is concluded that physical activity has a significant positive impact on the posture of older adults, particularly in the trunk, contributing 40% to the improvement of PCI components. The PCI values obtained, exceeding 84.67 in men and 82.67 in women according to the PSU evaluation, underscore the effectiveness of physical activity in postural correction and the prevention of issues associated with chronic diseases.

Exploring the Relationship Between CAIDE Dementia Risk and EEG Signal Activity in a Healthy Population

Background: Accounting for dementia risk factors is essential in identifying people who would benefit most from intervention programs. The CAIDE dementia risk score is commonly applied, but its link to brain function remains unclear. This study aims to determine whether the variation in this score is associated with neurophysiological changes and cognitive measures in normative individuals. Methods: The sample comprised 38 participants aged between 54 and 79 (M = 67.05; SD = 6.02). Data were collected using paper-and-pencil tests and electroencephalogram (EEG) recordings in the resting state, channels FP1 and FP2. The EEG signals were analyzed using Power Spectral Density (PSD)-based features. Results: The CAIDE score is positively correlated with the relative power activation of the θ band and negatively correlated with the MMSE cognitive test score, and MMSE variations align with those found in distributions of EEG-extracted PSD-based features. Conclusions: The findings suggest that CAIDE scores can identify individuals without noticeable cognitive changes who already exhibit brain activity similar to that seen in people with dementia. They also contribute to the convergent validity between CAIDE and the risk of cognitive decline. This underscores the importance of early monitoring of these factors to reduce the incidence of dementia.

Frailty transition and burden on mortality risk in middle-aged and older population: a prospective cohort study

The effect of frailty transition and burden on the risk of all-cause mortality in South Korea remains unclear. This study aimed to investigate the risk of all-cause mortality using the most recent frailty index (FI), changes in FI, and frailty burden. We analyzed data from the Korean Genome and Epidemiology Study (2013–2020). A total of 3,134 participants aged 53–87 years with a computable FI based on the osteoporotic fracture index during their initial visit. The FI was updated biennially during re-examinations and changes between the initial and last visits were categorized into four groups: (1) improved or maintained to non-frail, (2) worsened to pre-frail, (3) improved or maintained to pre-frail, and (4) worsened or maintained to frail. We used the Cox proportional hazards model, adjusted for age, sex, education, lifestyle factors, and diseases. During the follow-up, 218 participants died. Compared to those who were robust at the last visit, pre-frailty and frailty were associated with an increased risk of all-cause death. Of those who visited > 2 times, 62.3% improved or remained robust, and had a decreased risk of all-cause death. Those with > 63% of pre-frailty or frailty burden significantly higher risk of death, with > 60% increase compared to their non-frail counterparts. Maintaining or achieving robustness is associated with a decreased risk of mortality. To prevent premature death and extend healthy life expectancy, identifying biological aging through surrogate measures and implementing interventions to maintain or achieve a robust health status are needed.

Examining Sex-Based Delays in Utilizing Advocacy Support Services Among Australian Military Veterans: Implications for Health Care Access and Suicide Prevention

This study explores the impact of sex on delays experienced by Australian military veterans in accessing advocacy support services within the veterans’ non-profit sector. A detailed analysis of intake records from 150 injured veterans who entered the Returned and Services League of Australia’s advocacy program in 2021 reveals significant disparities between male and female veterans in seeking assistance. On average, male veterans delay accessing support by 20.4 years post-service, compared to 9.1 years for female veterans. These prolonged delays hinder veterans’ ability to secure financial and medical support from the Department of Veterans’ Affairs, limiting timely access to essential healthcare services. As a result, delays can exacerbate physical and psychological symptoms, impede recovery, and increase the risk of suicide. The findings provide valuable insights for international healthcare professionals on the influence of military culture and traditional masculine norms in shaping veterans’ help-seeking behaviors. By understanding these dynamics, healthcare practitioners can develop targeted, sex-sensitive interventions that address specific barriers faced by male and female veterans. Ensuring timely access to advocacy support is crucial for improving health outcomes and reducing suicide risk in this vulnerable population.

Outcomes of Low Barrier Hepatitis C Treatment in High Risk Populations from Primary Care

Outcomes of Low Barrier Hepatitis C Treatment in High Risk Populations from Primary Care

Vaping and smoking cue reactivity in young adult non-smoking electronic cigarette users: A functional neuroimaging study.

The rapid growth in the use of electronic cigarettes (e-cigarettes) among non-smoking young adults is concerning, as it raises the potential for chronic vaping and nicotine addiction. A key characteristic of drug addiction is the elevated neural response to conditioned drug-related cues (i.e., cue reactivity). Generalized reactivity to both vaping and smoking cues may signify an increased risk for smoking initiation in non-smoking vapers. In this study, we used functional magnetic resonance imaging (fMRI) to evaluate brain responses to vaping and smoking cues in young adult non-smoking vapers. Sixty-six young adult non-smoking vapers underwent functional MRI while viewing visual cues pertaining to vaping, smoking, and nicotine-unrelated unconditioned reward (i.e., food). A priori region-of-interest analysis combined with exploratory whole-brain analysis was performed to characterize neural reactivity to vaping and smoking cues in comparison to food cues. The medial prefrontal cortex and the posterior cingulate cortex, regions that play a key role in drug cue reactivity, showed significantly increased neural response to vaping cues compared to food cues. The posterior cingulate cortex additionally showed increased neural responses to smoking cues compared to food cues. Despite not currently smoking combustible cigarettes, young adult vapers exhibited heightened neural susceptibility to both vaping and smoking cues within brain systems associated with cue reactivity. The findings shed light on the mechanisms underlying nicotine addiction and smoking initiation risk in this critical population and may contribute to the development of science-based interventions and regulatory measures in the future. The escalating vaping prevalence among US non-smoking young adults is alarming, due to its potential ramifications for nicotine addiction development. Nicotine addiction is characterized by elevated neural response to conditioned nicotine-related cues. Using functional neuroimaging, we showed that young adult non-smoking vapers exhibited heightened neural susceptibility to both vaping and smoking cues within brain systems previously associated with cue reactivity. Such cross-reactivity to both types of nicotine cues may serve as the mechanism underlying nicotine addiction and smoking initiation risk in this population. Our findings may contribute to the development of science-based interventions and regulatory measures addressing the vaping epidemic.

Vitamin D and Cardiovascular Outcomes in Multiple Sclerosis

Background: Vitamin D (25(OH)D) deficiency is linked to increased cardiovascular disease (CVD) risk in the general population, but its implications for people with multiple sclerosis (pwMS) remain unexplored. This study aimed to evaluate the association of 25(OH)D with long-term CVD outcomes in pwMS and the impact of vitamin D supplementation. Methods: This observational cohort study analysed anonymised medical records from 70 healthcare organisations following pwMS for 5-years (2019-2024). PwMS and deficient or inadequate 25(OH)D levels were 1:1 propensity-score matched with pwMS and adequate 25(OH)D levels, for demographics, comorbidities, and cardiovascular care. Cox proportional hazard models analysed the incidence of all-cause mortality, stroke, acute myocardial infarction, heart failure, angina, atrial fibrillation/flutter, and a composite measure of major adverse cardiovascular events (MACE). Propensity-matched pwMS who had deficient or inadequate 25(OH)D levels taking cholecalciferol were compared to pwMS and adequate 25(OH)D levels (not taking supplementation). Results: Amongst 74,372 pwMS, 9% had deficient 25(OH)D levels, 18% inadequate, and 73% adequate. Deficient, or inadequate 25(OH)D levels were associated with an increased rate of MACE (HR, 1.32 [95%CI: 1.19, 1.46], HR, 1.29 [95%CI: 1.20, 1.40], respectively) compared to those with adequate levels. Cholecalciferol supplementation in pwMS and deficient or inadequate 25(OH)D levels did not alleviate the higher CVD rate (HR, 1.39 [95%CI: 1.21,1.60], HR, 1.31 [95%CI: 1.17, 1.47], respectively) in comparison to those with adequate 25(OH)D levels taking no vitamin D supplementation. Conclusions: Deficient or inadequate 25(OH)D levels in pwMS were associated with an increased rate of MACE, which may not be mitigated by vitamin D supplementation.

Modeling the health impact of wastewater contamination events in drinking water networks

Pathogen intrusion in drinking water systems can pose severe health risks. To better prepare in planning and responding to such events, computational models that capture the intrusion and health impact dynamics are needed. This study presents a novel benchmark testbed that integrates current knowledge on pathogen transport and fate in chlorinated systems and can assess infection risk from contamination events. The model considers organic matter degradation, chlorine decay mechanisms, pathogen inactivation kinetics, as well as stochastic water demands.We studied modeling of wastewater intrusion events that can occur anywhere within a chlorinated and non-chlorinated network. We applied the Quantitative Microbial Risk Assessment framework focusing on three pathogens: enterovirus, Campylobacter, and Cryptosporidium, and their respective dose-response models. Synthetic household-level water demand time series were used to model the individual water consumption timing and calculate the infection risk (exposure via ingestion).Model outcomes indicate that while chlorination aids mitigation, larger contaminations can still lead to infections due to chlorine resistance (for Cryptosporidium) and chlorine depletion at the contamination point. In our example scenarios, chlorine-susceptible pathogens infected of the downstream population, while chlorine-resistant ones infected the entire downstream population. Enterovirus infection risk is higher, despite the concentrations in the contamination source being lower, due to the lower susceptibility to chlorine than Campylobacter. In non-chlorinated networks, the modeled wastewater contamination events led to infection risk in the total population, depending on the contamination location. Hydraulic uncertainty had a limited influence on infection risk. Furthermore, Campylobacter’s infection risk is more sensitive to the initial concentration in the contamination source whereas enterovirus infection risk to the inactivation rate. The model further indicates that the time window for effective mitigation of the magnitude of a waterborne outbreak is short (within hours).

Association of Oral Microbiome Diversity and All-Cause Mortality in the General US Population and in Individuals With Chronic Diseases: A Prospective Cohort Study.

To investigate whether oral microbiome diversity is associated with all-cause mortality in the general US population and in individuals with chronic diseases. We included 8224 individuals with oral microbiome diversity data from the National Health and Nutrition Examination Survey (2009-2012), representing 164,000,205 US adults, using a survey-weighted analysis method. Cox regression analyses were performed to identify the association between oral microbiome diversity and all-cause mortality. During a survey-weighted mean follow-up period of 8.86 years, 429 all-cause deaths (survey-weighted number: 7,124,920) occurred in 8224 participants. Cox regression analysis revealed that higher oral microbiome diversity was significantly associated with a lower all-cause mortality risk. Significant differences in all-cause mortality risk were observed among the different clusters based on oral microbiome β-diversity (log-rank p < 0.001). Subgroup analyses revealed that the oral microbiome diversity was independently associated with all-cause mortality in individuals with diabetes mellitus and hypertension. A multivariate logistic regression model showed that current smoking and antibiotic use were significantly associated with lower oral microbiome α diversity. Higher oral microbiome diversity was significantly associated with a lower all-cause mortality risk in the general US population and in individuals with diabetes mellitus and hypertension.

Transforming the diabetes outcomes for people with mental illness

AbstractThere is a complex bidirectional relationship between diabetes and mental illness, where diabetes is associated with an increased prevalence of a range of mental disorders and several mental illnesses increase the risk of diabetes. The reasons why people with mental illness are at higher risk of diabetes and vice versa are multifactorial. When diabetes and mental illness occur together, the outcomes for both conditions are worsened, and the co‐morbidity places a higher burden on the individual living with the conditions.Severe mental illness is associated with a twofold increased risk of diabetes, and the onset of diabetes is approximately 10 years earlier in people with mental illness than in the general population. Health behaviour interventions to reduce the incidence of diabetes may be less effective than previously thought. However, trials on obesity drugs, particularly glucagon‐like peptide‐1 receptor agonists, are showing promise. Diabetes care for people with severe mental illness seems to have improved in the past decade. Interventions have been developed to address the unique challenges of living with severe mental illness and diabetes.Depression is twice as common in people with diabetes. Depression increases the risk of diabetes and vice versa. Although general population risk factors for depression apply to people with diabetes, diabetes‐specific risk factors include the development of complications and insulin use in people with type 2 diabetes. Managing depression includes efforts to prevent depression, timely diagnosis and treatment with psychological or pharmacological treatments.Health care professionals have a responsibility to ensure that people with mental illness and diabetes are not disadvantaged.

Immune-Mediated Inflammatory Diseases, Dyslipidemia, and Cardiovascular Risk: A Complex Interplay.

Individuals with autoimmune inflammatory diseases, such as systemic lupus erythematosus, rheumatoid arthritis, and psoriasis, are at increased risk for cardiovascular disease. While these diseases share common features of systemic inflammation, the impact of individual autoimmune inflammatory conditions on circulating lipids and lipoproteins varies by specific disease, disease activity, and the immune-suppressing medications used to treat these conditions. A common feature observed in many autoimmune inflammatory diseases is the development of a proatherogenic dyslipidemic state, characterized by dysfunctional HDLs (high-density lipoproteins) and increased oxidation of LDLs (low-density lipoproteins). Various disease-modifying antirheumatic drugs also have complex and variable effects on lipids, and it is critical to take this into consideration when evaluating lipid-related risk in individuals with immune-mediated inflammatory conditions. This review aims to critically evaluate the current understanding of the relationship between immune-mediated inflammatory diseases and dyslipidemia, the underlying mechanisms contributing to atherogenesis, and the impact of various pharmacotherapies on lipid profiles and cardiovascular risk. We also discuss the role of lipid-lowering therapies, particularly statins, in managing residual risk in this high-risk population and explore the potential of emerging therapies with complementary anti-inflammatory and lipid-lowering effects.

Skin Biopsy Detection of Phosphorylated α-Synuclein in Patients of Bullous Pemphigoid with or without Parkinson's Disease.

High positivity rate of skin phosphorylated α-synuclein (P-SYN) was observed in Parkinson's disease (PD). Bullous pemphigoid (BP) is one of the most common autoimmune skin diseases associated with PD. Our aim was to investigate whether BP patients might be a targeted risk population for the screening of skin P-SYN. Skin P-SYN expression was evaluated by immunohistochemistry in BP patients with/without PD. Twenty-two BP patients with PD, 24 BP patients without PD, and seven healthy donors were enrolled. Colocalization of P-SYN and PGP9.5 was found in all BP patients, but only one healthy control, whereas BP patients with PD showed higher expression than BP patients without PD (mean ± standard deviation, 10.7 ± 6.7 vs. 7.3 ± 3.2; P = 0.027). Positive expression was mainly observed in basement membrane zone and dermis. These results indicated BP patients might be a targeted risk population for the screening of skin P-SYN, which was helpful for the detection of PD early. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Assessment of lipid profile and its correlation with ASCVD risk in the general population

Background: Atherosclerotic cardiovascular disease (ASCVD) is a major global health issue with high morbidity, mortality, and healthcare costs, emphasizing the need for effective risk assessment for prevention and management. This study aimed to assess the lipid profile of the general population and establish correlations with their ASCVD risk. Methods: This cross-sectional study was conducted among the general population in India. Participants were invited through advertisements to attend the ASCVD camp for a lipid profile check-up. Results: A total of 1068 participants were included, with a mean age of 52.7 years. The majority of participants were male (69.8%). Approximately 33% of participants had low ASCVD risk, followed by 31.6% with high risk, and 26.7% with intermediate risk. In the high ASCVD risk group, participants aged ≥60 years were significantly higher compared to those in the low risk, borderline risk and intermediate risk groups (P&lt;0.001). The mean total cholesterol and low-density lipoprotein (LDL) were significantly increased in participants with high ASCVD risk compared to intermediate, borderline and low risk (P&lt;0.001 and P=0.001). The mean HDL cholesterol level was significantly lower in male participants compared to female participants (P&lt;0.001). There was a positive correlation between age (r=0.783), total cholesterol (r=0.372) and the ASCVD risk score (P&lt;0.001 for both). There was negative correlation between HDL and ASCVD risk score (r=-124; P&lt;0.001). Conclusion: This study demonstrates a significant association between lipid profiles and ASCVD risk. Age, total cholesterol, and LDL levels are positively correlated with ASCVD risk, while HDL levels show a negative correlation.

The role of metformin in modulating cardiometabolic risk in obese pediatric populations with metabolic syndrome: A systematic review

Introduction: Obesity significantly increases the risk of developing cardiometabolic complications, which are precursors to cardiovascular diseases (CVD). In children and adolescents, metabolic dysfunctions such as insulin resistance, dyslipidemia, and hypertension are key contributors to early-onset cardiovascular risk. Metformin, a well-established antidiabetic agent, has shown potential benefits in addressing these metabolic imbalances. However, the long-term impact of metformin on cardiovascular outcomes in obese pediatric patients remains unclear. Aim: This systematic review aims to evaluate the effect of metformin on cardiometabolic parameters in obese children and adolescents with metabolic syndrome, focusing on insulin sensitivity, body mass index (BMI), blood pressure, and lipid profiles. Methods: A systematic review was conducted by searching databases including PubMed, Cochrane Library, Embase, and Web of Science. The inclusion criteria targeted randomized controlled trials (RCTs), cohort studies, systematic reviews, and meta-analyses published between 2004 and 2024. Pediatric patients aged 6-18 years with obesity and metabolic syndrome were included. The primary outcomes assessed were BMI, insulin sensitivity, lipid profiles, blood pressure, and cardiovascular outcomes. Results: A total of 23 studies, including 10 RCTs and 1 meta-analysis, were reviewed, involving 777 patients. Metformin demonstrated consistent improvements in insulin sensitivity and BMI in obese children and adolescents. Several studies reported modest reductions in BMI, improved insulin resistance, and better lipid profiles. However, variability in results was observed regarding long-term cardiovascular outcomes. While metformin reduced systolic blood pressure and carotid intimal-medial thickness (CIMT), the long-term impact on preventing major cardiovascular events remained inconclusive. Discussion: Metformin’s benefits on cardiometabolic risk factors in obese children are primarily attributed to its effects on insulin sensitivity, lipid metabolism, and inflammatory pathways. Its ability to activate AMP-activated protein kinase (AMPK) leads to improved metabolic profiles and reduced inflammation and is crucial for mitigating obesity-related cardiovascular risks. Despite these positive effects, the evidence for long-term prevention of cardiovascular events is limited and requires further exploration. Conclusions: Metformin offers significant short-term benefits in improving BMI, insulin sensitivity, and cardiometabolic parameters in obese children and adolescents. However, its long-term efficacy in preventing cardiovascular events remains uncertain. Further studies are necessary to establish its role in long-term cardiovascular protection in pediatric populations

Association of prophylactic low-dose aspirin use with all-cause and cause-specific mortality in cancer patients

The long-term use of aspirin for preventing cardiovascular disease has been recommended for decades. However, there is currently uncertainty regarding the long-term effects of aspirin use on the risk of all-cause, cardiovascular, and cancer mortality in cancer patients. The aim of this work was to analyze the connection between the prophylactic use of low-dose aspirin and the risk of all-cause death, cardiovascular death, and carcinoma death in carcinoma patients in the United States. A cohort study was conducted using National Health and Nutrition Examination Survey (NHANES) data (2011–2012, 2013–2014, 2015–2016, and 2017–2018) and associated mortality data. The 95% confidence intervals (CIs) and hazard ratios (HRs) between non-aspirin use and prophylactic low-dose aspirin use and the risk of death were measured via Cox proportional hazard regression models. A total of 1819 participants were included in the present research, of whom 945 were nonaspirin users and 874 were prophylactic aspirin users. Compared with non-aspirin users, prophylactic low-dose aspirin users had a decreased risk of all-cause death (HR = 0.647, 95% CI = 0.489–0.857). There was no statistically significant difference in the risk of cardiovascular death (HR = 0.623, 95% CI = 0.362–1.074) or cancer death (HR = 0.709, 95% CI = 0.410–1.226). Prophylactic use of low-dose aspirin may lower all-cause mortality in individuals with cancer but does not have a substantial effect on cardiovascular risk or cancer-specific mortality in this patient population.

The impact of prediabetes on preclinical atherosclerosis in general apparently healthy population: A cross-sectional study

Background The hypothesis that not only diagnosed diabetes (DM), but also milder dysglycemia may affect the development of atherosclerosis still requires further study. In our population-based study, we aimed to evaluate the impact of prediabetic state on preclinical atherosclerosis and whether it may affect the cardiovascular risk (CVR) in the general population. Methods The analysis was a part of the Bialystok PLUS cohort study and represented a random sample of Bialystok (Poland) residents aged 20–79 years at the time of sampling (July 2017-January 2023). The cross-sectional analysis included 1431 participants of a population-based study (mean age 46.82 years). Comprehensive biochemical assessments were performed. An Oral Glucose Tolerance Test (OGTT) was performed on fasting patients who did not report having a DM. Results The population with prediabetes, based on HbA1c and OGTT, accounted for more than half of the study participants (n = 797, 55.7%). Atherosclerotic plaques in the carotid arteries were significantly more common in individuals with prediabetes considering all CVR categories. Prediabetes was associated with the occurrence of more advanced preclinical atherosclerosis, especially in the low to moderate CVR category. Serum glucose concentration after 1h and HbA1c proved to be statistically significant indicators of the presence of atherosclerotic plaques in ultrasound (respectively, AUC = 0.73 and 0.72). In multivariate logistic regression, prediabetes was independently associated with significantly increased risk of preclinical atherosclerosis (OR = 1.56, 95% CI 1.09–2.24), along with CVR categories, pulse wave velocity and central blood pressure augmentation index. Conclusions Prediabetes is associated with the occurrence and progression of the preclinical atherosclerosis. Importantly, many of those patients are in the low to moderate cardiovascular risk category, hence may have a severely underestimated risk. Inclusion of prediabetes into CVR assessment may improve risk stratification. An early identification of dysglycemic population is necessary to effectively implement the cardiovascular and metabolic prevention measures.

Atrial fibrillation and atrial flutter in the practice of the emergency medical team in Poland

Background: Atrial Fibrillation (AF) is one of the most common heart arrhythmias globally. It is characterized by irregular, chaotic contractions of the atrial muscle, leading to an irregular and often rapid heart rhythm. The prevalence of this arrhythmia increases with age, which is associated with both the aging population and cardiovascular risk factors such as hypertension, coronary artery disease, and diabetes. Atrial Flutter (AFL) represents a less common variant of atrial fibrillation, occurring significantly less frequently - in relation to atrial fibrillation (AF), it is estimated to account for less than one-tenth of cases. The aim of the study was to analyze emergency medical services delivered to patients diagnosed with atrial fibrillation (AF) and atrial flutter (AFL) in the Voivodeship of Warmia and Mazury (Poland). The patients were classified according to the 10th Revision of the International Classification of Diseases (ICD-10 )[1]. Methods: The study was based on a retrospective data analysis. From a total population of 400,251 subjects (n= 400,251), 4715 patients were selected for the study. The majority of the patients were women (n=2941; 62.38%), whereas men accounted for 37.62% of the examined sample (n=1774). The analysis relied on a database administered by the Governor of the Voivodeship of Warmia and Mazury in Olsztyn [2]. The analyzed data included the area of intervention, the patient's age and sex, and the diagnoses made by physicians, paramedics, and emergency nurses. Three research hypotheses postulating the presence of relationships between the patient's sex and the diagnosis (1), the patient's age and the diagnosis (2), and a life-threatening emergency and the patient's age (3) were formulated. Results: The results of the study suggest that the patient's sex affects the medical diagnosis. In particular, women were more frequently diagnosed with chest pain, whereas the probability of the remaining diagnoses was similar in both sexes. The patient's age does not significantly influence the diagnosis. The patient's sex is not a significant predictor of a life-threatening emergency. Conclusion: The conducted study on the dataset from the Warmian-Masurian Voivodeship revealed significant correlations between demographic variables and the diagnosis of atrial fibrillation (AF) and atrial flutter (AFL) in patients. Analyzing this data may have significant implications for emergency medical systems, enabling the adaptation of intervention strategies to different patient categories.