Significant Increase In Incidence Research Articles

Age and Gender Specific Lung Cancer Incidence and Mortality in Hungary: Trends from 2011 Through 2016.

Objective: No assessment was conducted describing the age and gender specific epidemiology of lung cancer (LC) prior to 2018 in Hungary, thus the objective of this study was to appraise the detailed epidemiology of lung cancer (ICD-10 C34) in Hungary based on a retrospective analysis of the National Health Insurance Fund database. Methods: This longitudinal study included patients aged ≥20 years with LC diagnosis (ICD-10 C34) between January 1, 2011 and December 31, 2016. Patients with different cancer-related codes 6 months before or 12 months after LC diagnosis or having any cancer treatment other than lung cancer protocols were excluded. Results: Lung cancer incidence and mortality increased with age, peaking in the 70–79 age group (375.0/100,000 person-years) among males, while at 60–69 age group for females (148.1/100,000 person-years). The male-to-female incidence rate ratio reached 2.46–3.01 (p < 0.0001) among the 70–79 age group. We found 2–11% decrease in male incidence rate at most age groups, while a significant 1–3% increase was observed in older females (>60) annually during the study period. Conclusion: This nationwide epidemiology study demonstrated that LC incidence and mortality in Hungary decreased in younger male and female population, however we found significant increase of incidence in older female population, similar to international trends. Incidence rates peaked in younger age-groups compared to Western countries, most likely due to higher smoking prevalence in these cohorts, while lower age LC incidence could be attributed to higher competing cardiovascular risk resulting in earlier mortality in smoking population.

Endoscopic management of intentional foreign body ingestion: experience from a UK centre

ObjectiveWe report on the increasing incidence and outcomes from intentional foreign body ingestion (iFoBI) presenting to our hospital over a 5-year period. The aim was to assess the impact on...

Pattern of Injuries Sustained in Cases of Four Wheelers without wearing Seat Belt Infatal Road Traffic Accidents in Mangalore

Introduction: Road traffic accidents (RTAs) have been the bane of the modern civilization accounting for considerableloss to the nation. General callous attitude for safety measures, poor law enforcement and uncontrolled motorizationhave caused significant increase in incidence of RTAs. World Health Organization (WHO) puts RTAs as the sixthleading cause of deaths in India, with a greater share of hospitalizations, deaths, disabilities and socioeconomic lossesin young and middle aged population.Aims and Objective: To study the pattern of injuries sustained in cases of four wheelers without wearing seat beltin fatal road traffic accidents in Mangalore.Materials and Method: All cases of road traffic accidents involving fatal head injuries among four wheelers withoutseat belt which underwent autopsy at the Wenlock District Hospital and Justice K.S Hegde charitable Hospital,Mangalore from January 2009 to December 2013 were included in the study. A proforma was prepared, the detailsabout the pattern of skull fractures and also about intracranial haemorrhages were obtained.Results:Majority of the victims of four wheeler not using seat belt were in the age group of 30-39 Years and 40-49Years (26.83% each). Majority of the victims were male (85.37%).Abrasion (46.34%) was the most common Injuryto face and head followed by laceration (29.27%) was observed.Rib fractures was the most common associatedinjury (43.90%) while no associated injury was observed in 56.10%.Diffuse Extravasation of Blood from Scalp wasobserved in 53.66% while from occipital are was seen in 26.83% victims. Linear Type of fracture in vault was seenin 36.59% of victims. Occipital and frontal bone fracture was observed in 29.27% and 24.39% victims respectively.While studying the Base of skull fractures it was seen that ACF was seen in 24.39% victims while PCF in 19.51%and MCF in 14.63% victims. Most common intra cranial haemorrhage was Sub arachnoid haemorrhage (90.24%)followed by sub dural haemorrhage (82.93%). Brain Oedema was seen in 73.17% victims while Contusion to brainwas seen in 26.83% victims. Frontal lobe of brain was injured in 46.34% victims while diffuse brain injury was seenin 29.27% victims.Conclusion:We conclude that the four wheeler accident among the non seat belt users was common in middle agedmales. Head injury and rib fracture was the most common type of injury observed. Liner fracture of skull withoccipital and frontal bone involvement was common. Most common intra cranial haemorrhage was Sub arachnoidhaemorrhage followed by sub dural haemorrhage. Brain Oedema and Contusion to brain were common brain injury.Frontal lobe brain injuries were common followed by diffuse brain injury.

Alendronate use in older patients with reduced renal function: challenges and opportunities in clinical practice.

Oral bisphosphonates are not recommended in patients with creatinine clearance (CrCl) <35ml/min, although this is not supported by post hoc analyses of pivotal oral bisphosphonate studies. As both osteoporosis and renal insufficiency are more prevalent with advancing age, it is important to determine the safety and efficacy of oral bisphosphonates among these patients. Patients with CrCl <35ml/min on alendronate (group A, n=98), with CrCl <35ml/min conservatively managed (group B, n=96), and with CrCl ≥35ml/min on alendronate (group C, n=96) were followed up to 22 months. Primary outcomes were mean change in CrCl from baseline in group A compared with groups B and C, respectively. Secondary outcomes were the incidence of osteoporotic fractures and adverse events between groups. There was no significant change in CrCl from baseline when comparing group A (-1.53±6.83ml/min) with group B (0.59±5.17ml/min) (p=0.075), and group A with group C (-3.71±7.54ml/min) (p=0.163). There was no significant increase in incidences of osteoporotic fractures in group A compared with group B (adjusted relative risk (aRR) 2.02, 95% confidence interval (CI) 0.64-6.37) and group A compared with group C (aRR 1.15, 95% CI 0.46-2.89). There was no significant difference in incidences of acute kidney injury (AKI) in group A compared with group B (aRR 0.48, 95% CI 0.20-1.12). Although statistically non-significant, there was an increase in AKI incidence in group A compared with group C (RR 7.84, 95% CI 0.98-62.66). Among patients with CrCl <35ml/min, alendronate therapy was not associated with significant deterioration in renal function from baseline. Although not powered for secondary outcomes, there were no statistically significant differences in osteoporotic fracture or AKI incidence between the groups.

Signs and Symptoms of Temporomandibular Disorder in Male Narghile Smokers versus Male Cigarette Smokers.

Objective: Narghile smoking is highly prevalent in Egypt. The act of narghile smoking involves strong contraction of the jaw muscles, which would putatively cause overloading of the temporomandibular joint; thereby leading to internal derangement of the joint. The current study compared symptoms and signs related to temporomandibular disorder in male narghile smokers versus male cigarette smokers. Methods: This prospective clinical study involved 233 male narghile smokers and 233 male cigarette smokers. A questionnaire and examination findings protocol was applied for each participant. Results: There was a significant increase in incidence of signs of internal derangement in the temporomandibular joints of narghile smokers versus those of cigarette smokers (p=0.001). Tympanic membrane retractions were also more common in narghile smokers versus cigarette smokers(p=0.001), reflecting the significant effects of jaw muscle mechanical efforts on the middle ear system, associated with narghile smoking. Conclusion: Narghile smoking is a traumatizing habit as regards its effects on the temporomandibular joints and ear structures.

Seasonality of acute kidney injury in a tertiary hospital academic center: an observational cohort study

BackgroundThe aim of our study was to describe seasonal trends of acute kidney injury (AKI) and its relationship with weather conditions in a hospitalized population.MethodsWe retrospectively collected demographic (age, sex), clinical (ICD-9-CM codes of diagnosis discharge) and laboratory data (creatinine values) from the inpatient population admitted to Fondazione Policlinico Universitario A. Gemelli IRCCS between January 2010 and December 2014 with inclusion of all patients ≥18 years with at least two values available for creatinine. The outcome of interest was AKI development, defined according to creatinine kinetics criteria. The exposures of interest were the months and seasons of the year; air temperature and humidity level were also evaluated. Log-binomial regression models adjusted for age, sex, eGFR, comorbidities, Charlson/Deyo index score, year of hospitalization were used to estimate risk ratios (RR) and 95% confidential intervals (CI).ResultsA total of 64,610 patients met the inclusion criteria. AKI occurred in 2864 (4.4%) hospital admissions. After full adjustment, winter period was associated with increased risk of AKI (RR 1.16, 95% CI 1.05, 1.29, p=0.003). Lower air temperature and higher humidity level were associated with risk of AKI, however in multivariable-adjusted models only higher humidity level showed a significant and independent association.ConclusionsAKI is one of the most common complications of hospitalized populations with a defined seasonal pattern and a significant increase in incidence during wintertime; weather conditions, particularly higher humidity level, are independent predictors of AKI and could partially justify the observed seasonal variations.

PCR in tuberculosis: An extremely useful tool?

Introduction: Tuberculosis is a global air borne infectious disease with significant increase in incidence and prevalence. Conventional methods take longer time for diagnosis and drug susceptibility with less sensitivity and specificity. So rapid diagnosis and detection of multi, extensive and total drug resistant bacilli are of up most importance for therapeutic purpose. Materials and Methods: It was a retrospective study in tertiary care. All clinical samples suspected for tuberculosis received by laboratory were included in the study. The samples were processed for microscopy by ZN stain, culture by LJ media and RT-PCR. Results: Total 566 sample were tested out of 177 (31%) were positive for tuberculosis. 62% samples were PCR positive, 51% were culture positive and 49% were smear positive. The most common sample received with maximum positivity rate was pleural fluid (34%). Male predominance was seen with young adults as the predominant group affected. Conclusion: The present study shows good specificity of PCR with sensitivity of 50%. It detects 50% times more cases in relation to conventional results where they fail to produce correct results. More such comparative studies are needed to establish importance of PCR in early diagnosis and treatment. Keywords: Mycobacteria, RT-PCR, Diagnosis, Detection, Infection.

Incidence and Survival Trends of Pancreatic Cancer in Girona: Impact of the Change in Patient Care in the Last 25 Years.

(1) Background: We investigated the incidence and survival trends for pancreatic cancer (PC) over the last 25 years in the Girona region, Catalonia, Spain; (2) Methods: Data were extracted from the population-based Girona Cancer Registry. Incident PC cases during 1994–2015 were classified using the International Classification of Diseases for Oncology Third Edition (ICD-O-3). Incidence rates age-adjusted to the European standard population (ASRE) and world standard population (ASRW) were obtained. Trends were assessed using the estimated annual percentage of change (EAPC) of the ASRE13. Observed and relative survivals (RS) were estimated with the Kaplan–Meier and Pohar Perme methods, respectively; (3) Results: We identified 1602 PC incident cases. According to histology, 44.4% of cases were exocrine PC, 4.1% neuroendocrine, and 51.1% malignant-non-specified. The crude incidence rate (CR) for PC was 11.43 cases-per-100,000 inhabitants/year. A significant increase of incidence with age and over the study period was observed. PC overall 5-year RS was 7.05% (95% confidence interval (CI) 5.63; 8.84). Longer overall survival was observed in patients with neuroendocrine tumours (5-year RS 61.45%; 95% CI 47.47; 79.55). Trends in 5-year RS for the whole cohort rose from 3.27% (95% CI 1.69–6.35) in 1994–1998 to 13.1% (95% CI 9.98; 17.2) in 2010–2015; (4) Conclusions: Incidence rates of PC in Girona have increased in the last two decades. There is a moderate but encouraging increase in survival thorough the study period. These results can be used as baseline for future research.

The Shortage of Benzathine Penicillin and Its Impact on Congenital Syphilis Incidence: An Ecologic Study in the City of Rio de Janeiro.

The Pan American Health Organization indicates that increased incidence of congenital syphilis (CS) can be attributed to the lack of penicillin. This study aimed to analyze the relationship between the benzathine penicillin shortage and the significant increase in the incidence of congenital syphilis in the city of Rio de Janeiro from 2013 to 2017. We used a mixed ecologic study design (temporal and multiple groups). Analysis units were the neighborhoods (spatial) and quarters (temporal) during those years. The study population consisted of CS patients who were living in the city of Rio de Janeiro. The benzathine penicillin supply measure for use in gestational syphilis considered the ratio between (1) the number of bottles dispensed to health facilities in each neighborhood and (2) the number of bottles necessary to treat pregnant women diagnosed with syphilis and their respective partners residing in each neighborhood. To evaluate the association between shortages and a significant increase in CS incidence, the negative-inflated zero-binomial regression model (longitudinal model) was used. During the study period, the incidence rate of CS in Rio de Janeiro neighborhoods was on average 19.6 per 1000 live births. In the simple analysis, shortage was associated with a 2.17-fold increase in the risk of a significant increase in CS incidence. After adjustment for the sufficient minimum set, the strength of association increased to 2.23 (95% confidence interval, 1.15-4.30). We conclude that the benzathine penicillin shortage had an impact on the increase in the incidence of CS in Rio de Janeiro.

Impact of Coronavirus Disease 2019 Pandemic on the Incidence and Management of Out-of-Hospital Cardiac Arrest in Patients Presenting With Acute Myocardial Infarction in England.

BackgroundStudies have reported significant reduction in acute myocardial infarction–related hospitalizations during the coronavirus disease 2019 (COVID‐19) pandemic. However, whether these trends are associated with increased incidence of out‐of‐hospital cardiac arrest (OHCA) in this population is unknown.Methods and ResultsAcute myocardial infarction hospitalizations with OHCA during the COVID‐19 period (February 1–May 14, 2020) from the Myocardial Ischaemia National Audit Project and British Cardiovascular Intervention Society data sets were analyzed. Temporal trends were assessed using Poisson models with equivalent pre–COVID‐19 period (February 1–May 14, 2019) as reference. Acute myocardial infarction hospitalizations during COVID‐19 period were reduced by >50% (n=20 310 versus n=9325). OHCA was more prevalent during the COVID‐19 period compared with the pre–COVID‐19 period (5.6% versus 3.6%), with a 56% increase in the incidence of OHCA (incidence rate ratio, 1.56; 95% CI, 1.39–1.74). Patients experiencing OHCA during COVID‐19 period were likely to be older, likely to be women, likely to be of Asian ethnicity, and more likely to present with ST‐segment–elevation myocardial infarction. The overall rates of invasive coronary angiography (58.4% versus 71.6%; P<0.001) were significantly lower among the OHCA group during COVID‐19 period with increased time to reperfusion (mean, 2.1 versus 1.1 hours; P=0.05) in those with ST‐segment–elevation myocardial infarction. The adjusted in‐hospital mortality probability increased from 27.7% in February 2020 to 35.8% in May 2020 in the COVID‐19 group (P<.001).ConclusionsIn this national cohort of hospitalized patients with acute myocardial infarction, we observed a significant increase in incidence of OHCA during COVID‐19 period paralleled with reduced access to guideline‐recommended care and increased in‐hospital mortality.

Effects of patient characteristics and comorbidities on temporal trends of low-flow, low-gradient aortic stenosis phenotypes

Abstract Background Aortic stenosis (AS) is a common primary heart valve disease in the elderly. Low-flow, low-gradient (LFLG) AS is an increasingly important phenotype. Purpose To evaluate the temporal changes in incidence of severe AS phenotypes: paradoxical LFLG, classical LFLG and non-LFLG and explore risk factors that contribute to temporal trends. Methods We analyzed 25,507 consecutive transthoracic echocardiograms over 6½ years between 2013 and 2019 divided into deciles. LFLG-AS was defined as mean transvalvular pressure gradient &amp;lt;40 mmHg and stroke volume index (SVi) &amp;lt;35 mL/m2, aortic valve area (AVA) &amp;lt;1 cm2 or indexed AVA &amp;lt;0.6 cm2/m2, with either normal (paradoxical LFLG) or decreased (&amp;lt;40%; classical LFLG) left ventricular ejection fraction. Trends and associations with patients characteristics and comorbidities were assessed over time in deciles. Results Of 891 cases that fulfilled severe AS criteria, there were 536 cases of LFLG-AS (85 classical and 451 paradoxical LFLG-AS). There was a statistically significant increase in incidence of paradoxical LFLG-AS between each time interval (p&amp;lt;0.0001), while significant reduction in incidence of non-LFLG-AS (p=0.009) that was not seen with classical LFLG-AS (p=0.7) (Figure). More comprehensive echocardiographic assessment of relevant parameters over time assisted with identification of LFLG-AS cases. Intrinsic patient factors such as age and E/e' contributed towards the increasing trend of paradoxical LFLG-AS. There was a rising population aged over 70 years (p=0.01). Multivariate logistic regression analysis showed that age, sex, E/e', obesity, atrial fibrillation and heart rate were potential risk factors responsible for temporal trend towards rising paradoxical LFLG-AS incidence. There was also a gradual increase in number of patients with low transvalvular flow rate (&amp;lt;200mL/s) over time (p=0.04). Conclusion The incidence of paradoxical LFLG-AS is rising in a hospital echocardiogram service. The parallel increase in LV filling pressure and age in AS patients suggests the increment in LFLG-AS is related to changes to the LV myocardium. Subtypes of aortic stenosis over time Funding Acknowledgement Type of funding source: None

Частота витреоретинальной адгезии в области ретинальных сосудов у пациентов с осевой миопией различных возрастных групп

Purpose. Finding out the frequency and structures posterior vitreous detachment (PVD), the proportion of local vitreoretinal adhesion in topographical zones of large retinal vessels of posterior pole of the eye in patients of different age groups with axial myopia. Material and methods. Clinical material was 82 eyes (41 patients). The age of patients ranged from 18 to 70 years. According to the age category, which is determined by the WHO classification, all patients were divided into 3 groups. The 1st group (18-44 years old) included 12 people (24 eyes); the 2nd group (45–59 years old) included 14 people (28 eyes); the 3rd group (60–74 years old) included 15 people (30 eyes). Results. In the 1st group PVD was not detected in 11 eyes (45.8%); in 13 eyes there were various variants of PVD (54.2%). In the 2nd group PVD was not detected in 9 eyes (32.1%); in 19 eyes there were various variants of PVD (67.9%). In the 3rd group PVD was not detected in 5 eyes (16.7%); in 25 eyes (83.3%) there were various variants of PVD. In this group, there was statistically significant predominance of partial PVD with fixation of the posterior hyaloid membrane to inner limiting membrane (PHM to ILM). Conclusion. In the group of elderly patients with axial myopia (60– 75 years), statistically significant increase in incidence of local adhesion of PHM to ILM in the projection of large retinal vessels was revealed in comparison with young and middle-aged groups (10 cases versus 1 and 2, respectively, p<0.05). This feature must be taken in examination and subsequent management of these patients.

Incidence of and Mortality Due to Human Prion Diseases in Taiwan: A Prospective 20-Year Nationwide Surveillance Study from 1998 to 2017.

IntroductionEpidemiologic studies of Creutzfeldt-Jakob disease (CJD) have been undertaken worldwide since the new variant CJD outbreak in 1996 in the United Kingdom. A nationwide report system, the Creutzfeldt-Jakob Disease Surveillance Unit (CJDSU), directed by the Centers for Disease Control of Taiwan, was established in 1997 to identify human prion diseases.MethodsFrom 1998 to 2017, 647 cases were referred to the committee for confirmation. The report to CJDSU included a structured questionnaire recording the clinical, demographic data, and potential iatrogenic exposure, and the results of the clinical and laboratory examination, including tests of blood and cerebrospinal fluid, electroencephalography, and brain magnetic resonance imaging.ResultsIn total, 356 cases (women, n=178) were ascertained to be human prion diseases, and 97.4% (n=347) were sporadic CJD, including three definite, 314 probable, and 30 possible cases; one probable variant CJD and 8 cases of the genetic form human prion diseases. The age- and gender-specific average annual incidence were also significantly higher in the second decade (0.95/1,000,000) than in the first decade (0.63/1,000,000), with an incidence rate ratio of 1.51. The incidences increased with increasing age, reaching a peak at the age of 70–79 years. The 10-year survival curve for sCJD patients showed that the 1-, 5-, and 10-year cumulative survival rate were 52%, 5%, and 1%, respectively. PRNP polymorphisms in 170 patients showed that 98.8% were M129M and 97.6% E219E.DiscussionThe significant increase in incidence after 2008 suggests the increase in the awareness of this rare disease among physicians. The longer disease duration in patients with sCJD in Taiwan than in other countries indicates that the comprehensive support of the health care system, as well as the end-of-life care culture in Taiwan, may prolong survival time in patients with such a progressive and fatal disease.

Trend and Outcomes of Cardiac Dysrhythmias in Lvad Recipients

Background Cardiac dysrhythmias are a common cause of hospitalization in patients with left ventricular assist device (LVAD). There is limited data on the incidence of VT over time and associated mortality in patients with LVAD. We aimed to identify the incidence of VT post LVAD implant and associated in hospital mortality. Methods Subjects with history of LVAD who had cardiac dysrhythmias as a primary diagnosis were identified from the National Inpatient Sample (NIS) dataset of the Healthcare Cost and Utilization Project (HCUP) for the years 2005-2017 using ICD-9 and10 codes. We also identified the in-hospital outcomes of VT. We excluded patients with history of orthotropic heart transplant and history of biventricular assist device (BiVAD). Associated morbidities and in-hospital outcomes were evaluated. Results A total of 15131 LAVD hospitalizations were identified and 703 patients hospitalized with a primary diagnosis of cardiac dysrhythmias. The median age of patients was 60 years (IQR 51-67), and 57.8% were White. VT was the primary cause of hospitalization in 542 patients (77.5%), followed by atrial fibrillation and flutter, 126(17.9%), then paroxysmal supraventricular tachycardia, 24(3.4%) . Among patients who had VT, 62 patients (11.4%) had cardiac arrest, 2 (0.4%) needed CPR, 17(3.1%) had cardiogenic shock, 4(0.7%) had acute myocardial infarction, 4(0.7%) had acute stroke, 2(0.4%) had brain death, 13 (2.4%) needed mechanical ventilation, 42 (7.7%) had ICD implanted. There was no significant increase in incidence of hospitalization for VT in LVAD patients over the study period.(Std. J-T Statistic 1.371, p = 0.170). Figure 1. The overall in hospital death in these patients was 13(1.8%). Conclusion In LVAD patient VT was found to be most common arrhythmia causing hospitalization but overall mortality was low.

IAP Chemotherapy Regimen Is a Viable and Cost-effective Option in Children and Adolescents With Osteosarcoma: A Comparative Analysis With MAP Regimen on Toxicity and Survival

Cisplatin and doxorubicin are integral components of chemotherapy regimens in the treatment of osteosarcoma. Choice of third agent high-dose methotrexate (HDMTX) or an alkylating agent such as ifosfamide is debatable. The present study compared the impact of MAP (HDMTX-doxorubicin-cisplatin) and IAP (ifosfamide-doxorubicin-cisplatin) chemotherapy regimens on toxicity and survival in children and adolescents with osteosarcoma. This was a retrospective study including patients 18 years and younger with osteosarcoma during the study period. Clinical, demographic, chemotherapy regimen, and surgical details and treatment-related toxicity were retrieved from hospital medical records. Prognostic factors affecting overall survival (OS) and event-free survival (EFS) were analyzed. Among 102 patients included in the study, 59 (57.8%) and 43 (42.2%) patients were treated with MAP and IAP regimens, respectively. Two groups were comparable in terms of pretreatment characteristics and surgical treatment. Overall, 95.9% patients underwent limb salvage surgery. There was a statistically increased incidence in supportive care admissions and delay in starting the next cycle of chemotherapy in the MAP group. Among the MAP cohort, the 5-year OS and EFS were 62% and 55% compared with 47% and 44%, respectively, in the IAP cohort (P=0.143 and 0.316, respectively). On univariate and multivariate analyses, statistically significant factors affecting EFS of the whole group included tumor size, stage, site of metastasis, histologic necrosis, and type of surgery. OS and EFS with both regimens were similar. However, the MAP regimen was associated with a statistically significant increase in incidence of supportive care admissions, delay in next cycle of chemotherapy, and predicted higher cost of treatment.

MM-197: Survival Rate of Multiple Myeloma (MM) Patients in Armenia: A Retrospective Analysis in Multiple Myeloma at a Single Institution

Context: MM is the second most commonly diagnosed hematological neoplasm over the world. MM primarily affects the elderly and is typically diagnosed between the ages of 65-74 years and characterized by severe bone, blood, and renal complications, impacting therapy choices and quality of life. Objective: The aim of the current study was a comprehensive analysis of MM, i.e., their prevalence, incidence, and survival rates in Armenia for the period of 2006-2020. Setting: The main data source for this study was outpatient and dispensary cards, hospitalization journals, as well as clinical data from the Register of Blood Diseases of the Hematology Center after. Prof. R. Yeolyan. This information has been supplemented by the data from National Oncological Centre after V.A. Fanarjyan, as well as from death registration service at Ministry of Justice RA. Results: We analyzed the data of 589 (48.2% female and 51.8% male) patients with MM registered in Armenian Hematology Center of the Ministry of Health of the Republic of Armenia from 2006 to 2020. The median age was 60.6 years. Data analysis showed that during the reported time period, the increase of the MM incidence was 1.23 per 100 000 population. In comparison to our earlier results, a significant increase in incidence of MM was found. The low five-year survival rates were beaten in groups of patients who initially refused therapy and/or were diagnosed already in higher ISS stage for this disease. Among patients receiving therapy, the best survival rates were beaten on MP, VAD protocols, and VCD and transplantation. The median survival for ISS stage II disease was 26 months, stage III disease 7 months, and stage I disease 20 months. Conclusions: In general, the results of treatment in the Armenian population with MM were comparable with the data of the total European cohort. Survival rate seems to be better among younger patients than in older ones, even with lower ISS stage of this disease. The MM-related deaths prevailed in the first 5 years of MM therapy. The appropriate monitoring and therapy interventions during the first year of MM treatment are apparently important for the long-term treatment results.

Rib stress injuries in the 2012–2016 (Rio) Olympiad: a cohort study of 151 Australian Rowing Team athletes for 88 773 athlete days

AimTo describe the demographics, frequency, location, imaging modality and clinician-identified factors of rib stress injury in a cohort of elite rowers over the Rio Olympiad (2012–2016).MethodsAnalysis of prospectively recorded medical...

Role of microRNA‑33a in malignant cells (Review)

Cancer causes most of the mortality and morbidity worldwide, with a significant increase in incidence during recent years. MicroRNAs (miRNAs/miRs) are non-coding small RNAs capable of regulating gene expression. They regulate crucial cellular processes, including proliferation, differentiation, metastasis and apoptosis. Therefore, abnormal miRNA expression is associated with multiple diseases, including cancer. There are two types of cancer-associated miRNAs, oncogenic and tumor suppressor miRNAs, depending on their roles and expression patterns in cancer. Accordingly, miRNAs are considered to be targets for cancer prevention and treatment. miR-33a controls cellular cholesterol uptake and synthesis, which are both closely associated with carcinogenesis. The present review thoroughly describes the roles of miR-33a in more than a dozen types of cancer and the underlying mechanisms. Accordingly, the present review may serve as a guide for researchers studying the involvement of miR-33a in diverse cancer settings.

Prevention of atrial fibrillation – non-modifiable and modifiable risk factors for AF

Atrial fibrillation is one of the most common arrhythmias, with a significant increase in incidence in recent years. AF is a major cause of stroke, heart failure, sudden cardiac death, and cardiovascular disease. Timely intervention and modification of risk factors increase chance to stop the disease. Aggressive, multilevel prevention tactics are a component of combined treatment, including – in addition to lifestyle changes, anticoagulant therapy, pharmacotherapy and invasive anti-arrhythmic treatment – prevention of cardiovascular diseases, hypertension, ischemia, valvular disease and heart failure.

Abstract A117: Thyroid cancer incidence trends among pediatrics, adolescents, and young adults in the United States 2001-2015

Abstract Background: The United States and other industrialized nations are experiencing what is known as the thyroid cancer epidemic. While there are studies of incidence trends among adult thyroid cancer patients in the United States, there is a paucity of data examining the relative contributions of different races/ethnicities and age groups, especially among the pediatric, adolescent, and young adult (AYA) population. This study aimed to identify which racial/ethnic groups may be driving the incidence trends of thyroid cancer among the pediatric and AYA population in the United States. Methods: We used data from the joint National Program of Cancer Registries/Surveillance, Epidemiology, and End Results databases from 2001 - 2015 (n = 149,578), which covered the entire United States (50 states and the District of Columbia). We calculated age-adjusted incidence rates of thyroid cancer for patients from 0 - 39 years, and rates were stratified by age, race/ethnicity, and sex and presented per 100,000 person-years (PY). Overall rates for the entire study period, rate ratios (RR) with 95% confidence intervals (CI), and annual percent changes (APC) comparing the 2001 rate and 2015 rate were calculated for each group. Joinpoint regression estimated increases/decreases in age-adjusted incidence over time for each group through average annual percent changes (AAPC). Results: The majority of thyroid cancer patients in this study were females (83%), white (60%), and between 15 - 39 years (98%). The overall incidence was 6.17 per 100,000 PY with an AAPC of 4.22 (p &amp;lt; 0.01). From 2001 to 2015, there was a 79% increase in age-adjusted incidence rate of thyroid cancer pediatric and AYAs in the United States (4.29 per 100,000 PY in 2001 vs. 7.69 per 100,000 PY in 2015). Both pediatric (0-14 years) and AYA (15 - 39 years) groups experienced significant increase in incidence of thyroid cancer in this time period (AAPC for 0 - 14 years = 4.38; AAPC for 15 - 39 years = 4.22; p &amp;lt; 0.01). The AYA population was 34 times as likely to develop thyroid cancer than the pediatric population (RR = 34.55, 95% CI 33.23, 35.94). Also, both males and females experienced significant rate increases from 2001-2015, but females were almost five times (RR = 4.81, 95% CI 4.74, 4.87) as likely to develop thyroid cancer than males (2.13 per 100,000 PY for males vs. 10.26 per 100,000 PY for females). Whites had the highest overall incidence rate (6.87 per 100,000 PY), while blacks had the lowest overall rate (2.89 per 100,000). Compared to whites, all other race/ethnicity groups were significantly less likely to develop thyroid cancer (RR range 0.42 - 0.90). All race/ethnicity groups had significant rate increases from 2001-2015 (AAPC range = 3.69 - 5.70). Conclusion: Incidence of thyroid cancer increased in both the pediatric and AYA population over the last 15 years, and white females aged 15 - 39 years accounted for most of this increase. These findings can inform future directed screening and reveal unaddressed health disparities. Citation Format: Katherine M. Polednik, Matthew C. Simpson, Aleksandr R. Bukatko, Matthew E. Gaubatz, Eric Adjei Boakye, Mark A. Vavaras, Nosayaba Osazuwa-Peters. Thyroid cancer incidence trends among pediatrics, adolescents, and young adults in the United States 2001-2015 [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A117.