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Current Obesity Reports Sep 2022The purpose of this review is to provide an update on the available data regarding the associations of Ultra-processed food (UPF) consumption with food intake and... (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to provide an update on the available data regarding the associations of Ultra-processed food (UPF) consumption with food intake and possible underlying mechanisms relating UPF consumption to weight gain and co-morbidities.
RECENT FINDINGS
In primarily observational studies, UPF consumption is consistently associated with an increased risk for weight gain among adults and children and increased risk for adiposity-related co-morbidities in adults. In a single mechanistic study, consumption of UPFs led to increased energy intake and weight gain relative to whole foods. UPFs tend to be more energy-dense than nutrient-dense, and UPF consumption is associated with increased adiposity and co-morbidity risk. These data suggest that recommendations to limit UPF consumption may be beneficial to health - though further mechanistic studies are needed.
Topics: Adult; Child; Diet; Fast Foods; Food Handling; Humans; Morbidity; Obesity; Weight Gain
PubMed: 34677812
DOI: 10.1007/s13679-021-00460-y -
Current Rheumatology Reports Jan 2022The epidemiology of antiphospholipid syndrome (APS) is poorly understood. Here, we review the current understanding of the epidemiology of antiphospholipid syndrome in... (Review)
Review
PURPOSE OF REVIEW
The epidemiology of antiphospholipid syndrome (APS) is poorly understood. Here, we review the current understanding of the epidemiology of antiphospholipid syndrome in the general population and the frequency of antiphospholipid antibodies in the general population in patients with obstetric morbidity, arterial events, and venous thromboembolism.
RECENT FINDINGS
There have been few population-based studies that estimated the prevalence and incidence of APS. The estimated incidence and prevalence among most these studies ranged between 1 and 2 cases per 100,000 and 40 and 50 cases per 100,000 respectively. The prevalence of antiphospholipid antibodies in patients with obstetric morbidity was 6-9%, while in arterial events and venous thromboembolism is 9-10%. However, this data remains limited. Mortality of patients with APS is 50-80% higher than the general population. The epidemiology of APS has been difficult to elucidate. Population-based studies patients with diverse age, racial, and ethnic backgrounds are needed.
Topics: Antibodies, Antiphospholipid; Antiphospholipid Syndrome; Female; Humans; Incidence; Pregnancy; Prevalence
PubMed: 34985614
DOI: 10.1007/s11926-021-01038-2 -
Seminars in Vascular Surgery Mar 2021End-stage kidney disease (ESKD) is a common and morbid disease that affects patients' quality and length of life, representing a large portion of health care expenditure... (Review)
Review
End-stage kidney disease (ESKD) is a common and morbid disease that affects patients' quality and length of life, representing a large portion of health care expenditure in the United States. These patients commonly have associated diabetes and cardiovascular disease, with high rates of cardiovascular-related death. Management of ESKD requires renal replacement therapy via dialysis or transplantation. While transplantation provides the greatest improvement in survival and quality of life, the vast majority of patients are treated initially with hemodialysis. However, outcomes differ significantly among patient populations. Barriers in access to care have particularly affected at-risk populations, such as Black and Hispanic patients. These patients receive less pre-ESKD nephrology care, are less likely to initiate dialysis with a fistula, and wait longer for transplants-even in pediatric populations. Priorities for ESKD care moving into the future include increasing access to nephrology care in underprivileged populations, providing patient-centered care based on each patient's "life plan," and focusing on team-based approaches to ESKD care. This review explores ESKD from the perspective of epidemiology, costs, vascular access, patient-reported outcomes, racial disparities, and the impact of the COVID-19 crisis.
Topics: COVID-19; Comorbidity; Global Health; Humans; Kidney Failure, Chronic; Morbidity; Pandemics; Renal Dialysis
PubMed: 33757639
DOI: 10.1053/j.semvascsurg.2021.02.010 -
International Journal of Stroke :... Feb 2021Atrial fibrillation is the most frequent cardiac arrhythmia. It has been estimated that 6-12 million people worldwide will suffer this condition in the US by 2050 and...
BACKGROUND
Atrial fibrillation is the most frequent cardiac arrhythmia. It has been estimated that 6-12 million people worldwide will suffer this condition in the US by 2050 and 17.9 million people in Europe by 2060. Atrial fibrillation is a major risk factor for ischemic stroke and provokes important economic burden along with significant morbidity and mortality.
AIM
We provide here comprehensive and updated statistics on worldwide epidemiology of atrial fibrillation.
METHODS
An electronic search was conducted for atrial fibrillation. The epidemiologic information was retrieved from the Global Health Data Exchange database, which is regarded as one of the most comprehensive worldwide catalogs of surveys, censuses, vital statistics, and other health-related data.
RESULTS
A total of 3.046 million new cases of atrial fibrillation worldwide were registered in the database during 2017. The estimated incidence rate for 2017 (403/millions inhabitants) was 31% higher than the corresponding incidence in 1997. The worldwide prevalence of atrial fibrillation is 37,574 million cases (0.51% of worldwide population), increased also by 33% during the last 20 years. The highest burden is seen in countries with high socio-demographic index, though the largest recent increased occurred in middle socio-demographic index countries. Future projections suggest that absolute atrial fibrillation burden may increase by >60% in 2050.
CONCLUSIONS
Our analyses suggest that atrial fibrillation incidence and prevalence have increased over the last 20 years and will continue to increase over the next 30 years, especially in countries with middle socio-demographic index, becoming one of the largest epidemics and public health challenges.
Topics: Atrial Fibrillation; Epidemics; Global Health; Humans; Incidence; Prevalence; Public Health; Stroke
PubMed: 31955707
DOI: 10.1177/1747493019897870 -
Sante Publique (Vandoeuvre-les-Nancy,... 2022Introduction : Maternal morbidity is a public health problem in developing countries.Purpose of research : The aim of this study was to determine the...
Introduction : Maternal morbidity is a public health problem in developing countries.Purpose of research : The aim of this study was to determine the prevalence of maternal morbidity among women of reproductive age in the province of Essaouira (Morocco) and to describe the factors associated with it. The authors conducted a cross-sectional structured interview survey of 1300 married women aged 18 to 49. Data entry and statistical processing were performed by the SPSS-PC 18 program.Results : The prevalence of maternal morbidity was 66.8%. The main morbidities were sexually transmitted infections (48.8%) and anemia (46.6%). Multivariate analysis showed that frequency of postnatal visits, literacy of the couple and socioeconomic level were statistically associated with maternal morbidity.Conclusion : The use of postnatal care, the fight against illiteracy and the improvement of the socio-economic level of households, are factors that would reduce maternal morbidity.
Topics: Female; Pregnancy; Humans; Morocco; Cross-Sectional Studies; Morbidity; Prevalence; Sexually Transmitted Diseases; Socioeconomic Factors
PubMed: 36577684
DOI: 10.3917/spub.224.0581 -
Pediatrics Jan 2024Mortality and morbidity for very preterm infants in the United States decreased for years. The current study describes recent changes to assess whether the pace of...
BACKGROUND
Mortality and morbidity for very preterm infants in the United States decreased for years. The current study describes recent changes to assess whether the pace of improvement has changed.
METHODS
Vermont Oxford Network members contributed data on infants born at 24 to 28 weeks' gestation from 1997 to 2021. We modeled mortality, late-onset sepsis, necrotizing enterocolitis, chronic lung disease, severe intraventricular hemorrhage, severe retinopathy of prematurity, and death or morbidity by year of birth using segmented relative risk regression, reporting risk-adjusted annual percentage changes with 95% confidence intervals overall and by gestational age week.
RESULTS
Analyses of data for 447 396 infants at 888 hospitals identified 3 time point segments for mortality, late onset sepsis, chronic lung disease, severe intraventricular hemorrhage, severe retinopathy of prematurity, and death or morbidity, and 4 for necrotizing enterocolitis. Mortality decreased from 2005 to 2021, but more slowly since 2012. Late-onset sepsis decreased from 1997 to 2021, but more slowly since 2012. Severe retinopathy of prematurity decreased from 2002 to 2021, but more slowly since 2011. Necrotizing enterocolitis, severe intraventricular hemorrhage, and death or morbidity were stable since 2015. Chronic lung disease has increased since 2012. Trends by gestational age generally mirror those for the overall cohort.
CONCLUSIONS
Improvements in mortality and morbidity have slowed, stalled, or reversed in recent years. We propose a 3-part strategy to regain the pace of improvement: research; quality improvement; and follow through, practicing social as well as technical medicine to improve the health and well-being of infants and families.
Topics: Infant; Infant, Newborn; Humans; United States; Infant, Premature; Retinopathy of Prematurity; Enterocolitis, Necrotizing; Infant, Premature, Diseases; Gestational Age; Infant Mortality; Cerebral Hemorrhage; Sepsis; Lung Diseases; Morbidity
PubMed: 38053449
DOI: 10.1542/peds.2023-064153 -
Anaesthesia Sep 2022Using a cohort study design, we analysed 17 diagnoses and 9 interventions (including critical care admission) as a composite measure of severe maternal morbidity for...
Using a cohort study design, we analysed 17 diagnoses and 9 interventions (including critical care admission) as a composite measure of severe maternal morbidity for pregnancies recorded over 14 years in Scotland. There were 762,918 pregnancies, of which 7947 (10 in 1000 pregnancies) recorded 9345 severe maternal morbidity events, 2802 episodes of puerperal sepsis being the most common (30%). Severe maternal morbidity incidence increased from 9 in 1000 pregnancies in 2012 to 17 in 1000 pregnancies in 2018, due in part to puerperal sepsis recording. The odds ratio (95%CI) for severe maternal morbidity was higher for: older women, for instance 1.22 (1.13-1.33) for women aged 35-39 years and 1.44 (1.27-1.63) for women aged > 40 years compared with those aged 25-29 years; obese women, for instance 1.13 (1.06-1.21) for BMI 30-40 kg.m and 1.32 (1.15-1.51) for BMI > 40 kg.m compared with BMI 18.5-24.9 kg.m ; multiple pregnancy, 2.39 (2.09-2.74); and previous caesarean delivery, 1.52 (1.40-1.65). The median (IQR [range]) hospital stay was 3 (2-5 [1-8]) days with severe maternal morbidity and 2 (1-3 [1-5]) days without. Forty-one women died during pregnancy or up to 42 days after delivery, representing mortality rates per 100,000 pregnancies of about 365 with severe maternal morbidity and 1.6 without. There were 1449 women admitted to critical care, 807 (58%) for mechanical ventilation or support of at least two organs. We recorded an incidence of severe maternal morbidity higher than previously published, possibly because sepsis was coded inaccurately in our databases. Further research may determine the value of this composite measure of severe maternal morbidity.
Topics: Aged; Cohort Studies; Female; Hospitalization; Humans; Incidence; Length of Stay; Maternal Mortality; Morbidity; Pregnancy; Sepsis
PubMed: 35820195
DOI: 10.1111/anae.15798 -
Orvosi Hetilap Sep 2020Worldwide, the prevalence of anemia is high, and iron deficiency anemia is the fifth most common disorder according to the study called "Global burden of disease". It...
Worldwide, the prevalence of anemia is high, and iron deficiency anemia is the fifth most common disorder according to the study called "Global burden of disease". It can be attributed to a number of factors, complex pathomechanisms, and etiology is highly variable in terms of age, gender, and geographical distribution. The prevalence of anemia increases with age. Demographic change and the aging of the population are now faster than in previous decades, posing major challenges to societies and health systems. The mean prevalence of anemia in the elderly is 17%, but significantly higher among nursing-home (47%) and hospitalized elderly (40%). The cause is usually multifactorial and often, due to comorbidities, several mechanisms are involved at the same time. The prevalence of preoperative anemia was higher (35%) than the prevalence of anemia in the general population, and evidence showed an unfavorable effect on postoperative morbidity and mortality. Timely identification and correction is a multidisciplinary task and a shared responsibility for both Patient Blood Management program and improving the patients' life expectancy. Orv Hetil. 2020; 161(37): 1569-1573.
Topics: Aged; Anemia; Anemia, Iron-Deficiency; Comorbidity; Humans; Morbidity; Prevalence
PubMed: 32894736
DOI: 10.1556/650.2020.31916 -
Archives of Cardiovascular Diseases Oct 2021Heart failure remains a health challenge in Africa, associated with significant rates of hospitalization, morbidity and mortality. The current review aims to summarize... (Review)
Review
Heart failure remains a health challenge in Africa, associated with significant rates of hospitalization, morbidity and mortality. The current review aims to summarize the most recent data on the epidemiology, aetiology, risk factors and management of heart failure, comparing countries in North Africa and sub-Saharan Africa. There is a paucity of data on heart failure epidemiology, aetiology and management, and on the sociodemographic characteristics of African patients with heart failure. Heart failure prevalence has been evaluated among all medical admissions or admissions to cardiac units or emergency departments in a few hospital-based studies conducted in countries in North Africa and sub-Saharan Africa. Common causes of heart failure in Africa include ischaemic heart disease, hypertensive heart disease, dilated cardiomyopathy and valvular heart disease. The aetiology of heart failure differs between countries in North Africa and sub-Saharan Africa. Diagnosing heart failure proves challenging in Africa because of a lack of basic tools and the necessary human resources. The principal drugs used frequently for heart failure therapy are lacking in sub-Saharan Africa. The clinical profile of heart failure in sub-Saharan Africa differs from that in North African countries; this is related to aetiological factors, socioeconomic status and availability of diagnostic tools. There is an evident need to establish a large multicentre registry to evaluate the heart failure burden in almost all African countries, and to highlight the major cardiovascular risk factors and co-morbidities. The present review highlights the importance of this syndrome in Africa, and calls for improvements in its early diagnosis, treatment and, possibly, prevention.
Topics: Heart Failure; Humans; Hypertension; Morbidity; Myocardial Ischemia; Prevalence
PubMed: 34563468
DOI: 10.1016/j.acvd.2021.07.001 -
BJOG : An International Journal of... Feb 2022To apply the iceberg model, quantifying absolute and relative incidence, to the four main causes of maternal morbidity and mortality in Ireland: haemorrhage,...
OBJECTIVE
To apply the iceberg model, quantifying absolute and relative incidence, to the four main causes of maternal morbidity and mortality in Ireland: haemorrhage, hypertension, sepsis and thrombosis.
DESIGN
Secondary analysis of national data on maternal morbidity and mortality.
SETTING
Republic of Ireland.
POPULATION OR SAMPLE
Approximately 715 000 maternities, 1 200 000 maternal hospitalisations, 2138 cases of severe maternal morbidity (SMM) and 54 maternal deaths.
METHODS
Incidence rates and case-fatality ratios were calculated.
MAIN OUTCOME MEASURES
Maternal death, SMM and hospitalisation.
RESULTS
At the 'tip of the iceberg', the incidence of maternal death per 10 000 maternities was 0.09 (95% CI 0.03-0.20) due to thrombosis and 0.03 (95% CI 0-0.11) due to haemorrhage, hypertension disorders or sepsis. For one death due to thrombosis there were 35 cases of pulmonary embolism and 257 thrombosis hospitalisations. For one death due to eclampsia, there were 58 eclampsia cases, 13 040 hospitalisations with pre-existing hypertension and 40 781 hospitalisations with gestational hypertension. For one death due to pregnancy-related sepsis, there were 92 cases of septicaemic shock and 9005 hospitalisations with obstetric sepsis. For one maternal death due to haemorrhage, there were 1029 cases of major obstetric haemorrhage and 53 715 maternal hospitalisations with haemorrhage. For every 100 maternities, there were approximately 16 hospitalisations associated with haemorrhage, 12 associated with hypertension disorders, three with sepsis and 0.2 with thrombosis.
CONCLUSIONS
Haemorrhage and hypertension disorders are leading causes of maternal morbidity in Ireland but they have very low case fatality. This indicates that these morbidities are managed effectively but their prevention requires more focus.
TWEETABLE ABSTRACT
Study shows that haemorrhage and hypertension are main causes of #maternalmorbidity in Ireland. Timely interventions for #maternalhealth and focus on prevention of severe and non-severe morbidities are needed. @NPEC #maternityservices #clinicalaudit #qualityimprovement.
Topics: Adult; Female; Hospitalization; Humans; Incidence; Ireland; Maternal Death; Maternal Mortality; Morbidity; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications; Sepsis; Thrombosis
PubMed: 34455672
DOI: 10.1111/1471-0528.16880