-
PloS One 2024Obesity is a high-morbidity chronic condition and risk factor for multiple diseases that necessitate imaging. This study assesses the relationship between BMI and...
OBJECTIVE
Obesity is a high-morbidity chronic condition and risk factor for multiple diseases that necessitate imaging. This study assesses the relationship between BMI and same-year utilization of CT and MR imaging in a large healthcare population.
METHODS
In this retrospective population-based study, all patients aged ≥18 years with a documented BMI in the multi-institutional Cosmos database were included. Cohorts were identified based on ≥1 documented BMI in 2021 within pre-defined ranges. For each cohort, we assessed the percentage of patients undergoing head, neck, chest, spine, or abdomen/pelvis CT and MR during the same year. Disease severity was quantified based on emergency department (ED) visits and mortality.
RESULTS
In our population of 49.6 million patients, same-year CT and MR utilization was 14.5 ±0.01% and 6.0±0.01%, respectively. The underweight cohort had the highest CT (25.8±0.1%) and MR (8.01 ± 0.05) imaging utilization. At high extremes of BMI (>50 kg/m2), CT utilization mildly increased (18.4±0.1%), but MR utilization decreased (5.3±0.04%). While morbidity differences may explain some BMI-utilization relationships, lower MR utilization in the BMI>50 cohort contrasts with higher age-adjusted mortality (1.8±0.03%) and ED utilization (32.4±0.1%) in this cohort relative to normal weight (1.5±0.01% and 25.7±0.02%, respectively).
CONCLUSION
Underweight patients had disproportionately high CT/MR utilization, and high extremes of BMI are associated with mildly higher CT and lower MR utilization than the normal weight cohort. The elevated mortality and ED utilization in severely obese patients contrasts with their lower MR imaging utilization. Our findings may assist public health efforts to accommodate obesity trends.
Topics: Humans; Body Mass Index; Magnetic Resonance Imaging; Male; Female; Tomography, X-Ray Computed; Middle Aged; Retrospective Studies; Adult; Obesity; Aged; Emergency Service, Hospital; Morbidity
PubMed: 38941332
DOI: 10.1371/journal.pone.0306087 -
PloS One 2024Although infant deaths worldwide have reduced, many children die before their first birthday. Infant deaths are widespread in low-income countries, and information about...
BACKGROUND
Although infant deaths worldwide have reduced, many children die before their first birthday. Infant deaths are widespread in low-income countries, and information about the cause of death is limited. In Ethiopia, 53% of infants' deaths occurred in their neonatal period, and 174 infants' deaths occurred from 3684 births. Hence, this study aimed to assess mothers' experiences with infant death and its predictors in Ethiopia.
METHODS
A total of 1730 weighted samples of mothers from the 2019 EDHS dataset, which was collected across the regions of Ethiopia, were included for analysis. A two-stage cluster sampling technique with a cross-sectional study design was used. All mothers whose children were under the age of 0-12 months were included in this study. Six count regression models were considered and compared using Akaike's information criteria and Bayesian information criterion with STATA version 15 software. The strength of the association between the number of infant deaths and possible predictors was determined at a P-value less than 0.05, with a 95% confidence interval. The findings were interpreted by using the incident rate ratio.
RESULTS
A total of 46.3% of mothers had lost at least one infant by death in the last five years before the 2019 EDHS survey was held. The mean and variance of infant deaths were 2.55 and 5.58, respectively. The histogram was extremely picked at the beginning, indicating that a large number of mothers did not lose their infants by death, and that shows the data had positive skewness. Mothers under 25-29 years of age (IRR: 1.75, 95% CI:1.48, 2.24), and 30-34 years of age (IRR: 1.42, 95% CI: 1.12, 2.82), Somali (IRR: 1.47, 95% CI: 1.02, 3.57), Gambela (IRR: 1.33, 95% CI: 1.10, 2.61), and Harari (IRR: 1.39, 95% CI: 1.02, 2.63) regions, rural resident mothers (IRR: 1.68, 95% CI: 1.09, 1.91, and Protestant (IRR = 1.43, 95% CI: 1.14, 2.96), and Muslim (IRR = 1.59, 95% CI: 1.07, 2.62) religion fellow of mothers were associated with a high risk of infants' deaths. Whereas, being rich IRR: 0.37, 95% CI: .27, .81) and adequate ANC visits (IRR: 0.28, 95% CI: .25, .83) were associated with a low risk of infant death.
CONCLUSION
Many mothers have experienced infant deaths, and the majority of infants' deaths occur after the first month of birth. Encouraging mothers to attend antenatal care visits, creating mothers' awareness about childcare, and ensuring equal health services distribution and utilization to rural residents are essential to minimize infant death. Educating lower-aged reproductive mothers would be a necessary intervention to prevent and control infant deaths.
Topics: Humans; Ethiopia; Mothers; Female; Infant; Adult; Infant, Newborn; Cross-Sectional Studies; Infant Mortality; Young Adult; Adolescent; Infant Death; Male; Rural Population; Bayes Theorem
PubMed: 38941290
DOI: 10.1371/journal.pone.0303358 -
PloS One 2024Hepatitis C virus (HCV) infection remains a major cause of liver related morbidity and mortality worldwide. Epidemiologic data on seroprevalence, viremia prevalence and...
Hepatitis C virus (HCV) infection remains a major cause of liver related morbidity and mortality worldwide. Epidemiologic data on seroprevalence, viremia prevalence and risk factors remain limited in sub-Saharan Africa. In Ghana, HCV-related deaths are estimated to have increased since 2015. Risk factors associated with HCV infection in Ghana are not well described. The aim of this study was to determine the prevalence of, and risk factors associated with hepatitis C virus infection in the Upper East Region located in the northern part of Ghana. A community-based cross-sectional study was conducted in 9 communities in the Upper East region of Ghana. A total of 1,769 participants aged ≥12 years were screened for HCV antibody (anti-HCV) using rapid diagnostic testing (RDT). Seventy-four participants undertook HCV RNA testing after a positive anti-HCV result. Multivariate logistic regression was used to determine risk factors associated with HCV seropositivity. The anti-HCV prevalence was 8.4%, with 149 out of 1,769 testing anti-HCV positive. Mean age (±SD) of seropositive persons was 45.4 (±16.3) years. The highest anti-HCV seroprevalence was amongst persons aged 60 years and above. Forty-four out of 74 (59.5%) seropositive cases had viremic infection and the estimated viremic prevalence in the screened population was 5.0%. Predictors of HCV seropositivity were age (OR 1.03 95% CI 1.01-1.04), history of female genital mutilation or circumcision (OR 1.63 95% CI 1.04-2.55), sexual activity (OR 2.57 95% CI 1.38-4.79), positive maternal HCV status (OR 10.38 95% CI 4.13-26.05) and positive HIV status (OR 4.03 95% CI 1.35-12.05). In conclusion, the Upper East Region demonstrates a high Hepatitis C antibody prevalence. Almost 60% of individuals have viremic infection, however the cost of RNA testing is a barrier to virological diagnosis. There is a need to educate the population about HCV-associated risk factors to reduce HCV transmission and burden of disease.
Topics: Humans; Ghana; Female; Male; Middle Aged; Cross-Sectional Studies; Risk Factors; Adult; Hepatitis C; Prevalence; Hepacivirus; Young Adult; Seroepidemiologic Studies; Adolescent; Hepatitis C Antibodies; Aged; Child
PubMed: 38941280
DOI: 10.1371/journal.pone.0306292 -
Journal of Vascular Surgery Mar 2024The outcomes of the best medical treatment (BMT) and intervention treatment (INT) in a single-center experience were reported in type B intramural hematoma (IMH). (Comparative Study)
Comparative Study
OBJECTIVE
The outcomes of the best medical treatment (BMT) and intervention treatment (INT) in a single-center experience were reported in type B intramural hematoma (IMH).
METHODS
From February 2015 to February 2021, a total of 195 consecutive patients with type B IMH were enrolled in the study. The primary end point was mortality, and the secondary end points included clinical and imaging outcomes. The clinical outcomes were aortic-related death, retrograde type A aortic dissection, stent graft-induced new entry tear, endoleak, and reintervention. The imaging outcome was evaluated through the latest follow-up computed tomography angiography, which included aortic rupture, aortic dissection, aortic aneurysm, rapid growth of aortic diameter, newly developed or enlarged penetrating aortic ulcer or ulcer-like projection (ULP) and increased aortic wall thickness. Kaplan-Meier curves were used to assess the association between different treatments.
RESULTS
Among the enrolled patients, 115 received BMT, and 80 received INT. There was no significant difference in early (1.7% vs 2.5%; P = 1.00) and midterm all-cause death (8.3% vs 5.2%; P = .42) between the BMT and INT groups. However, patients who underwent INT were at risk of procedure-related complications such as stent graft-induced new entry tear and endoleaks. The INT group was associated with a profound decrease in the risk of ULP, including newly developed ULP (4.3% vs 26.9%; P < .05), ULP enlargement (6.4% vs 31.3%; P < .05), and a lower proportion of high-risk ULP (10.9% vs 45.6%; P < .05). Although there was no significant difference in the incidence of IMH regression between the two groups, the maximum diameter of the descending aorta in patients receiving INT was larger compared with those treated with BMT.
CONCLUSIONS
Based on our limited experience, patients with type B IMH treated with BMT or INT shared similar midterm clinical outcome. Patients who underwent INT may have a decreased risk of ULPs, but a higher risk of procedure-related events and patients on BMT should be closely monitored for ULP progression.
Topics: Humans; Male; Female; Hematoma; Aged; Middle Aged; Retrospective Studies; Blood Vessel Prosthesis Implantation; Treatment Outcome; Endovascular Procedures; Risk Factors; Time Factors; Stents; Computed Tomography Angiography; Aortic Diseases; Aortic Dissection; Risk Assessment; Postoperative Complications; Blood Vessel Prosthesis; Aortic Intramural Hematoma
PubMed: 38941265
DOI: 10.1016/j.jvs.2023.10.044 -
The Journals of Gerontology. Series A,... Jun 2024Longevity, a hallmark of successful ageing, is a multifactorial trait with influences from birth onwards. However, limited evidence exists on the pathways linking...
BACKGROUND
Longevity, a hallmark of successful ageing, is a multifactorial trait with influences from birth onwards. However, limited evidence exists on the pathways linking diverse life-course exposures to longevity, especially within a single cohort.
METHODS
We investigated associations between life-course factors and longevity among community-dwelling adults aged 79 (N=547) from the Lothian Birth Cohort 1921 with a mortality follow-up of 24 years. Cox proportional hazards and structural equation (path) models were used to explore how factors from early-life (social class, childhood IQ, education), mid-life (social class), later-life (health, lifestyle, psychosocial well-being), as well as sex, personality and APOE e4 status, influence survival time in days.
RESULTS
During follow-up (1999-2023), 538 participants (98%) died (mean age of death=89.3 years) and 9 survived (mean age=101.6 years). Factors associated with lower mortality risk in the multivariable Cox model were higher cognitive function (HR=0.72; 95% CI:0.59-0.88), better physical function (HR=0.61; 95% CI:0.44-0.85), and greater physical activity (HR=0.81; 95% CI 0.71-0.92), while history of cancer was associated with higher mortality risk (HR=1.84; 95% CI:1.22-2.77). The life-course path model identified the same direct predictors, with additional contributions from female sex and non-smoking status, to greater longevity. Early- and mid-life factors (IQ, education, social class), and emotional stability, conscientiousness, and female sex, were indirectly and positively associated with survival trajectories via multiple dimensions of adult health.
CONCLUSIONS
In understanding why people live to very old ages it is necessary to consider factors from throughout the life course, and to include demographic, psychosocial, and health variables.
PubMed: 38941261
DOI: 10.1093/gerona/glae166 -
Chemistry (Weinheim An Der Bergstrasse,... Jun 2024The multiplexity of cancer has rendered it the second leading cause of mortality worldwide and theragnostic prodrugs have gained popularity in recent years as a means of...
The multiplexity of cancer has rendered it the second leading cause of mortality worldwide and theragnostic prodrugs have gained popularity in recent years as a means of treatment. Theragnostic prodrugs enable the simultaneous diagnosis and therapy of tumors via high-precision real-time drug release monitoring. Herein, we report the development of the small theragnostic prodrug GF, based on the nucleoside anticancer agent gemcitabine and the fluorescent dye 5(6)-carboxyfluorescein. We have successfully demonstrated its efficient internalization in tumor cells, showing localization throughout both the early and late endocytic pathways. Its mechanism of cell internalization was evaluated, confirming its independence from nucleoside transporters. Its cellular localization via confocal microscopy revealed a clathrin-mediated endocytosis mechanism, distinguishing it from analogous compounds studied previously. Furthermore, GF exhibited stability across various pH values and in human blood plasma. Subsequently, its in vitro cytotoxicity was assessed in three human cancer cell lines (A549, U87 and T98). Additionally, its pharmacokinetic profile in mice was investigated and the consequent drug release was monitored. Finally, its in vivo visualization was accomplished in zebrafish xenotransplantation models and its in vivo efficacy was evaluated in A549 xenografts. The results unveiled an intriguing efficacy profile, positioning GF as a compelling candidate warranting further investigation.
PubMed: 38941241
DOI: 10.1002/chem.202401327 -
Revista de La Facultad de Ciencias... Jun 2024Introducción: La embolia gaseosa cerebral es una afección inusual pero extremadamente grave que se produce cuando se introduce aire en la circulación arterial o...
Introducción: La embolia gaseosa cerebral es una afección inusual pero extremadamente grave que se produce cuando se introduce aire en la circulación arterial o venosa del cerebro. Aunque poco común, puede derivar en déficits neurológicos significativos e incluso la muerte del paciente. Caso Clínico: Paciente de 76 años con una enfermedad pulmonar intersticial difusa preexistente, que experimentó un ictus masivo debido a un neumomediastino espontáneo. Su presentación incluyó confusión, convulsiones y debilidad motora. Las pruebas de imagen revelaron burbujas de aire en los surcos cerebrales y áreas hipodensas en el cerebelo y parietooccipitales. Además, se observó neumotórax y aire en el mediastino superior en las radiografías de tórax y la tomografía torácica. A pesar de las medidas terapéuticas como el oxígeno hiperbárico, la paciente lamentablemente falleció debido al fallo multiorgánico. Discusión: El diagnóstico de embolia gaseosa cerebral generalmente implica la realización de una tomografía computarizada cerebral, que es altamente sensible para detectar la presencia de aire en los vasos cerebrales. El manejo incluye el control de las constantes vitales y neurológicas, así como medidas específicas como cierre de la entrada de aire, aspiración de catéteres venosos, posicionamiento de Trendelenburg y oxígeno hiperbárico. Conclusión: La embolia gaseosa cerebral es una afección potencialmente mortal que requiere una tomografía computarizada cerebral para el diagnóstico y de vital importancia conocer las medidas de prevención para evitar la aparición de esta complicación y así mismo conocer las medidas generales a adoptar cuando ésta se presenta.
Topics: Humans; Male; Embolism, Air; Aged; Fatal Outcome; Lung Diseases, Interstitial; Intracranial Embolism; Tomography, X-Ray Computed; Hyperbaric Oxygenation
PubMed: 38941227
DOI: 10.31053/1853.0605.v81.n2.42414 -
Revista de La Facultad de Ciencias... Jun 2024Introducción: Los modelos de predicción de riesgo de cirugías cardiovasculares se aplican ampliamente a la práctica médica. Sin embargo, han sido criticados por su...
Introducción: Los modelos de predicción de riesgo de cirugías cardiovasculares se aplican ampliamente a la práctica médica. Sin embargo, han sido criticados por su baja calidad metodológica y escasa validación externa. En América Latina se agrega la limitación de que la mayoría de estos modelos fueron desarrollados en Estados Unidos o Europa, existiendo diferencias geográficas marcadas. El objetivo de este estudio es caracterizar los eventos clínicos postoperatorios de cirugías cardiovasculares con uso de bomba de circulación extracorpórea en un escenario local y evaluar la predicción de mortalidad postoperatoria del modelo predictivo EuroSCORE II. Métodos: Corte transversal en un hospital universitario urbano de Buenos Aires. Se incluyeron a pacientes ≥21 años de edad, con indicación de cirugía cardiovascular con uso de bomba. Se excluyeron a pacientes con datos clínicos incompletos respecto a las variables del EuroSCORE II o respecto a la sobrevida intrahospitalaria, con ≥95 años de edad o sometidos a trasplante cardíaco. Resultados: Se enrolaron 195 pacientes. La mortalidad postoperatoria estimada por el EuroSCORE II presentó una clara subestimación del riesgo (3,0% vs 7,7%). La discriminación (AUC = 0,82; IC95% 0,74-0,92) y la bondad del ajuste del modelo fueron adecuadas (χ2 = 7,91; p = 0,4418). Las complicaciones postoperatorias más frecuentes fueron insuficiencia cardíaca postoperatoria (35,9%), shock vasopléjico (13,3%) y shock cardiogénico (10,26%). Conclusión: El EuroSCORE II es una herramienta apropiada para discriminar entre diferentes categorías de riesgo en pacientes sometidos a cirugías cardiovasculares con uso de bomba, si bien subestima el riesgo.
Topics: Humans; Female; Male; Middle Aged; Risk Assessment; Extracorporeal Circulation; Aged; Postoperative Complications; Cross-Sectional Studies; Risk Factors; Cardiovascular Surgical Procedures; Argentina; Hospital Mortality; Adult
PubMed: 38941226
DOI: 10.31053/1853.0605.v81.n2.42432 -
FASEB Journal : Official Publication of... Jul 2024In recent years, C2ORF40 has been identified as a tumor suppressor gene with multiple functions, including roles in cell proliferation, migration, and senescence. To...
In recent years, C2ORF40 has been identified as a tumor suppressor gene with multiple functions, including roles in cell proliferation, migration, and senescence. To explore the role of the C2ORF40 gene in different tumors, we used multiple databases for analysis. Compared to adjacent normal tissues, C2ORF40 is downregulated in a variety of malignant tumors, including tumors such as breast cancer, colorectal cancer, bladder cancer, hepatocellular carcinoma and prostate cancer. Notably, low expression of the gene is significantly associated with poor overall survival and relapse-free survival rates. In specific cancers including colon cancer and prostate cancer, the expression of C2ORF40 is correlated with the infiltration of CAFs. C2ORF40 is also involved in biological processes such as cell apoptosis and regulation of protein stability. In conclusion, C2ORF40 can hold promise as a prognostic marker for pan-cancer analysis.
Topics: Humans; Prognosis; Neoplasms; Gene Expression Regulation, Neoplastic; Biomarkers, Tumor; Male; Female
PubMed: 38941213
DOI: 10.1096/fj.202302386RR -
Chemistry & Biodiversity Jun 2024Delayed healing of chronic wounds results in amputation and mortality rates in serious cases. The present study examines the merged wound-restorative efficacy of...
Delayed healing of chronic wounds results in amputation and mortality rates in serious cases. The present study examines the merged wound-restorative efficacy of injectable bone marrow-derived mesenchymal stem cells (BMMSCs) and topical Callyspongia sp. extract in immunocompromised rats. HR-LC-MS analysis of Callyspongia sp. extract tentatively identified twenty-nine compounds (1-29) and highlighted its richness in fatty acids and terpenoids, known for their wound regenerating efficacies. The wound closure was greatly prominent in the BMMSCs/Callyspongia sp. group in contrast to the control group (p < 0.001). The RT-PCR gene expression emphasized these results by attenuating the oxidative, inflammatory, and immunity markers, further confirmed by histopathological findings. Additionally, in silico modeling was particularly targeting matrix metalloproteinase-9 (MMP9), a key player in wound healing processes. Computational analysis revealed that compounds 18 and 19 potentially modulate MMP9 activity. The combination of BMMSCs and topical Callyspongia sp. extract holds a promise for regenerative therapy constituting a drastic advance in the wound cure of immunocompromised patients, eventually further safety assessments and clinical trials are required.
PubMed: 38941178
DOI: 10.1002/cbdv.202400682