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Nephrologie & Therapeutique Jun 2024New Caledonia is a French territory located in the South Pacific Ocean. The prevalence rate of end-stage renal disease is nearly 3,000 per million inhabitants, making it...
New Caledonia is a French territory located in the South Pacific Ocean. The prevalence rate of end-stage renal disease is nearly 3,000 per million inhabitants, making it one of the highest prevalence rates in the world. Preventing chronic kidney disease is a major public health issue. This article presents prevalence rates of chronic kidney disease (CKD) stages 3-5 for New Caledonia defined by a glomerular filtration rate estimated below 60 mL/min/1.73 m2. Estimation was assessed from data collected during two “Adult health barometer” surveys carried out in the general adult population. Therefore, our study assessed two prevalence rates: 7.8% [6.1; 10.1] and 5.3% [3.3; 8.5]. Those prevalence rates were two to four times higher than in mainland France which is consistent with the high prevalence rate of end stage renal disease treated in New Caledonia. Hence, CKD prevention is essential for New Caledonia.
Topics: Humans; Prevalence; New Caledonia; Renal Insufficiency, Chronic; Male; Middle Aged; Female; Aged; Adult; Severity of Illness Index
PubMed: 38920046
DOI: 10.1684/ndt.2024.77 -
Military Medicine Jun 2024Musculoskeletal injuries (MSIs) occur frequently in military personnel. U.S. Marine Corps (USMC) recruits participate in an intense 13-week training program designed to...
INTRODUCTION
Musculoskeletal injuries (MSIs) occur frequently in military personnel. U.S. Marine Corps (USMC) recruits participate in an intense 13-week training program designed to transform civilians into basically trained Marines, during which they are susceptible to MSIs. Previous injury epidemiology research with USMC recruits was conducted in a non-gender-integrated training. Data for the current study were derived from a larger study, the USMC Gender-Integrated Recruit Training study, that was initiated to provide data-driven recommendations for gender integration during USMC recruit training. The purpose of the current analysis was to describe the unique profile of MSIs during USMC recruit training and compare MSIs between female and male recruits in gender-integrated training.
MATERIALS AND METHODS
Medical record-reviewed MSI data were obtained for recruits in three models of USMC recruit training: two models of gender-integrated recruit training at Marine Corps Recruit Depot (MCRD) Parris Island-the older Series Track (ST) model and the newer Integrated Company (IC) model, and a Male-Only (MO) cohort at MCRD San Diego. Incidence, anatomic region and subregion, event at the time of MSI, MSI type and onset, and disposition following MSI were described for each model. Group comparisons were conducted using Fisher's exact tests or independent samples t tests, as appropriate.
RESULTS
MSI data were available for 584 recruits (ST: 98 female recruits, 95 male recruits; IC: 85 female recruits, 106 male recruits; MO: 200 male recruits). The cumulative incidence of MSIs was significantly higher among female compared to male recruits in the ST (59.2% vs. 29.5%, P < .001) and in the IC (25.9% vs. 12.3%, P = .023) cohorts. The most frequent anatomic location for MSIs was the lower extremity (female recruits: ST: 76.5% of MSIs, IC: 88.6%; male recruits: ST: 81.1%, IC: 80.0%, MO: 83.8%). The most frequent body part affected was the hip among female recruits (ST: 26.5% of MSIs, IC: 37.1%). The most frequent body part affected by MSIs among the male recruits was the knee in the ST (32.4%) and IC (53.3%) cohorts and the lower leg (27.0%) in the MO cohort. A significantly greater percentage of female compared to male recruits sustained a hip MSI in the ST (23.5% vs. 2.1%, P < .001) and IC (12.9% vs. 0.0%, P < .001) cohorts. There was no significant difference in knee MSI incidence between sexes in the ST (P = .323) or IC (P = .757) cohorts. A large percentage of MSIs resulted in light duty (female recruits: ST: 69.4% of MSIs, IC: 74.3%; male recruits: ST: 64.9%, IC: 73.3%, MO: 94.6%).
CONCLUSIONS
This was the first study to assess the burden of MSIs concurrently among female and male USMC recruits in gender-integrated training. MSIs, especially those affecting the lower extremity, continue to occur frequently in this population. Female recruits are more susceptible to MSIs during USMC recruit training compared to male recruits and are especially prone to hip MSIs. Future research should focus on identifying modifiable risk factors for MSIs in this population, with a focus on reducing lower-extremity MSIs in all recruits and hip MSIs in female recruits.
Topics: Humans; Male; Female; Military Personnel; United States; Incidence; Musculoskeletal System; Adult; Young Adult; Sex Factors; Adolescent
PubMed: 38920037
DOI: 10.1093/milmed/usad206 -
Military Medicine Jun 2024Injury epidemiology research with military populations typically utilizes data obtained through medical chart review (MCR) or injury self-reports (ISRs). MCR data will...
INTRODUCTION
Injury epidemiology research with military populations typically utilizes data obtained through medical chart review (MCR) or injury self-reports (ISRs). MCR data will not capture musculoskeletal injury (MSKI) data for which medical care was not sought, which is common during military recruit training. Injury self-report is affected by issues with recall, especially for MSKIs perceived as less severe. U.S. Marine Corps (USMC) recruits participate in an intense 13-week recruit training program during which they are susceptible to MSKIs. The purpose of the current analysis was to utilize a novel statistical method, the capture-recapture (CRC) technique, to account for the undercounting inherent in MSKI data sources and estimate the ascertainment-corrected cumulative incidence of MSKIs during USMC recruit training.
MATERIALS AND METHODS
Data for the current study were derived from a larger study, the USMC Gender-Integrated Recruit Training Study, which was initiated to provide data-driven recommendations to increase gender integration in USMC recruit training. The estimated cumulative incidence of MSKIs during 13-weeks of USMC recruit training was calculated from the 2 sources of MSKI data (MCR, ISR) and using CRC analysis. Medical charts were reviewed to extract data about MSKIs that occurred during recruit training. Self-reported MSKI data for the same period were obtained from recruits at the end of recruit training. MSKIs were classified according to their anatomical location and type. The Chapman modification of the Lincoln-Peterson estimator was utilized to conduct the CRC analysis.
RESULTS
Medical chart review and ISR MSKI data were available for 464 USMC recruits (age: 19.1 ± 1.9 years; gender: men 70.0%). The observed 13-week cumulative incidence of MSKI in the sample was 21.8% in the MCR and 28.4% in the ISR, while the CRC incidence was much higher (62.0%). The MCR and ISR ascertainment were 35.1% and 45.9%, respectively, while the overall ascertainment or completeness of MSKI data when 2 sources were used was moderate (65.0%). When stratified by MSKI anatomical location, the overall ascertainment varied by anatomical location of the MSKI. It was highest for lower extremity MSKIs (64.8%), but lower for upper extremity (38.9%) and spine (33.3%) MSKIs. The overall ascertainment also varied by MSKI type; it was highest for sprain (55.1%), followed by strain (54.8%), and the pain/spasm/ache (43.3%).
CONCLUSIONS
This was the first study to utilize the CRC technique to access the ascertainment-corrected incidence of MSKIs among USMC recruits. There was significant undercounting in both sources of the data analyzed, and the extent of undercounting varied by both MSKI anatomical location and type. When 2 sources of data were utilized simultaneously, the percent of CRC-estimated MSKIs observed from 2 sources of data was more complete. There is a need for further application of the CRC technique to MSKI data in military populations to provide a more complete assessment of MSKIs. Identification of modifiable factors that influence completeness of MSKI data obtained during military recruit training is also warranted.
Topics: Humans; Military Personnel; Incidence; Male; Female; United States; Musculoskeletal System; Adult; Musculoskeletal Diseases; Young Adult; Self Report
PubMed: 38920034
DOI: 10.1093/milmed/usae129 -
Frontiers in Public Health 2024Viral diarrhea is one of the major causes of morbidity and mortality in children. This study aimed to conduct etiological surveillance of viral diarrhea in Zhangzhou...
BACKGROUND
Viral diarrhea is one of the major causes of morbidity and mortality in children. This study aimed to conduct etiological surveillance of viral diarrhea in Zhangzhou city, Fujian province, China, from 2017 to 2019 to identify the prevalence, distribution, and characteristics of viral pathogens causing gastrointestinal infections in the region.
METHODS
Stool samples were collected from patients with acute diarrhea in Zhangzhou city, Fujian province, China, from 2017 to 2019. Rotavirus, norovirus, astrovirus, and adenovirus were detected using fluorescence immunochromatography assay.
RESULTS
Of the total 5,627 samples that were collected, at least one of the viruses (rotavirus, norovirus, astrovirus and adenovirus) was found to be positive in 1,422 samples. Rotavirus, norovirus, astrovirus, and adenovirus, were detected in 53.73, 16.68, 15.52, and 14.97%, respectively. Mixed infections were determined in 17.65% of the positive samples. The predominant mixed infections observed were a combination of norovirus and astrovirus, followed by rotavirus and norovirus, and rotavirus and astrovirus. The highest positive rate was observed in the 12-23-month group for rotavirus and adenovirus, while a significantly higher positive rate was observed for norovirus and astrovirus in the 6-11-month group.
CONCLUSION
These findings from this etiological surveillance highlight the significant burden of viral diarrhea in Zhangzhou city, with rotavirus being the predominant pathogen. The identification of common mixed infections provides insights into the complex nature of viral diarrhea transmission. Target interventions and public health strategies should be implemented, particularly during the winter and spring seasons, to prevent and control the spread of viral pathogens causing gastrointestinal infections in this region.
Topics: Humans; China; Diarrhea; Child, Preschool; Infant; Male; Female; Feces; Child; Norovirus; Rotavirus; Prevalence; Virus Diseases; Adenoviridae; Adolescent; Infant, Newborn; Seasons; Coinfection; Adult
PubMed: 38919928
DOI: 10.3389/fpubh.2024.1403341 -
Frontiers in Public Health 2024Intestinal parasitic infections pose significant global health challenges, particularly in developing countries. Asymptomatic infections often present a considerable...
BACKGROUND
Intestinal parasitic infections pose significant global health challenges, particularly in developing countries. Asymptomatic infections often present a considerable burden with food handlers serving as potential carriers. In Ethiopia, the prevalence of these parasites varies across regions, and accurate data in the study area is lacking. Therefore, this study aimed to investigate the prevalence of intestinal parasites among food handlers working in hotels and restaurants in Gondar City, Northwest Ethiopia.
METHODS
A cross-sectional study collected stool samples from food handlers alongside a structured questionnaire gathering socio-demographic and hygiene practice information. Stool specimens were screened for intestinal parasites using direct wet mount and formol-ether concentration techniques. The collected data were checked for completeness, entered into EpiData software version 3.1, and exported to SPSS version 20 for analysis. A multivariable logistic regression analysis was deemed statistically significant if the -value was less than 0.05.
RESULTS
A total of 257 food handlers working in hotels and restaurants in Gondar City participated in the study. Of these, 33.5% (86/257) were found positive for one or more intestinal parasites, with a 95% confidence interval (CI) of 28.0-39.5%. The study identified nine types of intestinal parasites, with (8.2%, 21/257) and Ascaris lumbricoides (6.6%, 17/257) being the predominant parasites, followed by hookworm (3.5%, 9/257) and (2.3%, 6/257). The prevalence of mixed infections was 9.3% (24/257). A significant association was observed between intestinal parasitic infection and the educational level of food handlers.
CONCLUSION
In this study, a high prevalence of intestinal parasites was detected indicating poor hygiene practices of the food handlers at the study site. Even the prevalence of mixed infections was high. Regular training, strict adherence to personal hygiene and food-handling practices, and routine inspections and medical checkups for food handlers are crucial.
Topics: Humans; Ethiopia; Intestinal Diseases, Parasitic; Cross-Sectional Studies; Male; Female; Adult; Food Handling; Prevalence; Middle Aged; Feces; Surveys and Questionnaires; Risk Factors; Young Adult; Adolescent; Restaurants; Animals
PubMed: 38919920
DOI: 10.3389/fpubh.2024.1362086 -
Frontiers in Public Health 2024We investigated the temporal trends and examined age-, period-, and cohort-specific effects of injury-related deaths among residents in Jiangsu to provide evidence for...
OBJECTIVE
We investigated the temporal trends and examined age-, period-, and cohort-specific effects of injury-related deaths among residents in Jiangsu to provide evidence for future injury prevention.
METHODS
This study included 406,936 injury deaths from the Jiangsu provincial population death registration system. The average annual percent change (AAPC) in age-standardized mortality rates (ASMRs) was analyzed using joinpoint regression. Age-period-cohort models were generated to explore the effects of age, period, and birth cohort effects on mortality risk.
RESULTS
ASMRs for all injuries (AAPC = -2.3%), road traffic accidents (AAPC = -5.3%), suicide (AAPC = -3.8%), and drowning (AAPC = -3.9%) showed a downward trend during 2012-2021(all < 0.05), while unintentional falls showed an upward trend (AAPC = 5.1%, < 0.05). From 2012 to 2021, the age-standardized mortality rates (ASMRs) for four primary types of injuries consistently exhibited higher among males compared to females, with rural regions displaying higher ASMRs than urban areas. Trends in ASMRs for road traffic accidents, drowning, and unintentional falls by sex and urban/rural areas were consistent with overall trends. Significant age, cohort, and period effects were identified in the trends of injury-related deaths for both sexes in Jiangsu. The age effect showed that the highest age effect for injury-related deaths was for the ages of 85 years and above, except for suicide, which was for the ages 80-84 years. Between 2012 and 2021, the period effect on road traffic accidents declined, while that on accidental falls increased. Initially, the period effect on suicide decreased but then rose, peaking in 2012 with a Relative Risk (RR) of 1.11 (95% : 1.04-1.19). Similarly, the period effect on drowning initially declined before rising, with the highest effect observed in 2013, at an RR of 1.12 (95% : 1.07-1.19). The highest cohort effects for road traffic accidents were observed in the 1957-1961 group, for accidental falls in the 1952-1956 group, and for both drowning and suicide in the 1927-1931 group.
CONCLUSION
The mortality rate of unintentional falls has been increasing. Older adults are at high risk for the four leading injuries. The improvements in mortality rates can be attributed to advancements in education, urbanization, and the promulgation and implementation of laws and policies.
Topics: Humans; Male; Female; China; Middle Aged; Adult; Aged; Adolescent; Child; Child, Preschool; Accidents, Traffic; Young Adult; Wounds and Injuries; Infant; Cohort Studies; Aged, 80 and over; Suicide; Drowning; Accidental Falls; Infant, Newborn; Mortality; Rural Population; Age Factors; Cause of Death
PubMed: 38919918
DOI: 10.3389/fpubh.2024.1373238 -
Hospital Pharmacy Aug 2024Pharmaceutical care is an essential component of mental healthcare.
BACKGROUND
Pharmaceutical care is an essential component of mental healthcare.
OBJECTIVES
The study assessed pharmacists' collaborations, barriers, perceptions on therapeutic relationships and attitudes toward pharmaceutical care to persons with mental illness.
METHODS
A questionnaire-based descriptive cross-sectional survey was conducted among 175 pharmacists in a Nigerian state via purposive sampling. Average mean score of >3 (±SD) was considered positive attitude toward pharmaceutical care, and positive for respondents' perception of pharmacists-patient relationship during consultations. Data were analyzed using SPSS version 25.0 for descriptive statistics.
RESULTS
A total of 140 (80.0%) respondents participated in the study. Access to patients' medical records 90 (64.3%) was the major barrier to the provision of pharmaceutical care to persons with mental illness. Almost half of the study participants 69 (49.3%) desired collaboration with only general practitioners and psychiatrists. Only 44 (31.4%) had full co-operation from their desired collaborators. Average score for respondents' attitude toward provision of pharmaceutical care to the patients, and perception of pharmacist-patient relationship were 4.5 (±0.7) and 3.8 (±0.9) respectively.
CONCLUSIONS
Study participants' attitude toward pharmaceutical care, and perception on therapeutic relationship in persons with mental disorder were positive. Lack of access to patients' records mostly hindered provision of pharmaceutical care, and full collaboration with other mental health experts was mostly lacking. Appropriate policies are required to improve these vital components of mental healthcare for desired outcomes.
PubMed: 38919761
DOI: 10.1177/00185787241229177 -
Frontiers in Immunology 2024The incidence of severe infections (SIs) in patients with autoimmune nephropathy after rituximab (RTX) treatment varies significantly. Our study aims to identify... (Comparative Study)
Comparative Study
BACKGROUND
The incidence of severe infections (SIs) in patients with autoimmune nephropathy after rituximab (RTX) treatment varies significantly. Our study aims to identify high-risk populations, specifically by comparing the differences in the risk of SIs between patients with primary nephropathy and those with nephropathy in the context of systemic autoimmune diseases (referred to as secondary nephropathy).
METHODS
This retrospective cohort study investigated the occurrence of SIs in adult patients with immune-related kidney disease who received RTX treatment at our institution from 2017 to 2022. Multivariable COX regression models were used to analyze the association between the type of nephropathy (primary or secondary) and SIs. Propensity score analyses, subgroup analyses, and E-value calculations were performed to ensure the reliability of the results.
RESULTS
Out of 123 patients, 32 (26%) developed 39 cases of SIs during a mean follow-up period of 19.7 ± 14.6 months post-RTX treatment, resulting in an incidence rate of 18.9/100 patient-years. The multivariable COX regression analysis indicated that patients with secondary nephropathy had a significantly higher risk of SIs compared to those with primary nephropathy (HR = 5.86, 95% CI: 1.05-32.63, P = 0.044), even after accounting for confounding variables including gender, age, BMI, history of prior SIs, baseline eGFR, lymphocyte counts, IgG levels, and the utilization of other immunosuppressive therapies. Various sensitivity analyses consistently supported these findings, with an E-value of 5.99. Furthermore, advanced age (HR: 1.03; 95% CI: 1.01-1.06; P = 0.023), low baseline IgG levels (HR: 0.75; 95% CI: 0.64-0.89; P < 0.001), and recent history of SIs (HR: 5.68; 95% CI: 2.2-14.66; P < 0.001) were identified as independent risk factors.
CONCLUSION
The incidence of SIs following RTX administration in patients with autoimmune nephropathy is significant. It is crucial to note that there are distinct differences between the subgroups of primary and secondary nephropathy. Patients with secondary nephropathy, particularly those who are elderly, have low baseline IgG levels, and have a recent history of SI, are more susceptible to SIs.
Topics: Humans; Rituximab; Male; Female; Retrospective Studies; Middle Aged; Aged; Adult; Incidence; Infections; Autoimmune Diseases; Risk Factors; Immunologic Factors; Kidney Diseases
PubMed: 38919606
DOI: 10.3389/fimmu.2024.1390997 -
Frontiers in Endocrinology 2024This study aimed to investigate the prevalence and co-prevalence of comorbidities among Chinese individuals with type 2 diabetes (T2DM). (Observational Study)
Observational Study
Prevalence and co-prevalence of comorbidities among Chinese adult patients with type 2 diabetes mellitus: a cross-sectional, multicenter, retrospective, observational study based on 3B study database.
PURPOSE
This study aimed to investigate the prevalence and co-prevalence of comorbidities among Chinese individuals with type 2 diabetes (T2DM).
METHODS
Medical records were retrospectively retrieved from the 3B Study database, which provided a comprehensive assessment of comorbid conditions in Chinese adult outpatients with T2DM. Patient characteristics, laboratory measures, and comorbidities were summarized via descriptive analyses, overall and by subgroups of age (<65, 65-74, 75 years) and gender.
RESULTS
Among 25,454 eligible patients, 53% were female, and the median age was 63 years. The median time of diabetes duration was 6.18 years. A total of 20,309 (79.8%) patients had at least one comorbid condition alongside T2DM. The prevalence of patients with one, two, three, and four or more comorbid conditions was 28.0%, 24.6%, 15.6%, and 11.6%, respectively. Comorbidity burden increased with longer T2DM duration. Older age groups also exhibited higher comorbidity burden. Females with T2DM had a higher overall percentage of comorbidities compared to males (42.7% vs. 37.1%). The most common comorbid conditions in T2DM patients were hypertension (HTN) in 59.9%, overweight/obesity in 58.3%, hyperlipidemia in 42.0%, retinopathy in 16.5%, neuropathy in 15.2%, cardiovascular disease (CVD) in 14.9%, and renal disease in 14.4%. The highest co-prevalence was observed for overweight/obesity and HTN (37.6%), followed by HTN and hyperlipidemia (29.8%), overweight/obesity and hyperlipidemia (27.3%), HTN and CVD (12.6%), HTN and retinopathy (12.1%), and HTN and renal disease (11.3%).
CONCLUSION
The majority of T2DM patients exhibit multiple comorbidities. Considering the presence of multimorbidity is crucial in clinical decision-making.
SYSTEMATIC REVIEW REGISTRATION
https://clinicaltrials.gov/, identifier NCT01128205.
Topics: Humans; Diabetes Mellitus, Type 2; Male; Female; Retrospective Studies; Middle Aged; Aged; Prevalence; Comorbidity; Cross-Sectional Studies; China; Adult; Databases, Factual; Hypertension; East Asian People
PubMed: 38919489
DOI: 10.3389/fendo.2024.1362433 -
Frontiers in Endocrinology 2024The Oxidative Balance Score (OBS), which quantifies the balance between antioxidants and pro-oxidants influenced by diet and lifestyle, is crucial given oxidative...
BACKGROUND
The Oxidative Balance Score (OBS), which quantifies the balance between antioxidants and pro-oxidants influenced by diet and lifestyle, is crucial given oxidative stress's significant role in Chronic Kidney Disease (CKD). This study aims to determine the association between OBS and CKD using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018.
METHODS
We analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018. OBS was constructed from a detailed array of 20 factors, including dietary nutrients and lifestyle behaviors. The relationship between OBS and CKD risk was evaluated using weighted logistic regression models, adjusted for potential confounders, with a generalized additive model (GAM) examining non-linear associations. Subgroup analyses and interaction effects across diverse demographic and clinical groups, along with sensitivity analyses, were performed to validate the findings.
RESULTS
Among 32,120 participants analyzed, 4,786 were identified with CKD. Fully adjusted weighted logistic regression analysis revealed that each unit increase in OBS was associated with a 2% reduction in CKD prevalence [OR: 0.98 (0.98-0.99), P < 0.001]. Higher OBS quartiles were significantly correlated with a decreased CKD risk [Q4 . Q1: OR: 0.82 (0.68-0.98), P = 0.03; P for trend = 0.01]. The GAM and smoothed curve fit indicated a linear relationship between OBS and the risk of CKD. Stratified and sensitivity analyses further substantiated the inverse relationship between OBS and CKD prevalence.
CONCLUSIONS
Our findings from the NHANES data affirm a significant inverse association between OBS and CKD risk in the U.S. population, underscoring the role of optimizing dietary and lifestyle factors in managing CKD risk. These results advocate for incorporating OBS considerations into CKD prevention and treatment strategies.
Topics: Humans; Renal Insufficiency, Chronic; Nutrition Surveys; Female; Male; Middle Aged; Oxidative Stress; Adult; Aged; Life Style; Diet; Cross-Sectional Studies; Prevalence; Risk Factors; Antioxidants; United States
PubMed: 38919480
DOI: 10.3389/fendo.2024.1396465