Temporal and spatial analysis of over 7,000 measles cases outbreak from 2018 to 2019 in the Brazilian Amazon

ABSTRACT Objective: This study aimed to present a temporal and spatial analysis of the 2018 measles outbreak in Brazil, particularly in the metropolitan city of Manaus in the Amazon region, and further introduce a new tool for spatial analysis. Methods: We analyzed the geographical data of the residences of over 7,000 individuals with measles in Manaus during 2018 and 2019. Spatial and temporal analyses were conducted to characterize various aspects of the outbreak, including the onset and prevalence of symptoms, demographics, and vaccination status. A visualization tool was also constructed to display the geographical and temporal distribution of the reported measles cases. Results: Approximately 95% of the included participants had not received vaccination within the past decade. Heterogeneity was observed across all facets of the outbreak, including variations in the incubation period and symptom presentation. Age distribution exhibited two peaks, occurring at one year and 18 years of age, and the potential implications of this distribution on predictive analysis were discussed. Additionally, spatial analysis revealed that areas with the highest case densities tended to have the lowest standard of living. Conclusion: Understanding the spatial and temporal spread of measles outbreaks provides insights for decision-making regarding measures to mitigate future epidemics.

Distribution pattern and related factors of single osteoporotic vertebral compression fractures / 中华骨科杂志

Objective:To identify the anatomical distribution of and factors related to single-segment osteoporotic vertebral compression fractures (OVCF).Methods:The radiology and clinical data of 944 patients with single-segment OVCF hospitalized in Zhongda Hospital Southeast University between June 2016 and October 2020 were retrospectively analyzed, including 175 males and 769 females, aged 72.1±9.6 years (range, 45-97 years). The anatomical distribution of OVCF was quantified. The demographics, comorbidity profile, spine trauma, back pain duration, vertebral compression degree, and bone mineral density of the OVCF patients in different anatomical segments were summarized and compared.Results:Of the 944 single-segment OVCF, 864 were located in the lower thoracic and lumbar spine that peaked at L 1 (Modal-1 group), and 80 were located in the middle and upper thoracic spine (Modal-2 group) that peaked at T 7, demonstrating an asymmetric bimodal distribution. The difference in the female/male ratio between the two groups was insignificant (χ 2=0.06, P=0.803). Patients in Modal-2 were aged 75.0±9.8 years and on average older than the patients (aged 71.8±9.6 years) in Modal-1 ( t=2.78, P=0.005). The female patients in Modal-2 (aged 75.0±9.6 years) were significantly older than that (aged 71.2±9.3 years) in Modal-1 ( t=3.17, P=0.002). The ratio of back pain duration for <1 week in Modal-2 (43.8%) was lower than that in Modal-1 (60.2%), and the ratio of back pain for 1-weeks (28.8%) was significantly higher than that (15.5%) in Modal-1 (χ 2=11.50, P=0.009). The most frequently reported spine traumas in Modal-2 (50.0%) were heavy lifting injury, lumbar sprain, and strenuous cough, which were significantly different from and less apparent than the fall on ground or crush injury to the spine (64.1%) in Modal-1 (χ 2=60.71, P<0.001). The anterior to posterior height ratio of the fractured vertebrae in Modal-2 was 0.78±0.13, 0.83±0.14, 0.84±0.13, and 0.78±0.18 in the OVCF patients complaining of back pain for <1 week, 1-weeks, 2-weeks, and >4 weeks respectively, showing no significant difference between groups ( F=1.01, P=0.009). In Modal-1, the anterior to posterior height ratio of the fractured vertebrae was lower in the OVCF patients complaining of back pain for 2-weeks (0.80±0.15) and >4 weeks (0.77±0.19) than in those with back pain for <1 week (0.85±0.11) and 1-weeks (0.86±0.14), with sinificant differences ( P<0.05). 32.4% (306/944) of the OVCF patients had one of the following geriatric comorbidities: hypertension, diabetes mellitus, coronary heart disease, cerebral infarction, and chronic obstructive pulmonary disease. The OVCF patients in Model-2 had higher comorbidity of coronary heart disease (21.3%) and cerebral infarction (36.3%) than those in Model-1 (11.6% and 20.3%). Bone mineral density information was available from 371 patients (308 females). In the age groups of <70, 70-, and >80 years, no significant difference was detected in the T-score values of the lumbar spine or hip joint between the OVCF patients in Model-1 and Model-2 ( F=0.13, P=0.880; F=0.62, P=0.538). Conclusion:Single-segment OVCF feature an asymmetric bimodal distribution that is demarcated by the T 10 vertebrae. The distribution pattern is not determined by gender or baseline bone mineral density but highlights the risk of mechanical stress and vertebral fragility within a specific segment. OVCF in the middle and upper thoracic spine is less frequent but common in older patients with higher comorbidity of coronary heart disease and cerebral infarction, which tend to be caused by less apparent spine trauma and maintain vertebral compression but complain of long back pain duration.

Etiology and Age Distribution of Syncope in Delta Area Patients

Background: Syncope is a Total Loss of Consciousness (TLOC) due to cerebral hypo-perfusion, characterized by a rapid onset, short duration, and spontaneous complete recovery. It shares many clinical features with other disorders; it therefore presents in many differential diagnoses. This group of disorders is labelled TLOC. The aim of the present study was to determine the etiologies and the age distribution of patients with syncope in Delta area. Methods: This study included thirty patients who had at least one episode of syncope. All patients in this study were subjected to history taking, clinical examination, laboratory investigations, standard 12-lead Electrocardiogram (ECG), Resting Transthoracic Echocardiography (TTE). Some patients were subjected to Prolonged ECG monitoring (Holter, Event, ILR), Brain computed tomography (CT) and Magnetic resonance imaging (MRI), Tilt table test and Electrophysiology study (EP study). Results: Most common ECG rhythm was normal sinus rhythm, complete heart block, left ventricular hypertrophy, Slow Atrial fibrillation (AF), Left bundle branch block (LBBB), ventricular tachycardia. The most common diagnosis of syncope was vasovagal syncope, idiopathic syncope then cardiac syncope. Incidence of idiopathic syncope in populations under 40 years was significantly higher than in populations over 40 years, meanwhile regarding cardiac-related etiology for syncope in patients under age 40 was significantly lower than those patients over age 40. Conclusion: For age distribution, the incidence of idiopathic syncope in populations under 40 years was significantly higher than in populations over 40 years, meanwhile cardiac-related etiology for syncope in patients under age 40 was significantly lower than those patients over age 40.

Short-term efficacy of sublingual immunotherapy in patients with allergic rhinitis of all ages / 中国基层医药

Objective:To investigate the short-term efficacy of sublingual immunotherapy in patients with allergic rhinitis of all ages.Methods:The data of 230 patients with allergic rhinitis of all ages who received sublingual immunotherapy in The Third People's Hospital of Bengbu from November 2020 to September 2021 were included in this study. Patient distribution characteristics were analyzed. Ninety-three patients were randomly selected and divided into child, adolescent, and adult groups according to different ages. Total nasal symptom scores measured before and 4 months after sublingual immunotherapy were compared among patients of different ages to evaluate the short-term efficacy of sublingual immunotherapy. The skin prick test was used to determine the allergic state of patients. Change in total nasal symptom score after treatment relative to that before treatment was used to evaluate the efficacy of sublingual immunotherapy.Results:The age range of patients receiving sublingual immunotherapy was large (3-71 years), but the average age was only 17.70 years. Ninety-three patients were followed up, including 50 children and 43 adolescents or adults. After 4 months of sublingual immunotherapy, total nasal symptom score in children and adolescents or adults were significantly decreased compared with those before treatment [(3.66 ± 1.69) points vs. (6.60 ± 1.96) points, (3.49 ± 1.72) points vs. (6.28 ± 2.28) points, both P < 0.001]. Before and after treatment, there was no significant difference in total nasal symptom score between children and adolescents or adults (both P > 0.05). Conclusion:Patients with allergic rhinitis who receive sublingual immunotherapy tend to be young. Short-term sublingual immunotherapy is effective for allergic rhinitis. There is no remarkable difference in the efficacy of sublingual immunotherapy between patients with allergic rhinitis of all ages.

Infección por el VIH/sida en personas de 50 años y más en la provincia de Guantánamo

RESUMEN Introducción: La epidemiologia de la infección por el virus de inmunodeficiencia humana/síndrome de inmunodeficiencia adquirida ha cambiado en los últimos años, actualmente existe en el mundo un aumento de los diagnósticos en personas de 50 años y más. Objetivo: Caracterizar pacientes con 50 años y más infectados por el virus de la inmunodeficiencia humana/síndrome de inmunodeficiencia adquirida. Métodos: Estudio descriptivo. El universo de estudio constituido por los 88 pacientes de 50 años y más en la provincia Guantánamo con diagnóstico de infección por el virus de la inmunodeficiencia humana/síndrome de inmunodeficiencia adquirida en el periodo de enero 2010 a diciembre 2019. Se determinaron las siguientes variables: edad, sexo, orientación sexual, grupo de pesquisa, diagnósticos por año y número de defunciones por sexo (de acuerdo a las enfermedades definitorias de sida u otras causas). Resultados: En el periodo estudiado del total de pacientes diagnosticados los hombres representaron 79,5 %. El grupo de edad más afectado fue el de 50 a 59 años (68,1 %). La orientación sexual predominante fue la homosexual (40,9 %). El grupo de pesquisa más frecuente fue el de los captados (38,6 %). 2019 fue el año con mayor incidencia. Fallecieron 15,9 % del total de pacientes diagnosticados. Conclusiones: Se precisa abordar la problemática con enfoque clínico epidemiológico diferente, mediante estrategias educativas que permitan realizar el diagnóstico precoz.

ABSTRACT Introduction: The epidemiology of human immunodeficiency virus infection or acquired immunodeficiency syndrome has changed in recent years. Currently, there is an increase in diagnoses in people aged 50 years and over worldwide. Objective: To describe patients aged 50 years and older infected with the human immunodeficiency virus/ acquired immunodeficiency syndrome. Methods: This is a descriptive study. The study universe is eighty eight patients aged 50 years and older in the Guantanamo province, who were diagnosed with infection by the human immunodeficiency virus/ acquired immunodeficiency syndrome from January 2010 to December 2019. The variables determined were age, sex, sexual orientation, research group, diagnoses per year and number of deaths by sex, according to AIDS-defining illnesses or other causes. Results: In the period studied, out of the total number of diagnosed patients, men represented 79.5%. The most affected age group was 50 to 59 years old (68.1%). Homosexually was the predominant sexual orientation (40.9%). The most frequent research group was that of those recruited (38.6%). 2019 was the year with the highest incidence. 15.9% of all diagnosed patients died. Conclusions: It is necessary to address the problem with different clinical epidemiological approach, through educational strategies to allow early diagnosis.

Observation on the composition and distribution of human papillomavirus infection and its aging changes in female genital tract of Zhuang and Han nationality in Guangxi / 中华老年医学杂志

Objective:To study the composition and distribution of human papillomavirus(HPV)in female genital tract of Zhuang and Han nationality in Guangxi.Methods:The composition and distribution of cervical human papillomavirus(HPV)infection in Han and Zhuang women visiting Department of Gynecology and Obstetrics of the First Affiliated Hospital of Guangxi Medical University from August 2012 to October 2020 were retrospectively analyzed to provide the basic data for prevention and treatment of HPV infection.A total of 20 736 cases were divided into Han nationality group(n=16 390 cases)and Zhuang nationality group(n=4 346 cases). Polymerase chain reaction(PCR)was used to detect HPV type 21 and analyze the epidemiological characteristics of cervical HPV in women of different ethnic groups in this area.Results:In the 20, 736 cases, the proportion of positive HPV was 27.0%(5 591/20, 736). Among them, positive HPV accounted for 27.7%(4 536)in the Han group, and 24.3%(1 055)in Zhuang group, which were statistically significant( χ2=20.17, P<0.01). Peak age of infection in Zhuang women was more than 65 years.The most common HPV genotypes in both ethnics groups in Guangxi were HPV 16, 52, 58, 18, and 53.In women with positive HPV, the constituent ratio of HPV16 and HPV 52 rose with age ageing, while constituent ratio of HPV 6 and 11 presented the opposite trend. Conclusions:The HPV and HR(high-risk)-HPV positive composition ratio is lower in Zhuang women than in Han women in Guangxi.Among Han and Zhuang females, HPV 16, 52, 58, 18 and 53 have the highest positive composition ratio.HPV genotyping shows an age-increasing change.

Age related changes in cervical range of motion and its relationship with cervical spondylosis in school students aged 12-18 in Nanyang City / 中国学校卫生

Objective@#To investigate the age related changes in cervical range of motion (CROM) and its relationship with cervical spondylosis in school students aged 12-18 in Nanyang City, to provide reference for prevention, early diagnosis and treatment evaluation of cervical spondylosis.@*Methods@#Stratified sampling was adopted in 13 counties and districts of Nanyang City and 890 students aged 12-18 were assessed for CROM using the Coda Motion Analyzer. SPSS 19.0 was used to data analyze.@*Results@#A decreasing trend was observed in CROM among boys and girls aged 12-18 years in Nanyang. For boys aged 15 and 18 years old, higher anterior flexion ( t =2.02, 2.70), posterior extension ( t =2.01, 2.81), left flexion ( t =3.51, 2.99), right flexion ( t =5.07, 2.66), sinistral ( t =2.28, 2.92) and dextral ( t =2.91,3.60) were found compared with younger age groups ( P <0.05). Similar findings were found in girls aged 15 and 18-years old [anterior flexion ( t =2.38, 2.20), posterior extension ( t =2.09,2.02), left flexion ( t =2.33, 2.55), right flexion ( t =7.34, 4.60), sinistral ( t =3.73, 2.35) and dextral ( t =2.31, 3.99, P <0.05). Except for the right flexion, the CROM of boys in was higher than that of girls at the same age group. The prevalence of cervical spondylosis showed an increasing trend (boys: χ 2 trend =13.93, girls: χ 2 trend =12.87, P <0.05). Except for 14-year-old group, the prevalence of cervical spondylosis in girls was higher than that in boys, with significant differences observed in 15 and 17-year-old groups ( χ 2=10.35, 9.64, P <0.05).@*Conclusion@#With the increase of age, the CROM of male and female students shows a downward trend in general. The prevalence of cervical spondylosis increases with the decrease of CROM. CROM measurement is conducive to the prevention, early diagnosis and treatment of juvenile cervical spondylosis.

On the increasing incidence of SARSCoV-2 in older adolescents and younger adults during the epidemic in Mexico / Sobre la incidencia creciente de SARS-CoV-2 en adolescentes mayores y adultos jóvenes durante la epidemia en México

Abstract Objective: To estimate temporary changes in the incidence of SARS-CoV-2-confirmed hospitalizations (by date of symptom onset) by age group during and after the national lockdown. Materials and methods: For each age group g, we computed the proportion E(g) of individuals in that age group among all cases aged 10-59y during the early lockdown period (April 20-May 3, 2020), and the corresponding proportion L(g) during the late lockdown (May 18-31, 2020) and post-lockdown (June 15-28, 2020) periods and computed the prevalence ratio: PR(g)=L(g)/E(g). Results: For the late lockdown and post-lockdown periods, the highest PR values were found in age groups 15-19y (late: PR=1.69, 95%CI 1.05,2.72; post-lockdown: PR=2.05, 1.30,3.24) and 20-24y (late: PR=1.43, 1.10,1.86; post-lockdown: PR=1.49, 1.15,1.93). These estimates were higher in individuals 15-24y compared to those ≥30y. Conclusions: Adolescents and younger adults had an increased relative incidence of SARS-CoV-2 during late lockdown and post-lockdown periods. The role of these age groups should be considered when implementing future pandemic response efforts.

Resumen Objetivo: Estimar los cambios temporales en la incidencia de hospitalizaciones confirmadas por SARS-CoV-2 (por fecha de inicio de los síntomas) por grupo de edad durante y después del cierre nacional. Material y métodos: Para cada grupo de edad g, calculamos la proporción E(g) de individuos en ese grupo de edad entre todos los casos de 10 a 59 años durante el periodo de cierre temprano (del 20 de abril al 3 de mayo de 2020) y la proporción correspondiente L(g) durante los periodos de cierre tardío (18-31 de mayo de 2020) y posterior al cierre (15-28 de junio de 2020), y se calculó la razón de prevalencia: RP(g)=L(g)/E(g). Resultados: Para los periodos de cierre tardío y posterior al cierre, los valores de RP más altos se dieron en los grupos de edad de 15 a 19 años (tardío: RP=1.69, IC95% 1.05,2.72; después del cierre: RP=2.05, 1.30,3.24) y 20-24 años (tardío: RP=1.43, 1.10,1.86; después del cierre: RP=1.49, 1.15,1.93). Estas estimaciones fueron más altas en personas de 15 a 24 años en comparación con las de ≥ 30 años Conclusiones: Los adolescentes y los adultos jóvenes tuvieron una mayor incidencia relativa de SARS-CoV-2 durante los periodos de cierre tardío y posteriores al cierre. El papel de estos grupos de edad en la transmisión de la enfermedad debe tenerse en cuenta al implementar futuros esfuerzos de respuesta a una pandemia.

Asma en Chile: tendencia de la mortalidad 1992-2017 / Asthma in Chile: mortality trend 1992-2017

OBJETIVOS: El asma, un problema de salud pública, tiene tasas de mortalidad global variables. En Chile, no existen estudios que informen respecto a la situación nacional. Analizamos la tendencia de mortalidad en adultos chilenos durante un período de 26 años. MÉTODOS: Utilizando datos del Departamento de Estadísticas e Información de Salud y el Instituto Nacional de Estadísticas se calcularon las tasas de mortalidad por asma 1992-2017 en personas ≥ 15 años de edad. Para evitar el impacto de los cambios por edad, las tasas de mortalidad ajustadas se calcularon mediante un método de ajuste directo utilizando la población de 2017 como referencia. Se usó Joinpoint para calcular la pendiente de las tasas ajustadas y para análisis de datos se utilizó Excel STATA versión13. RESULTADOS: Durante el período de 26 años, hubo 5.749 muertes relacionadas con el asma, con un promedio de 221 eventos / año. Las tasas de mortalidad ajustadas por edad disminuyeron significativamente de 3,26 en 1992 a 1,4 por 100.000 habitantes en 2017, con un promedio de disminución anual de -3,3%. La mayor proporción de defunciones se produjo en personas de 65 años o más, representando 79% de los casos en 1992 y 88% de los casos en 2017. CONCLUSIONES: las tendencias de las tasas de mortalidad por asma en Chile, ajustadas por edad, muestran una disminución significativa en los 26 años que abarca este estudio, disminución que es menos acentuada en los últimos 15 años.

OBJETIVES: Asthma, a public health problem, has variable global mortality rates. In Chile, there are no studies to report on the national situation. This study analyzes the mortality trend in Chilean adults over a period of 26 years. METHODS: Using data from the Department of Health Statistics and Information and the National Institute of Statistics, asthma mortality rates 1992-2017 were calculated in people ≥ 15 years-old. To avoid the impact of age changes, adjusted mortality rates were calculated using a direct adjustment method using the 2017 population as a reference. Joinpoint was used to calculate the slope of adjusted rates, and Excel STATA version13 was used for data analysis. RESULTS: Over the 26-year period, there were 5,749 asthma-related deaths, with an average of 221 events per year. Age-adjusted mortality rates decreased significantly from 3.26 in 1992 to 1.4 per 100,000 inhabitants in 2017, with an average annual decline of -3.3%. The highest proportion of deaths occurred in people 65 years of age or older, accounting for 79% of cases in 1992 and 88% of cases in 2017. CONCLUSIONS: In Chile trends in asthma mortality rates age-adjusted show a significant decrease in the 26 years covered by this study, a decrease that is less pronounced in the last 15 years.

Impact of age in health-related quality of life in older adults with cancer / Impacto da idade na qualidade de vida relacionada à saúde em idosos com câncer

OBJECTIVE: To evaluate the impact of age in health-related quality of life (HRQoL) in older adults with cancer. METHODS: This was a cross-sectional study of 608 older adults diagnosed with cancer. Age groups were considered an independent variable. For the analysis of HRQoL, the mean scores of age groups were compared by analysis of variance and the Scheffé comparison test. For measuring the association between age and HRQoL, we used simple and multiple linear regression analyses. RESULTS: Cognitive function showed the highest scores (average 87.94 ± 26.87), while physical function showed the lowest ones (68.04 ± 28.63). The highest symptom score was observed for financial difficulties (34.21 ± 39.06), followed by pain (29.47 ± 33.92) and insomnia (28.51 ± 37.03). After adjustment, we observed a decrease in physical function (p = 0.028) and an improvement in emotional function (p = 0.003) with increasing age. CONCLUSIONS: In older patients with cancer, age negatively impacted physical function and positively impacted emotional function.

OBJETIVO: Avaliar o impacto da idade na qualidade de vida relacionada à saúde (QVRS) em idosos com câncer. MÉTODOS: Estudo transversal envolvendo 608 idosos diagnosticados com câncer. Os grupos etários foram considerados uma variável independente. Para a análise da QVRS, os escores médios dos grupos etários foram comparados utilizando a análise de variância e o teste de Scheffé. Para medir a associação entre idade e QVRS, foram utilizadas análises de regressão linear simples e múltipla. RESULTADOS: A função cognitiva apresentou os maiores escores (média 87,94 ± 26,87), enquanto a função física apresentou os menores (68,04 ± 28,63). O maior escore de sintomas foi observado em dificuldades financeiras (34,21 ± 39,06), seguido por dor (29,47 ± 33,92) e insônia (28,51 ± 37,03). Após o ajuste, observamos diminuição da função física (p = 0,028) e melhora da função emocional (p = 0,003) com o aumento da idade. CONCLUSÕES: Em pacientes idosos com câncer, a idade impactou negativamente a função física e positivamente a função emocional.

O efeito da idade relativa nas delegações olímpicas brasileiras / The relative age effect on the olympic brazilian delegations

Estudos prévios sugerem que jovens atletas nascidos nos primeiros meses do ano podem ser beneficiados no processo de seleção e formação quando comparados a atletas de mesma idade nascidos nos últimos meses do ano. Esse fenômeno é descrito na literatura como o efeito da idade relativa (EIR). O objetivo do presente estudo foi analisar o EIR nas delegações brasileiras participantes dos Jogos Olímpicos de Atenas 2004, Pequim 2008 e Londres 2012. Para esta investigação, a amostra foi composta por 543 atletas olímpicos (masculino e feminino). O teste Qui-Quadrado (x 2 ) foi adotado para a comparação entre a distribuição esperada e a distribuição observada. O nível de significância adotado foi de p<0,05. Os resultados do presente estudo não indicam diferença significante para distribuição de nascimentos entre os quartis do ano para a amostra investigada (p>0,05). Considerando que a análise principal foi realizada com agrupamentos das modalidades, é possível especular que esse resultado pode ser atribuído a diversos fatores, como: i) menor demanda por uma vaga nas categorias de base em determinadas modalidades esportivas, ii) divisões por categorias competitivas que além da idade também levam em consideração outras variáveis, iii) adoção de diferentes abordagens de formação de jovens atletas.(AU)

Previous studies suggest that young athletes born in the first months of the year may have an advantage during selection and development process compared to athletes of the same age born in the last months of the year. This phenomenon is described in the literature as the relative age effect (RAE). The aim of this study was to analyze the occurrence of RAE in participants of Brazilian delegations of the Olympic Games Athens 2004, Beijing 2008 and London 2012. For this study, the sample consisted of 543 Olympic athletes (male and female). The chi-square (x 2 ) was adopted to compare the expected distribution and the observed distribution. The significance level was set at p <0.05. The results of this study do not indicate significant difference in the birth distribution among quarters of the year for the population investigated (p> 0.05). Considering that the main analysis was conducted by pooled data, it is reasonable to speculate this outcome might be due to multiple factors such: i) lower demand for a place in the early categories in some sports, ii) rating for competitive categories beyond age also take into account other variables such as weight and height iii) the adoption of different long-term youth training approaches.(AU)

Caracterización demográfica de la población con esófago de Barrett en dos instituciones médicas de Bogotá, Colombia / Demographic characterization of the population with Barretts esophagus in two medical centers of Bogotá, Colombia

Resumen Introducción: el esófago de Barrett es un trastorno en el que ocurre un cambio del epitelio escamoso estratificado del esófago por uno columnar especializado, lo cual se da como consecuencia del reflujo gastroesofágico crónico. En Colombia no se conoce la prevalencia actual de esta patología, ni se ha caracterizado a la población que la padece. El presente estudio tiene como objetivo conocer cuáles son las características demográficas principales de la población diagnosticada con esófago de Barrett en dos instituciones médicas de Bogotá. Material y métodos: se realizó un estudio de corte transversal multicéntrico, en el cual se evaluaron los reportes de endoscopias y de histopatología de 3000 pacientes que asistieron a estas instituciones por cualquier indicación. A partir de estos reportes se tomaron los datos requeridos. Asimismo, se realizó un análisis estadístico descriptivo de dichos datos. Resultados: la prevalencia del esófago de Barrett en la muestra es del 0,73 %. Se observó, además, que la correlación endoscópico-patológica es baja (28,5 %). De los casos diagnosticados, el rango de edad más frecuente se ubica entre los 60 y 80 años, con una edad promedio de 65,5 años. Asimismo, existe una predominancia de esta patología en el sexo femenino (63,6 %), en personas con un índice de masa corporal (IMC) >25 kg/m² y en aquellas con antecedentes de tabaquismo, sin historial de consumo de alcohol. En la mayoría de pacientes, se realizó la endoscopia por síntomas de reflujo gastroesofágico (50 %). La longitud del segmento observado no fue reportada en una gran cantidad de endoscopias. Conclusiones: en las instituciones analizadas, el esófago de Barrett es una patología de muy baja prevalencia y predominante en mujeres de edad avanzada con síntomas de reflujo gastroesofágico, sobrepeso y antecedente de tabaquismo.

Abstract Introduction: Barrett's esophagus occurs when the stratified squamous epithelium of the esophagus changes to a specialized columnar epithelium as a result of chronic gastroesophageal reflux. Its current prevalence in Colombia is unknown and the population suffering from it has not been characterized. The present study aims to determine the main demographic characteristics of the population diagnosed with Barrett's esophagus treated at two medical centers in Bogotá, Colombia. Materials and methods: A multicenter cross-sectional study was conducted to assess the endoscopy and histopathology reports of 3,000 patients who underwent this procedure for any reason. A descriptive statistical analysis of the data was performed. Results: The prevalence of Barrett's esophagus in the sample was 0.73%. The endoscopic-histology correlation was low (28.5%). Of the diagnosed cases, the most frequent age range was 60-80 years, with an average age of 65.5 years. This condition is predominant in the female sex (63.6%), in people with a BMI over 25 kg/m², with a history of smoking, and no history of alcohol consumption. Most patients underwent endoscopy for symptoms associated with gastroesophageal reflux (50%). The length of the observed segment was not reported in most endoscopies. Conclusions: In the medical centers included in this study, Barrett's esophagus is a rare pathology, found predominantly in elderly women with symptoms of gastroesophageal reflux, overweight, and with a history of smoking.

Influence of the relative age effect on height, motor performance and technical elements of olympic volleyball athletes / O efeito da idade relativa na estatura, desempenho motor e elementos técnicos dos atletas olímpicos de voleibol / El efecto de la edad relativa en la estatura, desempeño motor y elementos técnicos de los atletas olímpicos de vóleibol

ABSTRACT Introduction The Relative Age Effect (RAE) refers to the chronological age difference that occurs between athletes of the same age category, which can benefit individuals born in the first two quartiles of the year. This phenomenon is commonly studied in team sports, yet the results are still inconsistent, especially in volleyball. Objective This study analyzed the distribution of the number of births per quartile of Olympic volleyball athletes and whether this would influence anthropometric/motor variables and technical elements. Methods The sample consisted of 116 male athletes who scored during the Rio 2016 Olympics. For data analysis, we identified each athlete's quartile as well as data on height, attack and defensive (or block) range, and respective scores during the games. The Chi-square test was then used to verify interquartile distribution. To assess the normality of the other variables, we conducted the Kolmogorov-Smirnov test. Once accepted, one-way ANOVA was performed with the Bonferroni post-hoc test to verify significance between quartiles. A significance level of p≤0.05 was adopted. Results There was no significant difference in the distribution of athletes between quartiles (p = 0.74). When comparing the other variables in terms of the athletes' trimester of birth, we did not observe any significant difference between height (p = 0.79), attack (p=0.59) and defensive range (p=0.07), and in the scores for serving, attacking and blocking between quartiles either. Conclusion The Relative Age Effect was not observed in Olympic volleyball athletes, therefore this phenomenon is not related to the athletes' performance. This shows that other possible variables may influence the development of these athletes, discarding the relative age phenomenon. Level of Evidence III; Retrospective and Comparative Study.

RESUMO Introdução O efeito da idade relativa (EIR) refere-se à diferença da idade cronológica que ocorre entre os atletas de uma mesma categoria de idade que pode beneficiar os indivíduos nascidos nos dois primeiros quartis do ano. Esse fenômeno é comumente estudado em esportes coletivos, entretanto, os resultados ainda são inconsistentes, principalmente, no voleibol. Objetivo O presente estudo analisou a distribuição do número de nascimentos por quartil dos atletas olímpicos de voleibol e se isso influenciaria em variáveis antropométricas, motoras e em elementos técnicos. Métodos A amostra foi composta por 116 atletas masculinos que pontuaram durante as olimpíadas do Rio 2016. Para análise de dados, foi identificado o quartil de cada atleta, assim como os dados referentes à estatura, alcance no ataque e bloqueio e as respectivas pontuações durante os jogos. Em seguida, utilizou-se o teste de qui-quadrado para verificar a distribuição entre os quartis. Para avaliar a normalidade das outras variáveis, foi efetivado o teste de Kolmogorov-Smirnov. Após aceito, foi realizado ANOVA - one way, com o post-hoc de Bonferroni, a fim de verificar as significâncias entre os quartis. Adotou-se o nível de significância de p≤0,05. Resultados Não houve diferença significativa na distribuição dos atletas entre os quartis (p=0,74). Quando comparamos as outras variáveis em relação ao trimestre de nascimento dos atletas, também não observamos diferença significativa entre a estatura (p=0,79), alcance de ataque (p=0,59) e bloqueio (p=0,07), e nas pontuações de saque, ataque e bloqueio entre os quartis. Conclusão O efeito da idade relativa não foi observado nos atletas olímpicos de voleibol, portanto, esse fenômeno não está relacionado ao desempenho dos atletas. Isso mostra que outras possíveis variáveis podem influenciar a formação desses atletas, descartando o fenômeno da idade relativa. Nível de evidência III; Estudo retrospectivo e comparativo.

RESUMEN Introducción El efecto de la edad relativa (EER) se refiere a la diferencia de la edad cronológica que ocurre entre los atletas de una misma categoría de edad que puede beneficiar a los individuos nacidos en los primeros dos cuartiles del año. Este fenómeno se estudia comúnmente en deportes colectivos, entretanto, los resultados aún son inconsistentes, especialmente en el vóleibol. Objetivo El presente estudio analizó la distribución del número de nacimientos por cuartil de los atletas olímpicos de vóleibol y si eso influenciaría en variables antropométricas, motoras y en elementos técnicos. Métodos La muestra fue compuesta por 116 atletas masculinos que puntuaron durante las Olimpíadas de Río 2016. Para análisis de datos, fue identificado el cuartil de cada atleta, así como datos referentes a la altura, alcance en el ataque y bloqueo, y sus respectivas puntuaciones durante los juegos. Luego, se utilizó el test de Chi-cuadrado para verificar la distribución entre los cuartiles. Para evaluar la normalidad de las otras variables, se realizó el test de Kolmogorov-Smirnov. Después de aceptar, se realizó ANOVA one-way, con post-hoc de Bonferroni a fin de verificar las significancias entre los cuartiles. Se adoptó el nivel de significancia de p≤0.05. Resultados No hubo diferencia significativa en la distribución de los atletas entre los cuartiles (p = 0,74). Cuando comparamos las otras variables con relación al trimestre de nacimiento de los atletas, tampoco observamos diferencia significativa entre la estatura (p = 0,79), alcance de ataque (p=0,59) y bloqueo (p=0,07), y en las puntuaciones de saque, ataque y bloqueo entre los cuartiles. Conclusión El efecto de la edad relativa no fue observado en los atletas olímpicos de vóleibol, por lo tanto, este fenómeno no está relacionado al desempeño de los atletas. Esto muestra que otras posibles variables pueden influenciar la formación de estos atletas, descartando el fenómeno de la edad relativa. Nivel de evidencia III; Estudio retrospectivo y comparativo.

Reflexões em tempos de COVID-19: diferenciais por sexo e idade / Reflectionsaboutthe COVID-19: differentials by sex and age

O estudo apresenta reflexões sobre os diferenciais de mortalidade e hospitalização por sexo e estrutura por idade da pandemia de COVID-19. Calculou-se taxas específicas de mortalidade por COVID-19, taxas de hospitalização por Síndrome Respiratória Aguda Grave (SRAG) e razões de sexo entre as taxas. No Brasil, 58,3% dos óbitos e 53,3% das hospitalizações são de homens, além de um maior risco de morte por idade, pela doença, do sexo masculino.A proporção de óbitos aos 60 anos e mais é 71,4%, enquanto as hospitalizações por SRAG representam 39,2%. Como homens e idosos experimentam maior risco, a análise pela ótica da estrutura etária e por sexo é útil para mensurar os impactos da pandemia.(AU)

This study presents reflections on the differences in mortality and hospitalization by sex and age structure of the COVID-19 pandemic. Specific mortality rates by COVID-19, hospitalization rates by Severe Acute Respiratory Syndrome (SARS) and the sex ratio between rates were calculated. In Brazil, 58.3% of deaths, 53.3% of hospitalizations were from men, besides a higher male risk of death by age due to this disease. The proportion of deaths at age 60 and over is 71.4%, while the hospitalizations for SARS represent 39.2%. As men and the elderly experience greater risk, the analysis from the perspective of sex and age distribution were useful to measure the impact of the pandemic.(AU)

Trends in prostate cancer mortality in the state of São Paulo, 2000 to 2015 / Tendências na mortalidade por câncer de próstata no estado de São Paulo, 2000 a 2015

ABSTRACT OBJECTIVE To estimate the magnitude and identify patterns of change in prostate cancer mortality in the state of São Paulo and in the 17 regional health care networks, according to age groups from 50 years onwards, in the period between 2000 to 2015. METHODS Age-adjusted mortality rates (per 100,000 men) were calculated by the direct method using the Segi world population as standard. Joinpoint regression was used to calculate the average annual percent change (AAPC), with a confidence interval of 95% (95%CI), by regional network and age group (50-59, 60-69, 70-79 and 80 years or more). RESULTS For the state of São Paulo, age-adjusted mortality rates were 15.2, 13.3 and 11.9 per 100,000 men, respectively, in the periods between 2000 to 2005, 2006 to 2010 and 2011 to 2015, with a significant decrease trend (AAPC = -2.10%; 95%CI -2.42 - -1.79) each year. Among the 17 networks, 11 presented significant mean annual reductions, ranging from -1.72% to -3.05%. From the age of 50 onwards, there was a sharper reduction in the groups from 50 to 59 (AAPC = -2.33%; 95%CI -3.04 - -1.62) and 60 to 69 years (AAPC = -2.84%; 95%CI - 3.25 - -2.43). CONCLUSION Although reductions in mortality are still slight, they indicate progress in prostate cancer control actions. Screening actions and changes in therapeutic behaviors in recent decades may be modifying incidence and survival, resulting in changes in the mortality profile. More detailed studies will be useful in understanding the factors that lead to the interregional variations found.

RESUMO OBJETIVO Estimar a magnitude e identificar padrões de mudança na mortalidade por câncer de próstata no estado de São Paulo e nas 17 redes regionais de atenção à saúde, segundo grupos etários a partir dos 50 anos, no período de 2000 a 2015. MÉTODOS As taxas de mortalidade ajustadas por idade (por 100 mil homens) foram calculadas pelo método direto usando a população mundial de Segi como padrão. A análise de regressão Joinpoint foi utilizada para calcular as variações percentuais anuais médias (AAPC), com intervalo de confiança de 95% (IC95%), por rede regional e grupo etário (50-59, 60-69, 70-79 e 80 anos ou mais). RESULTADOS Para o estado de São Paulo, as taxas ajustadas de mortalidade foram de 15,2, 13,3 e 11,9/100 mil homens, respectivamente, nos períodos de 2000 a 2005, 2006 a 2010 e 2011 a 2015, com tendência de decréscimo significativo (AAPC = -2,10%; IC95% -2,42 - -1,79) a cada ano. Das 17 redes, 11 apresentaram reduções médias anuais significativas, que variaram entre -1,72% e -3,05%. A partir dos 50 anos, verificou-se redução mais acentuada nos grupos de 50 a 59 (AAPC = -2,33%; IC95% -3,04 - -1,62) e 60 a 69 anos (AAPC = -2,84%; IC95% -3,25 - -2,43). CONCLUSÕES Embora as reduções na mortalidade ainda sejam discretas, indicam progresso nas ações de controle do câncer de próstata. Ações de rastreamento e mudanças nas condutas terapêuticas nas últimas décadas podem estar modificando a incidência e a sobrevida, resultando em mudanças no perfil de mortalidade. Estudos mais detalhados serão úteis na compreensão dos fatores que levam às variações inter-regionais encontradas.

Analysis of allergen characteristics of allergic rhinitis patients in Shanghai, China / 第二军医大学学报

Objective: To retrospectively analyze the allergen characteristics and the onset season of allergic rhinitis (AR) patients in Shanghai, China. Methods: From Jan. 1, 2015 to Dec. 31, 2017, 1 570 suspected AR patients were selected from the Department of Otolaryngology/Head and Neck Surgery, Changzheng Hospital, Naval Medical University (Second Military Medical University). One milliliter of serum was extracted from each patient and the specific immunoglobulin E (IgE) levels of 22 kinds of allergens and total IgE levels were detected using allergen specific IgE antibody detection kit (immunoblotting method). The AR patients were divided into 5-16, 17-39, 40-64 and ≥65 years old groups, and the positive rates of allergens were compared. The number of AR patients with one or more positive allergens was recorded every month, and the seasonal distribution of positive allergen was analyzed. Results: Of the 1 570 suspected AR patients, 143 (9.1%) had elevated serum total IgE, and 1 182 (75.3%) had one or more positive allergens, including 491 (41.5%) with single positive allergen and 691 (58.5%) with two or more positive allergens. Among the 22 kinds of allergens, dust mites (including Dermatophagoides pteronyssinus and Dermatophagoides farinae) were the most common allergens (715 cases, 60.5%), followed by penicillin (239 cases, 20.2%) and Chinese parasol (167 cases, 14.1%). Among the 1 182 AR patients, 17-39 years old was the highest proportion (61.0%, 721 cases). The positive rate of dust mites in the 5-16 years old group was significantly higher than those in the 17-39, 40-64 and ≥65 years old groups (all P<0.05). The prevalence peaks of AR were in Apr., May, Jun., Aug., Sep., Oct. and Nov.; and the numbers of AR patients with one or more positive allergens were 175±21, 156±16, 259±31, 172±15, 176±14, 164±4 and 204±32, respectively, which were significantly higher than the average value (97±42) of 36 months from Jan. 1, 2015 to Dec. 31, 2017 (all P<0.05). The positive detection time of dust mites was mainly in May, Jun., Jul., Aug., Sep. and Nov.; and the numbers of dust mite positive AR patients were 64±11, 113±21, 68±18, 76±15, 70±11 and 89±21, respectively, which were significantly higher than the average value (52±32) of the 36 months (all P<0.05). Conclusion: Dust mites are the most common and main allergens of AR patients in Shanghai, China. The proportion is high in AR patients aged 17-39 years old, and the prevalence peaks are from Apr. to Jun. and from Aug. to Nov..

Validation of applicability of reference intervals for serum alpha-fetoprotein and carcinoembryonic antigen for adults in Changchun, China / 临床肝胆病杂志

ObjectiveTo investigate whether the reference intervals for serum alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA) in WS/T 645.2-2018 are applicable to the adults in Changchun, China. MethodsAccording to the validation method for the reference intervals in WS/T 645.2-2018, 5420 subjects, aged from 20-79 years, who underwent physical examination from January 2016 to April 2019 were enrolled and divided into 12 subgroups based on age and sex. Each subgroup was analyzed in terms of whether more than 90% of the measured values fell into the reference intervals, and the changing trend of AFP and CEA with age and sex was analyzed. The Mann-Whitney U test was used for comparison between two groups. ResultsMore than 90% of the measured values of serum AFP and CEA fell into the reference intervals, which passed the validation test. There was a significant difference in serum AFP between male and female subjects aged 30-39 years (Z=-4.51, P＜0.05), and there was a significant difference in serum CEA between male and female subjects aged 20-29, 30-39, 40-49, 50-59, and 60-69 years (Z=-13.45, -18.15, -17.34, -10.82, and -3.65, all P＜0.05). Serum AFP increased slowly with age in female subjects aged 20-69 years and decreased with age in male and female subjects aged 70-79 years. Serum CEA increased with age in male and female subjects aged 20-79 years, and male subjects had a higher measured value than female subjects. ConclusionReference intervals for serum AFP and CEA in WS/T 645.2-2018 issued by National Health Commission are applicable to the adults in Changchun.

Analysis of factors associated with skin lesion distribution in 1 125 patients with non-segmental vitiligo / 中华皮肤科杂志

Objective To analyze correlations of the distribution of non-segmental vitiligo lesions with gender,age of onset,duration of disease,personal and family history of autoimmune diseases,family history of vitiligo,and so on.Methods Clinical data were collected from 1 125 patients with confirmed nonsegmental vitiligo in Department of Dermatology,Beijing Hospital from January 2009 to January 2019,and analyzed retrospectively.Statistical analysis was carried out with SPSS 20.0 software by using independentsample t test and chi-square test.Results Of the 1 125 patients with non-segmental vitiligo,599 were males and 526 were females,with a male-to-female ratio of 1.14:1.Their age of onset was 27.9 ± 17.1 years,and duration of disease was 5.2 ± 8.0 years.Skin lesions mostly occurred on the trunk (544 cases,48.4％) and face (535 cases,47.6％),followed by acral regions (430 cases,38.2％),extremities (297 cases,26.4％) and neck (231 cases,20.5％).The perioral region (17.2％),hands (47.9％) and genital region (14.5％) in the 599 male patients were more frequently affected than those in the 526 females (9.7％,22.6％,6.3％,x2 =13.33,77.66,20.01,respectively,all P ＜ 0.001),while the neck (27.0％) was more frequently affected in the female patients than in the male patients (14.9％,x2 =25.29,P ＜ 0.001).The age of onset was significantly lower in the patients with vitiligo lesions involving the legs,knees,feet,trunk,genital and periocular regions than in those without skin lesions on the above corresponding body sites (all P ＜ 0.05),but significantly higher in the patients with vitiligo lesions involving the arms and hands than in those without lesions on the above 2 sites (both P ＜ 0.05).Vitiligo lesions more likely occurred on the hands of patients with a personal or family history of autoimmune thyroid diseases compared with those without the personal or family history (50.0％ vs.27.9％,x2 =6.62,P =0.010).The trunk was more frequently affected in the patients with a family history of vitiligo than in those without (59.6％ vs.45.7％,x2 =13.36,P ＜ 0.001).Conclusion The distribution of non-segmental vitiligo lesions are correlated to some extent with gender,age of onset,personal and family history of autoimmune diseases and family history of vitiligo.

Seroepidemiology of hepatitis B in individuals born between 1945-1985 on a Brazilian regional metropolis / Soroepidemiologia da hepatite B em indivíduos nascidos entre 1945-1985 em uma metrópole regional Brasileira

Background: hepatitis B prevalence can be influenced by social/cultural behavior and the Baby Boomer (BB) generation(1945-1964) may have been more susceptible to this infection. Objectives: We investigated the seroprevalence of markers for HBV infection and vaccination and its association with main risk factors. Methodology: a random sample of individuals aged 30-70 years old in a public clinical laboratory from a metropolitan area of Bahia/Brazil were tested for HBsAg/Total Anti-HBc/Anti-HBs/Anti-HBc-IgM and a socio-demographic questionnaire was applied. Results: of the650 participants, 349 were 51-70 yo (BB) and 301 were non-BB. The prevalences were HBsAg (2.3%), Total Anti-HBc (17.1%) and Anti-HBs (27.4%). Anti-HBcIgM (2.7%) was performed in 112 participants sera who had contact/infection with HBV. The laboratory profiles were characterized as susceptibility (68%), vaccine response (14.8%) and contact/infection with HBV (17.2%). BB participants were more susceptible and less vaccinated than non-BB. The higher frequency of contact/infection status was observed in the BB generation. Statistically significant differences were found for the contact/infection status in males(50,9%) illicit drug use (11,6%), syringe/needle sharing (7,1%), and blood transfusion (10,7%). Non-BB with contact/ infection profile reported more tattoo/piercing and BB reported higher use of glass syringes. Conclusion: the majority of the study population was susceptible to infection but participants older than 50 years showed both, a higher frequency of this profile and also a higher frequency of contact/infection status, thus suggesting the need for greater health care attention for this age group.

Introdução: a prevalência de hepatite B pode ser influenciada pelo comportamento sociocultural e a geração Baby Boomer (BB) (1945-1964) pode ter sido mais suscetível a esta infecção. Objetivos: Investigar a soroprevalência de marcadores para a infecção pelo VHB e resposta vacinal e associação com fatores de risco. Metodologia: soro de indivíduos de 30 a 70 anos randomicamente selecionados em um laboratório publico de análises clínicas na área metropolitana do Brasil foram testados para AgHBs/ Anti-HBc Total /Anti-HBs/Anti-HBc-IgM. Todos responderam questionário sociodemográfico contendo perguntas sobre fatores de risco para hepatite B. Resultados: dos 650 participantes, 349 eram BB (51-70 anos) e 301 eram não-BB (30-50 anos). As prevalências estimadas foram: HBsAg (2,3%), Anti-HBs (27,4%). Entre os Anti-HBc Total (17,1%) apenas 2,7% foram Anti-HBc IgM. Os perfis laboratoriais foram caracterizados como suscetibilidade (68%), resposta vacinal (14,8%) e contato com VHB (17,2%). Na distribuição por idade, os BB foram mais susceptíveis, menos vacinados e apresentaram maior frequência de contato/infecção que os não-BB. Diferenças estatisticamente significantes foram encontradas no status contato/infecção e as seguintes variáveis: sexo masculino, uso de drogas ilícitas, compartilhamento de seringas de vidro/agulhas e transfusão de sangue. Não-BB com status contato/infecção relataram ter mais tatuagem/piercing e BB relataram maior uso de seringas de vidro. Conclusão: a maioria da população estudada era suscetível ao VHB, mas os participantes com mais de 50 anos apresentaram tanto uma maior frequência desse status quanto do status contato/ infecção, sugerindo a necessidade de maior atenção à saúde para indivíduos desta faixa etária.

Demographic Profile of India – Opportunity or Threat (Qualitative Systemic Review Literature)

The demographic dividend is an important aspect for any country to raise its gross domestic product and per capita income. Thisreview mainly focuses on exploring the current scenario of Indian population in terms of its dividend, skill set of population andinfluence of the various factors on the demographic dividend of India which is the deciding factor and plays an important role forthe country on in terms of its dividend, skill Skill sets the areas of improvement to make Indian demographic dividend productive