Global trends in COVID-19 incidence and case fatality rates (2019-2023): a retrospective analysis.

Objectives: Analyzing and comparing COVID-19 infection and case-fatality rates across different regions can help improve our response to future pandemics. Methods: We used public data from the WHO to calculate and compare the COVID-19 infection and case-fatality rates in different continents and income levels from 2019 to 2023. Results: The Global prevalence of COVID-19 increased from 0.011 to 0.098, while case fatality rates declined from 0.024 to 0.009. Europe reported the highest cumulative infection rate (0.326), with Africa showing the lowest (0.011). Conversely, Africa experienced the highest cumulative case fatality rates (0.020), with Oceania the lowest (0.002). Infection rates in Asia showed a steady increase in contrast to other continents which observed initial rises followed by decreases. A correlation between economic status and infection rates was identified; high-income countries had the highest cumulative infection rate (0.353) and lowest case fatality rate (0.006). Low-income countries showed low cumulative infection rates (0.006) but the highest case fatality rate (0.016). Initially, high and upper-middle-income countries experienced elevated initial infection and case fatality rates, which subsequently underwent significant reductions. Conclusions: COVID-19 rates varied significantly by continent and income level. Europe and the Americas faced surges in infections and low case fatality rates. In contrast, Africa experienced low infection rates and higher case fatality rates, with lower- and middle-income nations exceeding case fatality rates in high-income countries over time.

[Therapeutic Effect of Autologous Platelet-rich Gel in the Treatment of Chronic Skin Ulcer with Tophus].

OBJECTIVE: To evaluate the clinical effectiveness and safety of autologous platelet-rich gel (APG) in the treatment of chronic skin ulcer with tophus. METHODS: Four patients of chronic skin ulcer with tophus received routine debridement to remove necrotic tissue and erasion tophus as far as possible,and then received the treatment of APG. RESULTS: All of the patients had their wounds healed after the treatment of APG (one wound was treated twice). The wounds were healed between 8 to 22 d, average (13. 7±6. 8) d, while there were no adverse effects observed. CONCLUSION: Topical therapy with APG may be considered as an effective and safe adjuvant method for the treamtment of chronic skin ulcer with tophus.

[Joint diagnostic value of four temperature sensation tests in elderly patients with type 2 diabetic peripheral neuropathy].

OBJECTIVE: To explore the joint diagnostic value of four temperature sensation tests in elderly patients with type 2 diabetic peripheral neuropathy. METHODS: Thermal sensory analyzer-II were applied to measure cool sensation (CS), warm sensation (WS), cold pain sensation (CP)and heat pain sensation (HP) of 308 elderly patients with type 2 diabetes. Logistic regression model was adopted to create the new variable Temp4 from four temperature sensation tests to diagnose type 2 diabetic peripheral neuropathy. The ROC curve analysis was used to determine the best cut-off points of the four temperature sensation and Temp4, and the diagnostic value of it was evaluated. RESULTS: The means of temperature sensation tests of the diabetic peripheral neuropathy (DPN) group were significantly different from those of the non-DPN group (P < 0.05). According to the current reference intervals of the four temperature sensation tests to diagnose the DPN, the sensitivity of WS test was the highest, and the value was 0.710; but the specificity, positive predictive value, negative predictive value, Youden index, diagnostic accuracy and Kappa value of cold sensation test were the highest, and the values were 0.842, 0.746, 0.799, 0.528, 77.92% and 0.535, respectively; the Kappa values of the other three temperature sensation tests were all greater than 0.4 (P < 0.05). The area under the ROC curve of the new variable Temp4 was 0.93 (95% CI 0.91-0.96), and was larger than the four temperature sensation tests (P < 0.05). The sensitivity, specificity, Youden index and diagnostic accuracy of Temp4 were 0.823, 0.897, 0.719 and 86.69%, respectively. The new best cut-off points of the CS test, WS test, CP test, HP test and Temp4 was 27.5 degrees C, 34.7 degrees C, 20.5 degrees C, 43.5 degrees C and 0.416, respectively. CONCLUSION: The results of the four temperature sensation quantitative tests were in good agreementand could be applied to diagnose DPN; the new variable Temp4 could be used for diagnosis of DPN with a higher diagnostic accuracy.