Prevalence and incidence of mild cognitive impairment in adults with diabetes in the United States.

BACKGROUND: Limited evidence exists about the prevalence and incidence of mild cognitive impairment (MCI) in individuals with diabetes in the U.S. We aimed to address such knowledge gaps using a nationally representative study dataset. METHOD: We conducted a secondary analysis from the Health and Retirement Study (HRS) (1996-2018). The sample for examining the prevalence of MCI was14,988, with 4192 (28.0%) having diabetes, while the sample for the incidence was 21,824, with 1534 (28.0%) having diabetes. RESULTS: Participants with diabetes had a higher prevalence of MCI than those without diabetes (19.9 % vs. 14.8 %; odds ratio [95 % confidence interval] (OR[95 %CI]): 1.468 [1.337, 1.611], p <.001). The incidence of MCI in participants with/without newly diagnosed diabetes was 42.9 % vs. 31.6 % after a mean 10-year follow-up, with the incidence rate ratio (IRR) [95 %CI] (1.314 [1.213, 1.424], p <.001). Newly diagnosed diabetes was associated with elevated risks of MCI compared with non-diabetes, with the uncontrolled hazard ratio (HR) [95 %CI] (1.498 [1.405, 1.597], p <.001). CONCLUSIONS: Using a nationally representative study data in the U.S., participants with diabetes had a higher prevalence and incidence of MCI than those without diabetes. Findings show the importance of developing interventions tailored to the needs of individuals with diabetes and cognitive impairment.

Prevalence of cervical cancer in Ain Defla region (Algeria)

The high rate of cervical cancer in Algeria and the absence of organized screening programs are well shown in this study, which aims to determine the prevalence of cervical cancer and describe the risk factors associated with this alarming prevalence. This retrospective study is based on data collected from medical records and A questionnaire was developed to assess the risk factors (such as: parity, age at first marriage, smoking, oral contraceptive, and Hormonal status) of cervical cancer among the participants. Face to Face interview were conducted with the participants. The result obtained from this study revealed that cervical cancer occupies the fourth place of cancer in the Wilaya of Ain Defla (4,71 %); the results confirm the effect of several risk factors such as early marriage age (below 20 years: 46.66 %), multiparity (53.33%), menopause (66.66 %); taking contraception (53.33%) and smoking in the development of this pathology. The adoption of an early and annual screening program in our region would be very important to us. In addition, the interest of annual screening is to raise women's awareness of this pathology, particularly in isolated regions. (

Prevalence of Fibromyalgia in Pharmacy Professionals and Students: A Cross-Sectional Study.

BACKGROUND: The prevalence of fibromyalgia (FM) in pharmacy students and professionals is unknown. This study identifies the prevalence of FM in pharmacy students and professionals using three screening tools and factors associated with its development. Furthermore, this study assesses the level of agreement between the tools and the magnitude of the participants' responses to each item in the screening tools. METHODS: This was a cross-sectional survey conducted on members of the Saudi Pharmaceutical Society using an online questionnaire. The participants were asked to fill three questionnaires: the London Fibromyalgia Epidemiology Study Screening Questionnaire (LFESSQ), Fibromyalgia Rapid Screening Tool (FiRST) and Fibromyalgia Survey Questionnaire (FSQ). Demographic data and factors affecting FM in pharmacy students and professionals were collected and analysed. RESULTS: Two hundred ninety-three participants accessed the survey: most of them were Saudi (93.5%) and females (78.8%) with a mean (standard deviation) age of 29 (8) years. Furthermore, 52% of the participants had generalised body pain. The prevalence of FM using FiRST, LFESSQ Pain, LFESSQ with fatigue criteria and FSQ was 27.1%, 34.9%, 50.9% and 68.4%, respectively. Fleiss' kappa coefficient revealed fair agreement among all three screening tools (kappa = 0.350; p < 0.001). After adjusting for significant variables, the resulting adjusted odds ratio of developing FM was 4.86 in people working for 41-45 h weekly (95% confidence interval [CI], 1.32-17.84; p = 0.017), 5.16 in people who frequently wake up during sleep (95% CI, 1.85-14.40; p = 0.002) and 12.99 in people with sleep apnea or other sleeping disorders (95% CI, 2.07-81.68; p = 0.006). CONCLUSION: FM was prevalent among pharmacy students and professionals and was much more than data reported on the general population or other healthcare workers. Traditional factors along with higher working hours were identified as significant variables.

First report of detection of IgA anti-Acanthamoeba antibodies among Saudi population and amoeba isolation from their surroundings

@#Acanthamoeba is an opportunistic protozoan pathogen which is found in diverse environment worldwide. Being ubiquitous nature of this amoeba we come across it in our daily life. Acanthamoeba species are recognized as human pathogens; that may cause blinding keratitis and rare but fatal granulomatous encephalitis involving central nervous system. To date, there is not a single report in literature demonstrating anti-Acanthamoeba antibodies among the Saudi population, and thus aim of the present study. Using ELISA, we identified the antibody level in the local population. Our results represent the secretory IgA antiAcanthamoeba in mucosal secretions from 133 individuals aged 15–60 years. The antiAcanthamoeba antibody prevalence rate was > 80%, and no considerable differences were observed between prevalence in males (80.28%) and that in females (80.64%). In addition, environmental sources (soil and water) from the environment of the participants in our study were evaluated for amoeba incidence. The amoeba was identified by morphological characteristics of cysts or trophozoites on non-nutrient agar plates grown with E. coli. Overall, 58.75% of samples from water and 32.85% of those from soil were culture positive for outgrowth of amoeba on non-nutrient agar plates. Furthermore, PCR was carried out with genus-specific primers to confirm the presence of Acanthamoeba DNA. Our results revealed that about 68% of cultures from water and 43% of those from soil were successfully amplified and proved to be amoeba DNA. Interestingly, a few samples yielded more than one product, which suggests that some other amoebic species may be present in the same sample (MAC-W1 and MADW1). To the best of our knowledge, we described for the first time the amoeba isolation from the participant’s close environment and antibodies level among Saudi population. Our future studies will be focused on additional molecular characterization of isolated amoeba and their pathogenic potential which could be a possible threat for the community.

Incidence, risk factors and re-exacerbation rate of severe asthma exacerbations in a multinational, multidatabase pediatric cohort study.

BACKGROUND: There are sparse real-world data on severe asthma exacerbations (SAE) in children. This multinational cohort study assessed the incidence of and risk factors for SAE and the incidence of asthma-related rehospitalization in children with asthma. METHODS: Asthma patients 5-17 years old with ≥1 year of follow-up were identified in six European electronic databases from the Netherlands, Italy, the UK, Denmark and Spain in 2008-2013. Asthma was defined as ≥1 asthma-specific disease code within 3 months of prescriptions/dispensing of asthma medication. Severe asthma was defined as high-dosed inhaled corticosteroids plus a second controller. SAE was defined by systemic corticosteroids, emergency department visit and/or hospitalization all for reason of asthma. Risk factors for SAE were estimated by Poisson regression analyses. RESULTS: The cohort consisted of 212 060 paediatric asthma patients contributing to 678 625 patient-years (PY). SAE rates ranged between 17 and 198/1000 PY and were higher in severe asthma and highest in severe asthma patients with a history of exacerbations. Prior SAE (incidence rate ratio 3-45) and younger age increased the SAE risk in all countries, whereas obesity, atopy and GERD were a risk factor in some but not all countries. Rehospitalization rates were up to 79% within 1 year. CONCLUSIONS: In a real-world setting, SAE rates were highest in children with severe asthma with a history of exacerbations. Many severe asthma patients were rehospitalized within 1 year. Asthma management focusing on prevention of SAE is important to reduce the burden of asthma.

Epidemiology of rheumatoid arthritis, clinical aspects and socio-economic determinants in Pakistani patients: A systematic review and meta-analysis.

OBJECTIVE: The study aimed to evaluate literature on rheumatoid arthritis disease in Pakistani patients, to have an understanding about its epidemiology, clinical aspects and socio-economic determinants. METHODS: The review study was conducted from December 2017, to May 2018. An online search was conducted in international and local health databases using appropriate search keywords as well as scanning reference lists of related articles. Literature published after year 2000 that reported epidemiological, demographic, clinical and socioeconomic data of Pakistani rheumatoid arthritis patients was included. Meta-analysis was performed where possible. This systematic review was registered on the international prospective register of systematic reviews PROSPERO (CRD42018090582). RESULTS: Of the 334 research articles found, 29 (8.7%) were selected. Patients were mostly females, but no study explored impact of disease on household and family role functioning of rheumatoid arthritis-affected women in Pakistan. Most patients were uneducated (55%) and unemployed; had low disease knowledge (N = 149, 74.5%) and poor adherence to disease-modifying anti-rheumatic drugs (N = 23, 23%). Point prevalence of rheumatoid arthritis reported from Karachi was high at 26.9%. Moderate disease activity, i.e., 4.5}0.7 and mild functional disability (N = 66, 51.6%) were seen in RA patients. Almost half (N = 799, 46.9%) had comorbidities. Almost a fifth proportion of RA patients had dyslipidaemia as a comorbidity (N = 134, 16.77%) and higher cardiovascular risk score as modifiable risk factor. Undiagnosed depression (N = 134, 58.3%) and low bone mineral density (N = 93, 40.6%) were reported in RA patients. Direct monthly treatment cost of disease was significantly high considering patients' socio-economic status, i.e., USD 16.47 - 100.68. Most commonly used drug was methotrexate. CONCLUSIONS: There is a paucity of data on Pakistani rheumatoid arthritis patients' demographic and socio-economic parameters, especially the gender element.

Type A viral hepatitis: A summary and update on the molecular virology, epidemiology, pathogenesis and prevention.

Although epidemic jaundice was well known to physicians of antiquity, it is only in recent years that medical science has begun to unravel the origins of hepatitis A virus (HAV) and the unique pathobiology underlying acute hepatitis A in humans. Improvements in sanitation and the successful development of highly efficacious vaccines have markedly reduced the worldwide prevalence and incidence of this enterically-transmitted infection over the past quarter century, yet the virus persists in vulnerable populations and remains a common cause of food-borne disease outbreaks in economically-advantaged societies. Reductions in the prevalence of HAV have led to increases in the median age at which infection occurs, often resulting in more severe disease in affected persons and paradoxical increases in disease burden in some developing nations. Here, we summarize recent advances in the molecular virology of HAV, an atypical member of the Picornaviridae family, survey what is known of the pathogenesis of hepatitis A in humans and the host-pathogen interactions that typify the infection, and review medical and public health aspects of immunisation and disease prevention.

Prevalencia de hipertensión pulmonar y factores asociados en adultos con insuficiencia mitral de una institución prestadora de servicios de salud de tercer nivel de la ciudad de Tunja / Prevalence of pulmonary hypertension and associated factors in adults with mitral regurgitation of a third level health services provider institution of Tunja city / Prevalência de hipertensão pulmonar e fatores associados em adultos com regurgitação mitral de uma instituição prestadora de serviços de saúde de terceiro nível na cidade de Tunja

Introducción. La hipertensión pulmonar es el aumento de la presión en las arterias pulmonares. Cuando la presión media en la arteria pulmonar sobrepasa los 25 mm Hg, se considera que existe hipertensión arterial pulmonar. Objetivo. Determinar la prevalencia y los factores asociados de la hipertensión pulmonar en adultos con insuficiencia mitral. Métodos. Se llevó a cabo un estudio de corte transversal que incluyó 676 pacientes mediante mues-treo no probabilístico de tipo censo, con diagnóstico de insuficiencia mitral comprobada mediante ecocardiografía, atendidos en un periodo de un año en una institución de tercer nivel de complejidad de Tunja. Se contó con autorización para el acceso y la revisión de las historias clínicas y los ecocar-diogramas. Resultados. La prevalencia de hipertensión pulmonar en pacientes con insuficiencia mitral fue de 42,9% El promedio de edad de los pacientes fue de 73,7 años y la proporción por sexo fue similar, con 50,7 % de mujeres y 49,3 % de hombres. Se encontró una asociación estadísticamente significativa de la variable enfermedad pulmonar obstructiva crónica con la de hipertensión pulmonar (OR ajustada de 1,82) (IC95% 1,2-2,7) y con la de falla cardiaca (OR ajustada de 3,01) (IC95% 1,7-5,3). Conclusiones. En los pacientes con insuficiencia mitral, se encontró una alta prevalencia de hiper-tensión pulmonar, situación que, según elementos clínicos, puede empeorar su pronóstico. Se halló una asociación estadísticamente significativa entre hipertensión pulmonar, y enfermedad pulmonar obstructiva crónica y falla cardiaca.

Introduction: Pulmonary hypertension is the increase in the pressure of the pulmonary arteries. When the average pressure in the pulmonary artery exceeds 25 mm Hg, it is considered to be associated with pulmonary arterial hypertension. Objective: To determine the prevalence and associated factors of pulmonary hypertension in adults with mitral insufficiency. Methods: A cross-sectional study of 676 patients with mitral insufficiency determined by echocar-diography performed in the one-year period in a third-level complexity institution of Tunja city was carried out. Access and review of clinical records and echocardiograms was authorized. A total of 676 patients was included using non-probabilistic sensorial type sampling. Results: A 42.9% prevalence of pulmonary hypertension was found in patients with mitral insuffi-ciency with a mean age of 73.7 years, the proportion of gender was similar, 50.7% in females and 49.3% in the male gender. A statistically significant association was found between chronic obstructi-ve pulmonary disease and pulmonary hypertension with an adjusted OR of 1.82 [95% CI: 1.24-2.66]; likewise, with heart failure with an adjusted OR of 3.01 [95% CI: 1.70-5.33]. Conclusions: A high prevalence of pulmonary hypertension was found in patients with mitral insu-fficiency, which according to clinical elements may worsen the prognosis of patients with this type of pathology. A statistically significant association was found in the population among pulmonary hypertension with chronic obstructive pulmonary disease or heart failure

Introdução. Hipertensão pulmonar é o aumento da pressão nas artérias pulmonares. Quando a pressão média na artéria pulmonar excede 25 mm Hg, considera-se a presencia da hipertensão arterial pulmonar. Objetivo. Determinar a prevalência e fatores associados à hipertensão pulmonar em adultos com regurgitação mitral. Métodos. Foi levado a cabo um estudo transversal que incluiu 676 pacientes com amostragem não probabilística de tipo censo, com diagnóstico de regurgitação mitral comprovada por ecocardiografia, atendido em um período de um ano em uma instituição de complexidade de terceiro nível em Tunja. Houve autorização para acesso e revisão de prontuários e ecocardiogramas. Resultados. A prevalência de hipertensão pulmonar em pacientes com regurgitação mitral foi de 42,9%. A média de idade dos pacientes foi de 73,7 anos e a proporção por sexo foi semelhante, com 50,7% das mulheres e 49,3% dos homens. Encontrou-se associação estatisticamente significativa entre a variável doença pulmonar obstrutiva crônica e hipertensão pulmonar (OR ajustada de 1,82) (IC95% 1,2-2,7) e com insuficiência cardíaca (OR ajustada de 3,01). (IC95% 1,7-5,3). Conclusões. Nos pacientes com regurgitação mitral, foi encontrada alta prevalência de hipertensão pulmonar, situação que, segundo os elementos clínicos, pode piorar seu prognóstico. Uma associação estatisticamente significativa foi encontrada entre hipertensão pulmonar, doença pulmonar obstrutiva crônica e insuficiência cardíaca.

Prevalence of Cerebral Palsy among 8-Year-Old Children in 2010 and Preliminary Evidence of Trends in Its Relationship to Low Birthweight.

BACKGROUND: The public health objective for cerebral palsy (CP) in the United States is to reduce the percentage of children with CP who were born low birthweight (LBW, <2500 g) by 10% between 2006 and 2020. This study reports the prevalence of CP in a constant surveillance area for the years 2006, 2008, and 2010 and describes initial progress towards the CP public health objective. METHODS: Data on children with CP at age 8 years were ascertained by the Autism and Developmental Disabilities Monitoring (ADDM) Network, a population-based surveillance system that monitored CP in four areas of the United States. RESULTS: CP prevalence in 2010 was 2.9 per 1000 [95% confidence interval (CI) 2.6, 3.2], down from 3.5 (95% CI 3.2, 3.9) in the same surveillance area in 2006. Among CP cases with no documented postneonatal aetiology, 49.1% (95% CI 42.9, 55.2) were born LBW in 2010 compared with 54.3% (95% CI 48.4, 60.1) in 2006. In 2010, 28.1% (95% CI 22.9, 30.4) were born very low birthweight (VLBW, <1500 g) compared with 35.4% (95% CI 30.0, 41.2) in 2006. The relative risks for associations between CP and both LBW and VLBW also declined, though not significantly, during the study period. CONCLUSIONS: Declines in the associations between CP and LBW categories may have contributed to declines during the study period in both the prevalence of CP and the percentage of children with CP who were born LBW or VLBW. Ongoing monitoring of these trends is warranted.

Decline in admissions for childhood asthma, a 26-year period population-based study.

BACKGROUND: The prevalence of childhood asthma has increased, although the rate of hospitalization for asthma seems to decrease. In Norway, the rate of hospital admission for childhood asthma from 1984 to 2000 increased. The aim of this study was to assess further trends in hospital admissions for childhood asthma up to 2010. METHODS: A population-based study including children 1-13 yrs of age hospitalized for asthma during six periods from 1984/1985 to 2009/2010 in Rogaland, Norway, was performed. Medical records from 1536 admissions (1050 children) were studied; and gender, age, number of admissions, length of hospital stay, medications and symptoms were recorded. RESULTS: For all age groups, the rate of admissions per 10.000 increased from 20.1 in 1984/85 to 33.7 in 1989/90, but declined to 14.4 in 2009/2010. Rates were highest in boys (OR 1.87; 95% CI: 1.69, 2.09), younger age groups (OR 2.51; 2.38, 2.64) and decreased from 1984 to 2010 (OR 0.92; 0.88, 0.94). The rates of readmissions were higher than for primary admissions (OR 1.33; 1.19, 1.47). From 1984 to 2010, there was an increased use of inhaled corticosteroids prior to admission (6 to 51%) and started at discharge (7 to 37%), and systemic steroids given during admission (19 to 83%). CONCLUSION: There has been a substantial decline in the rate of hospital admissions for childhood asthma after 1989/1990, with major differences between age groups and genders. The decline could be due to improved care of children with asthma or a real reduction in asthma exacerbations.

[Prevalence and severity of wheezing in the first year of life in the city of Santo André, Brazil]. / Prevalência e gravidade da sibilância no primeiro ano de vida no município de Santo André

OBJECTIVE: To determine the prevalence and the severity of wheezing in the first year of life for infants who live in Santo André, São Paulo, Brazil. METHODS: Cross sectional study with the administration of the Estudio Internacional de Sibilancias en Lactantes (EISL), which is a standardized and validated written questionnaire applied to parents and/or guardians of infants aged 12-24 months treated at primary health units, vaccination centers, day care centers, or kindergartens. The questionnaire consisted of questions regarding demographic characteristics, presence of wheezing, respiratory infections, and risk factors. Results were analyzed using the SPSS for Windows, 20.0 (SPSS Inc. - Chicago, Il, United States). Logistic regression was applied to verify variables associated to recurrent wheezing. RESULTS: Among the 1,028 infants studied, 48.5% had one or more episodes of wheezing during the first 12 months of life (wheezing once), and 23.9% had three or more episodes (recurrent wheezing). Nocturnal symptoms, severe breathing difficulty, and visits to the emergency room were observed in 67.3%, 42.4%, and 60.7% of infants, respectively. Among the studied infants, 19.4% were hospitalized, and 11.0% had a medical diagnosis of asthma in the first year of life. Use of ß2-agonists, inhaled corticosteroids, oral corticosteroids, and leukotriene receptor antagonists were observed in 88.8%, 21.0%, 54.9%, and 3.2% of children with wheezing, respectively. Use of oral corticosteroids, perception of breathlessness by parents, diagnosis of asthma, pneumonia, and hospitalization for pneumonia were more frequent among infants with recurrent wheezing (p<0.001). CONCLUSIONS: In the city of Santo André, approximately half of infants had at least one episode of wheezing in the first year of life, and almost 25% had recurrent wheezing. Wheezing disorders in Santo André have early onset and high morbidity.

Prevalência e gravidade da sibilância no primeiro ano de vida no município de Santo André / Prevalence and severity of wheezing in the first year of life in the city of Santo André, Brazil

Objetivo: Verificar a prevalência e a gravidade da sibilância no primeiro ano de vida em lactentes no município de Santo André. Métodos: Estudo transversal com aplicação de questionário escrito, padronizado e validado do estudo EISL (do espanhol: Estudio Internacional de Sibilancias en Lactantes) aos pais e/ou responsáveis por lactentes de 12 a 24 meses de idade, em unidades básicas de saúde, durante campanhas de vacinação em creches e escolas maternais. O questionário consiste de questões sobre características demográficas, presença de sibilância, infecções respiratórias e fatores de risco. Os dados obtidos foram analisados com o Statistical Package for the Social Sciences for Windows, versão 20.0 (SPSS inc., Chicago, Il, EUA). A regressão logística foi aplicada para analisar as variáveis associadas à presença de sibilos recorrentes. Resultados: Do total de 1.028 lactentes estudados, 48,5% apresentaram um ou mais episódios de sibilância nos primeiros 12 meses de vida (sibilância alguma vez) e 23,9%, três ou mais episódios (sibilância recorrente). Sintomas noturnos, dificuldade intensa para respirar e visitas à emergência estiveram presentes em 67,3%, 42,4% e 60,7% dos lactentes, respectivamente, sendo que 19,4% foram hospitalizados e 11,0% tiveram diagnóstico médico de asma. O uso de β2-agonistas, corticoides inalatórios, corticoides orais e antagonistas do receptor de leucotrienos foram observados em 88,8%, 21,0%, 54,9% e 3,2% das crianças com sibilância, respectivamente. Uso de corticoide oral, percepção de falta de ar pelos pais, diagnóstico de asma, pneumonia e hospitalização por pneumonia foram mais frequentes entre os sibilantes recorrentes (p<0,001). Conclusões: No município...

Objective: To determine the prevalence and the severity of wheezing in the first year of life for infants who live in Santo André, São Paulo, Brazil. Methods: Cross sectional study with the administration of the Estudio Internacional de Sibilancias en Lactantes (EISL), which is a standardized and validated written questionnaire applied to parents and/or guardians of infants aged 12-24 months treated at primary health units, vaccination centers, day care centers, or kindergartens. The questionnaire consisted of questions regarding demographic characteristics, presence of wheezing, respiratory infections, and risk factors. Results were analyzed using the SPSS for Windows, 20.0 (SPSS Inc. - Chicago, Il, United States). Logistic regression was applied to verify variables associated to recurrent wheezing. Results: Among the 1,028 infants studied, 48.5% had one or more episodes of wheezing during the first 12 months of life (wheezing once), and 23.9% had three or more episodes (recurrent wheezing). Nocturnal symptoms, severe breathing difficulty, and visits to the emergency room were observed in 67.3%, 42.4%, and 60.7% of infants, respectively. Among the studied infants, 19.4% were hospitalized, and 11.0% had a medical diagnosis of asthma in the first year of life. Use of β2-agonists, inhaled corticosteroids, oral corticosteroids, and leukotriene receptor antagonists were observed in 88.8%, 21.0%, 54.9%, and 3.2% of children with wheezing, respectively. Use of oral corticosteroids, perception of breathlessness by parents, diagnosis of asthma, pneumonia, and hospitalization for pneumonia were more frequent among infants with recurrent wheezing (p<0.001). Conclusions: In the city of Santo André, approximately half of infants had at least one episode of wheezing in the first year of life, and almost 25% had recurrent wheezing. Wheezing disorders in Santo André have early onset and high morbidity...