Prevalência, incidência e caracterização sociodemográfica e clínica das pessoas com estoma de eliminação em Portugal / Prevalence, incidence, and sociodemographic and clinical characterization of individuals with an intestinal or urinary stoma in Portugal / Prevalencia, incidencia y caracterización sociodemográfica y clínica de las personas con ostomía de eliminación en Portugal

Resumo Enquadramento: Dados que caracterizam as pessoas com estoma em Portugal são escassos. Estabelecer estimativas epidemiológicas pode melhorar o conhecimento sobre esta população e adaptar modelos de cuidados de saúde. Objetivos: Estimar a prevalência e incidência de pessoas com estoma de eliminação em Portugal em 2021. Metodologia: Estudo observacional, longitudinal e retrospetivo, a partir de uma base de dados de dispensa de dispositivos para ostomia. Resultados: Em 2021, o número estimado de pessoas com pelo menos um estoma foi de 22.045. Entre estes, 19.793 [IC95%:19.599;19.994] tinham um estoma de eliminação. Na sua maioria eram homens (61,4%), em média tinham 70,5 anos e residiam preferencialmente na região interior do país. O tipo de estoma de eliminação mais prevalente foi a colostomia (48,8%). A incidência estimada de novos casos foi de 6.622, sendo 5.834 [IC95%:5.680;5.984] referentes a estomas de eliminação. Conclusão: Estes resultados permitiram caracterizar o perfil das pessoas com estoma de eliminação em Portugal. Poderão ser úteis para ajustar os programas de prevenção/acompanhamento em saúde desta população e ainda alocar recursos especializados.

Abstract Background: Data characterizing individuals with a stoma in Portugal is limited. Establishing epidemiological estimates can enhance understanding of this population and facilitate the adaptation of healthcare models. Objectives: To estimate the prevalence and incidence of individuals in Portugal who have undergone intestinal or urinary ostomy in 2021. Methodology: Observational, longitudinal, and retrospective study using a stoma appliance dispensing database. Results: In 2021, an estimated 22,045 individuals had at least one stoma, with 19,793 [95%CI:19,599;19,994] having an intestinal/urinary stoma. Most of these individuals were men (61.4%) with a mean age of 70.5 years and resided in the inland region of Portugal. Colostomy was the most prevalent type of intestinal/urinary stoma (48.8%). The estimated incidence of new cases was 6,622, of which 5,834 [95%CI:5,680;5,984] were intestinal/urinary stomas. Conclusion: These results characterize the profile of individuals with intestinal and urinary stomas in Portugal. They may be useful in adjusting prevention and health monitoring programs for this population and allocating specialized resources.

Resumen Marco contextual: Los datos que caracterizan a las personas con estomas en Portugal son escasos. Establecer estimaciones epidemiológicas puede mejorar el conocimiento sobre esta población y adaptar modelos sanitarios. Objetivos: Estimar la prevalencia y la incidencia de personas con estoma de eliminación en Portugal en 2021. Metodología: Estudio observacional, longitudinal y retrospectivo, basado en una base de datos de dispensaciones de dispositivos de ostomía. Resultados: En 2021, el número estimado de personas con al menos un estoma era de 22.045, de las cuales 19.793 [IC95%:19.599;19.994] tenían un estoma de eliminación. La mayoría de ellos eran hombres (61,4%), tenían una edad media de 70,5 años y vivían principalmente en el interior del país. El tipo de estoma de eliminación más frecuente era la colostomía (48,8%). La incidencia estimada de nuevos casos fue de 6.622, de los cuales 5.834 [IC95%:5.680;5.984] eran estomas de eliminación. Conclusión: Estos resultados han permitido caracterizar el perfil de las personas con estoma de eliminación en Portugal. Podrían ser útiles para ajustar los programas de prevención/seguimiento de la salud de esta población y para asignar recursos especializados.

Refractive errors in Tianjin youth aged 6-18 years: exploring urban-rural variations and contributing factors.

Purpose: Refractive errors, particularly myopia, constitute a significant global public health concern, contributing to morbidity and disability. A more comprehensive understanding of the determinants of refractive errors and the differences between urban and rural areas is essential to develop effective preventive measures for youth. This study aimed to compare the prevalence and risk factors of refractive errors among youth in urban and rural Tianjin, China. Methods: This school-based cross-sectional study was conducted in 2022. Elementary, middle, and high school students aged 6-18 years from both urban and rural areas of Tianjin were included. All participants underwent visual acuity testing and refractive measurement and completed comprehensive questionnaires. Results: A total of 346,146 participants (176,628 boys) were included in this investigation (50.36% for urban and 49.64% for rural, respectively). Myopia, hyperopia, astigmatism, and anisometropia were present in 56.8, 9.7, 56.64, and 21.3% of urban students, respectively. Similarly, rural students had a prevalence of 57.6, 11.5, 56.48, and 22.0% for the respective conditions. Compared to rural students, after adjusting for age, sex, and other significant variables, urban students were 1.05 times more likely to have myopia (95% CI: 1.03-1.07, p < 0.0001), 0.71 times less likely to have hyperopia (95% CI: 0.69-0.73, p < 0.0001), and 1.02 times more likely to have astigmatism (95% CI: 0.69-0.73, p < 0.0001). There was no significant association between anisometropia and residence (OR: 1.00, 95% CI: 0.98-1.02, p = 0.9850). Sociodemographic and physiological factors contribute to the disparities in the prevalence of refractive errors between urban and rural areas. Age, increased near-work activities, and Decreased outdoor time were identified as risk factors for myopia, astigmatism, and anisometropia. Conversely, the absence of a parental history of refractive errors emerged as a protective factor for myopia and astigmatism among students. Lower parental education levels were negatively correlated with the risk of myopia and anisometropia in their children. Specifically, the lower the parental education, the greater the risk of myopia in their offspring. For urban students only, lower parental education was associated with an increased risk of astigmatism. Conclusion: Crude prevalence estimates May not accurately reflect the true burden of refractive error due to confounding factors such as age and sex. Accounting for these factors revealed that urban students were more likely to have myopia and astigmatism but less likely to have hyperopia compared to their rural counterparts. These disparities highlight the importance of considering geographical variations when implementing strategies for myopia control and prevention.

Global prevalence of depression, anxiety, and stress in the elderly population: a systematic review and meta-analysis.

BACKGROUND: Several preliminary studies have been conducted in the field of the prevalence of depression, anxiety, and stress in the elderly population. These studies have examined the prevalence in limited geographic areas with small sample sizes. Also, there are many limitations in the meta-analysis studies. The objective of the present study was to synthesize the global prevalence statistics of depression, anxiety, and stress in the elderly population through a systematic review and meta-analysis. METHODS: The present systematic review included retrieval of primary studies from the oldest relevant study up to 2023. To find the relevant studies, international databases such as Scopus, Embase, PubMed, and Web of Science (WoS) were systematically searched. Also, a manual search was performed through the Google Scholar search engine and a review of the sources of related articles. The qualitative assessment of the studies was conducted using the Joanna Briggs Institute (JBI) checklist. Due to a high heterogeneity among the study results, a Random Effects model was chosen. RESULTS: A total of 42 articles on depression, 47 articles on anxiety and 13 articles on stress were included in the meta-analysis. The overall estimates for prevalence based on a random-effects model were as follows: depression, 19.2% (95% CI: 13.0 - 27.5%); anxiety, 16.5% (95% CI: 11.1 - 22.8%); and stress, 13.9% (95% CI: 5.5 - 30.9%). The highest prevalence of depression and anxiety was recorded in Africa. The prevalence of depression was higher in nursing homes, and stress was more prevalent in individuals with COVID-19 compared to other populations. CONCLUSION: The findings revealed a high prevalence of depression, anxiety, and stress in the elderly population. Therefore, it is recommended that healthcare professionals and policymakers pay more attention to the prevention and management of these disorders in the elderly population.

Prevalence and management of cataracts among older adults in Sub-Saharan Africa: a scoping review.

INTRODUCTION: Cataract is a leading cause of visual impairment and blindness, mainly affecting older adults in sub-Saharan Africa (SSA). This scoping review aims to map evidence on the prevalence, contextual factors, and management strategies for cataracts among older adults in SSA. METHOD: Four central databases (PubMed, Scopus, Medline, and Google Scholar) were searched, yielding 383 records. Additional searches produced eight records. After screening and applying inclusion criteria, 26 full-text articles were eligible for further review. Finally, seven full-text records were included in the thematic analysis and synthesis. RESULTS: Cataract prevalence among older adults in SSA ranged from  13.5-62.5% across different countries. Surgery remains the primary management strategy, but cataract surgical coverage varies widely (12.1-96%). Significant barriers to effective management include lack of awareness, limited access to healthcare, economic constraints, gender disparities, and cultural misconceptions about cataract surgery. CONCLUSION: There is a significant burden of cataracts among older adults in SSA, with considerable variations in prevalence and surgical coverage across the region. Comprehensive strategies addressing awareness, accessibility, affordability, and cultural factors are needed to improve cataract management and reduce visual impairment in SSA.

Global resurgence of pertussis: A perspective from China.

Pertussis (or whooping cough) is a highly infectious acute respiratory disease primarily caused by Bordetella pertussis, which is also one of the most important causes of infant death worldwide. The widespread use of vaccines has greatly reduced the morbidity and mortality of pertussis. However, since the 1980s, in a number of countries with high vaccine coverage, the incidence of pertussis has risen again after remaining low for many years, with outbreaks even occurring in some areas. The peak onset of pertussis is shifting from infancy to adolescence, and adolescence is becoming the main source of infection for infants. Despite the increasing incidence of pertussis, serological findings suggest that the true prevalence of the disease may be significantly underestimated. Therefore, in this narrative review, we summarize the pathogenic process and immune characteristics of bacteria, the diagnosis and treatment of diseases, as well as vaccination and prevalence of pertussis at home and abroad, and attempt to analyze the causes and influencing factors of pertussis resurgence and summarize some prevention and control strategies to assist in improving the understanding of pertussis and preventing unexpected outbreaks.

Skin diseases among adults in Tasiilaq, East Greenland.

Cold climate and unique genetic and environmental factors may influence the prevalence of skin diseases in Greenland. However, there is a lack of epidemiological studies on skin diseases in the adult Greenlandic population. To address this unmet need a cross-sectional study, run by dermatologists from Denmark, the UK, and Switzerland estimated the prevalence and clinical manifestations of skin diseases among adults in East Greenland in May 2022. All adults ≥18 years in the town of Tasiilaq were invited, and 295 individuals aged 18-78 years participated (22.5% of the overall adult population in Tasiilaq). Two-hundred and three participants (69%) had visible signs of current skin disease, and among these, 242 cases of dermatoses were identified. The most common skin diseases were hand eczema (22.4%), lichen simplex (9.5%), discoid eczema (7.1%), psoriasis, atopic dermatitis and acne vulgaris (5.8% each). Scabies was the most frequent infectious skin disease (4.4%). No cases of skin cancer were identified. Atopic dermatitis and psoriasis presented with disease that was of limited extent and different from the classical presentations. Skin diseases showed a high prevalence among adults in East Greenland, and some of them were severe. This indicates a noteworthy public health problem that warrants better access to dermatologist support.

Prevalence of Tourette syndrome among children and adolescents in the United States, 2016-2022.

BACKGROUND: Tourette syndrome (TS) is a neurodevelopmental disorder. The prevalence of TS in 2016-2017 has been reported; however, little is known about the current prevalence and trend in children and adolescents with TS. This study aimed to estimate the prevalence and trend of Tourette syndrome (TS) among US children and adolescents aged 0-17 years from 2016 to 2022. METHODS: We analyzed data from a nationally representative sample of 278,472 children and adolescents aged 0-17 years who participated in the 2016-2022 National Survey of Children's Health (NSCH), a nationwide, population-based, cross-sectional survey of US children and adolescents. TS was defined as the affirmative response in the questionnaire completed by a parent or guardian. RESULTS: Among the 278,472 children and adolescents enrolled, 754 had been diagnosed with TS, with an overall prevalence of 0.23% in all children and adolescents aged 0-17 years. The weighted prevalence by age group was lower than 0.01% in children aged 0-2 years, 0.05% in children aged 3-5 years, 0.28% in children aged 6-11 years, and 0.38% in adolescents aged 12-17 years. There were significant sex and racial/ethnic differences in the overall prevalence of diagnosed TS (i.e., 0.35% in boys and 0.11% in girls, 0.22% in Hispanics, 0.28% in non-Hispanic whites and 0.16% in non-Hispanic blacks). There was no significant change in the estimated prevalence of TS from 2016 to 2022. CONCLUSION: Based on nationally representative data, this study found that the national prevalence of TS among the US children and adolescents differed by sex and race/ethnicity but remained stable from 2016 to 2022.

Prevalence and influencing factors of malnutrition in diabetic patients: A systematic review and meta-analysis.

The prevalence of malnutrition in diabetic patients and its influencing factors remain poorly described. We aim to investigate the prevalence of malnutrition and the influencing factors in diabetic patients through meta-analysis. Utilizing search terms, such as diabetes, malnutrition, and prevalence, we systematically searched eight databases, including Embase, PubMed, Web of Science, The Cochrane Library, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Chinese Biomedical Database (CBM), and VIP Database, from inception to May 4, 2023. The search aimed to identify studies related to the prevalence of malnutrition and its influencing factors in adult patients with diabetes. Cohort studies, case-control studies, and cross-sectional studies that met the inclusion criteria were included in the analysis. Stata 16.0 software was used for meta-analysis. Quality of the evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). The study protocol is registered with Prospective Register of Systematic Reviews (PROSPERO), CRD42023443649. A total of 46 studies were included, involving 18 062 patients with ages ranging from 18 to 95 years. The overall malnutrition prevalence was 33% (95% confidence interval [CI]: 0.25-0.40), compared with an at-risk prevalence of 44% (95% CI: 0.34-0.54). Sixteen factors associated with malnutrition in diabetic patients were identified. This meta-analysis provides insights into the prevalence of malnutrition and its risk factors in diabetic patients. Regular nutritional screening for patients with risk factors is essential for early detection and intervention.

Prevalence of internet gaming disorder among Chinese adolescents: A systematic review and meta-analysis.

This study aimed to evaluate the prevalence of IGD among Chinese adolescents. Articles published up to April 11, 2024 were retrieved from PubMed, Wiley Online Library, Embase, Web of Science, Ebsco, CNKI, and WanFang. Random-effects models and univariate meta-regression analyses were used to calculate prevalence and heterogeneity estimates with the support of Stata17.0 software. The prevalence of IGD in Chinese adolescents was 10 % (95 %CI: 8 %-12 %). Univariate regression analyses revealed some significant moderators of IGD prevalence, including gender, sample size, and survey year. Spatiotemporal analysis showed the prevalence of IGD varied considerably across provinces in different survey years.

Estimating the prevalence of chronic kidney disease in the older population using health screening data in Japan.

BACKGROUND: In aging societies, the prevalence of chronic kidney disease (CKD) is expected to increase but may be underestimated because many asymptomatic patients remain undiagnosed. This study aimed to estimate the CKD prevalence among the general older population in Japan. METHODS: This cross-sectional study used health screening data from the Japan Health Insurance Association collected between April 2014 and March 2023. Data from older people aged 65-90 years who underwent renal function screening for estimated glomerular filtration rate (eGFR) and urine protein tests were analyzed. CKD was defined as eGFR < 60 mL/min/1.73 m2 or proteinuria ≥ 1 + . Inverse probability weighting was used to account for the selection bias. The variables used for weighting were age, sex, insurance status, and the number of previous screenings. RESULTS: Among 2.98 million older individuals, 588,809 (19.7%) had undergone screening (median [IQR] age, 69.9 [67.9-76.2] years, 337,862 women [57.4%]). Regarding the weighted CKD prevalence, 25.3% of the individuals aged 65-90 years had CKD; 11.8% of those aged 65-75 years and 34.6% of those aged 75 years and over showed an increase in prevalence with age. Among the patients with CKD, over half exhibited mild renal dysfunction without proteinuria. Hypertension and diabetes were common comorbidities in older patients with CKD. CONCLUSIONS: This cross-sectional study revealed that the weighted prevalence of CKD in the older population aged 65-90 years was high (one in four individuals), indicating that it increases with age. Further studies are required to examine the clinical significance of these findings.

Epilepsy trends in Kazakhstan: A retrospective longitudinal study using data from unified national electronic health system 2014-2020.

OBJECTIVE: This study is designed to estimate the epidemiology of epilepsy in Kazakhstan, using a large-scale administrative health database during 2014-2020. METHODS: Using the Unified National Electronic Health System of Kazakhstan over a seven-year span, we explored incidence and prevalence rates, disability-adjusted life years (DALY), and all-cause mortality. Regression models using Cox proportional hazards were used to analyze the sociodemographic, mental, behavioral, and neurological factors affecting survival. Overall analyses were performed using STATA (V.16). RESULTS: The total cohort comprised of 82,907 patients, with a significant increase in the incidence of epilepsy from 26.15 in 2014 to 88.80 in 2020 per 100,000 people. Similar trends were observed in the prevalence rates, which tripled from 26.06 in 2014 to 73.10 in 2020. While mortality rates fluctuated, the elderly and children had the greatest rates of 9.97 and 2.98 per 1000 person-years respectively. DALYs revealed a substantial disease burden, with 153,532 DALYs (824.5 per 100,000) being lost during the study period. A few comorbidities, such as cerebral palsy (adjusted hazard ratio (aHR) 2.23) and central nervous system atrophy (aHR, 27.79), markedly elevated all-cause mortality. Furthermore, extrapyramidal and movement disorders (aHR 2.16, p = 0.06) and demyelinating diseases of the central nervous system (aHR 6.36, p = 0.06) showed a trend toward increased mortality risk. CONCLUSION: To the best of our knowledge, this is the first study from Central Asia exploring a large epilepsy cohort. The findings highlight the need for targeted interventions to address the growing burden of epilepsy, particularly among children, male sex, and those with neurological comorbities.

Exploring Histoplasma species seroprevalence and risk factors for seropositivity in The Gambia's working equid population: Baseline analysis of the Tackling Histoplasmosis project dataset.

Introduction: Exposure rates to Histoplasma species, the causative agent of equine epizootic lymphangitis (EL), are unknown amongst working equids in The Gambia. The primary aims of this study were to estimate anti-Histoplasma antibody seroprevalence in the equid population in rural The Gambia and to explore risk factors for seropositivity. Methods: A nationwide cross-sectional study was conducted (February-July 2022), representing baseline measurements of a longitudinal cohort study. Horses (n = 463) and donkeys (n = 92) without EL signs were recruited in 18 study sites. Following informed owner consent, equid clinical and management data were recorded. Blood samples were collected by jugular venepuncture, and sera were subject to the IMMY Latex Agglutination Histoplasma test (LAT). Seropositivity risk factors were explored by multi-level, multivariable logistic regression analysis. Study site and household variance were described using a latent-variable approach. Whole blood DNA extractions were subject to nested ITS-PCR to detect Histoplasma capsulatum var. farciminosum (HCF), and agreement with LAT results was measured using Cohen's kappa statistic. Results: Anti-Histoplasma antibody seroprevalence in horses and donkeys was 79.9% [95% confidence interval (CI) 76.0-83.5%] and 46.7% (95% CI 36.3-57.4%), respectively. In horses, two multivariable models explained the maximum amount of data variability. Model 1 demonstrated increased odds of seropositivity in mares [odds ratio (OR) = 2.90 95% CI 1.70-4.95, p < 0.001] and decreased odds in horses <2.5 years (OR = 0.46 95% CI 0.22-0.95, p = 0.04; reference: ≥4.5 years). Model 2 demonstrated increased odds in horses recruited during the rainy season (OR = 2.03 95% CI 1.08-3.84, p = 0.03) and those owned by farmers reporting previous EL in their equids (OR = 1.87 95% CI 1.04-3.37, p = 0.04). Decreased odds were measured in horses <2.5 years (OR = 0.37 95% CI 0.18-0.78, p = 0.01) and horses reported to transport firewood (OR = 0.45 95% CI 0.28-0.74, p = 0.001). On multivariable analysis of donkeys, decreased odds of seropositivity were demonstrated amongst donkeys owned by households which also owned horses (OR = 0.23 95% CI 0.06-0.85, p = 0.03). HCF infection prevalence in horses and donkeys was 22.0% (n = 102/463, 95% CI 18.3-26.1%) and 5.4% (n = 5/92, 95% CI 1.8-12.2%), respectively. No significant agreement was measured between LAT and nested ITS-PCR results (κ < 0.00). Conclusion: High Histoplasma spp. exposure was demonstrated amongst equids in The Gambia. Investigation of risk factors, including equid husbandry and management strategies, as well as geoclimatic variations, is warranted. Outcomes may inform sustainable and equitable EL control strategies in The Gambia and comparable settings worldwide.

Prevalence of undiagnosed diabetes mellitus and its associated factors in urban Burkina Faso.

Background: Community screening could be an effective strategy for identifying people with undiagnosed type 2 diabetes mellitus (T2DM) in low-income countries. Aim: This study aimed to estimate the prevalence of undiagnosed T2DM and its risk factors. Setting: This study was conducted in Ouagadougou, the capital of Burkina Faso. Methods: This was a cross-sectional study, including consenting population (≥ 18 years). Data were collected from 11 November 2020 to 16 November 2020, in five fix sites after a 10-day information campaign on T2DM. The SD CodeFreeTM glucose analyser was used to diagnose T2DM. Multivariable logistic regression was used to identify the associate factors. Results: A total of 1200 (95%) volunteered out of 1330 people were enrolled, which included 667 (52.27%) women. The mean age was 34.16 years (standard deviation: 12.42). Overall, 40.28% were abdominally obese and 31.43% hypertensive. The prevalence of T2DM was 10.74% (95% confidence interval [95% CI]: 9.15; 12.56). In multivariate analysis, being aged or greater than 35 years (adjusted odds ratio [ORa]: 2.30; 95% CI: 1.42; 3.72), having a family history of diabetes (ORa = 1.55; 95% CI: 1.006; 2.40), being overweight (ORa = 1.69; 95% CI: 1.09; 2.62), being obese (ORa = 1.80; 95% CI: 1.08; 3.00), being a known hypertensive (ORa = 2.92 95% CI: 1.64; 5.19) and having high blood pressure on the day of the survey (ORa = 1.86; 95% CI: 1.22; 2.85) increased significantly the probability to present T2DM. Conclusion: Community screening is useful to identify T2DM. A national programme to control diabetes mellitus and its associated risk factors is urgently needed in Burkina Faso. Contribution: This study will enable early detection of diabetes mellitus and its management in order to prevent or delay the onset of complications.

Assessing the Relationship Between Sleep Duration and the Prevalence of Chronic Kidney Disease Among Veterans in the United States: A 2022 Behavior Risk Factor Surveillance System (BRFSS) Cross-Sectional Study.

INTRODUCTION: Chronic kidney disease (CKD) is more prevalent among veterans in the United States than in the general population. Similarly, veterans also exhibit higher rates of abnormal sleep duration compared to the general population. The aim of this study was to investigate the association between self-reported length of sleep and the prevalence of CKD among veterans in the United States using responses from the 2022 Behavioral Risk Factor Surveillance System (BRFSS). METHODS: For this cross-sectional study, a total of 53,211 veterans who responded to the 2022 BRFSS survey were analyzed. Measures include the outcome variable which is self-reported CKD diagnosis and a major independent variable sleep duration. Sleep duration was recategorized into ≤ 5 hours (short sleep duration), 6-10 hours (normal sleep duration), and >10 hours (long sleep duration). Covariates included gender, age, race, residence, insurance, alcohol consumption, diabetes comorbidity, coronary artery disease (CAD) comorbidity, and stroke comorbidity. Descriptive, bivariate, and multivariate logistic regressions were conducted using the SAS software (SAS Institute Inc., Cary, North Carolina, United States).  Results: The prevalence of CKD among veterans in the United States is 3332 (6.29%). Veterans with sleep duration of 6-10 hours had 17.5% lower odds of CKD than veterans who slept for ≤5 hours (adjusted OR (AOR)= 0.825, 95%CI= 0.821-0.830; P=<0.0001). Veterans who slept for more than 10 hours had 68.2% higher odds of having CKD (AOR=1.682, 95%CI= 1.662-1.702; P=<0.0001). Additionally, veterans diagnosed with diabetes, stroke, and coronary artery disease had 2.447-2.103, and 2.838, respectively, higher odds of developing CKD (AOR=2.447, 95%CI= 2.435-2.459; p=<0.0001). Veterans who were 65 years and older had higher odds of developing CKD compared to those aged 35-44 years (AOR= 5.743, 95%CI= 5.669-5.818; P<0.001). The odds of having CKD were also higher among veterans who identified as Black (AOR 1.397, 95%CI =1.388-1.405; P<0.01) or as Hispanic (AOR =1.318, 95%CI = 1.307-1.329; P<0.01) compared to non-Hispanic White veterans. Those who identified as Asian had lower odds of CKD (AOR= 0.87, 95%CI=0.853-0.888; P<0.01). Furthermore, veterans who consumed alcohol had 7.8% lower odds of having CKD as compared to individuals who did not consume alcohol (AOR= 0.922, 95%CI =0.918-0.927; p=<0.0001). Male veterans had 24.7% lower odds of having CKD as compared to female veterans (AOR = 0.753, 95%CI= 0.747-0.758; P<0.001).  Conclusion: This research provides evidence of a greater prevalence of CKD among veterans with short sleep duration (≤ 5 hours) and long sleep duration (> 10 hours). Sleep hygiene education and sleep optimization programs can improve sleep and boost overall kidney health among veterans.

Prevalence and gender - specific analysis of a systemic sclerosis cohort in Latvia.

BACKGROUND: Systemic sclerosis (SSc) is considered by many to be one of the most severe autoimmune rheumatic diseases with lower prevalence observed in Northern Europe. No previous studies on the prevalence of SSc in Latvia have been conducted and the aim was to study the demographic and clinical data of patients with SSc in northeastern Europe country. METHODS: This study was conducted in two main Latvian hospitals for adults and includes patients with SSc who were consulted between 2016 and 2021. RESULTS: During the study period, 159 patients with SSc were consulted. The point prevalence on 1 January 2021 was 84.0 per million. Female to male ratio was 4.67:1, and highest gender ratio was observed in the age group 70-79-year (6.75:1). Antinuclear antibodies were present in 82.58% of patients, without gender difference. Centromere pattern was more frequently observed in females (40.19% vs. 19.04%), in contrast to speckled pattern (50.98% vs. 57.14%). At disease onset females tended to be younger (46.51 ± 13.52) than males (50.5 ± 16.64). Males had more diffuse cutaneous subtype, interstitial lung disease, pulmonary hypertension and esophageal dysmotility. More than half of patients received treatment with glucocorticoids at any point of the disease (68.31%), without gender difference. CONCLUSIONS: Systemic sclerosis is less common in Latvia than in other countries and regions. Due to its location, the data from Latvia are consistent with a north-south gradient in Europe. Gender ratio differences persisted in older age groups as well. Antinuclear antibodies presence did not differ between genders, but in female's centromere pattern was much more likely to be present. Males had more severe disease course, but in both genders more than half of patients received treatment with GCs at any point of the disease.

Prevalence Estimation of Dementia/Alzheimer's Disease Using Health and Retirement Study Database in the United States.

BACKGROUND: Updated prevalence estimates along the continuum of Alzheimer's disease (AD) can foster a more nuanced and effective approach to managing AD within the current healthcare landscape. OBJECTIVES: This study aims to estimate the prevalence and severity distribution of dementia/AD (including mild, moderate, and severe stages) and all-cause mild cognitive impairment (MCI) in the United States using data from the Health and Retirement Study (HRS). DESIGN: Retrospective study. SETTING: Data from the bi-annual HRS surveys involving in-depth interviews of a representative sample of Americans aged >50 years. PARTICIPANTS: Dementia/AD and all-cause MCI patients from the 4 most recent HRS surveys (2014, 2016, 2018 and 2020). MEASUREMENTS: AD was identified based on diagnosis (self-report). Cognitive performance (modified Telephone Interview of Cognitive Status [TICS-m]) scores in the dementia/AD range were also captured; all-cause MCI was similarly identified using the TICS-m. Dementia/AD and MCI prevalence, as well as the distribution by dementia/AD stage (mild, moderate, or severe), were estimated. Sampling weights developed by HRS were applied to ensure the sample's representativeness of the target population and unbiased estimates for population parameters. RESULTS: Across the four HRS surveys, the total number of HRS respondents ranged from 15,000 to 21,000 (unweighted); 7,000 to 14,000 had TICS-m scores. The estimated prevalence of AD (all severity categories combined) in the 2014, 2016, 2018, and 2020 HRS surveys was 1.2%, 1.2%, 1.3% and 1.0%, respectively using the diagnosis-based approach; using the cognitive performance-based approach, 23-27% patients had scores in the dementia/AD ranges across the 4 surveys. The estimated prevalence of all-cause MCI was consistently 23% in each survey. In the 2020 survey, the distribution of mild, moderate, and severe disease stages was 34%, 45%, and 21%, respectively, in patients self-reporting an AD diagnosis, and 55%, 40%, and 5%, respectively in all patients meeting TICS-m threshold for dementia/AD. CONCLUSION: The prevalence of AD diagnosis based on self-report was approximately 1% across the 4 most recent HRS surveys and may reflect the proportion of patients who have actively sought healthcare for AD. Among HRS survey respondents with cognitive scores available, over 20% were in the dementia/AD range. The distribution of disease by stage differed for self-reported AD diagnosis vs dementia/AD based on cognitive scores. Discordance in estimates of dementia/AD and stage distributions underscores a need for better understanding of clinical practice patterns in AD diagnosis, use of clinical assessment tools, and severity classification in the United States. Accurate patient identification is needed, especially early in the AD disease continuum, to allow for timely and appropriate initiation of new anti-amyloid treatments.

Cachexia in tuberculosis in South-East Asian and African regions: knowledge gaps and untapped opportunities.

Tuberculosis (TB) and cachexia are clinical entities that have a defined relationship, making them often found together. TB can lead to cachexia, while cachexia is a risk factor for TB. This article reviews cachexia in Tuberculosis patients in Southeast Asian and African regions by conducting a comprehensive literature search across electronic databases such as PubMed, Google Scholar, and Research Gate between 2013 and 2024 using keywords including 'Africa', 'cachexia', 'prevalence', 'implications', 'tuberculosis', and 'Southeast Asia. This article utilized only studies that satisfied the inclusion criteria, revealing knowledge gaps and untapped opportunities for cachexia in TB across Southeast Asian and African regions. Many Southeast Asian and Western Pacific patients initially receive a tuberculosis diagnosis. Sub-Saharan African countries are among the 30 high TB burden nations, according to the WHO. Food inadequacy and heightened energy expenditure can impair the immune system, leading to latent TB and subsequently, active infection. Symptoms needing attention: shortness of breath, productive cough, hyponatremia at 131 mmol/l, hypoalbuminemia at 2.1 g/dl, elevated aspartate transaminase at 75 U/l, increased lactate dehydrogenase at 654, and normocytic anemia. Comorbidities, such as kidney disease, cardiovascular disease, and asthma, can influence the nutritional status of individuals with TB. While efforts like screening, contact tracing, and utilizing gene Xpert to detect TB cases were implemented, only a few proved effective. It is essential to conduct further studies, including RCTs, in Southeast Asia and Africa to evaluate and manage cachexia in TB patients.

Post-traumatic stress disorder among military personnel admitted at the Northwest Command Level Three Military Hospital, Bahir Dar, Ethiopia, 2022: an institution-based cross-sectional study.

Background: Post-traumatic stress disorder (PTSD) is one of the most common mental health problems that military personnel encounter. It could be lifelong and affect every aspect of military personnel, including their mental and physical health, family and social interactions, and their work. However, in Ethiopia, the magnitude and its associated factors have not been well investigated. Objective: This study aimed to determine the prevalence of PTSD and its associated factors among military personnel, who were admitted at the Northwest Command Level Three Military Hospital, Bahir Dar, Northwest, Ethiopia, 2022. Methods: An institution-based cross-sectional study was conducted from 21 June to 21 July 2022, at the Northwest Command Level Three Military Hospital. A computer-generated simple random sampling technique was used to select a total of 627 participants. The 17-item Military Version Checklist was utilized to measure PTSD. The Patient Health Questionnaire, Brief Resilience Coping, and Critical War Zone Experience scale were utilized to measure depression, resilience, and combat exposure, respectively. Descriptive, bivariate, and multivariate binary logistic regressions with odds ratios and a 95% confidence interval were used. The level of significance of the association was determined at a p-value < 0.05. Results: A total of 612 respondents participated, with a response rate of 97.6%. The prevalence of PTSD in this study was 21.9% (95% CI: 18.6, 25.2). In multivariable regression, female sex [adjusted odds ratio (AOR) = 2.3, 95% CI; 1.3, 3.87], combat personnel (AOR = 2.75, 95% CI; 1.44, 6.36), handling dead bodies (AOR = 2.5, 95% CI,1.24, 5.02), having 4-5 deployments (AOR = 2.94, 95% CI, 1.63, 5.32), having ≥6 deployments (AOR = 3.4, 95% CI, 1.95, 6.17), low resilience coping (AOR = 2.02, 95% CI; 1.16, 3.53), poor social support (AOR = 2.46, 95% CI, 1.39, 4.35), very high combat exposures (AOR = 4.8, 95% CI, 2.03, 11.93), and depression (AOR = 2.8, 95% CI, 1.68, 4.67) were significantly associated with PTSD. Conclusion: PTSD is markedly prevalent among the Ethiopian military population, with key risk factors identified as being female, poor social support, low resilience coping skills, handling dead bodies, multiple deployments (four or more), high combat experiences, and depression. Healthcare professionals must prioritize the early diagnosis and intervention of PTSD in vulnerable groups of military personnel.

Prevalence, Determinants, and Coping Strategies of Preoperative Anxiety Among Surgical Patients: A Cross-Sectional Study in Jazan, Saudi Arabia.

BACKGROUND: Preoperative anxiety is a prevalent concern among surgical patients, significantly impacting their well-being and recovery. Common sources of anxiety include fears related to pain, anesthesia, and surgical outcomes. Despite the importance of addressing this issue, there is limited research on preoperative anxiety in Jazan, Saudi Arabia. This study explores the prevalence, determinants, and coping strategies for preoperative anxiety among surgical patients in this region. METHODS: A cross-sectional study was conducted using an online survey distributed to patients scheduled for surgery at healthcare facilities in Jazan. The survey collected data on demographics, surgical history, anxiety symptoms, sources of anxiety, and coping strategies. Descriptive statistics were used to analyze the data. RESULTS: The study included 312 participants, primarily young adults aged 18-24 years. The majority reported experiencing anxiety symptoms such as nausea (47.8%), sweating (47.8%), and irritability (41.3%). Pain (54.2%), surgical outcomes (49.0%), and anesthesia (32.4%) were the most common sources of anxiety. Support from family and friends (66.7%) and relaxation techniques (26.6%) were identified as the most effective coping strategies. A significant proportion (71.8%) expressed a need for additional support. CONCLUSION: Preoperative anxiety is common among surgical patients in Jazan, driven mainly by concerns about pain, anesthesia, and surgical outcomes. Effective coping strategies include support from family and friends and relaxation techniques. There is a need for additional support resources to improve patient care and reduce anxiety.

Prevalence of Diastolic Dysfunction in Critically Ill Patients Admitted to Intensive Care Unit from a Tertiary Care Hospital: A Prospective Observational Study.

Aim: Critically ill individuals may have left ventricular diastolic dysfunction (LVDD) which can prolong their intensive care unit (ICU) stay. The purpose of this study was to determine the prevalence of LVDD in critically ill adult patients requiring mechanical ventilation in ICU, the effect of LVDD on 28-day survival, and weaning from mechanical ventilation. Methodology: A total of 227 adults who had been on mechanical ventilation for more than 48 hours in an ICU were recruited for this study. The study's parameters were recorded on the third day of mechanical ventilation using a low-frequency phased array probe. A simplified definition of LVDD in critically ill adults was utilized to determine the presence or absence of LVDD. Weaning failure and 28-day mortality were noted. Results: The prevalence of LVDD in adults requiring mechanical ventilation in the ICU was found to be 35.4% (n = 79). Patients with LVDD had the odds of having a 28-day mortality increase by 7.48 (95% CI: 3.24-17.26, p < 0.0001). Patients with LVDD had the odds of having weaning failure increase by 5.37 (95% CI: 2.17-13.26, p = 0.0003). Conclusion: Measures should be taken to detect critically ill adults with LVDD with systolic dysfunction or heart failure with preserved ejection fraction early so that their fluid balance, myocardial contractility, and afterload can be optimized to minimize their morbidity and mortality. Highlights: Critically ill adults with LVDD may have adverse outcomes. Hence, protocol should be in place for diagnosing LVDD early in critically ill adults thereby, measures can be taken to minimize morbidity in those patients. How to cite this article: Luitel B, Senthilnathan M, Cherian A, Suganya S, Adole PS. Prevalence of Diastolic Dysfunction in Critically Ill Patients Admitted to Intensive Care Unit from a Tertiary Care Hospital: A Prospective Observational Study. Indian J Crit Care Med 2024;28(9):832-836.