Epidemiology

摘要： BACKGROUND Diabetes rates among pregnant women in the United States have been increasing and are associated with adverse pregnancy outcomes.AIM To investigate differences in birth outcomes(preterm birth,macrosomia,and neonatal death)by diabetes status.METHODS Cross-sectional design,using linked Missouri birth and death certificates(singleton births only),2010 to 2012(n=204057).Exposure was diabetes non-diabetic,pre-pregnancy diabetes-insulin dependent(PD-I),pre-pregnancy diabetes-non-insulin dependent(PD-NI),gestational diabetes-insulin dependent(GD-I),and gestational diabetes-non-insulin dependent(GD-NI).Outcomes included preterm birth,macrosomia,and infant mortality.Confounders included demographic characteristics,adequacy of prenatal care,body mass index,smoking,hypertension,and previous preterm birth.Bivariate and multivariate logistic regression assessed differences in outcomes by diabetes status.RESULTS Women with PD-I,PD-NI,and GD-I remained at a significantly increased odds for preterm birth(aOR 2.87,aOR 1.77,and aOR 1.73,respectively)and having a very large baby[macrosomia](aOR 3.01,aOR 2.12,and aOR 1.96,respectively);in reference to non-diabetic women.Women with GDNI were at a significantly increased risk for macrosomia(aOR1.53),decreased risk for their baby to die before their first birthday(aOR 0.41)and no difference in risk for preterm birth in reference to non-diabetic women.CONCLUSION Diabetes is associated with the poor birth outcomes.Clinical management of diabetes during pregnancy and healthy lifestyle behaviors before pregnancy can reduce the risk for diabetes and poor birth outcomes.

摘要： BACKGROUND In contrast to many Western countries,China has maintained its large psychiatric hospitals.The prevalence and clinical characteristics of coronavirus disease 2019(COVID-19)in inpatients with schizophrenia(SCZ)are unclear.AIM To assess the prevalence of COVID-19 among inpatients with SCZ and compare the infected to uninfected SCZ patients in a Wuhan psychiatric hospital.METHODS We retrospectively collected demographic characteristics and clinical profiles of all SCZ patients with COVID-19 at Wuhan’s Youfu Hospital.RESULTS Among the 504 SCZ patients,84 had COVID-19,and we randomly sampled 174 who were uninfected as a comparison group.The overall prevalence of COVID-19 in SCZ patients was 16.7%.Among the 84 SCZ patients with confirmed COVID-19,the median age was 54 years and 76.2%were male.The most common symptom was fever(82%),and less common symptoms were cough(31%),poor appetite(20%),and fatigue(16%).Compared with SCZ patients without COVID-19,those with COVID-19 were older(P=0.006)and significantly lighter(P=0.002),and had more comorbid physical diseases(P=0.001).Surprisingly,those infected were less likely to be smokers(<0.001)or to be treated with dozapine(P=0.03).Further logistic regression showed that smoking[odds ratio(OR)=5.61],clozapine treated(OR=2.95),and male(OR=3.48)patients with relatively fewer comorbid physical diseases(OR=0.098)were at a lower risk for COVID-19.SCZ patients with COVID-19 presented primarily with fever,but only one-third had a cough,which might otherwise be the most common mode of transmission between individuals.CONCLUSION Two unexpected protective factors for COVID-19 among SCZ inpatients are smoking and dozapine treatment.

摘要： Non-alcoholic fatty liver disease(NAFLD)has emerged as the most common liver disorder worldwide mainly attributed to the epidemic spread of obesity and type 2 diabetes mellitus.Although it is considered a benign disease,NAFLD can progress to non-alcoholic steatohepatitis,liver cirrhosis and hepatocellular carcinoma(HCC).Most data regarding the epidemiology of NAFLD-related HCC are derived from cohort and population studies and show that its incidence is increasing as well as it is likely to emerge as the leading indication for liver transplantation,especially in the Western World.Although cirrhosis constitutes the main risk factor for HCC development,in patients with NAFLD,HCC can arise in the absence of cirrhosis,indicating specific carcinogenic molecular pathways.Since NAFLD as an underlying liver disease for HCC is often underdiagnosed due to lack of sufficient surveillance in this population,NAFLDHCC patients are at advanced HCC stage at the time of diagnosis making the management of those patients clinically challenging and affecting their prognostic outcomes.In this current review,we summarize the latest literature on the epidemiology,other than liver cirrhosis-pathogenesis,risk factors and prognosis of NAFLD-HCC patients.Finally,we emphasize the prevention of the development of NAFLD-associated HCC and we provide some insight into the open questions and issues regarding the appropriate surveillance policies for those patients.

摘要： The microbiome's role in transplantation has received growing interest,but the role of virome remains understudied.Pegiviruses are single-stranded positivesense RNA viruses,historically associated with liver disease,but their pathogenicity is controversial.In the transplantation setting,pegivirus infection does not seem to have a negative impact on the outcomes of solid-organ and hematopoietic stem cell transplant recipients.However,the role of pegiviruses as proxies in immunosuppression monitoring brings novelty to the field of virome research in immunocompromised individuals.The possible immunomodulatory effect of pegivirus infections remains to be elucidated in further trials.

摘要： Introduction: Schizoaffective disorder is a chronic psychotic disorder. It is characterized by the simultaneous presence of symptoms of a characterized mood disorder and symptoms of schizophrenia. Data on this disorder are almost non-existent in West Africa. The objective was to describe the epidemiological, clinical and therapeutic aspects of schizoaffective disorder at the Campus University Hospital Centre (CHU-Campus) of Lomé in Togo. Framework and Method: This was a retrospective study with a descriptive aim on patients hospitalized at the Clinic of Psychiatry and Medical Psychology (CPPM) of CHU-Campus from January 1st, 2013 to December 31, 2018. Results: A total of 46 patients were included in this study. Their mean age was 39.5 years with extremes ranging from 14 to 65 years. Females had predominated at 52.18% or a sex ratio of 0.91. Married people represented 47.83%. Primary education represented 34.80%. The unemployed were in the majority at 32.92%. Sixty-five point twenty two percent (65.22%) of the patients had a personal psychiatric history. All patients had presented with delusions plus other psychotic and mood symptoms. Almost all patients (97.82%) had received a thymoregulator associated with a first generation antipsychotic (95.65%). Conclusion: More studies should be done in our countries to describe the cultural aspects of this disease.

摘要： BACKGROUND Millions of people have died of coronavirus disease 2019(COVID-19)due to severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)infection,and retrospective studies of the disease in local regions are necessary.AIM To characterize the epidemiological features and dynamic changes in blood biochemical indices for SARS-Co V-2-infected patients in Hebi,a representative city with a large floating population in North China.METHODS From January 25 to February 10,2020,the clinical data of patients who tested positive for SARS-Co V-2 by quantitative real-time polymerase chain reaction in Hebi city(China)were evaluated at admission,and laboratory data for hematologic parameters,inflammatory indices,coagulation function indices,liver function indices,blood lipid indices,renal function indices,myocardial enzyme activities and five blood biochemical markers of immunity were evaluated at admission,upon hospitalization and before discharge.RESULTS Sixteen confirmed COVID-19 patients developed pneumonia but were cured after adequate treatment.Fever and fatigue were the common symptoms.The most common laboratory abnormalities of patients at admission were leukopenia,eosinopenia,decreased percentage of eosinophils,elevated high sensitivity C-reactive protein and fibrinogen levels,hypoalbuminemia,mildly increased aspartate transferase activity and levels of bilirubin,and increased levels ofβ2-microglobulin.Importantly,aggravated liver dysfunction was detected in most patients,which may be partially attributed to virus infection as well as medicinal treatment.CONCLUSION This study provides several potential diagnostic markers and dynamic biochemical indices of disease progression to better prevent,diagnose and treat COVID-19 infection.

摘要： BACKGROUND Type 1 diabetes(T1D)incidence varies substantially between countries/territories,with most studies indicating increasing incidence.In Western Pacific region(WPR),reported rates are much lower than European-origin populations.In contrast,there are reports of substantial numbers of young people with type 2 diabetes(T2D).A deeper understanding of T1D and T2D in the WPR may illuminate factors important in pathogenesis of these conditions.Furthermore,with varying resources and funding for diabetes treatment in this region,there is a need to more clearly determine the current burden of disease and also any gaps in knowledge.AIM To compile and summarise published epidemiologic and phenotypic data on childhood diabetes in non-European populations in and from WPR.METHODS Research articles were systematically searched from PubMed(MEDLINE),Embase,Cochrane library,and gray literature.Primary outcome measures were incidence and prevalence,with secondary measures including phenotypic descriptions of diabetes,including diabetes type categorization,presence of diabetic ketoacidosis(DKA)at onset,autoantibody positivity,Cpeptide levels,and human leucocyte antigen phenotype.Extracted data were collected using a customized template.Three hundred and thirty relevant records were identified from 16 countries/territories,with analysis conducted on 265(80.3%)records published from the year 2000.RESULTS T1D incidence ranged from<1-7.3/100000 individuals/year,rates were highest in emigrant/mixed populations and lowest in South-East Asia,with most countries/territories(71.4%)having no data since 1999.Incidence was increasing in all six countries/territories with data(annual increases 0.5%-14.2%,highest in China).Peak age-of-onset was 10-14 years,with a female case excess.Rate of DKA at onset varied from 19.3%-70%.Pancreatic autoantibodies at diagnosis were similar to European-origin populations,with glutamic acid decarboxylase-65 autoantibody frequency of 44.1%-64.5%,insulinoma-associated 2 autoantibody 43.5%-70.7%,and zinc transporter-8 autoantibody frequency 54.3%(one study).Fulminant T1D also occurs.T2D was not uncommon,with incidence in Japan and one Chinese study exceeding T1D rates.Monogenic forms also occurred in a number of countries.CONCLUSION T1D is less common,but generally has a classic phenotype.Some countries/territories have rapidly increasing incidence.T2D is relatively common.Registries and studies are needed to fill many information gaps.

摘要： Introduction: Cardio-renal syndrome is a pathophysiological disorder of the heart and kidneys in which chronic or acute dysfunction of one can lead to chronic or acute dysfunction of the other. The objective of this study was to determine the prevalence of cardio-renal syndrome in the Medical Department of the Tombouctou Hospital in Mali. Methods: It is about a descriptive transversal study carried out over 18 months, from January 01st, 2020 to June 30th, 2021 and relating to the analysis of 75 files of patients hospitalized for heart failure and with impaired renal function. Results: The frequency of cardio-renal syndrome was 6.4% with a predominance of men (sex ratio: 2). Hypertension was the most widely described risk factor (50.6%). The history was dominated by chronic heart failure (14.6%) and diabetes (6.6%). The average age was 58 with extremes of 18 and 90. The main aetiologies were dilated cardiomyopathy (46.6%) and ischemic heart disease (20%). Symptoms were dominated by dyspnea (90.6%) and edema of the lower limbs and face (74.6%) accompanied by cough (74.6%). Anemia was noted in 15 patients (20%). The mean clearance (MDRD) was at 32 ml/min. Doppler echocardiography found left ventricular dilation (66.6%), lower left ventricular systolic fraction (64%) and kinetic abnormalities (20%). The kidney ultrasound performed in 9 patients returned to normal in 8 cases and in 1 patient the kidneys were small. Eight deaths (10.6%) were noted. Conclusion: Cardio-renal syndrome is a common feature in which mixed failure is observed in the unfavorable course of heart disease and nephropathy. Its prevalence is unfortunately under evaluated in cardiological settings in Africa and particularly in Mali, hence the interest of a more advanced study.

摘要： BACKGROUND Nephritic syndrome(NiS)is a major indicator of serious renal diseases necessitating kidney biopsies for histopathological evaluations,but due to the lack of comprehensive reviews in the literature,the current understanding of the syndrome and its significance is limited.AIM To collect all the evidence retrievable from the literature on the diagnoses made on the renal biopsies performed for NiS as the indication to the procedure.METHODS A literature search was conducted to find studies reporting final diagnoses on renal biopsies in NiS patients.Data were pooled and analyzed with stratifications on age and regions.Meta-analyzes were performed using Stata v.9.RESULTS Overall,26414 NiS patients from the total number of 96738 kidney biopsy diagnoses reported by 47 studies from 23 countries from all continents(except sub-Saharan Africa)were found and analyzed.NiS was the indication for renal biopsy in 21%of the patient populations across the reviewed studies.Immunoglobulin A(IgA)nephropathy was the single most frequent diagnosis in these patients(approximately 38%)followed by lupus nephritis(approximately 8%)and Henoch Schönlein purpura(approximately 7%).IgA nephropathy was the most frequent diagnosis reported for the NiS patients from the East Asia,comprising half of all the cases,and least prevalent in South Asia.Considering the age subgroups,adult(vs pediatric or elderly)patients were by far the most likely age group to be diagnosed with the IgA nephropathy.A myriad of such regional and age disparities have been found and reported.CONCLUSION As the indication for renal biopsy,NiS represents a very distinctive epidemiology of final renal disease diagnoses compared to the other major syndromes.

摘要： Both HIV and COVID-19 infections show that the centuries-old scientifically established epidemiological rules are still valid today, but they have to be applied in time and in a correct manner. Furthermore, when incompetent funded “rights defenders” or political organizations referring to human rights have spread lies and have spoken against the experts-created epidemiological rules as well as the acceptance of vaccination, they have not only cheated everybody but they could also be accused by the crime of endangering of great mass of people which action can cause occasionally death also! It has to be also stated that the interests and rights of the total population are always over that of a single person and also realized that all pathogens live their own life among us according to their determinacy independently from our rights and interests!