The national burden of cerebrovascular diseases in Spain: A population-based study using disability-adjusted life years

Abstract Objective We aimed to estimate the burden of UTIs by age, sex, and socioeconomic status in 204 countries and territories from 1990–2019. Method We used data from GBD 2019 to analyse the incidence, mortality, and disability-adjusted life-years (DALYs) due to UTIs at the global, regional, and national levels. Estimates are presented as numbers and age-standardised or age-specific rates per 100000 population, with 95% uncertainty intervals (UIs). We further explored the associations between the incidence, mortality, DALYs, and socio-demographic index (SDI) as a proxy for the development status of regions and countries. Results In 2019, more than 404.6 million (95% UI 359.4-446.5) individuals had UTIs globally and nearly 236 786 people (198 433 − 259 034) died of UTIs, contributing to 5.2 million (4.5–5.7) DALYs. The age-standardised incidence rate increased from 4 715.0 (4 174.2-5 220.6) per 100 000 population in 1990 to 5 229.3 (4 645.3-5 771.2) per 100 000 population in 2019. At the GBD regional level, the highest age-standardised incidence rate in 2019 occurred in Tropical Latin America (13 852.9 [12 135.6–15 480.3] per 100 000 population). At the national level, Ecuador had the highest age-standardised incidence rate (15 511.3 [13 685.0–17 375.6] per 100 000 population). The age-standardised death rates were highest in Barbados (19.5 [13.7–23.5] per 100 000 population). In addition, age-standardised incidence, death, and DALY rates generally increased across the SDI. Conclusions Our study results suggest a globally rising trend of UTI burden between 1990 and 2019. The results of this study could be useful in policy-making, priority setting, and resource allocation in UTI prevention and treatment.

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Population-Based Epidemiology Study of Paraneoplastic Neurologic Syndromes

Neurology Neuroimmunology & Neuroinflammation ◽

10.1212/nxi.0000000000001124 ◽

2021 ◽

Vol 9 (2) ◽

pp. e1124

Author(s):

Shailee Shah ◽

Eoin P. Flanagan ◽

Pritikanta Paul ◽

Carin Y. Smith ◽

Sandra C. Bryant ◽

...

Keyword(s):

The United States ◽

Population Based ◽

Years Of Life Lost ◽

Disability Adjusted Life Years ◽

Epidemiology Study ◽

Disability Adjusted Life ◽

Life Years ◽

Years Lived With Disability ◽

Paraneoplastic Neurologic Syndromes

ObjectivesPopulation-based epidemiologic data for paraneoplastic neurologic syndromes (PNSs) in the United States are lacking. Our objective was to evaluate the incidence, prevalence, and associated morbidity of PNS.MethodsWe performed a population-based epidemiology study in Olmsted County, Minnesota, with patients identified between January 1, 1987, and December 31, 2018, using the medical records linkage system of the Rochester Epidemiology Project (REP) who met the definite/probable 2021 PNS criteria and 2004 PNS criteria. Patients with dermatomyositis and myasthenia gravis with underlying tumors were included. Age- and sex-specific population counts were obtained from REP resources for January 1, 2014 (prevalence denominator) and annually for 1987–2018 (incidence denominator). Morbidity was estimated using disability-adjusted life years (DALYs; years lived with disability [YLD] plus years of life lost [YLL]).ResultsThere were 28 patients with PNS identified (50% female) residing in Olmsted County, Minnesota, with median age at diagnosis of 54.5 (IQR 46.5–69.0) years. All patients had a cancer diagnosis, and 18 (64%) patients were neural autoantibody positive including antineuronal nuclear autoantibody type 1 (ANNA-1/anti-Hu; n = 1), ANNA-2/anti-Ri (n = 1), muscle-type acetylcholine receptor (AChR; n = 6), Purkinje cell cytoplasmic antibody type 1 (PCA-1/anti-Yo; n = 1), kelch-like protein 11 (KLH11; n = 3), collapsin response mediator protein 5 (CRMP-5/anti-CV2; n = 2), α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (n = 1), neurofilament light chain (n = 1), leucine zipper 4 (LUZP4; n = 1), and unclassified neural antibodies (n = 1). PNS incidence was 0.6/100,000 person-years and increased over time from 0.4/100,000 person-years (1987–2002) to 0.8/100,000 person-years (2003–2018) (p = 0.06). Prevalence was 5.4/100,000 people. The median follow-up period after PNS diagnosis was 3.1 years (IQR, 1.1–9.9 years). Total disability-adjusted life years (DALYs) for 28 patients with PNS were 472.7 years, based on total years of life lost (YLL) for patients dying between 1987 and 2018 (n = 15) of 445.3 years plus years lived with disability (YLD) 27.4 years.DiscussionPNSs are rare neurologic disorders but are associated with severe morbidity and mortality. The estimated number of prevalent PNS cases in the United States is 17,099, and predicted DALY for all US PNS cases is 292,393 years. Their apparent increasing rate of detection is attributable to increasing physician awareness and availability of serologic testing.

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