Respiratory tract infection and risk of bleeding in oral anticoagulant users: self-controlled case series

Objective To estimate the association between untreated, community acquired, respiratory tract infections and bleeding in oral anticoagulant users. Design Self-controlled case series. Setting General practices in England contributing data to the Clinical Practice Research Datalink GOLD. Participants 1208 adult users of warfarin or direct oral anticoagulants with a general practice or hospital admission record of a bleeding event between January 2010 and December 2019, and a general practice record of a consultation for a community acquired respiratory tract infection for which immediate antibiotics were not prescribed (that is, untreated). Main outcome measures Relative incidence of major bleeding and clinically relevant non-major bleeding in the 0-14 days after an untreated respiratory tract infection, compared to unexposed time periods. Results Of 1208 study participants, 58% (n=701) were male, median age at time of first bleed was 79 years (interquartile range 72-85), with a median observation period of 2.4 years (interquartile range 1.3-3.8). 292 major bleeds occurred during unexposed time periods and 41 in the 0-14 days after consultation for a respiratory tract infection. 1003 clinically relevant non-major bleeds occurred during unexposed time periods and 81 in the 0-14 days after consultation for a respiratory tract infection. After adjustment for age, season, and calendar year, the relative incidence of major bleeding (incidence rate ratio 2.68, 95% confidence interval 1.83 to 3.93) and clinically relevant non-major bleeding (2.32, 1.82 to 2.94) increased in the 0-14 days after an untreated respiratory tract infection. Findings were robust to several sensitivity analyses and did not differ by sex or type of oral anticoagulant. Conclusions This study observed a greater than twofold increase in the risk of bleeding during the 0-14 days after an untreated respiratory tract infection. These findings have potential implications for how patients and clinicians manage oral anticoagulant use during an acute intercurrent illness and warrant further investigation into the potential risks and how they might be mitigated.

Unequal burden of COVID-19 in Hungary: a geographical and socioeconomic analysis of the second wave of the pandemic

IntroductionWe describe COVID-19 morbidity, mortality, case fatality and excess death in a country-wide study of municipalities in Hungary, exploring the association with socioeconomic status.MethodsThe spatial distribution of morbidity, mortality and case fatality was mapped using hierarchical Bayesian smoothed indirectly standardised ratios. Indirectly standardised ratios were used to evaluate the association between deprivation and the outcome measures. We looked separately at morbidity and mortality in the 10 districts with the highest and 10 districts with the lowest share of Roma population.ResultsCompared with the national average, the relative incidence of cases was 30%–36% lower in the most deprived quintile but the relative mortality and case fatality were 27%–32% higher. Expressed as incidence ratios relative to the national average, the most deprived municipalities had a relative incidence ratio of 0.64 (CI: 0.62 to 0.65) and 0.70 (CI: 0.69 to 0.72) for males and females, respectively. The corresponding figures for mortality were 1.32 (CI: 1.20 to 1.44) for males and 1.27 (CI: 1.16 to 1.39) for females and for case fatality 1.27 (CI: 1.16 to 1.39) and 1.32 (CI: 1.20 to 1.44) for males and females, respectively. The excess death rate (per 100 000) increased with deprivation levels (least deprived: 114.12 (CI: 108.60 to 119.84) and most deprived: 158.07 (CI: 149.30 to 167.23)). The 10 districts where Roma formed the greatest share of the population had an excess mortality rate 17.46% higher than the average for the most deprived quintile.ConclusionsThose living in more deprived municipalities had a lower risk of being identified as a confirmed COVID-19 case but had a higher risk of death. An inverse association between trends in morbidity and mortality by socioeconomic conditions should be a cause for concern and points to the need for responses, including those involving vaccination, to pay particular attention to inequalities and their causes.

Retraction: Lyons-Weiler, J.; Thomas, P. Relative Incidence of Office Visits and Cumulative Rates of Billed Diagnoses along the Axis of Vaccination. Int. J. Environ. Res. Public Health 2020, 17, 8674

The journal retracts the article “Relative Incidence of Office Visits and Cumulative Rates of Billed Diagnoses along the Axis of Vaccination” cited above [...]

The relative incidence of COVID-19 in healthcare workers versus non-healthcare workers: evidence from a web-based survey of Facebook users in the United States

Background: Healthcare workers are at the forefront of the COVID-19 pandemic and it is essential to monitor the relative incidence rate of this group, as compared to workers in other occupations. This study aimed to produce estimates of the relative incidence ratio between healthcare workers and workers in non-healthcare occupations. Methods: Analysis of cross-sectional data from a daily, web-based survey of 1,822,662 Facebook users from September 8, 2020 to October 20, 2020. Participants were Facebook users in the United States aged 18 and above who were tested for COVID-19 because of an employer or school requirement in the past 14 days. The exposure variable was a self-reported history of working in healthcare in the past four weeks and the main outcome was a self-reported positive test for COVID-19. Results: On October 20, 2020, in the United States, there was a relative COVID-19 incidence ratio of 0.73 (95% UI 0.68 to 0.80) between healthcare workers and workers in non-healthcare occupations. Conclusions: In fall of 2020, in the United States, healthcare workers likely had a lower COVID-19 incidence rate than workers in non-healthcare occupations.

Relative incidence of aphid (Lipaphis erysimi) and Alternaria blight on mustard in sub-mountainous region of Punjab

Aim: To study the relative incidence of mustard aphid and Alternaria blight on different rapeseed-mustard varieties to assess their resistant or tolerant and most suitable variety for sub-mountainous area of Punjab. Methodology: The experiment was conducted on four mustard varieties (RLM-619, PBR-97, PBR-357 and Giriraj) with five replications in randomized block design during two crop seasons, i.e. Rabi 2018-19 and 2019-20 under sub-mountainous areas of Punjab. Aphid population was recorded at weekly interval. Disease severity was calculated using 0-5 rating scale and per cent disease intensity was calculated. Results: RLM-619 variety exhibited the lowest aphid infestation (7.92 and 8.96%) and minimum per cent disease intensity (28.0 and 33.33%) on leaves and siliqua (33.33 and 38.33%) which also gave highest yield (739.33 kg acre-1 and 735.67 kg acre-1) during the year 2018-19 and 2019-20. The lowest seed yield (487.67 kg acre-1 and 480.67 kg acre-1) was recorded in variety Giriraj, which was found susceptible to aphid infestation and Alternaria blight. Interpretation: RLM-619 exhibited tolerance against aphid and Alternaria blight, hence, this variety may be used as a key component under integrated pest and disease management in sub-mountainous area of Punjab in future.

On the increasing incidence of SARS-CoV- 2 in older adolescents and younger adults during the epidemic in Mexico

Objective. To estimate temporary changes in the inciden­ce of SARS-CoV-2-confirmed hospitalizations (by date of symptom onset) by age group during and after the national lockdown. Materials and methods. For each age group g, we computed the proportion E(g) of individuals in that age group among all cases aged 10-59y during the early lock­down period (April 20-May 3, 2020), and the corresponding proportion L(g) during the late lockdown (May 18-31, 2020) and post-lockdown (June 15-28, 2020) periods and computed the prevalence ratio: PR(g)=L(g)/E(g). Results. For the late lockdown and post-lockdown periods, the highest PR values were found in age groups 15-19y (late: PR=1.69, 95%CI 1.05,2.72; post-lockdown: PR=2.05, 1.30,3.24) and 20-24y (late: PR=1.43, 1.10,1.86; post-lockdown: PR=1.49, 1.15,1.93). These estimates were higher in individuals 15-24y compared to those ≥30y. Conclusions. Adolescents and younger adults had an increased relative incidence of SARS-CoV-2 during late lockdown and post-lockdown periods. The role of these age groups should be considered when implementing future pandemic response efforts.

Features of the Epidemiological Situation on Tick-Borne Rickettsioses in the Russian Federation in 2010–2020 and Prognosis for 2021

Objective is to analyze the incidence of Siberian tick typhus (STT) in the Russian Federation over the period of 2010–2020, Astrakhan spotted fever (ASF) and Mediterranean fever (MF) since the official registration, and to forecast the development of the epidemic process for endemic rickettsioses for 2021. The analysis of the incidence of STT, ASF and MF in Russia for the period of 2010–2020, 2013–2020 and 2014–2020, respectively, has been carried out. The forecast of endemic rickettsioses morbidity in the European and Asian parts of Russia for 2021 has been made. The average long-term incidence of STT for 2010–2020 in the Russian Federation as a whole was 1.04 (CI95 1.02÷1.05) 0/0000, with no tendency to change. The maximum relative incidence of STT is typical for the Siberian Federal District (SFD), where the average long-term incidence rate for 2010–2020 was 6.20 (CI95 6.08÷6.31) per 100 thousand of the population. The Far Eastern Federal District (FEFD) – 4.70 (CI95 4.53÷4.87) 0/0000 came in second place, the third place was taken by the Ural Federal District (UFD) – 0.08 (CI95 0.07÷0.10) 0/0000. When assessing the 11-year dynamics of the relative incidence of STT by the Federal Districts, we have detected a tendency to its stabilization in the SFD and the FEFD. In the UFD, a significant downward trend was revealed. The upward trend in the incidence of STT remained in the Altai Republic. Major decline in STT incidence was observed in the Kurgan Region, Trans-Baikal Territory, Krasnoyarsk Territory, and the Republic of Khakassia. There was a declining trend in the incidence of Astrakhan spotted fever in the Astrakhan Region and the Republic of Kalmykia. In the Republic of Crimea and the city of Sevastopol there is no trend to increase the incidence of Mediterranean fever.

Detection and Molecular Characterization of Watermelon Mosaic Virus (WMV) Spread Along the Syrian Coast

Mouhanna, A.M., A.A. Ali Hasan and H.N.H. Alobaidi. 2021. Detection and Molecular Characterization of Watermelon Mosaic Virus (WMV) Spread Along the Syrian Coast. Arab Journal of Plant Protection, 39(1): 47-54. Identification of local isolates of Watermelon mosaic virus (WMV) was investigated using serological and molecular methods. A total of 293 leaf samples from watermelon, zucchini, pumpkin, cucumber, pepper, beans and potato, with symptoms suggestive of virus infection, were collected from fields in two Syrian governorates (Latakia, Tartus) along the Syrian coast. DAS-ELISA tests revealed the presence of WMV in watermelon, zucchini, pumpkin and cucumber samples, with an average relative incidence of 36.95, 26.31, 29.27 and 37.70%, respectively. The infection of pepper with Watermelon mosaic virus was reported for the first time in Syria, with an average relative incidence of 2.94%. WMV was not detected in potato and beans, and these results were confirmed by RT-PCR. The local WMV isolate Cu4 was grouped with an Iranian isolate [EU660584.1] with 98.9% sequence identity. A Turkish isolate [EU660579] was grouped with local WMV isolate Wa2 with 98.3% sequence identity. Furthermore, two local isolates Zu6 and Cu8 represented one sub-group with 99.3% sequence identity. Keywords: Watermelon mosaic virus, DAS-ELISA, RT-PCR, CI, Phylogenetic Tree.

Correction: Lyons-Weiler, J., et al. Relative Incidence of Office Visits and Cumulative Rates of Billed Diagnoses along the Axis of Vaccination. Int. J. Environ. Res. Public Health 2020, 17, 8674

There were two errors in the original article [...]

The Esophageal Adenocarcinoma Epidemic Has Reached Hungary: A Multicenter, Cross-Sectional Study

BackgroundThe epidemiology of esophageal cancer has changed dramatically over the past 4 decades in many Western populations. We aimed to understand the Hungarian epidemiologic trends of esophageal squamous cell cancer (SCC) and adenocarcinoma (AC).MethodsWe performed a cross-sectional study using data from esophageal cancer patients diagnosed between 1992 and 2018 at eight tertiary referral centers in four major cities of Hungary. We retrospectively identified cases in the electronic databases of each center and collected data on gender, age at diagnosis, year of diagnosis, specialty of the origin center, histological type, and localization of the tumor. Patients were grouped based on the two main histological types: AC or SCC. For statistical analysis, we used linear regression models, chi-square tests, and independent sample t tests.ResultsWe extracted data on 3,283 patients with esophageal cancer. Of these, 2,632 were diagnosed with either of the two main histological types; 737 had AC and 1,895 SCC. There was no significant difference in the gender ratio of the patients between AC and SCC (80.1 vs 81.8% males, respectively; p = 0.261). The relative incidence of AC increased over the years (p < 0.001, b = 1.19 CI: 0.84–1.54). AC patients were older at diagnosis than SCC patients (64.37 ± 11.59 vs 60.30 ± 10.07 years, p < 0.001). The age of patients at the diagnosis of primary esophageal cancer increased over time (p < 0.001, R = 0.119).ConclusionsThe rapid increase in the relative incidence of AC and simultaneous decrease of the relative incidence of SCC suggest that this well-established Western phenomenon is also present in Hungary.