Hyperglycemia associated with Chagas disease

Chagas disease and type 2 diabetes mellitus are the two main causes of Years Lived with Disability. The consequences and possible interaction between both illnesses have been scarcely studied. A population study of blood donors from the Centro Estatal de Transfusión Sanguinea (CETS) was carried out with a reagent related to the Chagas test. Detection was carried out with an enzyme-linked immunosorbent assay (ELISA) of anti- Trypanosoma cruzi antibodies and also, an HbA1C test was performed with 4 mL of whole blood. Descriptive statistics were used to analyze quantitative and qualitative data. The Chi-square test was applied to determine the existence of an association between hyperglycemia and Chagas disease. A total of 4,952 participants were screened. All of the participants (100%) were from Hidalgo State and did not have a chagoma as evidence of having been bitten or denied contact with a “kissing bug”. Of the total, 26 reacted to the first screening test to detect anti-Trypanosoma cruzi antibodies; of these, five were confirmed as positive on the second screening test. The seroprevalence of T. cruzi was 0.01%. The results do not show a clear association but the frequency of hyperglycemia in population with Chagas coincides with that reported by other authors. Considering the scarce clinical–epidemiological evidence between Chagas disease, obesity, and hyperglycemia, long-term follow up of both morbidities is an area of opportunity for clinical and epidemiological study of T. cruzi reactivity.

Population-Based Epidemiology Study of 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.

Steps to Development and Increase of Physical Movement and Health Literacy

According to the WHO, healthis a state of complete physical, mental and social well-being while maintaining the body's ability to adapt to changing environmental conditions. The definition is concise, but it is important to be aware of the es- sential facts that affect people of the 21st century. Is it possible to adapt to rapidly changing environmental conditions? Mus- culoskeletal conditions are considered a global epidemic as their incidence and severity increase worldwide. Consideration should be given to the fact that musculoskeletal conditions, such as back pain (diagnosis of M54: dorsalgia), are beginning to be epidemiological in developed countries. According to the Institute for Health Metrics and Evaluation, the most common causes of years lived with disability (YLDs) in the Slovak Republic from 2005 to 2015 were non-communicable diseases. In 1st place were musculoskeletal deformities; 2nd place men- tal disorders and addictions; 3rd place other unspecified non- infectious diseases (Source: GBD, 2015). It is important to tackle this issue not only because of its permanent growth but especially for the frequent complications that cause higher morbidity. Various postural deformities caused by poor posture, which affect the relationships between internal organs and the musculoskeletal system/viscero-vertebral relationships but also vice versa. The prevalence of musculoskeletal diseases has an increasing trend in Slovakia, and therefore it is important to look for a way to raise awareness of the possibilities of these diseases’ prevention. It is essential to revise outdated plans for physical development and adapt them to today's people. After all, the movement literacy of our children has a significantly declining tendency. Such intervention gives meaning to the public health; there should be a focus on the primary support of the health of the population where one of the possibilities may be the spiral mobilization method SM system. This method is intended for a person living in current times, who sits to a large extent and performs movements that are monot- onously loading the muscles. The SM system is a simple and effective exercise that on the principle of spiral muscle chains pulls the spine upwards and stabilizes the balance of the spine. When performed in an optimal way, they relax overloaded parts of the spine; reduce muscle imbalance; contribute to over- all health. The priority for proper physical movement should be a desire for a healthy body without pain and disease. The path to health leads through cognition and education because the most important result of any education is self-knowledge.

Global Trends in the Incidence, Prevalence, and Years Lived With Disability of Parkinson's Disease in 204 Countries/Territories From 1990 to 2019

Background: Parkinson's disease (PD) is an increasing challenge to public health. Tracking the temporal trends of PD burden would inform health strategies.Methods: Data of PD burden was obtained from the Global Burden of Disease 2019. Trends in the incidence, prevalence, and years lived with disability (YLDs) of PD were estimated using the annual percentage change (EAPC) and age-standardized rate (ASR) from 1990 to 2019. The EAPCs were calculated with ASR through a linear regression model.Results: The overall ASR of the incidence, prevalence, and YLDs of PD increased from 1990 to 2019, and their EAPCs were 0.61 (95% confidence interval [CI]: 0.58–0.65), 0.52 (95% CI: 0.43–0.61), and 0.53 (95% CI: 0.44–0.62). The largest number of PD patients was seen in the groups aged more than 65 years, and the percentage rapidly increased in the population aged more than 80 years. Upward trends in the ASR of PD were observed in most settings over the past 30 years. Incident trends of ASR increased pronouncedly in the United States of America and Norway, in which the respective EAPCs were 2.87 (95% CI: 2.35–3.38) and 2.14 (95% CI: 2.00–2.29). Additionally, the largest increasing trends for prevalence and YLDs were seen in Norway, with the respective EAPCs of 2.63 (95% CI: 2.43–2.83) and 2.61 (95% CI: 2.41–2.80). However, decreasing trends in PD appeared in about 30 countries, particularly Italy and the Republic of Moldova.Conclusions: Increasing trends in the burden of PD were observed globally, and in most regions and countries from 1990 to 2019. Our findings suggested that the control and management of PD should be strengthened, especially when considering the aging tendency of the population.

The global burden of decubitus ulcers from 1990 to 2019

There are no studies assessing the epidemiology and burden of decubitus ulcers at global, regional, and national levels. We aim to report this issue from 1990 to 2019 by extracting data from the Global Burden of Disease Study (GBD) 2019 and stratifying it by age, gender, and socio-demographic index (SDI). Globally, the number of prevalent cases of decubitus ulcers in 2019 is 0.85 (95% UI 0.78 to 0.94) million. The age-standardized rates of prevalence, incidence, and years lived with disability (YLDs) in 2019 are 11.3 (95% UI 10.2 to 12.5), 41.8 (37.8 to 46.2), and 1.7 (1.2 to 2.2) per 100,000 population, and compared with 1990, it has decreased by 10.6% (95% UI 8.7% to 12.3%), 10.2% (8.2 to 11.9%), and 10.4% (8.1 to 12.5%), respectively. In addition, the global prevalence rate of decubitus ulcers increases with age, peaking at the > 95 age group among men and women. At the regional and national levels, we observe a positive correlation between age-standardized YLDs and SDI. Malaysia, Saudi Arabia, and Thailand experienced the most significant increases in age-standardized prevalence rates at the national level. Finally, we concluded that the age-standardized prevalence, incidence, and YLDs rates of decubitus ulcer declined from 1990 to 2019, with significant regional differences. In order to monitor the dynamic changes of decubitus ulcers burden, it is recommended to improve the quality of decubitus ulcer health data in all regions and countries.

The burden of skin diseases in India: Global Burden of Disease Study 2017

Background: The prevalence of skin diseases has increased over the last few decades, and they contribute to a significant burden on health-care systems across the world. Aims/Objective: This report looks at the burden of skin and subcutaneous diseases in terms of years lived with disability and agestandardised years lived with disability in India using the Global Burden of Disease Study results from 2017. Methods: Data were obtained from the Global Burden of Disease online interactive tool. Updated estimates of the world’s health for 359 diseases and injuries and 84 risk factors from 1990 to 2017 are available in this interactive tool. Results: Years lived with disability due to skin and subcutaneous diseases accounted for 4.02% of the total years lived with disability in India in 2017. There was an increase of 53.7% in all age standardised years lived with disability for all the skin and subcutaneous diseases from 1990 to 2017. Among skin and subcutaneous diseases, dermatitis contributed maximum years lived with disability (1.40 million; 95% uncertainty interval, 0.82–2.21) in 2017, followed by urticaria (1.02 million; 95% uncertainty interval, 0.06–1.44) with percentage increases of 48.9% and 45.7% respectively. Conclusion: The burden due to infectious skin diseases (e.g., scabies, fungal skin disease and bacterial skin disease) and non-infectious diseases (e.g., dermatitis, urticaria and psoriasis) has increased over the past three decades, however the age-standardised years lived with disability for leprosy, scabies, fungal infections, sexually transmitted infections and non-melanoma skin cancer (basal cell carcinoma) has decreased. The high burden of skin and subcutaneous diseases demand that they be given due importance in the national programmes and health policy of India.

User-Operated Audiometry Project (UAud) – Introducing an Automated User-Operated System for Audiometric Testing Into Everyday Clinic Practice

Hearing loss is the third leading cause of years lived with disability. It is estimated that 430 million people worldwide are affected, and the number of cases is expected to increase in the future. There is therefore increased pressure on hearing health systems around the world to improve efficiency and reduce costs to ensure increased access to quality hearing health care. Here, we describe the User-Operated Audiometry project, the goal of which is to introduce an automated system for user-operated audiometric testing into everyday clinic practice as a means to relieve part of this pressure. The alternative to the existing referral route is presented in which examination is executed via the user-operated system. This route is conceptualized as an interaction between the patient, the system, and the hearing care professional (HCP). Technological requirements of the system and challenges that are related to the interaction between patients, the user-operated system, and the HCPs within the specific medical setting are discussed. Lastly, a strategy for the development and implementation of user-operated audiometry is presented, which includes initial investigations, a validation study, and implementation in a real-life clinical situation.

Socio-economic disparity in visual impairment from cataract

AIM: To investigate the association of visual impairment from cataract with human development index (HDI) by years lived with disability (YLDs). METHODS: Published data on national age-standardized YLD rates caused by cataract and national HDIs in 2019 were obtained. Age-standardized YLD rates from 1990 to 2019 were analyzed to explore cataract burden among patients with different income levels. Age-standardized YLD rates in different HDI groups were compared by different degrees of visual impairment. Association between national age-standardized YLD rates and HDI in 2019 was analyzed. RESULTS: The age-standardized YLD rates of populations with visual impairment or blindness due to cataract declined from 1990 to 2019, especially among those with lower middle income. Multiple comparison tests revealed that countries with low HDI had significantly higher age-standardized YLD rates of blindness due to cataract than those with high and very high HDI (P<0.001). The age-standardized YLD rates of populations with blindness (β= -0.588, P<0.001), severe vision loss (β=-0.378, P<0.001), and moderate vision loss (β=-0.389, P<0.001) inversely correlated with HDI. CONCLUSION: Age-standardized YLD rates caused by cataract have declined since 1990. The burden of visual impairment due to cataract inversely correlate with national socioeconomic development and is more concentrated in countries with low HDI than those with high HDI, especially among the blind. These findings highlight the need to provide additional cataract services and cataract surgery coverage to developing countries to decrease the burden of avoidable blindness caused by cataract.

Setting Mental Health Priorities in Ghana: A 15-Year Contextual Analysis of the Presidential State of the Nation Address

Globally, mental health issues have been neglected and allowed to be suppressed by stigma and discrimination for a very long time, although mental disorders are responsible for about 30% of the global non-fatal disease burden. Thus, the global call for solution to this challenge admonishes governments, donors, and mental health service users to prioritise mental health. Towards this end, speeches by key political actors can be used to garner public support and set out strong arguments for the prioritisation of mental health. Guided by the agenda-setting theory, this study sought to contribute to the evidence on the mental health priorities in Ghana by conducting a summative qualitative content analysis of the state of the nation addresses (SONAs) presented by presidents of Ghana from 2007 to 2021. Findings show that no mental health condition was highlighted in any of the SONAs, and mental health priorities in terms of policy and investment were superficial, inadequate, and woefully incomparable to those of physical health. It is suggested that government should heighten mental health priorities, given that mental disorders are leading the top 10 causes of the years lived with disability burden in the country.