Psychosocial Burden of Women Who Are to Undergo Additional Diagnostic Procedures Due to Positive Screening for Cervical Cancer.

Background/Objectives: This study aimed to evaluate psychosocial burden and its associated factors in women who were referred for additional diagnostic procedures following receipt of a positive cervical-cancer-screening smear result. Methods: A cross-sectional study was performed in a consecutive cohort of only women who received an abnormal Papanicolaou screening result and therefore presented to a gynecologist for additional diagnostic examinations (colposcopy/biopsy/endocervical curettage) at the Clinic for Gynecology and Obstetrics of the Clinical Center. Multivariate linear regression was used for data analysis, with Bonferroni correction applied for multiple comparisons. Results: Significant independent predictors for the occurrence of psychosocial burden-worry in women with a positive Papanicolaou screening test before diagnostic procedures were the use of oral contraceptives (ß = -0.174, p < 0.001), alcohol consumption (ß = 0.188, p < 0.001), anxiety (ß = -0.189, p = 0.001), high burden of depressive symptoms (ß = 0.191, p = 0.001) and insufficient knowledge of the meaning of the term dysplasia/precancerous (ß = -0.187, p < 0.001), according to the multivariate linear regression. The significant independent predictor for the occurrence of psychosocial burden-satisfaction with information/support in women with a positive Papanicolaou screening test before diagnostic procedures was psychological distress (ß = -0.210, p = 0.001). Conclusions: Providing information in order to improve understanding of the term dysplasia/precancerous, as well as identifying which women are at risk of psychosocial burden, may help protect against this potential harm among women who receive a positive cervical-cancer-screening result and may facilitate their intention to undergo further diagnostic procedures.

Detecting the impact of diagnostic procedures in Pap-positive women on anxiety using artificial neural networks.

INTRODUCTION: Women who receive a result of an abnormal Papanicolaou (Pap) smear can fail to participate in follow up procedures, and this is often due to anxiety. This study aimed to apply artificial neural networks (ANN) in prediction of anxiety in women with an abnormal Pap smear test, prior to and following diagnostic procedures. METHODS: One hundred-seventy two women who received an abnormal Pap screening result took part in this study, completing a questionnaire about socio-demographic characteristics and Hospital Anxiety and Depression Scale (HADS), right before and two to four weeks after diagnostics (i.e. colposcopy/biopsy/endocervical curettage). A feedforward back-propagation multilayer perceptron model was applied in analysis. RESULTS: Prior to diagnostic procedures 50.0% of women experienced anxiety, while after diagnostics anxiety was present in 61.6% of women. The correlation-based feature selection showed that anxiety prior to diagnostic procedures was associated with the use of sedatives, worry score, depression score, and score for concern about health consequences. For anxiety following diagnostics, predictors included rural place of residence, depression score, history of spontaneous abortion, and score for tension and discomfort during colposcopy. The ANN models yielded highly accurate anxiety prediction both prior and after diagnostics, 76.47% and 85.30%, respectively. CONCLUSION: The presented findings can aid in identification of those women with a positive Pap screening test who could develop anxiety and thus represent the target group for psychological support, which would consequently improve adherence to follow-up diagnostics and enable timely treatment, finally reducing complications and fatal outcome.

An Artificial Neural Network Prediction Model of Depressive Symptoms among Women with Abnormal Papanicolaou Smear Results before and after Diagnostic Procedures.

(1) Background: Cervical screening and additional diagnostic procedures often lead to depression. This research aimed to develop a prediction model for depression in women who received an abnormal Papanicolaou screening test, prior to and following the diagnostic procedures. (2) Methods: The study included women who had a positive Papanicolaou screening test (N = 172) and attended the Clinical Center of Kragujevac in Serbia for additional diagnostic procedures (colposcopy/biopsy/endocervical curettage). Women filled out a sociodemographic survey and the Center for Epidemiologic Studies Depression questionnaire (CES-D scale) before and after diagnostic procedures. A prediction model was built with multilayer perceptron neural networks. (3) Results: A correlation-based filter method of feature selection indicated four variables that correlated with depression both prior to and following the diagnostic procedures-anxiety, depression, worry, and concern about health consequences. In addition, the use of sedatives and a history of both induced and spontaneous abortion correlated with pre-diagnostic depression. Important attributes for predicting post-diagnostic depression were scores for the domains 'Tension/discomfort' and 'Embarrassment' and depression in personal medical history. The accuracy of the pre-diagnostic procedures model was 70.6%, and the area under the receiver operating characteristic curve (AUROC) was 0.668. The model for post-diagnostic depression prediction showed an accuracy of 70.6%, and an AUROC = 0.836. (4) Conclusions: This study helps provide means to predict the occurrence of depression in women with an abnormal Papanicolaou screening result prior to and following diagnostic procedures, which can aid healthcare professionals in successfully providing timely psychological support to those women who are referred to further diagnostics.

Academic burnout syndrome among medical students in Serbia: prevalence of high risk and determinants.

BACKGROUND: Although burnout syndrome has been described in numerous research studies, the data on burnout syndrome among medical students in developing countries is scanty. This study aimed to determine the prevalence of high-risk for burnout syndrome and its associated factors among university undergraduate medical students in Serbia. METHODS: An observational, analytical, cross-sectional study was conducted using the Maslach Burnout Inventory-Student Survey and a survey on associated factors. The research was carried out from February to March 2014. Multivariate logistic regression was used to determine the adjusted odds ratio (Odds Ratio, OR) with 95% Confidence Interval (95%CI) in order to identify independent correlates of high risk of burnout syndrome. RESULTS: A high risk for burnout syndrome was noted in 15.0% of respondents; that is, 114/760 medical students suffered from high emotional exhaustion, high cynicism, and low academic efficiency. According to the results of multivariate logistic regression, the main significant independent correlates of high risk for burnout syndrome in medical students were: age of students (for aged 22-24: adjusted OR = 5.64, 95%CI = 2.58-12.34, p < 0.001 for aged ≥ 25: adjusted OR = 5.65, 95%CI = 2.08-15.39, p = 0.001) with p for trend < 0.001, higher frequency of alcohol consumption (for habit 1-2 times a week: adjusted OR = 2.01, 95%CI = 1.01-4.03, p = 0.048) with p for trend = 0.025, and use of sedatives (adjusted OR = 3.44, 95%CI = 1.31-9.04; p = 0.012). CONCLUSION: The present study identified several factors associated with burnout syndrome in Serbian medical students. Some factors associated with the high risk of burnout syndrome in medical students are modifiable. It is important to carry out similar research on burnout syndrome in the future, especially using longitudinal studies, in order to evaluate the associations found in this cross-sectional study.

Mortality Attributable to Clostridioides difficile Infection: The Rising Burden of Disease in European Countries.

Background and Objectives: Clostridioides difficile infection is a major public health issue, being among the main causes of mortality due to healthcare-associated diarrhea. This study aimed to assess the trends in mortality attributable to Clostridioides difficile infections in European countries over a period of 30 years. Materials and Methods: A descriptive epidemiological study was conducted, with the application of an ecological study design, to evaluate the trends in mortality due to Clostridioides difficile infection in the Central, Eastern, and Western European sub-regions from 1990 to 2019. The Global Burden of Disease study database was used. Trends were evaluated with the joinpoint regression analysis. Results: In both sexes, about 76% of all deaths attributable to Clostridioides difficile infections were recorded in the Western European sub-region in 2019. The age-standardized rates of the burden of Clostridioides difficile infection in 2019 were the highest in the Central European sub-region, followed by the Western European sub-region, while the lowest rates were observed in the Eastern European sub-region. A significantly increasing trend in mortality attributable to Clostridioides difficile infection from 1990 to 2019 was recorded both in males (by +2.1% per year) and females (by +2.8% per year). The burden of Clostridioides difficile infection showed increasing trends in most of the European countries, significantly correlating with the country's development, according to the Human Development Index. Conclusions: The rising burden of Clostridioides difficile infection in European countries in the last few decades suggests a need for improving public health measures, with a focus both on the hospital setting and community.

A Detailed Examination of Retroperitoneal Undifferentiated Pleomorphic Sarcoma: A Case Report and Review of the Existing Literature.

This detailed review focuses on retroperitoneal undifferentiated pleomorphic sarcoma (UPS), a particularly aggressive soft-tissue sarcoma that poses unique diagnostic and therapeutic challenges due to its rarity and complex presentation. By documenting a new case of retroperitoneal UPS and conducting a comprehensive review of all known cases, this article aims to expand the existing body of knowledge on the epidemiology, molecular pathogenesis, and treatment strategies associated with this rare disease. The complexity of diagnosing UPS is emphasized given that it rarely occurs in the retroperitoneal space and its histological and molecular complexity often complicates its recognition. This review highlights the need for specialized diagnostic approaches, including advanced imaging techniques and histopathological studies, to accurately diagnose and stage the disease. In terms of treatment, this paper advocates a multidisciplinary approach that combines surgery, radiotherapy and chemotherapy and tailors it to individual patients to optimize treatment outcomes. This review highlights case studies that illustrate the effectiveness of surgical intervention in the treatment of these tumors and emphasize the importance of achieving clear surgical margins to prevent recurrence. Furthermore, this review discusses the potential of new molecular targets and the need for innovative therapies that could bring new hope to patients affected by this challenging sarcoma.

High risk of burnout syndrome and associated factors in medical students: A cross-sectional analytical study.

INTRODUCTION: Although research on burnout syndrome in medical students has increased in recent years, results are inconsistent about which factors are associated with a high risk for burnout syndrome. The aim of this study was to assess the prevalence of high risk of burnout syndrome and to identify factors associated with burnout in medical students in preclinical and clinical training. METHOD: A cross-sectional study was conducted at the University of Kragujevac, Serbia. The Maslach Burnout Inventory Student Survey and an epidemiological questionnaire on basic socio-demographic and academic characteristics were used. Statistical evaluation was performed through logistic regression analysis, using Odds Ratio (OR) and 95% Confidence Interval (CI). RESULTS: Among medical students, no statistically significant differences were found in the prevalence of high risk of burnout syndrome in preclinical (14.8%) and clinical grade (15.1%), p > 0.05. High risk for burnout syndrome in preclinical study years was independently associated with the female sex (adjusted OR = 0.41, 95%CI = 0.19-0.91, p = 0.028), and cigarette smoking (adjusted OR = 2.47, 95%CI = 1.05-5.78, p = 0.038). The high risk of burnout syndrome was associated with sedatives use (adjusted OR = 4.03, 95%CI = 1.27-12.73; p = 0.018) only in clinical years medical students. The frequency of alcohol consumption was correlated with the high risk of burnout syndrome in medical students in both preclinical and clinical training, but without statistical significance (both p for trend < 0.1). CONCLUSION: There was a significant prevalence of burnout among medical students, with some modifiable associated factors revealed.

Global Patterns of Trends in Incidence and Mortality of Dengue, 1990-2019: An Analysis Based on the Global Burden of Disease Study.

Background and Objectives: Dengue is an important public health concern that warrants an examination of the longer-term global trends of its disease burden. The aim of this study was to assess the trends in dengue incidence and mortality worldwide over the last three decades. Materials and Methods: A descriptive epidemiological study was carried out, investigating the trends in the incidence and mortality of dengue from 1990 to 2019. The dengue incidence and mortality data were obtained from the Global Burden of Disease study database. Trends were examined using joinpoint regression analysis. Results: Globally, there were 56.7 million new cases of dengue reported in 2019: the disease was diagnosed in 27.4 million males and 29.3 million females. A total of 36,055 (18,993 males and 17,032 females) related deaths were reported worldwide in 2019. In both sexes, about 60% of new cases were recorded in the South-East Asia region (16.3 million in males and 17.4 million in females). Globally, the incidence of dengue exhibited an increasing tendency from 1990 to 2019 in both sexes (equally, by 1.2% per year). A significantly decreasing trend in the mortality of dengue was recorded only in females (by -0.5% per year), while an increasing trend was observed in males (by +0.6% per year). Conclusions: The rise in the number of new dengue cases and deaths in the world in the last several decades suggests a need for implementing more effective prevention and management measures.

Antimicrobial treatment in invasive infections caused by Gordonia bronchialis: systematic review.

Background: Corynebacterium, Nocardia, Rhodococcus, Mycobacterium, as well as Gordonia genera belongs to the genus Gordonia, Actinomycetia class. Gordonia bronchialis is a nitrate-reducing, urease-producing, non-motile, force aerobe with a rod-like figure that is known to arrangement into sessile, cord-like groups. This systematic review aimed to establish whether and what invasive infections in humans were caused by Gordonia bronchialis, and to evaluate outcomes of administered antibiotic treatment. Methods: We have registered this systematic review in PROSPERO database of systematic reviews and meta-analyses with the number CRD42022369974. Results: A total of 24 publications were included (22 case reports and two case series) with 28 individual cases. The oldest patients had 92 years, and the youngest patients had 13 years. Clinical signs of infection were present in six patients (21%). All isolates were susceptible to ciprofloxacin, imipenem, and amikacin. Vancomycin was the most frequently used antibiotic with nine cases followed by ciprofloxacin, ceftriaxone, and amoxicillin/clavulanic acid. Conclusion: Although there are no standardized recommendations to date, successful treatment with a favorable outcome has most often been carried out with fluoroquinolones, vancomycin with or without aminoglycosides, as well as carbapenems.

Global Burden of Pancreatic Cancer Attributable to High Body-Mass Index in 204 Countries and Territories, 1990-2019.

(1) Background: This study aimed to assess the global burden of pancreatic cancer attributable to a high BMI in 1990-2019. (2) Methods: An ecological study was carried out. Data about deaths and Disability-Adjusted Life Years (DALYs) for pancreatic cancer were extracted from the Global Burden of Disease (GBD) study. The age-standardized rates (ASRs, per 100,000) were presented. In order to determine trends of pancreatic cancer burden, joinpoint regression analysis was used to calculate the average annual percent change (AAPC). (3) Results: The highest ASRs of DALYs of pancreatic cancer were found in the United Arab Emirates (47.5 per 100,000), followed by countries with about 25.0 per 100,000 (such as Hungary, Czechia, and Montenegro). From 1990 to 2019, the ASRs of deaths and DALYs of pancreatic cancer attributable to a high BMI significantly increased (p < 0.001) for both sexes in all ages, and across all SDI quintiles and all GBD regions. The highest fraction of DALYs attributable to a high BMI was found in the United States of America and China (equally about 15.0%), followed by the Russian Federation, India, Germany, and Brazil (about 5.0%, equally). (4) Conclusions: Further analytical epidemiological studies are necessary to elucidate the relationship between pancreatic cancer and a high BMI.

The use of vitreous humour as a potential source of DNA for postmortem identification in forensic science.

Vitreous humour (VH) is routinely collected for toxicological analyses. However, only a few studies have examined its possible use in genotyping. Because of its isolation from the rest of the body, later onset of postmortem changes, and availability, VH could be a potential source of DNA for postmortem identification and other molecular analyses in forensic genetics. During forensic autopsies, samples of different VH volumes (5 ml, 4 ml, 3 ml, 2 ml, 1 ml, and 0.5 ml) were taken from 66 cadavers 24-48 h after death. DNA was also isolated from the samples immediately after collection and after a specific time of storage (1, 2, and 6 months). DNA was isolated using phenol‒chloroform‒isoamyl alcohol (PCI), and the yield and purity of the obtained DNA were determined spectrophotometrically using a FastGene NanoView Photometer. The integrity of the isolated DNA molecule was determined by PCR amplification of the hTERT (113 bp) gene. The results showed that VH could be a reliable source of genetic material for forensic analysis, and the method used for DNA extraction was effective. The yield of the isolated DNA ranged from 6.20 to 609.5 ng/µl, and the purity of the samples was 1.24-2.34. The isolated DNA concentration and integrity depend on the sample volume, but the DNA purity does not. It is also shown that DNA can be extracted from VH samples that have been stored for up to 6 months at - 20 °C. Therefore, using VH can be a valuable material for DNA identification.

Cancer of colon, rectum and anus: the rising burden of disease worldwide from 1990 to 2019.

BACKGROUND: Previous studies suggest that trends of cancer of colon, rectum and anus (CRA) incidence and mortality have been decreasing in recent decades. However, the trends are not uniform across age groups. This study aimed to assess the trends of the cancer of CRA burden worldwide. METHODS: A descriptive study was carried out with a joinpoint regression analysis using the database of the Global Burden of Disease study. RESULTS: About 2.2 million new cases of cancer of CRA were diagnosed in the world in 2019, whereby cancer of CRA caused ~1.1 million deaths. Globally, the incidence trend in both sexes together was increasing in 1990-2019, while the mortality trend was decreasing. The highest rise both in incidence and mortality was observed in the East Asia region (by 3.6% per year and by 1.4% per year, respectively) and the Andean Latin America region (by 2.7% per year and by 1.2% per year, respectively). However, of particular concern is the significant increase in the incidence (by 1.7% per year) and mortality (by 0.5% per year) from cancer of CRA in people aged 15-49. CONCLUSIONS: Unfavorable trends in cancer of CRA in the young require more attention in management plans.

The Difficulty Detecting Tuberculosis in a Child with Post-COVID-19 and Cerebral Palsy.

When hypostatic pneumonia is present at the same time as COVID-19 pneumonia, the clinical course is almost always prolonged (prolonged-COVID-19) due to persistent inflammation, long-term anti-inflammatory syndrome, followed by immune exhaustion, i.e., by immunosuppression and catabolic syndrome. In the immunosuppression phase, viral reactivation can be accompanied by a secondary infection, which, in this case, is pulmonary tuberculosis. Pulmonary tuberculosis in post-COVID-19 patients and in patients with spastic quadriplegic cerebral palsy does not have a typical clinical course nor laboratory, radiological, immunological, microbiological, or fiberbronchoscopic pathohistological confirmation. Due to this, the treatment of pulmonary tuberculosis was not carried out on time, postponed after the unsuccessful treatment of sepsis, post-COVID-19, and other accompanying viral (adenovirus, RSV) and bacterial (streptococcus viridans) infections. The treatment of pulmonary tuberculosis was possible only "ex juvantibus" (trial) post-COVID-19. It becomes imperative to search for a new, more precise and reliable diagnostic test for the detection of tuberculosis bacillus.

Epidemiology of Hip Fractures Due to Falls.

Background and Objectives: The epidemiological pattern of the hip fracture burden attributable to falls in Central European countries is still insufficiently known. The aim of this study was to assess the regional and national trends of hip fractures due to falls in Central Europe from 1990 to 2019. Materials and Methods: Using the Global Burden of Disease (GBD) 2019 study, this descriptive epidemiological study presents trends in incidence of and Years Lived with Disability (YLDs) from hip fractures due to falls in the region of Central Europe. All estimates (age- and sex-specific rates, and age-standardized rates) were expressed per 100,000. A joinpoint regression analysis was used to assess trends: the average annual percent change (AAPC) with a corresponding 95% confidence interval (95% CI) was calculated. Results: Among all new cases of hip fracture in the population as a whole in Central Europe in 2019, 3.9% in males and 7.0% in females were attributable to falls, while the share of hip fractures due to falls in the population aged 70 and over was 16.9% in males and 20.0% in females. About 400,000 new cases of hip fracture due to falls occurred in the Central European region in 2019 (220,000 among males and 160,000 among females), resulting in 55,000 YLDs (32,000 in females and 22,000 in males). About one-third of all new cases (59,326 in males and 72,790 in females) and YLDs (8585 in males, and 10,622 in females) of hip fractures due to falls were recorded in Poland. From 1990 to 2019, the age-standardized incidence rates of hip fracture due to falls showed a decreasing tendency in females (AAPC = -1.1%), and an increasing tendency in males (AAPC = 0.1%). Both in males and females, YLDs rates of hip fracture due to falls in the Central European region decreased (AAPC = -1.6% and AAPC = -2.4%, respectively). Conclusions: Hip fracture due to falls represents an important health issue in the Central European region, although incidences and YLDs declined in the most recent decades. However, further efforts to reduce the burden of hip fractures attributed to falls are needed.

Psychological Distress in Women With Abnormal Pap Smear Results Attending Cervical Cancer Screening.

OBJECTIVE: Women often experience psychological distress upon receipt of an abnormal Pap test result. This study aimed to evaluate psychological distress and its correlates among women who received an abnormal Pap screening test result. MATERIAL AND METHODS: A cross-sectional study was performed in a cohort of 172 consecutive women who had attended screening for cervical cancer and who received abnormal Pap smear results and underwent additional diagnostic procedures (colposcopy/biopsy/endocervical curettage). The participants filled out a questionnaire on sociodemographic variables and the Cervical Dysplasia Distress Questionnaire. Multivariate linear regression was used for the analysis of the data. For multiple comparisons, the Bonferroni correction was applied to adjust the level of significance. RESULTS: In women who received an abnormal Pap smear result, the independent correlate of higher psychological distress (by Cervical Dysplasia Distress Questionnaire score) before diagnostic procedures was lower satisfaction with information/support received from other people ( p = .002). Correlates of psychological distress in women older than 40 years with abnormal Pap smear were anxiety ( p = .042) and worry about having cervical cancer, general health and having sex ( p = .044). CONCLUSIONS: The authors' findings could enable control of factors predictive of psychological distress in women who received a positive Pap smear screening test before undergoing diagnostic procedures, primarily via active provision of targeted information.

Atopic Dermatitis in Children Under 5: Prevalence Trends in Central, Eastern, and Western Europe.

BACKGROUND: Atopic dermatitis is a major public health issue worldwide, but data on trends in prevalence in children in European countries are sparse. The aim of this study was to assess the trends in the prevalence of atopic dermatitis in children under 5 in the Central, Eastern, and Western European sub-regions from 1990 to 2019. METHODS: In this study, a descriptive, observational epidemiological method was applied. In addition, an ecological study design was used. Joinpoint regression analysis was used to assess trends. RESULTS: A total of 118 million (54 million males and 64 million females) prevalent cases of atopic dermatitis in children under 5 were reported in European countries in 1990-2019. More than half of all cases of atopic dermatitis in children under 5 in Europe were recorded in the Western European sub-region. The highest prevalence rates of atopic dermatitis in children under 5 were observed in the Eastern European sub-region, with the highest rates in both males and females recorded in Estonia (equally at about 15,000 per 100,000), followed by the Russian Federation (equally at about 12,000 per 100,000). Moreover, the lowest prevalence rates were reported in the Eastern European sub-region (equally at about 5000 per 100,000 in Romania and Latvia). A sex disparity in the prevalence and trends of atopic dermatitis in children under 5 was observed. A significantly increased trend in atopic dermatitis prevalence in children under 5 was recorded in the Eastern European sub-region from 1990 to 2019 (by +0.3% per year in males and by +0.1% per year in females). Conversely, in the Western and Central European sub-regions, trends in the prevalence of atopic dermatitis in children under 5 slightly decreased (about -0.1% per year). The Pearson coefficient showed a significant negative correlation between the prevalence of atopic dermatitis in children under 5 and the Human Development Index in most countries in the Eastern European sub-region, while a significant positive correlation was reported between the prevalence and HDI in high-income countries in the Western European sub-region. CONCLUSIONS: High prevalence rates and mostly stable trends during the last three decades make atopic dermatitis still a major health issue in children under 5 in European countries.

International patterns and trends in the brain cancer incidence and mortality: An observational study based on the global burden of disease.

Background: Brain cancer is a serious issue in the global burden of diseases. This observational research aimed to assess trends of the brain cancer incidence and mortality in the world in the period 1990-2019. Methods: Brain cancer incidence and mortality data were retrieved from the Global Burden of Disease 2019 study database. The joinpoint regression analysis was done to assess the brain cancer indicence and mortality trends: the average annual percent change (AAPC) along with its 95% confidence interval (95% CI) was calculated. Results: In both sexes, the highest age-standardized rates of incidence and mortality were found in high-income regions (Europe and America), while the lowest were observed in the African Region. A significant rise in brain cancer incidence rates both in males and females was observed in all regions, with one exception of a significantly decreased trend only among males in the South-East Asia Region. Among countries with increased trends in incidence and mortality from brain cancer, Cuba experienced the most marked increase in both incidence (AAPC = +5.7% in males and AAPC = +5.4% in females) and mortality rates (AAPC = +5.5% in males and AAPC = +5.1% in females). Among countries that experienced a decline in brain cancer incidence and mortality, Hungary and Greenland showed the most marked decline in both sexes (equally by -1.0%). Conclusion: Brain cancer shows increasing global incidence rates in both sexes and represents a priority for prevention and further research.

The relationship between the burnout syndrome and academic success of medical students: a cross-sectional study.

The burnout syndrome may affect academic achievement, but research on burnout and academic success of medical students is sparse. This research aimed to estimate the prevalence of high risk of burnout in students of medicine and to investigate its association with academic performance. It included 760 full-time medical students who completed the survey (response rate = 90.9 %). A significant independent predictor for high burnout risk in students with lower grade point average (GPA) was male gender (adjusted OR=2.44; 95 % CI=1.14-5.23; P=0.022). Among students with higher GPA, high burnout risk was associated with the use of sedatives (adjusted OR=6.44; 95 % CI=1.80-22.99; P=0.004).

Diabetes Mellitus after SARS-CoV-2 Infection: An Epidemiological Review.

Diabetes mellitus (DM) is among the major global public health issues. According to recent projections, a continued rise in DM prevalence is expected in the following decades. The research has shown that DM is associated with poorer outcomes of coronavirus disease 2019 (COVID-19). However, there is growing evidence suggesting that COVID-19 is associated with new-onset DM type 1 and type 2. This review aims to summarize the current knowledge about the new onset of DM following COVID-19. All identified studies were longitudinal, and they have predominantly shown a significantly increased risk for new-onset DM (both type 1 and type 2) following a SARS-CoV-2 infection. Increased risk of poorer COVID-19 outcomes (mechanical ventilation, death) was noted in persons with new-onset DM following SARS-CoV-2 infection. Studies investigating risk factors for new-onset DM in COVID-19 patients showed that severe disease, age, ethnicity, ventilation, and smoking habits were associated with DM occurrence. The information summarized in this review presents a valuable source of evidence for healthcare policymakers and healthcare workers in the effort of planning prevention measures for new-onset DM after SARS-CoV-2 infection and the timely identification and appropriate treatment of patients with COVID-19 who could be at greater risk for new-onset DM.

Global Patterns of Trends in Cholera Mortality.

BACKGROUND: Cholera is a large public health issue, especially in countries with limited resources. The aim of the study was to determine trends in global cholera mortality from 1990-2019. METHODS: This research is an observational, descriptive epidemiological study. The age-standardized rates (ASRs, per 100,000 population) of cholera mortality from 1990 to 2019 were evaluated through joinpoint regression analysis (by calculating Odds Ratio-OR, with corresponding 95% Confidence Interval-95% CI). RESULTS: From 1990-2019 in the world, the number of deaths due to cholera in both sexes together increased, ranging from 83,045 in 1990 to 117,167 in 2019. During the observed period, there were about 3.0 million deaths due to cholera in the world. In both sexes together in 2019, the cholera mortality rate was the highest in Nigeria (ARS = 39.19) and Central African Republic (ARS = 38.80), followed by populations in Eritrea (ARS = 17.62) and Botswana (ARS = 13.77). Globally, cholera-related mortality significantly decreased in males (AAPC = -0.4%, 95% CI = -0.7 to -0.1), while a stable trend was noted in females (AAPC = -0.1%, 95% CI = -0.4 to 0.2) in the observed period. In the African Region, significantly increasing cholera-related mortality trends were observed both in males and females (AAPC = 1.3% and AAPC = 1.1%, respectively). CONCLUSIONS: Cholera mortality showed a constantly increasing trend in the African Region over the last three decades. More efforts in cholera management are necessary for effective response to the growing mortality in developing countries.