Mortality risk among adult americans living with cancer and elevated CRP.

The role of C Reactive Protein (CRP) in predicting long-term outcomes among people living with cancer has not been well explored. We aimed to assess the role of elevated CRP in predicting all-cause mortality among a community-based sample of adult Americans living with cancer. The National Health and Nutrition Examination Survey, 1999-2010 was linked with mortality files up to December 2019 from the National Death Index. Sociodemographic and health-related variables of 30,711 participants (mean age=46.5 years) were analyzed to compute adjusted hazard ratios (HR) for all-cause mortality. The risk of mortality, in unadjusted analysis, was significantly higher among those with cancer compared to those without cancer 3.53 (95% CI= 3.13-3.98, p < 0.001). In adjusted analysis, when stratified by CRP levels (elevated=cutoff point at ≥2 mg/dL), among individuals with elevated CRP but no cancer history, the risk of mortality was significantly higher (HR=1.67, 95% CI=1.24-2.25) compared to those without cancer or elevated CRP. Among individuals with cancer but without elevated CRP as well, the risk of mortality was 20% higher compared to their counterparts. The highest risk of mortality was observed among those with both cancer and elevated CRP (HR=2.10, 95% CI=1.11-4.33). Age and income were significant predictors of these relationships. Among people living with cancer, CRP may serve as a marker for mortality and future studies should explore the pathways by which the risk of mortality may increase due to variation of CRP in cancer patients.

Depression increases the risk of mortality among people living with diabetes: Results from national health and nutrition examination survey, USA.

INTRODUCTION: Type 2 Diabetes (T2D) and depression are leading global public health problems associated with profound disability and lower quality of life. Extensive evidence suggests that the two disorders are frequently comorbid. However, long-term effects such as the risk of mortality due to depression among people living with T2D are not well explored. METHODS: Data from the National Health and Nutrition Examination Survey, 2005-2010 were linked with mortality files from the National Death Index up to December 31st, 2019. RESULTS: A total of 14,920 American adults were included in the study sample; nearly a tenth of them had depression (9.08 %) or T2D (10 %). In adjusted analysis, individuals with T2D were 1.70 times more likely (95 % CI = 1.42-2.03) to die than those without T2D. Among people living with T2D without depression, the risk of mortality was 1.55 times higher, but those with both T2D and depression had a 4.24 times higher risk of mortality. CONCLUSIONS: Given the greater risk of morbidity and premature mortality with cooccurring T2D and depression, widespread screening is warranted with a focus on high-risk groups. Integrated and collaborative care models can help address the psychosocial needs of people with T2D and should be widely implemented with the sensitization of clinicians and care teams in primary and specialist care for T2D.

Assessment of donor quality and risk of graft failure after liver transplantation: The ID2 EAL score.

Accurate assessment of donor quality at the time of organ offer for liver transplantation candidates may be inadequately captured by the donor risk index (DRI). We sought to develop and validate a novel objective and simple model to assess donor risk using donor level variables available at the time of organ offer. We utilized national data from candidates undergoing primary LT (2013-2019) and assessed the prediction of graft failure 1 year after LT. The final components were donor Insulin-dependent diabetes mellitus, Donor type (DCD or DBD), cause of Death = CVA, serum creatinine, Age, height, and weight (length). The ID2 EAL score had better discrimination than DRI using bootstrap corrected concordant index over time, especially in the current era. We explored donor-recipient matching. Relative risk of graft failure ranged from 1.15 to 3.5 based on relevant donor-recipient matching by the ID2 EAL score. As an example, for certain recipients, a young DCD donor offer was preferable to an older DBD with relevant comorbidities. The ID2 EAL score may serve as an important tool for patient discussion about donor risk and decisions regarding offer acceptance. In addition, the score may be preferable to succinctly capture donor risk in future organ allocation that considers continuous distribution (www.iddealscore.com).

Prevalence and Risk Factors of Obesity among Workers in the Oil and Gas Industry of the Niger Delta Region.

Background: Obesity prevalence among oil and gas industry workers over the past decade globally has been on the increase, adversely affecting workers' well-being and productivity. Therefore, necessitates the increased need for both occupational, and public health policymakers to take action. Data on obesity prevalence rates among workers in the oil and gas industry of the Niger-Delta region needed to drive public and occupational health policies regarding obesity is scarce. Therefore, this study aimed to determine the prevalence of obesity and its risk factors among oil and gas industry workers in the Niger Delta Region of Nigeria. Methodology: A cross-sectional study of 280 oil and gas industry workers in the Niger Delta region of Nigeria aged 29 -to 61 years, from November - to - December 2017 was done. A structured survey data of Body Mass Index (BMI) measurements and socio-demographics was collected. Statistical analysis with Chi-Square and Multinomial Logistic Regression tests was used. Results: Results indicated that the Obesity prevalence rate among the oil and gas industry workers of the Niger Delta region was 49.6% (p=0.002). Obesity was significantly associated with a family history of cardiovascular diseases (OR=2.761, p=0.001, 95%CI=1.491-5.112). Conclusion: The Obesity prevalence of 49.6% (p=0.002) among oil and gas industry workers in the Niger-Delta region, is statistically significantly high. Therefore, concretive preventive measures are needed to reduce obesity prevalence among workers.

Food Insecurity and Mortality in American Adults: Results From the NHANES-Linked Mortality Study.

Food insecurity is a significant public health problem in the United States leading to substantial social, economic, and health care-related burdens. While studies continue to estimate the prevalence of food insecurity, the long-term outcomes are not extensively explored. The purpose of this study was to assess the impact of food insecurity on mortality. We analyzed data on adults (≥ 20 years) from the 1999-2010 National Health and Nutrition Examination Survey, with mortality data obtained through 2015. Among the total study participants (n = 25,247), 17.6% reported food insecurity. Food-insecure individuals were more likely to be younger in age, minorities, poorer, with lesser education, obese, smokers, and with diabetes compared to food-secure counterparts. During a 10.2-year follow-up, among the food insecure, 821 individuals died (11%). The hazard ratio (HR) for mortality among the food insecure compared with the food secure, with adjustment for age and gender only, was 1.58; 95% confidence interval [CI: 1.25, 2.01]. The adjusted HRs for all-cause mortality, HR = 1.46, CI [1.23, 1.72], p < .001, and cardiovascular mortality, HR = 1.75, CI [1.19, 2.57], p < .01, were statistically significantly higher among food-insecure individuals, after adjustment for multiple demographic and health risk factors. Individuals who are food-insecure have a significantly higher probability of death from any cause or cardiovascular disease in long-term follow-up. Comprehensive and interdisciplinary approaches to reducing food insecurity-related disparities and health risks should be implemented. Including food insecurity in health risk assessments and addressing food insecurity as a determinant of long-term outcomes may contribute to lower premature death rates.

A systematic review of epidemiological patterns and proposed interventions to address pediatric burns in Nigeria.

BACKGROUND: Unintentional injuries from burns comprise a significant proportion of public health morbidity in Nigeria. In order to understand the type and impact of burns on youth in Low-and-Middle-Income countries, the epidemiology of burns must be adequately assessed. METHODS: This review describes the epidemiological patterns of burn occurrences in the pediatric populations and proposes interventions using the Haddon Matrix to address injuries in specific populations in Nigeria. A literature search was conducted using the Proquest, CINAHL, and PubMed databases at the Johns Hopkins University library (January 1, 1990 to August 14, 2018), on burns or thermal injury among pediatric populations in Nigeria. The review focused on the forms of injury, risk factors and potential interventions. RESULTS: Ten studies were identified and the main risk factors for burns were socioeconomic status, overcrowding, and involving young girls in traditional cooking roles. The main types of injuries include scald injuries (50%) and fire burns (45%) affecting mainly children aged 14 and below with significant regional epidemiological variations. We created a novel intervention to develop countermeasures and reduce the number of pediatric burns based on biological, physical and sociocultural environment.. CONCLUSION: Interventions such as improved supervision of children, improved emergency infrastructure and culturally sensitive first aid education and treatment can help ensure a reduction in morbidity and mortality resulting from burns. Epidemiological studies can provide an accurate depiction of the burden of burn injuries in different regions of Nigeria.

Time-series study of cardiovascular rates in India: A systematic analysis between 1990 and 2017.

Cardiovascular disease represents a significant public health issue and places an immense burden on India's citizens, families, health systems, and the population. Predictive models provide structure and direction in anticipating future needs. This time-series study employed Box-Jenkins time series modeling to forecast 2030 prevalence and mortality rates of stroke, ischemic heart disease, and cardiovascular disease. The 2030 projected cardiovascular disease prevalence rate was predicted to increase to 5.26% (95% prediction interval, 5.19%-5.28%), with major contributors being stroke and ischemic heart disease. The authors propose increased investment across the continuum of care to efficaciously promote, prevent, and rehabilitate cardiovascular disease.

Prevalence of Psychosocial Stress and Its Risk Factors among Health-care Workers in Nigeria: A Systematic Review and Meta-Analysis.

CONTEXT: Health-care workers experience psychosocial stress in their workplace. Available statistics are at variance, and hence, the need to know the overall prevalence of psychosocial stress among Nigerian health-care workers and associated risk factors. AIMS: The aim of this study was to determine the prevalence of psychosocial stress and its risk factors among health-care workers in Nigeria through meta-analysis. MATERIALS AND METHODS: PubMed, CINAHL, and Google Scholar databases were searched for articles. Search terms include "psychosocial stress," "occupational health," and "Nigerian health-care worker." Articles were included if they used validated psychosocial stress assessment instruments. Of the 17 articles with data on psychosocial stress prevalence, eight met all inclusion criteria. Each article independently reviewed by the authors and relevant data abstracted. Statistical analysis was done using MedCalc version 18.10. RESULTS: Overall, the prevalence of psychosocial stress was 61.97% (95% confidence interval [CI]: 41.013-80.823) based on analyzed eight articles with the sample size of 1763. Work overload rate at 67.72% (95% CI: 33.24-93.76) was the most prevalent psychosocial stress risk factor. Other risk factors were poor communication and staff attitude and lack of resources and equipment at 50.37% (95% CI: 13.35-87.16) and 62.4% (95% CI: 7.70-99.9), respectively. Headache, with neck and back pain, was the most prevalent psychosocial stress-related health outcome at 73.26% (95% CI: 66.14-79.82). CONCLUSION: Prevalence of psychosocial stress is high among health-care workers in Nigeria, necessitating preventive measures.

Association between food insecurity, cardiorenal syndrome and all-cause mortality among low-income adults.

BACKGROUND: Food insecurity is known to be a major public health issue. There is limited data on food insecurity and chronic disease in the general population. AIM: We aimed to assess effect of food insecurity on mortality of individuals with chronic disease like cardiorenal syndrome (CRS). METHODS: The study was conducted on participants aged 20 years or older in the United States living below the 130% Federal Poverty Level. We assessed food insecurity utilizing the Household Food Security Survey Module in NHANES survey for the years 1999 to 2010 with mortality follow-up. Prospective analysis was performed using complex samples Cox regression with adjustment for known confounders to determine the relationship of food insecurity and CRS. RESULTS: Prevalence of food insecurity among the low-income population was 16.1% among males and 21.7% among females. The mean follow-up was 6.5 years. For all-cause mortality, the overall unadjusted hazard ratio (HR) of food insecurity to no food insecurity was 1.28 (95% confidence interval [CI], 1.18-1.37, p < 0.001). Adjusted HR was elevated, 2.81 (CI 1.57-5.05, p < 0.001), among participants who were CRS-positive and food insecure but closer to 1.0 (2.48 CI 1.73-3.55, p < 0.001) among those who were CRS-positive and food secure, after controlling for medical and demographic risk factors. CONCLUSIONS: Food insecurity is associated with higher mortality than food security. Food insecurity also may modify the effect of CRS on all-cause mortality in a representative general population. Social policy, when addressing food insecurity, should be inclusive among those with specific chronic diseases.

Diabetes and cardiorenal syndrome: Understanding the "Triple Threat".

OBJECTIVE: Diabetes is known to be associated with chronic kidney disease (CKD) and cardiovascular disease (CVD) independently. Type 2 cardiorenal syndrome (CRS), a recently defined syndrome, is characterized by primary renal failure that progressively leads to cardiac dysfunction. The effect of diabetes on cardiorenal syndrome has not been explored in a multi-ethnic population. In this retrospective secondary analysis, the hypothesis that diabetes modifies the effect of CVD on CKD was tested. METHODS: The National Health and Nutrition Examination Survey (NHANES) is a cross-sectional survey that was performed on the non-institutionalized population in the United States. All patients from the NHANES study, who were 20 years and older between the years 1999 and 2010, were included in the analysis. CKD was determined using the Cockcroft-Gault equation. The analysis was performed using a complex samples logistic regression to determine the relationship between diabetes and CRS. RESULTS: The prevalence of CKD among the population was 9.6% in Non-Hispanic Whites, 8.9% in African-Americans, and 4.5% in Hispanics. The overall unadjusted odds ratio for CKD to no CKD was 6.89 (95% confidence interval [CI], 6.13-7.75, p < 0.001). The adjusted OR was elevated, 2.25 (CI 1.56-3.23, p < 0.001), among individuals with diabetes but was approximately 1.0 (1.43 CI 1.16-1.76, p < 0.05) among patients without diabetes after controlling for medical risk factors and demographic risk factors. CONCLUSION: Diabetes is strongly associated with Type 2 CRS in a nationally representative multi-ethnic population and must be considered when treating patients. Longitudinal studies should further examine this association.