Trends of primary liver cancer incidence and mortality in the United States: A population-based study over the last four decades.

BACKGROUND: Primary liver cancer is the third leading cause of cancer deaths worldwide and has one of the worst 5-year survival rates. This study examines US primary liver cancer incidence and incidence-based mortality trends over four decades. RESEARCH DESIGN AND METHODS: The SEER-9 registry was used to study primary liver cancer cases from 1978 to 2018. The incidence and mortality rates were calculated based on gender, age, race, and stage of diagnosis. Joinpoint regression software was used to calculate the annual percent change. RESULTS: The overall incidence rate of primary liver cancer from 1978 to 2018 increased by 2.71%/year (p<0.001). Rates in patients <50 years old began to fall in 2002 at a rate of -3.62%/year (p<0.001). Similarly, the incidence-based mortality rates for primary liver cancer increased by 2.15%/year (p<0.001). Whereas Whites incidence-based mortality rates began to plateau in 2012 (0.18%/year; p = 0.84), Blacks rates have declined since 2010 (-2.93%/year; p = 0.03), and Asian rates have declined since 1999 (-1.30%/year; p<0.001). CONCLUSION: While the overall primary liver cancer incidence and incidence-based mortality have been increasing over the last four decades, there was an observed decline in incidence and incidence-based mortality in recent years, especially among at-risk subgroups.

Early vs. late transcatheter aortic valve replacement in acute heart failure hospitalizations: A comparative nationwide analysis.

BACKGROUND: Severe aortic stenosis (AS) is the most common valvular disease in the USA. Patients undergoing urgent or emergent transcatheter aortic valve replacement (TAVR) have worse clinical outcomes than those undergoing non-urgent procedures. No studies have examined the impact of procedural TAVR timing on outcomes in AS complicated by acute heart failure (AHF). AIMS: We aimed to evaluate differences in in-hospital mortality and clinical outcomes between early (<48 h) vs. late (≥48 h) TAVR in patients hospitalized with AHF using a real-world US database. METHODS: We queried the National Inpatient Sample database to identify hospitalizations with a diagnosis of AHF, aortic valve disease, and a TAVR procedure (2015-2020). The associations between TAVR timing and clinical outcomes were examined using logistic regression model. RESULTS: A total of 25,290 weighted AHF hospitalizations were identified, of which 6855 patients (27.1 %) underwent early TAVR, and 18,435 (72.9 %) late TAVR. Late TAVR patients had higher in-hospital mortality rate (2.2 % vs. 2.8 %, p < 0.01) on unadjusted analysis but no significant difference following adjustment for demographic, clinical, and hospital characteristics [aOR 1.00 (0.82-1.23)]. Late TAVR was associated with higher odds of cardiac arrest (aOR 1.50, 95 % CI: 1.18-1.90) and use of mechanical circulatory support (aOR 2.05, 95 % CI: 1.68-2.51). Late TAVR was associated with longer hospital stay (11 days vs. 4 days, p < 0.01) and higher costs ($72,851 vs. $53,209, p < 0.01). CONCLUSION: Early TAVR was conducted in approximately 25 % of the AS patients admitted with AHF, showing improved in-hospital outcomes before adjustment, with no significant differences observed after adjustment.

Trends of chronic lymphocytic leukemia incidence and mortality in the United States: a population-based study over the last four decades.

BACKGROUND: Chronic lymphocytic leukemia (CLL) is the most common leukemia among adults, and its incidence is higher in elderly individuals. This study aims to examine the burden of CLL in the United States (US) by exploring the incidence-based rates (IBR) and incidence-based mortality (IBMR) across four decades. RESEARCH DESIGN AND METHODS: CLL incidence data were obtained from the SEER-8 registry, covering 8.3% of the US population. Cases were identified using specific diagnostic codes and excluded if diagnosed on autopsy or death certificate. Age-standardized IBR and IBMR were calculated based on age, sex, and ethnicity/race. Joinpoint Regression Program was used to analyze changing trends in incidence and mortality. RESULTS: Since 2011, males' and females' IBRs declined by -1.72%/year (p = 0.028) and -1.07%/year (p = 0.222), respectively. IBR of patients > 75 years increased by 4.01%/year (p < 0.001) form 1998-2010, then declined by 2.02%/year (p = 0.011). IBR of Blacks increased by 0.96%/year (p < 0.001) throughout the study period. CLL IBMR stabilized at -0.38%/year (p = 0.457) since 2012. Whites' IBMR plateaued at a rate of -0.10%/year (p = 0.857) form 2012-2019, while blacks' IBMR increased by 1.40%/year (p = 0.056) between 2000-2019. CONCLUSIONS: The analysis revealed a decline in CLL incidence since 2013, with stable mortality rates since 2012, indicating advancements in CLL management.

Potential anticancer properties of calotropis procera: An investigation on breast and colon cancer cells.

Calotropis procera is a perennial flowering plant of the Apocynaceae family, traditionally used in medicine to treat various ailments. Recent investigations have revealed its potential therapeutic activities such as anti-inflammatory, gastroprotective, analgesic, anti-obesity, and anti-diabetic properties. RP-HPLC qualitatively and quantitatively evaluated the phenolic acids and flavonoids in the ethanolic extract at two different wavelengths, 280 and 330 nm. In addition, total phenolic and flavonoid contents were measured via spectrophotometric determination in addition to the antioxidant activity. The antiproliferative effects of C. procera were investigated on two cancer cell lines: human colon (HCT-116) and breast (MCF-7) cancer. Several methods were utilised to analyse the effectiveness of the plant extract on the cytotoxicity, apoptosis, cell cycle progression, genes involved in the cell cycle, and protein expression profiles of HCT-116 and MCF-7 cells. These included the MTT assay, Annexin V-FITC/PI, analysis of the cell cycle, and Western blot. Results indicated that ferulic and caffeic acids were the major compounds at λmax 280 nm (1.374% and 0.561%, respectively), while the major compounds at λmax 325 nm were kaempferol and luteolin (1.036% and 0.512%, respectively). The ethanolic extract had significantly higher antioxidant activity (80 ± 2.3%) compared to ascorbic acid (90 ± 3.1%). C. procera extract exhibited dose-dependent cell growth inhibition, with an estimated IC50 of 50 µg/mL for MCF-7 and 55 µg/mL for HCT-116 cells at 24 h. Annexin V-FITC/PI confirmed the induction of apoptosis. Remarkably, cell cycle arrest occurred at the sub-G1 phase in MCF-7 cells, while in HCT-116 cells, it was observed at the G2-M phase. The sub-G1 arrest was associated with dysregulation of Akt, p-AKT, mTOR, and p-mTOR proteins, as confirmed by the Western blot analysis, while downregulation of CDK1, cyclin B1, and survivin caused G2-M arrest.

RhoA/ROCK inhibition attenuates endothelin-1-induced glomerulopathy in the rats.

Endothelin-1 (ET-1) contributes to the development of kidney diseases. However, the underlying molecular mechanism is largely undefined. Here we sought to investigate the potential role of ET-1 receptors, ETA and ETB in the regulation of increased glomerular permeability and underlying signaling pathways post-ET-1 infusion. Male Sprague-Dawley rats were infused with ET-1 (2 pmol/kg per minute, i.v.) for four weeks, and the effect on glomerular permeability to albumin (Palb) and albuminuria was measured. The selective ROCK-1/2 inhibitor, Y-27632, was administered to a separate group of rats to determine its effect on ET-1-induced Palb and albuminuria. The role of ETA and ETB receptors in regulating RhoA/ROCK activity was determined by incubating isolated glomeruli from normal rats with ET-1 and with selective ETA and ETB receptor antagonists. ET-1 infusion for four weeks significantly elevated Palb and albuminuria. Y-27632 significantly reduced the elevation of Palb and albuminuria. The activities of both RhoA and ROCK-1/2 were increased by ET-1 infusion. Selective ETB receptor antagonism had no effect on the elevated activity of both RhoA and ROCK-1/2 enzymes. Selective ETA receptor and combined ETA/ETB receptors blockade restored the activity of RhoA and ROCK-1/2 to normal levels. In addition, chronic ET-1 infusion increased the levels of glomerular inflammatory and fibrotic markers. These effects were all attenuated in rats following ROCK-1/2 inhibition. These observations suggest that ET-1 contributes to increased albuminuria, inflammation, and fibrosis by modulating the activity of the ETA-RhoA/ROCK-1/2 pathway. Selective ETA receptor blockade may represent a potential therapeutic strategy to limit glomerular injury and albuminuria in kidney disease.

Knowledge, attitudes, and practices of the United Arab Emirates population towards Herpes Zoster vaccination: A cross-sectional study.

Herpes Zoster is a viral infection that occurs due to reactivation of the Varicella Zoster virus. A vaccine has been approved for adults aged 50 and above for the prevention of Herpes Zoster and its complications. This study aims to assess the at-risk population's awareness of the disease and its vaccine, and attitudes and practices toward the vaccine. A quantitative, observational, cross-sectional study was conducted among 420 adults above the age of 50. Non-probability, convenience sampling was used to select participants from public venues. SPSS-25 was used to analyze the data. 64.3% (n = 270) of participants heard of Herpes Zoster. 78.3% (n = 329) did not recognize the link between chickenpox and Herpes Zoster. Multiple linear regression showed that being female, Arab expatriate, or healthcare professional were the only positive predictors of Herpes Zoster knowledge. 14.8% (n = 62) heard of Herpes Zoster vaccine but 96.7% (n = 406) had not taken it. Participants with chronic diseases were 2.064 times more likely to hear about the vaccine than healthy participants (p = 0.026). Multiple linear regression showed that being a healthcare professional was the only significant predictor of Herpes Zoster vaccine knowledge. 28.1% (n = 118) were not willing to take optional vaccines. Those reluctant to take optional vaccines were 26.023 times more likely to take them if recommended by a healthcare professional (p < 0.001). Attitudes toward Herpes Zoster vaccine were generally positive; however, due to lack of knowledge, poor practices were observed. Nationwide campaigns aimed toward at-risk groups can raise awareness on Herpes Zoster and its vaccine, subsequently improving Herpes Zoster vaccination rate.

Evaluating the knowledge, attitudes and practices of the UAE community on microbiota composition and the main factors affecting it: a cross-sectional study.

OBJECTIVES: This study aims to explore the knowledge, attitudes and practices (KAP) of the population in the United Arab Emirates (UAE) regarding microbiota and the main factors affecting its composition. DESIGN/SETTING: A cross-sectional study, using a self-administered questionnaire, was conducted from May 2018 to September 2018, recruiting participants in public venues via convenience sampling. PARTICIPANTS: UAE residents (aged 18 years and above) who spoke either Arabic or English. RESULTS: 419 responses were completed and analysed using SPSS V.24. Only 29.3% (n=94) of the participants who defined microbiota correctly had good knowledge. There was a significant difference in knowledge among different age groups (p=0.004) and educational levels (p<0.001). Multiple linear regression (MLR) model indicated that being a university student and a healthcare professional (HCP) are the only significant predictors regarding microbiota knowledge (p=0.014 and p<0.001, respectively). Of the respondents who claimed to be aware of probiotics, only 9.1% (n=15) exhibited good knowledge. MLR model showed that being a postgraduate and an HCP are the only significant predictors for probiotics knowledge (p=0.016 and p<0.001, respectively). 42.4% (n=143) and 34.6% (n=28) of the non-medical and HCP participants, respectively, use antibiotics without a prescription. None of the respondents, with or without a medical background, demonstrated good attitudes and practices toward the use of antibiotics. CONCLUSION: Despite the fact that the participants had a basic understanding of microbiota and probiotics, the overall knowledge was substandard. Additionally, the respondents engaged in improper practices that alter the microbiota composition, especially via antibiotics misuse. Campaigns should target the general population as well as HCPs to upheave their overall KAP.

Evaluating the knowledge, attitudes, and uptake of the influenza vaccine in healthcare professionals: A cross-sectional study from the United Arab Emirates.

Background: Influenza, a yearly epidemic, can present with a wide array of symptoms ranging from mild rhinorrhoea and cough to life-threatening superadded bacterial infections. It affects the lives of around 12.5% of the world's population every year and accounts for almost half a billion deaths. With growing populations, these numbers will follow a similar growth resulting in increased morbidity and mortality. Currently, the recommended method to prevent influenza is through the administration of a yearly vaccine that entails the suspected strains of the virus for the year and region. Objective: This study aims to explore the knowledge, attitudes, and practices of the health care professionals in the United Arab Emirates (UAE) regarding Influenza vaccination. Methods: A cross-sectional study, utilizing a self-administered questionnaire, was distributed amongst health care professionals in the four largest emirates in the UAE, via convenience sampling. 417 responses were completed and analysed using SPSS-24. Results: 54.1% (n=225) of participants continue going to work while being sick despite 67.6% (n=282) reporting they are aware of the recommendations published by the Centers for Disease Control and Prevention (CDC). Multiple linear regression showed that age and profession were the only significant predictor of influenza vaccine knowledge. 54.2% (n=226) of the participants reported receiving the vaccine; of those, only 38.9% (n=88) receive it annually. One of the most commonly reported barriers to taking the vaccine was the uncertainty of its effectiveness. Those using a reminder system were 2.044 times more likely to take the vaccine regularly. Conclusion: This study demonstrates that the attitudes and practices towards taking the influenza vaccine as recommended are suboptimal. Campaigns targeting health care professionals regarding the influenza vaccine and the CDC recommendations would perhaps positively skew the results in the future.