RESUMO
BACKGROUND: Urinary tract infections (UTI), urolithiasis, and benign prostatic hyperplasia (BPH) are three of the most common nonmalignant conditions in urology. However, there is still a lack of comprehensive and updated epidemiological data. This study aimed to investigate the disease burden of UTI, urolithiasis, and BPH in 203 countries and territories from 1990 to 2019. METHODS: Data were extracted from the Global Burden of Disease 2019, including incident cases, deaths, disability-adjusted life-years (DALYs) and corresponding age-standardized rate (ASR) from 1990 to 2019. Estimated annual percentage changes (EAPC) were calculated to evaluate the trends of ASR. The associations between disease burden and social development degrees were analyzed using a sociodemographic index (SDI). RESULTS: Compared with 1990, the incident cases of UTI, urolithiasis, and BPH increased by 60.40%, 48.57%, and 105.70% in 2019, respectively. The age-standardized incidence rate (ASIR) of UTI increased (EAPC = 0.08), while urolithiasis (EAPC = - 0.83) and BPH (EAPC = - 0.03) decreased from 1990 to 2019. In 2019, the age-standardized mortality rate (ASMR) of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000, respectively. BPH had the largest increase (110.56%) in DALYs in the past three decades, followed by UTI (68.89%) and urolithiasis (16.95%). The burden of UTI was mainly concentrated in South Asia and Tropical Latin America, while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe. Moreover, the ASIR and SDI of urolithiasis in high-SDI regions from 1990 to 2019 were negatively correlated, while the opposite trend was seen in low-SDI regions. In 2019, the ASIR of UTI in females was 3.59 times that of males, while the ASIR of urolithiasis in males was 1.96 times higher than that in females. The incidence was highest in the 30-34, 55-59, and 65-69 age groups among the UTI, urolithiasis, and BPH groups, respectively. CONCLUSION: Over the past three decades, the disease burden has increased for UTI but decreased for urolithiasis and BPH. The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.
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Hiperplasia Prostática , Infecções Urinárias , Urolitíase , Feminino , Carga Global da Doença , Humanos , Masculino , Hiperplasia Prostática/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida , Infecções Urinárias/epidemiologia , Urolitíase/epidemiologiaRESUMO
BACKGROUND: The burden of kidney, bladder, and prostate cancers has changed in recent decades. This study aims to investigate the global and regional burden of, and attributable risk factors for genitourinary cancers during the past 30 years. METHODS: We extracted data of kidney, bladder, and prostate cancers from the Global Burden of Disease 2019 database, including incidence, mortality, disability-adjusted life-years (DALYs), and attributable risk factors from 1990 to 2019. Estimated annual percentage changes (EAPC) were calculated to assess the changes in age-standardized incidence rate, age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). The associations between cancers burden and socio-demographic index (SDI) were also analyzed. RESULTS: Compared with 1990, the global incident cases in 2019 were higher by 154.78%, 123.34%, and 169.11% for kidney, bladder, and prostate cancers, respectively. During the 30-year study period, there was a downward trend in ASMR and ASDR for bladder cancer (EAPC = - 0.68 and - 0.83, respectively) and prostate cancer (EAPC = - 0.75 and - 0.71, respectively), but an upward trend for kidney cancer (EAPC = 0.35 and 0.12, respectively). Regions and countries with higher SDI had higher incidence, mortality, and DALYs for all three types of cancers. The burden of bladder and prostate cancers was mainly distributed among older men, whereas the burden of kidney cancer increased among middle-aged men. Smoking related mortality and DALYs decreased, but high body mass index (BMI) and high fasting plasma glucose (FPG) related mortality and DALYs increased among kidney, bladder, and prostate cancers during the study period. CONCLUSIONS: Kidney, bladder, and prostate cancers remain major global public health challenges, but with distinct trend for different disease entity across different regions and socioeconomic status. More proactive intervention strategies, at both the administrative and academic levels, based on the dynamic changes, are needed.
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Neoplasias da Próstata , Bexiga Urinária , Idoso , Carga Global da Doença , Humanos , Rim , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida , Fatores de RiscoRESUMO
Traceability offers significant information about the quality and safety of Chinese Angelica, a medicine and food homologous substance. In this study, a systematic four-step strategy, including sample collection, specific metal element fingerprinting, multivariate statistical analysis, and benefit-risk assessment, was developed for the first time to identify Chinese Angelica based on geographical origins. Fifteen metals in fifty-six Chinese Angelica samples originated from three provinces were analyzed. The multivariate statistical analysis model established, involving hierarchical cluster analysis (HCA), principal component analysis (PCA), and self-organizing map clustering analysis was able to identify the origins of samples. Furthermore, benefit-risk assessment models were created by combinational calculation of chemical daily intake (CDI), hazard index (HI), and cancer risk (CR) levels to evaluate the potential risks of Chinese Angelica using as traditional Chinese medicine (TCM) and food, respectively. Our systematic strategy was well convinced to accurately and effectively differentiate Chinese Angelica based on geographical origins.
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Angelica , Medicina Tradicional Chinesa , Metais , Análise de Componente Principal , Medição de RiscoRESUMO
Objective: To develop a physical- cognitive scale for assessment of frailty and compare the clinical features between the new scale and the conventional Fried criteria. Methods: 1757 individuals aged 70-84 were analyzed. Participants reporting three or more Fried phenotypes were grouped as frail patients (FP) whereas others as non-frail (NF). A score of Hasegawa's dementia scale (HDS-R) higher than 21.5 were classified as non-cognitive impairment group (NCI) group. By combining the cognitive and frailty criteria, participants manifesting three or more positive components out of the six were categorized into the Physical-cognitive frailty group (Pc-F) while others into non- Pc-F (Pc-NF). Results: Of all the participants, 46.7% (820) were males and 53.3% (937) were females. The mean age was 75.33 ± 3.90. 10.1% (178/1757) were evaluated as FP patients. The prevalence of CI was 53.2%; CI was much higher in the frail group (77.0%) than in the non-frail group (50.5%). Based on the new Pc-F scale, 163 out of 1579 NF participants were identified as Pc-F, and the prevalence of Pc-F reached 19.4% (341/1757). In the Pc-F group, there are more females, patients of advanced age, diabetes, stroke, CHD, CKD, metabolic syndrome, and high hs-CRP. Within the Pc-F group, patients with CI showed a higher incidence of exhaustion, low activity, weakness, and slowness than those without CI. Conclusions: Our study revealed a significantly worse status in frail participants with CI than without. Our new scale shows a stronger correlation between frailty and complications than the classic phenotype.
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Disfunção Cognitiva/diagnóstico , Fragilidade/diagnóstico , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Povo Asiático , China , Disfunção Cognitiva/complicações , Feminino , Idoso Fragilizado , Fragilidade/complicações , Indicadores Básicos de Saúde , Humanos , Masculino , Escalas de Graduação PsiquiátricaRESUMO
BACKGROUND: Neonatal hearing screening (NHS) has been routinely offered as a vital component of early childhood care in developed countries, whereas such a screening program is still at the pilot or preliminary stage as regards its nationwide implementation in developing countries. To provide significant evidence for health policy making in China, this study aims to determine the cost-effectiveness of NHS program implementation in case of eight provinces of China. METHODS: A cost-effectiveness model was conducted and all neonates annually born from 2007 to 2009 in eight provinces of China were simulated in this model. The model parameters were estimated from the established databases in the general hospitals or maternal and child health hospitals of these eight provinces, supplemented from the published literature. The model estimated changes in program implementation costs, disability-adjusted life years (DALYs), average cost-effectiveness ratio (ACER), and incremental cost-effectiveness ratio (ICER) for universal screening compared to targeted screening in eight provinces. RESULTS AND DISCUSSION: A multivariate sensitivity analysis was performed to determine uncertainty in health effect estimates and cost-effectiveness ratios using a probabilistic modeling technique. Targeted strategy trended to be cost-effective in Guangxi, Jiangxi, Henan, Guangdong, Zhejiang, Hebei, Shandong, and Beijing from the level of 9%, 9%, 8%, 4%, 3%, 7%, 5%, and 2%, respectively; while universal strategy trended to be cost-effective in those provinces from the level of 70%, 70%, 48%, 10%, 8%, 28%, 15%, 4%, respectively. This study showed although there was a huge disparity in the implementation of the NHS program in the surveyed provinces, both universal strategy and targeted strategy showed cost-effectiveness in those relatively developed provinces, while neither of the screening strategy showed cost-effectiveness in those relatively developing provinces. This study also showed that both strategies especially universal strategy achieve a good economic effect in the long term costs. CONCLUSIONS: Universal screening might be considered as the prioritized implementation goal especially in those relatively developed provinces of China as it provides the best health and economic effects, while targeted screening might be temporarily more realistic than universal screening in those relatively developing provinces of China.
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Transtornos da Audição/diagnóstico , Perda Auditiva/diagnóstico , Testes Auditivos/economia , Triagem Neonatal/economia , China , Redução de Custos/estatística & dados numéricos , Redução de Custos/tendências , Análise Custo-Benefício/tendências , Bases de Dados Factuais , Educação Inclusiva/economia , Acessibilidade aos Serviços de Saúde/economia , Transtornos da Audição/terapia , Perda Auditiva/reabilitação , Perda Auditiva/terapia , Testes Auditivos/métodos , Maternidades , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , Modelos Estatísticos , Programas Nacionais de Saúde , Avaliação de Programas e Projetos de Saúde , Qualidade de Vida , Anos de Vida Ajustados por Qualidade de VidaRESUMO
The objectives of this study were to determine the environmental impacts of polychlorinated dibenzo-p-dioxin and polychlorinated dibenzofuran (PCDD/Fs) emitted from two typical municipal solid-waste incinerators (MSWIs), named M and L, in China. The main differences between the two MSWIs relate to incineration technologies, treatment capacities, emission standards and meteorological conditions. The distribution of PCDD/Fs in the surrounding ambient air and soils of the MWSIs were monitored and compared. In addition, air dispersion models and health risk assessments were combined to determine the behaviour and transport of PCDD/Fs. The results indicated that higher PCDD/F emission levels resulted in higher concentrations in the surrounding environment. The average PCDD/F levels emitted from the M MSWI was about seven times higher than those emitted from the L MSWI and about 10 times and 2 times higher in air and soils, respectively. The simulation results were similar to the trend of the monitored results. Both the observed and the simulation results suggested that the atmospheric pollution by PCDD/F surrounding the M MSWI was relatively serious; the environmental impact of the L MSWI was not significant.