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1.
BMC Infect Dis ; 21(1): 663, 2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34238232

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is associated with a high mortality rate, especially in patients with severe illness. We conducted a systematic review and meta-analysis to assess the potential predictors of mortality in patients with COVID-19. METHODS: PubMed, EMBASE, the Cochrane Library, and three electronic Chinese databases were searched from December 1, 2019 to April 29, 2020. Eligible studies reporting potential predictors of mortality in patients with COVID-19 were identified. Unadjusted prognostic effect estimates were pooled using the random-effects model if data from at least two studies were available. Adjusted prognostic effect estimates were presented by qualitative analysis. RESULTS: Thirty-six observational studies were identified, of which 27 were included in the meta-analysis. A total of 106 potential risk factors were tested, and the following important predictors were associated with mortality: advanced age, male sex, current smoking status, preexisting comorbidities (especially chronic kidney, respiratory, and cardio-cerebrovascular diseases), symptoms of dyspnea, complications during hospitalization, corticosteroid therapy and a severe condition. Additionally, a series of abnormal laboratory biomarkers of hematologic parameters, hepatorenal function, inflammation, coagulation, and cardiovascular injury were also associated with fatal outcome. CONCLUSION: We identified predictors of mortality in patients with COVID-19. These findings could help healthcare providers take appropriate measures and improve clinical outcomes in such patients.


Assuntos
COVID-19/diagnóstico , COVID-19/mortalidade , Corticosteroides/administração & dosagem , Distribuição por Idade , Doenças Cardiovasculares/epidemiologia , Comorbidade , Bases de Dados Factuais , Dispneia/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Inflamação/epidemiologia , Rim/fisiopatologia , Fígado/fisiopatologia , Masculino , Estudos Observacionais como Assunto , Prognóstico , Fatores de Risco , Distribuição por Sexo , Fumantes/estatística & dados numéricos
2.
Pak J Pharm Sci ; 34(1(Supplementary)): 321-325, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34275857

RESUMO

The study was aimed to mention the epidemiology of smoking in Pakistani COVID-19 infected patients along with the disease severity, oxygen dependency and fatality rate. A cross sectional epidemiological study was carried out on 555 confirmed cases of COVID-19 infection. The median age was 47±16 years. 59% were male and 41% were female. Most of the patients (97.5%) survived, while only 2.5% expired. 25.6% patients required the oxygen. Total 17 (3%) COVID-19 patients with age 20-75 years were identified as smokers. No mortality was observed in smokers. The 1.4% smokers presented with mild disease, 1.2% with moderate disease and 0.4% had severe disease. According to Chi-Square test, there existed an insignificant difference (p-value: 0.38649) between smokers and non-smokers in disease severity levels. Smoking is a precursor for countless diseases, but it behaved differently in COVID-19 infected patients, as its prevalence was significantly low. We found no significant variation of the disease severity among the smokers and non-smokers. Profound experiments should be conducted to recommend whether nicotine can be used as a protective agent to negate COVID-19 infection.


Assuntos
COVID-19/epidemiologia , COVID-19/etiologia , Fumar/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia , Índice de Gravidade de Doença , Distribuição por Sexo , Fumar Tabaco/epidemiologia , Adulto Jovem
3.
Arch Iran Med ; 24(5): 434-444, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-34196210

RESUMO

BACKGROUND: To better manage the COVID-19 pandemic, it is necessary to carefully study information about patients with COVID-19. Objective: To report clinical and epidemiological characteristics of COVID-19 patients in southern Iran. METHODS: This cross-sectional retrospective study was conducted based on data extracted from the COVID-19 registry of Hormozgan. Data from patients with confirmed COVID-19 based on CT-scan results or real-time reverse transcriptase-polymerase chain reaction (RT-PCR) results until September 25, 2020, were analyzed for this study (2351 inpatients). We reported demographics, signs and symptoms on admission, comorbidities, and treatments, as well as clinical outcomes, hospital stay, and intensive care unit (ICU) admission. RESULTS: Most of patients were men (1235/2351; 52.5%) and the most common signs and symptoms included cough (1343/2351; 57.1%), shortness of breath (1224/2351; 52.1%) and fever. The most common comorbidities included hypertension (410/2351 (17.4%), diabetes (343/2351; 14.6%) and chronic cardiac disease (282/2351; 12%). Also, 228 patients (9.7%) were hospitalized in the ICU. The mortality rate was 12.5% (295/2351) among all patients and 64.5% (147/228) in ICU wards, respectively. The number of cases with comorbidities including hypertension, chronic cardiac disease, diabetes, chronic neurological disorders, chronic kidney disease, chronic hematologic disease, malignant neoplasm, moderate or severe liver disease, dementia and fauvism in the ICU was significantly higher than the general wards. CONCLUSION: Most characteristics of our patients were similar to those reported in other studies; however, our patients were younger and suffered from a less severe disease. The mortality rate in the ICU was higher than other studies.


Assuntos
COVID-19/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , COVID-19/diagnóstico , COVID-19/terapia , Criança , Pré-Escolar , Cuidados Críticos , Estudos Transversais , Feminino , Hospitalização , Humanos , Lactente , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Distribuição por Sexo , Taxa de Sobrevida , Adulto Jovem
4.
Mayo Clin Proc ; 96(7): 1907-1920, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34218863

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has rapidly created widespread impacts on global health and the economy. Data suggest that women are less susceptible to severe illness. However, sex-disaggregated data are incomplete, leaving room for misinterpretation, and focusing only on biologic sex underestimates the gendered impact of the pandemic on women. This narrative review summarizes what is known about gender disparities during the COVID-19 pandemic and the economic, domestic, and health burdens along with overlapping vulnerabilities related to the pandemic. In addition, this review outlines recommended strategies that advocacy groups, community leaders, and policymakers should implement to mitigate the widening gender disparities related to COVID-19.


Assuntos
COVID-19/epidemiologia , Saúde Mental , Pandemias , Feminino , Saúde Global , Humanos , Masculino , SARS-CoV-2 , Distribuição por Sexo , Fatores Sexuais
5.
Reprod Health ; 18(Suppl 1): 120, 2021 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-34134720

RESUMO

BACKGROUND: In sub-Saharan Africa HIV transmission is a major challenge in adolescents, especially among girls and those living in urban settings. Major international efforts have aimed at reducing sexual transmission of HIV. This analysis aims to assess the trends in HIV prevalence by gender in adolescents, as well as urban-rural disparities. METHODS: HIV prevalence data at ages 15-19 years were obtained for 31 countries with a national survey since 2010 and for 23 countries with one survey circa 2005 and a recent survey circa 2015. Country medians and average annual rates of changes were used to summarize the trends for two subregions in sub-Saharan Africa, Eastern and Southern Africa and West and Central Africa, which largely correspond with higher and lower HIV prevalence countries. Data on HIV incidence at ages 15-24 and prevalence at 5-9 and 10-14 years were reviewed from 11 recent national surveys. Trends in urban-rural disparities in HIV prevalence and selected indicators of sexual and HIV testing behaviours were assessed for females and males 15-24 years, using the same surveys. RESULTS: HIV prevalence among girls 15-19 years declined in eastern and Southern Africa from 5.7 to 2.6% during 2005-2015 (country median), corresponding with an average annual rate of reduction of 6.5% per year. Among boys, the median HIV prevalence declined from 2.1 to 1.2%. Changes were also observed in West and Central Africa where median HIV prevalence among girls decreased from 0.7 to 0.4% (average annual rate of reduction 5.9%), but not for boys (0.3%). Girl-boy differences at 10-14 years were small with a country median HIV of 1.0% and 1.3%, respectively. Urban females and males 15-24 had at least 1.5 times higher HIV prevalence than their rural counterparts in both subregions, and since the urban-rural declines were similar, the gaps persisted during 2005-2015. CONCLUSIONS: HIV prevalence among adolescents declined in almost all countries during the last decade, in both urban and rural settings. The urban-rural gap persisted and HIV transmission to girls, but not boys, is still a major challenge in Eastern and Southern African countries.


Assuntos
Infecções por HIV/epidemiologia , Características de Residência/estatística & dados numéricos , População Rural , População Urbana , Adolescente , África ao Sul do Saara/epidemiologia , África Austral , Feminino , Humanos , Incidência , Masculino , Vigilância da População/métodos , Prevalência , Distribuição por Sexo , Adulto Jovem
6.
West J Emerg Med ; 22(3): 702-709, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-34125050

RESUMO

INTRODUCTION: Workplace violence in the emergency department (ED) is a serious threat to staff and is likely to go unreported. We sought to identify the incidence of violence among staff at our academic ED over a six-month period. METHODS: An anonymous survey was sent to all ED staff, asking whether respondents had experienced verbal abuse or physical assault over the prior six months and whether they had reported it. Those working in the department <6 months were excluded from analysis. We used chi-squared comparison to analyze the results. RESULTS: We analyzed 242 responses. Overall, 208 (86%) respondents indicated being verbally abused in the preceding six months, and 90 (37%) indicated being physically assaulted. Security officers had the highest incidence of verbal abuse (98%), followed by nursing (95%), patient care assistants (PCA) (90%) and clinicians (90%), phlebotomists (75%), care team assistants (73%), registration staff (50%) and electrocardiogram (ECG)/radiology technicians (50%). Security also had the highest incidence of physical assault (73%), followed by nursing (49%), PCAs (30%), clinicians (24%), phlebotomists (17%), and ECG/radiology technicians (13%). A total of 140 (69%) non-security personnel indicated that they never report incidents of violence. CONCLUSION: Our results indicate that violence in the ED affects more than just nurses and doctors. As health systems seek to improve the safety of their employees in violence-prone areas, it is imperative that they direct initiatives to the entire healthcare team as no one group is immune.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Violência no Trabalho/estatística & dados numéricos , Adulto , Vítimas de Crime/estatística & dados numéricos , Revelação/estatística & dados numéricos , Feminino , Humanos , Masculino , Estudos Prospectivos , Distribuição por Sexo , Inquéritos e Questionários
7.
Euro Surveill ; 26(25)2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34169817

RESUMO

BackgroundLegionnaires' disease (LD) incidence has been increasing in several European countries since 2011. Currently, Denmark is experiencing one of the highest annual incidences of LD despite its relatively cold climate and homogenous population, and the incidence differs notably across the country.AimWe sought to determine whether provincial differences in LD incidence are attributable to the age and sex distribution of the population, and to characterise the risk of LD by province and age group in Denmark.MethodsUsing national routine surveillance data for domestic LD cases collected between 2015 and 2018, we assessed the incidence of disease by province and year. Poisson regression models were fit to understand the risk of LD by year and province, as well as by 5-year age groups.ResultsIncidence of domestic LD increased 48% between 2015 and 2018 across Denmark. Some provinces continuously had a high incidence of disease, even after adjusting for yearly trends and the underlying population distribution. Variations in the proportion of the population aged 65 years and older were not responsible for the increase in disease in our analysis. Finally, incidence of disease increased with each 5-year age group in both men and women.ConclusionsThe relative differences in incidence between Danish provinces could not be explained by the age and sex distribution of the population, indicating that other factors must be responsible for the varying incidence across the country. These results may help inform trends in other countries in Europe also experiencing an unexplained high incidence of LD.


Assuntos
Doença dos Legionários , Dinamarca/epidemiologia , Europa (Continente) , Feminino , Humanos , Incidência , Doença dos Legionários/epidemiologia , Masculino , Distribuição por Sexo
8.
Medicine (Baltimore) ; 100(22): e26121, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087861

RESUMO

ABSTRACT: This community-based study aimed to elucidate whether there is a gender difference in the effect of metabolic syndrome (MetS) and its individual components on an elevated risk for incident colorectal adenoma.A prospective cohort study was conducted by enrolling 59,767 subjects aged 40 years or older between 2001 and 2009 in Keelung, Taiwan, to test this hypothesis, excluding those with a prior history of colorectal cancer and those with colorectal cancer diagnosed at the first screening. Cox proportional hazards regression models were used to assess the effect of MetS in terms of a dichotomous classification, each individual component and the number of components for males and females.Colorectal adenoma was present in 2.7% (n = 652) of male participants and 1.1% (n = 403) of female participants. The prevalence rate of MetS was 26.7% and 23.3% for males and females, respectively. The effect of MetS on colorectal adenoma was statistically significant and similar for the 2 genders, with an adjusted hazard ratio (aHR) of 1.33 (95% CI: 1.13-1.58) in males and 1.33 (95% CI: 1.06-1.66) in females after adjustment for confounders. However, MetS led to higher risk of advanced colorectal adenoma in men than in women. Regarding the effect of each component of MetS on colorectal adenoma, abnormal waist circumference and hypertriglyceridemia led to an elevated risk of colorectal adenoma in both genders. A rising risk of colorectal adenoma among females was noted in those with a moderately higher level of glycemia (100-125 mg/dL, aHR = 1.44, 95% CI: 1.12-1.85). Hypertriglyceridemia and high blood pressure were associated with an increased risk of advance colorectal adenoma in males.Both male and female subjects with MetS had a higher risk of colorectal adenoma. The contributions from individual components of MetS varied by gender. These findings suggest that the possible risk reduction of colorectal adenoma through metabolic syndrome-based lifestyle modifications may differ between genders.


Assuntos
Adenoma/epidemiologia , Neoplasias Colorretais/epidemiologia , Síndrome Metabólica/epidemiologia , Adulto , Idoso , Pesos e Medidas Corporais , Feminino , Humanos , Hipertensão/epidemiologia , Hipertrigliceridemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Distribuição por Sexo , Taiwan/epidemiologia
9.
J Infect Dev Ctries ; 15(5): 618-624, 2021 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-34106883

RESUMO

INTRODUCTION: This study was planned to assess the trends of epidemiological indicators and demographic determinants related to the COVID-19 in India. METHODOLOGY: This was a descriptive analysis of the COVID-19 cases and their outcomes between 1st March to 31st May 2020 in India. Unpaired t-test and ANOVA were used to determine the statistical differences. Linear regression models were prepared to estimate the effect of testing on the fatalities. The Infection Fatality Rate (IFR)/Case Fatality Rate (CFR), doubling time, and Basic Reproduction Number (R0) per week were calculated. RESULTS: Two-thirds of the cases were between 21-50 years of age, while three-fourth of deaths were among people above 50-years of age. The mean age of people infected with COVID-19 was declining throughout the study period. The mean age of infected males and females was significantly different. The male-female ratio of both infection and deaths due to COVID-19 was near about 2:1. IFR/CFR was 3.31 (95% CI = 3.13-3.50) in April, which reduced to 2.84 (95% CI = 2.77-2.92) in May. An incremental trend was observed in the recovery rates (9.42% to 48.18%), tests conducted / million population (12 / million to 2708 / million) and doubling time (3.59 to 17.71 days). The number of tests was significantly influencing the fatalities (ß = 0.016, 95% CI = 0.012-0.020). The overall R0 was found to be 1.72. CONCLUSIONS: Public health interventions were likely effective in containing the spread of COVID-19. There is a need to further improve the testing capacity. The high-risk category of individuals being prioritized for hospital admission should be redefined to include individuals older than 50 years.


Assuntos
Teste para COVID-19/estatística & dados numéricos , COVID-19/mortalidade , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , COVID-19/diagnóstico , Criança , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Fatores de Risco , SARS-CoV-2 , Distribuição por Sexo , Adulto Jovem
10.
J Infect Dev Ctries ; 15(5): 646-652, 2021 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-34106887

RESUMO

INTRODUCTION: The COVID-19 outbreak first occurred in China and has developed throughout the world, including Indonesia. The Indonesian government reports that up to May 22, 2020 there have been 21,430 confirmed cases. The purpose of this study is to describe the epidemiology, clinical symptoms and comorbidities of COVID-19 as well as the various government interventions to reduce the rate of incidence. METHODOLOGY: A retrospective cohort study was designed. The population in this study is based data from the official Indonesian government website run by the Task Force for the Acceleration of Handling COVID-19. The sample was observed b March 2 to April 24, 2020. The total sample included 8,211 cases of patients diagnosed with COVID-19, among these 1,002 recovered and 689 died. Data analysis used percentages from various recorded epidemiological variables. RESULTS: The results showed that COVID-19 epidemiological features were mostly observed in men (56.5%) and patients of productive age (31-59 of age) by 57.5%; most deaths were recorded in patients aged > 60 years (43.6%). The most recurrent clinical symptom was cough (77.8%), the most recurrent comorbidity was hypertension (52.4%), and the province with the highest COVID-19 incidence was DKI Jakarta (34.3%). CONCLUSIONS: The combination of common sources and propagated source was observed during the COVID-19 outbreak in Indonesia. Special attention should be given to protecting vulnerable populations such as children, health care providers, and the elderly. The community is expected to participate in preventing the transmission of COVID-19 by complying with health protocols.


Assuntos
COVID-19/epidemiologia , Pandemias , Adulto , Distribuição por Idade , Idoso , COVID-19/prevenção & controle , COVID-19/transmissão , Controle de Doenças Transmissíveis/métodos , Feminino , Humanos , Incidência , Indonésia/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias/estatística & dados numéricos , Estudos Retrospectivos , SARS-CoV-2 , Distribuição por Sexo
11.
Arch Cardiovasc Dis ; 114(5): 394-406, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34154954

RESUMO

BACKGROUND: Although women account for up to half of patients hospitalized for coronavirus disease 2019 (COVID-19), no specific data have been reported in this population. AIMS: To assess the burden and impact of cardiovascular comorbidities in women with COVID-19. METHODS: All consecutive patients hospitalized for COVID-19 across 24 hospitals from 26 February to 20 April 2020 were included. The primary composite outcome was transfer to an intensive care unit or in-hospital death. RESULTS: Among 2878 patients, 1212 (42.1%) were women. Women were older (68.3±18.0 vs. 65.4±16.0 years; P<0.001), but had less prevalent cardiovascular comorbidities than men. Among women, 276 (22.8%) experienced the primary outcome, including 161 (13.3%) transfers to an intensive care unit and 115 (9.5%) deaths without transfer to intensive care unit. The rate of in-hospital death or transfer to an intensive care unit was lower in women versus men (crude hazard ratio [HR]: 0.62, 95% confidence interval [CI]: 0.53-0.72). Age (adjusted HR: 1.05 per 5-year increase, 95% CI: 1.01-1.10), body mass index (adjusted HR: 1.06 per 2-unit increase, 95% CI: 1.02-1.10), chronic kidney disease (adjusted HR: 1.57, 95% CI: 1.11-2.22) and heart failure (adjusted HR: 1.52, 95% CI: 1.04-2.22) were independently associated with the primary outcome in women. Elevated B-type natriuretic peptide/N-terminal prohormone of B-type natriuretic peptide (adjusted HR: 2.41, 95% CI: 1.70-3.44) and troponin (adjusted HR: 2.00, 95% CI: 1.39-2.88) concentrations at admission were also associated with the primary outcome, even in women free of previous coronary artery disease or heart failure. CONCLUSIONS: Although female sex was associated with a lower risk of transfer to an intensive care unit or in-hospital death, COVID-19 remained associated with considerable morbimortality in women, especially in those with cardiovascular diseases.


Assuntos
COVID-19/epidemiologia , Doenças Cardiovasculares/epidemiologia , Idoso , Asma/epidemiologia , Biomarcadores , Doenças Cardiovasculares/sangue , Comorbidade , Diabetes Mellitus/epidemiologia , Feminino , França/epidemiologia , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Distribuição por Sexo , Fumar/epidemiologia , Troponina/sangue
12.
J Safety Res ; 77: 212-216, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34092311

RESUMO

INTRODUCTION: Under current law in our rural state, there is no universal requirement for motorcyclists to wear helmets. Roughly 500 motorcycle crashes are reported by the state each year and only a fraction of those riders wear helmets. We sought to determine the difference in injury patterns and severity in helmeted versus non-helmeted riders. METHODS: Retrospective review (2014-2018) of a single level 1 trauma center's registry was done for subjects admitted after a motorcycle collision. Demographic, injury and patient outcome data were collected. Patients were stratified by helmet use (n = 81), no helmet use (n = 144), and unknown helmet use (n = 194). Statistical analysis used Student's t-test or Pearson's χ2p-value ≤0.05 as significant. State Department of Transportation data registry for state level mortality and collision incidence over the same time period was also obtained. RESULTS: Of the 2,022 state-reported motorcycle collisions, 419 individuals admitted to our trauma center were analyzed (21% capture). State-reported field fatality rate regardless of helmet use was 4%. Our inpatient mortality rate was 2% with no differences between helmet uses. Helmeted riders were found to have significantly fewer head and face injuries, higher GCS, lower face, neck, thorax and abdomen AIS, fewer required mechanical ventilation, shorter ICU length of stay, and had a greater number of upper extremity injuries and higher upper extremity AIS. CONCLUSIONS: Helmeted motorcyclists have fewer head, face, and cervical spine injuries, and lower injury severities: GCS and face, neck, thorax, abdomen AIS. Helmeted riders had significantly less mechanical ventilation requirement and shorter ICU stays. Non-helmeted riders sustained worse injuries. Practical Applications: Helmets provide safety and motorcycle riders have a 34-fold higher risk of death following a crash. Evaluating injury severities and patterns in motorcycle crash victims in a rural state with no helmet laws may provide insight into changing current legislation.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , População Rural/estatística & dados numéricos , Centros de Traumatologia/estatística & dados numéricos , Acidentes de Trânsito/mortalidade , Adulto , Distribuição por Idade , Traumatismos Craniocerebrais/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Respiração Artificial , Estudos Retrospectivos , Índice de Gravidade de Doença , Distribuição por Sexo , Fatores Socioeconômicos
13.
J Safety Res ; 77: 217-228, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34092312

RESUMO

INTRODUCTION: The market share of e-scooters in the United States has proliferated in cities: 86 million trips were made on shared e-scooters in 2019, a more than 100% increase compared to 2018. However, the interaction of e-scooters with other road users and infrastructure remains uncertain. METHOD: This study scrutinized 52 e-scooter and 79 bicycle police-reported crashes in Nashville, Tennessee, from April 2018 to April 2020 from the Tennessee Integrated Traffic Analysis Network (TITAN) database. We used descriptive analysis and a recent prototype version of the Pedestrian and Bicycle Crash Analysis Tool (PBCAT) to classify crashes based on the locations of the crashes relative to roadway segments or intersections, as well as the maneuver of the motor vehicle and e-scooter/bicycle relative to the motor vehicle. RESULTS: Two crash typologies can explain the majority of e-scooter crashes, while bicycle crashes are distributed over several crash typologies. Additionally, 1 in 10 e-scooter- and bicycle-motor vehicle crashes leads to the injury or fatality of the e-scooter rider or bicyclist. Furthermore, we noted statistically significant differences in spatial and temporal distribution, demographics, lighting conditions, and crash distance from home for e-scooter and bicycle crashes. CONCLUSIONS: The police crash report provides a comprehensive picture of e-scooter safety complementing existing literature. We found that e-scooter crash characteristics do not fully overlap with features of bicycle crashes. PRACTICAL IMPLICATIONS: A generalized engineering, education, and enforcement treatment to reduce and prevent e-scooter and bicycle crashes, injuries, and fatalities might not result in equal outcomes for each mode. More rigorous enforcement could be implemented to deter e-scooters riders under the age of 18 years and e-scooter safety campaigns could target female riders.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Automóveis/estatística & dados numéricos , Ciclismo/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Fatores Socioeconômicos , Análise Espacial , Tennessee , Estados Unidos , Adulto Jovem
14.
J Safety Res ; 77: 229-240, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34092313

RESUMO

INTRODUCTION: This study performed a path analysis to uncover the behavioral pathways (from contributing factors, pre-crash actions to injury severities) in bicycle-motor vehicle crashes. METHOD: The analysis investigated more than 7,000 bicycle-motor vehicle crashes in North Carolina between 2007 and 2014. Pre-crash actions discussed in this study are actions of cyclists and motorists prior to the event of a crash, including "bicyclist failed to yield," "motorist failed to yield," "bicyclist overtaking motorist," and "motorist overtaking bicyclist." RESULTS: Model results show significant correlates of pre-crash actions and bicyclist injury severity. For example, young bicyclists (18 years old or younger) are 23.5% more likely to fail to yield to motor traffic prior to the event of a crash than elder bicyclists. The "bicyclist failed to yield" action is associated with increased bicyclist injury severity than other actions, as this behavior is associated with an increase of 5.88 percentage points in probability of a bicyclist being at least evidently injured. The path analysis can highlight contributing factors related to risky pre-crash actions that lead to severe injuries. For example, bicyclists traveling on regular vehicle travel lanes are found to be more likely to involve the "bicyclist failed to yield" action, which resulted in a total 44.38% (7.04% direct effect + 37.34% indirect effect) higher likelihood of evident or severe injuries. The path analysis can also identify factors (e.g., intersection) that are not directly but indirectly correlated with injury severity through pre-crash actions. Practical Applications: This study offers a methodological framework to quantify the behavioral pathways in bicycle-motor vehicle crashes. The findings are useful for cycling safety improvements from the perspective of bicyclist behavior, such as the educational program for cyclists.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Ciclismo/estatística & dados numéricos , Veículos Automotores/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Ciclismo/lesões , Criança , Meio Ambiente , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , North Carolina , Probabilidade , Distribuição por Sexo , Índices de Gravidade do Trauma , Viagem , Adulto Jovem
15.
PLoS One ; 16(6): e0253193, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34125851

RESUMO

BACKGROUND: There is a worrying lack of epidemiological data on the sex differential in COVID-19 infection and death rates between the regions of Peru. METHODS: Using cases and death data from the national population-based surveillance system of Peru, we estimated incidence, mortality and fatality, stratified by sex, age and geographic distribution (per 100,000 habitants) from March 16 to November 27, 2020. At the same time, we calculated the risk of COVID-19 death. RESULTS: During the study period, 961894 cases and 35913 deaths were reported in Peru. Men had a twofold higher risk of COVID-19 death within the overall population of Peru (odds ratio (OR), 2.11; confidence interval (CI) 95%; 2.06-2.16; p<0.00001), as well as 20 regions of Peru, compared to women (p<0.05). There were variations in incidence, mortality and fatality rates stratified by sex, age, and region. The incidence rate was higher among men than among women (3079 vs. 2819 per 100,000 habitants, respectively). The mortality rate was two times higher in males than in females (153 vs. 68 per 100,000 habitants, respectively). The mortality rates increased with age, and were high in men 60 years of age or older. The fatality rate was two times higher in men than in women (4.96% vs. 2.41%, respectively), and was high in men 50 years of age or older. CONCLUSIONS: These findings show the higher incidence, mortality and fatality rates among men than among women from Peru. These rates vary widely by region, and men are at greater risk of COVID-19 death. In addition, the mortality and fatality rates increased with age, and were most predominant in men 50 years of age or older.


Assuntos
COVID-19/epidemiologia , COVID-19/mortalidade , Vigilância da População/métodos , SARS-CoV-2 , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , COVID-19/virologia , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Razão de Chances , Peru/epidemiologia , Distribuição por Sexo , Fatores Sexuais , Adulto Jovem
16.
Rev Esp Salud Publica ; 952021 Jun 25.
Artigo em Espanhol | MEDLINE | ID: mdl-34168107

RESUMO

OBJECTIVE: Herpes Zoster (HZ) results from reactivation of latent varicella-zoster virus infection and is associated with immunosuppression and ageing. HZ is of increasing importance in advanced societies. Vaccination appears as a powerful tool to reduce HZ as well as postherpetic neuralgia, the main zoster complication. This study aims to describe the temporal trend, the age and sex distribution of cases, hospitalisations and deaths by zoster occurred in Spain between 1998 and 2018. METHODS: The available information for zoster in Spain were used: cases from National Surveillance System (2014-2018), registries from Spanish hospitalisation database (1998-2018) and deaths from the Spanish mortality statistics (1999-2018). Incidence, hospitalization (HR) and mortality (MR) rates per year and period were calculated. Rates by age group and sex as well as percentage and cumulative percentage for cases and hospitalisations by age group, were also calculated. RESULTS: The global HZ incidence was 351.6/100,000 inhabitants and 625.5/100,000 among population aged 50 and over. The incidence increases with age, especially from the age of 50-54 years (41% increase over the 45-49 age group) and is always higher in women. The global HR was 6.75/100,000 and 15.7/100,000 in persons aged 50 and over; HR increases with age, especially from 60-64 years onwards (50% increase over 54-59 age group) and is always higher in men. The 68.8% of cases and 80.2% of hospitalisations for HZ occurred from the age of 50. CONCLUSIONS: In Spain HZ is a frequent and severe entity in adults and elderly people requiring public health interventions. The demographic changes and the introduction of vaccination require continued monitoring of HZ behaviour in terms of incidence and severity.


Assuntos
Herpes Zoster/epidemiologia , Vigilância da População , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Herpes Zoster/mortalidade , Herpes Zoster/terapia , Vacina contra Herpes Zoster/administração & dosagem , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Distribuição por Sexo , Espanha/epidemiologia , Adulto Jovem
18.
Natl Vital Stat Rep ; 70(4): 1-115, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34029179

RESUMO

Objectives-This report presents final 2018 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2018," the National Center for Health Statistics' annual report of final mortality statistics. Methods-Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2018. Causes of death classified by the International Classification of Diseases, 10th Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. Race and Hispanic-origin data are based on the Office of Management and Budget's 1997 standards for reporting race and Hispanic origin. Results-In 2018, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Accidents (unintentional injuries); Chronic lower respiratory diseases; Cerebrovascular diseases; Alzheimer disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 73.8% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2018 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Newborn affected by maternal complications of pregnancy; Sudden infant death syndrome; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Diseases of the circulatory system; Respiratory distress of newborn; and Neonatal hemorrhage. Variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.


Assuntos
Causas de Morte/tendências , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Grupos de Populações Continentais/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Gravidez , Distribuição por Sexo , Estados Unidos/epidemiologia , Estatísticas Vitais , Adulto Jovem
19.
Cir Cir ; 89(3): 416-417, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34037608

RESUMO

La salud mental en respuesta a la pandemia de COVID-19 es un tema importante. En este artículo se hace una comparación en la población peruana dando a conocer diversos estudios, agregando los factores asociados a su desarrollo.Mental health as a response to the COVID-19 pandemic is an important subject. This article makes a comparison with the Peruvian population, releasing many studies, adding the factors associated with its development.


Assuntos
COVID-19/psicologia , Depressão/epidemiologia , Pandemias , Adulto , Ansiedade/epidemiologia , COVID-19/epidemiologia , Comunicação , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Masculino , Peru/epidemiologia , Distribuição por Sexo , Televisão , Adulto Jovem
20.
Medicine (Baltimore) ; 100(20): e25930, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34011066

RESUMO

BACKGROUND: To study the epidemic features of hand-foot-mouth disease (HFMD) in mainland China through systematic review and meta-analysis so as to provide evidence for the future prevention and control of HFMD. METHODS: Articles on the epidemic features of HFMD in mainland China, written in English or Chinese and released between January 1, 2015 and January 1, 2020, were searched from English literature databases including Embase, Web of Science, PubMed, Cochrane library, Google academic, and Chinese literature databases including China national knowledge infrastructure (CNKI), Wanfang, and China Biology Medicine (CBM). Papers were selected according to the inclusion and exclusion criteria, and quality scoring was performed. Meta-analysis, sensitivity analysis, and identification of publication bias were finished through STATA version 12.0 software. RESULTS: A total of 23 articles were included in this study, the total number of cases was 377,083, of which the total number of male cases was 231,798 and the total number of female cases was 145,285, the sex ratio was about 1.6:1, and the incidence of HFMD in China was 1.61‰ (95% confidence interval [CI]: 1.21‰-1.94‰). The results of the subgroup analysis showed that the incidence of HFMD in mainland China was the highest in South China, in 2014, in 1-year-old group and in other types of enteroviruses, respectively, with the rate of 3.48‰ (95% CI: 1.22‰-5.73‰), 1.81‰ (95% CI: 1.06‰-2.57‰), 15.20‰ (95% CI: 5.00‰-25.30‰), and 1.83‰ (95% CI: 1.32‰-2.33‰), respectively. The differences among the above 4 subgroups were statistically significant (P < .05). There were no publication bias in this study, and the sensitivity analysis results suggested that the meta-analysis results were robust. CONCLUSION: There were differences in the distribution of region, time, population, and etiology of HFMD in mainland China. Health departments should adopt key strategies and measures for key populations in key areas to prevent and control the development of HFMD, and improve the ability of pathogen detection and typing in laboratories.


Assuntos
Enterovirus/isolamento & purificação , Doença de Mão, Pé e Boca/epidemiologia , Distribuição por Idade , Pré-Escolar , China/epidemiologia , Enterovirus/genética , Feminino , Geografia , Doença de Mão, Pé e Boca/virologia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Epidemiologia Molecular , Tipagem Molecular/estatística & dados numéricos , Distribuição por Sexo
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