Blood pressure variability and mortality in patients admitted with acute stroke in a tertiary care stroke centre (2016-2019): a retrospective cohort study

Objectives
The influence of short-term variations in blood pressure (BP) in acute stroke on clinical outcomes remains uncertain. Our study explores the relationship between BP variability (BPV) from stroke admission up to 72 hours and in-hospital and 1-year mortality.

Design
Retrospective observational cohort study.

Setting
Hamad General Hospital (HGH) a tertiary care stroke centre in Qatar.

Participants
2820 participants were initially included. After the exclusion of ineligible subjects, 2554 patients (82.5% male, median age 53±9 years) were included. 893 (34.96%) were from the Middle East and North Africa, 1302 (50.98%) were from South Asia, 258 (10.10%) from Southeast Asia, 9 (0.35%) were from East Asia and 92 (3.60%) were from other regions. Eligible participants were adult patients above 18 years of age who presented with acute ischaemic or haemorrhagic stroke. Excluded individuals were those younger than 18 years, had incomplete data, had transient ischaemic attack (TIA), had severe hypoglycaemia on admission (

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Maggio 2025

Analysis of the disease burden of malignancies in the female reproductive system in China from 1990 to 2019: an age-period-cohort study and joinpoint analysis

Objective
To analyse the trend of the disease burden of common malignancies of the female reproductive system and the influence of age, period and birth cohort in China from 1990 to 2019.

Design
We used the joinpoint model based on the global burden of disease (GBD 2019) database to explore the trend of the burden of common malignancies of the female reproductive system in China from 1990 to 2019, and further analyzed the impact of age, period, and birth cohort using the age-period-cohort model.

Setting
GBD data from 1990 to 2019.

Participants
Data were publicly available and individuals were not involved.

Main outcomes
Outcomes included age standardised incidence rate, standardised mortality, standardised disability-adjusted life year (DALY), annual percentage change, average annual percentage change, age (period, cohort) effect coefficient, relative coefficient and SE. Akchi information criterion and Bayesian information criterion were used to estimate model goodness of fit.

Results
From 1990 to 2019, the standardised incidence and prevalence of cervical cancer and endometrial cancer increased, while the standardised mortality and DALY rate decreased. The standardised incidence, prevalence, mortality and DALY rates of ovarian cancer increased. The risk of cervical cancer, ovarian cancer and endometrial cancer increased first and then decreased with age, reaching its peak at ages 55, 70 and 55, respectively, while the risk of death increased with age. The risk of the onset and death of cervical cancer and ovarian cancer increased with the period, while those of endometrial cancer increased first and then decreased. The cohort with later female reproductive system malignancies had a lower risk of morbidity and mortality than the previous cohort.

Conclusion
From 1990 to 2019, the disease burden of malignant tumours in the female reproductive system in China was high. Relevant departments should pay attention to the prevention and treatment of malignant tumours in the reproductive system. Middle-aged and elderly women are the key target group for prevention and control.

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Aprile 2025

Trends and demographic differences in interpersonal violence against children in sub-Saharan Africa: findings from the 1990-2019 Global Burden of Disease Study

Objectives
To analyse the past 30-year trends in mortality and morbidity of interpersonal violence against children, its demographic distribution and correlation with specific risk factors.

Design
Ecological study at the country and regional level.

Setting
46 countries and 4 subregions of sub-Saharan Africa (SSA): Central, Eastern, Southern and Western.

Participants
Children aged 0–19 years old.

Primary and secondary outcome measures
Trends in mortality rates and disability-adjusted life-years (DALYs) attributed to interpersonal violence injuries in children; correlation between socio-demographic index (SDI)/alcohol consumption per capita and child interpersonal violence.

Results
Deaths and DALYs per 100 000 population from child violence-related injuries in SSA declined from 4.0 (95% uncertainty interval (UI): 3.3–4.9) to 3.1 (95% UI: 2.3 to 3.9) and 334.9 (95% UI: 276.4 to 407.7) to 260.3 (95% UI: 197.9 to 321.9) respectively from 1990 to 2019 (reductions of 22.5% and 22.3%). Southern SSA had the highest deaths/DALYs rates for each type of physical violence (sharp object/firearm/other) and Central SSA for sexual violence. Alcohol consumption correlated significantly with deaths and DALYs, but SDI showed a non-significant correlation.

Conclusions
Rates of child interpersonal violence deaths and DALYs decreased from 2009 to 2019 in SSA, driven by remarkable decreases in the Southern subregion. Understanding the determinants of these downward trends and implementation of policies targeting known risk factors like alcohol consumption may pave the way for enhanced child safety protection. Further curbing the disparities between countries and subregions necessitates long-term commitment to evidence-based action plans.

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Aprile 2025