Risultati per: [ESC 2021] Prevenzione delle malattie cardiovascolari nella pratica clinica

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Con screening 159 decessi in meno all’anno per diagnosi tardiva

Objective
This study aimed to assess the status of infant and young child feeding (IYCF) practices and associated factors among children aged 0–23 months in the low-income regions of Dhaka City, Bangladesh.

Design
A community-based cross-sectional study.

Settings
Low-income regions of Dhaka City, Bangladesh.

Participants
530 children aged 0–23 months and their mothers.

Primary and secondary outcome measures
Prevailing IYCF practices were assessed against the 17 indicators of IYCF recommended by the WHO/UNICEF in 2021. Modified Poisson regression models were built to explore the relation between socio-demographic variables and each of the selected IYCF indicators (early initiation of breastfeeding (EIBF), exclusive breastfeeding (EBF), minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD)).

Results
More than two-thirds of the children were reported to follow appropriate breastfeeding practices (EIBF, 70.4% and EBF, 60.9%). Among the complementary feeding indicators, almost half of the children (48.8%) were reported to meet MMF; however, only about 26% of the children reportedly met the MDD with a consequent low prevalence (22.9%) of the composite indicator MAD. More than half (55%) of the children were reported to consume egg and/or flesh food consumption; still, inappropriate dietary practices were observed among 60% had unhealthy food consumption, and 56% had zero vegetable or fruit consumption). Child age was a significant determinant of IYCF practices. The children of mothers with no pregnancy complications exhibited a greater chance of having EIBF (estimate: 1.21, 95% CI: 1.04, 1.42, p=0.02), MDD (Estimate: 1.67, 95% CI: 1.09, 2.55, p=0.02), and MAD (estimate: 1.70, 95% CI: 1.04, 2.77, p=0.03) compared with the children of mothers with pregnancy complications. The children with a mother having secondary or higher education had a higher chance of having MDD (estimate: 1.93, 95% CI: 1.35, 2.76, p=0.003) and MMF (estimate: 1.27, 95% CI: 1.03, 1.56, p=0.02) than the children of mothers having primary or no education. Similarly, children from higher-income households had a higher chance of getting MDD (estimate: 1.57, 95% CI: 1.07, 2.03, p=0.02), and MAD (estimate: 1.73, 95% CI: 1.14, 2.64, p=0.01) compared with children from lower-income households.

Conclusion
IYCF practices among a considerable proportion of children aged 0–23 months in the low-income regions of Dhaka City were found to be suboptimal and predicted by children’s age, maternal education and pregnancy complications, and household income.

Objectives
Using the Korea Health Panel 2021 survey data, we identify factors associated with health literacy (HL) among older adults aged 65 years and older.

Design
A secondary data analysis of the 2021 Korea Health Panel survey.

Setting
Korea Health Panel survey.

Participants
Data were from 3410 older adults greater double equals65 years of age, drawn from the 2016 registration census of the Korea Health Panel 2021 survey, with a stratified selection approach for participants.

Outcome measure
To explore the factors associated with HL within the framework of the Andersen behavioural model, considering predisposing factors (age, gender, region and spouse), enabling factors (National Basic Livelihood Security recipient, education level, economic activity, usual source of care) and need factors (subjective health status, usual activities, depression/anxiety and chronic disease).

Analysis
Stepwise multiple regression analysis was employed to examine the factors associated with HL among the study participants within the framework of the Andersen behavioural model.

Results
Statistically significant associations with HL were found for predisposition factors (age, gender and residential area), enabling factors (National Basic Livelihood Security recipient, educational background and usual source of care) and need factors (subjective health status, usual activities and the presence of chronic diseases). While the National Basic Livelihood Security recipient was significant in model 2 (p=0.011), it became nonsignificant in model 3 after adding need factors (p=0.093). Adding enabling factors to model 1 significantly increased the explanatory power (R2=0.084, p

Objectives
Using the Korea Health Panel 2021 survey data, we identify factors associated with health literacy (HL) among older adults aged 65 years and older.

Design
A secondary data analysis of the 2021 Korea Health Panel survey.

Setting
Korea Health Panel survey.

Participants
Data were from 3410 older adults greater double equals65 years of age, drawn from the 2016 registration census of the Korea Health Panel 2021 survey, with a stratified selection approach for participants.

Outcome measure
To explore the factors associated with HL within the framework of the Andersen behavioural model, considering predisposing factors (age, gender, region and spouse), enabling factors (National Basic Livelihood Security recipient, education level, economic activity, usual source of care) and need factors (subjective health status, usual activities, depression/anxiety and chronic disease).

Analysis
Stepwise multiple regression analysis was employed to examine the factors associated with HL among the study participants within the framework of the Andersen behavioural model.

Results
Statistically significant associations with HL were found for predisposition factors (age, gender and residential area), enabling factors (National Basic Livelihood Security recipient, educational background and usual source of care) and need factors (subjective health status, usual activities and the presence of chronic diseases). While the National Basic Livelihood Security recipient was significant in model 2 (p=0.011), it became nonsignificant in model 3 after adding need factors (p=0.093). Adding enabling factors to model 1 significantly increased the explanatory power (R2=0.084, p

Il ministro a InLife: “Carta di Ascoli momento importante”

This study elucidates a significant non-linear relationship between BMI and asthma risk in populations aged 45 years and older, providing insights for tailored asthma prevention strategies, although the cross-sectional design limits causal inference. Future studies should focus on collecting and stratifying longitudinal data and adjusting for asthma diagnosis timing to obtain more accurate results.

Usa producano dosi farmaco iniettabili solo due volte l’anno

Saltamartini, ‘Promuoviamo corretti stili di vita tra i giovani’

Gemmato, aggiornare Ssn per affrontare nuove sfide

Lo aveva presentato la maggioranza. M5s: ‘Però usano soldi per le armi’

Objectives
Subarachnoid haemorrhage (SAH) is the third most prevalent subtype of stroke, representing a critical and potentially life-threatening cerebrovascular emergency. Given their large populations and diverse healthcare infrastructures, the BRICS (Brazil, Russian Federation, India, China and South Africa) nations play a pivotal role in the global SAH landscape. This investigation assesses the mortality trends of SAH in BRICS countries from 1982 to 2021.

Design and participants
This study uses data from the Global Burden of Disease (GBD) 2021 public dataset to investigate the temporal trends in SAH mortality over four decades globally and within BRICS countries. The age-period-cohort (APC) model was employed to estimate net drift, local drift, age-specific curves and period (cohort) relative risks.

Primary outcome measures
Mortality.

Results
From 1982 to 2021, there was a 3.85% increase in global SAH deaths and a 59.46% decrease in age-standardised mortality rates. SAH mortality rates are increasing across various age groups in BRICS countries, except in China and the Russian Federation, where most age groups show increasing trends. The annual net drift in SAH mortality varied from a decrease of 5.62% in China to an increase of 0.31% in the Russian Federation. Countries demonstrated similar age-effect patterns, with risk decreasing as age increased. However, period and cohort effects varied, suggesting different control measures and temporal mortality trends.

Conclusions
Changing patterns of mortality from SAH in the BRICS countries over the last four decades vary. We suggest using local resources to step up SAH prevention. Healthcare for all ages, especially the vulnerable, should improve to prevent and treat SAH better.

Objective
This study aimed to assess the global, regional and national burden of pulmonary arterial hypertension (PAH) from 1990 to 2021 using data from the Global Burden of Disease Study 2021. The focus was on evaluating trends in incidence, prevalence, mortality and disability-adjusted life-years (DALYs) associated with PAH and examining these trends by age, gender and sociodemographic index (SDI).

Design
This is a systematic analysis leveraging data from the Global Burden of Disease Study 2021. The analysis focused on both crude and age-standardised rates to track temporal trends in PAH burden, with data stratified by region and SDI.

Setting
The study used global, regiona, and national data from 204 countries and regions, spanning from 1990 to 2021.

Participants
The participants in this study include individuals diagnosed with PAH, with data representing populations globally, categorised by age, gender and SDI.

Primary and secondary outcome measures
Primary outcome measures included global, regional and national incidence, prevalence, mortality and DALYs related to PAH. Secondary outcomes consisted of age-standardised rates (age-standardised incidence rate (ASIR), age-standardised mortality rate (ASMR)) and trends over the study period. A key strength of this study is the detailed stratification by SDI, revealing how PAH burden varies across different socio-economic settings. This extended temporal analysis offers new insights into long-term trends, highlighting the rising burden in lower-SDI regions and significant regional disparities in disease management and outcomes.

Results
From 1990 to 2021, global PAH cases showed substantial increases in both incidence (85.62%) and prevalence (81.46%), while age-standardised rates remained stable. Across SDI levels, high-SDI regions maintained stable ASIRs (0.37 per 100 000) with a slight decline (estimated average percentage change (EAPC) –0.06%), while low-SDI regions demonstrated the most significant reduction (EAPC –0.30%). Deaths increased by 48.36% globally, though the ASMR decreased from 0.35 to 0.27 per 100 000. The disease burden measured by DALYs decreased by 6.59%, with high-SDI regions showing better improvements in age-standardised DALY rates (–1.39% EAPC) compared with other SDI levels. Gender analysis revealed persistent female predominance (female-to-male ratio 1.62:1), particularly pronounced in populations over 50 years across all SDI quintiles.

Conclusions
While global age-standardised rates have declined, PAH remains a significant global health burden, particularly in low-SDI regions. These findings underscore the need for targeted prevention and intervention strategies, especially for high-risk populations, such as females and the elderly, to reduce the global health impact of PAH.

Stroke, Ahead of Print. BACKGROUND:The purpose of this study is to examine the association between race and ethnicity and ischemic stroke severity in the United States.METHODS:We performed an analysis of adult hospital discharges in the National Inpatient Sample from 2018 to 2021 with a primary discharge diagnosis of ischemic stroke. We stratified our cohort based on self-reported race and ethnicity and evaluated stroke severity using the National Institutes of Health Stroke Scale. Age- and sex-adjusted estimates of the National Institutes of Health Stroke Scale were derived from linear regression models.RESULTS:We included 231 396 stroke discharges with a mean National Institutes of Health Stroke Scale of 6.5±7.2. The cohort was 68.1% White, 17.4% Black, 8.2% Hispanic, and 6.3% other. The age- and sex-adjusted National Institutes of Health Stroke Scale for White patients was 6.25 (95% CI, 6.22–6.29), for Black patients was 7.12 (95% CI, 7.05–7.19), for Hispanic patients was 6.86 (95% CI, 6.76–6.97), and for patients of other races and ethnicities was 7.29 (95% CI, 7.18–7.41). Further adjustment for the Charlson Comorbidity Index, socioeconomic factors, and poorly controlled hypertension or diabetes did not significantly alter these findings.CONCLUSIONS:In a large, contemporary, and nationally representative sample of patients with acute ischemic stroke, we show an association between non-White race and ethnicity and higher stroke severity. These results are concerning for an underappreciated health disparity in acute ischemic stroke.

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