Heart Failure(HF)is one of the leading problems in cardiology practice today.Acute decompensated heart failure(ADHF)is a significant cause of mortality and morbidity worldwide,and this is more relevant in the Asian su...Heart Failure(HF)is one of the leading problems in cardiology practice today.Acute decompensated heart failure(ADHF)is a significant cause of mortality and morbidity worldwide,and this is more relevant in the Asian subcontinent with a high population burden.Various regional registries in Asia have given us valuable insight into the aetiology and outcomes in this context.Though there are regional differences,it is clear from the review carried out in this paper that HF affects a much younger population.The comorbidities like diabetes and hypertension are high.Chronic kidney disease and atrial fibrillation are higher compared to the Western cohort.Heart failure with preserved ejection fraction is less often seen.The in-hospital mortality ranges from 2.8%to 8.4%.The one-year mortality is higher,and re-hospitalization is very high.Though in many Asian countries,guideline-directed medical therapy is initiated in hospitals,adherence is low.This is the challenge,and the way forward is only a practical team-based heart failure treatment approach.In the modern-day world of digital technology,the onus is on us to develop an integrated system of care in HF.This is by using available resources and opening up HF clinics.This review compares the strengths and limitations of various heart failure registries conducted in Asia and also gives a direction to plan effective strategies for improving heart failure care.展开更多
Iron deficiency without anemia and iron deficiency anemia are common and frequently overlooked complications of inflammatory bowel disease. Despite the frequency and impact of iron deficiency in inflammatory bowel dis...Iron deficiency without anemia and iron deficiency anemia are common and frequently overlooked complications of inflammatory bowel disease. Despite the frequency and impact of iron deficiency in inflammatory bowel disease, there are gaps in our understanding about its incidence, prevalence and natural history and, consequently, patients may be undertreated. Medical registries have a key role in collecting data on the disease's natural history, the safety and effectiveness of drugs in routine clinical practice, and the quality of care delivered by healthcare services. Even though iron deficiency impacts inflammatory bowel disease patients and healthcare systems substantially, none of the established European inflammatory bowel disease registries systematically collects information on iron parameters and related outcomes. Collection of robust iron parameter data from patient registries is one way to heighten awareness about the importance of iron deficiency in this disease and to generate data to improve the quality of patient care, patient outcomes, and thus quality of life. This objective could be achieved through collection of specific laboratory, clinical, and patientreported measurements that could be incorporated into existing registries. This review describes the status of current European inflammatory bowel disease registries and the data they generate, in order to highlight their potential role in collecting iron data, to discuss how such information gathering could contribute to our understanding of iron deficiency anemia, and to provide practical information in regard to the incorporation of accumulated iron parameter data into registries.展开更多
Objective:This report presents an overview on the progress of clinical trials in Indonesia based on database assessment from clinical trial registries.Methods:Study records that were registered up to December 26,2018,...Objective:This report presents an overview on the progress of clinical trials in Indonesia based on database assessment from clinical trial registries.Methods:Study records that were registered up to December 26,2018,were extracted from three clinical trial registries(ClinicalTrials.gov,ISRCTN registry,and EudraCT)and a clinical trial register(WHO International Clinical Trials Registry Platform(ICTRP))with the keyword“Indonesia”.A total of 505 records comprised of 402 interventional studies and 103 observational studies were found and analyzed.Results:The top five noncommunicable diseases(NCDs)studied were cancers,diabetes,cardiac diseases,hypertension,and gastrointestinal diseases,while the top five infectious diseases(IDs)were malaria,tuberculosis,vaccines for IDs,HIV,and dengue.Remarkably,the proportion of regional studies(within Indonesia only)was higher than that of multiregional studies(including areas outside of Indonesia)in general.This trend became most apparent after the issuance of national regulations on Material Transfer Agreements(MTA)and other rules.Upon closer scrutiny,regional clinical trials and multiregional clinical trials(MRCTs)in Indonesia differed in terms of sponsorship,target population and size,interventions,and study phases.Conclusions:The total number of clinical trials in Indonesia is increasing and is mainly attributed to the growing number of regional clinical trials sponsored from within the country.Interrelated factors have shaped the characteristics of these as compared to the dwindling number of MRCTs.Establishment of a national level of management is an option that can better facilitate both MRCTs as well as regional clinical trials,to better address the national health issues,and to cope with the regulations.展开更多
Objective： The National Central Cancer Registry （NCCR） collected cancer registration data in 2009 from local cancer registries in 2012, and analyzed to describe cancer incidence and mortality in China. Methods： On...Objective： The National Central Cancer Registry （NCCR） collected cancer registration data in 2009 from local cancer registries in 2012, and analyzed to describe cancer incidence and mortality in China. Methods： On basis of the criteria of data quality from NCCR, data submitted from 104 registries were checked and evaluated. There were 72 registries＇ data qualified and accepted for cancer registry annual report in 2012. Descriptive analysis included incidence and mortality stratified by area （urban/rural）, sex, age group and cancer site. The top 10 common cancers in different groups, proportion and cumulative rates were also calculated. Chinese population census in 1982 and Segi＇s population were used for age-standardized incidence/mortality rates. Results： All 72 cancer registries covered a total of 85,470,522 population （57,489,009 in urban and 27,981,513 in rural areas）. The total new cancer incident cases and cancer deaths were 244,366 and 154,310, respectively. The morphology verified cases accounted for 67.23%, and 3.14% of incident cases only had information from death certifications. The crude incidence rate in Chinese cancer registration areas was 285.91/100,000 （males 317.97/100,000, females 253.09/100,000）, age-standardized incidence rates by Chinese standard population （ASIRC） and by world standard population （ASIRW） were 146.87/100,000 and 191.72/100,000 with the cumulative incidence rate （0-74 age years old） of 22.08%. The cancer incidence and ASIRC were 303.39/100,000 and 150.31/100,000 in urban areas whereas in rural areas, they were 249.98/100,000 and 139.68/100,000, respectively. The cancer mortality in Chinese cancer registration areas was 180.54/100,000 （224.20/100,000 in males and 135.85/100,000 in females）, age-standardized mortality rates by Chinese standard population （ASMRC） and by world standard population （ASMRW） were 85.06/100,000 and 115.65/100,000, and the cumulative incidence rate （0-74 age years old） was 12.94%. The cancer mortality and ASMRC were 181.86/100,000 and 80.86/100,000 in urban areas, whereas in rural areas, they were 177.83/100,000 and 94.40/100,000 respectively. Lung cancer, gastric cancer, colorectal cancer, liver cancer, esophageal cancer, pancreas cancer, encephaloma, lymphoma, female breast cancer and cervical cancer, were the most common cancers, accounting for 75% of all cancer cases in urban and rural areas. Lung cancer, gastric cancer, liver cancer, esophageal cancer, colorectal cancer, pancreatic cancer, breast cancer, encephaloma, leukemia and lymphoma accounted for 80% of all cancer deaths. The cancer spectrum showed difference between urban and rural areas, males and females. The main cancers in rural areas were cancers of the stomach, followed by esophageal cancer, lung cancer, liver cancer and colorectal cancer, whereas the main cancer in urban areas was lung cancer, followed by liver cancer, gastric cancer and colorectal cancer. Conclusions： The coverage of cancer registration population has been increasing and data quality is improving. As the basis of cancer control program, cancer registry plays an important role in making anti- cancer strategy in medium and long term. As cancer burdens are different between urban and rural areas in China, prevention and control should be implemented based on practical situation.展开更多
Objective： Annual cancer incidence and mortality in 2008 were provided by National Central Cancer Registry in China, which data were collected from population‐based cancer registries in 2011. Methods： There were 56...Objective： Annual cancer incidence and mortality in 2008 were provided by National Central Cancer Registry in China, which data were collected from population‐based cancer registries in 2011. Methods： There were 56 registries submitted their data in 2008. After checking and evaluating the data quality, total 41 registries＇ data were accepted and pooled for analysis. Incidence and mortality rates by area （urban or rural areas） were assessed, as well as the age‐ and sex‐specific rates, age‐standardized rates, proportions and cumulative rate. Results： The coverage population of the 41 registries was 66,138,784 with 52,158,495 in urban areas and 13,980,289 in rural areas. There were 197,833 new cancer cases and 122,136 deaths in cancer with mortality to incidence ratio of 0.62. The morphological verified rate was 69.33%, and 2.23% of cases were identified by death certificate only. The crude cancer incidence rate in all areas was 299.12/100,000 （330.16/100,000 in male and 267.56/100,000 in female） and the age‐standardized incidence rates by Chinese standard population （ASIRC） and world standard population （ASIRW） were 148.75/100,000 and 194.99/100,000, respectively. The cumulative incidence rate （0-74 years old） was of 22.27%. The crude incidence rate in urban areas was higher than that in rural areas. However, after adjusted by age, the incidence rate in urban was lower than that in rural. The crude cancer mortality was 184.67/100,000 （228.14/100,000 in male and 140.48/100,000 in female）, and the age‐standardized mortality rates by Chinese standard population （ASMRC） and by world population were 84.36/100,000 and 114.32/100,000, respectively. The cumulative mortality rate （0-74 years old） was of 12.89%. Age‐adjusted mortality rates in urban areas were lower than that in rural areas. The most common cancer sites were lung, stomach, colon‐rectum, liver, esophagus, pancreas, brain, lymphoma, breast and cervix which accounted for 75% of all cancer incidence. Lung cancer was the leading cause of cancer death, followed by gastric cancer, liver cancer, esophageal cancer, colorectal cancer and pancreas cancer, which accounted for 80% of all cancer deaths. The cancer spectrum varied by areas and sex in rural areas, cancers from digestive system were more common, such as esophageal cancer, gastric cancer and liver cancer, while incidence rates of lung cancer and colorectal cancer were much higher in urban areas. In addition, breast cancer was the most common cancer in urban women followed by liver cancer, gastric cancer and colorectal cancer. Conclusion： Lung cancer, gastric cancer, colorectal cancer, liver cancer, esophageal cancer and female breast cancer contributed to the increased incidence of cancer, which should be paid more attention to in further national cancer prevention and control program. Different cancer control strategies should be carried out due to the varied cancer spectrum in different groups.展开更多
Background:Cancer incidence rate has been increasing in recent years,and it has improved people’s living and financial burden.The incidence and mortality of malignant tumors in the Heilongjiang cancer registry area i...Background:Cancer incidence rate has been increasing in recent years,and it has improved people’s living and financial burden.The incidence and mortality of malignant tumors in the Heilongjiang cancer registry area in 2016 were analyzed,which provided a scientific basis for the prevention and treatment of malignant tumors in Heilongjiang.Methods:The incidence and death data of tumors were collected from 10 tumor registration areas in Heilongjiang Province in 2016.According to the stratification of urban and rural areas and gender,the crude rate,standard rate,accumulative rates(0–74 years old)were calculated.The China 2000 population census data and Segi’s standard population were used for calculating age-standardized rates.Results:The incidence rate of malignant tumors in the Heilongjiang cancer registry area was 286.05/100,000 in 2016,age-standardized incidence rates by standard Chinese population and by standard world population were 168.11/100,000 and 164.69/100,000 with the cumulative incidence rate(0–74 years old)of 18.55%.The incidence of malignant tumors in urban areas was 313.60/100,000,and that in rural areas was 212.26/100,000.The frequency of malignant tumors in males was 295.94/100,000,higher than that in females(276.40/100,000).Lung cancer had the highest incidence followed by breast cancer,colorectal cancer,liver cancer and thyroid cancer.The mortality rate of malignant tumors in Heilongjiang cancer registration areas was 183.56/100,000,age-standardized mortality rates by standard Chinese population and by standard world population were 99.89/100,000 and 99.78/100,000 with the cumulative mortality rate(0–74 years old)of 10.95%.The mortality rate of malignant tumors in urban areas was 194.69/100,000,and that in rural areas was 153.73/100,000.The mortality rate of the male malignant tumor was 222.55/100,000,higher than that of a female malignant tumor(145.51/100,000).Lung cancer had the highest mortality followed by liver cancer,colorectal cancer,gastric cancer and breast cancer.Conclusion:Lung cancer,liver cancer,breast cancer and colorectal cancer were the most common cancers in Heilongjiang Province,which should be taken as the key cancer species for prevention and treatment.The incidence of thyroid cancer is higher in Heilongjiang Province,but the mortality rate is lower,which also needs attention.展开更多
In China, liver transplantation is an important discipline in the field of organ transplantation. China Liver Transplant Registry (CLTR) is a scientific project that has been set up to advance surgical techniques and ...In China, liver transplantation is an important discipline in the field of organ transplantation. China Liver Transplant Registry (CLTR) is a scientific project that has been set up to advance surgical techniques and procedures and to improve both short-and long-term post-transplant follow-up and outcome of the liver recipients. CLTR also serves as a robust data support platform for the National Liver Transplant Quality Control Center in the quest to upscale its quality control protocols. The mission of CLTR is to register all liver transplantation activities in the mainland of China and to conduct scientific analyses of the collected data. The huge number of compiled cases and the scientific research conducted over the past decade based on this database drastically revolutionized the clinical practice in the country. All CLTR activities and projects will be a guarantee to foster progresses of liver transplantation in China in a more scientific way, to standardize the systematic care in the field of liver transplantation.展开更多
Trauma is a major cause of morbidity and mortality across the globe accounting for significant health burden.Relevance of trauma care revolves round prevention,planning and execution of safety regulations.Acquisition ...Trauma is a major cause of morbidity and mortality across the globe accounting for significant health burden.Relevance of trauma care revolves round prevention,planning and execution of safety regulations.Acquisition of the actual data regarding the type of trauma,affected age group,timings of trauma occurrence,involved part of the body constitute the initial steps in the building of the composite overview of the epidemiology of trauma.In succession,would be the measures directed towards avoidance of trauma and capacity building of trauma center.展开更多
BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related co...BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related complications in colorectal cancer patients who underwent stoma creation.METHODS Patients with stoma was prospectively recorded in the established stoma system.Data was collected from this stoma management system from November 2021 through May 2024.The rates of stoma-related complications were assessed,and potential risk factors were analyzed using univariate and multivariate logistic regression models.RESULTS A total of 734 patients were included in the analysis.The results showed that 12.3%of patients experienced stoma-related complications,with mucocutaneous separation,edema,and skin excoriation being the most common complications.The majority(90%)of complications were classified as grade 2 according to the Clavien-Dindo classification.Surgical factors,such as blood loss volume greater than 500 mL and open surgery,were significantly associated with stoma complications.Additionally,stoma features like location,shape,color,height,and edema were important factors in the association with complications.Body mass index over 30 kg/m²was also found to be a significant risk factor.CONCLUSION These findings highlight the need for a holistic approach to preventing and managing stoma complications,considering both patient-related and surgical factors.展开更多
In April 2024,the International Agency for Research on Cancer(IARC)published the 2022 Global Cancer Statistics Report in CA:A Cancer Journal for Clinicians,focusing on the incidence of 36 kinds of cancers in 185 count...In April 2024,the International Agency for Research on Cancer(IARC)published the 2022 Global Cancer Statistics Report in CA:A Cancer Journal for Clinicians,focusing on the incidence of 36 kinds of cancers in 185 countries or regions around the world,different gender,geographical area and Human Development Index differences in different economic regions.Previously,China's National Cancer Center(NCC)collaborated with IARC to estimate China's cancer incidence data using actual and up-to-date surveillance data from China.This collaboration aimed to ensure consistency between the cancer burden data published by IARC and NCC.In February of the same year,the NCC released the latest estimated statistics regarding the cancer incidence in China for 2022 in the Journal of the National Cancer Center.This research seeks to gather and evaluate the latest reports on cancer incidence from both a global perspective and within China for the year 2022.By conducting a multi-dimensional analysis of cancer incidence patterns,gender distribution,geographic spread,and trends over time,the study highlights the distinctions in the burden of malignant tumors between China and the global scenario.Additionally,it explores the risk factors associated with high-incidence cancer types and examines the current status of prevention and control measures.The findings aim to serve as a valuable reference for developing effective cancer prevention and control strategies in China.展开更多
BACKGROUND Mild cognitive impairment(MCI)and subjective cognitive decline(SCD)are risk indicators for dementia and require ongoing management.Traditional Korean medicine(TKM)commonly employs acupuncture and herbal med...BACKGROUND Mild cognitive impairment(MCI)and subjective cognitive decline(SCD)are risk indicators for dementia and require ongoing management.Traditional Korean medicine(TKM)commonly employs acupuncture and herbal medicine for cognitive impairment;yet,clinical research on acupotomy is lacking.Although most TKM treatments occur in primary care,the research is largely hospital-based.This registry was established to systematically collect real-world data on the clinical progress,efficacy,and safety of TKM with acupotomy for patients with MCI or SCD in primary care.It is hypothesized that TKM with acupotomy improves cognitive function and is safe for these patients.AIM To establish an MCI or SCD registry of patients receiving TKM,including acupotomy,to analyze its clinical efficacy and safety.METHODS This observational registry study will be conducted across 22 medical institutions;approximately 500 participants will be recruited.Data—sociodemographic information,medication history,height,weight,vital signs,and assessment questionnaires(Montreal Cognitive Assessment-Korean,short form of Korean-Everyday Cognition,Numeric Rating Scale,Korean version of the Insomnia Severity Index)—will be collected at 3-month intervals over a year.This study will also document the TKM treatment administered and any adverse events.Routine TKM procedures will be followed,with acupuncture and acupotomy administered as per protocol;treatments including herbal medicine,Chuna therapy,and moxibustion may be administered at the practitioner’s discretion.RESULTS The registry will capture a wide range of real-world clinical data regarding demographic profiles,treatment processes,and adverse events.This detailed documentation is expected to clarify patient characteristics,evaluate the clinical course,and identify factors that may affect cognitive improvement in patients with MCI and SCD.CONCLUSION This research may provide evidence supporting acupotomy for cognitive impairment in primary care by confirming its efficacy and safety,providing preliminary evidence for TKM-based interventions aimed at improving cognitive function.展开更多
BACKGROUND Total hip arthroplasty is a safe and effective procedure.To improve survivorship,ultrahigh molecular weight polyethylene hip liners with antioxidants have been developed.Additive antioxidant was deployed to...BACKGROUND Total hip arthroplasty is a safe and effective procedure.To improve survivorship,ultrahigh molecular weight polyethylene hip liners with antioxidants have been developed.Additive antioxidant was deployed to reduce oxidation and consequential wear,loosening,or osteolysis.A unique manufacturing process was utilized for two such hip liners,the Novation®and Alteon®XLE hip liners and this research represents the first large series on this specific material.The study hypothesis was that Novation and Alteon XLE hip liners have similar short-term survivorship as other manufacturers’antioxidant liners according to procedure and outcome data from the American Joint Replacement Registry(AJRR).AIM To demonstrate similar short-term survivorship of XLE antioxidant hip liners compared to all antioxidant hip liners in AJRR.METHODS Utilizing total hip arthroplasty data from the AJRR,a retrospective review was performed for subjects who underwent implantation of Novation XLE(n=461),Alteon XLE(n=989),or any other antioxidant hip liner(termed the aggregate antioxidant group;n=39964)as of March 31,2022.Survivorship at three years and revision rates were compared statistically between the Novation group and the aggregate antioxidant group as well as the Alteon group and the aggregate antioxidant group.RESULTS Survivorship at three years post-surgery was 99.09%for Novation,97.73%for Alteon,and 97.69%for the aggregate antioxidant group.There were no reports of failure due to wear in either the Novation or Alteon groups.Among the revision categories(fracture,infection,aseptic loosening,instability,mechanical complications,wear,pain,hematoma/wound complications,or other),there were no significant differences identified in either comparison.There were also no significant differences in cumulative percent revision rates up to three years post-surgery for the Novation vs aggregate antioxidant group or the Alteon vs aggregate antioxidant group.CONCLUSION Novation and Alteon XLE hip liner revision rate and survivorship are equivalent to other antioxidant hip liners in the short term.展开更多
Objective To describe survival trends and global patterns of esophageal cancer(EC)using survival data from population-based cancer registries.Methods We systematically searched PubMed,EMBASE,Web of Science,SEER,and Si...Objective To describe survival trends and global patterns of esophageal cancer(EC)using survival data from population-based cancer registries.Methods We systematically searched PubMed,EMBASE,Web of Science,SEER,and SinoMed databases for articles published up to 31 December 2023.Eligible EC survival estimates were evaluated according to country or region,period,sex,age group,pathology,and disease stage.Results After 2010,Jordan exhibited the highest age-standardized 5-year relative survival rates(RSRs)/net survival rates(NSRs)at 41.1%between 2010 and 2014,while India had the lowest,at 4.1%.Survival rates generally improved with diagnostic age across most countries,with significant increases in South Korea and China,of 12.7%and 10.5%between 2000 and 2017,respectively.Survival was higher among women compared to men,ranging from 0.4%-10.9%.Survival rates for adenocarcinoma and squamous cell carcinoma were similar,differing by about 4%.In China,the highest age-standardized RSRs/NSRs was 33.4%between 2015 and 2017.Meanwhile,the lowest was 5.3%,in Qidong(Jiangsu province)between 1992-1996.Conclusion Global EC survival rates have improved significantly in recent decades,but substantial geographical,sex,and age disparities still exist.In Asia,squamous cell carcinoma demonstrated superior survival rates compared to adenocarcinoma,while the opposite trend was observed in Western countries.Future research should clarify the prognostic factors influencing EC survival and tailor prevention and screening strategies to the changing EC survival patterns.展开更多
BACKGROUND Hyponatremia is the most common electrolyte imbalance,however the prognostic significance of hyponatremia in peripartum cardiomyopathy(PPCM)remains unclear.AIM To assess the prognostic significance of hypon...BACKGROUND Hyponatremia is the most common electrolyte imbalance,however the prognostic significance of hyponatremia in peripartum cardiomyopathy(PPCM)remains unclear.AIM To assess the prognostic significance of hyponatremia in PPCM patients.METHODS We consecutively recruited patients with PPCM from 14 sites in Nigeria and followed them up for a median of 18 months.Serum sodium was measured at baseline,and patients with hyponatremia(<135 mmol/L)were compared with those with normal sodium levels.Cox proportional hazards regression models were developed to identify factors associated with all-cause mortality.RESULTS Of the 191 PPCM patients recruited,90(47.1%)had hyponatremia at presentation.All-cause mortality among the hyponatremic patients(24/90;26.7%)was significantly higher than among patients with normal serum sodium(7/101;6.9%)(P-value<0.001).In the Cox proportional hazards regression model,hyponatremia was independently associated with an increased risk of all-cause mortality[hazard ratio:3.18(95%confidence interval:1.35-7.52;P=0.008)],as were hypotension(systolic blood pressure<100 mmHg)[2.22(1.03-4.79);P=0.043]and left ventricular ejection fraction(LVEF)<25%[3.14(1.47-6.73),P=0.003].CONCLUSION Hyponatremia was common in our cohort of PPCM patients,and was independently associated with a threefold increased risk for all-cause mortality.Hypotension and a LVEF below 25%at presentation were also independent predictors of mortality.展开更多
BACKGROUND Truliant®posterior stabilized(PS)and Truliant cruciate retaining(CR)are two designs used for total knee arthroplasty.Survivorship and reason for revision rates are now available from the American Joint...BACKGROUND Truliant®posterior stabilized(PS)and Truliant cruciate retaining(CR)are two designs used for total knee arthroplasty.Survivorship and reason for revision rates are now available from the American Joint Replacement Registry(AJRR)at short-term time points for both Truliant designs.It was hypothesized that Truliant PS and Truliant CR perform comparably to similar designs in terms of survivorship.AIM To analyze short-term survivorship of Truliant PS or CR total knee arthroplasty relative to non-Truliant PS or CR total knee arthroplasty.METHODS Utilizing data from the AJRR,a retrospective review was performed for subjects who underwent implantation of Truliant PS,Truliant CR,non-Truliant PS,and non-Truliant CR designs as of June 30,2022.Survivorship and reasons for revision were compared statistically between Truliant PS vs non-Truliant PS as well as Truliant CR vs non-Truliant CR groups.Cumulative percent revision rates were compared across three registries,AJRR,Australian Orthopaedic Association National Joint Replacement Registry(AOANJRR),and the United Kingdom National Joint Registry(UK NJR).RESULTS Truliant PS survivorship was 97.95%at the four-year mark,while Truliant CR survivorship was 99.61%at the three-year mark.There were no significant differences in survivorship hazard ratios or reasons for revision for both Truliant groups vs non-Truliant comparison aggregate groups at short-term time points.Cumulative percent revision rate comparisons were made to device appropriate groups from AJRR,AOANJRR,and UK NJR data.Truliant PS cumulative percent revision rates were similar to non-Truliant cumulative percent revision rates in the AJRR and similar to AOANJRR and UKNJR at both one and three years.Truliant CR cumulative percent revision rates were lower than aggregate AJRR,AOANJRR,and UK NJR cumulative percent revision rates at the one-year and three-year marks.CONCLUSION This study demonstrates high survivorship for Truliant PS total knee arthroplasty out to four-years and Truliant CR total knee arthroplasty out to three-years of follow-up.展开更多
Inflammatory bowel disease(IBD)is an increasing global health issue that poses specific challenges in Nigeria.Although awareness of IBD is growing in the country,research and resources remain limited.This review aims ...Inflammatory bowel disease(IBD)is an increasing global health issue that poses specific challenges in Nigeria.Although awareness of IBD is growing in the country,research and resources remain limited.This review aims to address this significant gap.To identify key gaps in IBD research within Nigeria and highlight opportunities for advancing future investigations to improve patient outcomes.A comprehensive review of the existing literature was conducted to evaluate current trends in IBD research,healthcare barriers,and potential areas for investigation specific to the Nigerian context.The analysis highlights significant deficiencies,including scarce epidemiological data,low levels of awareness among clinicians and patients,limited access to healthcare,and inadequate diagnostic and treatment resources.Additionally,there is a profound lack of localized research addressing genetic,environmental,and dietary factors relevant to the Nigerian population.Future investigations should prioritize epidemiological studies to assess IBD prevalence in Nigeria,establish specialized care centers for diagnosis and management,and launch public health initiatives to promote awareness and education.Strengthening collaboration between researchers,healthcare providers,and policymakers is imperative to achieving these goals.Bridging these research gaps presents an invaluable opportunity to enhance IBD healthcare delivery and patient outcomes in Nigeria.Collaborative,multidisciplinary efforts are essential for advancing knowledge,improving resources,and ultimately elevating the quality of life for individuals living with IBD in the country.展开更多
BACKGROUND Antithrombotic strategies after percutaneous coronary interventions(PCI)in elderly patients on oral anticoagulant therapy(OAT)are debated due to the balance between ischemic and bleeding risks.Recent guidel...BACKGROUND Antithrombotic strategies after percutaneous coronary interventions(PCI)in elderly patients on oral anticoagulant therapy(OAT)are debated due to the balance between ischemic and bleeding risks.Recent guidelines recommend early transitioning from triple antithrombotic therapy to dual antithrombotic therapy,but there are limited data on elderly patients.METHODS We performed a post-hoc age-specific analysis of the PERSEO Registry population aimed to compare clinical features,therapeutic strategies,and outcomes of individuals aged≥80 years and<80 years who were on OAT and underwent PCI with stent.The primary endpoint was net adverse clinical events at 1-year follow-up.Secondary endpoints included major adverse cardiac and cerebral events(MACCE),major bleeding[Bleeding Academic Research Consortium(BARC)type 3–5],and clinically relevant bleeding(BARC type 2-5).RESULTS Among the 1234 patients enrolled,31%of patients were aged≥80 years(84±3 years,76% males).Compared to younger patients,elderly patients had higher rates of comorbidities such as hypertension,anaemia or chronic kidney disease,and atrial fibrillation was the leading indication for OAT.Elderly patients were more often discharged on dual antithrombotic therapy(23%)compared to younger patients(13%)(P<0.0001).They experienced higher net adverse clinical events(38%vs.21%,P<0.001),MACCE(24%vs.12%,P<0.001),as well as higher bleeding rates.Specifically,rates of major bleeding(9%vs.6%,P=0.026),and clinically relevant bleeding(21%vs.12%,P<0.001)were significantly higher in elderly patients.CONCLUSIONS Elderly patients on OAT undergoing PCI are a particular frail population with higher risk of MACCE and bleeding compared to younger patients despite a less aggressive antithrombotic therapy.展开更多
BACKGROUND Colorectal cancer(CRC)is a global health concern,with advanced-stage diagnoses contributing to poor prognoses.The efficacy of CRC screening has been well-established;nevertheless,a significant proportion of...BACKGROUND Colorectal cancer(CRC)is a global health concern,with advanced-stage diagnoses contributing to poor prognoses.The efficacy of CRC screening has been well-established;nevertheless,a significant proportion of patients remain unscreened,with>70%of cases diagnosed outside screening.Although identifying specific subgroups for whom CRC screening should be particularly recommended is crucial owing to limited resources,the association between the diagnostic routes and identification of these subgroups has been less appreciated.In the Japanese cancer registry,the diagnostic routes for groups discovered outside of screening are primarily categorized into those with comorbidities found during hospital visits and those with CRC-related symptoms.AIM To clarify the stage at CRC diagnosis based on diagnostic routes.METHODS We conducted a retrospective observational study using a cancer registry of patients with CRC between January 2016 and December 2019 at two hospitals.The diagnostic routes were primarily classified into three groups:Cancer screening,follow-up,and symptomatic.The early-stage was defined as Stages 0 or I.Multivariate and univariate logistic regressions were exploited to determine the odds of early-stage diagnosis in the symptomatic and cancer screening groups,referencing the follow-up group.The adjusted covariates were age,sex,and tumor location.RESULTS Of the 2083 patients,715(34.4%),1064(51.1%),and 304(14.6%)belonged to the follow-up,symptomatic,and cancer screening groups,respectively.Among the 2083 patients,CRCs diagnosed at an early stage were 57.3%(410 of 715),23.9%(254 of 1064),and 59.5%(181 of 304)in the follow-up,symptomatic,and cancer screening groups,respectively.The symptomatic group exhibited a lower likelihood of early-stage diagnosis than the follow-up group[P<0.001,adjusted odds ratio(aOR),0.23;95%confidence interval(95%CI):0.19-0.29].The likelihood of diagnosis at an early stage was similar between the follow-up and cancer screening groups(P=0.493,aOR for early-stage diagnosis in the cancer screening group vs follow-up group=1.11;95%CI=0.82-1.49).CONCLUSION CRCs detected during hospital visits for comorbidities were diagnosed earlier,similar to cancer screening.CRC screening should be recommended,particularly for patients without periodical hospital visits for comorbidities.展开更多
The Agatsuma et al’s study shows that despite the evidence of the benefits of an early colorectal cancer(CRC)diagnosis,through screening in asymptomatic subjects,up to 50%of candidates reject this option and many of ...The Agatsuma et al’s study shows that despite the evidence of the benefits of an early colorectal cancer(CRC)diagnosis,through screening in asymptomatic subjects,up to 50%of candidates reject this option and many of those affected are diagnosed later,in advanced stages.The efficacy of screening programs has been well-established for several years,which reduces the risk of CRC morbidity and mortality,without taking into account the test used for screening,or other tools.Nevertheless,a significant proportion of patients remain unscreened,so understanding the factors involved,as well as the barriers of the population to adherence is the first step to possibly modify the participation rate.These barriers could include a full range of social and political aspects,especially the type of financial provision of each health service.In Japan,health services are universal,and this advantageous situation makes it easier for citizens to access to these services,contributing to the detection of various diseases,including CRC.Interestingly,the symptomatic CRC group had a lower early-stage diagnosis rate than the patients detected during follow-up for other comorbidities,and symptomatic and cancer screening groups showed similar early-stage diagnosis.展开更多
Background:The National Cancer Center(NCC)of China regularly reports the nationwide statistics on cancer incidence and mortality in China.The International Agency for Research on Cancer(IARC)calculates and publishes t...Background:The National Cancer Center(NCC)of China regularly reports the nationwide statistics on cancer incidence and mortality in China.The International Agency for Research on Cancer(IARC)calculates and publishes the cancer burden of countries around the world every two years.To ensure consistency between the actual surveillance data in China and the data published by IARC,NCC has received approval from the National Health Commission and IARC to simultaneously release the cancer burden data for China in GLOBOCAN 2022.Methods:There were a total of 700 registries reporting high-quality data on cancer incidence and mortality across China in 2018,of which 106 registries with continuous monitoring from 2010 to 2018 were used to establish an age-period-cohort model to simulate the trend of cancer incidence and mortality and to estimate the incidence and mortality in China in 2022.In addition,we analyzed the temporal trends of age-standardized cancer incidence and mortality from 2000 to 2018 using data from 22 continuous cancer registries.Results:It was estimated about 4,824,700 new cancer cases and 2,574,200 new cancer deaths occurred in China in 2022.Cancers of the lung,colon-rectum,thyroid,liver and stomach were the top five cancer types,accounting for 57.42%of new cancer cases.Cancers of the lung,liver,stomach,colon-rectum and esophagus were the five leading causes of cancer deaths,accounting for 67.50%of total cancer deaths.The crude rate and age-standardized incidence rate(ASIR)were 341.75 per 100,000 and 201.61 per 100,000,respectively.The crude mortality rate was 182.34 per 100,000 and the age-standardized mortality rate(ASMR)was 96.47 per 100,000.The ASIR of all cancers combined increased by approximately 1.4%per year during 2000–2018,while the ASMR decreased by approximately 1.3%per year.We observed decreasing trends in ASIR and ASMR for cancers of the esophagus,stomach,and liver,whereas the ASIR increased significantly for cancers of the thyroid,prostate,and cervix.Conclusions:Cancer remains a major public health concern in China,with a cancer profile that reflects the coexistence of developed and developing regions.Sustained implementation of prevention and control measures has resulted in significant reductions in the incidence and mortality rates of certain historically high incidence cancers,such as esophageal,stomach and liver cancers.Adherence to the guidelines of the Healthy China Action Plan and the Cancer Prevention and Control Action Plan,along with continued efforts in comprehensive risk factor control,cancer screening,early diagnosis and treatment,and standardization of diagnostic and therapeutic protocols,are key strategies to effectively mitigate the increasing cancer burden by 2030.展开更多
文摘Heart Failure(HF)is one of the leading problems in cardiology practice today.Acute decompensated heart failure(ADHF)is a significant cause of mortality and morbidity worldwide,and this is more relevant in the Asian subcontinent with a high population burden.Various regional registries in Asia have given us valuable insight into the aetiology and outcomes in this context.Though there are regional differences,it is clear from the review carried out in this paper that HF affects a much younger population.The comorbidities like diabetes and hypertension are high.Chronic kidney disease and atrial fibrillation are higher compared to the Western cohort.Heart failure with preserved ejection fraction is less often seen.The in-hospital mortality ranges from 2.8%to 8.4%.The one-year mortality is higher,and re-hospitalization is very high.Though in many Asian countries,guideline-directed medical therapy is initiated in hospitals,adherence is low.This is the challenge,and the way forward is only a practical team-based heart failure treatment approach.In the modern-day world of digital technology,the onus is on us to develop an integrated system of care in HF.This is by using available resources and opening up HF clinics.This review compares the strengths and limitations of various heart failure registries conducted in Asia and also gives a direction to plan effective strategies for improving heart failure care.
文摘Iron deficiency without anemia and iron deficiency anemia are common and frequently overlooked complications of inflammatory bowel disease. Despite the frequency and impact of iron deficiency in inflammatory bowel disease, there are gaps in our understanding about its incidence, prevalence and natural history and, consequently, patients may be undertreated. Medical registries have a key role in collecting data on the disease's natural history, the safety and effectiveness of drugs in routine clinical practice, and the quality of care delivered by healthcare services. Even though iron deficiency impacts inflammatory bowel disease patients and healthcare systems substantially, none of the established European inflammatory bowel disease registries systematically collects information on iron parameters and related outcomes. Collection of robust iron parameter data from patient registries is one way to heighten awareness about the importance of iron deficiency in this disease and to generate data to improve the quality of patient care, patient outcomes, and thus quality of life. This objective could be achieved through collection of specific laboratory, clinical, and patientreported measurements that could be incorporated into existing registries. This review describes the status of current European inflammatory bowel disease registries and the data they generate, in order to highlight their potential role in collecting iron data, to discuss how such information gathering could contribute to our understanding of iron deficiency anemia, and to provide practical information in regard to the incorporation of accumulated iron parameter data into registries.
文摘Objective:This report presents an overview on the progress of clinical trials in Indonesia based on database assessment from clinical trial registries.Methods:Study records that were registered up to December 26,2018,were extracted from three clinical trial registries(ClinicalTrials.gov,ISRCTN registry,and EudraCT)and a clinical trial register(WHO International Clinical Trials Registry Platform(ICTRP))with the keyword“Indonesia”.A total of 505 records comprised of 402 interventional studies and 103 observational studies were found and analyzed.Results:The top five noncommunicable diseases(NCDs)studied were cancers,diabetes,cardiac diseases,hypertension,and gastrointestinal diseases,while the top five infectious diseases(IDs)were malaria,tuberculosis,vaccines for IDs,HIV,and dengue.Remarkably,the proportion of regional studies(within Indonesia only)was higher than that of multiregional studies(including areas outside of Indonesia)in general.This trend became most apparent after the issuance of national regulations on Material Transfer Agreements(MTA)and other rules.Upon closer scrutiny,regional clinical trials and multiregional clinical trials(MRCTs)in Indonesia differed in terms of sponsorship,target population and size,interventions,and study phases.Conclusions:The total number of clinical trials in Indonesia is increasing and is mainly attributed to the growing number of regional clinical trials sponsored from within the country.Interrelated factors have shaped the characteristics of these as compared to the dwindling number of MRCTs.Establishment of a national level of management is an option that can better facilitate both MRCTs as well as regional clinical trials,to better address the national health issues,and to cope with the regulations.
文摘Objective： The National Central Cancer Registry （NCCR） collected cancer registration data in 2009 from local cancer registries in 2012, and analyzed to describe cancer incidence and mortality in China. Methods： On basis of the criteria of data quality from NCCR, data submitted from 104 registries were checked and evaluated. There were 72 registries＇ data qualified and accepted for cancer registry annual report in 2012. Descriptive analysis included incidence and mortality stratified by area （urban/rural）, sex, age group and cancer site. The top 10 common cancers in different groups, proportion and cumulative rates were also calculated. Chinese population census in 1982 and Segi＇s population were used for age-standardized incidence/mortality rates. Results： All 72 cancer registries covered a total of 85,470,522 population （57,489,009 in urban and 27,981,513 in rural areas）. The total new cancer incident cases and cancer deaths were 244,366 and 154,310, respectively. The morphology verified cases accounted for 67.23%, and 3.14% of incident cases only had information from death certifications. The crude incidence rate in Chinese cancer registration areas was 285.91/100,000 （males 317.97/100,000, females 253.09/100,000）, age-standardized incidence rates by Chinese standard population （ASIRC） and by world standard population （ASIRW） were 146.87/100,000 and 191.72/100,000 with the cumulative incidence rate （0-74 age years old） of 22.08%. The cancer incidence and ASIRC were 303.39/100,000 and 150.31/100,000 in urban areas whereas in rural areas, they were 249.98/100,000 and 139.68/100,000, respectively. The cancer mortality in Chinese cancer registration areas was 180.54/100,000 （224.20/100,000 in males and 135.85/100,000 in females）, age-standardized mortality rates by Chinese standard population （ASMRC） and by world standard population （ASMRW） were 85.06/100,000 and 115.65/100,000, and the cumulative incidence rate （0-74 age years old） was 12.94%. The cancer mortality and ASMRC were 181.86/100,000 and 80.86/100,000 in urban areas, whereas in rural areas, they were 177.83/100,000 and 94.40/100,000 respectively. Lung cancer, gastric cancer, colorectal cancer, liver cancer, esophageal cancer, pancreas cancer, encephaloma, lymphoma, female breast cancer and cervical cancer, were the most common cancers, accounting for 75% of all cancer cases in urban and rural areas. Lung cancer, gastric cancer, liver cancer, esophageal cancer, colorectal cancer, pancreatic cancer, breast cancer, encephaloma, leukemia and lymphoma accounted for 80% of all cancer deaths. The cancer spectrum showed difference between urban and rural areas, males and females. The main cancers in rural areas were cancers of the stomach, followed by esophageal cancer, lung cancer, liver cancer and colorectal cancer, whereas the main cancer in urban areas was lung cancer, followed by liver cancer, gastric cancer and colorectal cancer. Conclusions： The coverage of cancer registration population has been increasing and data quality is improving. As the basis of cancer control program, cancer registry plays an important role in making anti- cancer strategy in medium and long term. As cancer burdens are different between urban and rural areas in China, prevention and control should be implemented based on practical situation.
文摘Objective： Annual cancer incidence and mortality in 2008 were provided by National Central Cancer Registry in China, which data were collected from population‐based cancer registries in 2011. Methods： There were 56 registries submitted their data in 2008. After checking and evaluating the data quality, total 41 registries＇ data were accepted and pooled for analysis. Incidence and mortality rates by area （urban or rural areas） were assessed, as well as the age‐ and sex‐specific rates, age‐standardized rates, proportions and cumulative rate. Results： The coverage population of the 41 registries was 66,138,784 with 52,158,495 in urban areas and 13,980,289 in rural areas. There were 197,833 new cancer cases and 122,136 deaths in cancer with mortality to incidence ratio of 0.62. The morphological verified rate was 69.33%, and 2.23% of cases were identified by death certificate only. The crude cancer incidence rate in all areas was 299.12/100,000 （330.16/100,000 in male and 267.56/100,000 in female） and the age‐standardized incidence rates by Chinese standard population （ASIRC） and world standard population （ASIRW） were 148.75/100,000 and 194.99/100,000, respectively. The cumulative incidence rate （0-74 years old） was of 22.27%. The crude incidence rate in urban areas was higher than that in rural areas. However, after adjusted by age, the incidence rate in urban was lower than that in rural. The crude cancer mortality was 184.67/100,000 （228.14/100,000 in male and 140.48/100,000 in female）, and the age‐standardized mortality rates by Chinese standard population （ASMRC） and by world population were 84.36/100,000 and 114.32/100,000, respectively. The cumulative mortality rate （0-74 years old） was of 12.89%. Age‐adjusted mortality rates in urban areas were lower than that in rural areas. The most common cancer sites were lung, stomach, colon‐rectum, liver, esophagus, pancreas, brain, lymphoma, breast and cervix which accounted for 75% of all cancer incidence. Lung cancer was the leading cause of cancer death, followed by gastric cancer, liver cancer, esophageal cancer, colorectal cancer and pancreas cancer, which accounted for 80% of all cancer deaths. The cancer spectrum varied by areas and sex in rural areas, cancers from digestive system were more common, such as esophageal cancer, gastric cancer and liver cancer, while incidence rates of lung cancer and colorectal cancer were much higher in urban areas. In addition, breast cancer was the most common cancer in urban women followed by liver cancer, gastric cancer and colorectal cancer. Conclusion： Lung cancer, gastric cancer, colorectal cancer, liver cancer, esophageal cancer and female breast cancer contributed to the increased incidence of cancer, which should be paid more attention to in further national cancer prevention and control program. Different cancer control strategies should be carried out due to the varied cancer spectrum in different groups.
文摘Background:Cancer incidence rate has been increasing in recent years,and it has improved people’s living and financial burden.The incidence and mortality of malignant tumors in the Heilongjiang cancer registry area in 2016 were analyzed,which provided a scientific basis for the prevention and treatment of malignant tumors in Heilongjiang.Methods:The incidence and death data of tumors were collected from 10 tumor registration areas in Heilongjiang Province in 2016.According to the stratification of urban and rural areas and gender,the crude rate,standard rate,accumulative rates(0–74 years old)were calculated.The China 2000 population census data and Segi’s standard population were used for calculating age-standardized rates.Results:The incidence rate of malignant tumors in the Heilongjiang cancer registry area was 286.05/100,000 in 2016,age-standardized incidence rates by standard Chinese population and by standard world population were 168.11/100,000 and 164.69/100,000 with the cumulative incidence rate(0–74 years old)of 18.55%.The incidence of malignant tumors in urban areas was 313.60/100,000,and that in rural areas was 212.26/100,000.The frequency of malignant tumors in males was 295.94/100,000,higher than that in females(276.40/100,000).Lung cancer had the highest incidence followed by breast cancer,colorectal cancer,liver cancer and thyroid cancer.The mortality rate of malignant tumors in Heilongjiang cancer registration areas was 183.56/100,000,age-standardized mortality rates by standard Chinese population and by standard world population were 99.89/100,000 and 99.78/100,000 with the cumulative mortality rate(0–74 years old)of 10.95%.The mortality rate of malignant tumors in urban areas was 194.69/100,000,and that in rural areas was 153.73/100,000.The mortality rate of the male malignant tumor was 222.55/100,000,higher than that of a female malignant tumor(145.51/100,000).Lung cancer had the highest mortality followed by liver cancer,colorectal cancer,gastric cancer and breast cancer.Conclusion:Lung cancer,liver cancer,breast cancer and colorectal cancer were the most common cancers in Heilongjiang Province,which should be taken as the key cancer species for prevention and treatment.The incidence of thyroid cancer is higher in Heilongjiang Province,but the mortality rate is lower,which also needs attention.
基金supported by grants from the National Natural Science Foundation of China (82470690 and 92159202)the Major Research Plan of Key Research and Development Project of Zhejiang Province (2024C03149 and 2023C03046)。
文摘In China, liver transplantation is an important discipline in the field of organ transplantation. China Liver Transplant Registry (CLTR) is a scientific project that has been set up to advance surgical techniques and procedures and to improve both short-and long-term post-transplant follow-up and outcome of the liver recipients. CLTR also serves as a robust data support platform for the National Liver Transplant Quality Control Center in the quest to upscale its quality control protocols. The mission of CLTR is to register all liver transplantation activities in the mainland of China and to conduct scientific analyses of the collected data. The huge number of compiled cases and the scientific research conducted over the past decade based on this database drastically revolutionized the clinical practice in the country. All CLTR activities and projects will be a guarantee to foster progresses of liver transplantation in China in a more scientific way, to standardize the systematic care in the field of liver transplantation.
文摘Trauma is a major cause of morbidity and mortality across the globe accounting for significant health burden.Relevance of trauma care revolves round prevention,planning and execution of safety regulations.Acquisition of the actual data regarding the type of trauma,affected age group,timings of trauma occurrence,involved part of the body constitute the initial steps in the building of the composite overview of the epidemiology of trauma.In succession,would be the measures directed towards avoidance of trauma and capacity building of trauma center.
基金Beijing Municipal Administration of Hospitals Incubating Program,No.PZ20200272018 Beijing Talent Incubating Funding,No.2018-4+3 种基金National Natural Science Foundation of China,No.81773214Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support,No.ZYLX202116the National Key R&D Program of China,No.2021YFF1201104Science Foundation of Peking University Cancer Hospital-2023,No.JC202310.
文摘BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related complications in colorectal cancer patients who underwent stoma creation.METHODS Patients with stoma was prospectively recorded in the established stoma system.Data was collected from this stoma management system from November 2021 through May 2024.The rates of stoma-related complications were assessed,and potential risk factors were analyzed using univariate and multivariate logistic regression models.RESULTS A total of 734 patients were included in the analysis.The results showed that 12.3%of patients experienced stoma-related complications,with mucocutaneous separation,edema,and skin excoriation being the most common complications.The majority(90%)of complications were classified as grade 2 according to the Clavien-Dindo classification.Surgical factors,such as blood loss volume greater than 500 mL and open surgery,were significantly associated with stoma complications.Additionally,stoma features like location,shape,color,height,and edema were important factors in the association with complications.Body mass index over 30 kg/m²was also found to be a significant risk factor.CONCLUSION These findings highlight the need for a holistic approach to preventing and managing stoma complications,considering both patient-related and surgical factors.
文摘In April 2024,the International Agency for Research on Cancer(IARC)published the 2022 Global Cancer Statistics Report in CA:A Cancer Journal for Clinicians,focusing on the incidence of 36 kinds of cancers in 185 countries or regions around the world,different gender,geographical area and Human Development Index differences in different economic regions.Previously,China's National Cancer Center(NCC)collaborated with IARC to estimate China's cancer incidence data using actual and up-to-date surveillance data from China.This collaboration aimed to ensure consistency between the cancer burden data published by IARC and NCC.In February of the same year,the NCC released the latest estimated statistics regarding the cancer incidence in China for 2022 in the Journal of the National Cancer Center.This research seeks to gather and evaluate the latest reports on cancer incidence from both a global perspective and within China for the year 2022.By conducting a multi-dimensional analysis of cancer incidence patterns,gender distribution,geographic spread,and trends over time,the study highlights the distinctions in the burden of malignant tumors between China and the global scenario.Additionally,it explores the risk factors associated with high-incidence cancer types and examines the current status of prevention and control measures.The findings aim to serve as a valuable reference for developing effective cancer prevention and control strategies in China.
基金Supported by The Korea Health Technology Project through the Korea Health Industry Development Institute,funded by the Ministry of Health and Welfare,Republic of Korea,No.RS-2023-KH138802.
文摘BACKGROUND Mild cognitive impairment(MCI)and subjective cognitive decline(SCD)are risk indicators for dementia and require ongoing management.Traditional Korean medicine(TKM)commonly employs acupuncture and herbal medicine for cognitive impairment;yet,clinical research on acupotomy is lacking.Although most TKM treatments occur in primary care,the research is largely hospital-based.This registry was established to systematically collect real-world data on the clinical progress,efficacy,and safety of TKM with acupotomy for patients with MCI or SCD in primary care.It is hypothesized that TKM with acupotomy improves cognitive function and is safe for these patients.AIM To establish an MCI or SCD registry of patients receiving TKM,including acupotomy,to analyze its clinical efficacy and safety.METHODS This observational registry study will be conducted across 22 medical institutions;approximately 500 participants will be recruited.Data—sociodemographic information,medication history,height,weight,vital signs,and assessment questionnaires(Montreal Cognitive Assessment-Korean,short form of Korean-Everyday Cognition,Numeric Rating Scale,Korean version of the Insomnia Severity Index)—will be collected at 3-month intervals over a year.This study will also document the TKM treatment administered and any adverse events.Routine TKM procedures will be followed,with acupuncture and acupotomy administered as per protocol;treatments including herbal medicine,Chuna therapy,and moxibustion may be administered at the practitioner’s discretion.RESULTS The registry will capture a wide range of real-world clinical data regarding demographic profiles,treatment processes,and adverse events.This detailed documentation is expected to clarify patient characteristics,evaluate the clinical course,and identify factors that may affect cognitive improvement in patients with MCI and SCD.CONCLUSION This research may provide evidence supporting acupotomy for cognitive impairment in primary care by confirming its efficacy and safety,providing preliminary evidence for TKM-based interventions aimed at improving cognitive function.
文摘BACKGROUND Total hip arthroplasty is a safe and effective procedure.To improve survivorship,ultrahigh molecular weight polyethylene hip liners with antioxidants have been developed.Additive antioxidant was deployed to reduce oxidation and consequential wear,loosening,or osteolysis.A unique manufacturing process was utilized for two such hip liners,the Novation®and Alteon®XLE hip liners and this research represents the first large series on this specific material.The study hypothesis was that Novation and Alteon XLE hip liners have similar short-term survivorship as other manufacturers’antioxidant liners according to procedure and outcome data from the American Joint Replacement Registry(AJRR).AIM To demonstrate similar short-term survivorship of XLE antioxidant hip liners compared to all antioxidant hip liners in AJRR.METHODS Utilizing total hip arthroplasty data from the AJRR,a retrospective review was performed for subjects who underwent implantation of Novation XLE(n=461),Alteon XLE(n=989),or any other antioxidant hip liner(termed the aggregate antioxidant group;n=39964)as of March 31,2022.Survivorship at three years and revision rates were compared statistically between the Novation group and the aggregate antioxidant group as well as the Alteon group and the aggregate antioxidant group.RESULTS Survivorship at three years post-surgery was 99.09%for Novation,97.73%for Alteon,and 97.69%for the aggregate antioxidant group.There were no reports of failure due to wear in either the Novation or Alteon groups.Among the revision categories(fracture,infection,aseptic loosening,instability,mechanical complications,wear,pain,hematoma/wound complications,or other),there were no significant differences identified in either comparison.There were also no significant differences in cumulative percent revision rates up to three years post-surgery for the Novation vs aggregate antioxidant group or the Alteon vs aggregate antioxidant group.CONCLUSION Novation and Alteon XLE hip liner revision rate and survivorship are equivalent to other antioxidant hip liners in the short term.
基金supported by the National Key Project of Research and Development Program of China[2021YFC2500404,2021YFC2500405].
文摘Objective To describe survival trends and global patterns of esophageal cancer(EC)using survival data from population-based cancer registries.Methods We systematically searched PubMed,EMBASE,Web of Science,SEER,and SinoMed databases for articles published up to 31 December 2023.Eligible EC survival estimates were evaluated according to country or region,period,sex,age group,pathology,and disease stage.Results After 2010,Jordan exhibited the highest age-standardized 5-year relative survival rates(RSRs)/net survival rates(NSRs)at 41.1%between 2010 and 2014,while India had the lowest,at 4.1%.Survival rates generally improved with diagnostic age across most countries,with significant increases in South Korea and China,of 12.7%and 10.5%between 2000 and 2017,respectively.Survival was higher among women compared to men,ranging from 0.4%-10.9%.Survival rates for adenocarcinoma and squamous cell carcinoma were similar,differing by about 4%.In China,the highest age-standardized RSRs/NSRs was 33.4%between 2015 and 2017.Meanwhile,the lowest was 5.3%,in Qidong(Jiangsu province)between 1992-1996.Conclusion Global EC survival rates have improved significantly in recent decades,but substantial geographical,sex,and age disparities still exist.In Asia,squamous cell carcinoma demonstrated superior survival rates compared to adenocarcinoma,while the opposite trend was observed in Western countries.Future research should clarify the prognostic factors influencing EC survival and tailor prevention and screening strategies to the changing EC survival patterns.
文摘BACKGROUND Hyponatremia is the most common electrolyte imbalance,however the prognostic significance of hyponatremia in peripartum cardiomyopathy(PPCM)remains unclear.AIM To assess the prognostic significance of hyponatremia in PPCM patients.METHODS We consecutively recruited patients with PPCM from 14 sites in Nigeria and followed them up for a median of 18 months.Serum sodium was measured at baseline,and patients with hyponatremia(<135 mmol/L)were compared with those with normal sodium levels.Cox proportional hazards regression models were developed to identify factors associated with all-cause mortality.RESULTS Of the 191 PPCM patients recruited,90(47.1%)had hyponatremia at presentation.All-cause mortality among the hyponatremic patients(24/90;26.7%)was significantly higher than among patients with normal serum sodium(7/101;6.9%)(P-value<0.001).In the Cox proportional hazards regression model,hyponatremia was independently associated with an increased risk of all-cause mortality[hazard ratio:3.18(95%confidence interval:1.35-7.52;P=0.008)],as were hypotension(systolic blood pressure<100 mmHg)[2.22(1.03-4.79);P=0.043]and left ventricular ejection fraction(LVEF)<25%[3.14(1.47-6.73),P=0.003].CONCLUSION Hyponatremia was common in our cohort of PPCM patients,and was independently associated with a threefold increased risk for all-cause mortality.Hypotension and a LVEF below 25%at presentation were also independent predictors of mortality.
文摘BACKGROUND Truliant®posterior stabilized(PS)and Truliant cruciate retaining(CR)are two designs used for total knee arthroplasty.Survivorship and reason for revision rates are now available from the American Joint Replacement Registry(AJRR)at short-term time points for both Truliant designs.It was hypothesized that Truliant PS and Truliant CR perform comparably to similar designs in terms of survivorship.AIM To analyze short-term survivorship of Truliant PS or CR total knee arthroplasty relative to non-Truliant PS or CR total knee arthroplasty.METHODS Utilizing data from the AJRR,a retrospective review was performed for subjects who underwent implantation of Truliant PS,Truliant CR,non-Truliant PS,and non-Truliant CR designs as of June 30,2022.Survivorship and reasons for revision were compared statistically between Truliant PS vs non-Truliant PS as well as Truliant CR vs non-Truliant CR groups.Cumulative percent revision rates were compared across three registries,AJRR,Australian Orthopaedic Association National Joint Replacement Registry(AOANJRR),and the United Kingdom National Joint Registry(UK NJR).RESULTS Truliant PS survivorship was 97.95%at the four-year mark,while Truliant CR survivorship was 99.61%at the three-year mark.There were no significant differences in survivorship hazard ratios or reasons for revision for both Truliant groups vs non-Truliant comparison aggregate groups at short-term time points.Cumulative percent revision rate comparisons were made to device appropriate groups from AJRR,AOANJRR,and UK NJR data.Truliant PS cumulative percent revision rates were similar to non-Truliant cumulative percent revision rates in the AJRR and similar to AOANJRR and UKNJR at both one and three years.Truliant CR cumulative percent revision rates were lower than aggregate AJRR,AOANJRR,and UK NJR cumulative percent revision rates at the one-year and three-year marks.CONCLUSION This study demonstrates high survivorship for Truliant PS total knee arthroplasty out to four-years and Truliant CR total knee arthroplasty out to three-years of follow-up.
文摘Inflammatory bowel disease(IBD)is an increasing global health issue that poses specific challenges in Nigeria.Although awareness of IBD is growing in the country,research and resources remain limited.This review aims to address this significant gap.To identify key gaps in IBD research within Nigeria and highlight opportunities for advancing future investigations to improve patient outcomes.A comprehensive review of the existing literature was conducted to evaluate current trends in IBD research,healthcare barriers,and potential areas for investigation specific to the Nigerian context.The analysis highlights significant deficiencies,including scarce epidemiological data,low levels of awareness among clinicians and patients,limited access to healthcare,and inadequate diagnostic and treatment resources.Additionally,there is a profound lack of localized research addressing genetic,environmental,and dietary factors relevant to the Nigerian population.Future investigations should prioritize epidemiological studies to assess IBD prevalence in Nigeria,establish specialized care centers for diagnosis and management,and launch public health initiatives to promote awareness and education.Strengthening collaboration between researchers,healthcare providers,and policymakers is imperative to achieving these goals.Bridging these research gaps presents an invaluable opportunity to enhance IBD healthcare delivery and patient outcomes in Nigeria.Collaborative,multidisciplinary efforts are essential for advancing knowledge,improving resources,and ultimately elevating the quality of life for individuals living with IBD in the country.
基金was given by a 2017 Research Grant of the Italian Society of Interventional Cardiology (SICI-GISE)
文摘BACKGROUND Antithrombotic strategies after percutaneous coronary interventions(PCI)in elderly patients on oral anticoagulant therapy(OAT)are debated due to the balance between ischemic and bleeding risks.Recent guidelines recommend early transitioning from triple antithrombotic therapy to dual antithrombotic therapy,but there are limited data on elderly patients.METHODS We performed a post-hoc age-specific analysis of the PERSEO Registry population aimed to compare clinical features,therapeutic strategies,and outcomes of individuals aged≥80 years and<80 years who were on OAT and underwent PCI with stent.The primary endpoint was net adverse clinical events at 1-year follow-up.Secondary endpoints included major adverse cardiac and cerebral events(MACCE),major bleeding[Bleeding Academic Research Consortium(BARC)type 3–5],and clinically relevant bleeding(BARC type 2-5).RESULTS Among the 1234 patients enrolled,31%of patients were aged≥80 years(84±3 years,76% males).Compared to younger patients,elderly patients had higher rates of comorbidities such as hypertension,anaemia or chronic kidney disease,and atrial fibrillation was the leading indication for OAT.Elderly patients were more often discharged on dual antithrombotic therapy(23%)compared to younger patients(13%)(P<0.0001).They experienced higher net adverse clinical events(38%vs.21%,P<0.001),MACCE(24%vs.12%,P<0.001),as well as higher bleeding rates.Specifically,rates of major bleeding(9%vs.6%,P=0.026),and clinically relevant bleeding(21%vs.12%,P<0.001)were significantly higher in elderly patients.CONCLUSIONS Elderly patients on OAT undergoing PCI are a particular frail population with higher risk of MACCE and bleeding compared to younger patients despite a less aggressive antithrombotic therapy.
基金the Foundation for Cancer Research supported by Kyoto Preventive Medical Center and the Japan Society for the Promotion of Science(JSPS)Grants-in-Aid KAKENHI,No.JP 22K21080.
文摘BACKGROUND Colorectal cancer(CRC)is a global health concern,with advanced-stage diagnoses contributing to poor prognoses.The efficacy of CRC screening has been well-established;nevertheless,a significant proportion of patients remain unscreened,with>70%of cases diagnosed outside screening.Although identifying specific subgroups for whom CRC screening should be particularly recommended is crucial owing to limited resources,the association between the diagnostic routes and identification of these subgroups has been less appreciated.In the Japanese cancer registry,the diagnostic routes for groups discovered outside of screening are primarily categorized into those with comorbidities found during hospital visits and those with CRC-related symptoms.AIM To clarify the stage at CRC diagnosis based on diagnostic routes.METHODS We conducted a retrospective observational study using a cancer registry of patients with CRC between January 2016 and December 2019 at two hospitals.The diagnostic routes were primarily classified into three groups:Cancer screening,follow-up,and symptomatic.The early-stage was defined as Stages 0 or I.Multivariate and univariate logistic regressions were exploited to determine the odds of early-stage diagnosis in the symptomatic and cancer screening groups,referencing the follow-up group.The adjusted covariates were age,sex,and tumor location.RESULTS Of the 2083 patients,715(34.4%),1064(51.1%),and 304(14.6%)belonged to the follow-up,symptomatic,and cancer screening groups,respectively.Among the 2083 patients,CRCs diagnosed at an early stage were 57.3%(410 of 715),23.9%(254 of 1064),and 59.5%(181 of 304)in the follow-up,symptomatic,and cancer screening groups,respectively.The symptomatic group exhibited a lower likelihood of early-stage diagnosis than the follow-up group[P<0.001,adjusted odds ratio(aOR),0.23;95%confidence interval(95%CI):0.19-0.29].The likelihood of diagnosis at an early stage was similar between the follow-up and cancer screening groups(P=0.493,aOR for early-stage diagnosis in the cancer screening group vs follow-up group=1.11;95%CI=0.82-1.49).CONCLUSION CRCs detected during hospital visits for comorbidities were diagnosed earlier,similar to cancer screening.CRC screening should be recommended,particularly for patients without periodical hospital visits for comorbidities.
文摘The Agatsuma et al’s study shows that despite the evidence of the benefits of an early colorectal cancer(CRC)diagnosis,through screening in asymptomatic subjects,up to 50%of candidates reject this option and many of those affected are diagnosed later,in advanced stages.The efficacy of screening programs has been well-established for several years,which reduces the risk of CRC morbidity and mortality,without taking into account the test used for screening,or other tools.Nevertheless,a significant proportion of patients remain unscreened,so understanding the factors involved,as well as the barriers of the population to adherence is the first step to possibly modify the participation rate.These barriers could include a full range of social and political aspects,especially the type of financial provision of each health service.In Japan,health services are universal,and this advantageous situation makes it easier for citizens to access to these services,contributing to the detection of various diseases,including CRC.Interestingly,the symptomatic CRC group had a lower early-stage diagnosis rate than the patients detected during follow-up for other comorbidities,and symptomatic and cancer screening groups showed similar early-stage diagnosis.
基金supported by the CAMS Innovation Fund for Medical Sciences(grant numbers:2021-I2M-1-010,2021-I2M-1-046,2021-I2M-1-011,2021-I2M-1-023).
文摘Background:The National Cancer Center(NCC)of China regularly reports the nationwide statistics on cancer incidence and mortality in China.The International Agency for Research on Cancer(IARC)calculates and publishes the cancer burden of countries around the world every two years.To ensure consistency between the actual surveillance data in China and the data published by IARC,NCC has received approval from the National Health Commission and IARC to simultaneously release the cancer burden data for China in GLOBOCAN 2022.Methods:There were a total of 700 registries reporting high-quality data on cancer incidence and mortality across China in 2018,of which 106 registries with continuous monitoring from 2010 to 2018 were used to establish an age-period-cohort model to simulate the trend of cancer incidence and mortality and to estimate the incidence and mortality in China in 2022.In addition,we analyzed the temporal trends of age-standardized cancer incidence and mortality from 2000 to 2018 using data from 22 continuous cancer registries.Results:It was estimated about 4,824,700 new cancer cases and 2,574,200 new cancer deaths occurred in China in 2022.Cancers of the lung,colon-rectum,thyroid,liver and stomach were the top five cancer types,accounting for 57.42%of new cancer cases.Cancers of the lung,liver,stomach,colon-rectum and esophagus were the five leading causes of cancer deaths,accounting for 67.50%of total cancer deaths.The crude rate and age-standardized incidence rate(ASIR)were 341.75 per 100,000 and 201.61 per 100,000,respectively.The crude mortality rate was 182.34 per 100,000 and the age-standardized mortality rate(ASMR)was 96.47 per 100,000.The ASIR of all cancers combined increased by approximately 1.4%per year during 2000–2018,while the ASMR decreased by approximately 1.3%per year.We observed decreasing trends in ASIR and ASMR for cancers of the esophagus,stomach,and liver,whereas the ASIR increased significantly for cancers of the thyroid,prostate,and cervix.Conclusions:Cancer remains a major public health concern in China,with a cancer profile that reflects the coexistence of developed and developing regions.Sustained implementation of prevention and control measures has resulted in significant reductions in the incidence and mortality rates of certain historically high incidence cancers,such as esophageal,stomach and liver cancers.Adherence to the guidelines of the Healthy China Action Plan and the Cancer Prevention and Control Action Plan,along with continued efforts in comprehensive risk factor control,cancer screening,early diagnosis and treatment,and standardization of diagnostic and therapeutic protocols,are key strategies to effectively mitigate the increasing cancer burden by 2030.
