Burden and risk factors for Pseudomonas aeruginosa community-acquired pneumonia:a Multinational Point Prevalence Study of Hospitalised Patients

Pseudornonas aeruginosa is a challenging bacterium to treat due to its intrinsic resistance to the antibiotics used most frequently in patients with community-acquired pneumonia (CAP). Data about the global burden and risk factors associated with P. aeruginosa-CAP are limited. We assessed the multinational burden and specific risk factors associated with P. aeruginosa-CAP. We enrolled 3193 patients in 54 countries with confirmed diagnosis of CAP who underwent microbiological testing at admission. Prevalence was calculated according to the identification of P. aeruginosa. Logistic regression analysis was used to identify risk factors for antibiotic-susceptible and antibiotic-resistant P. aeruginosa-CAP. The prevalence of P. aeruginosa and antibiotic-resistant P. aeruginosa-CAP was 4.2% and 2.0%, respectively. The rate of P. aeruginosa CAP in patients with prior infection/colonisation due to P. aeruginosa and at least one of the three independently associated chronic lung diseases (i.e. tracheostomy, bronchiectasis and/or very severe chronic obstructive pulmonary disease) was 67%. In contrast, the rate of P. aeruginosa-CAP was 2% in patients without prior P. aeruginosa infection/colonisation and none of the selected chronic lung diseases. The multinational prevalence of P. aeruginosa-CAP is low. The risk factors identified in this study may guide healthcare professionals in deciding empirical antibiotic coverage for CAP patients

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Population growth and cyst production of the rotifer Brachionus plicatilis (Monogonta: Brachionidae) fed with three different diets

This study compares the effect of different diets on population growth, fecundity rate, production, and cyst hatching efficiency of the rotifer Brachionus plicatilis. Microalgae were cultured using filtered and sterilized seawater at 25 and 26ºC. The volume of the containers for algae, bread yeast, and rotifer was duplicated daily from 31mL to 16L in nine days. Rotifers were cultured at 25°C and 35o/oo salinity. The mean values of daily population growth rate for the rotifers fed on C. muelleri, I. galbana and bread yeast were 0,91, 0,89 and 0,87 daily counts, respectively.  After 10 cultured days, fecundity was 72%, 63% and 36% using C. muelleri, I. galbana and bread yeast, respectively. The highest mean value for cysts production was 4 064 000 cysts found from 63 243 (1,55%) rotifers fed on C. muelleri. Hatching efficiency after 36 hours of cysts from rotifers fed C. muelleri was 51 500 (94,3%) new borns, followed by 45 000 (93,3%) with I. galbana, and 31 000 (92,6%) with bread yeast. C. muelleri is a good food source for B. plicatilis.KEY WORDSFecundity, feeding, hatching, salinity, temperatureEste estudio compara el efecto de la dieta alimenticia en el crecimiento poblacional, la tasa de fecundidad, producción y eficiencia de desove de quistes en el rotífero Brachionus plicatilis. Para la producción de microalgas, el agua marina se filtró sucesivamente y se mantuvo entre 25º y 26ºC. El volumen de los contenedores para algas, levadura y rotíferos se duplicó diariamente de 31mL a 16L en nueve días. Los rotíferos se mantuvieron a temperaturas de 25ºC y salinidad de 35o/oo. La tasa de crecimiento de los rotíferos por día fue de 0,91 alimentados con C. muelleri, 0,89 con I. galbana y de 0,87 con levadura. La fecundidad de los rotíferos 10 días fue de 0,72 cuando fueron alimentados con C. muelleri, 0,63 con I. galbana y 0,36 con levadura. La producción más alta de quistes fue de 63 243 (1,55%) a partir de 4 064 000 rotíferos cuando se alimentan con C. muelleri. La eficiencia de desove de quistes de rotíferos alimentados con C. muelleri fue de 51 500 (94,6%) de neonatos después de 36 horas, 45 000 (93,3%) con la dieta de I. galbana y de 31 000 (92,6%) con levadura. C. muelleri mostró ser una buena fuente de alimentación.PALABRAS CLAVEAlimentación, desove, fecundidad, temperatura, salinida

Cancer Incidence, Mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life Years for 29 Cancer Groups from 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019

Importance: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. Objective: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. Evidence Review: The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95 uncertainty intervals (UIs). Findings: In 2019, there were an estimated 23.6 million (95 UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95 UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3 (95 UI, 20.3-32.3) increase in new cases, a 20.9 (95 UI, 14.2-27.6) increase in deaths, and a 16.0 (95 UI, 9.3-22.8) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4 (1.1-1.8) in the low SDI quintile to 5.7 (4.2-7.1) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. Conclusions and Relevance: The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.. © 2021 American Medical Association. All rights reserved