The global, regional, and national burden of stomach cancer in 195 countries, 1990-2017 : a systematic analysis for the Global Burden of Disease study 2017

Background: Stomach cancer is a major health problem in many countries. Understanding the current burden of stomach cancer and the differential trends across various locations is essential for formulating effective preventive strategies. We report on the incidence, mortality, and disability-adjusted life-years (DALYs) due to stomach cancer in 195 countries and territories from 21 regions between 1990 and 2017. Methods: Estimates from GBD 2017 were used to analyse the incidence, mortality, and DALYs due to stomach cancer at the global, regional, and national levels. The rates were standardised to the GBD world population and reported per 100 000 population as age-standardised incidence rates, age-standardised death rates, and age-standardised DALY rates. All estimates were generated with 95% uncertainty intervals (UIs). Findings: In 2017, more than 1·22 million (95% UI 1·19–1·25) incident cases of stomach cancer occurred worldwide, and nearly 865 000 people (848 000–885 000) died of stomach cancer, contributing to 19·1 million (18·7–19·6) DALYs. The highest age-standardised incidence rates in 2017 were seen in the high-income Asia Pacific (29·5, 28·2–31·0 per 100 000 population) and east Asia (28·6, 27·3–30·0 per 100 000 population) regions, with nearly half of the global incident cases occurring in China. Compared with 1990, in 2017 more than 356 000 more incident cases of stomach cancer were estimated, leading to nearly 96 000 more deaths. Despite the increase in absolute numbers, the worldwide age-standardised rates of stomach cancer (incidence, deaths, and DALYs) have declined since 1990. The drop in the disease burden was associated with improved Socio-demographic Index. Globally, 38·2% (21·1–57·8) of the age-standardised DALYs were attributable to high-sodium diet in both sexes combined, and 24·5% (20·0–28·9) of the age-standardised DALYs were attributable to smoking in males. Interpretation: Our findings provide insight into the changing burden of stomach cancer, which is useful in planning local strategies and monitoring their progress. To this end, specific local strategies should be tailored to each country's risk factor profile. Beyond the current decline in age-standardised incidence and death rates, a decrease in the absolute number of cases and deaths will be possible if the burden in east Asia, where currently almost half of the incident cases and deaths occur, is further reduced. Funding: Bill & Melinda Gates Foundation

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Serum Sodium Changes in Fluoxetine Users at Different Age Groups

"n Objective: Fluoxetine, a widely used antidepressant, can affect the serum sodium level. The aim of this study was to evaluate and compare changes in the serum sodium level of depressive patients taking fluoxetine according to age. "n Methods:This quasi-experimental study was conducted on 126 patients with depression, dividing the patients into two age groups of 15 to 35 years, and above 55 years, who referred to psychiatric clinics of the Isfahan University of Medical Sciences. Serum sodium level was measured prior to fluoxetine therapy and at the first and third week after; adverse symptoms were recorded. Serum sodium level, hyponatremia, and other adverse effects were compared between the two age groups. Results: There was a significant decrease in serum sodium levels in the older patients at the first and third week after the therapy; but the serum sodium levels decreased only after the third week of therapy in the younger patients (p < 0.05). Serum sodium level was significantly lower in older than in younger patients at the third week of the therapy (140.8±2.26 vs. 135.2±2.06; p < 0.05), and hyponatremia was detected only in the older patients after the first and third week of therapy, 4.7% and 15.8%, respectively. Conclusions: Using fluoxetine can decrease serum sodium level, which is more frequent, more severe, and more clinically manifested in older than younger patients. Monitoring serum sodium level is recommended in early weeks of fluoxetine therapy especially for patients older than 55 years of age

The evaluation of mood condition among depressed adolescent students in Isfahan after 6 years

Background: This study has carried out to find the recovery rate, depression recurrence, changing of diagnose into bipolar mood disorder (BMD) and appearing other psychiatric disorders including obsessive compulsive disorder, oppositional defiant disorder (ODD), substance induced disorders, attention deficit and hyperactivity disorder, and anxiety disorders after 6 years among students having major depression disorder in Isfahan and its relation to some demographic factors. Materials and Methods: In this historical cohort study, 278 students studying in guidance school, in 2006 being 11–16-year-old and were diagnosed to have major depressive disorder participated. Data collection was done by completing children depression on inventory, Young Maria Rating Scale and also final diagnosis determination through interview by psychiatrists. To analyze the data, in addition to use descriptive statistics, multinomial and multiple logistic regressions were used to evaluate the relationships. All the analyses were done using SPSS 20. Results: About 34.9 of adolescents have suffered from depression after 6 years. Depression in 12.2% has been changed into BMD. The BMD morbidity chance was less in girls rather than depression one. The ratio of drug abuse in girls was less than boys (odds ratio [OR] = 0.471, P = 0.046). Students received no treatment or only pharmacotherapy, were more caught by ODD in comparison with those cases who received both pharmacotherapy and psychotherapy (P = 0.005, 0.038 and OR = 4.29 and 5.88). Conclusion: About half of students after 6 years are caught by depression or BMD. It reveals the importance of this disorder and its role in making behavioral problems for adolescents in their future

Looking at the Levels of Bloom's Taxonomy in a Flipped Classroom Utilizing Study Guide and Interactive Assignment for Undergraduate Medical Students

Our aims were determining the student’s views about the effect of using the study guide on advance preparation in a flipped class setting and testing the effect of flipped class on higher cognition. Using a quasi-experimental design in Tehran University of Medical Sciences, one batch was taught using a flipped classroom and another batch by a lecture in 3 sessions. The student’s views were assessed using a questionnaire, and the effect of flipped class on levels of higher cognition based on Bloom's taxonomy was measured using two tests in two-time intervals. Seventy-two students believed that the study guide helped them to devote their time to study. Data did not support our hypothesis that flipped class could result in higher cognition one month and four months after the intervention T=-0.75, df=197, P=0.45 in knowledge Questions, T=-1.08, df=197, P=0.28 in comprehensive questions, T=-0.30, df=197, P=0.76 in an application, and T=-0.91, df=197, P=0.36 in analytical questions. Study guides could be effective tools to get students to interact with pre-assigned readings in a flipped class context. Our hypothesis that flipped class could result in higher cognition was not supported

The global, regional, and national burden of stomach cancer in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease study 2017

Etemadi A, Safiri S, Sepanlou SG, et al. The global, regional, and national burden of stomach cancer in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease study 2017. LANCET GASTROENTEROLOGY & HEPATOLOGY. 2020;5(1):42-54.Background Stomach cancer is a major health problem in many countries. Understanding the current burden of stomach cancer and the differential trends across various locations is essential for formulating effective preventive strategies. We report on the incidence, mortality, and disability-adjusted life-years (DALYs) due to stomach cancer in 195 countries and territories from 21 regions between 1990 and 2017. Methods Estimates from GBD 2017 were used to analyse the incidence, mortality, and DALYs due to stomach cancer at the global, regional, and national levels. The rates were standardised to the GBD world population and reported per 100 000 population as age-standardised incidence rates, age-standardised death rates, and age-standardised DALY rates. All estimates were generated with 95% uncertainty intervals (UIs). Findings In 2017, more than 1.22 million (95% UI 1.19-1.25) incident cases of stomach cancer occurred worldwide, and nearly 865 000 people (848 000-885 000) died of stomach cancer, contributing to 19.1 million (18.7-19.6) DALYs. The highest age-standardised incidence rates in 2017 were seen in the high-income Asia Pacific (29.5, 28.2-31.0 per 100 000 population) and east Asia (28.6, 27.3-30.0 per 100 000 population) regions, with nearly half of the global incident cases occurring in China. Compared with 1990, in 2017 more than 356 000 more incident cases of stomach cancer were estimated, leading to nearly 96 000 more deaths. Despite the increase in absolute numbers, the worldwide age-standardised rates of stomach cancer (incidence, deaths, and DALYs) have declined since 1990. The drop in the disease burden was associated with improved Socio-demographic Index. Globally, 38.2% (21.1-57.8) of the age-standardised DALYs were attributable to high-sodium diet in both sexes combined, and 24.5% (20.0-28.9) of the age-standardised DALYs were attributable to smoking in males. Interpretation Our findings provide insight into the changing burden of stomach cancer, which is useful in planning local strategies and monitoring their progress. To this end, specific local strategies should be tailored to each country's risk factor profile. Beyond the current decline in age-standardised incidence and death rates, a decrease in the absolute number of cases and deaths will be possible if the burden in east Asia, where currently almost half of the incident cases and deaths occur, is further reduced. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license