Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019

BACKGROUND: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. METHODS: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. FINDINGS: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. INTERPRETATION: The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. FUNDING: The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38)

Global, regional, and national incidence of six major immune-mediated inflammatory diseases : findings from the global burden of disease study 2019

DATA SHARING STATEMENT : Data used for the analyses are publicly available from the Institute of Health Metrics and Evaluation (http://www.healthdata.org/; http:// ghdx.healthdata.org/gbd-results-tool).BACKGROUND : The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. METHODS : We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. FINDINGS : In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. INTERPRETATION : The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively.The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. Support from Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital; Shaqra University; the School of Pharmacy, University of Botswana; the Indian Council of Medical Research (ICMR); an Australian National Health and Medical Research Council (NHMRC) Investigator Fellowship; the Italian Center of Precision Medicine and Chronic Inflammation in Milan; the Department of Environmental Health Engineering of Isfahan University of Medical Sciences, Isfahan, Iran; National Health and Medical Research Council (NHMRC), Australia; Jazan University, Saudi Arabia; the Clinician Scientist Program of the Clinician Scientist Academy (UMEA) of the University Hospital Essen; AIMST University, Malaysia; the Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India; a Kornhauser Research Fellowship at The University of Sydney; the National Research, Development and Innovation Office Hungary; Taipei Medical University; CREATE Hope Scientific Fellowship from Lung Foundation Australia; the National Institute for Health and Care Research Manchester Biomedical Research Centre and an NIHR Clinical Lectureship in Respiratory Medicine; Kasturba Medical College, Mangalore and Manipal Academy of Higher Education, Manipal; Author Gate Publications; the Cleveland Clinic Foundation and Nassau University Medical center; the Italian Ministry of Health (RRC); King Abdulaziz University (DSR), Jeddah, and King Abdulaziz City for Science & Technology (KACSAT), Saudi Arabia, Science & Technology Development Fund (STDF), and US-Egypt Science & Technology joint Fund: The Academy of Scientific Research and Technology (ASRT), Egypt; partially supported by the Centre of Studies in Geography and Spatial Planning; the International Center of Medical Sciences Research (ICMSR), Islamabad Pakistan; Ain Shams University and the Egyptian Fulbright Mission Program; the Belgian American Educational Foundation; Health Data Research UK; the Spanish Ministry of Science and Innovation, Institute of Health Carlos III, CIBERSAM, and INCLIVA; the Clinical Research Development Unit, Imam Reza Hospital, Mashhad University of Medical Sciences; Shaqra University; Saveetha Institute of Medical and Technical Sciences and SRM Institute of Science and Technology; University of Agriculture, Faisalabad-Pakistan; the Chinese University of Hong Kong Research Committee Postdoctoral Fellowship Scheme; the institutional support of the Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Egypt; the European (EU) and Developing Countries Clinical Trials Partnership, the EU Horizon 2020 Framework Programme, UK-National Institute for Health and Care Research, the Mahathir Science Award Foundation and EU-EDCTP.http://www.thelancet.comam2024School of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-bein

Acurácia dos fatores de risco para delirium em paciente de unidade de terapia intensiva adulto

Objective: To assess the accuracy measurements for predisposing and precipitating Risk Factors for delirium in an adult Intensive Care Unit. Method: Cohort, prospective study with patients over 18 who had been hospitalized for over 24 hours and were able to communicate. The patients were assessed once a day until the onset of delirium or permanence in the Intensive Care Unit. Instruments were employed to track delirium, characterize the sample, and identify the risk factors. Descriptive statistics was employed for sample characterization and accuracy tests for risk factors. Results: The included patients amounted to 102, 31 of which presented delirium. The predisposing predictive risk factors were hypoalbuminemia, American Society of Anesthesiology over three, severity, altered tissue perfusion, dehydration, and being a male, whereas precipitating predictive factors were physical restraint, infection, pharmacological agent, polypharmacy, anemia, altered renal function, dehydration, invasive devices, altered tissue perfusion and altered quality and quantity of sleep. Conclusion: An accurate identification of predisposing and precipitating risk factors may contribute to planning preventive measures against delirium.Objetivo: Evaluar las medidas de exactitud de los factores de riesgo predisponentes y precipitantes del delírium en pacientes de una Unidad de Cuidados Intensivos de adultos. Método: Estudio de cohorte prospectivo en pacientes mayores de 18 años con más de 24 horas de hospitalización y capaces de comunicarse, evaluados una vez al día hasta el desarrollo de delírium o estancia en la Unidad de Cuidados Intensivos. Se utilizaron instrumentos para seguir el delírium, caracterizar la muestra y identificar los factores de riesgo. Se utilizaron estadísticas descriptivas para caracterizar la muestra y pruebas de exactitud para los factores de riesgo. Resultados: Se incluyeron 102 pacientes y 31 presentaron delírium. Se identificaron los factores de riesgo predictivos predisponentes: hipoalbuminemia, puntuación de la American Society of Anesthesiology superior a tres, gravedad, cambios en la perfusión tisular, deshidratación y sexo masculino. Los factores de riesgo precipitantes fueron: restricción física, infección, agente farmacológico, polifarmacia, anemia, cambio de la función renal, deshidratación, dispositivos invasivos, cambios en la perfusión tisular y cambios en la calidad y cantidad del sueño. Conclusión: La identificación exacta de los factores de riesgo predisponentes y precipitantes puede ayudar a planificar medidas preventivas contra el delírium.Objetivo: Avaliar as medidas de acurácia dos Fatores de Risco predisponentes e precipitantes para o delirium em pacientes em Unidade de Terapia Intensiva adulto. Método: Estudo de coorte prospectivo em pacientes maiores de 18 anos, mais de 24 horas de internação, capazes de se comunicar, avaliados uma vez ao dia, até desenvolvimento do delirium ou permanência na Unidade de Terapia Intensiva. Utilizou-se instrumentos para rastreio do delirium, caracterização da amostra e identificação dos fatores de risco. Estatística descritiva para caracterização da amostra e testes de acurácia aos fatores de risco. Resultados: Incluídos 102 pacientes e 31 apresentaram delirium, identificado fatores de risco preditivos predisponentes: hipoalbuminemia, American Society of Anestesiology maior que três, gravidade, alteração da perfusão tissular, desidratação e sexo masculino, já os preditivos precipitantes: restrição física, infecção, agente farmacológico, polifarmácia, anemia, alteração da função renal, desidratação, dispositivos invasivos, alteração da perfusão tissular e alteração na qualidade e quantidade do sono. Conclusão: Identificação acurada dos fatores de risco predisponentes e precipitantes podem auxiliar no planejamento de medidas preventivas ao delirium

Árbol de clasificación para la inferencia del diagnóstico de enfermería Volumen de Líquido Excesivo (00026)*

Objetivo: Gerar Árvore de Classificação para correta inferência do Diagnóstico de Enfermagem Volume de Líquido Excessivo (00026) em pacientes renais crônicos hemodialíticos. Método: Estudo metodológico, transversal, com pacientes em tratamento renal. Os dados foram coletados por meio de entrevista e avaliação física, utilizando instrumento com variáveis sociodemográficas, fatores relacionados, condição associada e características definidoras do Diagnóstico estudado. As árvores de classificação foram geradas pelo método Chi-Square Automation Interaction Detection, que se baseou no teste do Qui-quadrado. Resultados: Participaram 127 pacientes. Apresentaram o referido diagnóstico 79,5% (101), e as árvores incluíram os elementos “Ingesta excessiva de sódio” e “Ingestão maior que a eliminação” significativos para ocorrência do evento. Os pacientes com esses indicadores tiveram probabilidade de apresentar o diagnóstico de 0.87 e 0.94, e a capacidade de predição das árvores foi de 63% e 74%, respectivamente. Conclusão: A construção das árvores permitiu quantificar a probabilidade de ocorrência de Volume de Líquido Excessivo (00026) na população estudada. Os elementos “Ingesta excessiva de sódio” e “Ingestão maior que a eliminação” foram considerados preditores do referido diagnóstico na amostra.Objetivo: Generar un Árbol de Clasificación para la inferencia correcta del Diagnóstico de Enfermería Volumen de Líquido Excesivo (00026) en pacientes renales crónicos que hacen hemodiálisis. Método: Se trata de un estudio metodológico transversal con pacientes en tratamiento renal. Los datos se recogieron mediante entrevistas y evaluación física, utilizando un instrumento con variables sociodemográficas, factores relacionados, condición asociada y características definidoras del diagnóstico estudiado. Los árboles de clasificación se generaron por el método Detección de Interacción Automática del Chi-cuadrado, basado en la prueba del Chi-cuadrado. Resultados: Participaron 127 pacientes, de los cuales el 79,5% (101) presentaba el diagnóstico mencionado; los árboles incluían los elementos “Ingestión excesiva de sodio” e “Ingestión superior a la eliminación”, ambos significativos para el acaecimiento del evento. Los pacientes con estos indicadores tenían probabilidades de presentar el diagnóstico de 0,87 y 0,94, y la capacidad de predicción de los árboles era del 63% y 74%, respectivamente. Conclusión: La construcción de los árboles ha permitido cuantificar la probabilidad del acaecimiento del Volumen de Líquido Excesivo (00026) en la población estudiada. Los elementos “Ingestión excesiva de sodio” e “Ingestión superior a la eliminación” están considerados como premonitores del referido diagnóstico en la muestra.Objective: To generate a Classification Tree for the correct inference of the Nursing Diagnosis Fluid Volume Excess (00026) in chronic renal patients on hemodialysis. Method: Methodological, cross-sectional study with patients undergoing renal treatment. The data were collected through interviews and physical evaluation, using an instrument with socio-demographic variables, related factors, associated conditions and defining characteristics of the studied diagnosis. The classification trees were generated by the Chi-Square Automation Interaction Detection method, which was based on the Chi-square test. Results: A total of 127 patients participated, of which 79.5% (101) presented the diagnosis studied. The trees included the elements “Excessive sodium intake” and “Input exceeds output”, which were significant for the occurrence of the event, as the probability of occurrence of the diagnosis in the presence of these was 0.87 and 0.94, respectively. The prediction accuracy of the trees was 63% and 74%, respectively. Conclusion: The construction of the trees allowed to quantify the probability of the occurrence of Fluid Volume Excess (00026) in the studied population and the elements “Excessive sodium intake” and “Input exceeds output” were considered predictors of this diagnosis in the sample

Ghrelin delays premature aging in Hutchinson‐Gilford progeria syndrome

International audienceAbstract Hutchinson‐Gilford progeria syndrome (HGPS) is a rare and fatal genetic condition that arises from a single nucleotide alteration in the LMNA gene, leading to the production of a defective lamin A protein known as progerin. The accumulation of progerin accelerates the onset of a dramatic premature aging phenotype in children with HGPS, characterized by low body weight, lipodystrophy, metabolic dysfunction, skin, and musculoskeletal age‐related dysfunctions. In most cases, these children die of age‐related cardiovascular dysfunction by their early teenage years. The absence of effective treatments for HGPS underscores the critical need to explore novel safe therapeutic strategies. In this study, we show that treatment with the hormone ghrelin increases autophagy, decreases progerin levels, and alleviates other cellular hallmarks of premature aging in human HGPS fibroblasts. Additionally, using a HGPS mouse model ( Lmna G609G/G609G mice), we demonstrate that ghrelin administration effectively rescues molecular and histopathological progeroid features, prevents progressive weight loss in later stages, reverses the lipodystrophic phenotype, and extends lifespan of these short‐lived mice. Therefore, our findings uncover the potential of modulating ghrelin signaling offers new treatment targets and translational approaches that may improve outcomes and enhance the quality of life for patients with HGPS and other age‐related pathologies

Ghrelin delays premature aging in Hutchinson‐Gilford progeria syndrome

International audienceAbstract Hutchinson‐Gilford progeria syndrome (HGPS) is a rare and fatal genetic condition that arises from a single nucleotide alteration in the LMNA gene, leading to the production of a defective lamin A protein known as progerin. The accumulation of progerin accelerates the onset of a dramatic premature aging phenotype in children with HGPS, characterized by low body weight, lipodystrophy, metabolic dysfunction, skin, and musculoskeletal age‐related dysfunctions. In most cases, these children die of age‐related cardiovascular dysfunction by their early teenage years. The absence of effective treatments for HGPS underscores the critical need to explore novel safe therapeutic strategies. In this study, we show that treatment with the hormone ghrelin increases autophagy, decreases progerin levels, and alleviates other cellular hallmarks of premature aging in human HGPS fibroblasts. Additionally, using a HGPS mouse model ( Lmna G609G/G609G mice), we demonstrate that ghrelin administration effectively rescues molecular and histopathological progeroid features, prevents progressive weight loss in later stages, reverses the lipodystrophic phenotype, and extends lifespan of these short‐lived mice. Therefore, our findings uncover the potential of modulating ghrelin signaling offers new treatment targets and translational approaches that may improve outcomes and enhance the quality of life for patients with HGPS and other age‐related pathologies

Avaliação de diferentes sanificantes na qualidade microbiológica de mandioquinha-salsa minimamente processada Evaluation of different sanitizers on the microbiological quality of fresh-cut peruvian carrot

Objetivou-se, neste trabalho, avaliar a eficiência dos sanificantes hipoclorito de sódio, peróxido de hidrogênio e dicloro isocianurato de sódio aplicados antes e após o processamento mínimo de mandioquinha-salsa. Foram utilizadas raízes de mandioquinhasalsa da cultivar Amarela de Senador Amaral adquiridas no comércio local. Para limpeza superficial das raízes foram utilizados detergente e água. Após, as raízes foram divididas em dois grupos: controle (não sanificado) e sanificado, por imersão em dicloro isocianurato de sódio 100 mg.L-1, por 15 minutos. Em seguida foram descascadas, fatiadas em rodelas e imersas nos seguintes sanificantes: hipoclorito de sódio (25, 50 e 100 mg.L-1, por 10 minutos), peróxido de hidrogênio (3 e 6%, por 5 minutos) e dicloro isocianurato de sódio (50, 100 e 200 mg.L-1, por 10 minutos); embaladas e armazenadas em câmara fria ( 5 ± 1ºC e 98% UR), durante 15 dias. As análises realizadas a cada 3 dias foram pH, acidez titulável, sólidos solúveis, colimetria e pesquisa de Salmonella sp.. As variáveis pH, AT e SS não foram influenciadas pelos tratamentos utilizados. A presença de coliformes 45 ºC e Salmonella sp. não foi detectada, durante o armazenamento de mandioquinha-salsa minimamente processada, controle ou sanificada e foram observadas contagens baixas para coliformes 35 ºC. A sanificação do produto antes do processamento com dicloro isocianurato de sódio 100 mg.L-1 e condições higiênico-sanitárias adequadas, durante o processamento, possibilita a obtenção de um produto com padrão microbiológico de acordo com a legislação de alimentos, até o 15º dia de armazenamento.<br>The objective of this work was to evaluate the efficiency of the sanitizers sodium hypochlorite, hydrogen peroxide and sodium dichloro isocianurate applied before and after the minimum processing of the Peruvian carrot. Peruvian carrots of the cultivar Amarela de Senador Amaral purchased in the local commerce were utilized. Detergent and water were used for the surface cleaning of the roots. Afterwards, the roots were divided into two groups: control (not sanitized) and sanitized, for immersion into 100mg.L-1 sodium dichloro isocyanurate for 15 minutes. They were then peeled, sliced into rings and immersed into the following sanitizers: sodium hypochlorite (25, 50 and 100 mg.L-1 for 10 minutes), hydrogen peroxide (3 and 6%, for 5 minutes) and sodium dichloro isocyanurate (50, 100 and 200 mg.L-1 for 10 minutes); packed and stored in cold chamber ( 5 ± 1ºC and 98% RH) for 15 days. The following analyses were performed every 3 days: pH, titrable acidity, soluble solids, coliforms determination and search for Salmonella. The pH, AT and SS variables were not affected by the used treatments. The presence of coliforms at 45ºC and Salmonella was not detected during the storage of either control or sanitized fresh-cut Peruvian carrots and low counts for coliforms at 35ºC were found. The sanitization of the produce before processing with 100mg.L-1 sodium dichloro isocyanurate and hygienic-sanitary conditions during processing allow obtaining a produce with microbiological standard according to the food legislation until the 15th day of storage

Qualidade de palmito pupunha minimamente processado: aplicação de antioxidantes Quality of fresh cut pupunha palm cabbage: application of antioxidants

Objetivou-se, neste trabalho, a avaliação de antioxidantes na prevenção do escurecimento e na manutenção da qualidade de palmito pupunha minimamente processado armazenado a 5º C (± 1º C e 90% ± 5% UR). Os palmitos foram adquiridos no município de Coqueiral (MG), lavados em água corrente e detergente neutro, sanificados com hipoclorito de sódio 200 mg L-1 por 15 min, processados em rodelas de 1 cm de espessura, sanificados com hipoclorito de sódio 100 mg L-1 por 10 min e submetidos aos seguintes tratamentos: controle, cisteína 0,5%, ácido cítrico 0,5% e cisteína 0,5% + ácido cítrico 0,5%. Posteriormente, foram acondicionados em embalagens rígidas de polipropileno, armazenados por 12 dias a 5º C (± 1º C e 90% ± 5% UR). O delineamento experimental foi inteiramente causalizado em fatorial 4x7 (4 tratamentos e 7 tempos de armazenamento) com 3 repetições. O palmito sem tratamento apresentou vida útil de oito dias. O tratamento com cisteína 0,5% foi o que melhor manteve a qualidade de palmito pupunha (Bactris gasipaes Kunth) minimamente processado, caracterizando um produto com menores valores e menos oscilações de a* e b*, manutenção da firmeza e da acidez titulável ao longo do armazenamento, redução da atividade da peroxidase e manutenção da qualidade do produto durante o período avaliado.<br>The objective of this work was to evaluate the role antioxidants in preventing both browning and quality maintenance of fresh cut pupunha palm cabbage stored at 5º C (± 1º C and 90% ± 5% RH). The pupunha palm cabbages were purchased in the town of Coqueiral (MG), washed in running water and neutral detergent, sanitized with 200 mg L-1 sodium hypochlorite for 15 min, processed into 1cm-thick rings, sanitized with 100 mg L-1 sodium hypochlorite for 10 min and submitted to the following treatments: control, 0.5% cysteine, 0.5% citric acid and 0.5% cysteine + 0.5% citric acid. Afterwards, they were packed into stiff polypropylene packages stored for 12 days at 5º C (± 1º C and 90% ± 5% RH). The experimental design was completely randomized in a factorial 4x7 (4 treatments and 7 storage times) with three replicates. The control group showed useful life of 8 days. The treatment with 0.5% cysteine was the one which kept the quality of the fresh cut pupunha palm cabbage (Bactris gasipaes Kunth), characterizing a product with lower values and fewer oscillations of a* e b*, maintenance of firmness and titrable acidity along the storage, reduction of proxidase activity and maintenance of the product quality during the period valued