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1,896 results on '"Postma, A."'

1. Endovascular Treatment for Posterior Circulation Stroke in Routine Clinical Practice: Results of the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands Registry

Author: F. Anne V. Pirson, Nikki Boodt, Josje Brouwer, Agnetha A.E. Bruggeman, Sanne J. den Hartog, Robert-Jan B. Goldhoorn, Lucianne C.M. Langezaal, Julie Staals, Wim H. van Zwam, Christiaan van der Leij, Rutger J.B. Brans, Charles B.L.M. Majoie, Jonathan M. Coutinho, Bart J. Emmer, Diederik W.J. Dippel, Aad van der Lugt, Jan-Albert Vos, Robert J. van Oostenbrugge, Wouter J. Schonewille, Yvo B.W.E.M. Roos, Jelis Boiten, Jan Albert Vos, Ivo G.H. Jansen, Maxim J.H.L. Mulder, Kars C.J. Compagne, Manon Kappelhof, Wouter H. Hinsenveld, Bob Roozenbeek, Marieke J.H. Wermer, Marianne A.A. van Walderveen, Adriaan C.G.M. van Es, Jeannette Hofmeijer, Jasper M. Martens, Geert J. Lycklama à Nijeholt, Sebastiaan F. de Bruijn, Lukas C. van Dijk, H. Bart van der Worp, Rob H. Lo, Ewoud J. van Dijk, Hieronymus D. Boogaarts, J. de Vries, Paul L.M. de Kort, Julia van Tuijl, Jo P. Peluso, Puck Fransen, Jan S.P. van den Berg, Boudewijn A.A.M. van Hasselt, Leo A.M. Aerden, René J. Dallinga, Maarten Uyttenboogaart, Omid Eschgi, Reinoud P.H. Bokkers, Tobien H.C.M.L. Schreuder, Roel J.J. Heijboer, Koos Keizer, Lonneke S.F. Yo, Heleen M. den Hertog, Emiel J.C. Sturm, Paul J.A.M. Brouwers, Marieke E.S. Sprengers, Sjoerd F.M. Jenniskens, René van den Berg, Albert J. Yoo, Ludo F.M. Beenen, Alida A. Postma, Stefan D. Roosendaal, Bas F.W. van der Kallen, Ido R. van den Wijngaard, Joost Bot, Pieter-Jan van Doormaal, Anton Meijer, Elyas Ghariq, Marc P. van Proosdij, G. Menno Krietemeijer, Rob Lo, Dick Gerrits, Wouter Dinkelaar, Auke P.A. Appelman, Bas Hammer, Sjoert Pegge, Anouk van der Hoorn, Saman Vinke, Sandra Cornelissen, H. Zwenneke Flach, Hester F. Lingsma, Naziha el Ghannouti, Martin Sterrenberg, Wilma Pellikaan, Rita Sprengers, Marjan Elfrink, Michelle Simons, Marjolein Vossers, Joke de Meris, Tamara Vermeulen, Annet Geerlings, Gina van Vemde, Tiny Simons, Gert Messchendorp, Nynke Nicolaij, Hester Bongenaar, Karin Bodde, Sandra Kleijn, Jasmijn Lodico, Hanneke Droste, Maureen Wollaert, Sabrina Verheesen, D. Jeurrissen, Erna Bos, Yvonne Drabbe, Michelle Sandiman, Nicoline Aaldering, Berber Zweedijk, Jocova Vervoort, Eva Ponjee, Sharon Romviel, Karin Kanselaar, Denn Barning, Esmee Venema, Vicky Chalos, Ralph R. Geuskens, Tim van Straaten, Saliha Ergezen, Roger R.M. Harmsma, Daan Muijres, Anouk de Jong, Olvert A. Berkhemer, Anna M.M. Boers, J. Huguet, P.F.C. Groot, Marieke A. Mens, Katinka R. van Kranendonk, Kilian M. Treurniet, Manon L. Tolhuisen, Heitor Alves, Annick J. Weterings, Eleonora L.F. Kirkels, Eva J.H.F. Voogd, Lieve M. Schupp, Sabine L. Collette, Adrien E.D. Groot, Natalie E. LeCouffe, Praneeta R. Konduri, Haryadi Prasetya, Nerea Arrarte-Terreros, Lucas A. Ramos, Neurology, Graduate School, Radiology and Nuclear Medicine, ACS - Microcirculation, ANS - Brain Imaging, ACS - Atherosclerosis & ischemic syndromes, ANS - Neurovascular Disorders, Klinische Neurowetenschappen, MUMC+: MA Niet Med Staf Neurologie (9), RS: Carim - B05 Cerebral small vessel disease, MUMC+: MA AIOS Neurologie (9), MUMC+: MA Med Staf Spec Neurologie (9), Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: Carim - B06 Imaging, MUMC+: MA Neurologie (3), Radiology & Nuclear Medicine, Public Health, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Damage and Repair in Cancer Development and Cancer Treatment (DARE), and Radiology and nuclear medicine
Subjects: Male, medicine.medical_specialty, Mechanical Thrombolysis, posterior stroke, Treatment outcome, law.invention, Postoperative Complications, Randomized controlled trial, law, large vessel occlusion, medicine, Humans, Routine clinical practice, Prospective Studies, Endovascular treatment, PREDICTORS, Stroke, Acute ischemic stroke, Aged, Ischemic Stroke, Netherlands, Advanced and Specialized Nursing, OUTCOMES, BASILAR ARTERY-OCCLUSION, business.industry, Endovascular Procedures, Other Research Radboud Institute for Health Sciences [Radboudumc 0], registries, Middle Aged, THROMBECTOMY, medicine.disease, reperfusion, Clinical Practice, Tissue Plasminogen Activator, Emergency medicine, treatment outcome, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, Intracranial Hemorrhages, Large vessel occlusion
Abstract: Background and Purpose: The benefit of endovascular treatment (EVT) for posterior circulation stroke (PCS) remains uncertain, and little is known on treatment outcomes in clinical practice. This study evaluates outcomes of a large PCS cohort treated with EVT in clinical practice. Simultaneous to this observational study, several intervention centers participated in the BASICS trial (Basilar Artery International Cooperation Study), which tested the efficacy of EVT for basilar artery occlusion in a randomized setting. We additionally compared characteristics and outcomes of patients treated outside BASICS in trial centers to those from nontrial centers. Methods: We included patients with PCS from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands Registry: a prospective, multicenter, observational study of patients who underwent EVT in the Netherlands between 2014 and 2018. Primary outcome was a score of 0 to 3 on the modified Rankin Scale at 90 days. Secondary outcomes included reperfusion status and symptomatic intracranial hemorrhage. For outcome comparison between patients treated in trial versus nontrial centers, we used ordinal logistic regression analysis. Results: We included 264 patients of whom 135 (51%) had received intravenous thrombolysis. The basilar artery was most often involved (77%). Favorable outcome (modified Rankin Scale score 0–3) was observed in 115/252 (46%) patients, and 109/252 (43%) patients died. Successful reperfusion was achieved in 178/238 (75%), and symptomatic intracranial hemorrhage occurred in 9/264 (3%). The 154 nontrial patients receiving EVT in BASICS trial centers had similar characteristics and outcomes as the 110 patients treated in nontrial centers (modified Rankin Scale adjusted cOR: 0.77 [95% CI, 0.5–1.2]). Conclusions: Our study shows that high rates of favorable clinical outcome and successful reperfusion can be achieved with EVT for PCS, despite high mortality. Characteristics and outcomes of patients treated in trial versus nontrial centers were similar indicating that our cohort is representative of clinical practice in the Netherlands. Randomized studies using modern treatment approaches are needed for further insight in the benefit of EVT for PCS.
Published: 2022

2. Myasthenia gravis after glioblastoma resection: paraneoplastic syndrome or coincidence? A unique case report and review of the literature

Author: Martinus P.G. Broen, J. G. J. Hoeijmakers, Ann Hoeben, Inge Compter, Olaf E. M. G. Schijns, T. A. M. Bouwens van der Vlis, R. J. Slegers, Alida A. Postma, Linda Ackermans, and Jan Beckervordersandforth
Subjects: medicine.medical_specialty, Neurology, Thymoma, Paraneoplastic Syndromes, Brain tumor, Neuromuscular junction, Malignancy, Postoperative Complications, Paraneoplastic neurological syndrome, medicine, Humans, Myasthenia gravis, Neuroradiology, Aged, EXTRATHYMIC MALIGNANCIES, medicine.diagnostic_test, business.industry, Interventional radiology, Thymus Neoplasms, medicine.disease, Surgery, Neurology (clinical), Radiology, Neurosurgery, business, Glioblastoma
Abstract: Paraneoplastic neurological syndromes (PNS) can manifest with every type of malignancy. A well-known syndrome is myasthenia gravis (MG) in combination with thymomas. No association between primary brain tumors and neuromuscular disorders has been described. Here, we present a case of a 65-year-old patient who developed MG, following an uncomplicated, gross-total resection of a glioblastoma. To our knowledge, this is the first case describing the onset of MG during the early postoperative phase after glioblastoma resection. Current criteria of PNS are insufficient when the neurological syndrome is diagnosed at the time of a malignancy or shortly thereafter and should be revisited.
Published: 2022

3. Inter-method reliability of the modified Rankin Scale in patients with subarachnoid hemorrhage

Author: Wim I. M. Verhagen, Inger L. Abma, P.J. van der Wees, R Haeren, H Schenck, Hieronymus D. Boogaarts, Edith Nobels-Janssen, E N Postma, M H den Hertog, Bert A Coert, D Nanda, Dagmar Verbaan, Ronald H. M. A. Bartels, Adriaan R E Potgieser, W A Moojen, J M C van Dijk, RS: MHeNs - R3 - Neuroscience, MUMC+: MA Med Staf Spec Neurochirurgie (9), Neurochirurgie, Movement Disorder (MD), Graduate School, Neurosurgery, and ANS - Neurovascular Disorders
Subjects: medicine.medical_specialty, TELEPHONE, Subarachnoid hemorrhage, Modified Rankin Scale, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Outcome Assessment, Health Care, Humans, Medicine, Prospective Studies, Stroke, Reliability (statistics), Neuroradiology, OUTCOMES, Original Communication, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Reproducibility of Results, medicine.disease, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Reliability, Clinical trial, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Treatment Outcome, Neurology, nervous system, AGREEMENT, Structured interview, Physical therapy, Neurology (clinical), business, Kappa, STROKE
Abstract: Background and objectives The modified Rankin Scale (mRS) is one of the most frequently used outcome measures in trials in patients with an aneurysmal subarachnoid hemorrhage (aSAH). The assessment method of the mRS is often not clearly described in trials, while the method used might influence the mRS score. The aim of this study is to evaluate the inter-method reliability of different assessment methods of the mRS. Methods This is a prospective, randomized, multicenter study with follow-up at 6 weeks and 6 months. Patients aged ≥ 18 years with aSAH were randomized to either a structured interview or a self-assessment of the mRS. Patients were seen by a physician who assigned an mRS score, followed by either the structured interview or the self-assessment. Inter-method reliability was assessed with the quadratic weighted kappa score and percentage of agreement. Assessment of feasibility of the self-assessment was done by a feasibility questionnaire. Results The quadratic weighted kappa was 0.60 between the assessment of the physician and structured interview and 0.56 between assessment of the physician and self-assessment. Percentage agreement was, respectively, 50.8 and 19.6%. The assessment of the mRS through a structured interview and by self-assessment resulted in systematically higher mRS scores than the mRS scored by the physician. Self-assessment of the mRS was proven feasible. Discussion The mRS scores obtained with different assessment methods differ significantly. The agreement between the scores is low, although the reliability between the assessment methods is good. This should be considered when using the mRS in clinical trials. Trial registration www.trialregister.nl; Unique identifier: NL7859.
Published: 2022

4. Terminal osseous dysplasia with pigmentary defects and cardiomyopathy caused by a novel FLNA variant

Author: Stephen P. Robertson, Joost van Schuppen, Ronald H. Lekanne Deprez, Marielle Alders, Marja W. Wessels, Lynne Rumping, Alex V. Postma, Marjon van Slegtenhorst, J. Peter van Tintelen, Saskia M. Maas, Jasper J. Saris, Human Genetics, Medical Biology, ACS - Heart failure & arrhythmias, ACS - Pulmonary hypertension & thrombosis, Amsterdam Cardiovascular Sciences, Amsterdam Reproduction & Development (AR&D), Radiology and Nuclear Medicine, Amsterdam Neuroscience - Cellular & Molecular Mechanisms, Amsterdam Neuroscience - Complex Trait Genetics, and Clinical Genetics
Subjects: Proband, Noncompaction cardiomyopathy, Pathology, medicine.medical_specialty, business.industry, phenotype–genotype correlation, Cardiomyopathy, Restrictive cardiomyopathy, medicine.disease, Terminal osseous dysplasia with pigmentary defects, terminal osseous dysplasia with pigmentary defects, FLNA, Exon, filaminopathies, Dysplasia, Genetics, medicine, business, cardiomyopathy, Genetics (clinical)
Abstract: Terminal osseous dysplasia with pigmentary defects (TODPD), also known as digitocutaneous dysplasia, is one of the X-linked filaminopathies caused by a variety of FLNA-variants. TODPD is characterized by skeletal defects, skin fibromata and dysmorphic facial features. So far, only a single recurrent variant (c.5217G>A;p.Val1724_Thr1739del) in FLNA has found to be responsible for TODPD. We identified a novel c.5217+5G>C variant in FLNA in a female proband with skeletal defects, skin fibromata, interstitial lung disease, epilepsy, and restrictive cardiomyopathy. This variant causes mis-splicing of exon 31 predicting the production of a FLNA-protein with an in-frame-deletion of 16 residues identical to the miss-splicing-effect of the recurrent TODPD c.5217G>A variant. This mis-spliced transcript was explicitly detected in heart tissue, but was absent from blood, skin, and lung. X-inactivation analyses showed extreme skewing with almost complete inactivation of the mutated allele (>90%) in these tissues, except for heart. The mother of the proband, who also has fibromata and skeletal abnormalities, is also carrier of the FLNA-variant and was diagnosed with noncompaction cardiomyopathy after cardiac screening. No other relevant variants in cardiomyopathy-related genes were found. Here we describe a novel variant in FLNA (c.5217+5G>C) as the second pathogenic variant responsible for TODPD. Cardiomyopathy has not been described as a phenotypic feature of TODPD before.
Published: 2021

5. Across the continuum: Associations between (fluctuations in) momentary self-esteem and psychotic experiences

Author: Robin M. Murray, Matthew J. Kempton, Inez Myin-Germeys, Ulrich Reininghaus, Craig Morgan, Lucia Valmaggia, Therese van Amelsvoort, Charlotte Gayer-Anderson, Philippa Garety, Mary Rose Postma, Philip McGuire, Til Wykes, RS: MHeNs - R2 - Mental Health, Psychiatrie & Neuropsychologie, and MUMC+: MA Med Staf Spec Psychiatrie (9)
Subjects: Experience sampling method, Psychosis, media_common.quotation_subject, Psychological intervention, Prodrome, First episode psychosis, Self-esteem, medicine, COMPREHENSIVE ASSESSMENT, Humans, CLINICAL HIGH-RISK, Association (psychology), Ecological momentary assessment, PSYCHOLOGICAL PROCESSES, Biological Psychiatry, media_common, business.industry, PARANOIA, medicine.disease, First-episode psychosis, Self Concept, DAILY-LIFE STRESS, CHILDHOOD TRAUMA, Psychiatry and Mental health, INDIVIDUALS, Psychotic Disorders, Mental state, SAMPLING RESEARCH, SCHIZOPHRENIA SPECTRUM DISORDERS, Mechanism, business, ULTRA-HIGH-RISK, Clinical psychology
Abstract: OBJECTIVE: Low self-esteem has been suggested as a putative mechanism in the development and maintenance of psychosis. Uncertainty still exists about how unstable self-esteem relates to psychotic experiences. The present study examines the potential (temporal) associations between momentary self-esteem, fluctuations in self-esteem, and psychotic experiences in daily life. METHODS: Experience sampling data were collected from 46 individuals presenting with an at-risk mental state (ARMS), 51 individuals with first-episode psychosis (FEP), and 53 controls, to investigate associations between (fluctuations in) self-esteem and psychotic experiences within and across FEP, ARMS, and controls, using linear mixed models. RESULTS: In all three groups we found that lower momentary self-esteem was associated with a greater intensity of psychotic experiences (adj. βFEP = -0.15, 95% CI -0.20 to -0.10, p = 0.000; adj. βARMS = -0.20, 95% CI -0.26 to -0.15, p = 0.000; adj. βcontrols = -0.12, 95% CI -0.17 to -0.07, p = 0.000). Variability in momentary self-esteem was associated with a greater intensity of psychotic experiences only in ARMS (adj. βARMS = 0.08, 95% CI 0.04 to 0.11, p = 0.000) and controls (adj. βcontrols = 0.04, 95% CI 0.01 to 0.08, p = 0.023). For instability this association held only in controls (adj. βcontrols = 0.03, 95% CI 0.00 to 0.05, p = 0.020). Furthermore, findings may suggest a reciprocal temporal association between self-esteem and psychotic experiences. CONCLUSIONS: Our findings suggest that self-esteem may be an important mechanism targetable by ecological momentary interventions to reduce the intensity of psychotic experiences and potentially prevent illness progression at an early stage. ispartof: SCHIZOPHRENIA RESEARCH vol:238 pages:188-198 ispartof: location:Netherlands status: published
Published: 2021

6. Short digital spatial memory test detects impairment in alzheimer’s disease and mild cognitive impairment

Author: Poos, Jackie M., van der Ham, Ineke J.M., Leeuwis, Anna E., Pijnenburg, Yolande A.L., van der Flier, Wiesje M., Postma, Albert, Leerstoel Postma, Experimental Psychology (onderzoeksprogramma PF), Helmholtz Institute, Neurology, Leerstoel Postma, Experimental Psychology (onderzoeksprogramma PF), Helmholtz Institute, Amsterdam Neuroscience - Neurodegeneration, APH - Personalized Medicine, and APH - Methodology
Subjects: medicine.medical_specialty, Visual perception, Neuroscience(all), Neurosciences. Biological psychiatry. Neuropsychiatry, Audiology, Spatial memory, Article, Cognitive dysfunction, Neuropsychology, mental disorders, medicine, Dementia, Neuropsychological assessment, Cognitive decline, medicine.diagnostic_test, business.industry, General Neuroscience, Cognition, Early diagnosis, medicine.disease, Spatial navigation, Cohort, Memory disorders, business, RC321-571
Abstract: Background: Impairment in navigation abilities and object location memory are often seen in early-stage Alzheimer’s Disease (AD), yet these constructs are not included in standard neuropsychological assessment. We investigated the differential ability of a short digital spatial memory test in mild AD dementia and mild cognitive impairment (MCI). Methods: 21 patients with AD dementia (66.9 ± 6.9, 47% female), 22 patients with MCI (69.6 ± 8.3, 46% female) and 21 patients with subjective cognitive decline (SCD) (62.2 ± 8.9, 48% female) from the Amsterdam Dementia Cohort performed the Object Location Memory Test (OLMT), consisting of a visual perception and memory trial, and the Virtual Tübingen (VT) test, consisting of a scene recognition, route continuation, route ordering and distance comparison task. The correlations with other cognitive domains were examined. Results: Patients with mild AD dementia (Z: −2.51 ± 1.15) and MCI (Z: −1.81 ± 0.92) performed worse than participants with SCD (Z: 0.0 ± 1.0) on the OLMT. Scene recognition and route continuation were equally impaired in patients with AD dementia (Z: −1.14 ± 0.73, Z: −1.44 ± 1.13) and MCI (Z: −1.37 ± 1.25, Z: −1.21 ± 1.07). Route ordering was only impaired in patients with MCI (Z: −0.82 ± 0.78). Weak to moderate correlations were found between route continuation and memory (r(64) = 0.40, p &lt, 0.01), and between route ordering and attention (r(64) = 0.33, p &lt, 0.01), but not for the OLMT. Conclusion: A short digital spatial memory test battery was able to detect object location memory and navigation impairment in patients with mild AD dementia and MCI, highlighting the value of incorporating such a test battery in standard neuropsychological assessment.
Published: 2021

7. Global, regional, and national burden of stroke and its risk factors, 1990–2019 : a systematic analysis for the Global Burden of Disease Study 2019

Author: Mosiur Rahman, Rehab Salah, Mario F P Peres, Licia Iacoviello, Benjamin A Stark, Mahalaqua Nazli Khatib, Amir Radfar, Kamarul Imran Musa, Yannick Béjot, Deanna Anderlini, Carlos Cantú-Brito, Feng Sha, V. E. Nwatah, Pradip Gyanwali, Boris Bikbov, Bartosz Miazgowski, Sindhura Lakshmi Koulmane Laxminarayana, Ali Bijani, Imteyaz A Khan, Yaser Mokhayeri, Bogdan Oancea, Tarang Parekh, Martin Dichgans, Linh Gia Vu, Naohiro Yonemoto, Ahmad Ghashghaee, Marcos Roberto Tovani-Palone, Gebiyaw Wudie Tsegaye, Mona Pathak, Maciej Banach, Marissa B Reitsma, Derrick A Bennett, Treska S Hassan, Allen Seylani, Gdiom Gebreheat Abady, Islam Y. Elgendy, Hassan Mehmood Lak, Ismael R. Campos-Nonato, Sorin Hostiuc, Sheikh Mohammed Shariful Islam, Alessandra C. Goulart, Silvia Schiavolin, Simona Sacco, Atif Amin Baig, Azeem Majeed, Sahar Eftekharzadeh, Badr Hasan Sobaih, Archith Boloor, Aimé Bonny, Graeme J. Hankey, Jiregna Darega Gela, Mohamed I Hegazy, Pedram Keshavarz, Segun Emmanuel Ibitoye, Maseer Khan, Hatem Abdelaziz Mohamed Wafa, Hualiang Lin, Enayet Karim Chowdhury, Simon I. Hay, Vanessa De la Cruz-Góngora, Xuefeng Liu, Arokiasamy Perianayagam, Maryam Zamanian, Sezer Kisa, Preetam Bhalchandra Mahajan, Junmei Miao Jonasson, Alberto Raggi, Shubha Jayaram, Tahira Ashraf, Ejaz Ahmad Khan, Matthias Endres, Masoumeh Sadeghi, Dominique Vervoort, Hanadi Al Hamad, Mowafa Househ, Elena V. Gnedovskaya, Johan Ärnlöv, Andrea Sylvia Winkler, Yousef Khader, Mikhail Sergeevich Zastrozhin, Yuming Guo, Yunquan Zhang, Sami Almustanyir, Lalit Dandona, Amir Masoud Rahmani, Chythra R Rao, Giancarlo Lucchetti, Irena Ilic, Suzanne Barker-Collo, Priya Rathi, Emerito Jose A. Faraon, Mohamad-Hani Temsah, Reza Ghanei Gheshlagh, Gyu Ri Kim, Carlos A Castañeda-Orjuela, Alaa Makki, Yun Jin Kim, Vida Abedi, Shanshan Li, Kewal Krishan, David Flood, Abdollah Mohammadian-Hafshejani, Michele Romoli, Gregory A. Roth, Jagdish Khubchandani, Isabela M. Benseñor, Rupak Desai, Mohammed Shannawaz, Aziz Sheikh, Claudiu Herteliu, Xiaoyue Xu, Santi Martini, Kenji Shibuya, Jasvinder A. Singh, Ravi Prakash Jha, Kairat Davletov, Mahya Beheshti, Rahmatollah Moradzadeh, Ismaeel Yunusa, Maria Inês Schmidt, Koustuv Dalal, Sohail Ahmad, Patrick D. M. C. Katoto, Oladimeji Adebayo, Nima Hafezi-Nejad, Ranil Jayawardena, Giampiero Mazzaglia, Mitra Abbasifard, Usman Iqbal, Hamid Yimam Hassen, Alireza Rafiei, Catherine O. Johnson, Mark Thomaz Ugliara Barone, Simona Giampaoli, Gaetano Isola, Ricardo Lutzky Saute, Mandira Lamichhane Dhimal, Vishnu Renjith, Farshad Farzadfar, Irina Filip, Daniel Diaz, André Karch, Samer Hamidi, Diego Augusto Santos Silva, David Colozza, Gbenga A. Kayode, Dinh-Toi Chu, Truong-Minh Pham, Arielle Wilder Bell, Aziz Rezapour, David Laith Rawaf, Anasthasia Zastrozhina, Yves Miel H Zuniga, Ivo Iavicoli, Adrian Pana, Salman Rawaf, Pankaj Bhardwaj, Omid Dadras, Anayat Ullah, Gina Agarwal, Shafiu Mohammed, Bing-Fang Hwang, Eyayou Girma Tadesse, Charles D.A. Wolfe, Sanjay Basu, Michael Brauer, Tanuj Kanchan, Ahmad Azam Malik, Brigid Unim, Min Seo Kim, Kia Vosoughi, Tomasz Miazgowski, Warren D. Lo, Vivek Podder, Dana Bryazka, Chuanhua Yu, Hassan Magdy Abd El Razek, Rufus Akinyemi, Zhi-Jiang Zhang, Ettore Beghi, Xiaochen Dai, Meghnath Dhimal, Mehrnoosh Samaei, Sathish Kumar Jayapal, Bay Vo, Amanual Getnet Mersha, Rajaa Al-Raddadi, Savita Lasrado, Jalal Arabloo, Pablo M. Lavados, Samaneh Akbarpour, Khezar Hayat, Ritesh G. Menezes, Vahid Alipour, Sowmya J. Rao, Mariam Molokhia, Trang Huyen Nguyen, Aletta E. Schutte, Zahra Kamiab, Lidia Morawska, Mohammad Ali Moni, Bo Norrving, Tommi Vasankari, Bruno Ramos Nascimento, Ai Koyanagi, Tissa Wijeratne, Rizwan Kalani, Chenwen Zhong, Bright Opoku Ahinkorah, Sepideh Ahmadi, Bruce Bartholow Duncan, Andrzej Rynkiewicz, Pradyumna Agasthi, Saeed Shahabi, Adnan Kisa, Fares Alahdab, Vafa Rahimi-Movaghar, Adnan Ansar, Matilde Leonardi, Ali Koolivand, Jefferson Antonio Buendia Rodriguez, Leonardo Roever, Daniel Asfaw Erku, Alok Atreya, Jean Jacques Noubiap, Dhaval Kolte, Shajedur Rahman Shawon, Michael Ekholuenetale, Navid Manafi, Narayanaswamy Venketasubramanian, Syed Amir Gilani, Mohamed M. Gad, Christopher J L Murray, Louis Jacob, Robert Ancuceanu, Simona Costanzo, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Nazanin Rajai, Muhammed Elhadi, Abdelrahman Ibrahim Abushouk, Alireza Zandifar, Walter Muruet, Jagadish Rao Padubidri, Promit Ananyo Chakraborty, Hans Orru, Mikk Jürisson, Rajeev Gupta, Kurnia Dwi Artanti, Till Bärnighausen, Mark Woodward, Masao Iwagami, Brijesh Sathian, Bingyu Li, Vijay Krishnamoorthy, Ahamarshan Jayaraman Nagarajan, Sherief Ghozy, Amanda G. Thrift, Michael A. Piradov, Florian Fischer, Mayowa O. Owolabi, Lorenzo G. Mantovani, Aman Yesuf Endries, Sara Sheikhbahaei, Stefan Lorkowski, Muhammed Shahriar Zaman, Ali Yadollahpour, Abdiwahab Hashi, Sreenivas Narasimha Swamy, Krittika Bhattacharyya, Hiroshi Yatsuya, Mika Kivimäki, Olayinka Stephen Ilesanmi, Irmina Maria Michalek, Ruxandra Irina Negoi, Alberico L. Catapano, Gholamreza Bazmandegan, Ahmed Al Montasir, Fakher Rahim, Amirhossein Sahebkar, Syed Mohamed Aljunid, Giang Thu Vu, G Anil Kumar, Juan Jesus Carrero, Hiroyasu Iso, Abdallah M. Samy, Stefan Stortecky, Reza Malekzadeh, Ashwin Kamath, Nevine El Nahas, Ayesha Humayun, Miguel A Barboza, Sheng-Chia Chung, Carlo La Vecchia, Oluwakemi Ololade Odukoya, Rita Krishnamurthi, Masood Ali Shaikh, Milena Ilic, Lalit Yadav, Nahlah Elkudssiah Ismail, Abdel Douiri, Yousef Mohammad, Jason H Y Wu, Sahar Saeedi Moghaddam, Ramesh Holla, Sadaf G. Sepanlou, Itamar S. Santos, Jost B. Jonas, Dian Kusuma, Atte Meretoja, Yasir Waheed, Ben Lacey, Zahra Aryan, Mulugeta Molla Birhanu, Moien Ab Khan, K. M. Saif-Ur-Rahman, Ramin Zand, Anna Aleksandrovna Skryabina, Sung In Jang, Rakhi Dandona, Emanuele D'Amico, Priyanga Ranasinghe, Jaykaran Charan, Bhaskaran Unnikrishnan, Davide Sattin, Akram Pourshams, Markus P. Schlaich, Arief Hargono, Samaneh Asgari, Ovidiu Baltatu, Ippazio Cosimo Antonazzo, Sandhya Neupane Kandel, Nizal Sarrafzadegan, Jakub Morze, Man Mohan Mehndiratta, Manjari Tripathi, Panniyammakal Jeemon, Rohollah Kalhor, Yogeshwar Kalkonde, Soraya Siabani, Sojib Bin Zaman, Seyed Sina Naghibi Irvani, Shilpa Gaidhane, Sahel Valadan Tahbaz, Yihienew Mequanint Bezabih, Samath D Dharmaratne, Ingan Ukur Tarigan, Vivek Gupta, Klara Dokova, Alireza Vakilian, Vardhmaan Jain, Akshaya Srikanth Bhagavathula, Sarah Wulf Hanson, Umar Farooque, Mohammad Ali Mansournia, Vera Marisa Costa, Alessandro Gialluisi, Valery L. Feigin, Himal Kandel, Suzanne Polinder, Nermin Ghith, Deepak Dhamnetiya, Michael H. Criqui, Asif Hanif, Ahmed Abualhasan, Veer Bala Gupta, Mahaveer Golechha, Bach Xuan Tran, Jason A. Anderson, Catherine Bisignano, Kazumasa Yamagishi, Zahid A Butt, Budi Aji, Baye Dagnew, Rasmus Havmoeller, Victor Volovici, Jitendra Singh, Paramjit Gill, Saverio Stranges, Eun Cheol Park, Andrew T Olagunju, Milena Santric-Milicevic, Woldesellassie M. Bezabhe, Sheikh M. Alif, Junjie Huang, Foad Abd-Allah, Yvonne Teuschl, Rajkumar Doshi, Nelson Alvis-Guzman, Marcel Ausloos, Mohsen Naghavi, Yusra Ahmed Salih, Mohsen Abbasi-Kangevari, Maarten J. Postma, Ghozali Ghozali, Yanzhong Wang, Ali H. Mokdad, Valentin Yurievich Skryabin, Nitin Joseph, Andre M. N. Renzaho, Muhammad Aziz Rahman, Mohammad Athar, Rustam Al-Shahi Salman, Albertino Damasceno, Fatemeh Pashazadeh Kan, Marcello Tonelli, Florentino Luciano Caetano dos Santos, Sonali G. Choudhari, Abdullah Hamid Feroze, Walter D. Johnson, Ro-Ting Lin, Francesca Giulia Magnani, Hermann Brenner, Shaimaa I. El-Jaafary, Tea Lallukka, Niveen M E Abu-Rmeileh, Jacek Jerzy Jozwiak, GBD 2019 Stroke Collaborators, Feigin, V. L., Stark, B. A., Johnson, C. O., Roth, G. A., Bisignano, C., Abady, G. G., Abbasifard, M., Abbasi-Kangevari, M., Abd-Allah, F., Abedi, V., Abualhasan, A., Abu-Rmeileh, N. M. E., Abushouk, A. I., Adebayo, O. M., Agarwal, G., Agasthi, P., Ahinkorah, B. O., Ahmad, S., Ahmadi, S., Salih, Y. A., Aji, B., Akbarpour, S., Akinyemi, R. O., Al Hamad, H., Alahdab, F., Alif, S. M., Alipour, V., Aljunid, S. M., Almustanyir, S., Al-Raddadi, R. M., Salman, R. A. -S., Alvis-Guzman, N., Ancuceanu, R., Anderlini, D., Anderson, J. A., Ansar, A., Antonazzo, I. C., Arabloo, J., Arnlov, J., Artanti, K. D., Aryan, Z., Asgari, S., Ashraf, T., Athar, M., Atreya, A., Ausloos, M., Baig, A. A., Baltatu, O. C., Banach, M., Barboza, M. A., Barker-Collo, S. L., Barnighausen, T. W., Barone, M. T. U., Basu, S., Bazmandegan, G., Beghi, E., Beheshti, M., Bejot, Y., Bell, A. W., Bennett, D. A., Bensenor, I. M., Bezabhe, W. M., Bezabih, Y. M., Bhagavathula, A. S., Bhardwaj, P., Bhattacharyya, K., Bijani, A., Bikbov, B., Birhanu, M. M., Boloor, A., Bonny, A., Brauer, M., Brenner, H., Bryazka, D., Butt, Z. A., Dos Santos, F. L. C., Campos-Nonato, I. R., Cantu-Brito, C., Carrero, J. J., Castaneda-Orjuela, C. A., Catapano, A. L., Chakraborty, P. A., Charan, J., Choudhari, S. G., Chowdhury, E. K., Chu, D. -T., Chung, S. -C., Colozza, D., Costa, V. M., Costanzo, S., Criqui, M. H., Dadras, O., Dagnew, B., Dai, X., Dalal, K., Damasceno, A. A. M., D'Amico, E., Dandona, L., Dandona, R., Gela, J. D., Davletov, K., De La Cruz-Gongora, V., Desai, R., Dhamnetiya, D., Dharmaratne, S. D., Dhimal, M. L., Dhimal, M., Diaz, D., Dichgans, M., Dokova, K., Doshi, R., Douiri, A., Duncan, B. B., Eftekharzadeh, S., Ekholuenetale, M., El Nahas, N., Elgendy, I. Y., Elhadi, M., El-Jaafary, S. I., Endres, M., Endries, A. Y., Erku, D. A., Faraon, E. J. A., Farooque, U., Farzadfar, F., Feroze, A. H., Filip, I., Fischer, F., Flood, D., Gad, M. M., Gaidhane, S., Gheshlagh, R. 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M., Sarrafzadegan, N., Sathian, B., Sattin, D., Schiavolin, S., Schlaich, M. P., Schmidt, M. I., Schutte, A. E., Sepanlou, S. G., Seylani, A., Sha, F., Shahabi, S., Shaikh, M. A., Shannawaz, M., Shawon, Md. S. R., Sheikh, A., Sheikhbahaei, S., Shibuya, K., Siabani, S., Silva, D. A. S., Singh, J. A., Singh, J. K., Skryabin, V. Y., Skryabina, A. A., Sobaih, B. H., Stortecky, S., Stranges, S., Tadesse, E. G., Tarigan, I. U., Temsah, M. -H., Teuschl, Y., Thrift, A. G., Tonelli, M., Tovani-Palone, M. R., Tran, B. X., Tripathi, M., Tsegaye, G. W., Ullah, A., Unim, B., Unnikrishnan, B., Vakilian, A., Tahbaz, S. V., Vasankari, T. J., Venketasubramanian, N., Vervoort, D., Vo, B., Volovici, V., Vosoughi, K., Vu, G. T., Vu, L. G., Wafa, H. A., Waheed, Y., Wang, Y., Wijeratne, T., Winkler, A. S., Wolfe, C. D. A., Woodward, M., Wu, J. H., Hanson, S. W., Xu, X., Yadav, L., Yadollahpour, A., Jabbari, S. H. Y., Yamagishi, K., Yatsuya, H., Yonemoto, N., Yu, C., Yunusa, I., Zaman, M. S., Zaman, S. B., Zamanian, M., Zand, R., Zandifar, A., Zastrozhin, M. S., Zastrozhina, A., Zhang, Y., Zhang, Z. -J., Zhong, C., Zuniga, Y. M. H., Murray, C. J. L., Public Health, Neurosurgery, Department of Public Health, University of Helsinki, Faculty of Medicine, Helsinki Inequality Initiative (INEQ), HUS Neurocenter, Neurologian yksikkö, Helsinki University Hospital Area, Feigin, V, Stark, B, Johnson, C, Roth, G, Bisignano, C, Abady, G, Abbasifard, M, Abbasi-Kangevari, M, Abd-Allah, F, Abedi, V, Abualhasan, A, Abu-Rmeileh, N, Abushouk, A, Adebayo, O, Agarwal, G, Agasthi, P, Ahinkorah, B, Ahmad, S, Ahmadi, S, Salih, Y, Aji, B, Akbarpour, S, Akinyemi, R, Al Hamad, H, Alahdab, F, Alif, S, Alipour, V, Aljunid, S, Almustanyir, S, Al-Raddadi, R, Salman, R, Alvis-Guzman, N, Ancuceanu, R, Anderlini, D, Anderson, J, Ansar, A, Antonazzo, I, Arabloo, J, Arnlov, J, Artanti, K, Aryan, Z, Asgari, S, Ashraf, T, Athar, M, Atreya, A, Ausloos, M, Baig, A, Baltatu, O, Banach, M, Barboza, M, Barker-Collo, S, Barnighausen, T, Barone, M, Basu, S, Bazmandegan, G, Beghi, E, Beheshti, M, Bejot, Y, Bell, A, Bennett, D, Bensenor, I, Bezabhe, W, Bezabih, Y, Bhagavathula, A, Bhardwaj, P, Bhattacharyya, K, Bijani, A, Bikbov, B, Birhanu, M, Boloor, A, Bonny, A, Brauer, M, Brenner, H, Bryazka, D, Butt, Z, Dos Santos, F, Campos-Nonato, I, Cantu-Brito, C, Carrero, J, Castaneda-Orjuela, C, Catapano, A, Chakraborty, P, Charan, J, Choudhari, S, Chowdhury, E, Chu, D, Chung, S, Colozza, D, Costa, V, Costanzo, S, Criqui, M, Dadras, O, Dagnew, B, Dai, X, Dalal, K, Damasceno, A, D'Amico, E, Dandona, L, Dandona, R, Gela, J, Davletov, K, De La Cruz-Gongora, V, Desai, R, Dhamnetiya, D, Dharmaratne, S, Dhimal, M, Diaz, D, Dichgans, M, Dokova, K, Doshi, R, Douiri, A, Duncan, B, Eftekharzadeh, S, Ekholuenetale, M, El Nahas, N, Elgendy, I, Elhadi, M, El-Jaafary, S, Endres, M, Endries, A, Erku, D, Faraon, E, Farooque, U, Farzadfar, F, Feroze, A, Filip, I, Fischer, F, Flood, D, Gad, M, Gaidhane, S, Gheshlagh, R, Ghashghaee, A, Ghith, N, Ghozali, G, Ghozy, S, Gialluisi, A, Giampaoli, S, Gilani, S, Gill, P, Gnedovskaya, E, Golechha, M, Goulart, A, Guo, Y, Gupta, R, Gupta, V, Gyanwali, P, Hafezi-Nejad, N, Hamidi, S, Hanif, A, Hankey, G, Hargono, A, Hashi, A, Hassan, T, Hassen, H, Havmoeller, R, Hay, S, Hayat, K, Hegazy, M, Herteliu, C, Holla, R, Hostiuc, S, Househ, M, Huang, J, Humayun, A, Hwang, B, Iacoviello, L, Iavicoli, I, Ibitoye, S, Ilesanmi, O, Ilic, I, Ilic, M, Iqbal, U, Irvani, S, Islam, S, Ismail, N, Iso, H, Isola, G, Iwagami, M, Jacob, L, Jain, V, Jang, S, Jayapal, S, Jayaram, S, Jayawardena, R, Jeemon, P, Jha, R, Johnson, W, Jonas, J, Joseph, N, Jozwiak, J, Jurisson, M, Kalani, R, Kalhor, R, Kalkonde, Y, Kamath, A, Kamiab, Z, Kanchan, T, Kandel, H, Karch, A, Katoto, P, Kayode, G, Keshavarz, P, Khader, Y, Khan, E, Khan, I, Khan, M, Khatib, M, Khubchandani, J, Kim, G, Kim, M, Kim, Y, Kisa, A, Kisa, S, Kivimaki, M, Kolte, D, Koolivand, A, Laxminarayana, S, Koyanagi, A, Krishan, K, Krishnamoorthy, V, Krishnamurthi, R, Kumar, G, Kusuma, D, Vecchia, C, Lacey, B, Lak, H, Lallukka, T, Lasrado, S, Lavados, P, Leonardi, M, Li, B, Li, S, Lin, H, Lin, R, Liu, X, Lo, W, Lorkowski, S, Lucchetti, G, Saute, R, Abd El Razek, H, Magnani, F, Mahajan, P, Majeed, A, Makki, A, Malekzadeh, R, Malik, A, Manafi, N, Mansournia, M, Mantovani, L, Martini, S, Mazzaglia, G, Mehndiratta, M, Menezes, R, Meretoja, A, Mersha, A, Jonasson, J, Miazgowski, B, Miazgowski, T, Michalek, I, Mirrakhimov, E, Mohammad, Y, Mohammadian-Hafshejani, A, Mohammed, S, Mokdad, A, Mokhayeri, Y, Molokhia, M, Moni, M, Al Montasir, A, Moradzadeh, R, Morawska, L, Morze, J, Muruet, W, Musa, K, Nagarajan, A, Naghavi, M, Swamy, S, Nascimento, B, Negoi, R, Kandel, S, Nguyen, T, Norrving, B, Noubiap, J, Nwatah, V, Oancea, B, Odukoya, O, Olagunju, A, Orru, H, Owolabi, M, Padubidri, J, Pana, A, Parekh, T, Park, E, Kan, F, Pathak, M, Peres, M, Perianayagam, A, Pham, T, Piradov, M, Podder, V, Polinder, S, Postma, M, Pourshams, A, Radfar, A, Rafiei, A, Raggi, A, Rahim, F, Rahimi-Movaghar, V, Rahman, M, Rahmani, A, Rajai, N, Ranasinghe, P, Rao, C, Rao, S, Rathi, P, Rawaf, D, Rawaf, S, Reitsma, M, Renjith, V, Renzaho, A, Rezapour, A, Rodriguez, J, Roever, L, Romoli, M, Rynkiewicz, A, Sacco, S, Sadeghi, M, Moghaddam, S, Sahebkar, A, Saif-Ur-Rahman, K, Salah, R, Samaei, M, Samy, A, Santos, I, Santric-Milicevic, M, Sarrafzadegan, N, Sathian, B, Sattin, D, Schiavolin, S, Schlaich, M, Schmidt, M, Schutte, A, Sepanlou, S, Seylani, A, Sha, F, Shahabi, S, Shaikh, M, Shannawaz, M, Shawon, M, Sheikh, A, Sheikhbahaei, S, Shibuya, K, Siabani, S, Silva, D, Singh, J, Skryabin, V, Skryabina, A, Sobaih, B, Stortecky, S, Stranges, S, Tadesse, E, Tarigan, I, Temsah, M, Teuschl, Y, Thrift, A, Tonelli, M, Tovani-Palone, M, Tran, B, Tripathi, M, Tsegaye, G, Ullah, A, Unim, B, Unnikrishnan, B, Vakilian, A, Tahbaz, S, Vasankari, T, Venketasubramanian, N, Vervoort, D, Vo, B, Volovici, V, Vosoughi, K, Vu, G, Vu, L, Wafa, H, Waheed, Y, Wang, Y, Wijeratne, T, Winkler, A, Wolfe, C, Woodward, M, Wu, J, Hanson, S, Xu, X, Yadav, L, Yadollahpour, A, Jabbari, S, Yamagishi, K, Yatsuya, H, Yonemoto, N, Yu, C, Yunusa, I, Zaman, M, Zaman, S, Zamanian, M, Zand, R, Zandifar, A, Zastrozhin, M, Zastrozhina, A, Zhang, Y, Zhang, Z, Zhong, C, Zuniga, Y, Murray, C, Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Microbes in Health and Disease (MHD)
Subjects: Male, Aging, 030204 cardiovascular system & hematology, Stroke data, GUIDELINES, 3124 Neurology and psychiatry, Body Mass Index, Global Burden of Disease, 0302 clinical medicine, RA0421, Risk Factors, Epidemiology, Strokes, YOUNG-ADULTS, Prevalence, 80 and over, Aetiology, 610 Medicine & health, Stroke, POPULATION, 1103 Clinical Sciences, 1109 Neurosciences, Cause of death, Aged, 80 and over, education.field_of_study, Mortality rate, Incidence (epidemiology), Incidence, 1. No poverty, Articles, Hälsovetenskaper, Middle Aged, Stroke types, ddc, 3. Good health, ISCHEMIC-STROKE, Income, Female, Quality-Adjusted Life Years, Life Sciences & Biomedicine, Adult, medicine.medical_specialty, GBD, Population, Clinical Sciences, Clinical Neurology, 03 medical and health sciences, Clinical Research, MIDDLE-INCOME COUNTRIES, Health Sciences, medicine, Humans, Risk factor, education, GBD 2019 Stroke Collaborators, Cerebral Hemorrhage, Aged, Ischemic Stroke, Global burden, Science & Technology, Neurology & Neurosurgery, HYPERTENSION, business.industry, MORTALITY, Prevention, 3112 Neurosciences, Neurosciences, 1103 Clinical Sciences, SERVICES, Subarachnoid Hemorrhage, medicine.disease, PREVENTION, Brain Disorders, Good Health and Well Being, Attributable risk, Human medicine, Neurology (clinical), Neurosciences & Neurology, business, 1109 Neurosciences, 030217 neurology & neurosurgery, Demography, 2.4 Surveillance and distribution, RC
Abstract: Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. Funding Bill & Melinda Gates Foundation.
Published: 2021

8. Transient Cognitive Impairment and White Matter Hyperintensities in Severely Depressed Older Patients Treated With Electroconvulsive Therapy

Author: Frederik Barkhof, Filip Bouckaert, Annemieke Dols, Pascal Sienaert, Eric van Exel, Didi Rhebergen, Max L. Stek, Dick J. Veltman, Sigfried N.T.M. Schouws, Mardien L. Oudega, Kristof Vansteelandt, Aartjan T.F. Beekman, Rein Postma, Jasmien Obbels, Margot J. Wagenmakers, Psychiatry, Neurology, APH - Aging & Later Life, APH - Mental Health, Amsterdam Neuroscience - Mood, Anxiety, Psychosis, Stress & Sleep, Amsterdam Neuroscience - Neurodegeneration, Radiology and nuclear medicine, Amsterdam Neuroscience - Brain Imaging, Amsterdam Neuroscience - Neuroinfection & -inflammation, and Anatomy and neurosciences
Subjects: medicine.medical_specialty, medicine.medical_treatment, late life depression, Grey matter, behavioral disciplines and activities, Electroconvulsive therapy, Internal medicine, mental disorders, Humans, Medicine, Cognitive Dysfunction, Prospective Studies, Electroconvulsive Therapy, structural MRI, Aged, Mini–Mental State Examination, medicine.diagnostic_test, Depression, business.industry, Brain morphometry, transient cognitive impairment, Brain, Cognition, white matter hyperintensities, Late life depression, medicine.disease, White Matter, Hyperintensity, Psychiatry and Mental health, medicine.anatomical_structure, Mood disorders, Cardiology, severe depression, Geriatrics and Gerontology, business
Abstract: BACKGROUND: Although electroconvulsive therapy (ECT) is a safe and effective treatment for patients with severe late life depression (LLD), transient cognitive impairment can be a reason to discontinue the treatment. The aim of the current study was to evaluate the association between structural brain characteristics and general cognitive function during and after ECT. METHODS: A total of 80 patients with LLD from the prospective naturalistic follow-up Mood Disorders in Elderly treated with Electroconvulsive Therapy study were examined. Magnetic resonance imaging scans were acquired before ECT. Overall brain morphology (white and grey matter) was evaluated using visual rating scales. Cognitive functioning before, during, and after ECT was measured using the Mini Mental State Examination (MMSE). A linear mixed-model analysis was performed to analyze the association between structural brain alterations and cognitive functioning over time. RESULTS: Patients with moderate to severe white matter hyperintensities (WMH) showed significantly lower MMSE scores than patients without severe WMH (F(1,75.54) = 5.42, p = 0.02) before, during, and post-ECT, however their trajectory of cognitive functioning was similar as no time × WMH interaction effect was observed (F(4,65.85) = 1.9, p = 0.25). Transient cognitive impairment was not associated with medial temporal or global cortical atrophy (MTA, GCA). CONCLUSION: All patients showed a significant drop in cognitive functioning during ECT, which however recovered above baseline levels post-ECT and remained stable until at least 6 months post-ECT, independently of severity of WMH, GCA, or MTA. Therefore, clinicians should not be reluctant to start or continue ECT in patients with severe structural brain alterations. ispartof: American Journal Of Geriatric Psychiatry vol:29 issue:11 pages:1117-1128 ispartof: location:England status: accepted
Published: 2021

9. Blood Pressure in the First 6 Hours Following Endovascular Treatment for Ischemic Stroke Is Associated with Outcome

Author: Samuels, Noor, van de Graaf, Rob A., van den Berg, Carlijn A. L., Venema, Simone M. Uniken, Bala, Kujtesa, van Doormaal, Pieter Jan, van der Steen, Wouter, Witvoet, Elbert, Boiten, Jelis, den Hertog, Heleen, Schonewille, Wouter J., Hofmeijer, Jeannette, Schreuder, Floris, Schreuder, Tobien A. H. C. M. L., van der Worp, H. Bart, Roos, Yvo B. W. E. M., Majoie, Charles B. L. M., Burke, James F., van Es, Adriaan C. G. M., van der Lugt, Aad, Roozenbeek, Bob, Lingsma, Hester F., Dippel, Diederik W. J., van Oostenbrugge, Robert Jan, van Zwam, Wim, Goldhoorn, Robert-Jan, Staals, Julie, Postma - Jacobi, Linda, Public Health, Neurology, Radiology & Nuclear Medicine, ACS - Atherosclerosis & ischemic syndromes, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, ACS - Microcirculation, MUMC+: Hersen en Zenuw Centrum (3), RS: Carim - B05 Cerebral small vessel disease, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), MUMC+: MA AIOS Neurologie (9), MUMC+: MA Med Staf Spec Neurologie (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: DA BV AIOS Radiologie (9), and MUMC+: DA BV AIOS Nucleaire Geneeskunde (9)
Subjects: Male, Original Contributions, MULTICENTER, THERAPY, law.invention, Randomized controlled trial, law, Modified Rankin Scale, Acute ischemic stroke, Stroke, Endovascular Procedures, blood pressure, THROMBECTOMY, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], reperfusion, SAFETY, Hypertension, Cardiology, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, TRIAL, Female, Cardiology and Cardiovascular Medicine, Intracranial Hemorrhages, guideline, Adult, medicine.medical_specialty, Clinical and Population Sciences, All institutes and research themes of the Radboud University Medical Center, Internal medicine, SCORE, medicine, ischemic stroke, Humans, cardiovascular diseases, Endovascular treatment, Aged, Advanced and Specialized Nursing, cerebral hemorrhage, business.industry, Odds ratio, Recovery of Function, medicine.disease, Blood pressure, Ischemic stroke, Neurology (clinical), business
Abstract: Supplemental Digital Content is available in the text., Background and Purpose: Optimal blood pressure (BP) management in the acute phase of ischemic stroke remains an unresolved issue. It is uncertain whether guidelines for BP management during and after intravenous alteplase can be extrapolated to endovascular treatment (EVT) for stroke due to large artery occlusion in the anterior circulation. We evaluated the associations between systolic BP (SBP) in the first 6 hours following EVT and functional outcome as well as symptomatic intracranial hemorrhage. Methods: Patients of 8 MR CLEAN (Multicenter Randomized Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry centers, with available data on SBP in the 6 hours following EVT, were analyzed. We evaluated maximum, minimum, and mean SBP. Study outcomes were functional outcome (modified Rankin Scale) at 90 days and symptomatic intracranial hemorrhage. We used multivariable ordinal and binary regression analysis to adjust for important prognostic factors and studied possible effect modification by successful reperfusion. Results: Post-EVT SBP data were available for 1161/1796 patients. Higher maximum SBP (per 10 mm Hg increments) was associated with worse functional outcome (adjusted common odds ratio, 0.93 [95% CI, 0.88–0.98]) and a higher rate of symptomatic intracranial hemorrhage (adjusted odds ratio, 1.17 [95% CI, 1.02–1.36]). The association between minimum SBP and functional outcome was nonlinear with an inflection point at 124 mm Hg. Minimum SBP lower and higher than the inflection point were associated with worse functional outcomes (adjusted common odds ratio, 0.85 per 10 mm Hg decrements [95% CI, 0.76–0.95] and adjusted common odds ratio, 0.81 per 10 mm Hg increments [95% CI, 0.71–0.92]). No association between mean SBP and functional outcome was observed. Successful reperfusion did not modify the relation of SBP with any of the outcomes. Conclusions: Maximum SBP in the first 6 hours following EVT is positively associated with worse functional outcome and an increased risk of symptomatic intracranial hemorrhage. Both lower and higher minimum SBP are associated with worse outcomes. A randomized trial to evaluate whether modifying post-intervention SBP results in better outcomes after EVT for ischemic stroke seems justified.
Published: 2021

10. Promoting risk reduction among young adults with asthma during wildfire smoke: A feasibility study

Author: Solmaz Amiri, Tamara Odom-Maryon, Hans C. Haverkamp, Justin Whicker, Ana G. Rappold, Von P. Walden, Ross J. Bindler, and Julie Postma
Subjects: medicine.medical_specialty, Psychological intervention, Article, Wildfires, law.invention, Young Adult, Randomized controlled trial, law, Smoke, Intervention (counseling), medicine, Humans, Young adult, General Nursing, Asthma, business.industry, Public health, Public Health, Environmental and Occupational Health, medicine.disease, Clinical trial, Physical therapy, Feasibility Studies, business, Risk Reduction Behavior, Spirometer
Abstract: Objective(s) This study explored the feasibility, acceptability, preliminary impact, and functionality of two risk reduction mobile application (app) interventions on asthma outcomes as compared to a control arm during wildfire season. Design Three-arm, 8-week randomized clinical trial. Sample Sixty-seven young adults with asthma were enrolled. Measurements The Asthma Control Test, forced expiratory volume in one second (FEV1 ) and the System Usability Scale were measured at baseline, 4, and 8 weeks. The Research Attitude Scale was administered at 8 weeks. Twenty participants from the two intervention arms completed an optional survey and six were interviewed after completing the study. Intervention Both intervention arms could access Smoke Sense Urbanova, an app that supports reducing risks from breathing wildfire smoke. The Smoke Sense Urbanova Plus arm also monitored their daily FEV1 , received air quality notifications, and accessed preventive tips and a message board. Results Most participants agreed the app and spirometer were usable and their privacy and confidentiality were maintained. No adverse events were reported. Conclusions Participant-identified recommendations will support intervention refinement and testing. This research supports asthma self-management tools that public health nurses and community health workers can recommend for at-risk populations.
Published: 2021

11. Budget impact of optimizing rifaximin-alpha use for the prevention of recurrent hepatic encephalopathy in The Netherlands

Author: Hinko Stephan Hofstra, Bart van Hoek, Alexander V van Schoonhoven, Lisa Aniek de Jong, Maarten J. Postma, Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Microbes in Health and Disease (MHD)
Subjects: medicine.medical_specialty, Cirrhosis, Cost effectiveness, medicine.medical_treatment, hepatic encephalopathy, Liver transplantation, Gastroenterology, Rifaximin, Rifaximin-alpha, COST-EFFECTIVENESS, Lactulose, chemistry.chemical_compound, Gastrointestinal Agents, Internal medicine, medicine, Humans, Hepatic encephalopathy, CIRRHOSIS, health care economics and organizations, Netherlands, business.industry, Health Policy, Budget impact, medicine.disease, LIVER-TRANSPLANTATION, EFFICACY, budget impact, chemistry, lactulose, business, BURDEN, medicine.drug, economic model, hospitalization
Abstract: Aims Rifaximin-alpha as an adjunct to lactulose is reimbursed in the Netherlands for prevention of the third and subsequent episodes of overt Hepatic Encephalopathy (HE) in cirrhotic patients. However, use of rifaximin-alpha remains limited. This study evaluates the clinical and economic impact of treating all patients eligible under Dutch reimbursement conditions with rifaximin-alpha as an adjunct to lactulose for the prevention of overt HE in the Netherlands from a hospital and healthcare payer's perspective. Materials and methods A budget impact analysis was performed following national and international guidelines. Resource use was based on Dutch real-world data. HE-related cost inputs were based on the declaration codes, Dutch cost manual, and actual drug list prices. Several sensitivity and scenario analyses were conducted to assess model robustness. Results Treating eligible HE patients with rifaximin-alpha in addition to lactulose saves euro4,487 and costs euro249 per patient over a 5-year period compared with lactulose monotherapy from hospital and healthcare payer's perspectives, respectively. In the Netherlands, an estimated 38% of the 2,567 eligible patients are currently being treated with rifaximin-alpha. Optimizing rifaximin-alpha use by treating all eligible patients with the rifaximin-alpha + lactulose could save more than 3,000 hospital admissions, almost 15,000 hospital bed days, and 300 deaths over a 5-year period. Despite increased drug costs, treatment is estimated to result in potential cost savings over a 5-year period of 7.2 million euros from a Dutch hospital perspective. The budget impact is 397,770 euros from a healthcare payer's perspective. Conclusions Next to a clinical perspective, also from an economic perspective, wider prescription of rifaximin-alpha adhering to guidelines could be beneficial to reduce costs from a hospital perspective. From a healthcare payer's perspective, costs increase with addition of rifaximin-alpha due to relative better survival causing relatively higher drug and liver transplantation-related costs.
Published: 2021

12. The effect of carpal tunnel release on health-related quality of life of 2346 patients over a 5-year period

Author: Marius A. Kemler and Justin D Postma
Subjects: Health related quality of life, medicine.medical_specialty, business.industry, Decompression, Surgical, medicine.disease, Carpal Tunnel Syndrome, Quality of life, Societal perspective, Quality of Life, Carpal tunnel release, Physical therapy, Humans, Medicine, Surgery, Prospective Studies, Surgical treatment, business, Carpal tunnel syndrome, Prospective cohort study
Abstract: In this prospective cohort study, the health-related quality of life (HRQoL) from a societal perspective of carpal tunnel syndrome (CTS) patients was determined and compared with other diseases. In addition, the effect of carpal tunnel release (CTR) was analysed 6 weeks postoperatively with regard to mean EQ-5D index value improvement, side-effects of surgery and cost per quality adjusted life year (QALY) gained. We found a baseline mean EQ-5D index value of 0.75 (SD: 0.23), comparable with values seen in other disease like breast cancer, diabetes and asthma. Furthermore, we found that CTR improved HRQoL substantially 6 weeks postoperatively (mean + 0.12, SD: 0.22) and significantly reduced symptom reporting (mean −52%, SD: 53) with a cost per QALY gained of €396.05. In conclusion, CTS has a comparable impact on quality of life as compared with other diseases, and CTR has the potential to substantially improve patient’s HRQoL at a fairly modest cost. Level of evidence: III
Published: 2021

13. Prediction of Outcome and Endovascular Treatment Benefit Validation and Update of the MR PREDICTS Decision Tool

Author: Esmee Venema, Bob Roozenbeek, Maxim J.H.L. Mulder, Scott Brown, Charles B.L.M. Majoie, Ewout W. Steyerberg, Andrew M. Demchuk, Keith W. Muir, Antoni Dávalos, Peter J. Mitchell, Serge Bracard, Olvert A. Berkhemer, Geert J. Lycklama à Nijeholt, Robert J. van Oostenbrugge, Yvo B.W.E.M. Roos, Wim H. van Zwam, Aad van der Lugt, Michael D. Hill, Philip White, Bruce C.V. Campbell, Francis Guillemin, Jeffrey L. Saver, Tudor G. Jovin, Mayank Goyal, Diederik W.J. Dippel, Hester F. Lingsma, Jelis Boiten, Jan Albert Vos, Ivo G.H. Jansen, Robert- Jan B. Goldhoorn, Kars C.J. Compagne, Manon Kappelhof, Josje Brouwer, Sanne J. den Hartog, Wouter H. Hinsenveld, Adriaan C.G.M. van Es, Bart J. Emmer, Jonathan M. Coutinho, Wouter J. Schonewille, Marieke J.H. Wermer, Marianne A.A. van Walderveen, Julie Staals, Jeannette Hofmeijer, Jasper M. Martens, Sebastiaan F. de Bruijn, Lukas C. van Dijk, H. Bart van der Worp, Rob H. Lo, Ewoud J. van Dijk, Hieronymus D. Boogaarts, J. de Vries, Paul L.M. de Kort, Julia van Tuijl, Jo P. Peluso, Puck Fransen, Jan S.P. van den Berg, Boudewijn A.A.M. van Hasselt, Leo A.M. Aerden, René J. Dallinga, Maarten Uyttenboogaart, Omid Eschgi, Reinoud P.H. Bokkers, Tobien H.C.M.L. Schreuder, Roel J.J. Heijboer, Koos Keizer, Lonneke S.F. Yo, Heleen M. den Hertog, Tomas Bulut, Paul J.A.M. Brouwers, Marieke E.S. Sprengers, Sjoerd F.M. Jenniskens, René van den Berg, Albert J. Yoo, Ludo F.M. Beenen, Alida A. Postma, Stefan D. Roosendaal, Bas F.W. van der Kallen, Ido R. van den Wijngaard, Joost Bot, Pieter-Jan van Doormaal, Anton Meijer, Elyas Ghariq, Marc P. van Proosdij, G. Menno Krietemeijer, Rob Lo, Dick Gerrits, Wouter Dinkelaar, Auke P.A. Appelman, Bas Hammer, Sjoert Pegge, Anouk van der Hoorn, Saman Vinke, H. Zwenneke Flach, Naziha el Ghannouti, Martin Sterrenberg, Wilma Pellikaan, Rita Sprengers, Marjan Elfrink, Michelle Simons, Marjolein Vossers, Joke de Meris, Tamara Vermeulen, Annet Geerlings, Gina van Vemde, Tiny Simons, Gert Messchendorp, Nynke Nicolaij, Hester Bongenaar, Karin Bodde, Sandra Kleijn, Jasmijn Lodico, Hanneke Droste, Maureen Wollaert, Sabrina Verheesen, D. Jeurrissen, Erna Bos, Yvonne Drabbe, Michelle Sandiman, Nicoline Aaldering, Berber Zweedijk, Jocova Vervoort, Eva Ponjee, Sharon Romviel, Karin Kanselaar, Denn Barning, Vicky Chalos, Ralph R. Geuskens, Tim van Straaten, Saliha Ergezen, Roger R.M. Harmsma, Daan Muijres, Anouk de Jong, Anna M.M. Boers, J. Huguet, P.F.C. Groot, Marieke A. Mens, Katinka R. van Kranendonk, Kilian M. Treurniet, Manon L. Tolhuisen, Heitor Alves, Annick J. Weterings, Eleonora L.F. Kirkels, Eva J.H.F. Voogd, Lieve M. Schupp, Sabine L. Collette, Adrien E.D. Groot, Natalie E. LeCouffe, Praneeta R. Konduri, Haryadi Prasetya, Nerea Arrarte- Terreros, Lucas A. Ramos, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, MUMC+: Hersen en Zenuw Centrum (3), RS: Carim - B05 Cerebral small vessel disease, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: Carim - B06 Imaging, Neurology, Public Health, Radiology & Nuclear Medicine, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Radiology and Nuclear Medicine, ACS - Microcirculation, ANS - Neurovascular Disorders, ANS - Cellular & Molecular Mechanisms, and ACS - Atherosclerosis & ischemic syndromes
Subjects: Male, SELECTION, Original Contributions, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Cardiorespiratory Medicine and Haematology, registry, GUIDELINES, THERAPY, ANGIOGRAPHY, Brain Ischemia, law.invention, 0302 clinical medicine, Randomized controlled trial, Interquartile range, Modified Rankin Scale, law, 80 and over, Registries, 030212 general & internal medicine, ACUTE ISCHEMIC-STROKE, uncertainty, Stroke, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, Endovascular Procedures, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Outcome (probability), reperfusion, Treatment Outcome, thrombectomy, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Cardiology and Cardiovascular Medicine, Rare cancers Radboud Institute for Health Sciences [Radboudumc 9], medicine.medical_specialty, Concordance, Clinical Trials and Supportive Activities, Clinical Sciences, Clinical and Population Sciences, 03 medical and health sciences, Clinical Research, medicine, ischemic stroke, Humans, Endovascular treatment, Aged, Advanced and Specialized Nursing, Neurology & Neurosurgery, business.industry, MECHANICAL THROMBECTOMY, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Neurosciences, medicine.disease, Brain Disorders, HERMES collaborators and MR CLEAN Registry Investigators, Emergency medicine, Observational study, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: Supplemental Digital Content is available in the text., Background and Purpose: Benefit of early endovascular treatment (EVT) for ischemic stroke varies considerably among patients. The MR PREDICTS decision tool, derived from MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands), predicts outcome and treatment benefit based on baseline characteristics. Our aim was to externally validate and update MR PREDICTS with data from international trials and daily clinical practice. Methods: We used individual patient data from 6 randomized controlled trials within the HERMES (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials) collaboration to validate the original model. Then, we updated the model and performed a second validation with data from the observational MR CLEAN Registry. Primary outcome was functional independence (defined as modified Rankin Scale score 0–2) 3 months after stroke. Treatment benefit was defined as the difference between the probability of functional independence with and without EVT. Discriminative performance was evaluated using a concordance (C) statistic. Results: We included 1242 patients from HERMES (633 assigned to EVT, 609 assigned to control) and 3156 patients from the MR CLEAN Registry (all of whom underwent EVT within 6.5 hours). The C-statistic for functional independence was 0.74 (95% CI, 0.72–0.77) in HERMES and, after model updating, 0.80 (0.78–0.82) in the Registry. Median predicted treatment benefit of routinely treated patients (Registry) was 10.3% (interquartile range, 5.8%–14.4%). Patients with low (
Published: 2021

14. Moral reasoning, moral decision‐making, and empathy in Korsakoff’s syndrome

Author: Oudman, Erik, van Stigt Thans, Sioux, Montoya, Estrella R, Postma, Albert, Helmholtz Institute, Experimental Psychology (onderzoeksprogramma PF), Leerstoel Postma, Afd Psychologische functieleer, and Leerstoel Honk
Subjects: Cognitive Neuroscience, media_common.quotation_subject, Decision Making, Empathy, Moral reasoning, Morals, 050105 experimental psychology, Developmental psychology, 03 medical and health sciences, Behavioral Neuroscience, 0302 clinical medicine, Lawrence Kohlberg's stages of moral development, Social skills, social skills, Theory of mind, medicine, Humans, 0501 psychology and cognitive sciences, Problem Solving, health care economics and organizations, media_common, moral reasoning, 05 social sciences, Original Articles, medicine.disease, humanities, Maturity (psychological), Cross-Sectional Studies, Neuropsychology and Physiological Psychology, Interpersonal Reactivity Index, Korsakoff syndrome, Korsakoff's syndrome, Psychology, executive functioning, 030217 neurology & neurosurgery, Research Paper
Abstract: Korsakoff’s syndrome (KS) is a neuropsychiatric disorder, caused by a vitamin B1 deficiency. Although it is known that patients with KS display diminished theory of mind functioning and frequently exhibit marked antisocial interactions little attention has so far focused on the integrity of moral decision‐making abilities, moral reasoning, and empathy. In an experimental cross‐sectional design, 20 patients diagnosed with KS, and twenty age‐, education‐, and gender‐equivalent healthy participants performed tests assessing moral decision‐making, moral reasoning maturity, empathy, and executive functioning. Participants were administered the Moral Behaviour Inventory (MBI) for everyday moral dilemmas, and ten cartoons of abstract moral dilemmas. Responses were scored according to the Kohlberg stages of moral reasoning. Empathy and executive functioning were assessed with the Interpersonal Reactivity Index (IRI) and the Frontal Assessment Battery (FAB). In contrast to frontal traumatic brain injury patients, KS patients did not display a utilitarian bias, suggesting preserved moral decision‐making abilities. Of interest, KS patients had significantly lower levels of moral reasoning maturity on everyday moral dilemmas, and abstract moral dilemmas. In patients, empathy was moderately related to the level of moral maturity on both tasks, while executive functioning was not. In conclusion, KS patients have preserved moral decision‐making abilities, but their moral reasoning abilities are poorer in everyday and abstract situations. Lower moral reasoning abilities and lower levels of empathy together may be responsible for adverse social functioning in KS.
Published: 2020

15. Health problems and care needs in patients with Korsakoff’s syndrome: A systematic review

Author: van Dam, Mirjam Johanna, van Meijel, Berno, Postma, Albert, Oudman, Erik, Afd Psychologische functieleer, Helmholtz Institute, Experimental Psychology (onderzoeksprogramma PF), and Leerstoel Postma
Subjects: medicine.medical_specialty, Activities of daily living, Comorbidity, CINAHL, Disease, integrated, behavioral disciplines and activities, 03 medical and health sciences, 0302 clinical medicine, Activities of Daily Living, mental disorders, medicine, alcohol amnestic disorder, Humans, Psychiatry, Health Services Needs and Demand, somatic and psychiatric health problems, 030504 nursing, Delivery of Health Care, Integrated, business.industry, delivery of health care, Korsakoff’s syndrome, medicine.disease, 030227 psychiatry, Integrated care, Korsakoff Syndrome, Mood, Anxiety, Pshychiatric Mental Health, medicine.symptom, 0305 other medical science, business, Korsakoff's syndrome
Abstract: What is known on the subject?: Patients with Korsakoff's syndrome suffer from a broad range of comorbid somatic and/or psychiatric conditions. The various health problems in patients with Korsakoff's syndrome limit their ability to perform daily activities and also negatively affect their social functioning. What the paper adds to existing knowledge?: Patients with Korsakoff's syndrome have complex somatic and psychiatric comorbid conditions co-occurring with behavioural and functional problems. They are compounded by patients’ poor self-awareness regarding their health status and functioning. What are the implications for practice?: This review demonstrates that patients with Korsakoff's syndrome should receive integrated care. Integrated care for patients with Korsakoff's syndrome should be based on accurate multidimensional and multidisciplinary diagnostics in which nurses and nurse assistants have a prominent role due to their central position in the care process patients with Korsakoff's syndrome. Abstract: Introduction The literature shows that Korsakoff's syndrome is associated with a wide range of severe comorbid somatic and psychiatric health problems that lead to care needs in several domains of functioning. Aim To provide a comprehensive overview of Korsakoff patients’ health conditions and related care needs. Method Following the PRISMA guidelines, we searched MEDLINE, PsycInfo, Cochrane Library and CINAHL up to January 2019. After applying our inclusion criteria, two reviewers independently selected the studies, extracted the data and assessed methodological quality. Results Twelve articles were included. The commonest somatic comorbid conditions were liver disease, cardiovascular disease, COPD and diabetes mellitus. The commonest psychiatric comorbid conditions were mood disorder, personality disorder and psychotic disorder. Anxiety, aggressive/agitated behaviour, depressive symptoms and care needs in social functioning and (instrumental) activities of daily living were also very commonly reported. Discussion In patients with Korsakoff's syndrome, somatic and psychiatric comorbid conditions co-occur with behavioural and functional problems. They are compounded by patients’ poor self-awareness regarding their health status and functioning. Adequate responses to their care needs require high-quality integrated care. Implications for practice Patients with Korsakoff's syndrome should receive integrated care based on accurate multidimensional and multidisciplinary diagnostics in which nurses have a prominent role.
Published: 2020

16. Cost Effectiveness of a CYP2C19 Genotype-Guided Strategy in Patients with Acute Myocardial Infarction: Results from the POPular Genetics Trial

Author: Richard M. Tjon Joe Gin, Emanuele Barbato, Thomas O. Bergmeijer, Arnoud W J van 't Hof, Pim W. M. van Dorst, Daniel M.F. Claassens, Arend Mosterd, Vera H.M. Deneer, Renicus S Hermanides, Carmine Morisco, Folkert W. Asselbergs, Willem Dewilde, Gerrit J.A. Vos, C. Boersma, Pim van der Harst, Jean-Paul R. Herrman, Jurriën M. ten Berg, Maarten J. Postma, Claassens, D. M. F., van Dorst, P. W. M., Vos, G. J. A., Bergmeijer, T. O., Hermanides, R. S., van 't Hof, A. W. J., van der Harst, P., Barbato, E., Morisco, C., Tjon Joe Gin, R. M., Asselbergs, F. W., Mosterd, A., Herrman, J. -P. R., Dewilde, W. J. M., Postma, M. J., Deneer, V. H. M., ten Berg, J. M., Boersma, C., RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - B04 Clinical thrombosis and Haemostasis, Cardiovascular Centre (CVC), Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Microbes in Health and Disease (MHD)
Subjects: SELECTION, Acute coronary syndrome, Prasugrel, Cost effectiveness, AMERICAN-COLLEGE, GUIDELINES, ACUTE CORONARY SYNDROME, PRASUGREL, Medicine, Pharmacology (medical), ST-SEGMENT ELEVATION, TICAGRELOR, health care economics and organizations, Genetics, ANTIPLATELET THERAPY, business.industry, Standard treatment, General Medicine, Clopidogrel, medicine.disease, CLOPIDOGREL, Conventional PCI, Cohort, Cardiology and Cardiovascular Medicine, business, Ticagrelor, medicine.drug, TASK-FORCE
Abstract: INTRODUCTION: The POPular Genetics trial demonstrated that a CYP2C19 genotype-guided P2Y12 inhibitor strategy reduced bleeding rates compared with standard treatment with ticagrelor or prasugrel without increasing thrombotic event rates after primary percutaneous coronary intervention (PCI).OBJECTIVE: In this analysis, we aimed to evaluate the cost effectiveness of a genotype-guided strategy compared with standard treatment with ticagrelor or prasugrel.METHODS: A 1-year decision tree based on the POPular Genetics trial in combination with a lifelong Markov model was developed to compare costs and quality-adjusted life-years (QALYs) between a genotype-guided and a standard P2Y12 inhibitor strategy in patients with myocardial infarction undergoing primary PCI. The cost-effectiveness analysis was conducted from a Dutch healthcare system perspective. Within-trial survival and utility data were combined with lifetime projections to evaluate lifetime cost effectiveness for a cohort of 1000 patients. Costs and utilities were discounted at 4 and 1.5%, respectively, according to Dutch guidelines for health economic studies. Besides deterministic and probabilistic sensitivity analyses, several scenario analyses were also conducted (different time horizons, different discount rates, equal prices for P2Y12 inhibitors, and equal distribution of thrombotic events between the two strategies).RESULTS: Base-case analysis with a hypothetical cohort of 1000 subjects demonstrated 8.98 QALYs gained and €725,550.69 in cost savings for the genotype-guided strategy (dominant). The deterministic and probabilistic sensitivity analysis confirmed the robustness of the model and the cost-effectiveness results. In scenario analyses, the genotype-guided strategy remained dominant.CONCLUSION: In patients undergoing primary PCI, a CYP2C19 genotype-guided strategy compared with standard treatment with ticagrelor or prasugrel resulted in QALYs gained and cost savings.TRIAL REGISTRATION: Clinicaltrials.gov number: NCT01761786, Netherlands trial register number: NL2872.
Published: 2022

17. Progress on the elimination of viral hepatitis in Zimbabwe

Author: Blessing Dzingirai, Maarten J. Postma, Nyashadzaishe Mafirakureva, Leolin Katsidzira, Celia Moffat Joel Matyanga, and Marinus van Hulst
Subjects: hepatitis C virus, Zimbabwe, medicine.medical_specialty, Hepatitis, Viral, Human, Hepatitis C virus, viral hepatitis, World Health Organization, medicine.disease_cause, World health, 03 medical and health sciences, 0302 clinical medicine, Virology, Epidemiology, medicine, Humans, Hepatitis B Vaccines, 030212 general & internal medicine, Strategic planning, Hepatitis B virus, Hepatology, Health Policy, Original Articles, Hepatitis B, medicine.disease, Vaccination, Infectious Diseases, Work (electrical), Family medicine, Original Article, 030211 gastroenterology & hepatology, Business, Viral hepatitis, hepatitis B virus
Abstract: Very few low‐income countries have developed national plans to achieve the viral hepatitis elimination targets set in the World Health Organization (WHO) strategy. We reviewed the policy environment, strategies and challenges on the fight against viral hepatitis in Zimbabwe. The review focussed on the Ministry of Health and Child Care (MoHCC) policy documents, strategic plans and reports. We performed key informant interviews to enhance evidence generated from the document review. Twelve documents were reviewed and interviews with 10 key informants were completed. The MoHCC established a technical working group to work towards elimination of viral hepatitis. The technical working group drafted a strategic plan for elimination of viral hepatitis; however, it is still awaiting implementation. Key strategies that are working well include screening of donated blood for transfusion, safe injection practices and hepatitis B virus (HBV) three‐dose vaccination. Current challenges in the drive towards elimination of viral hepatitis include poor to non‐existent surveillance systems, lack of epidemiological data, absence of the HBV vaccine birth dose and lack of systematic screening and treatment services for viral hepatitis. In conclusion, despite political will demonstrated towards achieving viral hepatitis elimination, substantial investment and work are required to implement the strategic plan and realize significant success.
Published: 2021

18. A Culturally Tailored Diabetes Education Program in an Underserved Community Clinic

Author: Fionnuala Brown, Julie Postma, Charlotte Thrall, and Johannah Uriri-Glover
Subjects: Advanced and Specialized Nursing, Gerontology, education.field_of_study, Culturally tailored, business.industry, media_common.quotation_subject, Population, Type 2 Diabetes Mellitus, 030204 cardiovascular system & hematology, Diabetes education, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Medicine, 030212 general & internal medicine, business, Empowerment, education, Socioeconomic status, Glycemic, media_common
Abstract: Hispanic/Latino adults are disproportionately affected by type 2 diabetes mellitus (DM) than non-Hispanic Whites. Culturally tailored DM education has been proven to be an effective way of teaching self-management skills to this population. The purpose of this evidence-based practice project was to improve glycemic control in lower socioeconomic status Hispanic/Latino patients diagnosed with DM in a medically underserved community clinic using a culturally tailored DM education program. Pre/post results were analyzed at the conclusion of this project. Statistically significant improvements were noted in A1C levels, knowledge scores, and empowerment levels.
Published: 2021

19. Robotic nipple-sparing mastectomy complication rate compared to traditional nipple-sparing mastectomy: a systematic review and meta-analysis

Author: O. W. Bastian, Mando D. Filipe, Milan C. Richir, M. R. Vriens, E. de Bock, Arjen J. Witkamp, E. L. Postma, and P. P. A. Schellekens
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Cancer, Postoperative complication, Health Informatics, medicine.disease, Surgery, 03 medical and health sciences, 0302 clinical medicine, Hematoma, Breast cancer, 030220 oncology & carcinogenesis, Meta-analysis, medicine, 030212 general & internal medicine, Implant, Complication, business, Mastectomy
Abstract: Breast cancer is worldwide the most common cause of cancer in women and causes the second most common cancer-related death. Nipple-sparing mastectomy (NSM) is commonly used in therapeutic and prophylactic settings. Furthermore, (preventive) mastectomies are, besides complications, also associated with psychological and cosmetic consequences. Robotic NSM (RNSM) allows for better visualization of the planes and reducing the invasiveness. The aim of this study was to compare the postoperative complication rate of RNSM to NSM. A systematic search was performed on all (R)NSM articles. The primary outcome was determining the overall postoperative complication rate of traditional NSM and RNSM. Secondary outcomes were comparing the specific postoperative complication rates: implant loss, hematoma, (flap)necrosis, infection, and seroma. Forty-nine studies containing 13,886 cases of (R)NSM were included. No statistically significant differences were found regarding postoperative complications (RNSM 3.9%, NSM 7.0%, p = 0.070), postoperative implant loss (RNSM 4.1%, NSM 3.2%, p = 0.523), hematomas (RNSM 4.3%, NSM 2.0%, p = 0.059), necrosis (RNSM 4.3%, NSM 7.4%, p = 0.230), infection (RNSM 8.3%, NSM 4.0%, p = 0.054) or seromas (RNSM 3.0%, NSM 2.0%, p = 0.421). Overall, there are no statistically significant differences in complication rates between NSM and RNSM.
Published: 2021

20. Labral Index—Controlling Femoral Size to Evaluate the Relationship Between Relative Labral Size and Acetabular Version

Author: Cooper B. Ehlers, Arjun Minhas, William F Postma, and Andrew J. Curley
Subjects: musculoskeletal diseases, Labrum, medicine.diagnostic_test, business.industry, Rehabilitation, Public Health, Environmental and Occupational Health, Physical Therapy, Sports Therapy and Rehabilitation, Magnetic resonance imaging, medicine.disease, Continuous variable, Femoral head, medicine.anatomical_structure, medicine, Cutoff, Original Article, Orthopedics and Sports Medicine, Hip arthroscopy, Arthrogram, Nuclear medicine, business, Femoroacetabular impingement
Abstract: Purpose To assess the relationship of acetabular version with the length of the anterior and posterior labrum and to introduce a developed metric, the labral index, as a means of controlling for femoral head size when measuring labral length. Methods One hundred forty-eight patients who underwent hip arthroscopies for femoroacetabular impingement from October 2017 to October 2019 by a single hip surgeon were retrospectively reviewed. Magnetic resonance imaging arthrogram was used to measure central acetabular version (at the center of the femoral head) and cranial acetabular version (at the midpoint between the acetabular roof and center of the femoral head), as well as labral length at the anterior, posterior, and superolateral locations (3, 9, and 12 o’clock, respectively). Labral index was calculated by dividing anterior, posterior, and superolateral labral lengths by the radius of the femoral head. Pearson correlation analysis was used to assess the association between the 2 continuous variables. A priori alpha of 0.05 was established as the cutoff for significance. Results Forty-three patients (26 female, 17 male) with an average age of 34.2 ± 11.6 years were included in analysis. Increased central anteversion was significantly associated with a larger anterior labral length and index (P = .023, r = 0.343 and .005, r = 0.415, respectively). Cranial anteversion weakly correlated with a significantly increased anterior labral index (P = .047, r = 0.304) but not with larger anterior labral length (P = .089, r = 0.262). No statistically significant association was present for central or cranial version with posterior or superolateral labral measurements. Lateral center edge angle did not correlate with labral size at any location. Conclusions In patients undergoing hip arthroscopy for symptomatic femoroacetabular impingement, greater acetabular anteversion was significantly associated but weakly correlated with increased anterior labral length, whereas no association was found between posterior labral length and acetabular version. The labral index may be a useful metric to normalize labral length relative to the radius of the femoral head that warrants further investigation for its clinical utility in guiding labral reconstruction versus labral repair. Level of Evidence Level IV, diagnostic case series.
Published: 2021

21. Wernicke Encephalopathy in schizophrenia: a systematic review

Author: Oudman, Erik, Wijnia, Jan W., Oey, Misha J., van Dam, Mirjam J., Postma, Albert, Leerstoel Postma, Experimental Psychology (onderzoeksprogramma PF), Helmholtz Institute, Afd Psychologische functieleer, Leerstoel Postma, Experimental Psychology (onderzoeksprogramma PF), Helmholtz Institute, and Afd Psychologische functieleer
Subjects: medicine.medical_specialty, Clinical nutrition, Wernicke's encephalopathy, Wernicke’s Encephalopathy, thiamine, 03 medical and health sciences, 0302 clinical medicine, mental disorders, medicine, Humans, Wernicke Encephalopathy, Psychiatry, business.industry, digestive, oral, and skin physiology, fungi, food and beverages, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Schizophrenia, dietary schizophrenia, Thiamine, business, 030217 neurology & neurosurgery
Abstract: Introduction: In schizophrenia, patients can experience delusions or hallucinations regarding their food or health status, leading to diminished intake. Fasting or not eating a balanced diet can cause neurological complications after severe vitamin B1 malnourishment. The precise signs and symptoms of Wernicke’s Encephalopathy (WE) in schizophrenia are not clear. Our aim, therefore, was to conduct a systematic review of the characteristics of WE in patients with schizophrenia. Methods: We conducted our search from inception using Mesh terms schizophrenia, Wernicke Encephalopathy, Korsakoff’s syndrome. We searched Pubmed, ISI Web of Science, and Scopus. We defined WE as mental, oculomotor, and motoric alterations and thiamine deficiency; schizophrenia was defined as psychosis, hallucinations and/or delusions; adequate WE treatment as >500 mg/day intramuscular or intravenous. Our search yielded 15 WE cases. Results: WE is characterised by a triad of mental status change, ocular signs and ataxia. In alcohol use disorder, this triad is present in 16% of the cases, but 12 out of the 15 published schizophrenia cases presented themselves with a full triad. Importantly, as an additional characteristic, patients often lost weight within a short period of time. Conclusions: The development of a full triad and additional symptomatology suggests a late recognition of signs and symptoms of WE in schizophrenia. Prophylactic thiamine checks and treatment in patients with schizophrenia are relevant, and if WE is suspected adequate parenteral thiamine supplementation is necessary.Key points Only few cases of schizophrenia-related WE have been published in the literature, though challenges in diagnosing and recognising WE suggest that the vast majority of cases go undetected. Acute thiamine deficiency leads to Wernicke’s Encephalopathy. Patients diagnosed with schizophrenia are at risk to develop Wernicke’s Encephalopathy. Timely treatment with high doses of thiamine can adequately treat Wericke’s Encephalopathy.
Published: 2021

22. Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019

Author: Paulson, K. R., Kamath, A. M., Alam, T., Bienhoff, K., Abady, G. G., Abbas, J., Abbasi-Kangevari, M., Abbastabar, H., Abd-Allah, F., Abd-Elsalam, S. M., Abdoli, A., Abedi, A., Abolhassani, H., Abreu, L. G., Abu-Gharbieh, E., Abu-Rmeileh, N. M. E., Abushouk, A. I., Adamu, A. L., Adebayo, O. M., Adegbosin, A. E., Adekanmbi, V., Adetokunboh, O. O., Adeyinka, D. A., Adsuar, J. C., Afshari, K., Aghaali, M., Agudelo-Botero, M., Ahinkorah, B. O., Ahmad, T., Ahmadi, K., Ahmed, M. B., Aji, B., Akalu, Y., Akinyemi, O. O., Aklilu, A., Al-Aly, Z., Alam, K., Alanezi, F. M., Alanzi, T. M., Alcalde-Rabanal, J. E., Al-Eyadhy, A., Ali, T., Alicandro, G., Alif, S. M., Alipour, V., Alizade, H., Aljunid, S. M., Almasi-Hashiani, A., Almasri, N. A., Al-Mekhlafi, H. M., Alonso, J., Al-Raddadi, R. M., Altirkawi, K. A., Alumran, A. K., Alvis-Guzman, N., Alvis-Zakzuk, N. J., Ameyaw, E. K., Amini, S., Amini-Rarani, M., Amit, A. M. L., Amugsi, D. A., Ancuceanu, R., Anderlini, D., Andrei, C. L., Ansari, F., Ansari-Moghaddam, A., Antonio, C. A. T., Antriyandarti, E., Anvari, D., Anwer, R., Aqeel, M., Arabloo, J., Arab-Zozani, M., Aripov, T., Arnlov, J., Artanti, K. D., Arzani, A., Asaad, M., Asadi-Aliabadi, M., Asadi-Pooya, Ali A, Jafarabadi, M. A., Athari, S. S., Athari, S. M., Atnafu, D. D., Atreya, A., Atteraya, M. S., Ausloos, M., Awan, A. T., Quintanilla, B. P. A., Ayano, G., Ayanore, M. A., Aynalem, Y. A., Azari, S., Azarian, G., Azene, Z. N., Darshan, BB, Babaee, E., Badiye, A. D., Baig, A. A., Banach, M., Banik, P. C., Barker-Collo, S. L., Barqawi, H. J., Bassat, Q., Basu, S., Baune, B.T., Bayati, M., Bedi, N., Beghi, E., Beghi, M., Bell, M. L., Bendak, S., Bennett, D. A., Bensenor, I. M., Berhe, K., Berman, A. E., Bezabih, Y. M., Bhagavathula, A. S., Bhandari, D., Bhardwaj, N., Bhardwaj, P., Bhattacharyya, K., Bhattarai, S., Bhutta, Z. A., Bikbov, B., Biondi, A., Birihane, B. M., Biswas, R. K., Bohlouli, S., Bragazzi, N. L., Breusov, A. V., Brunoni, A. R., Burkart, K., Nagaraja, S. B., Busse, R., Butt, Z. A., dos Santos, F. L. C., Cahuana-Hurtado, L., Camargos, P., Camera, L. A., Cardenas, R., Carreras, G., Carrero, J. J., Carvalho, F., Castaldelli-Maia, J. M., Castaneda-Orjuela, C. A., Castelpietra, G., Cerin, E., Chang, J-C., Chanie, W. F., Charan, J., Chatterjee, S., Chattu, S. K., Chattu, V. K., Chaturvedi, S., Chen, S., Cho, D. Y., Choi, J-Y. J., Chu, D-T., Ciobanu, L. G., Cirillo, M., Conde, J., Costa, V. M., Couto, R. A. S., Dachew, B. A., Dahlawi, S. M. A., Dai, H., Dai, X., Dandona, L., Dandona, R., Daneshpajouhnejad, P., Darmstadt, G. L., Das, J. K., Davila-Cervantes, C. A., Davis, A. C., Davletov, K., De la Hoz, F. P., De Leo, D., Deeba, F., Denova-Gutierrez, E., Dervenis, N., Desalew, A., Deuba, K., Dey, S., Dharmaratne, S. D., Dhingra, S., Dhungana, G. P., da Silva, D. D., Diaz, D., Dorostkar, F., Doshmangir, L., Dubljanin, E., Duraes, A. R., Eagan, A. W., Edinur, H. A., Efendi, F., Eftekharzadeh, S., El Sayed, I., El Tantawi, M., Elbarazi, I., Elgendy, I. Y., El-Jaafary, S. I., Emami, A., Enany, S., Eyawo, O., Ezzikouri, S., Faris, P. S., Farzadfar, F., Fattahi, N., Fauk, N. K., Fazlzadeh, M., Feigin, V. L., Ferede, T. Y., Fereshtehnejad, S-M., Fernandes, E., Ferrara, P., Filip, I., Fischer, F., Fisher, J. L., Foigt, N. A., Folayan, M. O., Foroutan, M., Franklin, R. C., Freitas, M., Friedman, S. D., Fukumoto, T., Gad, M. M., Gaidhane, A. M., Gaidhane, S., Gaihre, S., Gallus, S., Garcia-Basteiro, A. L., Garcia-Gordillo, M., Gardner, W. M., Fonseca, M. G., Gebremedhin, K. B., Getacher, L., Ghashghaee, A., Gholamian, A., Gilani, S.A., Gill, T. K., Giussani, G., Gnedovskaya, E. V., Godinho, M. A., Goel, A., Golechha, M., Gona, P. N., Gopalani, S. V., Goudarzi, H., Grivna, M., Gugnani, H. C., Guido, D., Guimaraes, R. A., Das Gupta, R., Gupta, R., Hafezi-Nejad, N., Haider, M. R., Haj-Mirzaian, A., Hamidi, S., Hanif, A., Hankey, G. J., Hargono, A., Hasaballah, A. I., Hasan, M. M., Hasan, S. S., Hassan, A., Hassanipour, S., Hassankhani, H., Havmoeller, R. J., Hayat, K., Heidari-Soureshjani, R., Henry, N. J., Herteliu, C., Hole, M. K., Holla, R., Hossain, N., Hosseini, M., Hosseinzadeh, M., Hostiuc, M., Hostiuc, S., Househ, M., Huang, J., Humayun, A., Hwang, B-F., Iavicoli, I., Ibitoye, S. E., Ikuta, K. S., Ilesanmi, O. St., Ilic, I.M., Ilic, M. D., Inamdar, S., Inbaraj, L. R., Iqbal, K., Iqbal, U., Islam, M. M., Islam, S. M. S., Iso, H., Iwagami, M., Iwu, C. C. D., Jaafari, J., Jacobsen, K. H., Jagnoor, J., Jain, V., Janodia, M. D., Javaheri, T., Javanmardi, F., Jayaram, S., Jayatilleke, A. U., Jenabi, E., Jha, R. P., Ji, J. S., John, O., Jonas, J. B., Joo, T., Joseph, N., Joukar, F., Jozwiak, J.J., Jurisson, M., Kabir, A., Kabir, Z., Kalankesh, L. R., Kamyari, N., Kanchan, T., Kapoor, N., Matin, B. K., Karch, A., Karimi, S. E., Kassahun, G., Kayode, G. A., Karyani, A. K., Kemmer, L., Khalid, N., Khalilov, R., Khammarnia, M., Khan, E. A., Khan, G., Khan, M., Khan, M. N., Khang, Y-H., Khatab, K., Khater, A. M., Khater, M. M., Khayamzadeh, M., Khosravi, A., Kim, D., Kim, Y-E., Kim, Y. J., Kimokoti, R. W., Kisa, A., Kisa, S., Kissoon, N., Kopec, J. A., Kosen, S., Koul, P. A., Laxminarayana, S. L. K., Koyanagi, A., Krishan, K., Krishnamoorthy, V., Defo, B. K., Bicer, B. K., Kulkarni, V., Kumar, G. A., Kumar, M., Kumar, N., Kurmi, O. P., Kusuma, D., La Vecchia, C., Lacey, B., Lalloo, R., Lami, F.H., Landires, I., Larsson, A. O., Lasrado, S., Lassi, Z. S., Lauriola, P., Lee, P. H., Lee, S. W. H., Lee, Y. H., Leigh, J., Leonardi, M., Lewycka, S., Li, B., Li, S., Liang, J., Lim, L-L., Limenih, M. A., Lin, R-T., Liu, X., Lodha, R., Lopez, A. D., Lozano, R., Lugo, A., Lunevicius, R., Mackay, M. T., Kunjathur, S. M., Magnani, F. G., Prasad, D. R. M., Maheri, M., Mahmoudi, M., Majeed, A., Maled, V., Maleki, A., Maleki, S., Malekzadeh, R., Malik, A. A., Malta, D. C., Mamun, A. A., Mansouri, B., Mansournia, M. A., Martinez, G., Martini, S., Martins-Melo, F. R., Masoumi, S. Z., Maulik, P. K., McAlinden, C., McGrath, J. J., Medina-Solis, C. E., Nasab, E. M., Mejia-Rodriguez, F., Memish, Z.A., Mendoza, W., Menezes, R. G., Mengesha, E. W., Mensah, G. A., Meretoja, A., Meretoja, T. J., Mersha, A. M., Mestrovic, T., Miazgowski, B., Miazgowski, T., Michalek, I. M., Miller, T.R., Mini, G. K., Miri, M., Mirica, A., Mirrakhimov, .E M., Mirzaei, H., Mirzaei, M., Moazen, B., Moghadaszadeh, M., Mohajer, B., Mohamad, O., Mohammad, Y., Mohammadi, S. M., Mohammadian-Hafshejani, A., Mohammed, S., Mokdad, A. H., Molokhia, M., Monasta, L., Mondello, S., Moni, M. A., Moore, C. E., Moradi, G., Moradi, M., Moradzadeh, R., Moraga, P., Morawska, L., Morrison, S. D., Mosser, J. F., Khaneghah, A. M., Mustafa, G., Naderi, M., Nagarajan, A. J., Nagaraju, S. P., Naghavi, M., Naghshtabrizi, B., Naimzada, M. D., Nangia, V., Swamy, S. N., Nascimento, B. R., Naveed, M., Nazari, J., Ndejjo, R., Negoi, I., Negoi, R. I., Nena, E., Nepal, S., Netsere, H. B., Nguefack-Tsague, G., Ngunjiri, J. W., Nguyen, C. T. Y., Nguyen, C. T., Nguyen, H. L. T., Nigatu, Y. T., Nigussie, S. N., Nixon, M. R., Nnaji, C. A., Nomura, S., Noor, N. M., Noubiap, J. J., Nunez-Samudio, V., Nwatah, V. E., Oancea, B., Odukoya, O. O., Ogbo, F. A., Olusanya, B. O., Olusanya, J. O., Bali, A. O., Onwujekwe, O. E., Ortiz, A., Otoiu, A., Otstavnov, N., Otstavnov, S. S., Owolabi, M. O., Mahesh, P. A., Padubidri, J. R., Pakhale, S., Pakshir, K., Pal, P. K., Palladino, R., Pana, A., Panda-Jonas, S., Pandey, A., Pandi-Perumal, S. R., Pangaribuan, H. U., Pardo-Montano, A. M., Park, E-K., Patel, S. K., Patton, G. C., Pawar, S., Toroudi, H. P., Peden, A. E., Pepito, V. C. F., Peprah, E. K., Pereira, J., Perez-Gomez, J., Perico, N., Pesudovs, K., Pilgrim, T., Pinheiro, M., Piradov, M. A., Pirsaheb, M., Platts-Mills, J. A., Pokhrel, K. N., Postma, M. J., Pourjafar, H., Prada, S. I., Prakash, S., Pupillo, E., Syed, Z. Q., Rabiee, N., Radfar, A., Rafiee, A., Rafiei, A., Raggi, A., Rahimzadeh, S., Rahman, M. H. U., Rahmani, A. M., Ramezanzadeh, K., Rana, J., Ranabhat, C. L., Rao, S. J., Rasella, D., Rastogi, P., Rathi, P., Rawaf, D. L., Rawaf, S., Rawasia, W. F., Rawassizadeh, R., Jr, R. C. R., Remuzzi, G., Renzaho, A. M. N., Reshmi, B., Resnikoff, S., Rezaei, N., Rezapour, A., Riahi, S. M., Ribeiro, D., Rickard, J., Roever, L., Ronfani, L., Rothenbacher, D., Rubagotti, E., Rumisha, S. F., Ryan, P. M., Saddik, B., Sadeghi, E., Moghaddam, S. S., Sagar, R., Sahebkar, A., Salahshoor, M. R., Salehi, S., Salem, M. R., Salimzadeh, H., Salomon, J. A., Samodra, Y. L., Samy, A. M., Sanabria, J., Santric-Milicevic, M. M., Saraswathy, S. Y. I., Sarker, A.R., Sarrafzadegan, N., Sarveazad, A., Sathian, B., Sathish, T., Sattin, D., Saxena, S., Saya, G. K., Saylan, M., Schiavolin, S., Schlaich, M. P., Schwebel, D. C., Schwendicke, F., Senthilkumaran, S., Sepanlou, S. G., Servan-Mori, E., Sha, F., Shafaat, O., Shahabi, S., Shahbaz, M., Shaheen, A. A., Shahid, I., Shaikh, M. A., Shakiba, S., Shalash, A. S., Shams-Beyranvand, M., Shannawaz, M., Sharafi, K., Sheikh, A., Sheikhbahaei, S., Shiferaw, W. S., Shigematsu, M., Shin, J. I. l., Shiri, R., Shiue, I., Shuval, K., Siddiqi, T. J., Sidemo, N. B., Sigfusdottir, I. D., Sigurvinsdottir, R., Silva, J. P., Silverberg, J. I. S., Simonetti, B., Singh, B.B., Singh, J. A., Singhal, D., Sinha, D. N., Skiadaresi, E., Skryabin, V. Y., Skryabina, A. A., Sleet, D. A., Sobaih, B. H., Sobhiyeh, M. R., Soltani, S., Soriano, J. B., Spurlock, E. E., Sreeramareddy, C. T., Steiropoulos, P., Stokes, M. A., Stortecky, S., Sufiyan, M. B., Abdulkader, R. S., Sulo, G., Swope, C. B., Sykes, B. L., Szeto, M. D., Szocska, M., Tabares-Seisdedos, R., Tadesse, E. G., Taherkhani, A., Tamiru, A.T., Tareque, M. I., Tehrani-Banihashemi, A., Temsah, M-H., Tesfay, F. H., Tessema, G. A., Tessema, Z. T., Thankappan, K. 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J., GBD 2019 Under-5 Mortality Collaborators, Paulson K.R., Kamath A.M., Alam T., Bienhoff K., Abady G.G., Abbas J., Abbasi-Kangevari M., Abbastabar H., Abd-Allah F., Abd-Elsalam S.M., Abdoli A., Abedi A., Abolhassani H., Abreu L.G., Abu-Gharbieh E., Abu-Rmeileh N.M., Abushouk A.I., Adamu A.L., Adebayo O.M., Adegbosin A.E., Adekanmbi V., Adetokunboh O.O., Adeyinka D.A., Adsuar J.C., Afshari K., Aghaali M., Agudelo-Botero M., Ahinkorah B.O., Ahmad T., Ahmadi K., Ahmed M.B., Aji B., Akalu Y., Akinyemi O.O., Aklilu A., Al-Aly Z., Alam K., Alanezi F.M., Alanzi T.M., Alcalde-Rabanal J.E., Al-Eyadhy A., Ali T., Alicandro G., Alif S.M., Alipour V., Alizade H., Aljunid S.M., Almasi-Hashiani A., Almasri N.A., Al-Mekhlafi H.M., Alonso J., Al-Raddadi R.M., Altirkawi K.A., Alumran A.K., Alvis-Guzman N., Alvis-Zakzuk N.J., Ameyaw E.K., Amini S., Amini-Rarani M., Amit A.M.L., Amugsi D.A., Ancuceanu R., Anderlini D., Andrei C.L., Ansari F., Ansari-Moghaddam A., Antonio C.A.T., Antriyandarti E., 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J., Nagaraju, S. P., Naghavi, M., Naghshtabrizi, B., Naimzada, M. D., Nangia, V., Narasimha Swamy, S., Nascimento, B. R., Naveed, M., Nazari, J., Ndejjo, R., Negoi, I., Negoi, R. I., Nena, E., Nepal, S., Netsere, H. B., Nguefack-Tsague, G., Ngunjiri, J. W., Nguyen, C. T. Y., Nguyen, C. T., Nguyen, H. L. T., Nigatu, Y. T., Nigussie, S. N., Nixon, M. R., Nnaji, C. A., Nomura, S., Noor, N. M., Noubiap, J. J., Nunez-Samudio, V., Nwatah, V. E., Oancea, B., Odukoya, O. O., Ogbo, F. A., Olusanya, B. O., Olusanya, J. O., Omar Bali, A., Onwujekwe, O. E., Ortiz, A., Otoiu, A., Otstavnov, N., Otstavnov, S. S., Owolabi, M. O., P A, M., Padubidri, J. R., Pakhale, S., Pakshir, K., Pal, P. K., Palladino, R., Pana, A., Panda-Jonas, S., Pandey, A., Pandi-Perumal, S. R., Pangaribuan, H. U., Pardo-Montano, A. M., Park, E. -K., Patel, S. K., Patton, G. C., Pawar, S., Pazoki Toroudi, H., Peden, A. E., Pepito, V. C. F., Peprah, E. K., Pereira, J., Perez-Gomez, J., Perico, N., Pesudovs, K., Pilgrim, T., Pinheiro, M., Piradov, M. A., Pirsaheb, M., Platts-Mills, J. A., Pokhrel, K. N., Postma, M. J., Pourjafar, H., Prada, S. I., Prakash, S., Pupillo, E., Quazi Syed, Z., Rabiee, N., Radfar, A., Rafiee, A., Rafiei, A., Raggi, A., Rahimzadeh, S., Rahman, M. H. U., Rahmani, A. M., Ramezanzadeh, K., Rana, J., Ranabhat, C. L., Rao, S. J., Rasella, D., Rastogi, P., Rathi, P., Rawaf, D. L., Rawaf, S., Rawasia, W. F., Rawassizadeh, R., Reiner, R. C., Remuzzi, G., Renzaho, A. M. N., Reshmi, B., Resnikoff, S., Rezaei, N., Rezapour, A., Riahi, S. M., Ribeiro, D., Rickard, J., Roever, L., Ronfani, L., Rothenbacher, D., Rubagotti, E., Rumisha, S. F., Ryan, P. M., Saddik, B., Sadeghi, E., Saeedi Moghaddam, S., Sagar, R., Sahebkar, A., Salahshoor, M. R., Salehi, S., Salem, M. R., Salimzadeh, H., Salomon, J. A., Samodra, Y. L., Samy, A. M., Sanabria, J., Santric-Milicevic, M. M., Saraswathy, S. Y. I., Sarker, A. R., Sarrafzadegan, N., Sarveazad, A., Sathian, B., Sathish, T., Sattin, D., Saxena, S., Saya, G. K., Saylan, M., Schiavolin, S., Schlaich, M. P., Schwebel, D. C., Schwendicke, F., Senthilkumaran, S., Sepanlou, S. G., Servan-Mori, E., Sha, F., Shafaat, O., Shahabi, S., Shahbaz, M., Shaheen, A. A., Shahid, I., Shaikh, M. A., Shakiba, S., Shalash, A. S., Shams-Beyranvand, M., Shannawaz, M., Sharafi, K., Sheikh, A., Sheikhbahaei, S., Shiferaw, W. S., Shigematsu, M., Shin, J. I., Shiri, R., Shiue, I., Shuval, K., Siddiqi, T. J., Sidemo, N. B., Sigfusdottir, I. D., Sigurvinsdottir, R., Silva, J. P., Silverberg, J. I. S., Simonetti, B., Singh, B. B., Singh, J. A., Singhal, D., Sinha, D. N., Skiadaresi, E., Skryabin, V. Y., Skryabina, A. A., Sleet, D. A., Sobaih, B. H., Sobhiyeh, M. R., Soltani, S., Soriano, J. B., Spurlock, E. E., Sreeramareddy, C. T., Steiropoulos, P., Stokes, M. A., Stortecky, S., Sufiyan, M. B., Suliankatchi Abdulkader, R., Sulo, G., Swope, C. B., Sykes, B. L., Szeto, M. D., Szocska, M., Tabares-Seisdedos, R., Tadesse, E. G., Taherkhani, A., Tamiru, A. T., Tareque, M. I., Tehrani-Banihashemi, A., Temsah, M. -H., Tesfay, F. H., Tessema, G. A., Tessema, Z. T., Thankappan, K. R., Thapar, R., Tolani, M. A., Tovani-Palone, M. R., Traini, E., Tran, B. X., Tripathy, J. P., Tsapparellas, G., Tsatsakis, A., Tudor Car, L., Uddin, R., Ullah, A., Umeokonkwo, C. D., Unim, B., Unnikrishnan, B., Upadhyay, E., Usman, M. S., Vacante, M., Vaezi, M., Valadan Tahbaz, S., Valdez, P. R., Vasankari, T. J., Venketasubramanian, N., Verma, M., Violante, F. S., Vlassov, V., Vo, B., Vu, G. T., Wado, Y. D., Waheed, Y., Wamai, R. G., Wang, Y., Wang, Y. -P., Ward, P., Werdecker, A., Westerman, R., Wickramasinghe, N. D., Wilner, L. B., Wiysonge, C. S., Wu, A. -M., Wu, C., Xie, Y., Yahyazadeh Jabbari, S. H., Yamagishi, K., Yandrapalli, S., Yaya, S., Yazdi-Feyzabadi, V., Yip, P., Yonemoto, N., Yoon, S. -J., Younis, M. Z., Yousefi, Z., Yousefinezhadi, T., Yu, C., Yusuf, S. S., Zaidi, S. S., Zaman, S. B., Zamani, M., Zamanian, M., Zastrozhin, M. S., Zastrozhina, A., Zhang, Y., Zhang, Z. -J., Zhao, X. -J. G., Ziapour, A., Hay, S. I., Murray, C. J. L., Wang, H., Kassebaum, N. 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J, John, O, Jonas, J, Joo, T, Joseph, N, Joukar, F, Jozwiak, J, Jurisson, M, Kabir, A, Kabir, Z, Kalankesh, L, Kamyari, N, Kanchan, T, Kapoor, N, Karami Matin, B, Karch, A, Karimi, S, Kassahun, G, Kayode, G, Kazemi Karyani, A, Kemmer, L, Khalid, N, Khalilov, R, Khammarnia, M, Khan, E, Khan, G, Khan, M, Khang, Y, Khatab, K, Khater, A, Khater, M, Khayamzadeh, M, Khosravi, A, Kim, D, Kim, Y, Kimokoti, R, Kisa, A, Kisa, S, Kissoon, N, Kopec, J, Kosen, S, Koul, P, Koulmane Laxminarayana, S, Koyanagi, A, Krishan, K, Krishnamoorthy, V, Kuate Defo, B, Kucuk Bicer, B, Kulkarni, V, Kumar, G, Kumar, M, Kumar, N, Kurmi, O, Kusuma, D, La Vecchia, C, Lacey, B, Lalloo, R, Lami, F, Landires, I, Larsson, A, Lasrado, S, Lassi, Z, Lauriola, P, Lee, P, Lee, S, Lee, Y, Leigh, J, Leonardi, M, Lewycka, S, Li, B, Li, S, Liang, J, Lim, L, Limenih, M, Lin, R, Liu, X, Lodha, R, Lopez, A, Lozano, R, Lugo, A, Lunevicius, R, Mackay, M, Madhava Kunjathur, S, Magnani, F, Mahadeshwara Prasad, D, Maheri, M, Mahmoudi, M, Majeed, A, Maled, V, Maleki, A, Maleki, S, Malekzadeh, R, Malik, A, Malta, D, Mamun, A, Mansouri, B, Mansournia, M, Martinez, G, Martini, S, Martins-Melo, F, Masoumi, S, Maulik, P, Mcalinden, C, Mcgrath, J, Medina-Solis, C, Mehrabi Nasab, E, Mejia-Rodriguez, F, Memish, Z, Mendoza, W, Menezes, R, Mengesha, E, Mensah, G, Meretoja, A, Meretoja, T, Mersha, A, Mestrovic, T, Miazgowski, B, Miazgowski, T, Michalek, I, Miller, T, Mini, G, Miri, M, Mirica, A, Mirrakhimov, E, Mirzaei, H, Mirzaei, M, Moazen, B, Moghadaszadeh, M, Mohajer, B, Mohamad, O, Mohammad, Y, Mohammadi, S, Mohammadian-Hafshejani, A, Mohammed, S, Mokdad, A, Molokhia, M, Monasta, L, Mondello, S, Moni, M, Moore, C, Moradi, G, Moradi, M, Moradzadeh, R, Moraga, P, Morawska, L, Morrison, S, Mosser, J, Mousavi Khaneghah, A, Mustafa, G, Naderi, M, Nagarajan, A, Nagaraju, S, Naghavi, M, Naghshtabrizi, B, Naimzada, M, Nangia, V, Narasimha Swamy, S, Nascimento, B, Naveed, M, Nazari, J, Ndejjo, R, Negoi, I, Negoi, R, Nena, E, Nepal, S, Netsere, H, Nguefack-Tsague, G, Ngunjiri, J, Nguyen, C, Nguyen, H, Nigatu, Y, Nigussie, S, Nixon, M, Nnaji, C, Nomura, S, Noor, N, Noubiap, J, Nunez-Samudio, V, Nwatah, V, Oancea, B, Odukoya, O, Ogbo, F, Olusanya, B, Olusanya, J, Omar Bali, A, Onwujekwe, O, Ortiz, A, Otoiu, A, Otstavnov, N, Otstavnov, S, Owolabi, M, P A, M, Padubidri, J, Pakhale, S, Pakshir, K, Pal, P, Palladino, R, Pana, A, Panda-Jonas, S, Pandey, A, Pandi-Perumal, S, Pangaribuan, H, Pardo-Montano, A, Park, E, Patel, S, Patton, G, Pawar, S, Pazoki Toroudi, H, Peden, A, Pepito, V, Peprah, E, Pereira, J, Perez-Gomez, J, Perico, N, Pesudovs, K, Pilgrim, T, Pinheiro, M, Piradov, M, Pirsaheb, M, Platts-Mills, J, Pokhrel, K, Postma, M, Pourjafar, H, Prada, S, Prakash, S, Pupillo, E, Quazi Syed, Z, Rabiee, N, Radfar, A, Rafiee, A, Rafiei, A, Raggi, A, Rahimzadeh, S, Rahman, M, Rahmani, A, Ramezanzadeh, K, Rana, J, Ranabhat, C, Rao, S, Rasella, D, Rastogi, P, Rathi, P, Rawaf, D, Rawaf, S, Rawasia, W, Rawassizadeh, R, 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Yonemoto, N, Yoon, S, Younis, M, Yousefi, Z, Yousefinezhadi, T, Yu, C, Yusuf, S, Zaidi, S, Zaman, S, Zamani, M, Zamanian, M, Zastrozhin, M, Zastrozhina, A, Zhang, Y, Zhang, Z, Zhao, X, Ziapour, A, Hay, S, Murray, C, Wang, H, Kassebaum, N, and Lee Kong Chian School of Medicine (LKCMedicine)
Subjects: Male, Perinatal care, Newborn care, STILLBIRTHS, RJ101, UNDER-5 MORTALITY, Psychological intervention, 010501 environmental sciences, Infant mortality, Global Health, 01 natural sciences, 0302 clinical medicine, RA0421, Cause of Death, Infant Mortality, Global health, Life Tables, Healthcare improvements, 030212 general & internal medicine, 610 Medicine & health, Child, COVID-19, Humans, Infant, SARS-CoV-2, Sustainable Development, 11 Medical and Health Sciences, Cause of death, Life Table, Mortality rate, 1. No poverty, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, Articles, Hälsovetenskaper, Mortality analyses, 3. Good health, Child, Preschool, SDG 1 - No Poverty, Child Mortality, Female, Life Sciences & Biomedicine, Human, Child mortality, COUNTRIES, DEATHS, Infants -- Mortalitat, GBD, 03 medical and health sciences, Medicine, General & Internal, SDG 3 - Good Health and Well-being, Life tables, under-5 mortality rate, General & Internal Medicine, Health Sciences, Neonatal deaths, medicine, SYSTEMATIC ANALYSIS, Medicine [Science], Infants -- Salut, Preschool, 0105 earth and related environmental sciences, Science & Technology, Infants nadons -- Salut, business.industry, Infants nadons -- Mortalitat, INFORM, Infant, Newborn, Neonatal and child health, Sustainable Development Goal 3.2, GBD 2019 Under-5 Mortality Collaborators, medicine.disease, Newborn, TRENDS, Sustainable Development Goal, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Deaths, 3121 General medicine, internal medicine and other clinical medicine, RG, business, Systematic Analysis, Malaria, Demography
Abstract: Background: Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods: We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (U5MR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings: Global U5MR decreased from 71·2 deaths per 1000 livebirths (95% uncertainty interval [UI] 68·3-74·0) in 2000 to 37·1 (33·2-41·7) in 2019 while global NMR correspondingly declined more slowly from 28·0 deaths per 1000 live births (26·8-29·5) in 2000 to 17·9 (16·3-19·8) in 2019. In 2019, 136 (67%) of 204 countries had a U5MR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030, 154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9·65 million (95% UI 9·05-10·30) in 2000 and 5·05 million (4·27-6·02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3·76 million [95% UI 3·53-4·02]) in 2000 to 48% (2·42 million; 2·06-2·86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0·80 (95% UI 0·71-0·86) deaths per 1000 livebirths and U5MR to 1·44 (95% UI 1·27-1·58) deaths per 1000 livebirths, and in 2019, there were as many as 1·87 million (95% UI 1·35-2·58; 37% [95% UI 32-43]) of 5·05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation: Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve U5MR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. This article was supported by the European Research Council, ERC 848325. Alberto Ortiz was supported by FIS/Fondos FEDER (PI18/01366, PI19/00588, PI19/00815, DTS18/00032, ERA-PerMed-JTC2018 (KIDNEY ATTACK AC18/00064 and PERSTIGAN AC18/00071, ISCIII-RETIC REDinREN RD016/0009). Daniela Ribeiro acknowledges the financial support from the European Union [FEDER funds through COMPETE, POCI-01-0145-FEDER-029253). Joan B Soriano acknowledges support from the Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain Funding: Bill & Melinda Gates Foundation
Published: 2021

23. Unraveling Apathy in Korsakoff Syndrome Patients Receiving Long-Term Care with and without Cerebrovascular Comorbidity

Author: Oey, Misha J, Brouwer, Veerle H E W, Buijs, Marie J, Wijnia, J W, Postma, Albert, Oudman, Erik, Leerstoel Postma, Experimental Psychology (onderzoeksprogramma PF), Helmholtz Institute, Afd Psychologische functieleer, Leerstoel Postma, Experimental Psychology (onderzoeksprogramma PF), Helmholtz Institute, and Afd Psychologische functieleer
Subjects: Male, medicine.medical_specialty, Emotional blunting, Apathy, 030508 substance abuse, Medicine (miscellaneous), Toxicology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Humans, Medicine, Pathological, Aged, Inpatients, business.industry, Neuropsychiatric Symptoms, Cognition, Middle Aged, medicine.disease, Cerebrovascular Comorbidity, Comorbidity, Cerebrovascular Disorders, Psychiatry and Mental health, Long-term care, Neuropsychiatric disorder, Korsakoff Syndrome, Case-Control Studies, Concomitant, Female, Original Article, medicine.symptom, 0305 other medical science, business, 030217 neurology & neurosurgery, Neuroscience
Abstract: Background Korsakoff syndrome (KS) is a severe neuropsychiatric disorder caused by acute deficiency of vitamin B1 and concomitant alcoholism. Patients with KS are particularly vulnerable for cerebrovascular comorbidity. KS is characterized by cognitive and neuropsychiatric symptoms, one of which is apathy. Apathy is a pathological lack of goal-directed behaviors, goal-directed cognitions, and goal-directed emotions. Cerebrovascular accidents are known to carry a risk for developing apathy. Apathy has a dramatic effect on the autonomy and daily lives of patients suffering from this condition. Methods We assessed general apathy and related subconstructs in fifteen patients with KS, fifteen patients with KS and cerebrovascular comorbidity who reside in a 24-hour care facility, and fifteen healthy controls. Results Compared with healthy controls, both KS patient groups showed higher levels of apathy as rated by a close informant. We found no difference between both KS patient groups and the healthy control group on the self-report section of the Pleasant Activities List, suggesting that motivation is still intact in KS patients. It is important to note a discrepancy was found between self-reporting and proxy reporting on this list. KS patients with cerebrovascular comorbidity showed more severe emotional blunting compared to both KS patients without cerebrovascular comorbidity and healthy controls. The competency to consent was lower in patients compared with healthy controls, but no difference was found between KS patients with cerebrovascular comorbidity and those without. Conclusions Our results suggest that KS patients show increased levels of general apathy compared with healthy controls. Patients show a diminished competency to consent and increased emotional blunting, while motivation is not compromised. Cerebrovascular comorbidity in KS forms a high risk for emotional blunting. The results of this study suggest that apathy is a severe problem in KS. More attention in both the literature and clinical practice would benefit this complex patient population.
Published: 2021

24. Symptomatic mosaicism for a novel <scp> FBN1 </scp> splice site variant in a parent causing inherited neonatal Marfan syndrome

Author: C. Anthony Rupar, Victoria Mok Siu, Luis Altamirano-Diaz, and Julianne K Postma
Subjects: musculoskeletal diseases, 0301 basic medicine, Sanger sequencing, Genetics, Marfan syndrome, congenital, hereditary, and neonatal diseases and abnormalities, Daughter, business.industry, media_common.quotation_subject, 030105 genetics & heredity, medicine.disease, 03 medical and health sciences, symbols.namesake, 030104 developmental biology, RNA splicing, symbols, Medicine, Missense mutation, Clinical significance, Presentation (obstetrics), business, Genetics (clinical), media_common, Early onset
Abstract: Neonatal Marfan syndrome is a severe, early onset presentation of pathogenic variants in FBN1. Because of the significant cardiac involvement and early mortality, nearly all reported cases have been de novo, and the disorder has not been documented to be inherited from a symptomatic parent. Here, we present a female infant with neonatal Marfan syndrome who was born to a father with Marfan syndrome. Prior to the birth of his daughter, the father had been found to have an FBN1 missense variant of uncertain clinical significance. Initial familial variant testing of the infant did not reveal the same missense variant, but Sanger sequencing of FBN1 subsequently identified a pathogenic splice site variant. The father was then found to have 10%-20% mosaicism for the same splice site variant.
Published: 2021

25. Economic evaluations of chronic obstructive pulmonary disease pharmacotherapy

Author: Job F M van Boven, Maarten J. Postma, Tanja Fens, Eugène van Puijenbroek, Guiling Zhou, PharmacoTherapy, -Epidemiology and -Economics, Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Microbes in Health and Disease (MHD), and Groningen Research Institute for Asthma and COPD (GRIAC)
Subjects: medicine.medical_specialty, Side effect, Drug-Related Side Effects and Adverse Reactions, Cost effectiveness, pulmonary, Cost-Benefit Analysis, Comorbidity, lung, Pulmonary Disease, Chronic Obstructive, Pharmacotherapy, Pharmacovigilance, medicine, Humans, Pharmacology (medical), Intensive care medicine, health care economics and organizations, Pharmacology, COPD, Health economics, Lung, business.industry, copd, PHARMACOTHERAPY, General Medicine, medicine.disease, medicine.anatomical_structure, Pharmaceutical Preparations, Economic evaluation, medication adherence, RESPIRATORY HEALTH, business
Abstract: INTRODUCTION: When estimating the cost-effectiveness or budget impact of chronic obstructive pulmonary disease (COPD) medication, it is common practice to use trial data for clinical inputs. However, such inputs do not always reflect the real-world situation. Previous reviews recognized the need for taking real-world data (medication adherence, comorbidity and adverse drug reactions [ADRs]) into account. Whether recent cost-effectiveness analyses of COPD medication implemented those recommendations is unknown.AREAS COVERED: The authors reviewed recent economic evaluations of COPD-maintenance treatments focusing on medication adherence, comorbidity and ADRs.EXPERT OPINION: In most registration trials of COPD treatment, strict inclusion and exclusion criteria are applied. During trials, patient monitoring is well controlled. As such, medication adherence is often higher than seen in less controlled, real-world environments with more heterogeneous characteristics. Additionally, safety data collected in trials may not be widely generalizable due to more comorbidity and polypharmacy in the real-world. Consequently, when merely relying on trial data, the impact of adherence, comorbidity and ADRs on the cost-effectiveness can be underestimated. To overcome these real-world data gaps, use of pragmatic trials and observational studies in addition to strictly controlled trial data is recommended. To catalyze implementation of these real-world issues, reporting checklists should be updated.
Published: 2021

26. Health impact of tafamidis in transthyretin amyloid cardiomyopathy patients: an analysis from the Tafamidis in Transthyretin Cardiomyopathy Clinical Trial (ATTR-ACT) and the open-label long-term extension studies

Author: Bart Heeg, D. Tran, Maarten J. Postma, Benjamin Li, Ahmad Masri, Rahul Bhambri, Daniel Grima, Andrea Garcia, Mark H. Rozenbaum, Michelle Stewart, Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Microbes in Health and Disease (MHD)
Subjects: Tafamidis, medicine.medical_specialty, Cardiomyopathy, Amyloidosis, 030204 cardiovascular system & hematology, Transthyretin, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, Humans, Prealbumin, Medicine, 030212 general & internal medicine, Mortality, Survival analysis, Amyloid Neuropathies, Familial, Benzoxazoles, biology, business.industry, Health Policy, medicine.disease, Clinical trial, chemistry, Cohort, biology.protein, Open label, Cardiomyopathies, Cardiology and Cardiovascular Medicine, Amyloid cardiomyopathy, business
Abstract: Aim The Tafamidis in Transthyretin Cardiomyopathy Clinical Trial (ATTR-ACT) showed that tafamidis reduced all-cause mortality and cardiovascular-related hospitalizations in patients with transthyretin amyloid cardiomyopathy (ATTR-CM). This study aimed to estimate the impact of tafamidis on survival and quality-adjusted life-years (QALYs). Methods and results A multi-state, cohort, Markov model was developed to simulate the disease course of ATTR-CM throughout a lifetime. For survival extrapolation, survival curves were fitted by treatment arm and New York Heart Association (NYHA) Class I/II (68% of patients) and NYHA Class III (32% of patients) cohorts using the individual patient-level data from both the ATTR-ACT and the corresponding long-term extension study. Univariate and multivariate sensitivity analyses were conducted. The predicted mean survival for the total population (NYHA Class I/II + III) was 6.73 years for tafamidis and 2.85 years for the standard of care (SoC), resulting in an incremental mean survival of 3.88 years [95% confidence interval (CI) 1.32–5.66]. Of the 6.73 life-years, patients on tafamidis spend, on average, 4.82 years in NYHA Class I/II, while patients on SoC spend an average of 1.60 life-years in these classes. The combination of longer survival in lower NYHA classes produced a QALY gain of 5.39 for tafamidis and 2.11 for SoC, resulting in 3.29 incremental QALYs (95% CI 1.21–4.74) in favour of tafamidis. Conclusion Based on the disease simulation model results, tafamidis is expected to more than double the life expectancy and QALYs of ATTR-CM patients compared to SoC. Longer-term follow-up data from the ATTR-ACT extension study will further inform these findings. Clinical trials.gov identifier NCT01994889 (date of registration: 26 November 2013).
Published: 2021

27. The Effect of Radioactive Iodine Therapy on Ovarian Function and Fertility in Female Thyroid Cancer Patients: A Systematic Review and Meta-Analysis

Author: Iris M. C. van der Ploeg, Mando D. Filipe, Marcel P. M. Stokkel, Marceline W Piek, Emily L Postma, Jan de Boer, Annelies M E Bos, Rachel S van Leeuwaarde, and Christianne A.R. Lok
Subjects: Adult, Pediatrics, medicine.medical_specialty, Time Factors, Adolescent, Pregnancy Rate, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, 030209 endocrinology & metabolism, Fertility, Risk Assessment, Iodine Radioisotopes, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Ovarian function, Cancer Survivors, Pregnancy, Risk Factors, Female patient, medicine, Humans, Thyroid Neoplasms, Young adult, Child, Radiation Injuries, Thyroid cancer, media_common, business.industry, Incidence (epidemiology), Ovary, Middle Aged, medicine.disease, 030220 oncology & carcinogenesis, Meta-analysis, Female, Radioactive iodine therapy, Radiopharmaceuticals, business, Infertility, Female
Abstract: Introduction: Thyroid cancer is one of the most common carcinomas diagnosed in adolescents and young adults, with a rapidly rising incidence for the past three decades. Surgery is the standard trea...
Published: 2021

28. Impact of age on the comparison between short-term vs 12-month dual antiplatelet therapy in patients with acute coronary syndrome treated with the COMBO dual therapy stent: 2-Year follow-up results of the REDUCE trial

Author: Robaayah Zambahari, Erik Ligtenberg, Marc A. Brouwer, Harry Suryapranata, Jacques Lalmand, Jawed Polad, Dariusz Dudek, Giuseppe De Luca, Lucia Barbieri, Cyril Camaro, Leo Veenstra, Philippe Timmermans, Wan Aw. Ahmad, Sonja Postma, Dagmara Dilling-Boer, Arnoud W van 't Hof, Saman Rasoul, Monica Verdoia, René J. van der Schaaf, Edouard Benit, Sander A.J. Damen, Stephen Wl. Lee, Houng Bang Liew, Elvin Kedhi, Tian H. Koh, Evelien Jj. Kolkman, and Vincent Roolvink
Subjects: Male, 0301 basic medicine, Acute coronary syndrome, medicine.medical_specialty, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Subgroup analysis, 030204 cardiovascular system & hematology, Dual therapy stent, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Internal medicine, Clinical endpoint, medicine, Humans, Prospective Studies, Acute Coronary Syndrome, Stroke, Aged, business.industry, Infant, Stent, Drug-Eluting Stents, medicine.disease, Treatment Outcome, 030104 developmental biology, Drug-eluting stent, Child, Preschool, Conventional PCI, Drug Therapy, Combination, Stents, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors, Follow-Up Studies
Abstract: Contains fulltext : 233810.pdf (Publisher’s version ) (Closed access) BACKGROUND AND AIMS: The impact of advanced age on the optimal duration of dual antiplatelet therapy (DAPT) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary revascularization (PCI) is still greatly debated. Therefore, the aim of the present sub-analysis of the REDUCE trial was to assess the impact of age on the comparison between a short 3 months vs standard 12 months DAPT in ACS patients treated with the COMBO Dual Stent Therapy. METHODS: The REDUCE trial is a prospective, multicenter, investigator-initiated study that randomized ACS patients undergoing PCI with the COMBO drug eluting stent to either 3 or 12 months of DAPT. The study population was divided according to age (
Published: 2021

29. Association of Social Determinants of Health with Time to Diagnosis and Treatment Outcomes in Idiopathic Subglottic Stenosis

Author: Sid Khosla, Douglas J. Van Daele, Alexander Gelbard, Alexander Langerman, Gregory N. Postma, Seth H. Dailey, Seth M. Cohen, Libby J. Smith, Otis B. Rickman, Rebecca J. Howell, Anne S. Lowery, James L. Netterville, David Veivers, Elizabeth Guardiani, Cheryl Kinnard, Jaclyn Lee, David O. Francis, Brianna K. Crawley, Eric S. Edell, Brent E. Richardson, Ahmed M. Soliman, Yu Shyr, Matthew S. Clary, Catherine Anderson, Robert R. Lorenz, Alexander T. Hillel, Marshall E. Smith, Robert J. Lentz, Samir S. Makani, James J. Daniero, Lynn D Berry, Norman D. Hogikyan, Jonathan M. Bock, Donald T. Donovan, Michael M. Johns, Paul F. Castellanos, Albert L. Merati, Joel H. Blumin, Sarah L. Rohde, Andrew G. Sikora, Laura Matrka, Jan L. Kasperbauer, Matthew Mori, Robert J. Sinard, Alessandro de Alarcon, Michael J. Rutter, G. Todd Schneider, Joshua S. Schindler, Paul C. Bryson, Sunil P. Verma, Sigríður Sveinsdóttir, Li-Ching Huang, Ramon A. Franco, Dale C. Ekbom, Kyle Mannion, Fabien Maldonado, Christopher T. Wootten, Robbi A. Kupfer, Henry T. Hoffman, Karla O'Dell, Paul M. Weinberger, Rupali N. Shah, Milan R. Amin, C. Gaelyn Garrett, Sheau-Chiann Chen, Julina Ongkasuwan, Daniel Fink, Guri Sandhu, Clark A. Rosen, Andrew J. McWhorter, Lena K. Hussain, Lindsay Reder, David G. Lott, Philip A. Weissbrod, and Michael S. Benninger
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Time Factors, Social Determinants of Health, Subglottic stenosis, Treatment outcome, Article, 03 medical and health sciences, Social support, 0302 clinical medicine, Recurrence, Intervention (counseling), medicine, Humans, Prospective Studies, 030212 general & internal medicine, Social determinants of health, 030223 otorhinolaryngology, Association (psychology), Selection (genetic algorithm), Laryngoscopy, business.industry, Laryngostenosis, General Medicine, Middle Aged, medicine.disease, United States, Treatment Outcome, Otorhinolaryngology, Female, business, Follow-Up Studies, Time to diagnosis
Abstract: Objectives: To examine whether social determinants of health (SDH) factors are associated with time to diagnosis, treatment selection, and time to recurrent surgical intervention in idiopathic subglottic stenosis (iSGS) patients. Methods: Adult patients with diagnosed iSGS were recruited prospectively (2015-2017) via clinical providers as part of the North American Airway Collaborative (NoAAC) and via an online iSGS support community on Facebook. Patient-specific SDH factors included highest educational attainment (self-reported), median household income (matched from home zip code via U.S. Census data), and number of close friends (self-reported) as a measure of social support. Main outcomes of interest were time to disease diagnosis (years from symptom onset), treatment selection (endoscopic dilation [ED] vs cricotracheal resection [CTR] vs endoscopic resection with adjuvant medical therapy [ERMT]), and time to recurrent surgical intervention (number of days from initial surgical procedure) as a surrogate for disease recurrence. Results: The total 810 participants were 98.5% female, 97.2% Caucasian, and had a median age of 50 years (IQR, 43-58). The cohort had a median household income of $62 307 (IQR, $50 345-$79 773), a median of 7 close friends (IQR, 4-10), and 64.7% of patients completed college or graduate school. Education, income, and number of friends were not associated with time to diagnosis via multivariable linear regression modeling. Univariable multinominal logistic regression demonstrated an association between education and income for selecting ED versus ERMT, but no associations were noted for CTR. No associations were noted for time to recurrent surgical procedure via Kaplan Meier modeling and Cox proportional hazards regression. Conclusions: Patient education, income, and social support were not associated with time to diagnosis or time to disease recurrence. This suggests additional patient, procedure, or disease-specific factors contribute to the observed variations in iSGS surgical outcomes.
Published: 2021

30. Therapeutic treatment of dietary docosahexaenoic acid for particle-induced pulmonary inflammation in Balb/c mice

Author: Joseph F. Rhoderick, James J. Pestka, Andrij Holian, Paige Fletcher, Mary C. Buford, Raymond F. Hamilton, and Britten Postma
Subjects: Lung Diseases, Male, 0301 basic medicine, medicine.medical_specialty, Allergy, Docosahexaenoic Acids, Membrane permeability, Immunology, Anti-Inflammatory Agents, Inflammation, Pharmacology, Article, BALB/c, 03 medical and health sciences, 0302 clinical medicine, Macrophages, Alveolar, Animals, Medicine, Macrophage, Lung, Cells, Cultured, chemistry.chemical_classification, Mice, Inbred BALB C, biology, Nanotubes, Carbon, business.industry, Silicon Dioxide, medicine.disease, biology.organism_classification, Phenotype, 030104 developmental biology, chemistry, Docosahexaenoic acid, 030220 oncology & carcinogenesis, Dietary Supplements, Cytokines, Female, Histopathology, medicine.symptom, business, Polyunsaturated fatty acid
Abstract: OBJECTIVE AND DESIGN: The omega-3 polyunsaturated fatty acid docosahexaenoic acid (DHA) has been reported to suppress inflammation. Pulmonary inflammation can be directly linked to exposure of various occupational and man-made particles leading to pulmonary diseases. Therapeutic treatments are lacking for particle-induced pulmonary inflammation. These studies evaluated DHA as a therapeutic treatment for semi-acute and chronic particle-induced pulmonary inflammation. METHODS: Balb/c mice were oropharyngeal instilled with hydrophobic multi-walled carbon nanotube (MWCNT) or hydrophilic crystalline silica (SiO(2)) either as one instillation (semi-acute) or once a week for 4 weeks (chronic). One week later, the mice were placed on either a control or 1% DHA-containing diet for 3 weeks (semi-acute) or 12 weeks (chronic). Mice were assessed for inflammatory signaling within the lung lavage fluid, impact on phagolysosomal membrane permeability, shifts of macrophage phenotype gene expression (M1, M2a, M2b, and M2c), and pulmonary histopathology. RESULTS: DHA increased pulmonary inflammatory markers and lung pathology when mice were exposed to SiO(2). There were trending decreases of inflammatory markers for MWCNT-exposed mice with DHA treatment, however, mostly not statistically significant. CONCLUSION: The anti-inflammatory benefits of DHA treatment depend upon the type of inflammatory particle, magnitude of inflammation, and duration of treatment.
Published: 2021

31. Dual-Energy CT Angiography Improves Accuracy of Spot Sign for Predicting Hematoma Expansion in Intracerebral Hemorrhage

Author: R. Houben, Kim J.D. de Kort, Alida A. Postma, Robert J. van Oostenbrugge, Michaël T.J. Peeters, Wouter J. P. Henneman, Julie Staals, MUMC+: MA AIOS Neurologie (9), Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, MUMC+: Hersen en Zenuw Centrum (3), RS: Carim - B05 Cerebral small vessel disease, MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), MUMC+: DA BV AIOS Radiologie (9), and RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience
Subjects: CONTRAST EXTRAVASATION, Cerebral hemorrhage, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Hematoma, Iodinated contrast, Modified Rankin Scale, medicine, cardiovascular diseases, BRAIN, Computed tomography angiography, Intracerebral hemorrhage, medicine.diagnostic_test, business.industry, MORTALITY, Odds ratio, Prognosis, medicine.disease, Confidence interval, Intracranial hemorrhages, Angiography, Spot sign, GROWTH, Original Article, Neurology (clinical), Cardiology and Cardiovascular Medicine, Nuclear medicine, business, 030217 neurology & neurosurgery
Abstract: Background and Purpose Spot sign (SS) on computed tomography angiography (CTA) is associated with hematoma expansion (HE) and poor outcome after intracerebral hemorrhage (ICH). However, its predictive performance varies across studies, possibly because differentiating hyperdense hemorrhage from contrast media is difficult. We investigated whether dual-energy-CTA (DE-CTA), which can separate hemorrhage from iodinated contrast, improves the diagnostic accuracy of SS for predicting HE.Methods Primary ICH patients undergoing DE-CTA (both arterial as well as delayed venous phase) and follow-up computed tomography were prospectively included between 2014 and 2019. SS was assessed on both arterial and delayed phase images of the different DE-CTA datasets, i.e., conventional-like mixed images, iodine images, and fusion images. Diagnostic accuracy of SS for prediction of HE was determined on all datasets. The association between SS and HE, and between SS and poor outcome (modified Rankin Scale at 3 months >= 3) was assessed with multivariable logistic regression, using the dataset with highest diagnostic accuracy.Results Of 139 included patients, 47 showed HE (33.8%). Sensitivity of SS for HE was 32% (accuracy 0.72) on conventional-like mixed arterial images which increased to 76% (accuracy 0.80) on delayed fusion images. Presence of SS on delayed fusion images was independently associated with HE (odds ratio [OR], 17.5; 95% confidence interval [CI], 6.14 to 49.82) and poor outcome (OR, 3.84; 95% CI, 1.16 to 12.73).Conclusions Presence of SS on DE-CTA, in particular on delayed phase fusion images, demonstrates higher diagnostic performance in predicting HE compared to conventional-like mixed imaging, and it is associated with poor outcome.
Published: 2021

32. Deciphering the glioblastoma phenotype by computed tomography radiomics

Author: Andre Dekker, Dirk De Ruysscher, Robert Jan Smeenk, Tom Rozema, Henry C. Woodruff, Leonard Wee, Ann Hoeben, Inge Compter, M. Verduin, Ralph T.H. Leijenaar, Zhenwei Shi, Alida A. Postma, Philippe Lambin, René Monshouwer, Daniëlle B.P. Eekers, Radiotherapie, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, RS: GROW - R2 - Basic and Translational Cancer Biology, Interne Geneeskunde, Precision Medicine, MUMC+: MA Medische Oncologie (9), Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), MUMC+: DA BV AIOS Radiologie (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, and RS: FSE BISS
Subjects: EXTERNAL VALIDATION, PREDICTION, Radiography, medicine.medical_treatment, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, Medicine, RECURSIVE PARTITIONING ANALYSIS, Computed tomography, education.field_of_study, medicine.diagnostic_test, Brain Neoplasms, Model validation, SIGNATURE, TEMOZOLOMIDE, Hematology, Prognosis, Phenotype, Magnetic Resonance Imaging, Oncology, 030220 oncology & carcinogenesis, Urological cancers Radboud Institute for Health Sciences [Radboudumc 15], SURVIVAL, Radiology, medicine.drug, Rare cancers Radboud Institute for Health Sciences [Radboudumc 9], medicine.medical_specialty, Population, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, TEXTURE ANALYSIS, Biopsy, Humans, Radiology, Nuclear Medicine and imaging, education, Retrospective Studies, Temozolomide, Radiomics, Performance status, Radiotherapy, business.industry, Model development, medicine.disease, PHASE-III, Radiation therapy, MODEL, business, Glioblastoma, Tomography, X-Ray Computed
Abstract: Introduction: Glioblastoma (GBM) is the most common malignant primary brain tumour which has, despite extensive treatment, a median overall survival of 15 months. Radiomics is the high-throughput extraction of large amounts of image features from radiographic images, which allows capturing the tumour phenotype in 3D and in a non-invasive way. In this study we assess the prognostic value of CT radiomics for overall survival in patients with a GBM. Materials and methods: Clinical data and pre-treatment CT images were obtained from 218 patients diagnosed with a GBM via biopsy who underwent radiotherapy +/- temozolomide between 2004 and 2015 treated at three independent institutes (n = 93, 62 and 63). A clinical prognostic score (CPS), a simple radiomics model consisting of volume based score (VPS), a complex radiomics prognostic score (RPS) and a combined clinical and radiomics (C + R)PS model were developed. The population was divided into three risk groups for each prognostic score and respective Kaplan-Meier curves were generated. Results: Patient characteristics were broadly comparable. Clinically significant differences were observed with regards to radiation dose, tumour volume and performance status between datasets. Image acquisition parameters differed between institutes. The cross-validated c-indices were moderately discriminative and for the CPS ranged from 0.63 to 0.65; the VPS c-indices ranged between 0.52 and 0.61; the RPS cindices ranged from 0.57 to 0.64 and the combined clinical and radiomics model resulted in c-indices of 0.59-0.71. Conclusion: In this study clinical and CT radiomics features were used to predict OS in GBM. Discrimination between low-, middle- and high-risk patients based on the combined clinical and radiomics model was comparable to previous MRI-based models. (c) 2021 The Author(s). Published by Elsevier B.V. Radiotherapy and Oncology 160 (2021) 132-139 This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Published: 2021

33. The value of 18F-FDG PET/CT for the diagnosis of device-related infections in patients with a left ventricular assist device

Author: Ronald Borra, Andor W. J. M. Glaudemans, P. P. van Geel, Kevin Damman, G. Mecozzi, D Ten Hove, Marjan Wouthuyzen-Bakker, Olivier Gheysens, D. F. Postma, Giorgio Treglia, Bhanu Sinha, and Riemer H. J. A. Slart
Subjects: medicine.medical_specialty, Prosthesis-Related Infections, medicine.medical_treatment, Review Article, 030204 cardiovascular system & hematology, GUIDELINES, Sensitivity and Specificity, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography, MANAGEMENT, medicine, Humans, Radiology, Nuclear Medicine and imaging, INCREASED RISK, Heart-Assist Devices/adverse effects, Positron-Emission Tomography, Prosthesis-Related Infections/diagnostic imaging, Quality of Life, Radiopharmaceuticals, 18F-FDG PET/CT, LVAD infection, Meta-analysis, Systematic review, medicine.diagnostic_test, EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY, business.industry, General Medicine, medicine.disease, Confidence interval, Positron emission tomography, Heart failure, Ventricular assist device, Radiology, Heart-Assist Devices, Risk assessment, business, 18F-FDG PET, CT
Abstract: Background Left ventricular assist devices (LVADs) are increasingly used for the treatment of advanced heart failure. LVADs improve quality of life and decrease mortality, but the driveline carries substantial risk for major infections. These device-related LVAD and driveline infections are difficult to diagnose with conventional imaging. We reviewed and analysed the current literature on the additive value of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) imaging for the diagnosis of LVAD-related infections.” Materials/methods We performed a systematic literature review using several databases from their inception until the 31st of December, 2019. Studies investigating the diagnostic performance of FDG-PET/CT in patients with suspected LVAD infection were retrieved. After a bias risk assessment using QUADAS-2, a study-aggregate meta-analysis was performed on a per examination-based analysis. Results A total of 10 studies were included in the systematic review, eight of which were also eligible for study-aggregate meta-analysis. For the meta-analysis, a total of 256 FDG-PET/CT scans, examining pump/pocket and/or driveline infection, were acquired in 230 patients. Pooled sensitivity of FDG-PET/CT was 0.95 (95% confidence interval (CI) 0.89–0.97) and pooled specificity was 0.91 (95% CI 0.54–0.99) for the diagnosis of device-related infection. For pump/pocket infection, sensitivity and specificity of FDG-PET/CT were 0.97 (95%CI 0.69–1.00) and 0.93 (95%CI 0.64–0.99), respectively. For driveline infection, sensitivity and specificity were 0.96 (95%CI 0.88–0.99) and 0.99 (95%CI 0.13–1.00) respectively. Significant heterogeneity existed across studies for specificity, mostly caused by differences in scan procedures. Predefined criteria for suspicion of LVAD and/or driveline infection were lacking in all included studies. Conclusions FDG-PET/CT is a valuable tool for assessment of device-related infection in LVAD patients, with high sensitivity and high, albeit variable, specificity. Standardization of FDG-PET/CT procedures and criteria for suspected device-related LVAD infections are needed for consistent reporting of FDG-PET/CT scans.
Published: 2021

34. The 'hype' of hydrops in classifying vestibular disorders

Author: Raymond van de Berg, Vincent Van Rompaey, Dorien M Kimenai, Alida A Postma, Tjasse D. Bruintjes, Philippe Lambin, Marly F. J. A. van der Lubbe, Akshayaa Vaidyanathan, and Marc van Hoof
Subjects: medicine.medical_specialty, Neurology, SYMPTOMS, Vestibular disorders, Gadolinium, Disease, Review, INTERNATIONAL CLASSIFICATION, Schwannoma, 03 medical and health sciences, 0302 clinical medicine, Magnetic resonance imaging, CLINICAL CHARACTERISTICS, otorhinolaryngologic diseases, Medicine, Edema, Humans, Distinctiveness, Meni&#232, Endolymphatic hydrops, 030223 otorhinolaryngology, Meniere Disease, Neuroradiology, Vestibular system, Menière’s, ACOUSTIC NEUROMA, medicine.diagnostic_test, business.industry, HEARING-LOSS, medicine.disease, MENIERES-DISEASE, TEMPOROMANDIBULAR DISORDER, PREVALENCE, MIGRAINE, Ear, Inner, re&#8217, Neurology (clinical), Radiology, Human medicine, business, 030217 neurology & neurosurgery
Abstract: Background Classifying and diagnosing peripheral vestibular disorders based on their symptoms is challenging due to possible symptom overlap or atypical clinical presentation. To improve the diagnostic trajectory, gadolinium-based contrast-enhanced magnetic resonance imaging of the inner ear is nowadays frequently used for the in vivo confirmation of endolymphatic hydrops in humans. However, hydrops is visualized in both healthy subjects and patients with vestibular disorders, which might make the clinical value of hydrops detection on MRI questionable. Objective To investigate the diagnostic value of clinical and radiological features, including the in vivo visualization of endolymphatic hydrops, for the classification and diagnosis of vestibular disorders. Methods A literature search was performed in February and March 2019 to estimate the prevalence of various features in healthy subjects and in common vestibular disorders to make a graphical comparison between healthy and abnormal. Results Of the features studied, hydrops was found to be a highly prevalent feature in Menière’s disease (99.4%). Though, hydrops has also a relatively high prevalence in patients with vestibular schwannoma (48.2%) and in healthy temporal bones (12.5%) as well. In patients diagnosed with (definite or probable) Menière’s disease, hydrops is less frequently diagnosed by magnetic resonance imaging compared to the histological confirmation (82.3% versus 99.4%). The mean prevalence of radiologically diagnosed hydrops was 31% in healthy subjects, 28.1% in patients with vestibular migraine, and 25.9% in patients with vestibular schwannoma. An interesting finding was an absolute difference in hydrops prevalence between the two diagnostic techniques (histology and radiology) of 25.2% in patients with Menière’s disease and 29% in patients with vestibular schwannoma. Conclusions Although the visualization of hydrops has a high diagnostic value in patients with definite Menière’s disease, it is important to appreciate the relatively high prevalence of hydrops in healthy populations and other vestibular disorders. Endolymphatic hydrops is not a pathognomic phenomenon, and detecting hydrops should not directly indicate a diagnosis of Menière’s disease. Both symptom-driven and hydrops-based classification systems have disadvantages. Therefore, it might be worth to explore features “beyond” hydrops. New analysis techniques, such as Radiomics, might play an essential role in (re)classifying vestibular disorders in the future.
Published: 2020

35. Physical Activity and Sedentary Behavior From Discharge to 1 Year After Inpatient Rehabilitation in Ambulatory People With Spinal Cord Injury

Author: Ilse J. W. van Nes, Marcel W M Post, Rita J G van den Berg-Emons, Jos Dekkers, Karin Postma, Rutger Osterthun, Johannes B. J. Bussmann, Tijn van Diemen, Extremities Pain and Disability (EXPAND), and Rehabilitation Medicine
Subjects: Adult, Male, 030506 rehabilitation, medicine.medical_specialty, Time Factors, FITNESS, medicine.medical_treatment, Aftercare, Physical Therapy, Sports Therapy and Rehabilitation, Walking, PART, Sitting, Quadriplegia, Rehabilitation Centers, RECOMMENDATIONS, 03 medical and health sciences, 0302 clinical medicine, BENEFITS, medicine, Spinal cord injuries, Humans, Longitudinal Studies, Tetraplegia, Spinal cord injury, Exercise, Aged, ASSOCIATIONS, Rehabilitation, business.industry, Physical activity, Sedentary behavior, ADULTS, Middle Aged, medicine.disease, Confidence interval, Patient Discharge, TIME, INDIVIDUALS, ACCELEROMETRY, Cohort, Ambulatory, Physical therapy, Female, HEALTH, 0305 other medical science, business, 030217 neurology & neurosurgery
Abstract: Objective: To evaluate changes in duration of physical activity (PA) and sedentary behavior (SB) from discharge to 1 year after inpatient rehabilitation in ambulatory people with spinal cord injury (SCI).Design: Longitudinal cohort study with objective measurements of physical behavior at discharge and at 6 and 12 months post discharge.Setting: Three rehabilitation centers and the participant's home environment.Participants: Participants (N= 47) with ambulatory function were consecutively recruited from the self-management and self-efficacy in patients with SCI cohort (age 18 years or older, recent SCI, expected inpatient stay >4wk). Mean age was 54.5 +/- 12.9 years, all had incomplete lesions, 53% were men, 49% had tetraplegia, and 51% were community ambulators at discharge.Interventions: Not applicable.Main Outcome Measures: Duration (min) of PA (summed duration of walking, cycling, running, and wheeling) and SB (sitting/lying).Results: Mean duration of PA increased by 21 min/d (95% confidence interval, 7-35) and SB decreased by 64 min/d (95% confidence interval, -94 to -35) from discharge to 6 months after inpatient rehabilitation. No changes were found in the second half-year. One year after discharge mean PA was 116 +/- 59 min/d and mean SB was 665 +/- 121 min/d. The increase in PA was the result of an almost doubling of time spent walking. Variability in physical behavior and its change was large. Older age and lower ambulation level were associated with lower PA, lower ambulation level with higher SB, and tetraplegia was associated with a reduced increase in PA.Conclusions: At group level, duration of PA and SB improved following inpatient rehabilitation in ambulatory people with SCI. However, there were large differences between individuals. Levels 1 year after discharge were still unfavorable, particularly regarding SB. (C) 2020 by the American Congress of Rehabilitation Medicine
Published: 2020

36. Physician-Estimated Depth as a Screening Tool for Computed Tomography Evaluation of Pectus Excavatum

Author: Adam C. Alder, Dave Schindel, Faisal Qureshi, Heather Postma, Ali Mokdad, Jillian Jacobson, Barry Hicks, and Samir Pandya
Subjects: Male, medicine.medical_specialty, Adolescent, Sensitivity and Specificity, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Pectus excavatum, Reference Values, Preoperative Care, medicine, Deformity, Humans, Mass Screening, Thoracic Wall, Retrospective Studies, Anthropometry, business.industry, Patient Selection, Incidence (epidemiology), Retrospective cohort study, medicine.disease, Funnel Chest, 030220 oncology & carcinogenesis, Pectus carinatum, Female, 030211 gastroenterology & hepatology, Surgery, Haller index, Radiology, Underweight, medicine.symptom, Tomography, X-Ray Computed, business, Body mass index
Abstract: BACKGROUND Pectus excavatum (PE) is the most common congenital chest wall anomaly with a reported incidence of 1/300 to 1/400 live births and a male predominance. Preoperative evaluation of defect severity typically requires a calculation of the Haller index (HI) and/or correction index (CI) using computed tomography (CT) or x-rays. The purpose of this study was to determine whether physician-estimated depth (PED), a bedside screening tool, could be used to identify a subset of pediatric patients in whom CT was unnecessary. METHODS After institutional review board approval (IRB #032018-091), we retrospectively reviewed all patients with a diagnosis of PE between 2009 and 2018 at our academic pediatric center. Demographic information including age, sex, and body mass index were abstracted. Imaging was reviewed to obtain HI and CI and to retrospectively calculate PED. The PED is calculated at the bedside by measuring the depth of the pectus at the site of greatest depression relative to a horizontal surface laid across the deformity. For this retrospective study, we calculated the CT-derived PED by measuring the depth from the horizontal on the respective CT images. Patients without imaging studies and patients with pectus carinatum, arcuatum, or mixed deformities were excluded from this study. RESULTS A total of 94 patients met inclusion criteria. Of these, 82% were male, with a median age of 15 y. Patients were further subdivided by BMI, with 46% of patients having a BMI of
Published: 2020

37. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Soufiane Boufous, Yousef Veisani, Mehran Asadi-Aliabadi, Sharath Burugina Nagaraja, Maziar Moradi-Lakeh, Getachew Mullu Kassa, Edward J Mills, Dimas Ria Angga Pribadi, William James Dangel, Mohamad-Hani Temsah, Catherine O. Johnson, Gregory A. Roth, Giuseppe Gorini, Fariborz Mansour-Ghanaei, Alberto Ortiz, Samad Azari, Assefa Ayalew Ayalew Ayalew Gebreslassie, Salime Goharinezhad, Stephanie R. M. Zimsen, Peng Zheng, Michael Assmus, Elisabetta Pupillo, Bach Xuan Tran, Lal B. Rawal, Narayanaswamy Venketasubramanian, Noushin Mohammadifard, Stephen S Lim, Ata Rafiee, Maria Inês Schmidt, Vincent C. Iannucci, Suzanne Lyn Barker-Collo, Leah E. Cahill, Tauseef Ahmad, Platon D. Lopukhov, Kazumasa Yamagishi, Abdullah Al Mamun, Iqbal R. F. Elyazar, Giovanni Damiani, Mohammad Hossein Bakhshaei, Mehdi Fazlzadeh, Virginia Núñez-Samudio, Alyssa Pennini, Dietrich Plass, Atkilt Esaiyas Etisso, Gebre Teklemariam Demoz, Alexandrea Watson, Arvin Haj-Mirzaian, Paul S Briant, Frank B. Osei, Blair R. Bumgarner, Maciej Banach, Ravensara S. Travillian, Kai-Lan Chang, Shirin Djalalinia, Hasan Yusefzadeh, Silvano Gallus, Seyyed Meysam Mousavi, Bernhard T. Baune, Aaron van Donkelaar, Azeem Majeed, Hans Kromhout, Robert Ancuceanu, Blessing J. Akombi, Pushpendra Singh, Nayu Ikeda, William M. Gardner, Zahid A Butt, Mohammad Abdollahi, Temesgen Yihunie Akalu, Rahman Shiri, Benn Sartorius, Ai-Min Wu, Bing Fang Hwang, Flavia M. Cicuttini, Hiroyasu Iso, Luis Camera, Amin Soheili, Félix Carvalho, Yun Jin Kim, Caleb Mackay Salpeter Irvine, Mehdi Mirzaei-Alavijeh, Iman Halvaei, Saqib Ali, Giulio Castelpietra, Catalina Liliana Andrei, Ali Kazemi Karyani, Parkes J Kendrick, Hamidreza Haririan, Lucas Guimarães Abreu, Mukhammad David Naimzada, Jeff T. Zhao, Samiah Alam, Sorin Hostiuc, Shaun Wen Huey Lee, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Cyrus Alinia, Takahiro Tabuchi, Manu Raj Mathur, Søren Thorgaard Skou, Thomas Khaled Dwayne Classen, Reza Heidari-Soureshjani, Massimo Cirillo, Nikita Otstavnov, Mehdi Bohluli, Ruth W. Kimokoti, Animut Tagele Tamiru, Masoumeh Sadeghi, Mohammad Ali Jahani, Itamar S. Santos, Mekdes Tigistu Yilma, Lars Johansson, Arielle Wilder Eagan, Nevine El Nahas, Silvia Schiavolin, Kevin D. Shield, Dinh-Toi Chu, Shiva Borzouei, Paul S. F. Yip, Beatrix Haddock, Gianfranco Alicandro, Vasily Vlassov, Deanna Anderlini, Giuseppe Remuzzi, Khalid A Altirkawi, Farahnaz Joukar, Aso Mohammad Darwesh, Ratilal Lalloo, Panniyammakal Jeemon, Rohollah Kalhor, Daniel Youngwhan Cho, Weijia Fu, João Pedro Silva, Rodrigo Sarmiento-Suarez, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Jacob Olusegun Olusanya, José Neves, Gaorui Guo, Tomas Y. Yeheyis, John S. Ji, Charles D. H. Parry, Maryam Ghadimi, Seyed-Mohammad Fereshtehnejad, Serge Resnikoff, Anna E. Torre, Vinod C Nayak, Jamileh Shadid, Susanne Breitner, Mohammad Khammarnia, Mathilde Touvier, Ensiyeh Jenabi, Hosna Janjani, Floriane Ausloos, Irmina Maria Michalek, Alexandra S. Boon-Dooley, Jessica A. Cruz, Syed Mohamed Aljunid, Abiodun M. Adeoye, André Faro, Bartosz Miazgowski, Jobert Richie Nansseu, Erin C Mullany, Giannina Ferrara, Martin McKee, Emmanuel Peprah, Oommen John, Reza Saeedi, Yasser Vasseghian, Dragos Virgil Davitoiu, Sarah Wulf Hanson, Yingxi Zhao, Omid Shafaat, Ali Rajabpour-Sanati, Farid Najafi, Ana Maria Mantilla Herrera, Fatemeh Rajati, Tarun Gupta, Łukasz Szumowski, Mohammed Ibrahim Mohialdeen Gubari, Peter Njenga Keiyoro, Dharmesh Kumar Lal, Zhi Jiang Zhang, Osayomwanbo Osarenotor, Tanvir M. Huda, Perminder S. Sachdev, Farhad Ghamari, Era Upadhyay, Vivek Kumar, Guoqing Hu, Vinay Nangia, Vladimir Andreevich Korshunov, Saeed Shahabi, Golnaz Heidari, Ashraf Nabhan, Robert C. Reiner, Aziz Rezapour, Justin J. Lang, Rakhi Dandona, Josephine W. Ngunjiri, Anna-Karin Danielsson, André Karch, Filippo Ariani, Ahmed Abdelalim, Masih Tajdini, Stefanos Tyrovolas, Mohamed Hsairi, Jae Il Shin, Jasvinder A. Singh, Meghan D. Mooney, Fiona B. Bennitt, Hesam Alizade, Segun Emmanuel Ibitoye, Pradhum Ram, Soraya Siabani, Evanson Z. Sambala, Reza Malekzadeh, Falk Schwendicke, Lalit Dandona, Masoud Moradi, Molly R Nixon, Roya Mirzaei, Rachel Feldman, Hosni Salem, Alberto L. García-Basteiro, Lorainne Tudor Car, Sharareh Eskandarieh, Ramesh Holla, Ritesh G. Menezes, Taraneh Yousefinezhadi, Hai Quang Pham, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Ali Bijani, Harvey Whiteford, Shanshan Li, Aleksandr Y. Aravkin, Joshua A. Salomon, Franz Castro, Lisa M. Force, Abdilahi Yousuf Yousuf, Mina Anjomshoa, Ken Takahashi, Maigeng Zhou, Telma Zahirian Moghadam, Maseer Khan, Irina Filip, Santi Martini, Randah R. Hamadeh, Somayeh Bohlouli, Joana Morgado-da-Costa, Tim Driscoll, Jingkai Wei, Hermann Brenner, Reza Rawassizadeh, Radoslaw Sierpinski, Saman Esmaeilnejad, Emmanuel Wandera Okunga, Marisa Freitas, Srikanta Banerjee, Feleke Mekonnen Demeke, Shahin Soltani, Naser Mohammad Gholi Mezerji, Reed J D Sorensen, Elena V. Gnedovskaya, Johan Ärnlöv, Ivo Rakovac, Reza Mohammadpourhodki, Hussain Jafari, Atte Meretoja, Yasir Waheed, Fahad Alanezi, Arya Haj-Mirzaian, Sezer Kisa, Jaifred Christian F. Lopez, Khalid F. Alhabib, Basema Saddik, Michael R. Phillips, Vishnu Renjith, Yafeng Wang, Kevan R. Polkinghorne, Liliana G Ciobanu, Jacek Jerzy Jozwiak, Gelin Xu, Richard C. Franklin, Junjie Wu, Thomas R. Hird, Mohammad Zamani, Diana Silva, Fotis Topouzis, Irena Ilic, Jeffrey D. Stanaway, Hadi Pourjafar, Huong Lan Thi Nguyen, Khaled Khatab, Ammas Siraj Mohammed, Ziyad Al-Aly, A. A. Fomenkov, Charlie Ashbaugh, Mowafa Househ, Paul I. Dargan, Endalkachew Worku Mengesha, Shaimaa I. El-Jaafary, Ernoiz Antriyandarti, Iffat Elbarazi, Dara K. Mohammad, Naznin Hossain, Reza Shirkoohi, João M. Furtado, Arash Ziapour, Morteza Jafarinia, M. Mofizul Islam, Anamika Pandey, Ahmed I. Hasaballah, Tanuj Kanchan, Lee Ling Lim, Muktar Omer Omer, Charles D.A. Wolfe, Ulrich O Mueller, Helen Bitew, V. Prakash, Fereshteh Mehri, Randall V. Martin, Claudiu Herteliu, Constance D. Pond, Min Jeong Shin, Morteza Oladnabi, Antonio Maria Borzì, Yousef Mohammad, Yuichiro Yano, Luke D. Knibbs, Kevin S Ikuta, Maryam Mirzaei, Andreea Mirica, Sofia Boston Redford, Siamak Sabour, Mariya Vladimirovna Titova, Davood Anvari, Ghobad Moradi, Jordi Alonso, Shiwei Liu, Theo Vos, Tuomo J. Meretoja, Ireneous N. Soyiri, Owen R. Cooper, Seyed Sina Naghibi Irvani, Kejia Hu, Hannah J. Henrikson, Sanni Yaya, Robert P. Dellavalle, Chidozie Declan Iwu, Sergey Soshnikov, Jee-Young Jasmine Choi, Satinath Mukhopadhyay, Zabihollah Yousefi, Iman El Sayed, Biresaw Wassihun Alemu, Neeti Kapoor, Ahmad Daryani, Cathleen Keller, Ibrahim Abdollahpour, Nuno Taveira, Masoud Foroutan, Fatemeh Amiri, Mariam Molokhia, Songhomitra Panda-Jonas, Amy E. Peden, Rufus Akinyemi, Ejaz Ahmad Khan, Mostafa Amini-Rarani, J. Becker, Hamidreza Pazoki Toroudi, Ben Lacey, Kidanemaryam Berhe, Simon Yadgir, Spencer L. James, Cory N. Spencer, Aletta E. Schutte, Mu'awiyyah Babale Sufiyan, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Fereshteh Ansari, Rixing Xu, Jonathan F. Mosser, Josep Maria Haro, Enrico Rubagotti, Anurag Agrawal, Zahiruddin Quazi Syed, Hoa Thi Do, Ettore Beghi, Seyed Mohammad Kazem Aghamir, Abraham Geremew, Alireza Esteghamati, Paramjit Gill, Farzad Jalilian, J. Jason West, Mikhail Sergeevich Zastrozhin, Albertino Damasceno, Bruce Bartholow Duncan, Nazir Fattahi, Daniel Cury Ribeiro, Michael Brauer, Mark A. Stokes, Veincent Christian Filipino Pepito, Lidia Morawska, Fiona J Charlson, Babak Moazen, Dejana Braithwaite, Jonathan M. Kocarnik, Sergio I. Prada, Andrea Farioli, Zahra Atafar, Heather Orpana, Daniela Balzi, Marco Vacante, Rahmatollah Moradzadeh, Jacek A. Kopec, Iván Landires, Robert G. Weintraub, Leonardo Roever, Yannick Béjot, Markus P. Schlaich, Hamed Zandian, Subramanian Senthilkumaran, Klara Dokova, Vahid Alipour, Sowmya J. Rao, Rakesh Ghosh, Omar Mukhtar Salman, Faris Lami, Marcos Roberto Tovani-Palone, Hamid Reza Tohidinik, Seyed Mohammad Riahi, Adnan Kisa, Ghasem Azarian, Caroline Stein, Zulfiqar A. Bhutta, Sinead Langan, Kunihiro Matsushita, Lauren E. Schaeffer, Kathryn H. Jacobsen, Mehdi Naderi, Mehdi Hosseinzadeh, Nizal Sarrafzadegan, Bahram Armoon, Dan J. Stein, Jessica Fanzo, Morenike Oluwatoyin Folayan, Luca Ronfani, Phetole Walter Mahasha, Nicholas J K Breitborde, Adrian Oţoiu, Arash Sarveazad, Marc L. Serre, Mostafa Hosseini, Nicolas Cherbuin, George D. Thurston, Jalal Arabloo, Mokhtar Mahdavi, Andre Rodrigues Duraes, Ana Laura Manda, Ahmed Abualhasan, Nima Rezaei, Yuan-Pang Wang, Theodore Patrick Younker, Alireza Ansari-Moghaddam, Borhan Mansouri, Adam E. Berman, Khezar Hayat, Rosario Cárdenas, Bolajoko O. Olusanya, Tommi Vasankari, Simon I. Hay, Fatemeh Ghaffarifar, Leo Stockfelt, Ai Koyanagi, Giorgia Giussani, Yuming Guo, Sonia Saxena, Deborah Carvalho Malta, Mehedi Hasan, Negar Rezaei, Maja Pasovic, Jukka Takala, Bogdan Oancea, Sare Safi, A. Werdecker, Florian Fischer, Beatriz Paulina Ayala Quintanilla, Muhammad Shahdaat Bin Sayeed, Takeshi Fukumoto, Maha Atout, Brijesh Sathian, Cristina Bosetti, Mitchell T. Wallin, Agegnehu Bante, Helen Ippolito, Anthony Masaka, Chantal Huynh, Justin Lo, Jordan Weiss, Joemer C. Maravilla, Alberto Raggi, Peter W. Gething, Cristiana Abbafati, Daniela Ribeiro, Mohammad Farahmand, Yetunde O. John-Akinola, Isabela M. Benseñor, Emilie R Maddison, John J. McGrath, Salman Khazaei, Scott B. Patten, Jean Jacques Noubiap, Emmanuela Gakidou, Celine M. Barthelemy, Ashish Badiye, George C. Patton, Obinna Onwujekwe, Peter Allebeck, Victor Aboyans, Olayinka Stephen Ilesanmi, Mousa Yaminfirooz, Neeraj Bedi, Nicholas L S Roberts, Joht Singh Chandan, Hans W. Hoek, Usman Iqbal, Nima Hafezi-Nejad, Haley Lescinsky, Naohiro Yonemoto, Ahmad Ghashghaee, Anders Larsson, David C. Schwebel, Milena Ilic, Richard T. Burnett, Yang Liu, Carlo La Vecchia, Felix Akpojene Ogbo, Morteza Naserbakht, Sangram Kishor Patel, Melanie S. Hammer, Prasanna Mithra, Mohammad Amin Bahrami, Kanyin L. Ong, Mona Pathak, Afshin Maleki, Saeid Safiri, Masood Ali Shaikh, Kate Causey, Michael R.M. Abrigo, Jost B. Jonas, Dian Kusuma, Jagadish Rao Padubidri, Mihajlo Jakovljevic, Ali S. Shalash, Abdiwahab Hashi, Ionut Negoi, Nataliya A. Foigt, Andrey Nikolaevich Briko, François Alla, Giuseppe Grosso, Houman Goudarzi, Di H. Cross, Vera Marisa Costa, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Odgerel Chimed-Ochir, Sonia Rodríguez-Ramírez, Bo Norrving, Kerem Shuval, Jacob L. Stubbs, Muhammad Ali, Shuhei Nomura, Man Mohan Mehndiratta, Chisom Joyqueenet Akunna, Abdollah Mohammadian-Hafshejani, Navid Rabiee, Dana Bryazka, Hussen Mohammed, Asadollah Gholamian, Ashley Marks, Rizwan Kalani, Molly E. Herbert, Islam Y. Elgendy, Moritz U. G. Kraemer, Chuanhua Yu, Suzanne Polinder, Pascual R. Valdez, Jennifer Rickard, Kylie Ball, Turki Alanzi, Mohsen Bayati, Hamed Mirzaei, Christopher M Odell, Amira Shaheen, Ziad A. Memish, Thirunavukkarasu Sathish, Michael A. Piradov, Hamed Kalani, Lorenzo Monasta, Christopher S Yilgwan, Desalegn Getnet Demsie, Riaz Uddin, Rizwan Suliankatchi Abdulkader, Vinay Srinivasan, Hamid Ahmadieh, Claudio Alberto Dávila-Cervantes, Raffaele Palladino, Chukwudi A Nnaji, Mika Shigematsu, Stein Emil Vollset, Abbas Sheikhtaheri, Paulo A. Lotufo, Nasir Salam, Binyam Minuye Birihane, Mohammad Ali Mansournia, Tomislav Mestrovic, Samer Hamidi, Rajesh Sagar, Mayowa O. Owolabi, Kara Estep, Ester Cerin, Michael T. Chung, Simon Øverland, Amir Taherkhani, Sheng Chia Chung, Martin Amogre Ayanore, Nikolaos Dervenis, Joan B. Soriano, Tahereh Javaheri, Victor Adekanmbi, Seid Tiku Mereta, Gbenga A. Kayode, Christopher R. Cederroth, Razique Anwer, Rajan Nikbakhsh, Kaja Abbas, Fatemeh Heydarpour, Louisa Degenhardt, Tahiya Alam, Mohammad Miri, Alibek Mereke, David Laith Rawaf, Ippazio Cosimo Antonazzo, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Desta Debalkie Atnafu, Davide Sattin, Moslem Soofi, Edris Hasanpoor, Krittika Bhattacharyya, Mika Kivimäki, Nikolay Ivanovich Briko, Joanna L Whisnant, Christopher J L Murray, Simin Mouodi, Alize J. Ferrari, Damian Santomauro, Katrin Burkart, Tudorel Andrei, Alberto Baldasseroni, Hafiz Ansar Rasul Suleria, Valery L. Feigin, Nauman Khalid, Ewerton Cousin, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Themba G.G. Ginindza, Sadaf G. Sepanlou, Sheikh Mohammed Shariful Islam, Sanjay Basu, Getinet Ayano, Paula Moraga, Soheil Hassanipour, Jason A. Anderson, Catherine Bisignano, Iyad Sultan, Deepak Kumar Pasupula, Keivan Ahmadi, Fariba Dorostkar, Rajeev Gupta, David M. Pereira, Mustafa Z. Younis, Adel Spotin, Rasmus Havmoeller, Yeshambel T. Nigatu, Barthelemy Kuate Defo, Mithila Faruque, Alan D. Lopez, Shailesh Advani, Behshad Naghshtabrizi, Shane D. Morrison, Inga Dora Sigfusdottir, Konrad Pesudovs, Anna Gershberg Hayoon, Raaj Kishore Biswas, Reshmi Bhageerathy, H. Dean Hosgood, Giulia Carreras, Sarika Chaturvedi, James L. Fisher, In-Hwan Oh, G Anil Kumar, Christoph Nowak, Vijay Kumar Chattu, Puja C Rao, Marcel Ausloos, Ali Kabir, Rannveig Sigurvinsdottir, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Rafael Tabarés-Seisdedos, Minh Nguyen, Ashkan Afshin, Payman Salamati, Colin Angus, Mona M. 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Campos-Nonato, Biniyam Sahiledengle Geberemariyam, Godfrey Mutashambara Rwegerera, Alaa Badawi, James Leigh, Morteza Arab-Zozani, Kyle E. Simpson, Muluken Bekele Sorrie, Roghiyeh Faridnia, Vivekanand Jha, Tomasz Miazgowski, Aaron J Cohen, Chukwuma David Umeokonkwo, Alessandra Lugo, Adhanom Gebreegziabher Baraki, Akshaya Srikanth Bhagavathula, Caitlyn Steiner, Gholamreza Roshandel, Cuong Tat Nguyen, Tania G Sánchez-Pimienta, Ahamarshan Jayaraman Nagarajan, Laura Kemmer, Ihoghosa Osamuyi Iyamu, Seyedeh Zahra Masoumi, Vivian Chia-Rong Hsieh, Kris J. Krohn, Phoebe Anne Rhinehart, Sarah Wozniak, Sahar Saeedi Moghaddam, Kate E. LeGrand, Christian Kieling, Vahid Yazdi-Feyzabadi, Robin Room, Zelalem Nigussie Azene, Kelly Cercy, Paul H. Lee, Stanislav S. Otstavnov, Dinesh Bhandari, Rafael Alves Guimarães, Zemenu Tadesse Tessema, Aziz Sheikh, Michellr L. Bell, Marwa Rashad Salem, Kirsten E. Wiens, Emma U.R. Smith, Hassan Abolhassani, Cristiano Piccinelli, Kedir Hussein Abegaz, G.K. Mini, Christian Razo, Manuela L. Ferreira, Diego De Leo, Francesco Saverio Violante, Aristidis Tsatsakis, Zahra Sadat Dibaji Forooshani, Tea Lallukka, Dickson A. Amugsi, Anna Poznańska, Graeme J. Hankey, Kewal Krishan, Maryam Zamanian, Eirini Skiadaresi, Jai K Das, Felix Greaves, Tessa M. Pilz, Sameer Vali Gopalani, Mansour Ghafourifard, M. DeLang, Morteza Mahmoudi, Alton Lu, Brian J. Hall, Ravi Prakash Jha, David Edvardsson, Xiu Ju George Zhao, Farshad Farzadfar, Hadi Hassankhani, Samuel M. Ostroff, Gerhard Sulo, Keyghobad Ghadiri, Neeraj Bhala, Stefan Lorkowski, Mohammad Rabiee, Sivan Yegnanarayana Iyer Saraswathy, Amirhossein Sahebkar, Rashid Abdi Guled, Abdallah M. Samy, Roman Topor-Madry, Michal Grivna, Afsaneh Arzani, Ayesha Humayun, Simin Liu, Maryam Khayamzadeh, Davoud Adham, Ahad Bakhtiari, Shafiu Mohammed, Paolo Lauriola, Abbas Mosapour, Sophia Emmons-Bell, Khurshid Alam, Rajat Das Gupta, Matilde Leonardi, Muktar Beshir Ahmed, Jeffrey V. Lazarus, Mohamed M. 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Saeedi Moghaddam, S, Safari, Y, Safi, S, Safiri, S, Sagar, R, Sahebkar, A, Sajadi, S, Salam, N, Salamati, P, Salem, H, Salem, M, Salimzadeh, H, Salman, O, Salomon, J, Samad, Z, Samadi Kafil, H, Sambala, E, Samy, A, Sanabria, J, Sanchez-Pimienta, T, Santomauro, D, Santos, I, Santos, J, Santric-Milicevic, M, Saraswathy, S, Sarmiento-Suarez, R, Sarrafzadegan, N, Sarveazad, A, Sathian, B, Sathish, T, Sattin, D, Saxena, S, Schaeffer, L, Schiavolin, S, Schlaich, M, Schmidt, M, Schutte, A, Schwebel, D, Schwendicke, F, Senbeta, A, Senthilkumaran, S, Sepanlou, S, Serdar, B, Serre, M, Shadid, J, Shafaat, O, Shahabi, S, Shaheen, A, Shaikh, M, Shalash, A, Shams-Beyranvand, M, Shamsizadeh, M, Sharafi, K, Sheikh, A, Sheikhtaheri, A, Shibuya, K, Shield, K, Shigematsu, M, Shin, J, Shin, M, Shiri, R, Shirkoohi, R, Shuval, K, Siabani, S, Sierpinski, R, Sigfusdottir, I, Sigurvinsdottir, R, Silva, J, Simpson, K, Singh, J, Singh, P, Skiadaresi, E, Skou, S, Skryabin, V, Smith, E, Soheili, A, Soltani, S, Soofi, M, Sorensen, R, Soriano, J, Sorrie, M, Soshnikov, S, Soyiri, I, Spencer, C, Spotin, A, Sreeramareddy, C, Srinivasan, V, Stanaway, J, Stein, C, Stein, D, Steiner, C, Stockfelt, L, Stokes, M, Straif, K, Stubbs, J, Sufiyan, M, Suleria, H, Suliankatchi Abdulkader, R, Sulo, G, Sultan, I, Tabares-Seisdedos, R, Tabb, K, Tabuchi, T, Taherkhani, A, Tajdini, M, Takahashi, K, Takala, J, Tamiru, A, Taveira, N, Tehrani-Banihashemi, A, Temsah, M, Tesema, G, Tessema, Z, Thurston, G, Titova, M, Tohidinik, H, Tonelli, M, Topor-Madry, R, Topouzis, F, Torre, A, Touvier, M, Tovani-Palone, M, Tran, B, Travillian, R, Tsatsakis, A, Tudor Car, L, Tyrovolas, S, Uddin, R, Umeokonkwo, C, Unnikrishnan, B, Upadhyay, E, Vacante, M, Valdez, P, van Donkelaar, A, Vasankari, T, Vasseghian, Y, Veisani, Y, Venketasubramanian, N, Violante, F, Vlassov, V, Vollset, S, Vos, T, Vukovic, R, Waheed, Y, Wallin, M, Wang, Y, Watson, A, Wei, J, Wei, M, Weintraub, R, Weiss, J, Werdecker, A, West, J, Westerman, R, Whisnant, J, Whiteford, H, Wiens, K, Wolfe, C, Wozniak, S, Wu, A, Wu, J, Wulf Hanson, S, Xu, G, Xu, R, Yadgir, S, Yahyazadeh Jabbari, S, Yamagishi, K, Yaminfirooz, M, Yano, Y, Yaya, S, Yazdi-Feyzabadi, V, Yeheyis, T, Yilgwan, C, Yilma, M, Yip, P, Yonemoto, N, Younis, M, Younker, T, Yousefi, B, Yousefi, Z, Yousefinezhadi, T, Yousuf, A, Yu, C, Yusefzadeh, H, Moghadam, T, Zamani, M, Zamanian, M, Zandian, H, Zastrozhin, M, Zhang, Y, Zhang, Z, Zhao, J, Zhao, X, Zhao, Y, Zheng, P, Zhou, M, Ziapour, A, Zimsen, S, Lim, S, Murray, C, GBD 2019 Risk Factors Collaborator, Violante FS, Biosciences, Department of Public Health, Clinicum, Department of Neurosciences, HUS Comprehensive Cancer Center, Environmental Sciences, Sub Foundations&PhilosophyofNaturSc begr, IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Public Health, Bin Sayeed, M. S. B., Caetano Dos Santos, F. L., Camera, L. A., Elyazar, I. R. F., Ayalew Gebreslassie, A. A. A., Ginindza, T. G., Matin, B. K., Morgado-Da-Costa, J., Khaneghah, A. M., Mahesh, P. A., Toroudi, H. P., Syed, Z. Q., Salem, M. R., Skou, S. T., Tovani-Palone, M. R., Tudor Car, L. T., and Moghadam, T. Z.
Subjects: Male, Nutritional Sciences, Specific risk, Contaminación del Aire Interior, 030204 cardiovascular system & hematology, Socioeconomic Factor, systematic analysis, Global Health, Body Mass Index, Global Burden of Disease, Health Risk Behavior, Health Risk Behaviors, Disease studies, 0302 clinical medicine, Risk Factors, METABOLIC RISKS, 030212 general & internal medicine, 11 Medical and Health Sciences, Factores de Riesgo, 2. Zero hunger, education.field_of_study, Public health, Injuries, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, GBD, risck factors, attributable burden of disease, 3142 Public health care science, environmental and occupational health, 3. Good health, Relative risk, Environmental health, Health, Hypertension, Global Burden of Diseases, Injuries, Risk Factors, A990 Medicine and Dentistry not elsewhere classified, Female, Leading risk factors, Global Health Metrics, Cohort study, Human, medicine.medical_specialty, Substance-Related Disorders, Population, UNITED-STATES, Risk Assessment, DIET, ITC-HYBRID, 03 medical and health sciences, Life Expectancy, MORTALITY, DISABILITY, POLLUTION, CLUSTERS, SDG 3 - Good Health and Well-being, General & Internal Medicine, medicine, Humans, Global Burden of Disease Study, Risk factor, education, Global burden, business.industry, Risk Factor, Malnutrition, Klinisk medicin, Global Burden of Diseases, Environmental Exposure, medicine.disease, Enfermedades, purl.org/pe-repo/ocde/ford#3.02.00 [https], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Years of potential life lost, Socioeconomic Factors, Risk factors, Disease study, Hyperglycemia, ITC-ISI-JOURNAL-ARTICLE, NA, Clinical Medicine, business, RA
Abstract: Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk-outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk-outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk-outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10.8 million (95% uncertainty interval [UI] 9.51-12.1) deaths (19.2% [16.9-21.3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8.71 million (8.12-9.31) deaths (15.4% [14.6-16.2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253-350) DALYs (11.6% [10.3-13.1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0-9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10-24 years, alcohol use for those aged 25-49 years, and high systolic blood pressure for those aged 50-74 years and 75 years and older. Interpretation Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.
Published: 2020

38. Wernicke's encephalopathy in Crohn's disease and ulcerative colitis

Author: Oudman, Erik, Wijnia, Jan W., Oey, Misha J., van Dam, Mirjam, Postma, Albert, Leerstoel Postma, Experimental Psychology (onderzoeksprogramma PF), Helmholtz Institute, Leerstoel Postma, Experimental Psychology (onderzoeksprogramma PF), and Helmholtz Institute
Subjects: 0301 basic medicine, medicine.medical_specialty, Clinical nutrition, Gastrointestinal, medicine.medical_treatment, Endocrinology, Diabetes and Metabolism, Encephalopathy, Dietary, 030209 endocrinology & metabolism, Gastroenterology, Wernicke's encephalopathy, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Crohn Disease, Internal medicine, medicine, Humans, Wernicke Encephalopathy, Thiamine, Inflammation, Crohn's disease, 030109 nutrition & dietetics, Nutrition and Dietetics, business.industry, food and beverages, Thiamine Deficiency, Bowel resection, medicine.disease, Ulcerative colitis, Diabetes and Metabolism, Parenteral nutrition, Vomiting, Colitis, Ulcerative, medicine.symptom, business
Abstract: Crohn's disease (CD) and ulcerative colitis (UC) are chronic and debilitating inflammatory conditions of the gastrointestinal tract. Thiamine can deplete rapidly in CD and UC, which can lead to Wernicke's encephalopathy (WE), is an acute neurologic disorder. Our objective was to systematically review the presentation of WE in CD and UC. We conducted our search from inception using the MeSH terms "Crohn's disease," "ulcerative colitis," and "Wernicke's encephalopathy." Our search yielded 28 case studies reporting on 31 cases. CD was diagnosed in 21 cases, and UC in 10. The first signs of WE were nausea and vomiting (13 cases), double vision (10), blurred vision (10), and hearing loss (4). In 12 cases, partial or complete bowel resection was one of the etiologies of thiamine depletion. In nine cases, thiamine was not supplemented intramuscularly or intravenously while parenteral nutrition or glucose was given to the patient. In 10 cases, detailed descriptions of thiamine treatment were given. Thiamine treatment at suboptimal levels (7 of 10 cases) turned out to lead to residual cognitive deficits in three cases. In three cases with optimal treatment (1500 mg/d intravenously), complete remission of WE symptoms was achieved. Rapid treatment with high doses (500 mg, 3 times/d) of thiamine saves lives, and treats WE in its core symptomatology.
Published: 2020

39. The association between visuospatial neglect and balance and mobility post-stroke onset: A systematic review

Author: Embrechts, Elissa, Van Criekinge, Tamaya, Schröder, Jonas, Nijboer, Tanja, Lafosse, Christophe, Truijen, Steven, Saeys, Wim, Helmholtz Institute, Experimental Psychology (onderzoeksprogramma PF), Leerstoel Postma, Afd Psychologische functieleer, Physiotherapy, Human Physiology and Anatomy, Rehabilitation Research, Faculty of Physical Education and Physical Therapy, Helmholtz Institute, Experimental Psychology (onderzoeksprogramma PF), Leerstoel Postma, and Afd Psychologische functieleer
Subjects: Balance, 030506 rehabilitation, medicine.medical_specialty, Visuospatial neglect, Walking, Sitting, Perceptual Disorders, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Activities of Daily Living, Medicine, Humans, Psychology, Orthopedics and Sports Medicine, Association (psychology), Stroke, postural balance, Balance (ability), stroke rehabilitation, Mobility, business.industry, Stair climbing, Rehabilitation, medicine.disease, Gait, Cross-Sectional Studies, Cohort, Observational study, Human medicine, 0305 other medical science, business, 030217 neurology & neurosurgery, Perceptual Disorders/etiology, Stroke/complications
Abstract: Background Although previous narrative reviews have highlighted a potential association between visuospatial neglect (VSN) and balance disorders, to what extent different areas of balance and mobility could be affected is still unclear. Objectives This systematic review updates previous literature findings and systematically reviews sitting balance, standing balance and mobility outcomes. Methods PubMed, Web of Science, ScienceDirect, Naric-Rehabdata, PEDro and the Cochrane Trials Library were systematically searched. Methodological quality was assessed by the National Heart, Lung, and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The association between VSN and sitting balance, standing balance and mobility (walking, stair climbing/descending and transfers) was investigated. Results In total, 48 studies were included (4595 stroke survivors): at least 1319 (29%) showed symptoms of VSN. VSN was associated with less independence during sitting, with an asymmetric posture toward the affected body side. For standing balance, we revealed a significant negative association between VSN and mediolateral stability and weight shifting, whereas only activities of daily living-related VSN was associated with weight-bearing asymmetry during static stance. While walking, patients with VSN laterally deviated from their path. Results were inconclusive regarding other aspects of mobility. The association between VSN and balance/mobility seemed to decrease over time. Conclusions Despite great heterogeneity in results, this study suggests that stroke survivors with VSN show specific deviations in posture and movement in the mediolateral direction. Although the association between VSN and balance/mobility has been extensively investigated, explanatory studies evaluating underlying mechanisms of the frequently present association are lacking. Future studies should address this by combining clinical and instrumented assessment of balance and gait performance, preferably longitudinally to investigate the associations over time.
Published: 2021

40. Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3

Author: Priya Rathi, Ritesh G. Menezes, Edris Hasanpoor, Sanni Yaya, Mohsen Bayati, Maciej Banach, Raffaele Palladino, Mikhail Sergeevich Zastrozhin, Siamak Sabour, Theo Vos, Tuomo J. Meretoja, Dimas Ria Angga Pribadi, Shahin Soltani, Simona Cătălina Ștefan, Behzad Karami Matin, Cyrus Alinia, Tudorel Andrei, Mehdi Bohluli, Nikita Otstavnov, Yanfang Su, Mohammad Ali Mansournia, Simon I. Hay, Mansour Ghafourifard, Songhomitra Panda-Jonas, Pushpendra Singh, Salman Rawaf, Morteza Arab-Zozani, Robert Ancuceanu, Samer Hamidi, Maarten J. Postma, Vijay Kumar Chattu, Ted R. Miller, Stanislav S. Otstavnov, Gbenga A. Kayode, Chhabi Lal Ranabhat, João Vasco Santos, Savita Lasrado, Jonathan F. Mosser, Chaw Yin Myint, Mihajlo Jakovljevic, Masoud Moghadaszadeh, Tanvir M. Huda, Fakher Rahim, Seyedeh Zahra Masoumi, Yingxi Zhao, Aziz Sheikh, Subramanian Senthilkumaran, Sheikh Mohammed Shariful Islam, Fariborz Mansour-Ghanaei, Andrew T Olagunju, Atif Amin Baig, Ali H. Mokdad, Anders Larsson, Atte Meretoja, Bach Xuan Tran, Lal B. Rawal, Brandon Cunningham, Vahid Alipour, Sowmya J. Rao, Anamika Pandey, Vahid Yazdi-Feyzabadi, Salime Goharinezhad, Angela E Micah, Leticia Avila-Burgos, Hayley N Stutzman, Farshad Farzadfar, M. Mofizul Islam, Sharareh Eskandarieh, Saqib Ali, Srikanta Banerjee, Zhi-Jiang Zhang, Anirudh Kotlo, Ravensara S. Travillian, Aziz Rezapour, Huong Lan Thi Nguyen, Sergio I. Prada, Biagio Simonetti, Maitreyi Sahu, Sadaf G. Sepanlou, Carlos A Castañeda-Orjuela, Hoa Thi Do, Farahnaz Joukar, Aso Mohammad Darwesh, Syed Mohamed Aljunid, Modhurima Moitra, In-Hwan Oh, Ayman Grada, Kenji Shibuya, Sojib Bin Zaman, Steven D Bachmeier, Hilda L Harb, Edson Serván-Mori, Bahram Mohajer, Van C. Lansingh, Ali Almasi, German Martinez, Till Bärnighausen, Reza Malekzadeh, Adam E. Berman, Matthew T. Schneider, Michael K. Hole, Reza Rawassizadeh, Bing-Fang Hwang, Bianca S. Zlavog, Mohammad Rabiee, Moses K. Muriithi, Anton C Harle, Mokhtar Mahdavi, Yohannes Kinfu, Olatunde Aremu, Cristiana Abbafati, Nelson Alvis-Guzman, Joseph L Dieleman, Lucero Cahuana-Hurtado, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Zeleke Hailemariam Abebo, Muge Cevik, Hassan Abolhassani, Farnam Mohebi, Job F M van Boven, Nataliya Foigt, Neda Milevska Kostova, Abdallah M. Samy, Roman Topor-Madry, Golsum Tsakalos, Benjamin B. Massenburg, Spencer L. James, Erkin M. Mirrakhimov, Miloje Savic, Mehdi Hosseinzadeh, Sawyer W Crosby, Ayesha Humayun, Hamidreza Setayesh, G Anil Kumar, Juan Sanabria, Jalal Arabloo, Milena M Santric Milicevic, Ai Koyanagi, Shokofeh Maleki, Junjie Wu, Nathaniel J Henry, Efat Mohamadi, Francesco Saverio Violante, Samad Azari, Delia Hendrie, Ahad Bakhtiari, Olayinka Stephen Ilesanmi, Pankaj Bhardwaj, Ahamarshan Jayaraman Nagarajan, Adnan Kisa, Masood Ali Shaikh, Shafiu Mohammed, Justice Nonvignon, Firooz Esmaeilzadeh, Eduardo A. Undurraga, Khurshid Alam, Muktar Beshir Ahmed, Mohamed M. Gad, Mikk Jürisson, Usman Iqbal, Chuanhua Yu, Luis Camera, Mohammad Ali Jahani, Abigail Chapin, Pascual R. Valdez, Reinhard Busse, Tomislav Mestrovic, Paul S. F. Yip, Christopher J L Murray, Jacob Olusegun Olusanya, Salah Eddin Karimi, Mustafa Z. Younis, Michael R.M. Abrigo, Rahul R. Zende, Mina Anjomshoa, Shane D. Morrison, Marcel Ausloos, Bruno Piassi Sao Jose, Zohre Javaheri, Saravanan Muthupandian, Valentin Yurievich Skryabin, Endalkachew Worku Mengesha, Lalit Dandona, Jacek Jerzy Jozwiak, Omar Mukhtar Salman, Rakhi Dandona, Mojtaba Bagherzadeh, Mostafa Dianatinasab, Reza Mohammadpourhodki, Seyed Sina Naghibi Irvani, Nancy Fullman, Claudiu Herteliu, Andreea Mirica, Jasvinder A. Singh, Amin Soheili, Lee Ling Lim, Charles D.A. Wolfe, Catalina Liliana Andrei, Ali Kazemi Karyani, Bolajoko O. Olusanya, Carl Abelardo T. Antonio, Tommi Vasankari, Jean Jacques Noubiap, Mehdi Naderi, Jagadish Rao Padubidri, Bernhard T. Baune, Navid Rabiee, Mark G. Shrime, Mayowa O. Owolabi, Lorenzo G. Mantovani, Desta Debalkie Atnafu, Vasily Vlassov, Kyle E. Simpson, Sorin Hostiuc, Shaun Wen Huey Lee, Cuong Tat Nguyen, Ian E Cogswell, Tesleem Kayode Babalola, Sanjay Basu, Hassan Haghparast Bidgoli, Leila Doshmangir, Marcos Roberto Tovani-Palone, Maha El Tantawi, Obinna Onwujekwe, Mohammad Ali Sahraian, Ahmed Omar Bali, Joshua A. Salomon, Hamidreza Komaki, David Laith Rawaf, Zoubida Zaidi, Hassan Magdy Abd El Razek, Reshmi Bhageerathy, Emilie R Maddison, Naohiro Yonemoto, Ahmad Ghashghaee, Asadollah Gholamian, Ferrán Catalá-López, Stefan Kohler, Rafael Tabarés-Seisdedos, Anwar Faraj, Rafael Lozano, Rufus Akinyemi, Florian Fischer, Jost B. Jonas, Dian Kusuma, Martin Amogre Ayanore, Rohollah Kalhor, Falk Schwendicke, Seyyed Meysam Mousavi, Micah, A. E., Su, Y., Bachmeier, S. D., Chapin, A., Cogswell, I. E., Crosby, S. W., Cunningham, B., Harle, A. C., Maddison, E. R., Moitra, M., Sahu, M., Schneider, M. T., Simpson, K. E., Stutzman, H. N., Tsakalos, G., Zende, R. R., Zlavog, B. S., Abbafati, C., Abebo, Z. H., Abolhassani, H., Abrigo, M. R. M., Ahmed, M. B., Akinyemi, R. O., Alam, K., Ali, S., Alinia, C., Alipour, V., Aljunid, S. M., Almasi, A., Alvis-Guzman, N., Ancuceanu, R., Andrei, T., Andrei, C. L., Anjomshoa, M., Antonio, C. A. T., Arabloo, J., Arab-Zozani, M., Aremu, O., Atnafu, D. D., Ausloos, M., Avila-Burgos, L., Ayanore, M. A., Azari, S., Babalola, T. K., Bagherzadeh, M., Baig, A. A., Bakhtiari, A., Banach, M., Banerjee, S. K., Barnighausen, T. W., Basu, S., Baune, B. T., Bayati, M., Berman, A. E., Bhageerathy, R., Bhardwaj, P., Bohluli, M., Busse, R., Cahuana-Hurtado, L., Camera, L. L. A., Castaneda-Orjuela, C. A., Catala-Lopez, F., Cevik, M., Chattu, V. K., Dandona, L., Dandona, R., Dianatinasab, M., Do, H. T., Doshmangir, L., El Tantawi, M., Eskandarieh, S., Esmaeilzadeh, F., Faraj, A., Farzadfar, F., Fischer, F., Foigt, N. A., Fullman, N., Gad, M. M., Ghafourifard, M., Ghashghaee, A., Gholamian, A., Goharinezhad, S., Grada, A., Haghparast Bidgoli, H., Hamidi, S., Harb, H. L., Hasanpoor, E., Hay, S. I., Hendrie, D., Henry, N. J., Herteliu, C., Hole, M. K., Hosseinzadeh, M., Hostiuc, S., Huda, T. M., Humayun, A., Hwang, B. -F., Ilesanmi, O. S., Iqbal, U., Irvani, S. S. N., Islam, S. M. S., Islam, M. M., Jahani, M. A., Jakovljevic, M., James, S. L., Javaheri, Z., Jonas, J. B., Joukar, F., Jozwiak, J. J., Jurisson, M., Kalhor, R., Karami Matin, B., Karimi, S. E., Kayode, G. A., Kazemi Karyani, A., Kinfu, Y., Kisa, A., Kohler, S., Komaki, H., Kosen, S., Kotlo, A., Koyanagi, A., Kumar, G. A., Kusuma, D., Lansingh, V. C., Larsson, A. O., Lasrado, S., Lee, S. W. H., Lim, L. -L., Lozano, R., Magdy Abd El Razek, H., Mahdavi, M. M., Maleki, S., Malekzadeh, R., Mansour-Ghanaei, F., Mansournia, M. A., Mantovani, L. G., Martinez, G., Masoumi, S. Z., Massenburg, B. B., Menezes, R. G., Mengesha, E. W., Meretoja, T. J., Meretoja, A., Mestrovic, T., Milevska Kostova, N., Miller, T. R., Mirica, A., Mirrakhimov, E. M., Moghadaszadeh, M., Mohajer, B., Mohamadi, E., Mohammad Darwesh, A., Mohammadian-Hafshejani, A., Mohammadpourhodki, R., Mohammed, S., Mohebi, F., Mokdad, A. H., Morrison, S. D., Mosser, J. F., Mousavi, S. M., Muriithi, M. K., Muthupandian, S., Myint, C. -Y., Naderi, M., Nagarajan, A. J., Nguyen, C. T., Nguyen, H. L. T., Nonvignon, J., Noubiap, J. J., Oh, I. -H., Olagunju, A. T., Olusanya, J. O., Olusanya, B. O., Omar Bali, A., Onwujekwe, O. E., Otstavnov, S. S., Otstavnov, N., Owolabi, M. O., Padubidri, J. R., Palladino, R., Panda-Jonas, S., Pandey, A., Postma, M. J., Prada, S. I., Pribadi, D. R. A., Rabiee, M., Rabiee, N., Rahim, F., Ranabhat, C. L., Rao, S. J., Rathi, P., Rawaf, S., Rawaf, D. L., Rawal, L., Rawassizadeh, R., Rezapour, A., Sabour, S., Sahraian, M. A., Salman, O. M., Salomon, J. A., Samy, A. M., Sanabria, J., Santos, J. V., Santric Milicevic, M. M., Sao Jose, B. P., Savic, M., Schwendicke, F., Senthilkumaran, S., Sepanlou, S. G., Servan-Mori, E., Setayesh, H., Shaikh, M. A., Sheikh, A., Shibuya, K., Shrime, M. G., Simonetti, B., Singh, J. A., Singh, P., Skryabin, V. Y., Soheili, A., Soltani, S., Stefan, S. C., Tabares-Seisdedos, R., Topor-Madry, R., Tovani-Palone, M. R., Tran, B. X., Travillian, R., Undurraga, E. A., Valdez, P. R., van Boven, J. F. M., Vasankari, T. J., Violante, F. S., Vlassov, V., Vos, T., Wolfe, C. D. A., Wu, J., Yaya, S., Yazdi-Feyzabadi, V., Yip, P., Yonemoto, N., Younis, M. Z., Yu, C., Zaidi, Z., Zaman, S. B., Zastrozhin, M. S., Zhang, Z. -J., Zhao, Y., Murray, C. J. L., Dieleman, J. L., Global Burden of Disease Health Financing Collaborator Network, Violante FS, Micah, A, Su, Y, Bachmeier, S, Chapin, A, Cogswell, I, Crosby, S, Cunningham, B, Harle, A, Maddison, E, Moitra, M, Sahu, M, Schneider, M, Simpson, K, Stutzman, H, Tsakalos, G, Zende, R, Zlavog, B, Abbafati, C, Abebo, Z, Abolhassani, H, Abrigo, M, Ahmed, M, Akinyemi, R, Alam, K, Ali, S, Alinia, C, Alipour, V, Aljunid, S, Almasi, A, Alvis-Guzman, N, Ancuceanu, R, Andrei, T, Andrei, C, Anjomshoa, M, Antonio, C, Arabloo, J, Arab-Zozani, M, Aremu, O, Atnafu, D, Ausloos, M, Avila-Burgos, L, Ayanore, M, Azari, S, Babalola, T, Bagherzadeh, M, Baig, A, Bakhtiari, A, Banach, M, Banerjee, S, Barnighausen, T, Basu, S, Baune, B, Bayati, M, Berman, A, Bhageerathy, R, Bhardwaj, P, Bohluli, M, Busse, R, Cahuana-Hurtado, L, Camera, L, Castaneda-Orjuela, C, Catala-Lopez, F, Cevik, M, Chattu, V, Dandona, L, Dandona, R, Dianatinasab, M, Do, H, Doshmangir, L, El Tantawi, M, Eskandarieh, S, Esmaeilzadeh, F, Faraj, A, Farzadfar, F, Fischer, F, Foigt, N, Fullman, N, Gad, M, Ghafourifard, M, Ghashghaee, A, Gholamian, A, Goharinezhad, S, Grada, A, Haghparast Bidgoli, H, Hamidi, S, Harb, H, Hasanpoor, E, Hay, S, Hendrie, D, Henry, N, Herteliu, C, Hole, M, Hosseinzadeh, M, Hostiuc, S, Huda, T, Humayun, A, Hwang, B, Ilesanmi, O, Iqbal, U, Irvani, S, Islam, S, Islam, M, Jahani, M, Jakovljevic, M, James, S, Javaheri, Z, Jonas, J, Joukar, F, Jozwiak, J, Jurisson, M, Kalhor, R, Karami Matin, B, Karimi, S, Kayode, G, Kazemi Karyani, A, Kinfu, Y, Kisa, A, Kohler, S, Komaki, H, Kosen, S, Kotlo, A, Koyanagi, A, Kumar, G, Kusuma, D, Lansingh, V, Larsson, A, Lasrado, S, Lee, S, Lim, L, Lozano, R, Magdy Abd El Razek, H, Mahdavi, M, Maleki, S, Malekzadeh, R, Mansour-Ghanaei, F, Mansournia, M, Mantovani, L, Martinez, G, Masoumi, S, Massenburg, B, Menezes, R, Mengesha, E, Meretoja, T, Meretoja, A, Mestrovic, T, Milevska Kostova, N, Miller, T, Mirica, A, Mirrakhimov, E, Moghadaszadeh, M, Mohajer, B, Mohamadi, E, Mohammad Darwesh, A, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mohammed, S, Mohebi, F, Mokdad, A, Morrison, S, Mosser, J, Mousavi, S, Muriithi, M, Muthupandian, S, Myint, C, Naderi, M, Nagarajan, A, Nguyen, C, Nguyen, H, Nonvignon, J, Noubiap, J, Oh, I, Olagunju, A, Olusanya, J, Olusanya, B, Omar Bali, A, Onwujekwe, O, Otstavnov, S, Otstavnov, N, Owolabi, M, Padubidri, J, Palladino, R, Panda-Jonas, S, Pandey, A, Postma, M, Prada, S, Pribadi, D, Rabiee, M, Rabiee, N, Rahim, F, Ranabhat, C, Rao, S, Rathi, P, Rawaf, S, Rawaf, D, Rawal, L, Rawassizadeh, R, Rezapour, A, Sabour, S, Sahraian, M, Salman, O, Salomon, J, Samy, A, Sanabria, J, Santos, J, Santric Milicevic, M, Sao Jose, B, Savic, M, Schwendicke, F, Senthilkumaran, S, Sepanlou, S, Servan-Mori, E, Setayesh, H, Shaikh, M, Sheikh, A, Shibuya, K, Shrime, M, Simonetti, B, Singh, J, Singh, P, Skryabin, V, Soheili, A, Soltani, S, Stefan, S, Tabares-Seisdedos, R, Topor-Madry, R, Tovani-Palone, M, Tran, B, Travillian, R, Undurraga, E, Valdez, P, van Boven, J, Vasankari, T, Violante, F, Vlassov, V, Vos, T, Wolfe, C, Wu, J, Yaya, S, Yazdi-Feyzabadi, V, Yip, P, Yonemoto, N, Younis, M, Yu, C, Zaidi, Z, Zaman, S, Zastrozhin, M, Zhang, Z, Zhao, Y, Murray, C, Dieleman, J, University of Helsinki, Clinicum, HUS Comprehensive Cancer Center, HUS Neurocenter, Helsinki University Hospital Area, University of St Andrews. School of Medicine, University of St Andrews. Infection and Global Health Division, Groningen Research Institute for Asthma and COPD (GRIAC), Value, Affordability and Sustainability (VALUE), and Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET)
Subjects: Economic growth, Financing, Government, Psychological intervention, HIV Infections, burden of disease, 030204 cardiovascular system & hematology, DISEASE, ALLOCATION, 0302 clinical medicine, RA0421, RA0421 Public health. Hygiene. Preventive Medicine, Sustainable development, Global health, health economics, Healthcare Financing, HIV Infection, 030212 general & internal medicine, 10. No inequality, 11 Medical and Health Sciences, DALY, Healthy lives, 1. No poverty, Public Health, Global Health, Social Medicine and Epidemiology, 3rd-DAS, General Medicine, Sustainable Development, 3. Good health, tuberculosis, IMPOVERISHMENT, TERRITORIES, Financing, Human, Financing, Personal, Resource (biology), Tuberculosi, 195 COUNTRIES, Developing Countrie, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Acquired immunodeficiency syndrome (AIDS), General & Internal Medicine, SYSTEMATIC ANALYSIS, medicine, Humans, Burden, HIV/AIDS, tubercolosis, malaria, Human resources, Developing Countries, Government, Acquired Immunodeficiency Syndrome, Health economics, business.industry, DISABILITY, CATASTROPHE, Global Burden of Disease Health Financing Collaborator Network, GLOBAL BURDEN, medicine.disease, Malaria, SDG, health sector spending, development assistant for health, Health Expenditure, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, 3121 General medicine, internal medicine and other clinical medicine, NA, Health Expenditures, business, EXPENDITURE
Abstract: BACKGROUND: Sustainable Development Goal (SDG) 3 aims to "ensure healthy lives and promote well-being for all at all ages". While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available. METHODS: We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid private) from 1995 to 2017 for 195 countries and territories. For disease-specific health spending, we estimated spending for HIV/AIDS and tuberculosis for 135 low-income and middle-income countries, and malaria in 106 malaria-endemic countries, from 2000 to 2017. We also estimated development assistance for health (DAH) from 1990 to 2019, by source, disbursing development agency, recipient, and health focus area, including DAH for pandemic preparedness. Finally, we estimated future health spending for 195 countries and territories from 2018 until 2030. We report all spending estimates in inflation-adjusted 2019 US$, unless otherwise stated. FINDINGS: Since the development and implementation of the SDGs in 2015, global health spending has increased, reaching $7·9 trillion (95% uncertainty interval 7·8-8·0) in 2017 and is expected to increase to $11·0 trillion (10·7-11·2) by 2030. In 2017, in low-income and middle-income countries spending on HIV/AIDS was $20·2 billion (17·0-25·0) and on tuberculosis it was $10·9 billion (10·3-11·8), and in malaria-endemic countries spending on malaria was $5·1 billion (4·9-5·4). Development assistance for health was $40·6 billion in 2019 and HIV/AIDS has been the health focus area to receive the highest contribution since 2004. In 2019, $374 million of DAH was provided for pandemic preparedness, less than 1% of DAH. Although spending has increased across HIV/AIDS, tuberculosis, and malaria since 2015, spending has not increased in all countries, and outcomes in terms of prevalence, incidence, and per-capita spending have been mixed. The proportion of health spending from pooled sources is expected to increase from 81·6% (81·6-81·7) in 2015 to 83·1% (82·8-83·3) in 2030. INTERPRETATION: Health spending on SDG3 priority areas has increased, but not in all countries, and progress towards meeting the SDG3 targets has been mixed and has varied by country and by target. The evidence on the scale-up of spending and improvements in health outcomes suggest a nuanced relationship, such that increases in spending do not always results in improvements in outcomes. Although countries will probably need more resources to achieve SDG3, other constraints in the broader health system such as inefficient allocation of resources across interventions and populations, weak governance systems, human resource shortages, and drug shortages, will also need to be addressed. For complete list of authors see http://dx.doi.org/10.1016/S0140-6736(20)30608-5
Published: 2020

41. Episodic future thinking together with observational learning benefits prospective memory in high-functioning Korsakoff's syndrome patients

Author: Lloyd, Beth, Oudman, Erik, Altgassen, Mareike, Walvoort, Serge J.W., Kessels, Roy P.C., Postma, Albert, Leerstoel Postma, Experimental Psychology (onderzoeksprogramma PF), Helmholtz Institute, Afd Psychologische functieleer, Leerstoel Postma, Experimental Psychology (onderzoeksprogramma PF), Helmholtz Institute, and Afd Psychologische functieleer
Subjects: Male, 050103 clinical psychology, medicine.medical_specialty, Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1], Memory, Episodic, prospective memory, alcoholics, Alcohol use disorder, Audiology, Task (project management), All institutes and research themes of the Radboud University Medical Center, Prospective memory, medicine, Humans, Observational learning, 0501 psychology and cognitive sciences, Prospective Studies, Cognitive skill, Memory Disorders, future thinking, Neuro- en revalidatiepsychologie, Recall, 05 social sciences, Neuropsychology and rehabilitation psychology, Original Articles, General Medicine, Middle Aged, Korsakoff’s syndrome, medicine.disease, future event stimulation, Clinical Psychology, Korsakoff Syndrome, observational learning, Categorization, Female, Original Article, Korsakoff's syndrome, Psychology
Abstract: Contains fulltext : 219555.pdf (Publisher’s version ) (Open Access) Objective: Patients with Korsakoff's syndrome (KS) have difficulty carrying out tasks which rely on prospective memory (PM). Since remembering to carry out an action in the future is crucial for living independently, it is of primary interest to develop strategies that improve PM performance in KS patients. Design: The study employed a computer categorization task as an ongoing activity into which a PM task was embedded. We included episodic future thinking (EFT) and observational learning (Experiment 2) to boost PM. Methods: Experiment 1 evaluated the efficacy of EFT following written PM task instructions in ten KS patients. Due to floor-level PM performance in Experiment 1, Experiment 2 included an instructional video demonstrating the PM intention. In Experiment 2, twenty-six KS patients performed both conditions (EFT and no-EFT) at least 1 week apart, while twelve controls with alcohol use disorder without KS performed the no-EFT condition. In Experiment 2, the PM instructions were also shown through video (observational learning component). Mild cognitive impairment was assessed in a short test battery. Results: Experiment 1 showed overall floor performance in both conditions. Experiment 2 showed that KS patients performed PM tasks less accurately than the control group in the no-EFT condition. In Experiment 2, where the observational learning component was included, EFT improved PM performance in KS patients. This effect was driven by a sub-group of high-functioning KS patients. Conclusions: This study showed the value of an observational learning component together with EFT in improving PM performance, in relatively high-functioning KS patients. Practitioner points: KS patients performed the PM task less accurately than non-KS controls with alcohol use disorder, confirming PM impairment in this patient population. Controls with alcohol use disorder performed the PM task at ceiling level. Showing an instructional video demonstrating the PM intention improved PM performance and later recall of PM task instructions in KS patients. Episodic future thinking strategy improved PM performance in KS patients with relatively intact cognitive functioning. 15 p.
Published: 2020

42. Forgetting the new locations of one’s keys: spatial-memory interference in Korsakoff’s amnesia

Author: Postma, Albert, Morel, Sascha G., Slot, Margot E., Oudman, Erik, Kessels, Roy P.C., Leerstoel Postma, Leerstoel Verstraten, Experimental Psychology (onderzoeksprogramma PF), Helmholtz Institute, Afd Psychologische functieleer, Leerstoel Postma, Leerstoel Verstraten, Experimental Psychology (onderzoeksprogramma PF), Helmholtz Institute, and Afd Psychologische functieleer
Subjects: Adult, Male, medicine.medical_specialty, Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1], Object–location memory, Interference theory, Amnesia, Neuropsychological Tests, Audiology, Interference (genetic), behavioral disciplines and activities, 050105 experimental psychology, 03 medical and health sciences, 0302 clinical medicine, Alcohol Amnestic Disorder, Memory task, mental disorders, medicine, Humans, 0501 psychology and cognitive sciences, Spatial Memory, Analysis of Variance, Neuro- en revalidatiepsychologie, Forgetting, General Neuroscience, Neuropsychology and rehabilitation psychology, 05 social sciences, Plasticity and Memory [DI-BCB_DCC_Theme 3], Middle Aged, Verbal Learning, Korsakoff’s syndrome, medicine.disease, Space Perception, Female, medicine.symptom, Interference, Korsakoff's syndrome, Psychology, 030217 neurology & neurosurgery, Research Article
Abstract: Contains fulltext : 192386.pdf (Publisher’s version ) (Open Access) The present study focused on interference in a group of patients with amnesia due to Korsakoff's syndrome (KS) within the domain of spatial memory. An object–location memory task was used in which participants first learned an array of objects on a computer screen, followed by a reconstruction of the object positions. Next a trial was given in which the same objects were presented only now in different locations. Participants had to place the objects a second time but at the new locations. This was repeated for seven pairs of baseline/interference trials. Both Korsakoff patients and matched controls did worse on the interference trials than on the baseline trials, indicating that it is difficult to relearn new spatial locations for objects that previously were remembered in other locations. When computing relative interference effects (that is the percentage change from baseline in the interference trials), Korsakoff patients were less affected than controls. It is discussed in how far interference depends on the strength of the original memories, which are markedly lower in KS patients. 8 p.
Published: 2018

43. A case of ALS with posterior cortical atrophy

Author: Nijboer, Tanja C.W., Nitert, Bram, Westeneng, Henk Jan, Van Den Berg, Leonard H., van Es, Michael A., Experimental Psychology (onderzoeksprogramma PF), Leerstoel Postma, Helmholtz Institute, Experimental Psychology (onderzoeksprogramma PF), Leerstoel Postma, and Helmholtz Institute
Subjects: Pathology, medicine.medical_specialty, Neurology, MND-FTD continuum, Clinical Neurology, posterior cortical atrophy, Disease, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Atrophy, Humans, Medicine, Amyotrophic lateral sclerosis, Aged, business.industry, Brain, Posterior cortical atrophy, medicine.disease, Magnetic Resonance Imaging, Clinical neurology, Frontotemporal Dementia, Disease Progression, Female, Neurology (clinical), medicine.symptom, Cognition Disorders, business, 030217 neurology & neurosurgery, Frontotemporal dementia
Abstract: Here, we provide a case-report of an amyotrophic lateral sclerosis (ALS) patient with cognitive deficits best defined as posterior cortical atrophy (PCA). This is an unusual finding as ALS forms a spectrum with frontotemporal dementia (FTD), whereas PCA is predominantly associated with Alzheimer’s disease pathology. We hypothesize on whether ALS with PCA might be an under recognized phenotype considering multiple imaging studies in ALS have also reported (asymptomatic) parietal atrophy.
Published: 2019

44. Patients' and physicians' interpretation of chemotherapy-induced peripheral neurotoxicity

Author: Cavaletti, G., Cornblath, D. R., Merkies, I. S. J., Postma, T. J., Rossi, E., Alberti, Paola, Bruna, J., Argyriou, A. A., Briani, C., Velasco, Riccardo, Kalofonos, H. P., Psimaras, D., Ricard, D., Pace, A., Faber, C. G., Lalisang, R. I., Brandsma, D., Koeppen, S., Kerrigan, S., Schenone, A., Grisold, W., Mazzeo, A., Padua, L., Dorsey, S. G., Penas-Prado, M., Valsecchi, M. G., Frigeni, B., Lanzani, F., Mattavelli, L., Piatti, M. L., Binda, D., Bidoli, P., Cazzaniga, M., Cortinovis, D., Galie, E., Campagnolo, M., Salvalaggio, A., Ruiz, M., Vanhoutte, E. K., Boogerd, W., Hense, J., Grant, R., Storey, D., Reni, L., Demichelis, C., Pessino, A., Granata, G., Leandri, Martina, Ghigliotti, I., Plasmati, R., Pastorelli, Federica, Heimans, J. J., Eurelings, M., Meijer, R. J., Pozza, E. L., Toscano, A., Gentile, L., Santarpia, M., Gonzalez, C. D., Klinische Neurowetenschappen, MUMC+: MA Med Staf Spec Neurologie (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Interne Geneeskunde, MUMC+: MA Medische Oncologie (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: DA KG Polikliniek (9), Cavaletti, G, Cornblath, D, Merkies, I, Postma, T, Rossi, E, Alberti, P, Bruna, J, Argyriou, A, Briani, C, Velasco, R, Kalofonos, H, Psimaras, D, Ricard, D, Pace, A, Faber, C, Lalisang, R, Brandsma, D, Koeppen, S, Kerrigan, S, Schenone, A, Grisold, W, Mazzeo, A, Padua, L, Dorsey, S, Penas-Prado, M, Valsecchi, M, Bidoli, P, Cazzaniga, M, Neurology, and CCA - Cancer Treatment and quality of life
Subjects: Adult, medicine.medical_specialty, Activities of daily living, side effect, media_common.quotation_subject, medicine.medical_treatment, assessment, chemotherapy, neurotoxicity, patient reported outcome measures, side effects, Medizin, NEUROPATHY CIPN, Neurological examination, Severity of Illness Index, 03 medical and health sciences, Vibration perception, 0302 clinical medicine, Perception, Internal medicine, Activities of Daily Living, medicine, Humans, VALIDITY, media_common, Oncologists, Neuroscience (all), Neurology (clinical), Chemotherapy, medicine.diagnostic_test, business.industry, General Neuroscience, Neurotoxicity, Outcome measures, Peripheral Nervous System Diseases, assessment, chemotherapy, neurotoxicity, patient reported outcome measures, side effects, Adult, Humans, Neurotoxicity Syndromes, Peripheral Nervous System Diseases, Activities of Daily Living, Oncologists, Patient Reported Outcome Measures, Severity of Illness Index, OUTCOME MEASURES, medicine.disease, Peripheral, patient reported outcome measure, 030220 oncology & carcinogenesis, Neurotoxicity Syndromes, business, 030217 neurology & neurosurgery
Abstract: To test if and how chemotherapy-induced peripheral neurotoxicity (CIPN) is perceived differently by patients and physicians, making assessment and interpretation challenging. We performed a secondary analysis of the CI-PeriNomS study which included 281 patients with stable CIPN. We tested: (a) the association between patients' perception of activity limitation in performing eight common tasks and neurological impairment and (b) how the responses to questions related to these daily activities are interpreted by the treating oncologist. To achieve this, we compared patients' perception of their activity limitation with neurological assessment and the oncologists' blind interpretation. Distribution of the scores attributed by oncologists to each daily life maximum limitation ("impossible") generated three groups: Group 1 included limitations oncologists attributed mainly to motor impairment; Group 2 ones mainly attributed to sensory impairment and Group 3 ones with uncertain motor and sensory impairment. Only a subset of questions showed a significant trend between severity in subjective limitation, reported by patients, and neurological impairment. In Group 1, neurological examination confirmed motor impairment in only 51%-65% of patients; 76%-78% of them also had vibration perception impairment. In Group 2, sensory impairment ranged from 84% to 100%; some degree of motor impairment occurred in 43%-56% of them. In Group 3 strength reduction was observed in 49%-50% and sensory perception was altered in up to 82%. Interpretation provided by the panel of experienced oncologists was inconsistent with the neurological impairment. These observations highlight the need of a core set of outcome measures for future CIPN trials.
Published: 2019

45. The cooccurrence of heightened media attention and adverse drug reaction reports for hormonal contraception in the United Kingdom between 2014 and 2017

Author: Lobke Geesje Maria Postma and Parastou Donyai
Subjects: medicine.medical_specialty, Drug-Related Side Effects and Adverse Reactions, mass media, Affect (psychology), 030226 pharmacology & pharmacy, Pharmacovigilance, 03 medical and health sciences, 0302 clinical medicine, depressive disorder, Health care, Humans, Medicine, Attention, Pharmacology (medical), 030212 general & internal medicine, Psychiatry, Depression (differential diagnoses), Mass media, Pharmacology, business.industry, hormonal contraception, adverse drug reaction reporting systems, Original Articles, medicine.disease, United Kingdom, Mood, Hormonal contraception, drug‐related side effects and adverse reactions, Female, Original Article, business, Adverse drug reaction
Abstract: Aim: The aim of this study was to examine the cooccurrence of heightened media attention after the publication of a paper by Skovlund et al. in September 2016 on the link between hormonal contraception and depression or mood on adverse drug reaction (ADR) reports in the UK. Methods: A quantitative analysis of relevant newspaper articles published between January 2014 and December 2017 was performed, as well as a content analysis. ADR reports were collected from the Medicines and Healthcare products Regulatory Agency website and via a Freedom of Information request. A quantitative analysis was performed on ADR reports of hormonal contraceptives for all ADRs and for Depressed mood disorders and disturbances. Results: The publication of the Skovlund et al. paper did not lead to a peak in relevant newspaper articles, but there was a change in the content of the newspaper articles, which focussed more on the link between hormonal contraceptives and depression or mood. There was an overall increase in ADR reports by women relating to hormonal contraceptives between 2016 and 2017, and for combined contraceptives this was due to an increase in ADR reports of Depressed mood disorders and disturbances. Conclusions: The content of media attention appears to affect ADR reporting by women for combined contraceptives. In general, patients report the majority of Depressed mood disorders and disturbances ADRs as opposed to health professionals who report other ADRs. Care providers can anticipate to the effect of heightened media attention and help patients when they experience these ADRs.
Published: 2020

46. A personalised screening strategy for diabetic retinopathy

Author: Sajad Emamipour, Maarten J. Postma, Job F M van Boven, Talitha L Feenstra, Joline W.J. Beulens, Petra J. M. Elders, Amber A W A van der Heijden, Giel Nijpels, General practice, APH - Health Behaviors & Chronic Diseases, APH - Methodology, Amsterdam Reproduction & Development (AR&D), Epidemiology and Data Science, ACS - Diabetes & metabolism, ACS - Heart failure & arrhythmias, Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Microbes in Health and Disease (MHD), PharmacoTherapy, -Epidemiology and -Economics, and Methods in Medicines evaluation & Outcomes research (M2O)
Subjects: Pediatrics, medicine.medical_specialty, Screening intervals, Cost effectiveness, Cost-Benefit Analysis, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, FREQUENCY, Article, 03 medical and health sciences, 0302 clinical medicine, Diabetic retinopathy, PROGRAM, Internal Medicine, medicine, Humans, MAJOR RISK-FACTORS, INTERVAL, 030212 general & internal medicine, Medical diagnosis, OPTIMIZATION, Risk assessment, business.industry, GLOBAL PREVALENCE, Guideline, medicine.disease, Annual Screening, 3. Good health, MODEL, Diabetes Mellitus, Type 2, Cohort, Cost-effectiveness, business, Retinopathy
Abstract: Aims/hypothesis In this study we examined the cost-effectiveness of three different screening strategies for diabetic retinopathy: using a personalised adaptive model, annual screening (fixed intervals), and the current Dutch guideline (stratified based on previous retinopathy grade). Methods For each individual, optimal diabetic retinopathy screening intervals were determined, using a validated risk prediction model. Observational data (1998–2017) from the Hoorn Diabetes Care System cohort of people with type 2 diabetes were used (n = 5514). The missing values of retinopathy grades were imputed using two scenarios of slow and fast sight-threatening retinopathy (STR) progression. By comparing the model-based screening intervals to observed time to develop STR, the number of delayed STR diagnoses was determined. Costs were calculated using the healthcare perspective and the societal perspective. Finally, outcomes and costs were compared for the different screening strategies. Results For the fast STR progression scenario, personalised screening resulted in 11.6% more delayed STR diagnoses and €11.4 less costs per patient compared to annual screening from a healthcare perspective. The personalised screening model performed better in terms of timely diagnosis of STR (8.8% less delayed STR diagnosis) but it was slightly more expensive (€1.8 per patient from a healthcare perspective) than the Dutch guideline strategy. Conclusions/interpretation The personalised diabetic retinopathy screening model is more cost-effective than the Dutch guideline screening strategy. Although the personalised screening strategy was less effective, in terms of timely diagnosis of STR patients, than annual screening, the number of delayed STR diagnoses is low and the cost saving is considerable. With around one million people with type 2 diabetes in the Netherlands, implementing this personalised model could save €11.4 million per year compared with annual screening, at the cost of 658 delayed STR diagnoses with a maximum delayed time to diagnosis of 48 months. Graphical abstract
Published: 2020

47. Identifying a nasal gene expression signature associated with hyperinflation and treatment response in severe COPD

Author: Frank van den Elshout, Marc E. Lenburg, Wim Timens, Alen Faiz, Dirkje S. Postma, Corry-Anke Brandsma, Wim Boersma, Erica van der Wiel, Kai Imkamp, Sebastiaan J. Vroegop, Maarten van den Berge, Gerard H. Koppelman, Avrum Spira, Huib A. M. Kerstjens, Katrina Steiling, Henk R. Pasma, Ilse M. Boudewijn, Pascal Wielders, Irene H. Heijink, Khaled Mansour, Groningen Research Institute for Asthma and COPD (GRIAC), and Guided Treatment in Optimal Selected Cancer Patients (GUTS)
Subjects: Male, 0301 basic medicine, Budesonide, medicine.medical_specialty, lcsh:Medicine, Hyperinflation, 010502 geochemistry & geophysics, 01 natural sciences, Gastroenterology, Article, Placebos, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, Formoterol Fumarate, Internal medicine, Administration, Inhalation, Gene expression, medicine, Humans, Lung volumes, lcsh:Science, Adrenergic beta-2 Receptor Agonists, Lung, Aged, 0105 earth and related environmental sciences, COPD, Multidisciplinary, Dose-Response Relationship, Drug, Inhalation, business.industry, Gene Expression Profiling, lcsh:R, Middle Aged, respiratory system, medicine.disease, Pathophysiology, Bronchodilator Agents, respiratory tract diseases, 030104 developmental biology, Outcomes research, Case-Control Studies, lcsh:Q, Female, Formoterol, Nasal Cavity, business, medicine.drug
Abstract: Hyperinflation contributes to dyspnea intensity in COPD. Little is known about the molecular mechanisms underlying hyperinflation and how inhaled corticosteroids (ICS) affect this important aspect of COPD pathophysiology. To investigate the effect of ICS/long-acting β2-agonist (LABA) treatment on both lung function measures of hyperinflation, and the nasal epithelial gene-expression profile in severe COPD. 117 patients were screened and 60 COPD patients entered a 1-month run-in period on low-dose ICS/LABA budesonide/formoterol (BUD/F) 200/6 one inhalation b.i.d. Patients were then randomly assigned to 3-month treatment with either a high dose BDP/F 100/6 two inhalations b.i.d. (n = 31) or BUD/F 200/6 two inhalations b.i.d. (n = 29). Lung function measurements and nasal epithelial gene-expression were assessed before and after 3-month treatment and validated in independent datasets. After 3-month ICS/LABA treatment, residual volume (RV)/total lung capacity (TLC)% predicted was reduced compared to baseline (p Trial registration: ClinicalTrials.gov registration number NCT01351792 (registration date May 11, 2011), ClinicalTrials.gov registration number NCT00848406 (registration date February 20, 2009), ClinicalTrials.gov registration number NCT00158847 (registration date September 12, 2005).
Published: 2020

48. Surgery for multiple endocrine neoplasia type 1-related insulinoma

Author: van Beek, D. J., Nell, S., Verkooijen, H. M., Borel Rinkes, I. H. M., Valk, G. D., Vriens, M. R., Goudet, P., Vella, A., Donegan, D., Bartsch, D. K., Manoharan, J., Perrier, N. D., Christakis, I., Brandi, M. L., Zarnegar, R., Postma, E. L., Kebebew, E., Nockel, P., Brunaud, L., Pasternak, J. D., Kluijfhout, W. P., Sturgeon, C., Giri, S., Bonsing, B. A., van Eijck, C. H., van Goor, H., de Kleine, R. H. J., van Dijkum, E. J. Nieveen, Dejong, C. H. C., Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Clinical Genetics, and Department of Finance
Subjects: Male, endocrine system diseases, Kaplan-Meier Estimate, 0302 clinical medicine, Postoperative Complications, Multiple endocrine neoplasia, Child, Aged, 80 and over, Middle Aged, medicine.anatomical_structure, Treatment Outcome, 030220 oncology & carcinogenesis, HPB, Child, Preschool, Original Article, Female, Pancreas, hormones, hormone substitutes, and hormone antagonists, Adult, medicine.medical_specialty, endocrine system, Adolescent, Enucleation, Clinical Decision-Making, 030209 endocrinology & metabolism, Hypoglycemia, 03 medical and health sciences, Young Adult, Pancreatectomy, medicine, Multiple Endocrine Neoplasia Type 1, Humans, MEN1, General, Survival rate, Insulinoma, Aged, Retrospective Studies, business.industry, Original Articles, medicine.disease, Surgery, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Pancreatic Neoplasms, Localized disease, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract: Background Insulinomas are found in 10–15 per cent of patients with multiple endocrine neoplasia type 1 (MEN1) and lead to life‐threatening hypoglycaemia. Surgical outcome and the optimal surgical strategy for MEN1‐related insulinoma are unknown. Methods Patients with MEN1‐related insulinomas were identified in 46 centres in Europe and North America between 1990 and 2016. Insulinomas were considered localized if the lesion was in the pancreatic head or body/tail. Patients with pancreatic neuroendocrine tumours throughout the pancreas were suspected of having multifocal insulinoma. The primary outcome was postoperative hypoglycaemia, defined as persistent hypoglycaemia, or recurrent hypoglycaemia caused by a new insulinoma or insulin‐producing liver metastases. Hypoglycaemia‐free survival was estimated by the Kaplan–Meier method. Results Ninety‐six patients underwent resection for MEN1‐related insulinoma. Sixty‐three and 33 patients had localized and multifocal insulinomas respectively. After a median follow‐up of 8 (range 1–22) years, one patient (1 per cent) had persistent disease and six (6 per cent) had developed recurrent disease, of whom four had a new insulinoma. The 10‐year hypoglycaemia‐free survival rate was 91 (95 per cent c.i. 80 to 96) per cent. Of those with localized disease, 46 patients underwent pancreatic resection and 17 enucleation. One of these patients had persistent disease and one developed recurrent insulinoma. Among patients with multifocal disease, three developed new insulinomas and two developed insulin‐producing liver metastases. Conclusion Surgery for MEN1‐related insulinoma is more successful than previously thought., In this cohort of 96 patients with resected multiple endocrine neoplasia 1 (MEN1)‐related insulinomas, seven patients (7 per cent) developed postoperative persistent or recurrent hypoglycaemia after a median follow‐up of 8 years. The 10‐year hypoglycaemia‐free survival rate was 91 (95 per cent c.i. 80 to 96) per cent. For patients with localized insulinoma, enucleation seems the preferred procedure. PPPD, pylorus‐preserving pancreatoduodenectomy. Outcomes good
Published: 2020

49. The Cost-Effectiveness of Hepatitis C Virus Screening Strategies among Recently Arrived Migrants in the Netherlands

Author: Jan Wilschut, Marinus van Hulst, Maarten J. Postma, J.F.H. Eijsink, Mohamed N M T Al Khayat, Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Microbes in Health and Disease (MHD), and PharmacoTherapy, -Epidemiology and -Economics
Subjects: Cost effectiveness, Health, Toxicology and Mutagenesis, Hepatitis C virus, Cost-Benefit Analysis, lcsh:Medicine, migrants, Hepacivirus, medicine.disease_cause, Article, 03 medical and health sciences, Hepatitis C/diagnosis, 0302 clinical medicine, Health care, medicine, Humans, Mass Screening, 030212 general & internal medicine, cost-effectiveness, Mass screening, health care economics and organizations, Netherlands, Transients and Migrants, Cost–benefit analysis, business.industry, screening, lcsh:R, Public Health, Environmental and Occupational Health, virus diseases, Hepatitis C, social sciences, medicine.disease, Markov Chains, Quality-adjusted life year, budget impact, Cohort, population characteristics, 030211 gastroenterology & hepatology, Quality-Adjusted Life Years, hepatitis C, business, geographic locations, Demography
Abstract: Objective: We aimed to assess the cost-effectiveness of hepatitis C virus (HCV) screening strategies among recently arrived migrants in the Netherlands. Methods: A Markov model was used to estimate the health effects and costs of HCV screening from the healthcare perspective. A cohort of 50,000 recently arrived migrants was used. In this cohort, three HCV screening strategies were evaluated: (i) no screening, (ii) screening of migrants from HCV-endemic countries and (iii) screening of all migrants. Results: Strategy (ii) screening of migrants from HCV-endemic countries compared to strategy (i) no screening, yielded an incremental cost-effectiveness ratio (ICER) of &euro, 971 per quality-adjusted life-years (QALYs) gained. Strategy (iii) screening of all migrants compared with strategy (ii) screening of migrants from HCV-endemic countries yielded an ICER of &euro, 1005 per QALY gained. The budget impact of strategy (ii) screening of migrants from HCV-endemic countries and strategy (iii) screening of all migrants was &euro, 13,752,039 and &euro, 20,786,683, respectively. Conclusion: HCV screening is cost-effective. However, the budget impact may have a strong influence on decision making.
Published: 2020

50. The burden and costs of sepsis and reimbursement of its treatment in a developing country

Author: Abdul Khairul Rizki Purba, Nina Mariana, Gestina Aliska, Sonny Hadi Wijaya, Riyanti Retno Wulandari, Usman Hadi, null Hamzah, Cahyo Wibisono Nugroho, Jurjen van der Schans, Maarten J. Postma, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Value, Affordability and Sustainability (VALUE)
Subjects: 0301 basic medicine, Microbiology (medical), Adult, Male, Focal infection, medicine.medical_specialty, Cardiovascular infection, 030106 microbiology, Developing country, Context (language use), Developing countries, lcsh:Infectious and parasitic diseases, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Cost of Illness, medicine, Humans, lcsh:RC109-216, 030212 general & internal medicine, Survivors, Respiratory Tract Infections, Reimbursement, Universal health insurance, health care economics and organizations, Aged, Retrospective Studies, business.industry, Retrospective cohort study, General Medicine, Middle Aged, Focal infection theory, medicine.disease, Infectious Diseases, Indonesia, Emergency medicine, Insurance, Health, Reimbursement, Observational study, Female, business, Hospital costs
Abstract: OBJECTIVES: This study aimed to determine the burden of sepsis with focal infections in the resource-limited context of Indonesia and to propose national prices for sepsis reimbursement.METHODS: A retrospective observational study was conducted from 2013-2016 on cost of surviving and non-surviving sepsis patients from a payer perspective using inpatient billing records in four hospitals. The national burden of sepsis was calculated and proposed national prices for reimbursement were developed.RESULTS: Of the 14,076 sepsis patients, 5,876 (41.7%) survived and 8,200 (58.3%) died. The mean hospital costs incurred per surviving and deceased sepsis patient were US$1,011 (SE ± 23.4) and US$1,406 (SE ± 27.8), respectively. The national burden of sepsis in 100,000 patients was estimated to be US$130 million. Sepsis patients with multifocal infections and a single focal lower-respiratory tract infection (LRTI) were estimated as being the two with the highest economic burden (US$48 million and US$33 million, respectively, within 100,000 sepsis patients). Sepsis with cardiovascular infection was estimated to warrant the highest proposed national price for reimbursement (US$4,256).CONCLUSIONS: Multifocal infections and LRTIs are the major focal infections with the highest burden of sepsis. This study showed varying cost estimates for sepsis, necessitating a new reimbursement system with adjustment of the national prices taking the particular foci into account.
Published: 2020

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