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1. The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990–2019: Findings from the Global Burden of Disease Study 2019

Author: Giulio Castelpietra, Ann Kristin Skrindo Knudsen, Emilie E. Agardh, Benedetta Armocida, Massimiliano Beghi, Kim Moesgaard Iburg, Giancarlo Logroscino, Rui Ma, Fabrizio Starace, Nicholas Steel, Giovanni Addolorato, Catalina Liliana Andrei, Tudorel Andrei, Jose L Ayuso-Mateos, Maciej Banach, Till Winfried Bärnighausen, Francesco Barone-Adesi, Akshaya Srikanth Bhagavathula, Felix Carvalho, Márcia Carvalho, Joht Singh Chandan, Vijay Kumar Chattu, Rosa A.S. Couto, Natália Cruz-Martins, Paul I. Dargan, Keshab Deuba, Diana Dias da Silva, Adeniyi Francis Fagbamigbe, Eduarda Fernandes, Pietro Ferrara, Florian Fischer, Peter Andras Gaal, Alessandro Gialluisi, Juanita A. Haagsma, Josep Maria Haro, M. Tasdik Hasan, Syed Shahzad Hasan, Sorin Hostiuc, Licia Iacoviello, Ivo Iavicoli, Elham Jamshidi, Jost B. Jonas, Tamas Joo, Jacek Jerzy Jozwiak, Srinivasa Vittal Katikireddi, Joonas H. Kauppila, Moien A.B. Khan, Adnan Kisa, Sezer Kisa, Mika Kivimäki, Kamrun Nahar Koly, Ai Koyanagi, Manasi Kumar, Tea Lallukka, Berthold Langguth, Caterina Ledda, Paul H. Lee, Ilaria Lega, Christine Linehan, Joana A. Loureiro, Áurea M Madureira-Carvalho, Jose Martinez-Raga, Manu Raj Mathur, John J. McGrath, Enkeleint A. Mechili, Alexios-Fotios A. Mentis, Tomislav Mestrovic, Bartosz Miazgowski, Andreea Mirica, Antonio Mirijello, Babak Moazen, Shafiu Mohammed, Francesk Mulita, Gabriele Nagel, Ionut Negoi, Ruxandra Irina Negoi, Vincent Ebuka Nwatah, Alicia Padron-Monedero, Songhomitra Panda-Jonas, Shahina Pardhan, Maja Pasovic, Jay Patel, Ionela-Roxana Petcu, Marina Pinheiro, Richard Charles G. Pollok, Maarten J. Postma, David Laith Rawaf, Salman Rawaf, Esperanza Romero-Rodríguez, Luca Ronfani, Dominic Sagoe, Francesco Sanmarchi, Michael P Schaub, Nigussie Tadesse Sharew, Rahman Shiri, Farhad Shokraneh, Inga Dora Sigfusdottir, João Pedro Silva, Renata Silva, Bogdan Socea, Miklós Szócska, Rafael Tabarés-Seisdedos, Marco Torrado, Marcos Roberto Tovani-Palone, Tommi Juhani Vasankari, Massimiliano Veroux, Russell M. Viner, Andrea Werdecker, Andrea Sylvia Winkler, Simon I. Hay, Alize J. Ferrari, Mohsen Naghavi, Peter Allebeck, and Lorenzo Monasta
Subjects: Young people, Mental health, Mental disorders, Self-harm, Substance use, Europe, Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time. Methods: Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated. Findings: In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 – 21,630) for MDs, 3,891 (3,020 - 4,905) for SUDs, and 89·1 (63·8 - 123·1) for self-harm. In terms of disability, anxiety contributed to 647·3 (432–912·3) YLDs, while in terms of premature death, self-harm contributed to 319·6 (248·9–412·8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14·9%;9·4-20·1) and drug use disorders (16·9%;8·9-26·3), and decreased in idiopathic developmental intellectual disability (–29·1%;23·8-38·5). YLLs decreased in self-harm (–27·9%;38·3-18·7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs. Interpretation: Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people. Funding: The Bill and Melinda Gates Foundation
Published: 2022
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2. Changes in disease burden in Poland between 1990-2017 in comparison with other Central European countries: A systematic analysis for the Global Burden of Disease Study 2017.

Author: Maria Gańczak, Tomasz Miazgowski, Marta Kożybska, Artur Kotwas, Marcin Korzeń, Bartosz Rudnicki, Tomasz Nogal, Catalina Liliana Andrei, Marcel Ausloos, Maciej Banach, Alexandra Brazinova, Maria-Magdalena Constantin, Eleonora Dubljanin, Claudiu Herteliu, Mihaela Hostiuc, Sorin Hostiuc, Mihajlo Jakovljevic, Jacek Jerzy Jozwiak, Katarzyna Kissimova-Skarbek, Zbigniew J Król, Tomislav Mestrovic, Bartosz Miazgowski, Neda Milevska Kostova, Mohsen Naghavi, Ionut Negoi, Ruxandra Irina Negoi, Adrian Pana, Salvatore Rubino, Mario Sekerija, Radoslaw Sierpinski, Lucjan Szponar, Roman Topor-Madry, Isidora S Vujcic, Justyna Widecka, Katarzyna Widecka, Bogdan Wojtyniak, Vesna Zadnik, and Jacek A Kopec
Subjects: Medicine, Science
Abstract: BACKGROUND:Systematic collection of mortality/morbidity data over time is crucial for monitoring trends in population health, developing health policies, assessing the impact of health programs. In Poland, a comprehensive analysis describing trends in disease burden for major conditions has never been published. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides data on the burden of over 300 diseases in 195 countries since 1990. We used the GBD database to undertake an assessment of disease burden in Poland, evaluate changes in population health between 1990-2017, and compare Poland with other Central European (CE) countries. METHODS:The results of GBD 2017 for 1990 and 2017 for Poland and CE were used to assess rates and trends in years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs). Data came from cause-of-death registration systems, population health surveys, disease registries, hospitalization databases, and the scientific literature. Analytical approaches have been used to adjust for missing data, errors in cause-of-death certification, and differences in data collection methodology. Main estimation strategies were ensemble modelling for mortality and Bayesian meta-regression for disability. RESULTS:Between 1990-2017, age-standardized YLL rates for all causes declined in Poland by 46.0% (95% UI: 43.7-48.2), YLD rates declined by 4.0% (4.2-4.9), DALY rates by 31.7% (29.2-34.4). For both YLLs and YLDs, greater relative declines were observed for females. There was a large decrease in communicable, maternal, neonatal, and nutritional disease DALYs (48.2%; 46.3-50.4). DALYs due to non-communicable diseases (NCDs) decreased slightly (2.0%; 0.1-4.6). In 2017, Poland performed better than CE as a whole (ranked fourth for YLLs, sixth for YLDs, and fifth for DALYs) and achieved greater reductions in YLLs and DALYs than most CE countries. In 2017 and 1990, the leading cause of YLLs and DALYs in Poland and CE was ischaemic heart disease (IHD), and the leading cause of YLDs was low back pain. In 2017, the top 20 causes of YLLs and YLDs in Poland and CE were the same, although in different order. In Poland, age-standardized DALYs from neonatal causes, other cardiovascular and circulatory diseases, and road injuries declined substantially between 1990-2017, while alcohol use disorders and chronic liver diseases increased. The highest observed-to-expected ratios were seen for alcohol use disorders for YLLs, neonatal sepsis for YLDs, and falls for DALYs (3.21, 2.65, and 2.03, respectively). CONCLUSIONS:There was relatively little geographical variation in premature death and disability in CE in 2017, although some between-country differences existed. Health in Poland has been improving since 1990; in 2017 Poland outperformed CE as a whole for YLLs, YLDs, and DALYs. While the health gap between Poland and Western Europe has diminished, it remains substantial. The shift to NCDs and chronic disability, together with marked between-gender health inequalities, poses a challenge for the Polish health-care system. IHD is still the leading cause of disease burden in Poland, but DALYs from IHD are declining. To further reduce disease burden, an integrated response focused on NCDs and population groups with disproportionally high burden is needed.
Published: 2020
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3. Hypertriglyceridemia–induced acute pancreatitis: A systematic review of the literature

Author: Ionut Negoi, Sorin Paun, Massimo Sartelli, Fausto Catena, Luca Ansaloni, Ruxandra Irina Negoi, and Mircea Beuran
Subjects: Hypertriglyceridemia-induced, Acute pancreatitis, Systematic review, Etiology, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Objective: To summarize the current evidence about the hypertriglyceridemia–induced acute pancreatitis (HAP). Methods: Systematic review of the English language literature was conducted using PubMed/ Medline database from its inception until August 2016. As a searching methodology, we have used a combination of ‘acute pancreatitis’ and ‘hypertriglyceridemia’ as keywords into the title. >Results: The diagnosis of HAP should be based on two out of the three criteria recommended by the international guidelines: characteristic clinical picture, serum pancreatic enzymes, and appropriate imagistics. The diagnosis of HAP should be distinguished between mild hypertriglyceridemia (> 150 mg/dL), which accompanies around one-third of all-causes acute pancreatitis, and severe hypertriglyceridemia (> 1 000 mg/dL) which generates acute pancreatitis. There is mixed evidence regarding a worse prognosis for patients with HAP, and a clear conclusion cannot be drawn. Similar to all the other etiologies, in HAP the initial treatment efforts should be nonspecific and addressed to acute pancreatitis, while pharmacologic and mechanical techniques should be added to lower the serum triglycerides as soon as possible. >Conclusions: We may conclude that HAP should be managed to respect all the general principles, also adding all the available resources to lower the serum triglycerides value, as early as possible in the acute setting and on long-term to prevent recurrences.
Published: 2017
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4. Latest progress of research on acute abdominal injuries

Author: Ionut Negoi, Sorin Paun, Bogdan Stoica, Ioan Tanase, Mihaela Vartic, Ruxandra Irina Negoi, Sorin Hostiuc, and Mircea Beuran
Subjects: Polytrauma, Abdominal injuries, Management, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Major abdominal trauma, both blunt and penetrating, is commonly seen nowadays, being particularly difficult to manage due to the frequent altered mental status of the patients and severity of associated injuries. The review article aims to make an uptodate study of the current strategies for therapeutic approach of abdominal injuries in polytrauma setting. Review of the medical literature is up to 2015, by using the PubMed/Medline, Science Direct, Cochrane Library and Web of Science databases. We have used different combinations of the keywords of “abdominal trauma”, “liver”, “spleen”, “renal”, to review the reference list of retrieved articles for further relevant studies. Nowadays, we are facing a major change in abdominal trauma therapeutic approach, due to the continuous extending indications and very high successful rate of selective nonoperative management, completed or not with minimally invasive techniques like angiography and angiographic embolization. New imaging methods offer a high-quality characterization of solid organ injuries, being a secure support for decision algorithm in polytrauma patients. After a continuous decrease in number of laparotomies for trauma, new techniques should be developed for maintaining and developing the trauma surgeons' skills. According to the current standards, for a low morbidity and mortality, the trauma patients may be approached by a multidisciplinary and experienced trauma team. Even if nonoperative management is continuously expanding, this may be applied only by a trained and skillful trauma surgeon, who is able to perform difficult surgical techniques at any moments.
Published: 2016
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5. Mortality after acute trauma: Progressive decreasing rather than a trimodal distribution

Author: Ionut Negoi, Sorin Paun, Sorin Hostiuc, Bogdan Stoica, Ioan Tanase, Ruxandra Irina Negoi, Gabriel Constantinescu, and Mircea Beuran
Subjects: Polytrauma, Major abdominal trauma, Mortality, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Objective: To characterize the pattern of mortality for major trauma patients. Methods: Retrospective study of major trauma patients admitted in a Level I trauma center, during the latest 5 years was conducted. Selection criteria included (1) injury severity score (ISS) > 16 and (2) in-hospital death. Results: There were 47 patients, with a mean age of 37.2 ± 19.9 years. The mean ISS was 37.6 ± 12.7 and the mean revised trauma score was 4.5 ± 2.2. Computed tomography scan on admission was done in 18 (38%) patients, 20% being hemodynamically unstable (P = 0.001). The diagnostic peritoneal lavage was performed in 10 (22%) cases, 23.3% being hemodynamically unstable (P > 0.05). The mean number of intraabdominal injuries was 3. The need for transfusion was 8.2 ± 6.7 units. The mean time to death was 4.9 days. Early death was secondary to hemorrhagic shock (HS) (ISS = 35.2 ± 15.9, P > 0.05, revised trauma score = 3.74 ± 2.70, P = 0.008) and multiple organ failure (ISS = 36.6 ± 14.1, P > 0.05, revised trauma score = 5.94 ± 1.34, P = 0.008) was the cause for later mortality. Combined liver and splenic injuries were found in 13 cases, with secondary death through HS in 5 and multiple system organ failure (MSOF) in 8 cases. Combined liver, splenic and kidney injuries were found in 5 cases (cause of death: HS 2 cases, MSOF 3 cases). A total of 14 patients had associated head, thorax, abdomen and extremity trauma (cause of death: cerebral trauma 6 cases, MSOF 5 cases, HS 2 cases); 5 patients had thorax and abdomen trauma (cause of death: HS 5 cases); 8 patients had thorax, abdomen and extremity trauma (cause of death: MSOF 5 cases, HS 3 cases); 3 patients had abdomen and extremity trauma (HS 2 cases). We did not find a trimodal time distribution for mortality. Conclusions: The trimodal time distribution of mortality remains a milestone in trauma education and research. Nevertheless, it must be questioned in the modern and very efficient trauma systems, but still very actual for developing trauma care systems. In conclusion, the pattern of mortality due to major trauma seems decreasing continuously with time rather than presenting high peaks of frequency at some moments.
Published: 2015
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6. Massive lower gastrointestinal bleeding after low anterior resection for middle rectal cancer – case report

Author: Mircea Beuran, Ionut Negoi, Sorin Paun, Valentina Negoita, Bogdan Stoica, Ioan Tanase, Mihaela Vartic, Ruxandra Irina Negoi, and Sorin Hostiuc
Subjects: Rectal cancer, Postoperative bleeding, Angioembolization, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Objective: To emphasize the value of emergency diagnostic angiography and angioembolization in massive postoperative bleeding. Methods: A case report was presented and electronic search of U.S. National Library of Medicine National Institutes of Health PubMed/MEDLINE, EMBASE, Google Scholar, ISI Web of Knowledge, to identify original articles and reviews about the subject. Results: A 55 year-old male patient was addmited for rectal bleeding. ECOG index=2, digital rectal examination revealed the inferior pole of a middle rectal tumor. Colonoscopy exam validated the presence of a middle rectal tumor, 8 cm from the anal verge. CT scan showed rectal wall thickening up to 3 cm, that extends 9 cm proximally, whit infiltration of the perirectal fatty tissue and multiple enlarged lymph nodes up to 12 mm in dimension. There was a laparoscopic converted to open approach, with low anterior resection of the rectum and total mesorectal excision, an end to end stapled colorectal anastomosis and protective loop ileostomy. In the 5th postoperative day a massive lower gastrointestinal bleeding occured, with hypovolemic shock and a decrease in hemoglobin. Emergency angiography was performed. This revealed active bleeding from an internal iliac branch that was successfully angioembolized. Conclusions: Angiography with angioembolization is an effective tool in emergency setting, avoiding the morbidity and associated mortality of a surgical reinervention. In early postoperative hemorrhages, only a rapid clinical recognition, a personalized diagnostic workup and an agressive intervention may offer the patient the best chances for cure.
Published: 2015
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7. Quality management in general surgery: a review of the literature

Author: Mircea Beuran, Ionut Negoi, Sorin Paun, Mihaela Vartic, Bogdan Stoica, Ioan Tănase, Ruxandra Irina Negoi, and Sorin Hostiuc
Subjects: Quality management, Healthcare, General surgery, Trauma, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Introduction: Total quality management is a systematic approach focused on satisfying customers' expectations, identifying problems, analytically solving patient's problems and to implement continuous quality improvement. Method: Systematic review of the English language medical literature, using electronic search of the Pubmed, ProQuest and ScienceDirect databases with different combinations of the keywords: total quality management, healthcare, trauma, and minimally invasive surgery. Results: The assessment of outcomes in surgery represents a part of the quality assurance of patients' care. Usually, the surgeons have their own set of mental variables that can predict good and bad outcomes Surveys of complication rates and outcome are a poor substitute for quality control. For the reported complications it is impossible to know which complications are real (inherent to surgery and unavoidable) and which are a consequence of a mistake or an error in judgment. For polytrauma patients, optimal outcome requires an initial management fulfilling a high standard of quality assurance. A prerequisite is the availability of adequate resources at all times, including personnel, technical equipment, and special designed emergency room. Conclusions: Romanian hospitals need a more aggressive implementation of total quality management policy, in order to maintain their competitiveness on nowadays European Union competitive market.
Published: 2014
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8. Complex Perineal Trauma with Anorectal Avulsion

Author: Adelina Maria Cruceru, Ionut Negoi, Sorin Paun, Sorin Hostiuc, Ruxandra Irina Negoi, and Mircea Beuran
Subjects: Surgery, RD1-811
Abstract: Introduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock. Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture and massive perineal soft tissue destruction and anorectal avulsion. On arrival, the systolic blood pressure was 85 mm Hg and the hemoglobin was 7.1 g/dL. The patient was transported to the operating room, and perineal lavage, hemostasis, and repacking were performed. After 12 hours in the Intensive Care Unit, the abdominal ultrasonography revealed free peritoneal fluid. We decided emergency laparotomy, and massive hemoperitoneum due to intraperitoneal rupture of pelvic hematoma was confirmed. Pelvic packing controlled the ongoing diffuse bleeding. After 48 hours, the relaparotomy with packs removal and loop sigmoid colostomy was performed. The postoperative course was progressive favorable, with discharge after 70 days and colostomy closure after four months, with no long-term complications. Conclusions. Severe perineal injuries are associated with significant morbidity and mortality. Their management in high volume centers, with experience in colorectal and trauma surgery, allocating significant human and material resources, decreases the early mortality and long-term complications, offering the best quality of life for patients.
Published: 2016
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9. Most small bowel cancers are revealed by a complication

Author: Ionut Negoi, Sorin Paun, Sorin Hostiuc, Bodgan Stoica, Ioan Tanase, Ruxandra Irina Negoi, and Mircea Beuran
Subjects: Intestino delgado/patologia, Neoplasias, Emergências, Medicine
Abstract: ABSTRACT Objective To characterize the pattern of primary small bowel cancers in a tertiary East-European hospital. Methods A retrospective study of patients with small bowel cancers admitted to a tertiary emergency center, over the past 15 years. Results There were 57 patients with small bowel cancer, representing 0.039% of admissions and 0.059% of laparotomies. There were 37 (64.9%) men, mean age of 58 years; and 72 years for females. Out of 57 patients, 48 (84.2%) were admitted due to an emergency situation: obstruction in 21 (38.9%), perforation in 17 (31.5%), upper gastrointestinal bleeding in 8 (14.8%), and lower gastrointestinal bleeding in 2 (3.7%). There were 10 (17.5%) duodenal tumors, 21 (36.8%) jejunal tumors and 26 (45.6%) ileal tumors. The most frequent neoplasms were gastrointestinal stromal tumor in 24 patients (42.1%), adenocarcinoma in 19 (33.3%), lymphoma in 8 (14%), and carcinoids in 2 (3.5%). The prevalence of duodenal adenocarcinoma was 14.55 times greater than that of the small bowel, and the prevalence of duodenal stromal tumors was 1.818 time greater than that of the small bowel. Obstruction was the complication in adenocarcinoma in 57.9% of cases, and perforation was the major local complication (47.8%) in stromal tumors. Conclusion Primary small bowel cancers are usually diagnosed at advanced stages, and revealed by a local complication of the tumor. Their surgical management in emergency setting is associated to significant morbidity and mortality rates.
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10. Global fertility in 204 countries and territories, 1950-2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Author: V Bhattacharjee, N, E Schumacher, A, Aali, A, Habtegiorgis Abate, Y, Abbasgholizadeh, R, Abbasian, M, Abbasi-Kangevari, M, Abbastabar, H, Abd ElHafeez, S, Abd-Elsalam, S, Abdollahi, M, Abdollahifar, M, Abdoun, M, Abdullahi, A, Abebe, M, Shawel Abebe, S, Abiodun, O, Abolhassani, H, Abolmaali, M, Abouzid, M, Beressa Aboye, G, Guimarães Abreu, L, Aberhe Abrha, W, M Abrigo, M, Abtahi, D, Abualruz, H, Abubakar, B, Abu-Gharbieh, E, Me Abu-Rmeileh, N, Girum Girum Adal, T, Molla Adane, M, Atanda Adeagbo Adeagbo, O, Adesoji Adedoyin, R, Adekanmbi, V, Aden, B, Victor Adepoju, A, O Adetokunboh, O, Bunmi Adetunji, J, Adedayo Adeyinka, D, Israel Adeyomoye, O, Estiningtyas Sakilah Adnani, Q, Adra, S, Felix Afolabi, R, Afyouni, S, Sohail Afzal, M, Afzal, S, Aghamiri, S, Agodi, A, Agyemang-Duah, W, Opoku Ahinkorah, B, J Ahlstrom, A, Ahmad, A, Ahmad, D, Ahmad, F, M Ahmad, M, Ahmad, S, Ahmad, T, Ahmed, A, Ahmed, H, A Ahmed, L, Saleh Ahmed, M, Anees Ahmed, S, Ajami, M, Aji, B, Taddesse Akalu, G, Akbarialiabad, H, Olusola Akinyemi, R, Ahmed Akkaif, M, Akkala, S, Al Hamad, H, Mahfuz Al Hasan, S, Al Qadire, M, Mohammed Ali Al-Ahdal, T, O Alalalmeh, S, A Alalwan, T, Al-Aly, Z, Alam, K, Mustafa Al-Amer, R, Mashhour Alanezi, F, M Alanzi, T, Albakri, A, Albashtawy, M, T AlBataineh, M, Alemi, H, Alemi, S, Mulugeta Alemu, Y, Al-Eyadhy, A, Ali Saeed Al-Gheethi, A, F Alhabib, K, Alhajri, N, Alhalaiqa Naji Alhalaiqa, F, Kaba Alhassan, R, Ali, A, Abdulqadir Ali, B, Ali, L, Usman Ali, M, Ali, R, Shujait Shujait Ali, S, Mohammad Alif, S, Aligol, M, Alijanzadeh, M, M Aljasir, M, Mohamed Aljunid, S, Al-Marwani, S, Uy Almazan, J, M Al-Mekhlafi, H, Almidani, O, A Alomari, M, Al-Omari, B, S Alqahtani, J, Yaseen Alqutaibi, A, M Al-Raddadi, R, Khalifah Al-Sabah, S, Altaf, A, A Al-Tawfiq, J, A Altirkawi, K, Oyine Aluh, D, Jawad Alvi, F, Alvis-Guzman, N, Alwafi, H, Mohammed Al-Worafi, Y, Aly, H, Aly, S, H Alzoubi, K, Kwabena Ameyaw, E, Tawfik Amin, T, Amindarolzarbi, A, Amini-Rarani, M, Amiri, S, Gyamfuah Ampomah, I, A Amugsi, D, Adeniyi Amusa, G, Ancuceanu, R, Anderlini, D, Prata Andrade, P, Liliana Andrei, C, Andrei, T, Anil, A, Anil, S, Ansar, A, Ansari-Moghaddam, A, M Antony, C, Antriyandarti, E, Anvari, S, Anwar, S, Anwer, R, Edward Anyasodor, A, Arabloo, J, Arabzadeh Bahri, R, A Arafa, E, Arafat, M, Margarida Araújo, A, Y Aravkin, A, Aremu, A, Aripov, T, Arkew, M, Armocida, B, Ärnlöv, J, Arooj, M, A Artamonov, A, Arulappan, J, Taiwo Aruleba, R, Arumugam, A, Asadi-Lari, M, Asemi, Z, Asgary, S, Asghariahmadabad, M, Asghari-Jafarabadi, M, Yesse Ashemo, M, Ashraf, M, Ashraf, T, O Asika, M, Shamsadin Athari, S, Moh'd Wahbi Atout, M, Atreya, A, Aujayeb, A, Ausloos, M, Avan, A, Mulat Aweke, A, Melaku Ayele, G, Mohammad Ayyoubzadeh, S, Azadnajafabad, S, S Azevedo, R, Y Azzam, A, Badar, M, D Badiye, A, Baghdadi, S, Bagheri, N, Bagherieh, S, Bahmanziari, N, Bai, R, Amin Baig, A, L Baker, J, T Bako, A, Kaur Bakshi, R, Balasubramanian, M, Constantin Baltatu, O, Bam, K, Banach, M, 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Nima Sanadgol, Francesca Sanna, Milena M Santric-Milicevic, Haaris Saqib, Sivan Yegnanarayana Iyer Saraswathy, Aswini Saravanan, Babak Saravi, Yaser Sarikhani, Tanmay Sarkar, Rodrigo Sarmiento-Suárez, Gargi Sachin Sarode, Sachin C Sarode, Arash Sarveazad, Brijesh Sathian, Thirunavukkarasu Sathish, Anudeep Sathyanarayan, Abu Sayeed, Md Abu Sayeed, Nikolaos Scarmeas, Winfried Schlee, Art Schuermans, David C Schwebel, Falk Schwendicke, Siddharthan Selvaraj, Pallav Sengupta, Subramanian Senthilkumaran, Sadaf G Sepanlou, Dragos Serban, Edson Serván-Mori, Yashendra Sethi, SeyedAhmad SeyedAlinaghi, Seyed Arsalan Seyedi, Allen Seylani, Mahan Shafie, Jaffer Shah, Pritik A Shah, Ataollah Shahbandi, Samiah Shahid, Moyad Jamal Shahwan, Ahmed Shaikh, Masood Ali Shaikh, Muhammad Aaqib Shamim, Mehran Shams-Beyranvand, Mohammad Anas Shamsi, Mohd Shanawaz, Abhishek Shankar, Mohammed Shannawaz, Medha Sharath, Sadaf Sharfaei, Amin Sharifan, Javad Sharifi-Rad, Manoj Sharma, Rajesh Sharma, Ujjawal Sharma, Vishal Sharma, Rajesh P Shastry, Amin Shavandi, David H Shaw, Amir Mehdi Shayan, Maryam Shayan, Amr Mohamed Elsayed Shehabeldine, Aziz Sheikh, Rahim Ali Sheikhi, Manjunath Mala Shenoy, Pavanchand H Shetty, Peilin Shi, Desalegn Shiferaw, Mika Shigematsu, Rahman Shiri, Reza Shirkoohi, Aminu Shittu, Velizar Shivarov, Farhad Shokraneh, Sina Shool, Seyed Afshin Shorofi, Kanwar Hamza Shuja, Kerem Shuval, Emmanuel Edwar Siddig, João Pedro Silva, Luís Manuel Lopes Rodrigues Silva, Soraia Silva, Biagio Simonetti, Anjali Singal, Abhinav Singh, Balbir Bagicha Singh, Jasvinder A Singh, Md Shahjahan Siraj, Georgia Smith, Bogdan Socea, Anton Sokhan, Ranjan Solanki, Shipra Solanki, Hamidreza Soleimani, Sameh S M Soliman, Yonatan Solomon, Yimeng Song, Reed J D Sorensen, Michael Spartalis, Chandrashekhar T Sreeramareddy, Vijay Kumar Srivastava, Muhammad Haroon Stanikzai, Vladimir I Starodubov, Antonina V Starodubova, Simona Cătălina Stefan, Paschalis Steiropoulos, Mark A Stokes, Vetriselvan Subramaniyan, Muhammad Suleman, Rizwan Suliankatchi Abdulkader, Abida Sultana, Jing Sun, Chandan Kumar Swain, Bryan L Sykes, Lukasz Szarpak, Mindy D Szeto, Miklós Szócska, Payam Tabaee Damavandi, Rafael Tabarés-Seisdedos, Ozra Tabatabaei Malazy, Seyed-Amir Tabatabaeizadeh, Shima Tabatabai, Karen M Tabb, Mohammad Tabish, Moslem Taheri Soodejani, Jabeen Taiba, Ardeshir Tajbakhsh, Iman M Talaat, Ashis Talukder, Mircea Tampa, Jacques Lukenze Tamuzi, Ker-Kan Tan, Haosu Tang, Derbie Alemu DA Tareke, Mengistie Kassahun Tariku, Vivian Y Tat, Seyed Mohammad Tavangar, Mojtaba Teimoori, Mohamad-Hani Temsah, Reem Mohamad Hani Temsah, Masayuki Teramoto, Dufera Rikitu Terefa, Riki Tesler, Enoch Teye-Kwadjo, Ramna Thakur, Pugazhenthan Thangaraju, Kavumpurathu Raman Thankappan, Rekha Thapar, Samar Tharwat, Rasiah Thayakaran, Nihal Thomas, Ales Tichopad, Jansje Henny Vera Ticoalu, Tenaw Yimer Tiruye, Mariya Vladimirovna Titova, Marcello Tonelli, Marcos Roberto Tovani-Palone, Eugenio Traini, Jasmine T Tran, Nghia Minh Tran, Indang Trihandini, Samuel Joseph Tromans, Thien Tan Tri Tai Truyen, Aristidis Tsatsakis, Evangelia Eirini Tsermpini, Munkhtuya Tumurkhuu, Stefanos Tyrovolas, Sayed Mohammad Nazim Uddin, Aniefiok John Udoakang, Arit Udoh, Atta Ullah, Saeed Ullah, Sana Ullah, Srikanth Umakanthan, Chukwuma David Umeokonkwo, Brigid Unim, Bhaskaran Unnikrishnan, Era Upadhyay, Jibrin Sammani Usman, Marco Vacante, Seyed Mohammad Vahabi, Asokan Govindaraj Vaithinathan, Rohollah Valizadeh, Jef Van den Eynde, Elena Varavikova, Orsolya Varga, Priya Vart, Shoban Babu Varthya, Tommi Juhani Vasankari, Balachandar Vellingiri, Deneshkumar Venugopal, Nicholas Alexander Verghese, Madhur Verma, Massimiliano Veroux, Georgios-Ioannis Verras, Dominique Vervoort, Jorge Hugo Villafañe, Manish Vinayak, Francesco S Violante, Mukesh Vishwakarma, Sergey Konstantinovitch Vladimirov, Vasily Vlassov, Bay Vo, Simona Ruxandra Volovat, Theo Vos, Isidora S Vujcic, Hatem A Wafa, Yasir Waheed, Elias Bekele Wakwoya, Cong Wang, Denny Wang, Fang Wang, Shu Wang, Yanzhong Wang, Yuan-Pang Wang, Paul Ward, Emebet Gashaw Wassie, Stefanie Watson, Marcia R Weaver, Kosala Gayan Weerakoon, Daniel J Weiss, Katherine M Wells, Yi Feng Wen, Ronny Westerman, Taweewat Wiangkham, Dakshitha Praneeth Wickramasinghe, Nuwan Darshana Wickramasinghe, Peter Willeit, Yohannes Addisu Wondimagegene, Felicia Wu, Juan Xia, Hong Xiao, Gelin Xu, Suowen Xu, Xiaoyue Xu, Ali Yadollahpour, Shirin Yaghoobpoor, Tina Yaghoobpour, Sajad Yaghoubi, Zwanden Sule Yahaya, Danting Yang, Lin Yang, Yuichiro Yano, Habib Yaribeygi, Pengpeng Ye, Renjulal Yesodharan, Subah Abderehim Yesuf, Saber Yezli, Amanuel Yigezu, Paul Yip, Dong Keon Yon, Naohiro Yonemoto, Yuyi You, Mustafa Z Younis, Zabihollah Yousefi, Chuanhua Yu, Yong Yu, Chun-Wei Yuan, Nima Zafari, Fathiah Zakham, Nazar Zaki, Giulia Zamagni, Milad Zandi, Ghazal G Z Zandieh, Moein Zangiabadian, Mikhail Sergeevich Zastrozhin, Haijun Zhang, Meixin Zhang, Yunquan Zhang, Chenwen Zhong, Juexiao Zhou, Bin Zhu, Lei Zhu, Magdalena Zielińska, Zhiyong Zou, Samer H Zyoud, Christopher J L Murray, Amanda E Smith, and Stein Emil Vollset
Abstract: Background: Accurate assessments of current and future fertility-including overall trends and changing population age structures across countries and regions-are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. Methods: To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10-54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in
Published: 2024

11. Primary Aortoduodenal Fistula: First you Should Suspect it

Author: Mircea Beuran, Ionut Negoi, Ruxandra Irina Negoi, Sorin Hostiuc, and Sorin Paun
Subjects: Aorta, Abdominal, Duodenum, Digestive System Fistula, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: ABSTRACT A 59 year-old patient was admitted with upper gastrointestinal bleeding. The clinical exam showed mild hypotension and blood samples revealed acute anemia (hemoglobin = 7.5 g/dl). Emergency computed tomography showed an infrarenal abdominal aortic aneurysm and extravasation of the arterial contrast material toward the digestive tract. The patient was transported to the operating room for emergency laparotomy, which showed an aortoduodenal fistula. After proximal and distal aortic vascular control, the two anatomical structures were dissected with duodenorrhaphy, patch repair of the aortic tear and omentum interposition. The postoperative recovery was uneventful, with discharge after 12 days.
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12. Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

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Asemahagn, Thomas Astell-Burt, Seyyed Shamsadin Athari, Desta Debalkie Atnafu, Prince Atorkey, Alok Atreya, Floriane Ausloos, Marcel Ausloos, Getinet Ayano, Martin Amogre ayanore Ayanore, Olatunde O Ayinde, Jose L Ayuso-Mateos, Sina Azadnajafabad, Melkalem Mamuye Azanaw, Mohammadreza Azangou-Khyavy, Amirhossein Azari Jafari, Ahmed Y Azzam, Ashish D Badiye, Nasser Bagheri, Sara Bagherieh, Mohan Bairwa, Shankar M Bakkannavar, Ravleen Kaur Bakshi, Awraris Hailu Balchut/Bilchut, Till Winfried Bärnighausen, Fabio Barra, Amadou Barrow, Pritish Baskaran, Luis Belo, Derrick A Bennett, Isabela M Benseñor, Akshaya Srikanth Bhagavathula, Neeraj Bhala, Ashish Bhalla, Nikha Bhardwaj, Pankaj Bhardwaj, Sonu Bhaskar, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Bagas Suryo Bintoro, Elena A Elena Blokhina, Belay Boda Abule Bodicha, Archith Boloor, Cristina Bosetti, Dejana Braithwaite, Hermann Brenner, Nikolay Ivanovich Briko, Andre R Brunoni, Zahid A Butt, Chao Cao, Yin Cao, Rosario Cárdenas, 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Abdul-Aziz Seidu, Nachimuthu Senthil Kumar, SeyedAhmad SeyedAlinaghi, Allen Seylani, Feng Sha, Sarvenaz Shahin, Fariba Shahraki-Sanavi, Shayan Shahrokhi, Masood Ali Shaikh, Elaheh Shaker, Murad Ziyaudinovich Shakhmardanov, Mehran Shams-Beyranvand, Sara Sheikhbahaei, Rahim Ali Sheikhi, Adithi Shetty, Jeevan K Shetty, Damtew Solomon Shiferaw, Mika Shigematsu, Rahman Shiri, Reza Shirkoohi, K M Shivakumar, Velizar Shivarov, Parnian Shobeiri, Roman Shrestha, Negussie Boti Sidemo, Inga Dora Sigfusdottir, Diego Augusto Santos Silva, Natacha Torres da Silva, Jasvinder A Singh, Surjit Singh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, David A Sleet, Marco Solmi, YONATAN SOLOMON, Suhang Song, Yimeng Song, Reed J D Sorensen, Sergey Soshnikov, Ireneous N Soyiri, Dan J Stein, Sonu Hangma Subba, Miklós Szócska, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Majid Taheri, Ker-Kan Tan, Minale Tareke, Elvis Enowbeyang Tarkang, Gebremaryam Temesgen, Worku Animaw Temesgen, Mohamad-Hani Temsah, Kavumpurathu Raman Thankappan, Rekha Thapar, Nikhil Kenny Thomas, Chalachew Tiruneh, Jovana Todorovic, Marco Torrado, Mathilde Touvier, Marcos Roberto Tovani-Palone, Mai Thi Ngoc Tran, Sergi Trias-Llimós, Jaya Prasad Tripathy, Alireza Vakilian, Rohollah Valizadeh, Mehdi Varmaghani, Shoban Babu Varthya, Tommi Juhani Vasankari, Theo Vos, Birhanu Wagaye, Yasir Waheed, Mandaras Tariku Walde, Cong Wang, Yanzhong Wang, Yuan-Pang Wang, Ronny Westerman, Nuwan Darshana Wickramasinghe, Abate Dargie Wubetu, Suowen Xu, Kazumasa Yamagishi, Lin Yang, Gesila Endashaw E Yesera, Arzu Yigit, Vahit Yiğit, Ayenew Engida Ayenew Engida Yimaw, Dong Keon Yon, Naohiro Yonemoto, Chuanhua Yu, Siddhesh Zadey, Mazyar Zahir, Iman Zare, Mikhail Sergeevich Zastrozhin, Anasthasia Zastrozhina, Zhi-Jiang Zhang, Chenwen Zhong, Mohammad Zmaili, Yves Miel H Zuniga, Emmanuela Gakidou, University of St Andrews. School of Medicine, University of St Andrews. Population and Behavioural Science Division, Department of Public Health, University of Helsinki, Hjelt Institute (-2014), Helsinki Inequality Initiative (INEQ), Clinicum, Helsinki University Hospital Area, Bill & Melinda Gates Foundation, King Edward Medical University (Pakistán), Alexander von Humboldt Foundation, University of Oxford (Reino Unido), Medical Research Council (Reino Unido), NIH - National Institute of Mental Health (NIMH) (Estados Unidos), Canada Research Chairs, National Health and Medical Research Council (Australia), National Heart Foundation of Australia, Ministry of Education, Science and Technological Development (Serbia), Wellcome Trust, NIH - National Institute on Aging (NIA) (Estados Unidos), Finlands Akademi (Finlandia), Panjab University (India), Federal Ministry of Education & Research (Alemania), National Council for Scientific and Technological Development (Brasil), Danish National Research Foundation, Queensland Centre for Mental Health Research (Australia), South African Medical Research Council, National Natural Science Foundation of China, Charles Sturt University (Australia), Ain Shams University (Egipto), Mizoram University (India), Kasturba Medical College (India), Manipal Academy of Higher Education (India), Coordenação de Aperfeicoamento de Pessoal de Nível Superior (Brasil), Ministerio de Ciencia e Innovación (España), Collaborators, GBD 2020 Alcohol, Bryazka, Dana, Reitsma, Marissa B, Griswold, Max G, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbasi-Kangevari, Mohsen, Abbasi-Kangevari, Zeinab, Abdoli, Amir, Abdollahi, Mohammad, Abdullah, Abu Yousuf Md, Abhilash, E S, Abu-Gharbieh, Eman, Acuna, Juan Manuel, Addolorato, Giovanni, Adebayo, Oladimeji M, Adekanmbi, Victor, Adhikari, Kishor, Adhikari, Sangeet, Adnani, Qorinah Estiningtyas Sakilah, Afzal, Saira, Agegnehu, Wubetu Yimam, Aggarwal, Manik, Ahinkorah, Bright Opoku, Ahmad, Araz Ramazan, Ahmad, Sajjad, Ahmad, Tauseef, Ahmadi, Ali, Ahmadi, Sepideh, Ahmed, Haroon, Ahmed Rashid, Tarik, Akunna, Chisom Joyqueenet, Al Hamad, Hanadi, Alam, Md Zakiul, Alem, Dejene Tsegaye, Alene, Kefyalew Addi, Alimohamadi, Yousef, Alizadeh, Atiyeh, Allel, Kasim, Alonso, Jordi, Alvand, Saba, Alvis-Guzman, Nelson, Amare, Firehiwot, Ameyaw, Edward Kwabena, Amiri, Sohrab, Ancuceanu, Robert, Anderson, Jason A, Andrei, Catalina Liliana, Andrei, Tudorel, Arabloo, Jalal, Arshad, Muhammad, Artamonov, Anton A, Aryan, Zahra, Asaad, Malke, Asemahagn, Mulusew A, Astell-Burt, Thoma, Athari, Seyyed Shamsadin, Atnafu, Desta Debalkie, Atorkey, Prince, Atreya, Alok, Ausloos, Floriane, Ausloos, Marcel, Ayano, Getinet, Ayanore, Martin Amogre ayanore, Ayinde, Olatunde O, Ayuso-Mateos, Jose L, Azadnajafabad, Sina, Azanaw, Melkalem Mamuye, Azangou-Khyavy, Mohammadreza, Azari Jafari, Amirhossein, Azzam, Ahmed Y, Badiye, Ashish D, Bagheri, Nasser, Bagherieh, Sara, Bairwa, Mohan, Bakkannavar, Shankar M, Bakshi, Ravleen Kaur, Balchut/bilchut, Awraris Hailu, Bärnighausen, Till Winfried, Barra, Fabio, Barrow, Amadou, Baskaran, Pritish, Belo, Lui, Bennett, Derrick A, Benseñor, Isabela M, Bhagavathula, Akshaya Srikanth, Bhala, Neeraj, Bhalla, Ashish, Bhardwaj, Nikha, Bhardwaj, Pankaj, Bhaskar, Sonu, Bhattacharyya, Krittika, Bhojaraja, Vijayalakshmi S, Bintoro, Bagas Suryo, Blokhina, Elena A Elena, Bodicha, Belay Boda Abule, Boloor, Archith, Bosetti, Cristina, Braithwaite, Dejana, Brenner, Hermann, Briko, Nikolay Ivanovich, Brunoni, Andre R, Butt, Zahid A, Cao, Chao, Cao, Yin, Cárdenas, Rosario, Carvalho, Andre F, Carvalho, Márcia, Castaldelli-Maia, Joao Mauricio, Castelpietra, Giulio, Castro-de-Araujo, Luis F S, Cattaruzza, Maria Sofia, Chakraborty, Promit Ananyo, Charan, Jaykaran, Chattu, Vijay Kumar, Chaurasia, Akhilanand, Cherbuin, Nicola, Chu, Dinh-Toi, Chudal, Nandita, Chung, Sheng-Chia, Churko, Chuchu, Ciobanu, Liliana G, Cirillo, Massimo, Claro, Rafael M, Costanzo, Simona, Cowden, Richard G, Criqui, Michael H, Cruz-Martins, Natália, Culbreth, Garland T, Dachew, Berihun Assefa, Dadras, Omid, Dai, Xiaochen, Damiani, Giovanni, Dandona, Lalit, Dandona, Rakhi, Daniel, Beniam Darge, Danielewicz, Anna, Darega Gela, Jiregna, Davletov, Kairat, de Araujo, Jacyra Azevedo Paiva, de Sá-Junior, Antonio Rei, Debela, Sisay Abebe, Dehghan, Azizallah, Demetriades, Andreas K, Derbew Molla, Meseret, Desai, Rupak, Desta, Abebaw Alemayehu, Dias da Silva, Diana, Diaz, Daniel, Digesa, Lankamo Ena, Diress, Mengistie, Dodangeh, Milad, Dongarwar, Deepa, Dorostkar, Fariba, Dsouza, Haneil Larson, Duko, Bereket, Duncan, Bruce B, Edvardsson, Kristina, Ekholuenetale, Michael, Elgar, Frank J, Elhadi, Muhammed, Elmonem, Mohamed A, Endries, Aman Yesuf, Eskandarieh, Sharareh, Etemadimanesh, Azin, Fagbamigbe, Adeniyi Franci, Fakhradiyev, Ildar Ravisovich, Farahmand, Fatemeh, Farinha, Carla Sofia e Sá, Faro, Andre, Farzadfar, Farshad, Fatehizadeh, Ali, Fauk, Nelsensius Klau, Feigin, Valery L, Feldman, Rachel, Feng, Xiaoqi, Fentaw, Zinabu, Ferrero, Simone, Ferro Desideri, Lorenzo, Filip, Irina, Fischer, Florian, Francis, Joel Msafiri, Franklin, Richard Charle, Gaal, Peter Andra, Gad, Mohamed M, Gallus, Silvano, Galvano, Fabio, Ganesan, Balasankar, Garg, Tushar, Gebrehiwot, Mesfin Gebrehiwot Damtew, Gebremeskel, Teferi Gebru, Gebremichael, Mathewos Alemu, Gemechu, Tadele Regasa, Getacher, Lemma, Getachew, Motuma Erena, Getachew Obsa, Abera, Getie, Asmare, Ghaderi, Amir, Ghafourifard, Mansour, Ghajar, Alireza, Ghamari, Seyyed-Hadi, Ghandour, Lilian A, Ghasemi Nour, Mohammad, Ghashghaee, Ahmad, Ghozy, Sherief, Glozah, Franklin N, Glushkova, Ekaterina Vladimirovna, Godos, Justyna, Goel, Amit, Goharinezhad, Salime, Golechha, Mahaveer, Goleij, Pouya, Golitaleb, Mohamad, Greaves, Felix, Grivna, Michal, Grosso, Giuseppe, Gudayu, Temesgen Worku, Gupta, Bhawna, Gupta, Rajeev, Gupta, Sapna, Gupta, Veer Bala, Gupta, Vivek Kumar, Hafezi-Nejad, Nima, Haj-Mirzaian, Arvin, Hall, Brian J, Halwani, Rabih, Handiso, Tiilahun Beyene, Hankey, Graeme J, Hariri, Sanam, Haro, Josep Maria, Hasaballah, Ahmed I, Hassanian-Moghaddam, Hossein, Hay, Simon I, Hayat, Khezar, Heidari, Golnaz, Heidari, Mohammad, Hendrie, Delia, Herteliu, Claudiu, Heyi, Demisu Zenbaba, Hezam, Kamal, Hlongwa, Mbuzeleni Mbuzeleni, Holla, Ramesh, Hossain, Md Mahbub, Hossain, Sahadat, Hosseini, Seyed Kianoosh, Hosseinzadeh, Mehdi, Hostiuc, Mihaela, Hostiuc, Sorin, Hu, Guoqing, Huang, Junjie, Hussain, Salman, Ibitoye, Segun Emmanuel, Ilic, Irena M, Ilic, Milena D, Immurana, Mustapha, Irham, Lalu Muhammad, Islam, M Mofizul, Islam, Rakibul M, Islam, Sheikh Mohammed Shariful, Iso, Hiroyasu, Itumalla, Ramaiah, Iwagami, Masao, Jabbarinejad, Roxana, Jacob, Loui, Jakovljevic, Mihajlo, Jamalpoor, Zahra, Jamshidi, Elham, Jayapal, Sathish Kumar, Jayarajah, Umesh Umesh, Jayawardena, Ranil, Jebai, Rime, Jeddi, Seyed Ali, Jema, Alelign Tasew, Jha, Ravi Prakash, Jindal, Har Ashish, Jonas, Jost B, Joo, Tama, Joseph, Nitin, Joukar, Farahnaz, Jozwiak, Jacek Jerzy, Jürisson, Mikk, Kabir, Ali, Kabthymer, Robel Hussen, Kamble, Bhushan Dattatray, Kandel, Himal, Kanno, Girum Gebremeskel, Kapoor, Neeti, Karaye, Ibraheem M, Karimi, Salah Eddin, Kassa, Bekalu Getnet, Kaur, Rimple Jeet, Kayode, Gbenga A, Keykhaei, Mohammad, Khajuria, Himanshu, Khalilov, Rovshan, Khan, Imteyaz A, Khan, Moien AB, Kim, Hanna, Kim, Jihee, Kim, Min Seo, Kimokoti, Ruth W, Kivimäki, Mika, Klymchuk, Vitalii, Knudsen, Ann Kristin Skrindo, Kolahi, Ali-Asghar, Korshunov, Vladimir Andreevich, Koyanagi, Ai, Krishan, Kewal, Krishnamoorthy, Yuvaraj, Kumar, G Anil, Kumar, Narinder, Kumar, Nithin, Lacey, Ben, Lallukka, Tea, Lasrado, Savita, Lau, Jerrald, Lee, Sang-woong, Lee, Wei-Chen, Lee, Yo Han, Lim, Lee-Ling, Lim, Stephen S, Lobo, Stany W, Lopukhov, Platon D, Lorkowski, Stefan, Lozano, Rafael, Lucchetti, Giancarlo, Madadizadeh, Farzan, Madureira-Carvalho, Áurea M, Mahjoub, Soleiman, Mahmoodpoor, Ata, Mahumud, Rashidul Alam, Makki, Alaa, Malekpour, Mohammad-Reza, Manjunatha, Narayana, Mansouri, Borhan, Mansournia, Mohammad Ali, Martinez-Raga, Jose, Martinez-Villa, Francisco A, Matzopoulos, Richard, Maulik, Pallab K, Mayeli, Mahsa, Mcgrath, John J, Meena, Jitendra Kumar, Mehrabi Nasab, Entezar, Menezes, Ritesh G, Mensink, Gert B M, Mentis, Alexios-Fotios A, Meretoja, Atte, Merga, Bedasa Taye, Mestrovic, Tomislav, Miao Jonasson, Junmei, Miazgowski, Bartosz, Micheletti Gomide Nogueira de Sá, Ana Carolina, Miller, Ted R, Mini, Gk, Mirica, Andreea, Mirijello, Antonio, Mirmoeeni, Seyyedmohammadsadeq, Mirrakhimov, Erkin M, Misra, Sanjeev, Moazen, Babak, Mobarakabadi, Maryam, Moccia, Marcello, Mohammad, Yousef, Mohammadi, Esmaeil, Mohammadian-Hafshejani, Abdollah, Mohammed, Teroj Abdulrahman, Moka, Nagabhishek, Mokdad, Ali H, Momtazmanesh, Sara, Moradi, Yousef, Mostafavi, Ebrahim, Mubarik, Sumaira, Mullany, Erin C, Mulugeta, Beemnet Tekabe, Murillo-Zamora, Efrén, Murray, Christopher J L, Mwita, Julius C, Naghavi, Mohsen, Naimzada, Mukhammad David, Nangia, Vinay, Nayak, Biswa Prakash, Negoi, Ionut, Negoi, Ruxandra Irina, Nejadghaderi, Seyed Aria, Nepal, Samata, Neupane, Sudan Prasad Prasad, Neupane Kandel, Sandhya, Nigatu, Yeshambel T, Nowroozi, Ali, Nuruzzaman, Khan M, Nzoputam, Chimezie Igwegbe, Obamiro, Kehinde O, Ogbo, Felix Akpojene, Oguntade, Ayodipupo Sikiru, Okati-Aliabad, Hassan, Olakunde, Babayemi Oluwaseun, Oliveira, Gláucia Maria Morae, Omar Bali, Ahmed, Omer, Emad, Ortega-Altamirano, Doris V, Otoiu, Adrian, Otstavnov, Stanislav S, Oumer, Bilcha, P A, Mahesh, Padron-Monedero, Alicia, Palladino, Raffaele, Pana, Adrian, Panda-Jonas, Songhomitra, Pandey, Anamika, Pandey, Ashok, Pardhan, Shahina, Parekh, Tarang, Park, Eun-Kee, Parry, Charles D H, Pashazadeh Kan, Fatemeh, Patel, Jay, Pati, Siddhartha, Patton, George C, Paudel, Uttam, Pawar, Shrikant, Peden, Amy E, Petcu, Ionela-Roxana, Phillips, Michael R, Pinheiro, Marina, Plotnikov, Evgenii, Pradhan, Pranil Man Singh, Prashant, Akila, Quan, Jianchao, Radfar, Amir, Rafiei, Alireza, Raghav, Pankaja Raghav, Rahimi-Movaghar, Vafa, Rahman, Azizur, Rahman, Md Mosfequr, Rahman, Mosiur, Rahmani, Amir Masoud, Rahmani, Shayan, Ranabhat, Chhabi Lal, Ranasinghe, Priyanga, Rao, Chythra R, Rasali, Drona Prakash, Rashidi, Mohammad-Mahdi, Ratan, Zubair Ahmed, Rawaf, David Laith, Rawaf, Salman, Rawal, Lal, Renzaho, Andre M N, Rezaei, Negar, Rezaei, Saeid, Rezaeian, Mohsen, Riahi, Seyed Mohammad, Romero-Rodríguez, Esperanza, Roth, Gregory A, Rwegerera, Godfrey M, Saddik, Basema, Sadeghi, Erfan, Sadeghian, Reihaneh, Saeed, Umar, Saeedi, Farhad, Sagar, Rajesh, Sahebkar, Amirhossein, Sahoo, Harihar, Sahraian, Mohammad Ali, Saif-Ur-Rahman, Km, Salahi, Sarvenaz, Salimzadeh, Hamideh, Samy, Abdallah M, Sanmarchi, Francesco, Santric-Milicevic, Milena M, Sarikhani, Yaser, Sathian, Brijesh, Saya, Ganesh Kumar, Sayyah, Mehdi, Schmidt, Maria Inê, Schutte, Aletta Elisabeth, Schwarzinger, Michaël, Schwebel, David C, Seidu, Abdul-Aziz, Senthil Kumar, Nachimuthu, Seyedalinaghi, Seyedahmad, Seylani, Allen, Sha, Feng, Shahin, Sarvenaz, Shahraki-Sanavi, Fariba, Shahrokhi, Shayan, Shaikh, Masood Ali, Shaker, Elaheh, Shakhmardanov, Murad Ziyaudinovich, Shams-Beyranvand, Mehran, Sheikhbahaei, Sara, Sheikhi, Rahim Ali, Shetty, Adithi, Shetty, Jeevan K, Shiferaw, Damtew Solomon, Shigematsu, Mika, Shiri, Rahman, Shirkoohi, Reza, Shivakumar, K M, Shivarov, Velizar, Shobeiri, Parnian, Shrestha, Roman, Sidemo, Negussie Boti, Sigfusdottir, Inga Dora, Silva, Diego Augusto Santo, Silva, Natacha Torres da, Singh, Jasvinder A, Singh, Surjit, Skryabin, Valentin Yurievich, Skryabina, Anna Aleksandrovna, Sleet, David A, Solmi, Marco, Solomon, Yonatan, Song, Suhang, Song, Yimeng, Sorensen, Reed J D, Soshnikov, Sergey, Soyiri, Ireneous N, Stein, Dan J, Subba, Sonu Hangma, Szócska, Mikló, Tabarés-Seisdedos, Rafael, Tabuchi, Takahiro, Taheri, Majid, Tan, Ker-Kan, Tareke, Minale, Tarkang, Elvis Enowbeyang, Temesgen, Gebremaryam, Temesgen, Worku Animaw, Temsah, Mohamad-Hani, Thankappan, Kavumpurathu Raman, Thapar, Rekha, Thomas, Nikhil Kenny, Tiruneh, Chalachew, Todorovic, Jovana, Torrado, Marco, Touvier, Mathilde, Tovani-Palone, Marcos Roberto, Tran, Mai Thi Ngoc, Trias-Llimós, Sergi, Tripathy, Jaya Prasad, Vakilian, Alireza, Valizadeh, Rohollah, Varmaghani, Mehdi, Varthya, Shoban Babu, Vasankari, Tommi Juhani, Vos, Theo, Wagaye, Birhanu, Waheed, Yasir, Walde, Mandaras Tariku, Wang, Cong, Wang, Yanzhong, Wang, Yuan-Pang, Westerman, Ronny, Wickramasinghe, Nuwan Darshana, Wubetu, Abate Dargie, Xu, Suowen, Yamagishi, Kazumasa, Yang, Lin, Yesera, Gesila Endashaw E, Yigit, Arzu, Yiğit, Vahit, Yimaw, Ayenew Engida Ayenew Engida, Yon, Dong Keon, Yonemoto, Naohiro, Yu, Chuanhua, Zadey, Siddhesh, Zahir, Mazyar, Zare, Iman, Zastrozhin, Mikhail Sergeevich, Zastrozhina, Anasthasia, Zhang, Zhi-Jiang, Zhong, Chenwen, Zmaili, Mohammad, Zuniga, Yves Miel H, Gakidou, Emmanuela, Bryazka, D, Reitsma, Mb, Griswold, Mg, Abate, Kh, Abbafati, C, Kangevari, Ma, Kangevari, Za, Abdoli, A, Abdollahi, M, Abdullah, Am, Abhilash, E, Abu Gharbieh, E, Acuna, Jm, Addolorato, G, Adebayo, Om, Adekanmbi, V, Adhikari, K, Adhikari, S, Adnani, Qe, Afzal, S, Agegnehu, Wy, Aggarwal, M, Ahinkorah, Bo, Ahmad, Ar, Ahmad, S, Ahmad, T, Ahmadi, A, Ahmadi, S, Ahmed, H, Rashid, Ta, Akunna, Cj, Al Hamad, H, Alam, Mz, Alem, Dt, Alene, Ka, Alimohamadi, Y, Alizadeh, A, Allel, K, Alonso, J, Alvand, S, Guzman, Na, Amare, F, Ameyaw, Ek, Amiri, S, Ancuceanu, R, Anderson, Ja, Andrei, Cl, Andrei, T, Arabloo, J, Arshad, M, Artamonov, Aa, Aryan, Z, Asaad, M, Asemahagn, Ma, Burt, Ta, Athari, S, Atnafu, Dd, Atorkey, P, Atreya, A, Ausloos, F, Ausloos, M, Ayano, G, Ayanore, Ma, Ayinde, Oo, Mateos, Jla, Azadnajafabad, S, Azanaw, Mm, Khyavy, Ma, Jafari, Aa, Azzam, Ay, Badiye, Ad, Bagheri, N, Bagherieh, S, Bairwa, M, Bakkannavar, Sm, Bakshi, Rk, Balchut, Ah, Null, T, Barra, F, Barrow, A, Baskaran, P, Belo, L, Bennett, Da, Bensenor, Im, Bhagavathula, A, Bhala, N, Bhalla, A, Bhardwaj, N, Bhardwaj, P, Bhaskar, S, Bhattacharyya, K, Bhojaraja, V, Bintoro, B, Blokhina, Eae, Bodicha, Bba, Boloor, A, Bosetti, C, Braithwaite, D, Brenner, H, Briko, Ni, Brunoni, Ar, Butt, Za, Cao, C, Cao, Y, Cardenas, R, Carvalho, Af, Carvalho, M, Maia, Jmc, Castelpietra, G, de Araujo, Lfsc, Cattaruzza, M, Chakraborty, Pa, Charan, J, Chattu, Vk, Chaurasia, A, Cherbuin, N, Chu, Dt, Chudal, N, Chung, Sc, Churko, C, Ciobanu, Lg, Cirillo, M, Claro, Rm, Costanzo, S, Cowden, Rg, Criqui, Mh, Martins, Nc, Culbreth, Gt, Dachew, Ba, Dadras, O, Dai, Xc, Damiani, G, Dandona, L, Dandona, R, Daniel, Bd, Danielewicz, A, Gela, Jd, Davletov, K, de Araujo, Jap, de Sa, Ar, Debela, Sa, Dehghan, A, Demetriades, Ak, Molla, Md, Desai, R, Desta, Aa, da Silva, Dd, Diaz, D, Digesa, Le, Diress, M, Dodangeh, M, Dongarwar, D, Dorostkar, F, Dsouza, Hl, Duko, B, Duncan, Bb, Edvardsson, K, Ekholuenetale, M, Elgar, Fj, Elhadi, M, Elmonem, Ma, Endries, Ay, Eskandarieh, S, Etemadimanesh, A, Fagbamigbe, Af, Fakhradiyev, Ir, Farahmand, F, Farinha, Cse, Faro, A, Farzadfar, F, Fatehizadeh, A, Fauk, Nk, Feigin, Vl, Feldman, R, Feng, Xq, Fentaw, Z, Ferrero, S, Desideri, Lf, Filip, I, Fischer, F, Francis, Jm, Franklin, Rc, Gaal, Pa, Gad, Mm, Gallus, S, Galvano, F, Ganesan, B, Garg, T, Gebrehiwot, Mgd, Gebremeskel, Tg, Gebremichael, Ma, Gemechu, Tr, Getacher, L, Getachew, Me, Obsa, Ag, Getie, A, Ghaderi, A, Ghafourifard, M, Ghajar, A, Ghamari, Sh, Ghandour, La, Nour, Mg, Ghashghaee, A, Ghozy, S, Glozah, Fn, Glushkova, Ev, Godos, J, Goel, A, Goharinezhad, S, Golechha, M, Goleij, P, Golitaleb, M, Greaves, F, Grivna, M, Grosso, G, Gudayu, Tw, Gupta, B, Gupta, R, Gupta, S, Gupta, Vb, Gupta, Vk, Nejad, Nh, Mirzaian, Ah, Hall, Bj, Halwani, R, Handiso, Tb, Hankey, Gj, Hariri, S, Haro, Jm, Hasaballah, Ai, Moghaddam, Hh, Hay, Si, Hayat, K, Heidari, G, Heidari, M, Hendrie, D, Herteliu, C, Heyi, Dz, Hezam, K, Hlongwa, Mm, Holla, R, Hossain, Mm, Hossain, S, Hosseini, Sk, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Hu, Gq, Huang, Jj, Hussain, S, Ibitoye, Se, Ilic, Im, Ilic, Md, Immurana, M, Irham, Lm, Islam, Mm, Islam, Rm, Islam, Sm, Iso, H, Itumalla, R, Iwagami, M, Jabbarinejad, R, Jacob, L, Jakovljevic, M, Jamalpoor, Z, Jamshidi, E, Jayapal, Sk, Jayarajah, Uu, Jayawardena, R, Jebai, R, Jeddi, Sa, Jema, At, Jha, Rp, Jindal, Ha, Jonas, Jb, Joo, T, Joseph, N, Joukar, F, Jozwiak, Jj, Jurisson, M, Kabir, A, Kabthymer, Rh, Kamble, Bd, Kandel, H, Kanno, Gg, Kapoor, N, Karaye, Im, Karimi, Se, Kassa, Bg, Kaur, Rj, Kayode, Ga, Keykhaei, M, Khajuria, H, Khalilov, R, Khan, Ia, Ab Khan, M, Kim, H, Kim, J, Kim, M, Kimokoti, Rw, Kivimaki, M, Klymchuk, V, Knudsen, Ak, Kolahi, Aa, Korshunov, Va, Koyanagi, A, Krishan, K, Krishnamoorthy, Y, Kumar, Ga, Kumar, N, Ben, Lacey, Lallukka, T, Lasrado, S, Lau, J, Lee, Sw, Lee, Wc, Lee, Yh, Lim, Ll, Lim, S, Lobo, Sw, Lopukhov, Pd, Lorkowski, S, Lozano, R, Lucchetti, G, Madadizadeh, F, Mahjoub, S, Mahmoodpoor, A, Mahumud, Ra, Makki, A, Malekpour, Mr, Manjunatha, N, Mansouri, B, Mansournia, Ma, Raga, Jm, Villa, Fam, Matzopoulos, R, Maulik, Pk, Mayeli, M, Mcgrath, Jj, Meena, Jk, Nasab, Em, Menezes, Rg, Mensink, Gbm, Mentis, Afa, Meretoja, A, Merga, Bt, Mestrovic, T, Jonasson, Jm, Miazgowski, B, de Sa, Acmgn, Miller, Tr, Mini, G, Mirica, A, Mirijello, A, Mirmoeeni, S, Mirrakhimov, Em, Misra, S, Moazen, B, Mobarakabadi, M, Moccia, M, Mohammad, Y, Mohammadi, E, Hafshejani, Am, Mohammed, Ta, Moka, N, Mokdad, Ah, Momtazmanesh, S, Moradi, Y, Mostafavi, E, Mubarik, S, Mullany, Ec, Mulugeta, Bt, Zamora, Em, Murray, Cjl, Mwita, Jc, Naghavi, M, Naimzada, Md, Nangia, V, Nayak, Bp, Negoi, I, Negoi, Ri, Nejadghaderi, Sa, Nepal, S, Neupane, Spp, Kandel, Sn, Nigatu, Yt, Nowroozi, A, Nuruzzaman, Km, Nzoputam, Ci, Obamiro, Ko, Ogbo, Fa, Oguntade, A, Aliabad, Ho, Olakunde, Bo, Oliveira, Gmm, Bali, Ao, Omer, E, Altamirano, Dvo, Otoiu, A, Otstavnov, S, Oumer, B, Mahesh, Pa, Monedero, Ap, Palladino, R, Pana, A, Jonas, Sp, Pandey, A, Pardhan, S, Parekh, T, Park, Ek, Parry, Cdh, Kan, Fp, Patel, J, Pati, S, Patton, Gc, Paudel, U, Pawar, S, Peden, Ae, Petcu, Ir, Phillips, Mr, Pinheiro, M, Plotnikov, E, Pradhan, Pm, Prashant, A, Quan, Jc, Radfar, A, Rafiei, A, Raghav, Pr, Movaghar, Vr, Rahman, A, Rahman, Mm, Rahman, M, Rahmani, Am, Rahmani, S, Ranabhat, Cl, Ranasinghe, P, Rao, Cr, Rasali, Dp, Rashidi, Mm, Ratan, Za, Rawaf, Dl, Rawaf, S, Rawal, L, Renzaho, Amn, Rezaei, N, Rezaei, S, Rezaeian, M, Riahi, Sm, Rodriguez, Er, Roth, Ga, Rwegerera, Gm, Saddik, B, Sadeghi, E, Sadeghian, R, Saeed, U, Saeedi, F, Sagar, R, Sahebkar, A, Sahoo, H, Sahraian, Ma, Rahman, Ksu, Salahi, S, Salimzadeh, H, Samy, Am, Sanmarchi, F, Milicevic, Mm, Sarikhani, Y, Sathian, B, Saya, Gk, Sayyah, M, Schmidt, Mi, Schutte, Ae, Schwarzinger, M, Schwebel, Dc, Seidu, Aa, Seyedalinaghi, S, Seylani, A, Sha, F, Shahin, S, Sanavi, F, Shahrokhi, S, Shaikh, Ma, Shaker, E, Shakhmardanov, Mz, Beyranvand, M, Sheikhbahaei, S, Sheikhi, Ra, Shetty, A, Shetty, Jk, Shiferaw, D, Shigematsu, M, Shiri, R, Shirkoohi, R, Shivakumar, Km, Shivarov, V, Shobeiri, P, Shrestha, R, Sidemo, Nb, Sigfusdottir, Id, Silva, Da, da Silva, Nt, Singh, Ja, Singh, S, Skryabin, Vy, Skryabina, Aa, Sleet, Da, Solmi, M, Solomon, Y, Song, S, Song, Ym, Sorensen, Rjd, Soshnikov, S, Soyiri, In, Stein, Dj, Subba, Sh, Szocska, M, Seisdedos, Rt, Tabuchi, T, Taheri, M, Tan, Kk, Tareke, M, Tarkang, Ee, Temesgen, G, Temesgen, Wa, Temsah, Mh, Thankappan, Kr, Thapar, R, Thomas, Nk, Tiruneh, C, Todorovic, J, Torrado, M, Touvier, M, Palone, Mrt, Tran, Mtn, Llimos, St, Tripathy, Jp, Vakilian, A, Valizadeh, R, Varmaghani, M, Varthya, Sb, Vasankari, Tj, Vos, T, Wagaye, B, Waheed, Y, Walde, Mt, Wang, C, Wang, Yz, Wang, Yp, Westerman, R, Wickramasinghe, Nd, Wubetu, Ad, Xu, S, Yamagishi, K, Yang, L, Yesera, Gee, Yigit, A, Yimaw, Ae, Yon, Dk, Yonemoto, N, Yu, Ch, Zadey, S, Zahir, M, Zare, I, Zastrozhin, M, Zastrozhina, A, Zhang, Zj, Zhong, Cw, Zmaili, M, Zuniga, Ymh, Gakidou, E, Madureira-Carvalho, Am, Ciobanu, LG, Gakidou, Emma, and GBD 2020 Alcohol Collaborators
Subjects: Adult, Male, Alcohol Drinking, CONTROL POLICIES, adult, Child, Preschool, Female, Geography, Global Burden of Disease, Global Health, Humans, Middle Aged, Quality-Adjusted Life Years, Risk Factors, NDAS, ALL-CAUSE, GUIDELINES, GBD 2020 Alcohol Collaborators, COST-EFFECTIVENESS, Medicine, General & Internal, DRINKING, SDG 3 - Good Health and Well-being, RA0421, General & Internal Medicine, Quality-Adjusted Life Year, RA0421 Public health. Hygiene. Preventive Medicine, DRINKERS, Child, Preschool, 11 Medical and Health Sciences, METAANALYSIS, MCC, Science & Technology, global burden of disease, Risk Factor, General Medicine, CANCER, alcohol drinking, AC, 3121 General medicine, internal medicine and other clinical medicine, REDUCED MORTALITY, Life Sciences & Biomedicine, Human
Abstract: Background: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods: For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male. Interpretation: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Research reported in this publication was supported by the Bill & Melinda Gates Foundation. S Afzal acknowledges the support for intellectual contributions to this manuscript by the Department of Community Medicine and Epidemiology at King Edward Medical University, Lahore, Pakistan. T Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. L Belo acknowledges support from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB. D Bennett is supported by the UK Medical Research Council Population Health Research Unit at the University of Oxford (Oxford, UK). M Carvalho acknowledges support from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB. L Castro-de-Araujo was funded by the Medical Research Council (UK), Grant no. MR/T03355X/1 and by the National Institute of Mental Health Grant no. R01MH128911. FJ Elgar is supported by the Canada Research Chairs program. F Greaves acknowledges support from the NIHR Applied Research Collaboration for NW London. V K Gupta acknowledges funding support from the National Health and Medical Research Council (NHMRC), Australia. VB Gupta acknowledges funding support from the National Health and Medical Research Council (NHMRC), Australia. C Herteliu is partially supported by a grant from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. C Herteliu is partially supported by a grant from the Romanian Ministry of Research Innovation and Digitalization, MCID, project number ID-585-CTR-42-PFE-2021. S Hussain was supported by the Operational Programme Research, Development and Education –Project, Postdoc2MUNI “(No. CZ.02.2.69/0.0/0.0/18_053/0016952). S M S Islam is funded by the National Health and Medical Research Council and received funding from the National Heart Foundation of Australia. The Serbian part of this GBD-related contribution has been co-financed through Grant OI 175 014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. M Kivimaki was supported by the Wellcome Trust (221854/Z/20/Z), the UK Medical Research Council (MR/S011676/1), the US National Institute on Aging (R01AG056477), and the Academy of Finland (350426). K Krishan is supported by the UGC Centre of Advanced Study (Phase II), awarded to the Department of Anthropology, Panjab University, Chandigarh, India. B Lacey acknowledges support from the UK Biobank, funded largely by the UK Medical Research Council and Wellcome. S Lorkowski acknowledges institutional support from the Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig (Germany; German Federal Ministry of Education and Research; grant agreement number 01EA1808A). G Lucchetti received a productivity scholarship from the Brazilian National Council for Scientific and Technological Development — CNPq (Level 1D). J McGrath was supported by the Danish National Research Foundation (Niels Bohr Professor). J McGrath is employed by the Queensland Centre for Mental Health Research (Australia), which receives support from the Queensland Health Department. C Parry acknowleges the South African Medical Research Council. A Peden is supported by a National Health and Medical Research Council Emerging Leadership Fellowship (Grant ID: APP2009306). M R Phillips was supported in part by the Global Alliance for Chronic Diseases - National Natural Science Foundation of China (NSFC. No. 81761128031). M Pinheiro acknowledges FCT for funding through program DL 57/2016 – Norma transitória. A Rahman acknowledges the support from the Data Science Research Unit in Charles Sturt University (Bathurst, NSW, Australia). U Saeed would like to acknowledge the International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan. A M Samy acknowledges support from Ain Shams University (Cairo, Egypt) and the Egyptian Fulbright Mission Program. N Senthil Kumar acknowledges the DBT, New Delhi sponsored Advanced State Level Biotech Hub (BT/NER/143/SP44475/2021), Mizoram University (Aizawl, Mizoram, India) for facilitating this work. F Sha is supported by the Shenzhen Science and Technology Program (Grant No. KQTD20190929172835662). A Shetty acknowledges Kasturba Medical College (Mangalore, India) and Manipal Academy of Higher Education (Manipal, India) for all the academic support. R Shrestha acknowledges a career development award from the National Institutes of Health (K01DA051346). D Silva was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brazil (CAPES)-Finance Code 001 and is supported in part by CNPq - Brazil (309589/2021-5). D Sleet acknowledges partial support from Veritas Management Group, Inc and The Bizzell Group, LLC. S Trias-Llimós acknowledges research funding from the Juan de la Cierva-Formación program of the Spanish Ministry of Science and Innovation (FJC-2019-039314-I). Sí
Published: 2022

13. Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019

Author: Ewerton Cousin, Bruce B Duncan, Caroline Stein, Kanyin Liane Ong, Theo Vos, Cristiana Abbafati, Mohsen Abbasi-Kangevari, Michael Abdelmasseh, Amir Abdoli, Rami Abd-Rabu, Hassan Abolhassani, Eman Abu-Gharbieh, Manfred Mario Kokou Accrombessi, Qorinah Estiningtyas Sakilah Adnani, Muhammad Sohail Afzal, Gina Agarwal, Krishna K Agrawaal, Marcela Agudelo-Botero, Bright Opoku Ahinkorah, Sajjad Ahmad, Tauseef Ahmad, Keivan Ahmadi, Sepideh Ahmadi, Ali Ahmadi, Ali Ahmed, Yusra Ahmed Salih, Wuraola Akande-Sholabi, Tayyaba Akram, Hanadi Al Hamad, Ziyad Al-Aly, Jacqueline Elizabeth Alcalde-Rabanal, Vahid Alipour, Syed Mohamed Aljunid, Rajaa M Al-Raddadi, Nelson Alvis-Guzman, Saeed Amini, Robert Ancuceanu, Tudorel Andrei, Catalina Liliana Andrei, Ranjit Mohan Anjana, Adnan Ansar, Ippazio Cosimo Antonazzo, Benny Antony, Anayochukwu Edward Anyasodor, Jalal Arabloo, Damian Arizmendi, Benedetta Armocida, Anton A Artamonov, Judie Arulappan, Zahra Aryan, Samaneh Asgari, Tahira Ashraf, Thomas Astell-Burt, Prince Atorkey, Maha Moh'd Wahbi Atout, Martin Amogre Ayanore, Ashish D Badiye, Atif Amin Baig, Mohan Bairwa, Jennifer L Baker, Ovidiu Constantin Baltatu, Palash Chandra Banik, Anthony Barnett, Mark Thomaz Ugliara Barone, Francesco Barone-Adesi, Amadou Barrow, Neeraj Bedi, Rebuma Belete, Uzma Iqbal Belgaumi, Arielle Wilder Bell, Derrick A Bennett, Isabela M Bensenor, David Beran, Akshaya Srikanth Bhagavathula, Sonu Bhaskar, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Ali Bijani, Boris Bikbov, Setognal Birara, Virginia Bodolica, Aime Bonny, Hermann Brenner, Nikolay Ivanovich Briko, Zahid A Butt, Florentino Luciano Caetano dos Santos, Luis Alberto Cámera, Ismael R Campos-Nonato, Yin Cao, Chao Cao, Ester Cerin, Promit Ananyo Chakraborty, Joht Singh Chandan, Vijay Kumar Chattu, Simiao Chen, Jee-Young Jasmine Choi, Sonali Gajanan Choudhari, Enayet Karim Chowdhury, Dinh-Toi Chu, Barbara Corso, Omid Dadras, Xiaochen Dai, Albertino Antonio Moura Damasceno, Lalit Dandona, Rakhi Dandona, Claudio Alberto Dávila-Cervantes, Jan-Walter De Neve, Edgar Denova-Gutiérrez, Deepak Dhamnetiya, Daniel Diaz, Sanam Ebtehaj, Hisham Atan Edinur, Sahar Eftekharzadeh, Iman El Sayed, Islam Y Elgendy, Muhammed Elhadi, Mohamed A Elmonem, Mohammed Faisaluddin, Umar Farooque, Xiaoqi Feng, Eduarda Fernandes, Florian Fischer, David Flood, Marisa Freitas, Peter Andras Gaal, Mohamed M Gad, Piyada Gaewkhiew, Lemma Getacher, Mansour Ghafourifard, Reza Ghanei Gheshlagh, Ahmad Ghashghaee, Nermin Ghith, Ghozali Ghozali, Paramjit Singh Gill, Ibrahim Abdelmageed Ginawi, Ekaterina Vladimirovna Glushkova, Mahaveer Golechha, Sameer Vali Gopalani, Rafael Alves Guimarães, Rajat Das Gupta, Rajeev Gupta, Vivek Kumar Gupta, Veer Bala Gupta, Sapna Gupta, Tesfa Dejenie Habtewold, Nima Hafezi-Nejad, Rabih Halwani, Asif Hanif, Graeme J Hankey, Shafiul Haque, Ahmed I Hasaballah, Syed Shahzad Hasan, Abdiwahab Hashi, Soheil Hassanipour, Simon I Hay, Khezar Hayat, Mohammad Heidari, Mohammad Bellal 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Mosfequr Rahman, Mosiur Rahman, Setyaningrum Rahmawaty, Nazanin Rajai, Pradhum Ram, Juwel Rana, Kamal Ranabhat, Priyanga Ranasinghe, Chythra R Rao, Satish Rao, Salman Rawaf, David Laith Rawaf, Lal Rawal, Andre M N Renzaho, Nima Rezaei, Aziz Rezapour, Seyed Mohammad Riahi, Daniela Ribeiro, Jefferson Antonio Buendia Rodriguez, Leonardo Roever, Peter Rohloff, Godfrey M Rwegerera, Paul MacDaragh Ryan, Maha Mohamed Saber-Ayad, Siamak Sabour, Basema Saddik, Sahar Saeedi Moghaddam, Amirhossein Sahebkar, Harihar Sahoo, KM Saif-Ur-Rahman, Hamideh Salimzadeh, Mehrnoosh Samaei, Juan Sanabria, Milena M Santric-Milicevic, Brijesh Sathian, Thirunavukkarasu Sathish, Markus P Schlaich, Abdul-Aziz Seidu, Mario Šekerija, Nachimuthu Senthil Kumar, Allen Seylani, Masood Ali Shaikh, Hina Shamshad, Md Shajedur Rahman Shawon, Sara Sheikhbahaei, Jeevan K Shetty, Rahman Shiri, K M Shivakumar, Kerem Shuval, Jasvinder A Singh, Ambrish Singh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Ahmad Sofi-Mahmudi, Amin Soheili, Jing Sun, Viktória Szerencsés, Miklós Szócska, Rafael Tabarés-Seisdedos, Hooman Tadbiri, Eyayou Girma Tadesse, Md. 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Saif-Ur-Rahman, K, Salimzadeh, H, Samaei, M, Sanabria, J, Santric-Milicevic, M, Sathian, B, Sathish, T, Schlaich, M, Seidu, A, Sekerija, M, Senthil Kumar, N, Seylani, A, Shaikh, M, Shamshad, H, Shawon, M, Sheikhbahaei, S, Shetty, J, Shiri, R, Shivakumar, K, Shuval, K, Singh, J, Singh, A, Skryabin, V, Skryabina, A, Sofi-Mahmudi, A, Soheili, A, Sun, J, Szerencses, V, Szocska, M, Tabares-Seisdedos, R, Tadbiri, H, Tadesse, E, Tariqujjaman, M, Thankappan, K, Thapar, R, Thomas, N, Timalsina, B, Tobe-Gai, R, Tonelli, M, Tovani-Palone, M, Tran, B, Tripathy, J, Tudor Car, L, Tusa, B, Uddin, R, Upadhyay, E, Valadan Tahbaz, S, Valdez, P, Vasankari, T, Verma, M, Villalobos-Daniel, V, Vladimirov, S, Vo, B, Vu, G, Vukovic, R, Waheed, Y, Wamai, R, Werdecker, A, Wickramasinghe, N, Winkler, A, Wubishet, B, Xu, X, Xu, S, Yahyazadeh Jabbari, S, Yatsuya, H, Yaya, S, Yazie, T, Yi, S, Yonemoto, N, Yunusa, I, Zadey, S, Zaman, S, Zamanian, M, Zamora, N, Zastrozhin, M, Zastrozhina, A, Zhang, Z, Zhong, C, Zmaili, M, Zumla, A, Naghavi, M, Schmidt, M, GBD 2019 Diabetes Mortality Collaborators, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Cousin, E., Duncan, B. B., Stein, C., Ong, K. L., Vos, T., Abbafati, C., Abbasi-Kangevari, M., Abdelmasseh, M., Abdoli, A., Abd-Rabu, R., Abolhassani, H., Abu-Gharbieh, E., Accrombessi, M. M. K., Adnani, Q. E. S., Afzal, M. S., Agarwal, G., Agrawaal, K. K., Agudelo-Botero, M., Ahinkorah, B. O., Ahmad, S., Ahmad, T., Ahmadi, K., Ahmadi, S., Ahmadi, A., Ahmed, A., Ahmed Salih, Y., Akande-Sholabi, W., Akram, T., Al Hamad, H., Al-Aly, Z., Alcalde-Rabanal, J. E., Alipour, V., Aljunid, S. M., Al-Raddadi, R. M., Alvis-Guzman, N., Amini, S., Ancuceanu, R., Andrei, T., Andrei, C. L., Anjana, R. M., Ansar, A., Antonazzo, I. C., Antony, B., Anyasodor, A. E., Arabloo, J., Arizmendi, D., Armocida, B., Artamonov, A. A., Arulappan, J., Aryan, Z., Asgari, S., Ashraf, T., Astell-Burt, T., Atorkey, P., Atout, M. M. W., Ayanore, M. A., Badiye, A. D., Baig, A. A., Bairwa, M., Baker, J. L., Baltatu, O. C., Banik, P. C., Barnett, A., Barone, M. T. U., Barone-Adesi, F., Barrow, A., Bedi, N., Belete, R., Belgaumi, U. I., Bell, A. W., Bennett, D. A., Bensenor, I. M., Beran, D., Bhagavathula, A. S., Bhaskar, S., Bhattacharyya, K., Bhojaraja, V. S., Bijani, A., Bikbov, B., Birara, S., Bodolica, V., Bonny, A., Brenner, H., Briko, N. I., Butt, Z. A., Caetano dos Santos, F. L., Camera, L. A., Campos-Nonato, I. R., Cao, Y., Cao, C., Cerin, E., Chakraborty, P. A., Chandan, J. S., Chattu, V. K., Chen, S., Choi, J. -Y. J., Choudhari, S. G., Chowdhury, E. K., Chu, D. -T., Corso, B., Dadras, O., Dai, X., Damasceno, A. A. M., Dandona, L., Dandona, R., Davila-Cervantes, C. A., De Neve, J. -W., Denova-Gutierrez, E., Dhamnetiya, D., Diaz, D., Ebtehaj, S., Edinur, H. A., Eftekharzadeh, S., El Sayed, I., Elgendy, I. Y., Elhadi, M., Elmonem, M. A., Faisaluddin, M., Farooque, U., Feng, X., Fernandes, E., Fischer, F., Flood, D., Freitas, M., Gaal, P. A., Gad, M. M., Gaewkhiew, P., Getacher, L., Ghafourifard, M., Ghanei Gheshlagh, R., Ghashghaee, A., Ghith, N., Ghozali, G., Gill, P. S., Ginawi, I. A., Glushkova, E. V., Golechha, M., Gopalani, S. V., Guimaraes, R. A., Gupta, R. D., Gupta, R., Gupta, V. K., Gupta, V. B., Gupta, S., Habtewold, T. D., Hafezi-Nejad, N., Halwani, R., Hanif, A., Hankey, G. J., Haque, S., Hasaballah, A. I., Hasan, S. S., Hashi, A., Hassanipour, S., Hay, S. I., Hayat, K., Heidari, M., Hossain, M. B. H., Hossain, S., Hosseini, M., Hoveidamanesh, S., Huang, J., Humayun, A., Hussain, R., Hwang, B. -F., Ibitoye, S. E., Ikuta, K. S., Inbaraj, L. R., Iqbal, U., Islam, M. S., Islam, S. M. S., Islam, R. M., Ismail, N. E., Isola, G., Itumalla, R., Iwagami, M., Iyamu, I. O., Jahani, M. A., Jakovljevic, M., Jayawardena, R., Jha, R. P., John, O., Jonas, J. B., Joo, T., Kabir, A., Kalhor, R., Kamath, A., Kanchan, T., Kandel, H., Kapoor, N., Kayode, G. A., Kebede, S. A., Keshavarz, P., Keykhaei, M., Khader, Y. S., Khajuria, H., Khan, M. A., Khan, M. N., Khan, M., Khater, A. M., Khoja, T. A. M., Khubchandani, J., Kim, M. S., Kim, Y. J., Kimokoti, R. W., Kisa, S., Kisa, A., Kivimaki, M., Korshunov, V. A., Korzh, O., Koyanagi, A., Krishan, K., Kuate Defo, B., Kumar, G. A., Kumar, N., Kusuma, D., La Vecchia, C., Lacey, B., Larsson, A. O., Lasrado, S., Lee, W. -C., Lee, C. B., Lee, P. H., Lee, S. W. H., Li, M. -C., Lim, S. S., Lim, L. -L., Lucchetti, G., Majeed, A., Malik, A. A., Mansouri, B., Mantovani, L. G., Martini, S., Mathur, P., Mcalinden, C., Mehedi, N., Mekonnen, T., Menezes, R. G., Mersha, A. G., Miao Jonasson, J., Miazgowski, T., Michalek, I. M., Mirica, A., Mirrakhimov, E. M., Mirza, A. Z., Mithra, P., Mohammadian-Hafshejani, A., Mohammadpourhodki, R., Mohammed, A., Mokdad, A. H., Molokhia, M., Monasta, L., Moni, M. A., Moradpour, F., Moradzadeh, R., Mostafavi, E., Mueller, U. O., Murray, C. J. L., Mustafa, A., Nagel, G., Nangia, V., Naqvi, A. A., Nayak, B. P., Nazari, J., Ndejjo, R., Negoi, R. I., Neupane Kandel, S., Nguyen, C. T., Nguyen, H. L. T., Noubiap, J. J., Nowak, C., Oancea, B., Odukoya, O. O., Oguntade, A. S., Ojo, T. T., Olagunju, A. T., Onwujekwe, O. E., Ortiz, A., Owolabi, M. O., Palladino, R., Panda-Jonas, S., Pandi-Perumal, S. R., Pardhan, S., Parekh, T., Parvizi, M., Pepito, V. C. F., Perianayagam, A., Petcu, I. -R., Pilania, M., Podder, V., Polibin, R. V., Postma, M. J., Prashant, A., Rabiee, N., Rabiee, M., Rahimi-Movaghar, V., Rahman, M. A., Rahman, M. M., Rahman, M., Rahmawaty, S., Rajai, N., Ram, P., Rana, J., Ranabhat, K., Ranasinghe, P., Rao, C. R., Rao, S., Rawaf, S., Rawaf, D. L., Rawal, L., Renzaho, A. M. N., Rezaei, N., Rezapour, A., Riahi, S. M., Ribeiro, D., Rodriguez, J. A. B., Roever, L., Rohloff, P., Rwegerera, G. M., Ryan, P. M., Saber-Ayad, M. M., Sabour, S., Saddik, B., Saeedi Moghaddam, S., Sahebkar, A., Sahoo, H., Saif-Ur-Rahman, K. M., Salimzadeh, H., Samaei, M., Sanabria, J., Santric-Milicevic, M. M., Sathian, B., Sathish, T., Schlaich, M. P., Seidu, A. -A., Sekerija, M., Senthil Kumar, N., Seylani, A., Shaikh, M. A., Shamshad, H., Shawon, M. S. R., Sheikhbahaei, S., Shetty, J. K., Shiri, R., Shivakumar, K. M., Shuval, K., Singh, J. A., Singh, A., Skryabin, V. Y., Skryabina, A. A., Sofi-Mahmudi, A., Soheili, A., Sun, J., Szerencses, V., Szocska, M., Tabares-Seisdedos, R., Tadbiri, H., Tadesse, E. G., Tariqujjaman, M., Thankappan, K. R., Thapar, R., Thomas, N., Timalsina, B., Tobe-Gai, R., Tonelli, M., Tovani-Palone, M. R., Tran, B. X., Tripathy, J. P., Tudor Car, L., Tusa, B. S., Uddin, R., Upadhyay, E., Valadan Tahbaz, S., Valdez, P. R., Vasankari, T. J., Verma, M., Villalobos-Daniel, V. E., Vladimirov, S. K., Vo, B., Vu, G. T., Vukovic, R., Waheed, Y., Wamai, R. G., Werdecker, A., Wickramasinghe, N. D., Winkler, A. S., Wubishet, B. L., Xu, X., Xu, S., Yahyazadeh Jabbari, S. H., Yatsuya, H., Yaya, S., Yazie, T. S. Y., Yi, S., Yonemoto, N., Yunusa, I., Zadey, S., Zaman, S. B., Zamanian, M., Zamora, N., Zastrozhin, M. S., Zastrozhina, A., Zhang, Z. -J., Zhong, C., Zmaili, M., Zumla, A., Naghavi, M., Schmidt, M. I., Collaborators, GBD 2019 Diabetes Mortality, and Lacey, BWH
Subjects: Adult, Endocrinology, Diabetes and Metabolism, CHILDHOOD, universal health coverage, Global Health, 3121 Internal medicine, Global Burden of Disease, 1117 Public Health and Health Services, Endocrinology, SDG 3 - Good Health and Well-being, Risk Factors, RA0421, Internal Medicine, Humans, Diabetes mortality, diabetes, mortality, global burden of disease, under 25 years, COHORT, health care services, COMPLICATIONS, CHALLENGES, Diabetes, Mortality trends, Age-specific diabetes, 1103 Clinical Sciences, Public Health, Global Health, Social Medicine and Epidemiology, BRAZIL, Type I Diabetes, INSULIN, 3142 Public health care science, environmental and occupational health, the Socio-demographic Index, Treatment, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, 1101 Medical Biochemistry and Metabolomics, diabete, 3121 General medicine, internal medicine and other clinical medicine, ACCESS, RA, RC
Abstract: Background:Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods:We used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990–2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals. Findings:In 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73·7% (68·3 to 77·4) were classified as due to type 1 diabetes. The age-standardised death rate was 0·50 (0·44 to 0·58) per 100 000 population, and 15 900 (97·5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0·13 (0·12 to 0·14) per 100 000 population in the high SDI quintile, 0·60 (0·51 to 0·70) per 100 000 population in the low-middle SDI quintile, and 0·71 (0·60 to 0·86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r2=0·62). From 1990 to 2019, age-standardised death rates decreased globally by 17·0% (−28·4 to −2·9) for all diabetes, and by 21·0% (–33·0 to −5·9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (−13·6% [–28·4 to 3·4]) and for type 1 diabetes (−13·6% [–29·3 to 8·9]). Interpretation:Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN's Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations. Funding: Bill & Melinda Gates Foundation.
Published: 2022

14. The burden of bacterial antimicrobial resistance in the WHO European region in 2019: a cross-country systematic analysis

Author: Tomislav Mestrovic, Gisela Robles Aguilar, Lucien R Swetschinski, Kevin S Ikuta, Authia P Gray, Nicole Davis Weaver, Chieh Han, Eve E Wool, Anna Gershberg Hayoon, Simon I Hay, Christiane Dolecek, Benn Sartorius, Christopher J L Murray, Isaac Yeboah Addo, Bright Opoku Ahinkorah, Ayman Ahmed, Mamoon A Aldeyab, Kasim Allel, Robert Ancuceanu, Anayochukwu Edward Anyasodor, Marcel Ausloos, Fabio Barra, Akshaya Srikanth Bhagavathula, Dinesh Bhandari, Sonu Bhaskar, Natália Cruz-Martins, Anna Dastiridou, Klara Dokova, Eleonora Dubljanin, Oyewole Christopher Durojaiye, Adeniyi Francis Fagbamigbe, Simone Ferrero, Peter Andras Gaal, Veer Bala Gupta, Vijai Kumar Gupta, Vivek Kumar Gupta, Claudiu Herteliu, Salman Hussain, Irena M Ilic, Milena D Ilic, Elham Jamshidi, Tamas Joo, André Karch, Adnan Kisa, Sezer Kisa, Tomislav Kostyanev, Hmwe Hmwe Kyu, Judit Lám, Graciliana Lopes, Alexander G Mathioudakis, Alexios-Fotios A Mentis, Irmina Maria Michalek, Mohammad Ali Moni, Catrin E Moore, Francesk Mulita, Ionut Negoi, Ruxandra Irina Negoi, Tamás Palicz, Adrian Pana, João Perdigão, Ionela-Roxana Petcu, Navid Rabiee, David Laith Rawaf, Salman Rawaf, Murad Ziyaudinovich Shakhmardanov, Aziz Sheikh, Luís Manuel Lopes Rodrigues Silva, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Bogdan Socea, Andy Stergachis, Temenuga Zhekova Stoeva, Chandra Datta Sumi, Arulmani Thiyagarajan, Marcos Roberto Tovani-Palone, Metin Yesiltepe, Sojib Bin Zaman, Mohsen Naghavi, University of St Andrews. School of Medicine, University of St Andrews. Population and Behavioural Science Division, and Collaborators, European Antimicrobial Resistance
Subjects: MCC, Methicillin-Resistant Staphylococcus aureus, RM, Public Health, Environmental and Occupational Health, 3rd-DAS, World Health Organization, RM Therapeutics. Pharmacology, Anti-Bacterial Agents, SDG 3 - Good Health and Well-being, RA0421, RA0421 Public health. Hygiene. Preventive Medicine, Drug Resistance, Bacterial, Escherichia coli, Humans
Abstract: Funding: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care using UK aid funding managed by the Fleming Fund. Background Antimicrobial resistance (AMR) represents one of the most crucial threats to public health and modern health care. Previous studies have identified challenges with estimating the magnitude of the problem and its downstream effect on human health and mortality. To our knowledge, this study presents the most comprehensive set of regional and country-level estimates of AMR burden in the WHO European region to date. Methods We estimated deaths and disability-adjusted life-years attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen–drug combinations for the WHO European region and its countries in 2019. Our methodological approach consisted of five broad components: the number of deaths in which infection had a role, the proportion of infectious deaths attributable to a given infectious syndrome, the proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antimicrobial drug of interest, and the excess risk of mortality (or duration of an infection) associated with this resistance. These components were then used to estimate the disease burden by using two counterfactual scenarios: deaths attributable to AMR (considering an alternative scenario where infections with resistant pathogens are replaced with susceptible ones) and deaths associated with AMR (considering an alternative scenario where drug-resistant infections would not occur at all). Data were solicited from a wide array of international stakeholders; these included research hospitals, surveillance networks, and infection databases maintained by private laboratories and medical technology companies. We generated 95% uncertainty intervals (UIs) for final estimates as the 25th and 975th ordered values across 1000 posterior draws, and models were cross-validated for out-of-sample predictive validity. Findings We estimated 541 000 deaths (95% UI 370 000–763 000) associated with bacterial AMR and 133 000 deaths (90 100–188 000) attributable to bacterial AMR in the whole WHO European region in 2019. The largest fatal burden of AMR in the region came from bloodstream infections, with 195 000 deaths (104 000–333 000) associated with resistance, followed by intra-abdominal infections (127 000 deaths [81 900–185 000]) and respiratory infections (120 000 deaths [94 500–154 000]). Seven leading pathogens were responsible for about 457 000 deaths associated with resistance in 53 countries of this region; these pathogens were, in descending order of mortality, Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecium, Streptococcus pneumoniae, and Acinetobacter baumannii. Methicillin-resistant S aureus was shown to be the leading pathogen–drug combination in 27 countries for deaths attributable to AMR, while aminopenicillin-resistant E coli predominated in 47 countries for deaths associated with AMR. Interpretation The high levels of resistance for several important bacterial pathogens and pathogen–drug combinations, together with the high mortality rates associated with these pathogens, show that AMR is a serious threat to public health in the WHO European region. Our regional and cross-country analyses open the door for strategies that can be tailored to leading pathogen–drug combinations and the available resources in a specific location. These results underscore that the most effective way to tackle AMR in this region will require targeted efforts and investments in conjunction with continuous outcome-based research endeavours. Publisher PDF
Published: 2022

15. Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Author: Annie Haakenstad, Caleb Mackay Salpeter Irvine, Megan Knight, Corinne Bintz, Aleksandr Y Aravkin, Peng Zheng, Vin Gupta, Michael R M Abrigo, Abdelrahman I Abushouk, Oladimeji M Adebayo, Gina Agarwal, Fares Alahdab, Ziyad Al-Aly, Khurshid Alam, Turki M Alanzi, Jacqueline Elizabeth Alcalde-Rabanal, Vahid Alipour, Nelson Alvis-Guzman, Arianna Maever L Amit, Catalina Liliana Andrei, Tudorel Andrei, Carl Abelardo T Antonio, Jalal Arabloo, Olatunde Aremu, Martin Amogre Ayanore, Maciej Banach, Till Winfried Bärnighausen, Celine M Barthelemy, Mohsen Bayati, Habib Benzian, Adam E Berman, Kelly Bienhoff, Ali Bijani, Boris Bikbov, Antonio Biondi, Archith Boloor, Reinhard Busse, Zahid A Butt, Luis Alberto Cámera, Ismael R Campos-Nonato, Rosario Cárdenas, Felix Carvalho, Collins Chansa, Soosanna Kumary Chattu, Vijay Kumar Chattu, Dinh-Toi Chu, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, William James Dangel, Ahmad Daryani, Jan-Walter De Neve, Meghnath Dhimal, Isaac Oluwafemi Dipeolu, Shirin Djalalinia, Hoa Thi Do, Chirag P Doshi, Leila Doshmangir, Elham Ehsani-Chimeh, Maha El Tantawi, Eduarda Fernandes, Florian Fischer, Nataliya A Foigt, Artem Alekseevich Fomenkov, Masoud Foroutan, Takeshi Fukumoto, Nancy Fullman, Mohamed M Gad, Keyghobad Ghadiri, Mansour Ghafourifard, Ahmad Ghashghaee, Thomas Glucksman, Houman Goudarzi, Rajat Das Gupta, Randah R Hamadeh, Samer Hamidi, Josep Maria Haro, Edris Hasanpoor, Simon I Hay, Mohamed I Hegazy, Behzad Heibati, Nathaniel J Henry, Michael K Hole, Naznin Hossain, Mowafa Househ, Olayinka Stephen Ilesanmi, Mohammad-Hasan Imani-Nasab, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Mohammad Ali Jahani, Ankur Joshi, Rohollah Kalhor, Gbenga A Kayode, Nauman Khalid, Khaled Khatab, Adnan Kisa, Sonali Kochhar, Kewal Krishan, Barthelemy Kuate Defo, Dharmesh Kumar Lal, Faris Hasan Lami, Anders O Larsson, Janet L Leasher, Kate E LeGrand, Lee-Ling Lim, Narayan B Mahotra, Azeem Majeed, Afshin Maleki, Narayana Manjunatha, Benjamin Ballard Massenburg, Tomislav Mestrovic, GK Mini, Andreea Mirica, Erkin M Mirrakhimov, Yousef Mohammad, Shafiu Mohammed, Ali H Mokdad, Shane Douglas Morrison, Mohsen Naghavi, Duduzile Edith Ndwandwe, Ionut Negoi, Ruxandra Irina Negoi, Josephine W Ngunjiri, Cuong Tat Nguyen, Yeshambel T Nigatu, Obinna E Onwujekwe, Doris V Ortega-Altamirano, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Abhijit P Pakhare, Veincent Christian Filipino Pepito, Norberto Perico, Hai Quang Pham, David M Pigott, Khem Narayan Pokhrel, Mohammad Rabiee, Navid Rabiee, Vafa Rahimi-Movaghar, David Laith Rawaf, Salman Rawaf, Lal Rawal, Giuseppe Remuzzi, Andre M N Renzaho, Serge Resnikoff, Nima Rezaei, Aziz Rezapour, Jennifer Rickard, Leonardo Roever, Maitreyi Sahu, Abdallah M Samy, Juan Sanabria, Milena M Santric-Milicevic, Sivan Yegnanarayana Iyer Saraswathy, Soraya Seedat, Subramanian Senthilkumaran, Edson Serván-Mori, Masood Ali Shaikh, Aziz Sheikh, Diego Augusto Santos Silva, Caroline Stein, Dan J Stein, Mariya Vladimirovna Titova, Stephanie M Topp, Marcos Roberto Tovani-Palone, Saif Ullah, Bhaskaran Unnikrishnan, Marco Vacante, Pascual R Valdez, Tommi Juhani Vasankari, Narayanaswamy Venketasubramanian, Vasily Vlassov, Theo Vos, Jamal Akeem Yearwood, Naohiro Yonemoto, Mustafa Z Younis, Chuanhua Yu, Siddhesh Zadey, Sojib Bin Zaman, Taddese Alemu Zerfu, Zhi-Jiang Zhang, Arash Ziapour, Sanjay Zodpey, Stephen S Lim, Christopher J L Murray, Rafael Lozano, Tampere University, and Clinical Medicine
Subjects: Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Pharmaceutical Preparations, Universal Health Insurance, Health Sciences, Workforce, Humans, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, Occupations, Hälsovetenskaper, 3121 Internal medicine, Global Health, Global Burden of Disease
Abstract: Background: Human resources for health (HRH) include a range of occupations that aim to promote or improve human health. The UN Sustainable Development Goals (SDGs) and the WHO Health Workforce 2030 strategy have drawn attention to the importance of HRH for achieving policy priorities such as universal health coverage (UHC). Although previous research has found substantial global disparities in HRH, the absence of comparable cross-national estimates of existing workforces has hindered efforts to quantify workforce requirements to meet health system goals. We aimed to use comparable and standardised data sources to estimate HRH densities globally, and to examine the relationship between a subset of HRH cadres and UHC effective coverage performance. Methods: Through the International Labour Organization and Global Health Data Exchange databases, we identified 1404 country-years of data from labour force surveys and 69 country-years of census data, with detailed microdata on health-related employment. From the WHO National Health Workforce Accounts, we identified 2950 country-years of data. We mapped data from all occupational coding systems to the International Standard Classification of Occupations 1988 (ISCO-88), allowing for standardised estimation of densities for 16 categories of health workers across the full time series. Using data from 1990 to 2019 for 196 of 204 countries and territories, covering seven Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) super-regions and 21 regions, we applied spatiotemporal Gaussian process regression (ST-GPR) to model HRH densities from 1990 to 2019 for all countries and territories. We used stochastic frontier meta-regression to model the relationship between the UHC effective coverage index and densities for the four categories of health workers enumerated in SDG indicator 3.c.1 pertaining to HRH: physicians, nurses and midwives, dentistry personnel, and pharmaceutical personnel. We identified minimum workforce density thresholds required to meet a specified target of 80 out of 100 on the UHC effective coverage index, and quantified national shortages with respect to those minimum thresholds. Findings: We estimated that, in 2019, the world had 104·0 million (95% uncertainty interval 83·5-128·0) health workers, including 12·8 million (9·7-16·6) physicians, 29·8 million (23·3-37·7) nurses and midwives, 4·6 million (3·6-6·0) dentistry personnel, and 5·2 million (4·0-6·7) pharmaceutical personnel. We calculated a global physician density of 16·7 (12·6-21·6) per 10 000 population, and a nurse and midwife density of 38·6 (30·1-48·8) per 10 000 population. We found the GBD super-regions of sub-Saharan Africa, south Asia, and north Africa and the Middle East had the lowest HRH densities. To reach 80 out of 100 on the UHC effective coverage index, we estimated that, per 10 000 population, at least 20·7 physicians, 70·6 nurses and midwives, 8·2 dentistry personnel, and 9·4 pharmaceutical personnel would be needed. In total, the 2019 national health workforces fell short of these minimum thresholds by 6·4 million physicians, 30·6 million nurses and midwives, 3·3 million dentistry personnel, and 2·9 million pharmaceutical personnel. Interpretation: Considerable expansion of the world's health workforce is needed to achieve high levels of UHC effective coverage. The largest shortages are in low-income settings, highlighting the need for increased financing and coordination to train, employ, and retain human resources in the health sector. Actual HRH shortages might be larger than estimated because minimum thresholds for each cadre of health workers are benchmarked on health systems that most efficiently translate human resources into UHC attainment. Anders O. Larsson ingår i gruppen GBD 2019 Human Resources for Health Collaborators
Published: 2022

16. 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. G., Ghashghaee, A., Ghith, N., Ghozali, G., Ghozy, S., Gialluisi, A., Giampaoli, S., Gilani, S. A., Gill, P. S., Gnedovskaya, E. V., Golechha, M., Goulart, A. C., Guo, Y., Gupta, R., Gupta, V. B., Gupta, V. K., Gyanwali, P., Hafezi-Nejad, N., Hamidi, S., Hanif, A., Hankey, G. J., Hargono, A., Hashi, A., Hassan, T. S., Hassen, H. Y., Havmoeller, R. J., Hay, S. I., Hayat, K., Hegazy, M. I., Herteliu, C., Holla, R., Hostiuc, S., Househ, M., Huang, J., Humayun, A., Hwang, B. -F., Iacoviello, L., Iavicoli, I., Ibitoye, S. E., Ilesanmi, O. S., Ilic, I. M., Ilic, M. D., Iqbal, U., Irvani, S. S. N., Islam, S. M. S., Ismail, N. E., Iso, H., Isola, G., Iwagami, M., Jacob, L., Jain, V., Jang, S. -I., Jayapal, S. K., Jayaram, S., Jayawardena, R., Jeemon, P., Jha, R. P., Johnson, W. D., Jonas, J. B., Joseph, N., Jozwiak, J. J., Jurisson, M., Kalani, R., Kalhor, R., Kalkonde, Y., Kamath, A., Kamiab, Z., Kanchan, T., Kandel, H., Karch, A., Katoto, P. D. M. C., Kayode, G. A., Keshavarz, P., Khader, Y. S., Khan, E. A., Khan, I. A., Khan, M., Khan, M. A. B., Khatib, M. N., Khubchandani, J., Kim, G. R., Kim, M. S., Kim, Y. J., Kisa, A., Kisa, S., Kivimaki, M., Kolte, D., Koolivand, A., Laxminarayana, S. L. K., Koyanagi, A., Krishan, K., Krishnamoorthy, V., Krishnamurthi, R. V., Kumar, G. A., Kusuma, D., Vecchia, C. L., Lacey, B., Lak, H. M., Lallukka, T., Lasrado, S., Lavados, P. M., Leonardi, M., Li, B., Li, S., Lin, H., Lin, R. -T., Liu, X., Lo, W. D., Lorkowski, S., Lucchetti, G., Saute, R. L., Abd El Razek, H. M., Magnani, F. G., Mahajan, P. B., Majeed, A., Makki, A., Malekzadeh, R., Malik, A. A., Manafi, N., Mansournia, M. A., Mantovani, L. G., Martini, S., Mazzaglia, G., Mehndiratta, M. M., Menezes, R. G., Meretoja, A., Mersha, A. G., Jonasson, J. M., Miazgowski, B., Miazgowski, T., Michalek, I. M., Mirrakhimov, E. M., Mohammad, Y., Mohammadian-Hafshejani, A., Mohammed, S., Mokdad, A. H., Mokhayeri, Y., Molokhia, M., Moni, M. A., Al Montasir, A., Moradzadeh, R., Morawska, L., Morze, J., Muruet, W., Musa, K. I., Nagarajan, A. J., Naghavi, M., Swamy, S. N., Nascimento, B. R., Negoi, R. I., Kandel, S. N., Nguyen, T. H., Norrving, B., Noubiap, J. J., Nwatah, V. E., Oancea, B., Odukoya, O. O., Olagunju, A. T., Orru, H., Owolabi, M. O., Padubidri, J. R., Pana, A., Parekh, T., Park, E. -C., Kan, F. P., Pathak, M., Peres, M. F. P., Perianayagam, A., Pham, T. -M., Piradov, M. A., Podder, V., Polinder, S., Postma, M. J., Pourshams, A., Radfar, A., Rafiei, A., Raggi, A., Rahim, F., Rahimi-Movaghar, V., Rahman, M., Rahman, M. A., Rahmani, A. M., Rajai, N., Ranasinghe, P., Rao, C. R., Rao, S. J., Rathi, P., Rawaf, D. L., Rawaf, S., Reitsma, M. B., Renjith, V., Renzaho, A. M. N., Rezapour, A., Rodriguez, J. A. B., Roever, L., Romoli, M., Rynkiewicz, A., Sacco, S., Sadeghi, M., Moghaddam, S. S., Sahebkar, A., Saif-Ur-Rahman, K. M., Salah, R., Samaei, M., Samy, A. M., Santos, I. S., Santric-Milicevic, M. 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

17. Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019: A systematic analysis from the Global Burden of Disease Study 2019

Author: Mohsen Naghavi, Saman Esmaeilnejad, Irena Ilic, Chhabi Lal Ranabhat, Hubert Amu, Jalil Jaafari, Walter Mendoza, Yanzhong Wang, Atta Abbas Naqvi, Mahesh P A, Afshin Maleki, Songhomitra Panda-Jonas, Akila Prashant, Jessica Y Islam, Ali H. Mokdad, Rahmatollah Moradzadeh, Roman Shrestha, Muhammad Naveed, Andre M. N. Renzaho, Santi Martini, Reza Rawassizadeh, Chisom Joyqueenet Akunna, Tudorel Andrei, Jason A. Anderson, Martin McKee, Iffat Elbarazi, Golnaz Heidari, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Davood Anvari, Randah R. Hamadeh, G. K. Mini, Emerito Jose A. Faraon, Farhad Islami, Yasir Waheed, Fahad Alanezi, Maciej Banach, Sheikh Mohammed Shariful Islam, Ismaeel Yunusa, Suresh Mehata, Tarun Gupta, Mavra A Riaz, Derrick A Bennett, Nithin Kumar, Ali Soroush, Kurt Straif, Muhammad Aziz Rahman, Hasan Yusefzadeh, Avirup Guha, Catalina Liliana Andrei, Muhammed Shahriar Zaman, Arief Hargono, Sandhya Neupane Kandel, Adam E. Berman, Giulia Carreras, Ali Bijani, Christoph Nowak, Rafael Alves Guimarães, Aziz Sheikh, Kamal Hezam, Carlo Eduardo Medina-Solís, Simon I. Hay, Deborah Carvalho Malta, Rahman Shiri, Ashok Pandey, Ramesh Holla, Gyu Ri Kim, Aidin Abedi, Sharath Burugina Nagaraja, Andem Effiong, Samad Azari, Bhaskar Thakur, Mohsen Mazidi, Vahid Yazdi-Feyzabadi, Prashant Mathur, Bay Vo, Robert Ancuceanu, Eun-Kee Park, Mehdi Fazlzadeh, Thomas Hsiao, Richard G Pestell, Sindhura Lakshmi Koulmane Laxminarayana, Doo Woong Lee, Bayew Kelkay, Erkin M. Mirrakhimov, Hualiang Lin, Mohsen Bayati, Florian Fischer, Wei Liu, Stefan Stortecky, Javad Nazari, Fatemeh Pashazadeh Kan, Virginia Núñez-Samudio, Nitish Naik, Sreenivas Narasimha Swamy, Rajat Gupta, Rakhi Dandona, Hermann Brenner, Chandrashekhar T Sreeramareddy, Mohammad Ali Mansournia, Yuichiro Yano, Pankaj Bhardwaj, Samath D Dharmaratne, Constantine I. Vardavas, Gabriela Fernanda Gil, Azeem Majeed, Akram Pourshams, Nachimuthu Senthil Kumar, Florentino Luciano Caetano dos Santos, Juan Sanabria, Iván Landires, Parkes J Kendrick, Dinh-Toi Chu, Asma Tahir Awan, Khem Narayan Pokhrel, Siddharudha Shivalli, Omid Shafaat, Shankar Prasad Nagaraju, Manu Raj Mathur, Rachel L Updike, Mohammad Ebrahimi Kalan, Ryan David Kennedy, Alessandra Lugo, Olalekan A. Uthman, Tarek Tawfik Amin, Jiregna Darega Gela, Zhi-Jiang Zhang, Yeshambel T. Nigatu, Bedanta Roy, Arielle Wilder Eagan, Jalal Arabloo, Milena Ilic, Mehdi Hosseinzadeh, Jost B. Jonas, Dian Kusuma, Shahrzad Bazargan-Hejazi, Yo Han Lee, Mohammed Shannawaz, Mohammad Ali Moni, Valery L. Feigin, Himal Kandel, Lalit Dandona, Milena Santric-Milicevic, Jasvinder A. Singh, Till Bärnighausen, Neeraj Bhala, Sara Sheikhbahaei, Alireza Ansari-Moghaddam, Borhan Mansouri, Narayana Manjunatha, Giuseppe Gorini, Saif Ullah, Sheikh M. Alif, Giang Thu Vu, Ai Koyanagi, Mahaveer Golechha, Ingan Ukur Tarigan, Sumaira Mubarik, Naohiro Yonemoto, Ahmad Ghashghaee, Yves Miel H Zuniga, Bach Xuan Tran, Sorin Hostiuc, Catherine P. Benziger, Ritesh G. Menezes, Leonardo Roever, Xiaochen Dai, Meghnath Dhimal, Medhat Farwati, Chenwen Zhong, Seyed Sina Naghibi Irvani, G Anil Kumar, Jaya Prasad Tripathy, Amirhossein Sahebkar, Simiao Chen, Zubair Kabir, Meseret Derbew Molla, Tilahun Ali, Animut Tagele Tamiru, Negussie Boti Sidemo, Monika Sawhney, Bright Opoku Ahinkorah, Ruxandra Irina Negoi, Segun Emmanuel Ibitoye, Vin Gupta, Mona Pathak, Lorenzo Monasta, Andrew T Olagunju, Nermin Ghith, Nuwan Darshana Wickramasinghe, Kazumasa Yamagishi, Virendra Singh, Takahiro Tabuchi, Gholamreza Roshandel, Andre R. Brunoni, Hayley D. Tymeson, Madhur Verma, Eyayou Girma Tadesse, Adrian Pana, Isabela M. Benseñor, Abdullah Al Mamun, Jianrong Zhang, Hai Quang Pham, Mihaela Hostiuc, Sung-In Jang, Vinay Nangia, Luca Ronfani, Rizwan Suliankatchi Abdulkader, Dhirendra N Sinha, Josip Car, Sohail Ahmad, Rekha Thapar, Salman Rawaf, Joanna L Whisnant, Sanjay Basu, Abdallah M. Samy, Michal Grivna, Zahid A Butt, Abera Getachew Obsa, Mahdi Nalini, Ted R. Miller, Sanjeev Misra, Utsav Parekh, Budi Aji, Saeed Amini, João Pedro Silva, Felix Akpojene Ogbo, Mihajlo Jakovljevic, Demosthenes B. Panagiotakos, Baye Dagnew, Yousef Khader, Atif Amin Baig, Habib Benzian, Keivan Ahmadi, Marco Vacante, Brijesh Sathian, Akshaya Srikanth Bhagavathula, Savita Lasrado, Maryam Khayamzadeh, Darshan B B, Mohammad Rifat Haider, Yonas Akalu, Irmina Maria Michalek, Simone Vidale, Getie Lake Aynalem, Rosa A. S. Couto, Yigizie Yeshaw, Syed Mohamed Aljunid, Pradhum Ram, Shrikant Pawar, Kevin Welding, Suzanne Barker-Collo, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Hiba Jawdat Barqawi, Marcos Roberto Tovani-Palone, K M Shivakumar, Gebiyaw Wudie Tsegaye, Fares Alahdab, Vafa Rahimi-Movaghar, Om P Kurmi, Nataliya Foigt, André Karch, Marina Pinheiro, Basema Saddik, Paschalis Steiropoulos, Chuanhua Yu, Graeme J. Hankey, Panniyammakal Jeemon, Abdul-Aziz Seidu, Ramaiah Itumalla, Befikadu Legesse Wubishet, Vera Marisa Costa, Shanshan Li, Ambrish Singh, Yuming Guo, Reza Malekzadeh, Nikha Bhardwaj, Mikhail Sergeevich Zastrozhin, Maryam Zamanian, Onyema greg Chido-Amajuoyi, Ibtihal Fadhil, Sabina O Nduaguba, Turki Alanzi, Eun-Cheol Park, Nicholas Arian, Salah Eddin Karimi, Parnaz Daneshpajouhnejad, Minale Tareke, Paramjit Gill, Chukwudi A Nnaji, Haroon Ahmed, Irina Filip, Juwel Rana, Aziz Rezapour, Huong Lan Thi Nguyen, Ashish Badiye, Kewal Krishan, Nima Hafezi-Nejad, Masood Ali Shaikh, Tanuj Kanchan, Shilpashree Madhava Kunjathur, Reza Ghanei Gheshlagh, Thomas R. Hird, Yousef Mohammad, Soraya Siabani, Falk Schwendicke, Ziyad Al-Aly, Desta Debalkie Atnafu, Krittika Bhattacharyya, Mika Kivimäki, Ayodipupo Sikiru Oguntade, Zabihollah Yousefi, Neeti Kapoor, Syed Mahboob Shah, Kavumpurathu Raman Thankappan, Mika Shigematsu, Ben Lacey, Ireneous N. Soyiri, Amir Radfar, Lemma Getacher, Sameer Vali Gopalani, David Laith Rawaf, Amir Masoud Rahmani, Birhan Gebresillassie Gebregiorgis, Morenike Oluwatoyin Folayan, Salime Goharinezhad, Ambuj Roy, Ruth W Kimokoti, Nuworza Kugbey, Getinet Ayano, Mohammad Hifz Ur Rahman, Benny Antony, Katrin Burkart, Christopher J L Murray, Khalid F. AlHabib, Mariam Molokhia, Mansour Ghafourifard, Abebaw Alemayehu Desta, Tariku Tesfaye Bekuma, Shailesh Advani, Kiomars Sharafi, Kurnia Dwi Artanti, E S Abhilash, Ejaz Ahmad Khan, Sana Salehi, Dan J. Stein, Pankaj Chaturvedi, Mahmoud A. Alomari, Kawkab Shishani, Dejana Braithwaite, Jung-Chen Chang, Rajeev Gupta, Giovanni Damiani, Maha El Tantawi, Maria Sofia Sofia Cattaruzza, Amir Abdoli, Narayanaswamy Venketasubramanian, Rakibul M Islam, Ibrahim Abdelmageed Ginawi, Victor Aboyans, Ganesh Kumar Saya, Silvano Gallus, João Mauricio Castaldelli-Maia, Vardhmaan Jain, Masoud Foroutan, Janni Leung, Mohammad Abdollahi, Mohammed Zewdu Yimmer, Vahid Alipour, Wondwossen Niguse Asmare, Ravi Prakash Jha, Gerhard Sulo, Brigid Unim, Sheng-Chia Chung, Sadaf G. Sepanlou, Hamed Mirzaei, Anna Aleksandrovna Skryabina, In-Hwan Oh, Rannveig Sigurvinsdottir, Oladimeji Adebayo, Farshad Farzadfar, Anasthasia Zastrozhina, Shafiu Mohammed, Johan Sundström, Ali Kabir, Paolo Lauriola, Tilahun Belete Mossie, Sadia Bibi, Bartosz Miazgowski, Erin C Mullany, Keyvan Pakshir, Srikanta Banerjee, Mowafa Househ, Mohamed M. Gad, Leila R Kalankesh, Mikk Jürisson, Ismail Tareque, Albertino Damasceno, Musliu Adetola Tolani, Andrea Werdecker, Shane D. Morrison, Inga Dora Sigfusdottir, Marcel Ausloos, Monika Arora, Marissa B Reitsma, Filippos Filippidis, Biniyam Sahiledengle Geberemariyam, Bruno Piassi Sao Jose, Leeberk Raja Inbaraj, Antonio Biondi, Mohsen Abbasi-Kangevari, Junjie Huang, Mohammad Mahdi Zamani, Jean Jacques Noubiap, Emmanuela Gakidou, Valentin Yurievich Skryabin, Mayowa O. Owolabi, Shubha Jayaram, Hiroyasu Iso, Charles Ugochukwu Ibeneme, Molly R Nixon, Rachel Feldman, Liliana G Ciobanu, Kristina Edvardsson, Claudiu Herteliu, Andreea Mirica, Kindie Mitiku Kebede, Department of Public Health, Collaborators, GBD 2019 Chewing Tobacco, and Lacey, B
Subjects: Male, Health Status, Smoking Prevention, DETERMINANTS, Global Health, 01 natural sciences, Global Burden of Disease, SMOKELESS TOBACCO, 0302 clinical medicine, Risk Factors, Global health, Prevalence, 030212 general & internal medicine, 610 Medicine & health, RISK, High prevalence, WOMEN, Public Health, Global Health, Social Medicine and Epidemiology, Articles, Middle Aged, 3142 Public health care science, environmental and occupational health, Chewing tobacco, Smokeless tobacco, Population Surveillance, A990 Medicine and Dentistry not elsewhere classified, Female, Quality-Adjusted Life Years, Burden of disease, Adult, medicine.medical_specialty, Tobacco, Smokeless, Adolescent, WHO Framework Convention on Tobacco Control, VALIDATION, 03 medical and health sciences, Young Adult, Age Distribution, SDG 3 - Good Health and Well-being, Environmental health, medicine, Humans, 0101 mathematics, Sex Distribution, Chewing tobacco, Prevalence, Global Burden, Smokeless tobacco, business.industry, Public health, Smoking Tobacco, 010102 general mathematics, Public Health, Environmental and Occupational Health, Global Burden, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, STATES, Socioeconomic Factors, Smoking Cessation, business
Abstract: Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Findings In 2019, 273 center dot 9 million (95% uncertainty interval 258 center dot 5 to 290 center dot 9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 center dot 72% (4 center dot 46 to 5 center dot 01). 228 center dot 2 million (213 center dot 6 to 244 center dot 7; 83 center dot 29% [82 center dot 15 to 84 center dot 42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global agestandardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 center dot 21% [-1 center dot 26 to -1 center dot 16]), similar progress was not observed for chewing tobacco (0 center dot 46% [0 center dot 13 to 0 center dot 79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 center dot 94% [-1 center dot 72 to -0 center dot 14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273 & middot;9 million (95% uncertainty interval 258 & middot;5 to 290 & middot;9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 & middot;72% (4 & middot;46 to 5 & middot;01). 228 & middot;2 million (213 & middot;6 to 244 & middot;7; 83 & middot;29% [82 & middot;15 to 84 & middot;42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 & middot;21% [-1 & middot;26 to -1 & middot;16]), similar progress was not observed for chewing tobacco (0 & middot;46% [0 & middot;13 to 0 & middot;79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 & middot;94% [-1 & middot;72 to -0 & middot;14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. For complete list of authors see http://dx.doi.org/10.1016/S2468-2667(21)00065-7
Published: 2021

18. Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author: Mohsen Naghavi, Maarten J. Postma, Mahesh P A, Milena Santric-Milicevic, Barbora de Courten, Parvaiz A Koul, Elias Merdassa Roro, Marek Majdan, Ali H. Mokdad, Mihaela Hostiuc, Félix Carvalho, Rufus A. Adedoyin, Miriam Levi, Ejaz Ahmad Khan, Rakhi Dandona, Mohamad-Hani Temsah, Catalina Liliana Andrei, Benn Sartorius, Gebre Teklemariam Demoz, Derrick A Bennett, Ahmad Daryani, Paulo A. Lotufo, Fereshteh Ansari, Elissa M. Abrams, Luke D. Knibbs, Seyyed Meysam Mousavi, Azeem Majeed, Tomislav Mestrovic, Rajeev Gupta, Irina Filip, Leonardo Roever, G.K. Mini, Lorainne Tudor Car, Ghulam Mustafa, Josip Car, Lalit Dandona, Masoud Moradi, Molly R Nixon, Mohammad Zamani, Babak Moazen, Devasahayam J. Christopher, Chi Linh Hoang, Aaron J Cohen, Hossein Poustchi, Luca Ronfani, Sheikh Mohammed Shariful Islam, Nefsu Awoke, Miguel Tortajada-Girbés, Khalid A Altirkawi, Justin R. Ortiz, Adane Teshome Kefale, Shailesh Advani, Alireza Rafiei, Kristina E. Rudd, Tim Driscoll, Yousef Khader, Heather J. Zar, Josep M. Antó, Milena Ilic, Fakher Rahim, Jost B. Jonas, Trang Huyen Nguyen, Yonatal Mesfin Tefera, Simon I. Hay, Aloke Gopal Ghoshal, Adnan Kisa, Ranjani Somayaji, Gholamreza Roshandel, Smita Pakhale, Francesco Saverio Violante, Monika Sawhney, Eyal Oren, Ali Bijani, Gebrekiros Gebremichael Meles, Hajer Elkout, Shanshan Li, Michael Soljak, Masoud Foroutan, Narayan Bahadur Mahotra, Mina Anjomshoa, Jasvinder A. Singh, Mika Shigematsu, Abdel Douiri, Naohiro Yonemoto, Amir Kasaeian, Lorenzo Monasta, Hagazi Gebre Meles, Rupak Desai, Hai Quang Pham, Feleke Mekonnen Demeke, Marissa B Reitsma, Samath D Dharmaratne, Amr Jamal, Miguel Ángel García-Gordillo, Seyed Sina Naghibi Irvani, Michael K. Hole, Aman Yesuf Endries, Vinay Gupta, Mehdi Naderi, Tham Thi Le, Houman Goudarzi, Hamid Yimam Hassen, Siamak Sabour, Theo Vos, Anurag Agrawal, Ireneous N. Soyiri, Kathleen S Sachiko Berfield, Charles D.A. Wolfe, Jobert Richie Nansseu, Robert C. Reiner, Carlo La Vecchia, Michael Brauer, Jagdish Khubchandani, Alaa Badawi, Sezer Kisa, Basema Saddik, Amir Hasanzadeh, H. Dean Hosgood, Berhe Etsay Tesfay, Ibtihal Fadhil, Ketema Bizuwork Gebremedhin, Ai Koyanagi, Maheswar Satpathy, James Leigh, Si Si, Gregory R. Wagner, Eduarda Fernandes, Huong Lan Thi Nguyen, Isabela M. Benseñor, Tommi Vasankari, Gebreamlak Gebremedhn Gebremeskel, Andrew T Olagunju, Moslem Soofi, Jalal Arabloo, Muhammad Aziz Rahman, Mowafa Househ, Amir Radfar, Gebremicheal Gebreslassie Kasahun, Tara Ballav Adhikari, Songhomitra Panda-Jonas, Gessessew Bugssa Hailu, Komal Saleem, Bach Xuan Tran, Lal B. Rawal, Jee-Young Jasmine Choi, Hadi Pourjafar, Robert S. Bernstein, Ghobad Moradi, Farnam Mohebi, Mariam Molokhia, Kamarul Imran Musa, Elham Ahmadian, Pascual R. Valdez, Irfan Ullah, Ritesh G. Menezes, Dawit Zewdu Wondafrash, Olayinka Stephen Ilesanmi, Masood Ali Shaikh, Richard F. Gillum, Aziz Sheikh, Eun-Kee Park, Virendra Singh, Aziz Eftekhari, Yogesh Sabde, Florian Fischer, Krittika Bhattacharyya, Syed Mohamed Aljunid, Alemayehu Toma, Ruxandra Irina Negoi, Kebede Embaye Gezae, Abadi Kahsu Gebre, Abdullah Al Mamun, Junaid Khan, Yuming Guo, Parkes J Kendrick, Reza Malekzadeh, Bruno Piassi Sao Jose, Mohammad Hifz Ur Rahman, Lidia Morawska, Soraya Siabani, Tinuke O Olagunju, Zahid A Butt, Ronny Westerman, Eyasu Ejeta Duken, Khanh Bao Tran, Yousef Veisani, Getachew Mullu Kassa, Erkin M. Mirrakhimov, Miloje Savic, Anh Kim Dang, Vinay Nangia, Job F M van Boven, Adam Belay Wondmieneh, Alan D. Lopez, G Anil Kumar, Navid Manafi, Andre Pascal Kengne, Joan B. Soriano, Luis Camera, Seok Jun Yoon, Paramjit Gill, Yun Jin Kim, Seyyede Masoume Athari, Gurudatta Naik, Sadaf G. Sepanlou, Sanjeev Nair, Jarnail Singh Thakur, André Faro, Javad Nazari, Gene Bukhman, Nelson Alvis-Guzman, Mayowa O. Owolabi, Lorenzo G. Mantovani, Nobuyuki Horita, Zubair Kabir, Felix Akpojene Ogbo, Birhanu Geta Meharie, Daniel Diaz, Adrian Pana, Salman Rawaf, Mihajlo Jakovljevic, Ted R. Miller, Savita Lasrado, Joseph Adel Mattar Banoub, Fares Alahdab, Jan-Walter De Neve, Carlos A Castañeda-Orjuela, Saeed Safari, Farzad Manafi, Marco Vacante, Katherine R. Paulson, Hamidreza Komaki, Reza Shirkoohi, Young Eun Kim, Duduzile Ndwandwe, Nahla Anber, Ravi Prakash Jha, Farshad Farzadfar, Abdallah M. Samy, Richard Ofori-Asenso, Shafiu Mohammed, Paolo Lauriola, Fabiana Madotto, Yunquan Zhang, Qing Lan, David Laith Rawaf, Zoubida Zaidi, Karzan Abdulmuhsin Mohammad, Juan Jesus Carrero, Morteza Abdullatif Khafaie, Seyyed Shamsadin Athari, Cuong Tat Nguyen, UAM. Departamento de Medicina, Instituto de Investigación Sanitaria Hospital Universitario de La Princesa (IIS-IP), Soriano, J, Kendrick, P, Paulson, K, Gupta, V, Abrams, E, Adedoyin, R, Adhikari, T, Advani, S, Agrawal, A, Ahmadian, E, Alahdab, F, Aljunid, S, Altirkawi, K, Alvis-Guzman, N, Anber, N, Andrei, C, Anjomshoa, M, Ansari, F, Anto, J, Arabloo, J, Athari, S, Awoke, N, Badawi, A, Banoub, J, Bennett, D, Bensenor, I, Berfield, K, Bernstein, R, Bhattacharyya, K, Bijani, A, Brauer, M, Bukhman, G, Butt, Z, Camera, L, Car, J, Carrero, J, Carvalho, F, Castaneda-Orjuela, C, Choi, J, Christopher, D, Cohen, A, Dandona, L, Dandona, R, Dang, A, Daryani, A, de Courten, B, Demeke, F, Demoz, G, De Neve, J, Desai, R, Dharmaratne, S, Diaz, D, Douiri, A, Driscoll, T, Duken, E, Eftekhari, A, Elkout, H, Endries, A, Fadhil, I, Faro, A, Farzadfar, F, Fernandes, E, Filip, I, Fischer, F, Foroutan, M, Garcia-Gordillo, M, Gebre, A, Gebremedhin, K, Gebremeskel, G, Gezae, K, Ghoshal, A, Gill, P, Gillum, R, Goudarzi, H, Guo, Y, Gupta, R, Hailu, G, Hasanzadeh, A, Hassen, H, Hay, S, Hoang, C, Hole, M, Horita, N, Hosgood, H, Hostiuc, M, Househ, M, Ilesanmi, O, Ilic, M, Irvani, S, Islam, S, Jakovljevic, M, Jamal, A, Jha, R, Jonas, J, Kabir, Z, Kasaeian, A, Kasahun, G, Kassa, G, Kefale, A, Kengne, A, Khader, Y, Khafaie, M, Khan, E, Khan, J, Khubchandani, J, Kim, Y, Kisa, S, Kisa, A, Knibbs, L, Komaki, H, Koul, P, Koyanagi, A, Kumar, G, Lan, Q, Lasrado, S, Lauriola, P, La Vecchia, C, Le, T, Leigh, J, Levi, M, Li, S, Lopez, A, Lotufo, P, Madotto, F, Mahotra, N, Majdan, M, Majeed, A, Malekzadeh, R, Mamun, A, Manafi, N, Manafi, F, Mantovani, L, Meharie, B, Meles, H, Meles, G, Menezes, R, Mestrovic, T, Miller, T, Mini, G, Mirrakhimov, E, Moazen, B, Mohammad, K, Mohammed, S, Mohebi, F, Mokdad, A, Molokhia, M, Monasta, L, Moradi, M, Moradi, G, Morawska, L, Mousavi, S, Musa, K, Mustafa, G, Naderi, M, Naghavi, M, Naik, G, Nair, S, Nangia, V, Nansseu, J, Nazari, J, Ndwandwe, D, Negoi, R, Nguyen, T, Nguyen, C, Nguyen, H, Nixon, M, Ofori-Asenso, R, Ogbo, F, Olagunju, A, Olagunju, T, Oren, E, Ortiz, J, Owolabi, M, P A, M, Pakhale, S, Pana, A, Panda-Jonas, S, Park, E, Pham, H, Postma, M, Pourjafar, H, Poustchi, H, Radfar, A, Rafiei, A, Rahim, F, Rahman, M, Rawaf, S, Rawaf, D, Rawal, L, Reiner, R, Reitsma, M, Roever, L, Ronfani, L, Roro, E, Roshandel, G, Rudd, K, Sabde, Y, Sabour, S, Saddik, B, Safari, S, Saleem, K, Samy, A, Santric-Milicevic, M, Sao Jose, B, Sartorius, B, Satpathy, M, Savic, M, Sawhney, M, Sepanlou, S, Shaikh, M, Sheikh, A, Shigematsu, M, Shirkoohi, R, Si, S, Siabani, S, Singh, V, Singh, J, Soljak, M, Somayaji, R, Soofi, M, Soyiri, I, Tefera, Y, Temsah, M, Tesfay, B, Thakur, J, Toma, A, Tortajada-Girbes, M, Tran, K, Tran, B, Tudor Car, L, Ullah, I, Vacante, M, Valdez, P, van Boven, J, Vasankari, T, Veisani, Y, Violante, F, Wagner, G, Westerman, R, Wolfe, C, Wondafrash, D, Wondmieneh, A, Yonemoto, N, Yoon, S, Zaidi, Z, Zamani, M, Zar, H, Zhang, Y, Vos, T, GBD Chronic Respiratory Disease Collaborator, Violante FS, GBD Chronic Respiratory Disease Collaborators, Collaborators, GBD Chronic Respiratory Disease, 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: Male, Respiratory diseases, Respiratory Tract Diseases, Disease, Chronic respiratory diseases, Global Burden of Disease, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Cost of Illness, 11. Sustainability, METABOLIC RISKS, EPIDEMIOLOGY, 030212 general & internal medicine, Child, Cause of death, Aged, 80 and over, COPD, DALY, Chronic obstructive pulmonary disease, Mortality rate, Respiratory disease, 1. No poverty, Age Factors, Middle Aged, Death causes, 3. Good health, PREVALENCE, Health risks, Child, Preschool, COMPARATIVE RISK-ASSESSMENT, Female, death and disability worldwide, Quality-Adjusted Life Years, TERRITORIES, BURDEN, growth in absolute numbers, Pulmonary and Respiratory Medicine, Adult, ADJUSTED LIFE-YEARS, Health burdens, Adolescent, Medicina, 195 COUNTRIES, chronic respiratory diseases, Article, 1117 Public Health and Health Services, 03 medical and health sciences, Young Adult, Life Expectancy, Sex Factors, Burden of Disease, Respiratory disease, Sarcoidosis, Pulmonary, Environmental health, medicine, Disability-adjusted life year, Humans, EXPOSURE, Risk factor, Mortality, Aged, per-capita basis, business.industry, DISABILITY, Infant, Newborn, Infant, 1103 Clinical Sciences, asthma, medicine.disease, Asthma, Years of potential life lost, 030228 respiratory system, Risk factors, 13. Climate action, Systematic analyses, Chronic Disease, INJURIES, Human medicine, Pneumoconiosis, Morbidity, business, Lung Diseases, Interstitial, 1199 Other Medical and Health Sciences
Abstract: Artículo con numerosos autores. Sólo se hace referencia al primero que coincide con el de la UAM y al colectivo, Background Previous attempts to characterise the burden of chronic respiratory diseases have focused only on specific disease conditions, such as chronic obstructive pulmonary disease (COPD) or asthma. In this study, we aimed to characterise the burden of chronic respiratory diseases globally, providing a comprehensive and up-to-date analysis on geographical and time trends from 1990 to 2017. Methods Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we estimated the prevalence, morbidity, and mortality attributable to chronic respiratory diseases through an analysis of deaths, disability-adjusted life-years (DALYs), and years of life lost (YLL) by GBD super-region, from 1990 to 2017, stratified by age and sex. Specific diseases analysed included asthma, COPD, interstitial lung disease and pulmonary sarcoidosis, pneumoconiosis, and other chronic respiratory diseases. We also assessed the contribution of risk factors (smoking, second-hand smoke, ambient particulate matter and ozone pollution, household air pollution from solid fuels, and occupational risks) to chronic respiratory disease-attributable DALYs. Findings In 2017, 544·9 million people (95% uncertainty interval [UI] 506·9–584·8) worldwide had a chronic respiratory disease, representing an increase of 39·8% compared with 1990. Chronic respiratory disease prevalence showed wide variability across GBD super-regions, with the highest prevalence among both males and females in high-income regions, and the lowest prevalence in sub-Saharan Africa and south Asia. The age-sex-specific prevalence of each chronic respiratory disease in 2017 was also highly variable geographically. Chronic respiratory diseases were the third leading cause of death in 2017 (7·0% [95% UI 6·8–7·2] of all deaths), behind cardiovascular diseases and neoplasms. Deaths due to chronic respiratory diseases numbered 3 914 196 (95% UI 3 790 578–4 044 819) in 2017, an increase of 18·0% since 1990, while total DALYs increased by 13·3%. However, when accounting for ageing and population growth, declines were observed in age-standardised prevalence (14·3% decrease), agestandardised death rates (42·6%), and age-standardised DALY rates (38·2%). In males and females, most chronic respiratory disease-attributable deaths and DALYs were due to COPD. In regional analyses, mortality rates from chronic respiratory diseases were greatest in south Asia and lowest in sub-Saharan Africa, also across both sexes. Notably, although absolute prevalence was lower in south Asia than in most other super-regions, YLLs due to chronic respiratory diseases across the subcontinent were the highest in the world. Death rates due to interstitial lung disease and pulmonary sarcoidosis were greater than those due to pneumoconiosis in all super-regions. Smoking was the leading risk factor for chronic respiratory disease-related disability across all regions for men. Among women, household air pollution from solid fuels was the predominant risk factor for chronic respiratory diseases in south Asia and sub-Saharan Africa, while ambient particulate matter represented the leading risk factor in southeast Asia, east Asia, and Oceania, and in the Middle East and north Africa super-region. Interpretation Our study shows that chronic respiratory diseases remain a leading cause of death and disability worldwide, with growth in absolute numbers but sharp declines in several age-standardised estimators since 1990. Premature mortality from chronic respiratory diseases seems to be highest in regions with less-resourced health systems on a per-capita basis, Bill & Melinda Gates Foundation.
Published: 2020

19. Global, regional, and national burden of calcific aortic valve and degenerative mitral valve diseases, 1990-2017

Author: Irina Filip, Félix Carvalho, Dhaval Kolte, Jalal Arabloo, Muthiah Vaduganathan, Abdur Rahman Khan, Olayinka Stephen Ilesanmi, Trang Huyen Nguyen, Alaa Alashi, Ahmad Daryani, Ali Bijani, Adnan Kisa, Molly R Nixon, Charles D.A. Wolfe, Navid Manafi, Andre Pascal Kengne, Leonardo Roever, Tommi Vasankari, Andre Rodrigues Duraes, Adam E. Berman, Samer Hamidi, Seyed Sina Naghibi Irvani, Shanti Patel, Ruxandra Irina Negoi, Sezer Kisa, Celine M. Barthelemy, Aziz Rezapour, Huong Lan Thi Nguyen, Catherine O. Johnson, Ali H. Mokdad, Anas M. Saad, Berhe Etsay Tesfay, Mohsen Afarideh, Simon I. Hay, Erkin M. Mirrakhimov, Amir Manafi, Rufus A. Adedoyin, Eduarda Fernandes, Simon Yadgir, Catherine M Otto, Vahid Alipour, Irfan Ullah, George A. Mensah, Talha Farid, Bach Xuan Tran, Alireza Esteghamati, Farshad Farzadfar, Mohamed M. Gad, Oladimeji Adebayo, Mikk Jürisson, Amir Kasaeian, Victor Aboyans, Gregory A. Roth, Catherine P. Benziger, Naohiro Yonemoto, Amir Radfar, Wasiq Faraz Rawasia, David Laith Rawaf, Juan Jesus Carrero, Thomas Pilgrim, Samad Azari, Karen Sliwa, Seyedmohammad Saadatagah, Yousef Mohammad, Salman Rawaf, Fares Alahdab, and Subramanian Senthilkumaran
Subjects: Male, Aortic valve, Burden of disease, mitral valve, medicine.medical_specialty, Time Factors, Aortic Valve Insufficiency, 030204 cardiovascular system & hematology, Global Health, Risk Assessment, heart valve diseases, 1117 Public Health and Health Services, 03 medical and health sciences, Age Distribution, 0302 clinical medicine, Cost of Illness, Risk Factors, Physiology (medical), Mitral valve, Internal medicine, Prevalence, Humans, Medicine, 030212 general & internal medicine, Global Burden of Disease Study 2017 Nonrheumatic Valve Disease Collaborators, Healthcare Disparities, 610 Medicine & health, 1102 Cardiorespiratory Medicine and Haematology, Mitral Valve Prolapse, global burden of disease, business.industry, Mitral valve diseases, Calcinosis, Mitral Valve Insufficiency, 1103 Clinical Sciences, Aortic Valve Stenosis, Health Status Disparities, aortic valve, medicine.anatomical_structure, Cardiovascular System & Hematology, Quality of Life, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract: Background: Nonrheumatic valvular diseases are common; however, no studies have estimated their global or national burden. As part of the Global Burden of Disease Study 2017, mortality, prevalence, and disability-adjusted life-years (DALYs) for calcific aortic valve disease (CAVD), degenerative mitral valve disease, and other nonrheumatic valvular diseases were estimated for 195 countries and territories from 1990 to 2017. Methods: Vital registration data, epidemiologic survey data, and administrative hospital data were used to estimate disease burden using the Global Burden of Disease Study modeling framework, which ensures comparability across locations. Geospatial statistical methods were used to estimate disease for all countries, because data on nonrheumatic valvular diseases are extremely limited for some regions of the world, such as Sub-Saharan Africa and South Asia. Results accounted for estimated level of disease severity as well as the estimated availability of valve repair or replacement procedures. DALYs and other measures of health-related burden were generated for both sexes and each 5-year age group, location, and year from 1990 to 2017. Results: Globally, CAVD and degenerative mitral valve disease caused 102 700 (95% uncertainty interval [UI], 82 700–107 900) and 35 700 (95% UI, 30 500–42 500) deaths, and 12.6 million (95% UI, 11.4 million–13.8 million) and 18.1 million (95% UI, 17.6 million–18.6 million) prevalent cases existed in 2017, respectively. A total of 2.5 million (95% UI, 2.3 million–2.8 million) DALYs were estimated as caused by nonrheumatic valvular diseases globally, representing 0.10% (95% UI, 0.09%–0.11%) of total lost health from all diseases in 2017. The number of DALYs increased for CAVD and degenerative mitral valve disease between 1990 and 2017 by 101% (95% UI, 79%–117%) and 35% (95% UI, 23%–47%), respectively. There is significant geographic variation in the prevalence, mortality rate, and overall burden of these diseases, with highest age-standardized DALY rates of CAVD estimated for high-income countries. Conclusions: These global and national estimates demonstrate that CAVD and degenerative mitral valve disease are important causes of disease burden among older adults. Efforts to clarify modifiable risk factors and improve access to valve interventions are necessary if progress is to be made toward reducing, and eventually eliminating, the burden of these highly treatable diseases.
Published: 2020

20. Mapping disparities in education across low- and middle-income countries

Author: Lauren E. Schaeffer, Belay Tessema, Reza Malekzadeh, Olatunde Aremu, Mehdi Hosseinzadeh, Milena M Santric Milicevic, Seyyed Meysam Mousavi, Azeem Majeed, Badr Hasan Sobaih, Jalal Arabloo, Philimon Gona, Aliasghar Ahmad Kiadaliri, Mostafa Qorbani, Fatemeh Rajati, Ipsita Sutradhar, Giuseppe Remuzzi, Babak Eshrati, Olufemi Ajumobi, Lauren Woyczynski, Parul Puri, Vinay Nangia, Guoqing Hu, Yousef Khader, Suzanne Barker-Collo, Hamideh Salimzadeh, Félix Carvalho, Yun Jin Kim, Moslem Soofi, Ali Bijani, Shanshan Li, Catalina Liliana Andrei, Ali Kazemi Karyani, Mehran Asadi-Aliabadi, Andrea Sylvia Winkler, Arya Haj-Mirzaian, Maziar Moradi-Lakeh, Farnam Mohebi, Mohamad-Hani Temsah, Kala M. Mehta, Simon I. Hay, Benjamin B. Massenburg, Sanjay Zodpey, Tuomo J. Meretoja, Ireneous N. Soyiri, Bach Xuan Tran, George C Patton, Kavumpurathu Raman Thankappan, Engida Yisma, Vasily Vlassov, Samer Hamidi, Ghulam Mustafa, André Faro, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Rajat Gupta, Shirin Djalalinia, Dina Nur Anggraini Ningrum, Sheikh Mohammed Shariful Islam, Juan Sanabria, Leonardo Roever, Dayane Gabriele Alves Silveira, Samad Azari, Vahid Alipour, Gabrielle B. Britton, Luca Ronfani, Rosario Cárdenas, Maarten J. Postma, Hamid Yimam Hassen, Pn Sylaja, Brijesh Sathian, Paul S. F. Yip, Vegard Skirbekk, Chhabi Lal Ranabhat, Paramjit Gill, Walter Mendoza, Lorenzo Monasta, Dara K. Mohammad, Naznin Hossain, Dhirendra N Sinha, Ali H. Mokdad, Aziz Rezapour, Megan F. Schipp, Ziyad Al-Aly, Takeshi Fukumoto, Kebede Deribe, Paula Moraga, Mohammad Ebrahimi Kalan, Ai Koyanagi, Andre M. N. Renzaho, Cyrus Cooper, Ghobad Moradi, Ruth W Kimokoti, Swayam Prakash, Rafael Tabarés-Seisdedos, Zahra Jorjoran Shushtari, Zemenu Tadesse Tessema, Amir Radfar, Jean Jacques Noubiap, Emmanuela Gakidou, Mahdi Afshari, Suleman Atique, Reza Majdzadeh, Kiomars Sharafi, Seyed-Mohammad Fereshtehnejad, Foad Abd-Allah, Zahid A Butt, Beruk Berhanu Desalegn, Ruxandra Irina Negoi, Marek Majdan, Yoshan Moodley, Jianrong Zhang, Farid Najafi, Aso Mohammad Darwesh, Benn Sartorius, Amber Sligar, Nicole Davis Weaver, Naohiro Yonemoto, Jacob Olusegun Olusanya, Olayinka Stephen Ilesanmi, Neeraj Bedi, Suraj Bhattarai, Sadaf G. Sepanlou, Francisco Rogerlandio Martins-Melo, Malihe Nourollahpour Shiadeh, Bernardo Hernández Prado, Masood Ali Shaikh, Khalid A Altirkawi, Carlos Rios-Gonzalez, Claudiu Herteliu, Jason B. Hall, Irina Filip, Abdullah Sulieman Terkawi, Sojib Bin Zaman, Nathaniel J Henry, Eleonora Dubljanin, Jasvinder A. Singh, Pushpendra Kumar, Akram Pourshams, Jung-Chen Chang, Irfan Ullah, Lorainne Tudor Car, Franz Castro, George A. Mensah, Delia Hendrie, Mehran Shams-Beyranvand, Zulfiqar A Bhutta, Jaifred Christian F. Lopez, Laura Dwyer-Lindgren, Lee Ling Lim, Charles D.A. Wolfe, Adnan Kisa, Seyed Sina Naghibi Irvani, Alaa Badawi, Bolajoko O. Olusanya, Tomohide Yamada, Gholamreza Roshandel, Jonathan F. Mosser, Jose A. Garcia, Andre Rodrigues Duraes, Mohammadreza Amiresmaili, Krittika Bhattacharyya, Yuan-Pang Wang, Sebastian Vollmer, Felix Akpojene Ogbo, Birkneh Tilahun Tadesse, Mihajlo Jakovljevic, Songhomitra Panda-Jonas, Paul H. Lee, Michael Collison, Sanghamitra Pati, Aziz Sheikh, Kalkidan Hassen Abate, Anthony Barnett, Ejaz Ahmad Khan, Michael A. Cork, Meghnath Dhimal, Norberto Perico, Francesco Saverio Violante, Daniel N. Kiirithio, Ted R. Miller, Arundhati R. Sawant, Olalekan A. Uthman, Kewal Krishan, Ashish Awasthi, Anthony Masaka, Katherine F. Wilson, Padukudru Anand Mahesh, Roy Burstein, Amir Kasaeian, Yuming Guo, Peter Nyasulu, Chuanhua Yu, Pascual R. Valdez, Josephine W. Ngunjiri, Vipin Gupta, Tomislav Mestrovic, Long Hoang Nguyen, Neda Izadi, Faris Lami, Marcos Roberto Tovani-Palone, Azin Nahvijou, Jun She, Christopher J L Murray, Krishna K. Aryal, Payman Salamati, Mona M. Khater, Rajeev Gupta, Robert Reiner, Mustafa Z. Younis, Ali Rostami, Duduzile Ndwandwe, Obinna Onwujekwe, Manasi Kumar, Nafis Sadat, Nahla Anber, Joan B. Soriano, Victor Adekanmbi, John C. Wilkinson, Babak Moazen, Andrew T Olagunju, Nicholas Graetz, Andualem Henok, Mina Anjomshoa, Boris Bikbov, Melaku Desta, Yahya Safari, Jan-Walter De Neve, Carlos A Castañeda-Orjuela, Mohammad Fareed, Ayman Grada, Eduardo Ortiz-Panozo, Rajesh Sharma, Beatriz Paulina Ayala Quintanilla, Enrico Rubagotti, John S. Ji, Mika Shigematsu, Fakher Rahim, Randah R. Hamadeh, G. K. Mini, Yasir Waheed, Meghdad Pirsaheb, Yousef Veisani, Daniel Diaz, Adrian Pana, Salman Rawaf, Ehsan Sadeghi, Yahya Salimi, Joseph Adel Mattar Banoub, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, David M. Pigott, Fares Alahdab, Vafa Rahimi-Movaghar, Anbissa Muleta Senbeta, Tomi Akinyemiju, Damaris K. Kinyoki, Morteza Shamsizadeh, Ziad El-Khatib, Abdallah M. Samy, Roman Topor-Madry, Farah Daoud, Cuong Tat Nguyen, Aubrey J. Levine, Sameer Vali Gopalani, Ravi Prakash Jha, Mesfin Tadese Dinberu, Shafiu Mohammed, Simon Øverland, David Laith Rawaf, Arvin Haj-Mirzaian, Satar Rezaei, Oladimeji Adebayo, Nasir Salam, Mohammad Ali Mansournia, Rajesh Sagar, Alex Yeshaneh, Michael K. Hole, Agus Sudaryanto, Yunquan Zhang, Mahbobeh Faramarzi, Natalia V. Bhattacharjee, Aniruddha Deshpande, Soewarta Kosen, Mahmoud Yousefifard, Jacek Jerzy Jozwiak, Mehedi Hasan, Shane D. Morrison, Erkin M. Mirrakhimov, Marcel Ausloos, Ionut Negoi, Jacqueline Elizabeth Alcalde Rabanal, Barthelemy Kuate Defo, Giang Thu Vu, Lucas Earl, Doris D. V. Ortega-Altamirano, Yu Liao, Peter Njenga Keiyoro, Tanuj Kanchan, Chandrasekharan Nair Kesavachandran, Mu'awiyyah Babale Sufiyan, Mohammad Hifz Ur Rahman, Lidia Morawska, Tiffany K. Gill, Manisha Dubey, David C. Schwebel, Jost B. Jonas, Ester Cerin, Mehran Alijanzadeh, Florian Fischer, Stefan Listl, Benjamin K. Mayala, Mahmood Moosazadeh, Soraya Siabani, Derrick A Bennett, Collaborators, Local Burden of Disease Educational Attainment, Institute for Molecular Medicine Finland, HUS Comprehensive Cancer Center, Clinicum, Helsinki University Hospital Area, University of Helsinki, Local Burden Dis Educ Attainment C, Graetz N., Woyczynski L., Wilson K.F., Hall J.B., Abate K.H., Abd-Allah F., Adebayo O.M., Adekanmbi V., Afshari M., Ajumobi O., Akinyemiju T., Alahdab F., Al-Aly Z., Rabanal J.E.A., Alijanzadeh M., Alipour V., Altirkawi K., Amiresmaili M., Anber N.H., Andrei C.L., Anjomshoa M., Antonio C.A.T., Arabloo J., Aremu O., Aryal K.K., Asadi-Aliabadi M., Atique S., Ausloos M., Awasthi A., Quintanilla B.P.A., Azari S., Badawi A., Banoub J.A.M., Barker-Collo S.L., Barnett A., Bedi N., Bennett D.A., Bhattacharjee N.V., Bhattacharyya K., Bhattarai S., Bhutta Z.A., Bijani A., Bikbov B., Britton G., Burstein R., Butt Z.A., Cardenas R., Carvalho F., Castaneda-Orjuela C.A., Castro F., Cerin E., Chang J.-C., Collison M.L., Cooper C., Cork M.A., Daoud F., Das Gupta R., Weaver N.D., De Neve J.-W., Deribe K., Desalegn B.B., Deshpande A., Desta M., Dhimal M., Diaz D., Dinberu M.T., Djalalinia S., Dubey M., Dubljanin E., Duraes A.R., Dwyer-Lindgren L., Earl L., Kalan M.E., El-Khatib Z., Eshrati B., Faramarzi M., Fareed M., Faro A., Fereshtehnejad S.-M., Fernandes E., Filip I., Fischer F., Fukumoto T., Garcia J.A., Gill P.S., Gill T.K., Gona P.N., Gopalani S.V., Grada A., Guo Y., Gupta R., Gupta V., Haj-Mirzaian A., Hamadeh R.R., Hamidi S., Hasan M., Hassen H.Y., Hendrie D., Henok A., Henry N.J., Prado B.H., Herteliu C., Hole M.K., Hossain N., Hosseinzadeh M., Hu G., Ilesanmi O.S., Irvani S.S.N., Islam S.M.S., Izadi N., Jakovljevic M., Jha R.P., Ji J.S., Jonas J.B., Shushtari Z.J., Jozwiak J.J., Kanchan T., Kasaeian A., Karyani A.K., Keiyoro P.N., Kesavachandran C.N., Khader Y.S., Khafaie M.A., Khan E.A., Khater M.M., Kiadaliri A.A., Kiirithio D.N., Kim Y.J., Kimokoti R.W., Kinyoki D.K., Kisa A., Kosen S., Koyanagi A., Krishan K., Defo B.K., Kumar M., Kumar P., Lami F.H., Lee P.H., Levine A.J., Li S., Liao Y., Lim L.-L., Listl S., Lopez J.C.F., Majdan M., Majdzadeh R., Majeed A., Malekzadeh R., Mansournia M.A., Martins-Melo F.R., Masaka A., Massenburg B.B., Mayala B.K., Mehta K.M., Mendoza W., Mensah G.A., Meretoja T.J., Mestrovic T., Miller T.R., Mini G.K., Mirrakhimov E.M., Moazen B., Mohammad D.K., Darwesh A.M., Mohammed S., Mohebi F., Mokdad A.H., Monasta L., Moodley Y., Moosazadeh M., Moradi G., Moradi-Lakeh M., Moraga P., Morawska L., Morrison S.D., Mosser J.F., Mousavi S.M., Murray C.J.L., Mustafa G., Nahvijou A., Najafi F., Nangia V., Ndwandwe D.E., Negoi I., Negoi R.I., Ngunjiri J.W., Nguyen C.T., Nguyen L.H., Ningrum D.N.A., Noubiap J.J., Shiadeh M.N., Nyasulu P.S., Ogbo F.A., Olagunju A.T., Olusanya B.O., Olusanya J.O., Onwujekwe O.E., Ortega-Altamirano D.D.V., Ortiz-Panozo E., Overland S., Mahesh P.A., Pana A., Panda-Jonas S., Pati S., Patton G.C., Perico N., Pigott D.M., Pirsaheb M., Postma M.J., Pourshams A., Prakash S., Puri P., Qorbani M., Radfar A., Rahim F., Rahimi-Movaghar V., Rahman M.H.U., Rajati F., Ranabhat C.L., Rawaf D.L., Rawaf S., Reiner R.C., Remuzzi G., Renzaho A.M.N., Rezaei S., Rezapour A., Rios-Gonzalez C., Roever L., Ronfani L., Roshandel G., Rostami A., Rubagotti E., Sadat N., Sadeghi E., Safari Y., Sagar R., Salam N., Salamati P., Salimi Y., Salimzadeh H., Samy A.M., Sanabria J., Santric Milicevic M.M., Sartorius B., Sathian B., Sawant A.R., Schaeffer L.E., Schipp M.F., Schwebel D.C., Senbeta A.M., Sepanlou S.G., Shaikh M.A., Shams-Beyranvand M., Shamsizadeh M., Sharafi K., Sharma R., She J., Sheikh A., Shigematsu M., Siabani S., Silveira D.G.A., Singh J.A., Sinha D.N., Skirbekk V., Sligar A., Sobaih B.H., Soofi M., Soriano J.B., Soyiri I.N., Sreeramareddy C.T., Sudaryanto A., Babale Sufiyan M., Sutradhar I., Sylaja P., Tabares-Seisdedos R., Tadesse B.T., Temsah M.-H., Terkawi A.S., Tessema B., Tessema Z.T., Thankappan K.R., Topor-Madry R., Tovani-Palone M.R., Tran B.X., Car L.T., Ullah I., Uthman O.A., Valdez P.R., Veisani Y., Violante F.S., Vlassov V., Vollmer S., Thu Vu G., Waheed Y., Wang Y.-P., Wilkinson J.C., Winkler A.S., Wolfe C.D.A., Yamada T., Yeshaneh A., Yip P., Yisma E., Yonemoto N., Younis M.Z., Yousefifard M., Yu C., Bin Zaman S., Zhang J., Zhang Y., Zodpey S., Gakidou E., Hay S.I., Graetz, Nicholas, Woyczynski, Lauren, Wilson, Katherine F, Hall, Jason B, Yisma, Engida, Hay, Simon I, Local Burden of Disease Educational Attainment Collaborators, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Value, Affordability and Sustainability (VALUE)
Subjects: Male, ATTAINMENT, Health Status, Disease, education, low- and middle-income countries, 0302 clinical medicine, WORLD, gender, Global health, risk factors, 030212 general & internal medicine, Aetiology, 10. No inequality, media_common, Developing world, Pediatric, Multidisciplinary, 1. No poverty, Multidisciplinary Sciences, Geography, Science & Technology - Other Topics, Female, HEALTH, developing world, social and economic factors, Engineering sciences. Technology, disparitie, AFRICA, medicine.medical_specialty, Inequality, General Science & Technology, media_common.quotation_subject, MODELS, Developing country, Local Burden of Disease Educational Attainment Collaborators, Article, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Education, 03 medical and health sciences, 2.3 Psychological, medicine, Humans, Society, Social determinants of health, Developing Countries, Science & Technology, Equity (economics), MORTALITY, Public health, Bayes Theorem, Educational attainment, 3141 Health care science, society, Good Health and Well Being, Risk factors, Socioeconomic Factors, Demographic economics, 030217 neurology & neurosurgery
Abstract: Educational attainment is an important social determinant of maternal, newborn, and child health1–3. As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting4–6. The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness7,8; however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health9–11. Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but—to our knowledge—no analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries12–14. By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations., Analyses of the proportions of individuals who have completed key levels of schooling across all low- and middle-income countries from 2000 to 2017 reveal inequalities across countries as well as within populations.
Published: 2020

21. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Sorin Hostiuc, Shaun Wen Huey Lee, Jorge R. Ledesma, Carsten Flohr, Masoumeh Sadeghi, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Cyrus Alinia, Mehdi Bohluli, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Seyyed Meysam Mousavi, Bernhard T. Baune, Ehsan Ahmadpour, Dinh-Toi Chu, Beatrix Haddock, Gianfranco Alicandro, Vasily Vlassov, Mohammad Taghi Khodayari, Gianna Gayle Herrera Amul, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Fereshteh Ansari, Michael K. Hole, Azeem Majeed, Iman Halvaei, Saqib Ali, Arianna Maever L. Amit, Tomas Y. Yeheyis, John S. Ji, Martin McKee, Jamileh Shadid, Leonardo Roever, Peng Jia, Ettore Beghi, Pablo M. Lavados, Young Eun Kim, Vahid Alipour, Sowmya J. Rao, Ahmad Daryani, Cathleen Keller, Ibrahim Abdollahpour, Nicole K. DeCleene, Ebrahim Babaee, Saman Esmaeilnejad, Boris Bikbov, William M. Gardner, Lydia M. Haile, Luca Ronfani, Azalea M. Thomson, Irena Ilic, Ruth W. Kimokoti, Yingxi Zhao, Guoqing Hu, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Nathaniel J. Henry, Brijesh Sathian, Daniel Kim, Peter Memiah, Mohammad Hadi Abbasi, Andrea Farioli, Zahra Kamiab, Bolajoko O. Olusanya, Matthew C. Doxey, Tommi Vasankari, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Shanshan Li, Tanvir M. Huda, Dillon O Sylte, Rosario Cárdenas, Agegnehu Bante, Helen Ippolito, Alyssa Acebedo, Jeffrey D. Stanaway, Anwar Faraj, João Pedro Silva, Amin Mousavi Khaneghah, Pushpendra Kumar, Sangram Kishor Patel, Josephine W. Ngunjiri, Holly E. Erskine, Eugene Sobngwi, Filippo Ariani, Shane D. Morrison, Mohammad Aghaali, Meghan D. Mooney, Vera Marisa Costa, Palash Chandra Banik, Rupak Desai, Ken Takahashi, Maigeng Zhou, Morteza Oladnabi, Bogdan Oancea, Daniela Ribeiro, Mohammad Farahmand, Irmina Maria Michalek, Yetunde O. John-Akinola, Khem Narayan Pokhrel, Emilie R Maddison, Syed Mohamed Aljunid, Damian G. Hoy, Hosni Salem, V. Prakash, Shuhei Nomura, Inga Dora Sigfusdottir, Anders Larsson, Sharareh Eskandarieh, Abdollah Mohammadian-Hafshejani, Somayeh Bohlouli, Joana Morgado-da-Costa, Siamak Sabour, Theo Vos, Han Yong Wunrow, Khaled Khatab, Alireza Zangeneh, Ann Kristin Knudsen, Marissa B Reitsma, Hannah J. Henrikson, Randah R. Hamadeh, Tuomo J. Meretoja, Ireneous N. Soyiri, Giuseppe Grosso, Ziyad Al-Aly, Taraneh Yousefinezhadi, Joseph L Ward, Roba Khundkar, Ricardo Santiago Gomez, Reza Malekzadeh, John J. McGrath, Sandra B. Munro, Shahin Soltani, Amy E. Peden, Rufus Akinyemi, Marcel Ausloos, Naohiro Yonemoto, Bogdan Wojtyniak, Ahmad Ghashghaee, Guilherme Borges, Sadia Bibi, Farhad Islami, Hamed Mirzaei, Mohammad Ali Sahraian, M. Ashworth Dirac, Hosna Janjani, Kairat Davletov, Hermann Brenner, Yuichiro Yano, Elissa M. Abrams, Ana Vukovic, Bartosz Miazgowski, Jobert Richie Nansseu, Jennifer O Lam, Mona Pathak, Leeberk Raja Inbaraj, Thirunavukkarasu Sathish, Asadollah Gholamian, Carlos A Castañeda-Orjuela, Babak Eshrati, Edgar Denova-Gutiérrez, Atte Meretoja, Lorenzo Monasta, Ronan A. Lyons, Neda Kianipour, Desalegn Getnet Demsie, Yasir Waheed, Desta Debalkie Atnafu, Davide Sattin, Kevin S Ikuta, Ghobad Moradi, Srinivas Goli, Krittika Bhattacharyya, Mika Kivimäki, Christopher Troeger, Jordi Alonso, Alireza Ahmadi, Navid Manafi, Caroline Stein, Songhomitra Panda-Jonas, Jason Nguyen, Moses K. Muriithi, Aziz Rezapour, Ismael R. Campos-Nonato, Adrian Pana, H. Dean Hosgood, Noore Alam, James L. Fisher, Mariam Molokhia, Susan F. Rumisha, Ernoiz Antriyandarti, Ayman Grada, Emma Nichols, Babak Asghari, André Luiz Sena Guimarães, Ferrán Catalá-López, Aletta E. Schutte, Fiona B. Bennitt, Maciej Banach, Antonio Biondi, Donal Bisanzio, Josip Car, Ronny Westerman, Shafiu Mohammed, Biniyam Sahiledengle Geberemariyam, Kenji Shibuya, Meghdad Pirsaheb, Milena Santric-Milicevic, Karen M. Tabb, Paula Moraga, Soheil Hassanipour, Hasan Yusefzadeh, Avina Vongpradith, Dara K. Mohammad, Ralph Maddison, Babak Moazen, Getachew Mullu Kassa, Rahman Shiri, Fernando Neves Hugo, Hmwe H Kyu, Zachary V Dingels, Florian Fischer, Valentin Yurievich Skryabin, Rafael Tabarés-Seisdedos, Massimo Cirillo, Nikita Otstavnov, Robert C. Reiner, Van C. Lansingh, Rodrigo Sarmiento-Suarez, Ashkan Afshin, Benjamin A Stark, Mohsen Abbasi-Kangevari, Natalie C. Galles, Behnam Heidari, Eun-Kee Park, Mohammad Ali Jahani, Suzanne Polinder, Mahalaqua Nazli Khatib, Farhad Jadidi-Niaragh, Amir Radfar, Mowafa Househ, Derrick A Bennett, Gaorui Guo, Hesam Ghiasvand, Taweewat Wiangkham, Tamás Joó, Cristiana Abbafati, Kathryn Mei Ming Lau, Anita K. Nandi, Miklós Szócska, Manasi Kumar, Eduardo A. Undurraga, Oladimeji M. Adebayo, Simon Yadgir, Victor Aboyans, Justin J. Lang, Catherine O. Johnson, Soewarta Kosen, Carla Sofia e.Sá Farinha, Marcos Roberto Tovani-Palone, Kamarul Imran Musa, Farshad Pourmalek, Kiomars Sharafi, Heather Orpana, Samuel B. Albertson, Mahdi Afshari, Nicholas J K Breitborde, Nelson J. Alvis-Zakzuk, Adrian Oţoiu, Iván Landires, Robert G. Weintraub, Kidanemaryam Berhe, André Faro, Sophia Emmons-Bell, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Yordanos Gizachew Yeshitila, Mehdi Hosseinzadeh, Arash Etemadi, Oleguer Plana-Ripoll, Theodore Patrick Younker, Joemer C. Maravilla, Alireza Ansari-Moghaddam, Borhan Mansouri, Narayanaswamy Venketasubramanian, Seyed Mohammad Kazem Aghamir, Linda Morales, Amanda Deen, Noushin Mohammadifard, Obinna Onwujekwe, Ai Koyanagi, Michele Nguyen, Chieh Han, Kiana Ramezanzadeh, Mika Shigematsu, Mohammed Shannawaz, Khurshid Alam, Javad Nazari, Bryan L. Sykes, Rajat Das Gupta, Stephen S Lim, Lingkan Barua, Zubair Kabir, Michael Brauer, Afarin Rahimi-Movaghar, Deepa Jahagirdar, Kaja Abbas, Gholamreza Bazmandegan, Mark A. Stokes, Rajaa Al-Raddadi, Kanyin L. Ong, Kate Causey, Ahmed Omar Bali, Matilde Leonardi, Jeffrey V. Lazarus, Wondimeneh Shibabaw Shiferaw, André Karch, Blair R. Bumgarner, Nelson Alvis-Guzman, Jennifer H MacLachlan, Saeed Amini, Parvaiz A Koul, Blessing J. Akombi, Ro Ting Lin, Dabere Nigatu, Alaa Badawi, Flavia M. Cicuttini, Deanna Anderlini, Claudio Alberto Dávila-Cervantes, Rupert R A Bourne, Tanuj Kanchan, Catherine P. Benziger, Tahiya Alam, M. Mofizul Islam, Muktar Omer Omer, Leila Zaki, Mehdi Mirzaei-Alavijeh, Inbal Salz, Katharine J Looker, Shiwei Liu, Fatemeh Amiri, Christopher R. Cederroth, Mitra Abbasifard, Hamidreza Pazoki Toroudi, Gbenga A. Kayode, Antonio Luiz Pinho Ribeiro, Krishna Kumar Aryal, Mu'awiyyah Babale Sufiyan, Mohamed M. Gad, Assefa Desalew, Lidia Morawska, Davood Anvari, Mohammad Reza Salahshoor, Hadi Pourjafar, Abdu A. Adamu, Maryam Adabi, Zulfiqar A. Bhutta, Jessica A. Cruz, Foad Abd-Allah, Amir Hasanzadeh, Jordan Weiss, Maryam Ghadimi, Seyed-Mohammad Fereshtehnejad, Serge Resnikoff, Joanna L Whisnant, Kelly Compton, Priya Parmar, Sanjay Basu, Leila R Kalankesh, Nickolas Reinig, Ana Maria Mantilla Herrera, Fatemeh Rajati, Damian Santomauro, Mojisola Oluwasanu, Sheikh Mohammed Shariful Islam, David M. Pereira, Joht Singh Chandan, Deepak Kumar Pasupula, Aristidis Tsatsakis, Hoa Thi Do, Whitney L. Teagle, Hans W. Hoek, James Leigh, Morteza Arab-Zozani, Yasser Vasseghian, Stephanie R M Zimsen, Charlie Ashbaugh, Fariba Dorostkar, Abdelrahman Ibrahim Abushouk, Mikk Jürisson, Golnaz Heidari, Kala M. Mehta, Saeed Shahabi, Sarah Wulf Hanson, Nizal Sarrafzadegan, Dharmesh Kumar Lal, Hai Quang Pham, Aleksandr Y. Aravkin, Joshua A. Salomon, David C. Schwebel, Milena Ilic, Kareha M Agesa, Jost B. Jonas, Dian Kusuma, Benjamin B. Massenburg, Santosh Varughese, Yousef Mohammad, Beatriz Paulina Ayala Quintanilla, Mihaela Hostiuc, Richard G. Cowden, Morteza Shamsizadeh, Thomas Pilgrim, Alessandra C. Goulart, Leila Doshmangir, Gabriele Nagel, Saravanan Muthupandian, Zahra Sadat Dibaji Forooshani, Maryam Mirzaei, Zabihollah Yousefi, Shadrach Wilson, Iman El Sayed, Juanita A. Haagsma, Segun Emmanuel Ibitoye, Eirini Skiadaresi, Reza Shirkoohi, Tim Driscoll, Morteza Jafarinia, Maha El Tantawi, Telma Zahirian Moghadam, Katarzyna Kissimova-Skarbek, Abdilahi Yousuf Yousuf, Dickson A. Amugsi, Awoke Misganaw, Maseer Khan, Norito Kawakami, Jingkai Wei, Jai K Das, Vishnu Renjith, Tessa M. Pilz, Sameer Vali Gopalani, Roghiyeh Faridnia, Islam Y. Elgendy, Prateek Rastogi, Lauren B. Wilner, Josep Maria Haro, Zahiruddin Quazi Syed, Ben Lacey, Ketema Bizuwork Gebremedhin, Sam Rolfe, Iffat Elbarazi, Yannick Béjot, Raimundas Lunevicius, Sezer Kisa, Harish Chander Gugnani, Basema Saddik, Manu Raj Mathur, Mansour Ghafourifard, Riaz Uddin, Anna Poznańska, Faris Lami, Niguse Meles Alema, Michael T. Chung, Arya Aminorroaya, Arash Sarveazad, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, João M. Furtado, Hamid Ahmadieh, Sara Conti, Yunquan Zhang, Manthan D Janodia, Aislyn U. Orji, S. Mohammad Sajadi, Jalal Arabloo, Gabrielle B. Britton, Colm McAlinden, Francisco Rogerlândio Martins-Melo, Simona Cătălina Ştefan, Ester Cerin, Nuno Taveira, Lars Jacob Stovner, Amir Taherkhani, Masoud Foroutan, Tomasz Miazgowski, Amir Manafi, Yeshambel T. Nigatu, Barthelemy Kuate Defo, Mithila Faruque, Alan D. Lopez, Man Mohan Mehndiratta, Graeme J. Hankey, Mojgan Gitimoghaddam, Chantal Huynh, G Anil Kumar, Martin Amogre Ayanore, Abbas Sheikhtaheri, Turki Alanzi, Simon Øverland, David Laith Rawaf, Brian J. Hall, Edward J Mills, Ali Kabir, Ravi Prakash Jha, Akbar Barzegar, Simin Mouodi, Alize J. Ferrari, Chirag P. Doshi, Saleh Salehi Zahabi, Mohsen Naghavi, Mohammad Hassan Emamian, Amir Jalali, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Maarten J. Postma, David Edvardsson, Chhabi Lal Ranabhat, Catherine M. Antony, Hannah Han, Ken Lee Chin, Getinet Ayano, Kewal Krishan, Maryam Zamanian, Farshad Farzadfar, Ali A. Asadi-Pooya, Daniel Diaz, Oliver J. Brady, Mohsen Bayati, Christopher M Odell, Jalil Jaafari, Walter Mendoza, Susanna Dunachie, Raffaele Palladino, Raaj Kishore Biswas, Alessandra Lugo, Reshmi Bhageerathy, Paulo A. Lotufo, Maia Kereselidze, Salman Rawaf, Olayinka Stephen Ilesanmi, Mousa Yaminfirooz, Neeraj Bedi, Mahesh P A, Harvey Whiteford, Gina Agarwal, Pallab K. Maulik, Ranjitha S Shetty, Adhanom Gebreegziabher Baraki, Prasanna Mithra, Binyam Minuye Birihane, Mohammad Ali Mansournia, Tomislav Mestrovic, Razique Anwer, Marcello Tonelli, Hanne Christensen, Juan Jesus Carrero, Ali H. Mokdad, Alberto Ortiz, Samad Azari, Ted R. Miller, Rebecca Ivers, Stephen R. Robinson, Saeid Safiri, Masood Ali Shaikh, Rajesh Sagar, Kelly Cercy, Mehran Asadi-Aliabadi, João Vasco Santos, Maziar Moradi-Lakeh, Sarah Lewington, Dimas Ria Angga Pribadi, Savita Lasrado, Abdul Moiz Hafiz, Amir Almasi-Hashiani, Burcu Kucuk Bicer, Praveen Hoogar, Fatemeh Heydarpour, Hala Rashad Elhabashy, Peng Zheng, Senthilkumar Balakrishnan, Paul H. Lee, Cameron J. Kneib, Srinivasa Rao Bolla, Harrison Chase Gottlich, Andrew M. Briggs, Alibek Mereke, Om P Kurmi, Kavumpurathu Raman Thankappan, Nikolay Ivanovich Briko, Shahram Saeidi, Anbissa Muleta Senbeta, Assefa Ayalew Ayalew Ayalew Gebreslassie, Aminu K. 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L., Department of Public Health, Clinicum, Department of Neurosciences, HUS Comprehensive Cancer Center, Environmental Sciences, Public Health, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Sálfræðideild (HR), Department of Psychology (RU), Samfélagssvið (HR), School of Social Sciences (RU), Háskólinn í Reykjavík, Reykjavik University, GBD 2019 Diseases and Injuries Collaborator, Violante FS, Department of Earth Observation Science, Faculty of Geo-Information Science and Earth Observation, and UT-I-ITC-ACQUAL
Subjects: Male, Life expectancy, Disability-Adjusted Life Year, Diseases, Disease, communicable disease, systematic analysis, Global Burden of Disease, 0302 clinical medicine, 80 and over, Medicine, 10. No inequality, Child, 11 Medical and Health Sciences, injuries, Aged, 80 and over, education.field_of_study, Sjúkdómar, DEMENTIA, FALLS, General Medicine, Forvarnir, 3. Good health, Child, Preschool, Human, GBD, Population health, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Humans, Global Burden of Disease Study, education, Aged, Spatial Analysis, Global burden, Disability, Prevention, DISABILITY, Infant, Spatial Analysi, Mortality rate, Global Burden of Disease, Diseases, Injuries, Systematic analysis, PREVENTION, Years of potential life lost, Risk factors, Disease study, ITC-ISI-JOURNAL-ARTICLE, RISK-FACTORS, Clinical Medicine, RA, Demography, Fötlun, Dánartíðni, Áhættuþættir, 030204 cardiovascular system & hematology, Risk Factors, Cause of Death, Global health, 030212 general & internal medicine, 1. No poverty, Disability-Adjusted Life Years, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, 3142 Public health care science, environmental and occupational health, Adolescent, Adult, Age Distribution, Female, Infant, Newborn, Young Adult, Lýðheilsa, CLINICAL-TRIALS, Population, Settore MED/01 - Statistica Medica, diseases, ITC-HYBRID, Heilbrigðisvísindi, General & Internal Medicine, Mortality, Preschool, Disease burden, business.industry, Risk Factor, Klinisk medicin, Newborn, purl.org/pe-repo/ocde/ford#3.02.00 [https], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Áverkar, Systematic analysis, NA, business
Abstract: Publisher's version (útgefin grein), Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd., Research reported in this publication was supported by the Bill & Melinda Gates Foundation; the University of Melbourne; Queensland Department of Health, Australia; the National Health and Medical Research Council, Australia; Public Health England; the Norwegian Institute of Public Health; St Jude Children's Research Hospital; the Cardiovascular Medical Research and Education Fund; the National Institute on Ageing of the National Institutes of Health (award P30AG047845); and the National Institute of Mental Health of the National Institutes of Health (award R01MH110163). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. The authors alone are responsible for the views expressed in this Article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated, the National Health Service (NHS), the National Institute for Health Research (NIHR), the UK Department of Health and Social Care, or Public Health England; the United States Agency for International Development (USAID), the US Government, or MEASURE Evaluation; or the European Centre for Disease Prevention and Control (ECDC). This research used data from the Chile National Health Survey 2003, 2009-10, and 2016-17. The authors are grateful to the Ministry of Health, the survey copyright owner, for allowing them to have the database. All results of the study are those of the authors and in no way committed to the Ministry. The Costa Rican Longevity and Healthy Aging Study project is a longitudinal study by the University of Costa Rica's Centro Centroamericano de Poblacion and Instituto de Investigaciones en Salud, in collaboration with the University of California at Berkeley. The original pre-1945 cohort was funded by the Wellcome Trust (grant 072406), and the 1945-55 Retirement Cohort was funded by the US National Institute on Aging (grant R01AG031716). The principal investigators are Luis Rosero-Bixby and William H Dow and co-principal investigators are Xinia Fernandez and Gilbert Brenes. The accuracy of the authors' statistical analysis and the findings they report are not the responsibility of ECDC. ECDC is not responsible for conclusions or opinions drawn from the data provided. ECDC is not responsible for the correctness of the data and for data management, data merging and data collation after provision of the data. ECDC shall not be held liable for improper or incorrect use of the data. The Health Behaviour in School-Aged Children (HBSC) study is an international study carried out in collaboration with WHO/EURO. The international coordinator of the 1997-98, 2001-02, 2005-06, and 2009-10 surveys was Candace Currie and the databank manager for the 1997-98 survey was Bente Wold, whereas for the following surveys Oddrun Samdal was the databank manager. A list of principal investigators in each country can be found on the HBSC website. Data used in this paper come from the 2009-10 Ghana Socioeconomic Panel Study Survey, which is a nationally representative survey of more than 5000 households in Ghana. The survey is a joint effort undertaken by the Institute of Statistical, Social and Economic Research (ISSER) at the University of Ghana and the Economic Growth Centre (EGC) at Yale University. It was funded by EGC. ISSER and the EGC are not responsible for the estimations reported by the analysts. The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with license number SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law, 2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data. Data for this research was provided by MEASURE Evaluation, funded by USAID. The authors thank the Russia Longitudinal Monitoring Survey, conducted by the National Research University Higher School of Economics and ZAO Demoscope together with Carolina Population Center, University of North Carolina at Chapel Hill and the Institute of Sociology, Russia Academy of Sciences for making data available. This paper uses data from the Bhutan 2014 STEPS survey, implemented by the Ministry of Health with the support of WHO; the Kuwait 2006 and 2014 STEPS surveys, implemented by the Ministry of Health with the support of WHO; the Libya 2009 STEPS survey, implemented by the Secretariat of Health and Environment with the support of WHO; the Malawi 2009 STEPS survey, implemented by Ministry of Health with the support of WHO; and the Moldova 2013 STEPS survey, implemented by the Ministry of Health, the National Bureau of Statistics, and the National Center of Public Health with the support of WHO. This paper uses data from Survey of Health, Ageing and Retirement in Europe (SHARE) Waves 1 (DOI:10.6103/SHARE. w1.700), 2 (10.6103/SHARE.w2.700), 3 (10.6103/SHARE.w3.700), 4 (10.6103/SHARE.w4.700), 5 (10.6103/SHARE.w5.700), 6 (10.6103/SHARE.w6.700), and 7 (10.6103/SHARE.w7.700); see Borsch-Supan and colleagues (2013) for methodological details. The SHARE data collection has been funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N degrees 211909, SHARE-LEAP: GA N degrees 227822, SHARE M4: GA N degrees 261982) and Horizon 2020 (SHARE-DEV3: GA N degrees 676536, SERISS: GA N degrees 654221) and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the US National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C), and from various national funding sources is gratefully acknowledged. This study has been realised using the data collected by the Swiss Household Panel, which is based at the Swiss Centre of Expertise in the Social Sciences. The project is financed by the Swiss National Science Foundation. The United States Aging, Demographics, and Memory Study is a supplement to the Health and Retirement Study (HRS), which is sponsored by the National Institute of Aging (grant number NIA U01AG009740). It was conducted jointly by Duke University and the University of Michigan. The HRS is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan. This paper uses data from Add Health, a program project designed by J Richard Udry, Peter S Bearman, and Kathleen Mullan Harris, and funded by a grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies. Special acknowledgment is due to Ronald R Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website. No direct support was received from grant P01-HD31921 for this analysis. The data reported here have been supplied by the United States Renal Data System. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US Government. Collection of data for the Mozambique National Survey on the Causes of Death 2007-08 was made possible by USAID under the terms of cooperative agreement GPO-A-00-08-000_D3-00. This manuscript is based on data collected and shared by the International Vaccine Institute (IVI) from an original study IVI conducted. L G Abreu acknowledges support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (Brazil; finance code 001) and Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, a Brazilian funding agency). I N Ackerman was supported by a Victorian Health and Medical Research Fellowship awarded by the Victorian Government. O O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. A Agrawal acknowledges the Wellcome Trust DBT India Alliance Senior Fellowship. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. M Ausloos, C Herteliu, and A Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. A Badawi is supported by the Public Health Agency of Canada. D A Bennett was supported by the NIHR Oxford Biomedical Research Centre. R Bourne acknowledges the Brien Holden Vision Institute, University of Heidelberg, Sightsavers, Fred Hollows Foundation, and Thea Foundation. G B Britton and I Moreno Velasquez were supported by the Sistema Nacional de Investigacion, SNI-SENACYT, Panama. R Buchbinder was supported by an Australian National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship. J J Carrero was supported by the Swedish Research Council (2019-01059). F Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/MCTES through national funds. A R Chang was supported by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases grant K23 DK106515. V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundacao para a Ciencia e Tecnologia, IP, under the Norma Transitaria DL57/2016/CP1334/CT0006. A Douiri acknowledges support and funding from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South London at King's College Hospital NHS Foundation Trust and the Royal College of Physicians, and support from the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. B B Duncan acknowledges grants from the Foundation for the Support of Research of the State of Rio Grande do Sul (IATS and PrInt) and the Brazilian Ministry of Health. H E Erskine is the recipient of an Australian NHMRC Early Career Fellowship grant (APP1137969). A J Ferrari was supported by a NHMRC Early Career Fellowship grant (APP1121516). H E Erskine and A J Ferrari are employed by and A M Mantilla-Herrera and D F Santomauro affiliated with the Queensland Centre for Mental Health Research, which receives core funding from the Queensland Department of Health. M L Ferreira holds an NHMRC Research Fellowship. C Flohr was supported by the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust. M Freitas acknowledges financial support from the EU (European Regional Development Fund [FEDER] funds through COMPETE POCI-01-0145-FEDER-029248) and National Funds (Fundacao para a Ciencia e Tecnologia) through project PTDC/NAN-MAT/29248/2017. A L S Guimaraes acknowledges support from CNPq. C Herteliu was partially supported by a grant co-funded by FEDER through Operational Competitiveness Program (project ID P_40_382). P Hoogar acknowledges Centre for Bio Cultural Studies, Directorate of Research, Manipal Academy of Higher Education and Centre for Holistic Development and Research, Kalaghatagi. F N Hugo acknowledges the Visiting Professorship, PRINT Program, CAPES Foundation, Brazil. B-F Hwang was supported by China Medical University (CMU107-Z-04), Taichung, Taiwan. S M S Islam was funded by a National Heart Foundation Senior Research Fellowship and supported by Deakin University. R Q Ivers was supported by a research fellowship from the National Health and Medical Research Council of Australia. M Jakovljevic acknowledges the Serbian part of this GBD-related contribution was co-funded through Grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. P Jeemon was supported by a Clinical and Public Health intermediate fellowship (grant number IA/CPHI/14/1/501497) from the Wellcome Trust-Department of Biotechnology, India Alliance (2015-20). O John is a recipient of UIPA scholarship from University of New South Wales, Sydney. S V Katikireddi acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13, MC_UU_12017/15), and the Scottish Government Chief Scientist Office (SPHSU13, SPHSU15). C Kieling is a CNPq researcher and a UK Academy of Medical Sciences Newton Advanced Fellow. Y J Kim was supported by Research Management Office, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/00010). K Krishan is supported by UGC Centre of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar was supported by K43 TW 010716 FIC/NIMH. B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. J V Lazarus was supported by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III [ISCIII]/ESF, the EU [CP18/00074]). K J Looker thanks the NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, in partnership with Public Health England, for research support. S Lorkowski was funded by the German Federal Ministry of Education and Research (nutriCARD, grant agreement number 01EA1808A). R A Lyons is supported by Health Data Research UK (HDR-9006), which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, NIHR (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and Wellcome Trust. J J McGrath is supported by the Danish National Research Foundation (Niels Bohr Professorship), and the Queensland Health Department (via West Moreton HHS). P T N Memiah acknowledges support from CODESRIA. U O Mueller gratefully acknowledges funding by the German National Cohort Study BMBF grant number 01ER1801D. S Nomura acknowledges the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). A Ortiz was supported by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. S B Patten was supported by the Cuthbertson & Fischer Chair in Pediatric Mental Health at the University of Calgary. G C Patton was supported by an aNHMRC Senior Principal Research Fellowship. M R Phillips was supported in part by the National Natural Science Foundation of China (NSFC, number 81371502 and 81761128031). A Raggi, D Sattin, and S Schiavolin were supported by grants from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4-Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). P Rathi and B Unnikrishnan acknowledge Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. A L P Ribeiro was supported by Brazilian National Research Council, CNPq, and the Minas Gerais State Research Agency, FAPEMIG. D C Ribeiro was supported by The Sir Charles Hercus Health Research Fellowship (#18/111) Health Research Council of New Zealand. D Ribeiro acknowledges financial support from the EU (FEDER funds through the Operational Competitiveness Program; POCI-01-0145-FEDER-029253). P S Sachdev acknowledges funding from the NHMRC of Australia Program Grant. A M Samy was supported by a fellowship from the Egyptian Fulbright Mission Program. M M Santric-Milicevic acknowledges the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). R Sarmiento-Suarez received institutional support from Applied and Environmental Sciences University (Bogota, Colombia) and ISCIII (Madrid, Spain). A E Schutte received support from the South African National Research Foundation SARChI Initiative (GUN 86895) and Medical Research Council. S T S Skou is currently funded by a grant from Region Zealand (Exercise First) and a grant from the European Research Council under the EU's Horizon 2020 research and innovation program (grant agreement number 801790). J B Soriano is funded by Centro de Investigacion en Red de Enfermedades Respiratorias, ISCIII. R Tabares-Seisdedos was supported in part by the national grant PI17/00719 from ISCIII-FEDER. N Taveira was partially supported by the European & Developing Countries Clinical Trials Partnership, the EU (LIFE project, reference RIA2016MC-1615). S Tyrovolas was supported by the Foundation for Education and European Culture, the Sara Borrell postdoctoral programme (reference number CD15/00019 from ISCIII-FEDER). S B Zaman received a scholarship from the Australian Government research training programme in support of his academic career., "Peer Reviewed"
Published: 2020

22. Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: William M. Gardner, Rawlance Ndejjo, Govinda Prasad Dhungana, Fereshteh Ansari, Kathleen Pillsbury Hopf, João Pedro Silva, M. Mofizul Islam, Cong Zhu, Abdul Hafiz, Irmina Maria Michalek, Syed Mohamed Aljunid, Leonardo Roever, Mustefa Glagn, Davood Anvari, Tessa M. Pilz, Sameer Vali Gopalani, Joel M. Francis, Man Mohan Mehndiratta, Rakhi Dandona, Abbas Sheikhtaheri, Mansour Ghafourifard, Simon Øverland, David Laith Rawaf, Jaykaran Charan, Akram Pourshams, Mostafa Dianatinasab, Morteza Mahmoudi, Alton Lu, Alyssa N. Sbarra, Lorainne Tudor Car, Franz Castro, Hafiz Ansar Rasul Suleria, Luca Ronfani, Marina Pinheiro, Mehran Asadi-Aliabadi, Maziar Moradi-Lakeh, Hoa Thi Do, Whitney L. Teagle, Sofia Androudi, Carl Abelardo T. Antonio, Myron Anthony Godinho, Bhaskaran Unnikrishnan, Oluchi Ezekannagha, Getinet Ayano, Seyyed Shamsadin Athari, Dimas Ria Angga Pribadi, Kyle E. Simpson, Muluken Bekele Sorrie, Vivekanand Jha, Chukwuma David Umeokonkwo, Akshaya Srikanth Bhagavathula, Cuong Tat Nguyen, Amr Hassan, Akine Eshete Abosetugn, Hailay Abrha Gesesew, Anna V. Korotkova, Brijesh Sathian, Marcello Tonelli, Olatunde Aremu, Mohammad Reza Salahshoor, Juan Jesus Carrero, Cameron J. Kneib, Ravi Prakash Jha, David H. Shaw, Hossein Samadi Kafil, Tanuj Kanchan, Khezar Hayat, Hamid Sharifi, Morteza Shamsizadeh, Muktar Omer Omer, Fatemeh Amiri, Hamidreza Pazoki Toroudi, David Edvardsson, Xiu Ju George Zhao, Hannah Han, Leticia Avila-Burgos, Adam E. Berman, Jemal Abdu Mohammed, Thomas Pilgrim, Leila Doshmangir, Mu'awiyyah Babale Sufiyan, David M. Pigott, Hadi Hassankhani, Beatriz Paulina Ayala Quintanilla, Teklemariam Gultie, Arash Ziapour, Seyed Sina Naghibi Irvani, Ilse N. Dippenaar, Jean Jacques Noubiap, Emmanuela Gakidou, Abiyu Mekonnen Gebrehiwot, Maha El Tantawi, Xuefeng Liu, Zulfiqar A. Bhutta, Keyghobad Ghadiri, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Yunquan Zhang, Vera Marisa Costa, Iyad Sultan, Mostafa Hosseini, Abdulaziz Khalid Abu Haimed, Haidong Wang, Kaleab Alemayehu Zewdie, Celine M. Barthelemy, Hosna Janjani, Bartosz Miazgowski, Jobert Richie Nansseu, Arianna Maever L. Amit, John S. Ji, Ata Rafiee, Maria Inês Schmidt, Alireza Rafiei, Somayeh Bohlouli, Joana Morgado-da-Costa, Huong Lan Thi Nguyen, Pradyumna Agasthi, Tiffany K. Gill, Martin McKee, Khaled Khatab, Jae Il Shin, Animut Tagele Tamiru, Giancarlo Logroscino, Hassan Abolhassani, Syed Saoud Zaidi, Sivan Yegnanarayana Iyer Saraswathy, Garumma Tolu Feyissa, Ahmad Daryani, Ziyad Al-Aly, Gebreamlak Gebremedhn Gebremeskel, Michael T. Chung, Amirhossein Sahebkar, Mehedi Hasan, Saeed Shahabi, Diep Ngoc Nguyen, Yohannes Kinfu, Nicholas L S Roberts, Jagadish Rao Padubidri, Mika Shigematsu, Lucero Cahuana-Hurtado, Deepa Jahagirdar, Islam Y. Elgendy, Erkin M. Mirrakhimov, Tanvir M. Huda, Fakher Rahim, Dara K. Mohammad, Yingxi Zhao, Ruxandra Irina Negoi, Vinod C. Nayak, Reinhard Busse, Andrew T. Leever, Muhammad Aziz Rahman, Kathryn Mei Ming Lau, Stefania Mondello, Vivian Chia-Rong Hsieh, Kris J. Krohn, Reza Rawassizadeh, Vishnu Renjith, Jianing Ma, Moses K. Muriithi, Mark G. Shrime, Mayowa O. Owolabi, Nobuyuki Horita, Seyed Hossein Yahyazadeh Jabbari, Daniel Y. Cho, Miloje Savic, Moslem Soofi, Iqbal R. F. Elyazar, Freweini Gebrearegay G. Tela, Jonathan F. Mosser, Palash Chandra Banik, Andre Rodrigues Duraes, Yuan-Pang Wang, Natalie C. Galles, Rashid Abdi Guled, Abdallah M. Samy, Hadi Pourjafar, Roman Topor-Madry, Ayesha Humayun, Leila Zaki, Nuworza Kugbey, Maryam Khayamzadeh, Naznin Hossain, Jiregna Darega Gela, Jordi Alonso, Ruth W Kimokoti, A. A. Fomenkov, Jalal Arabloo, Aletta E. Schutte, Biruk Wogayehu Taddele, Teklehaimanot Gereziher Haile, Diego Augusto Santos Silva, Seyed Mohammad Kazem Aghamir, Maciej Banach, Deanna Anderlini, Moses J. Bockarie, Saleem Muhammad Rana, Randah R. Hamadeh, Farhad Islami, Olalekan A. Uthman, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Kairat Davletov, Soraya Seedat, Alan D. Lopez, Masoud Behzadifar, Benjamin B. Massenburg, Santosh Varughese, Ingan Ukur Tarigan, Amin Soheili, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Caleb Mackay Salpeter Irvine, Mojgan Gitimoghaddam, G Anil Kumar, Rasmus J. Havmoeller, Hiroyasu Iso, Atte Meretoja, Yasir Waheed, João M. Furtado, Christian Razo, Neeti Kapoor, Mowafa Househ, Rajaa Al-Raddadi, Mohammad Khammarnia, Santi Martini, Feng Sha, Marco Vacante, Jacek A. Kopec, Hunduma Amensisa Bojia, Jacob Olusegun Olusanya, Kate E. LeGrand, Nikolay Ivanovich Briko, Robert S. Bernstein, Arun Balachandran, Davoud Adham, Ahad Bakhtiari, Shafiu Mohammed, Leake G. Gebremeskel, Smita Pakhale, Ejaz Ahmad Khan, Daniel Cury Ribeiro, Yousef Mohammad, Bernhard T. Baune, Azeem Majeed, Luis Camera, Mohammad Ali Jahani, Hasan Yusefzadeh, Rahman Shiri, Massimo Cirillo, Nikita Otstavnov, Vahid Yazdi-Feyzabadi, Paolo Lauriola, Irfan Ullah, Aruna M Kamath, Maryam Mirzaei, Zabihollah Yousefi, Iman El Sayed, Mohammad Farahmand, Yetunde O. John-Akinola, Khem Narayan Pokhrel, Felix Akpojene Ogbo, Megan Knight, Nelson J. Alvis-Zakzuk, Teferi Mekonnen, Iván Landires, Robert G. Weintraub, Chukwudi A Nnaji, Lauren E. Schaeffer, Paulo A. Lotufo, Mehdi Naderi, Tomislav Mestrovic, André Faro, Mohsen Bayati, Raffaele Palladino, Shahin Soltani, Vladimir Andreevich Korshunov, Birhanu Geta Meharie, Mihajlo Jakovljevic, Abdiwahab Hashi, Olatunji O. Adetokunboh, Dejana Braithwaite, Sergio I. Prada, Bárbara Niegia Garcia de Goulart, Reza Pourmirza Kalhori, Jee-Young Jasmine Choi, Ernoiz Antriyandarti, Ronny Westerman, Meghdad Pirsaheb, Paul S. F. Yip, Mehdi Mirzaei-Alavijeh, Gebremariam Woldu, Rashmi Gupta, Onome Bright Oghenetega, Shane D. Morrison, Inga Dora Sigfusdottir, Marcel Ausloos, Mehdi Hosseinzadeh, Marcos Roberto Tovani-Palone, K M Shivakumar, Alireza Ansari-Moghaddam, Archith Boloor, Aidin Abedi, Binyam Minuye Birihane, Mohammad Ali Mansournia, Nihad A. Almasri, Simachew Animen Bante, Carlo Eduardo Medina-Solís, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Antonio Biondi, Valentin Yurievich Skryabin, Srinivasa Vittal Katikireddi, Sarika Chaturvedi, Francesco Saverio Violante, Abhay Gaidhane, George A. Mensah, Naohiro Yonemoto, Ahmad Ghashghaee, Ebrahim Babaee, Saman Esmaeilnejad, Sharath Burugina Nagaraja, Avina Vongpradith, Javad Nazari, Amir Khater, Michael K. Hole, Ben Lacey, Razique Anwer, Łukasz Szumowski, Ai Koyanagi, Rajesh Sagar, Ali Rajabpour-Sanati, Seyed M Karimi, Yordanos Gizachew Yeshitila, Mona Pathak, Nithin Kumar, Masoud Foroutan, Mehdi Fazlzadeh, Anusha Ganapati Bhat, Abbas Mosapour, Kebede Deribe, Nermin Ghith, Vaman Kulkarni, Sanjay Zodpey, Asadollah Gholamian, Mohammed Shannawaz, Nancy Fullman, Benn Sartorius, Giulio Castelpietra, Ghulam Mustafa, Silvia Schiavolin, Nelson Alvis-Guzman, Jeffrey D. Stanaway, Rafael Lozano, Christopher J L Murray, Guoqing Hu, Andrew M. Briggs, Ashish Badiye, Yousef Khader, Masoud Moghadaszadeh, Rahmatollah Moradzadeh, Valery L. Feigin, Claudia I. Mastrogiacomo, Emma Smith, Yasser Vasseghian, Saeed Amini, Asif Hanif, Achala Upendra Jayatilleke, Maryam Adabi, Sarah Wulf Hanson, Bhaskar Thakur, Ravi Mehrotra, Virginia Núñez-Samudio, Lalit Dandona, Segun Emmanuel Ibitoye, Simon I. Hay, Kiirithio N. Ngari, Obinna Onwujekwe, Deborah Carvalho Malta, Lorenzo Monasta, Neda Kianipour, Khurshid Alam, Luisa Sorio Flor, Priya Rathi, Ali Bijani, Khalid A Altirkawi, Jaimie Adelson, Hamed Zandian, Frank Tanser, Dharmesh Kumar Lal, John Everett Mumford, Morteza Oladnabi, Telma Zahirian Moghadam, Rodrigo Sarmiento-Suárez, Masoud Moradi, Maseer Khan, Mohammad Ali Sahraian, Amy E. Peden, Dhirendra N Sinha, Shanshan Li, Shailesh Advani, Behshad Naghshtabrizi, Matilde Leonardi, Lope H Barrero, Nicholas Steel, Dinh-Toi Chu, Claudio Alberto Dávila-Cervantes, Pushpendra Singh, Adrian Otoiu, Fabrizio Tediosi, Yonas Getaye Tefera, Pawan Faris, George C. Patton, Christopher Troeger, Mohammed Madadin, Jeffrey V. Lazarus, Paul H. Lee, Mohammad Amin Bahrami, Wondimeneh Shibabaw Shiferaw, Emmanuel Wandera Okunga, Biniyam Sahiledengle Geberemariyam, Samer Hamidi, Young-Ho Khang, Rufus Akinyemi, Farhad Jadidi-Niaragh, Godfrey Mutashambara Rwegerera, Naser Mohammad Gholi Mezerji, Rupak Desai, Eduardo Bernabé, Jamal A. Yearwood, Nima Rezaei, Emerito Jose A. Faraon, Vasily Vlassov, Stanislav S. Otstavnov, Reed J D Sorensen, Elena V. Gnedovskaya, Johan Ärnlöv, Mukhammad David Naimzada, Tahereh Javaheri, Tamer H. Farag, Paolo Cortesi, Gbenga A. Kayode, Lucas Guimarães Abreu, Manu Raj Mathur, Getie Lake Aynalem, Narayanaswamy Venketasubramanian, Doris V.V. Ortega-Altamirano, Giorgia Giussani, Liliana G Ciobanu, Suraj Bhattarai, Basema Saddik, Mustafa Z. Younis, Ensiyeh Jenabi, Ira Martopullo, Mohamed M. Gad, Kanyin L. Ong, Addisu Melese, Fotis Topouzis, Hanne Christensen, In-Hwan Oh, Arash Sarveazad, Shuhei Nomura, Peter Memiah, Sergej M. Ostojic, Santosh Kumar Tadakamadla, Dinesh Bhandari, Ahmed Omar Bali, Farahnaz Joukar, Arielle Wilder Eagan, Emma Elizabeth Spurlock, Ferrán Catalá-López, Caroline Stein, Jonathan M. Kocarnik, Stephen S Lim, Siamak Sabour, Kelly Compton, Shoaib Hassan, Rannveig Sigurvinsdottir, Claudiu Herteliu, Aso Mohammad Darwesh, Muluken Altaye Ayza, Angela Y. Chang, Leila R Kalankesh, Rafael Alves Guimarães, Abdollah Mohammadian-Hafshejani, Lal B. Rawal, Soewarta Kosen, Degena Bahrey Tadesse, Theo Vos, Paula Moraga, Soheil Hassanipour, Abdelrahman Ibrahim Abushouk, Oladimeji Adebayo, Mikk Jürisson, Tuomo J. Meretoja, Ireneous N. Soyiri, Carlo La Vecchia, Khalil Eskandari, Aziz Sheikh, Jagdish Khubchandani, James Leigh, Morteza Arab-Zozani, Sheikh Mohammed Shariful Islam, Stefan Kohler, Olayinka Stephen Ilesanmi, Kazumasa Yamagishi, Michele Romoli, Jasvinder A. Singh, Neeraj Bedi, Ivo Iavicoli, Alyssa Pennini, Subas Neupane, Emmanuel Peprah, Sojib Bin Zaman, Marwa Rashad Salem, Mohammed Ibrahim Mohialdeen Gubari, Ramesh Holla, Bayisa Abdissa Baye, Robert Ancuceanu, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Ettore Beghi, Quique Bassat, B Reshmi, Masood Ali Shaikh, Ionut Negoi, Peter Azzopardi, Florian Fischer, Kerem Shuval, Sorin Hostiuc, Hmwe H Kyu, Ver Bilano, Siddhesh Zadey, Davide Rasella, Vahid Alipour, Sowmya J. Rao, Radoslaw Sierpinski, Irina Filip, Michelle L. Bell, Malke Asaad, Ravensara S. Travillian, Christopher R. Cederroth, Rafael Tabarés-Seisdedos, Ashkan Afshin, Saqib Ali, Mahalaqua Nazli Khatib, Saad M.A. Dahlawi, Hedayat Abbastabar, Zahid A Butt, Sagun Paudel, Vahid Rashedi, B. Suresh Kumar Shetty, Thomas R. Hird, Shokofeh Maleki, Atif Amin Baig, Reza Heidari-Soureshjani, Shaun Wen Huey Lee, Jorge R. Ledesma, Ai-Min Wu, Fablina Sharara, Zemenu Tadesse Tessema, Ratilal Lalloo, Rohollah Kalhor, Rosario Cárdenas, Amir Radfar, Salime Goharinezhad, Fereshteh Mehri, Katarzyna Kissimova-Skarbek, Spencer A. Pease, Diana Silva, Amir Hossein Goudarzian, Samath D Dharmaratne, Darshan B B, Mariya Vladimirovna Titova, Dickson A. Amugsi, Lee Ling Lim, Agegnehu Bante, Charles D.A. Wolfe, Majid A Almadi, Seyed Mohammad Riahi, Nader Jahanmehr, Yuming Guo, Tauseef Ahmad, Platon D. Lopukhov, Takahiro Tabuchi, Nicholas J Kassebaum, Jacek Jerzy Jozwiak, Ritesh G. Menezes, Giovanni Damiani, Delia Hendrie, Mostafa Amini-Rarani, Sanjay Basu, Mohammad Hossein Bakhshaei, Gholamreza Roshandel, Borhan Mansouri, Enrico Rubagotti, Anurag Agrawal, Alireza Esteghamati, Paramjit Gill, Graeme J. Hankey, Mikhail Sergeevich Zastrozhin, Nima Hafezi-Nejad, Bruce Bartholow Duncan, Silvano Gallus, Jeevan Pereira, Ahamarshan Jayaraman Nagarajan, Giulia Carreras, Fariba Dorostkar, Pietro Ferrara, Andrea Farioli, Christoph Nowak, Ahmed I. Hasaballah, Vijay Kumar Chattu, Bolajoko O. Olusanya, Perminder S. Sachdev, Era Upadhyay, Tommi Vasankari, Susan M Sawyer, Adnan Kisa, Farshad Pourmalek, Kiomars Sharafi, Golnaz Heidari, Mohammad Abdollahi, Georges Nguefack-Tsague, Sajid Hameed, Sanni Yaya, Bach Xuan Tran, Ole Frithjof Norheim, Robert Kaba Alhassan, Morenike Oluwatoyin Folayan, Ismail Tareque, Phetole Walter Mahasha, Kewal Krishan, Soraya Siabani, Aleksandr Y. Aravkin, Helena Ullyartha Pangaribuan, Maryam Zamanian, Joshua A. Salomon, Bianca S. Zlavog, Vinay Nangia, Falk Schwendicke, Takeshi Fukumoto, Hung Chak Ho, Jordan Weiss, Maha Atout, Tariku Tesfaye Bekuma, Efat Mohamadi, Nikolaos Dervenis, Joan B. Soriano, Syed Amir Gilani, Victor Adekanmbi, Marina Karanikolos, Alberto Raggi, Michael R.M. Abrigo, Weijia Fu, Reza Shirkoohi, Aditya Prasad Dash, Peng Jia, Masoumeh Sadeghi, Ashraf Nabhan, Isabela M. Benseñor, Morteza Jafarinia, Joht Singh Chandan, Usman Iqbal, Amira Shaheen, Deepak Saxena, Lauren B. Wilner, Nataliya A. Foigt, Jeadran N. Malagón-Rojas, David C. Schwebel, Gail Davey, Milena Ilic, Josep Maria Haro, Peter Njenga Keiyoro, Stein Emil Vollset, Andrea Werdecker, Zahiruddin Quazi Syed, Yared Asmare Aynalem, Entezar Mehrabi Nasab, Yihun Mulugeta Alemu, Muhammad Ali, Mona M. Khater, Ehsan Sadeghi, Thirunavukkarasu Sathish, Pascual R. Valdez, Jennifer Rickard, Mark A. Stokes, Davide Sattin, Ewerton Cousin, Oliver J. Brady, Krittika Bhattacharyya, Mika Kivimäki, Andrew T Olagunju, Jost B. Jonas, Dian Kusuma, Goura Kishor Rath, Alberto Ortiz, Samad Azari, Nayu Ikeda, James L. Fisher, Peng Zheng, Elisabetta Pupillo, Pankaj Bhardwaj, Suzanne Lyn Barker-Collo, Riaz Uddin, Ester Cerin, Amir Taherkhani, Martin Amogre Ayanore, Richard G. Wamai, Anders Larsson, Josephine W. Ngunjiri, Hosni Salem, Hesham M. Al-Mekhlafi, Sharareh Eskandarieh, Taraneh Yousefinezhadi, Srikanta Banerjee, Yang Xie, Yuichiro Yano, Songhomitra Panda-Jonas, Themba G. Ginindza, Manasi Kumar, Babak Moazen, Bing-Fang Hwang, Cristiana Abbafati, Florentino Luciano Caetano dos Santos, Juan Sanabria, Milena Santric-Milicevic, Carla Sofia e.Sá Farinha, Samuel B. Albertson, Chieh Han, Parvaiz A Koul, Foad Abd-Allah, Mojisola Oluwasanu, Mihaela Hostiuc, Chinwe Juliana Iwu, Colm McAlinden, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Jalil Jaafari, Walter Mendoza, Abdulaziz M. Almulhim, Magdalene K. Walters, Ali H. Mokdad, Andre M. N. Renzaho, Catherine M. Antony, Ken Lee Chin, Ali A. Asadi-Pooya, Daniel Diaz, Adrian Pana, Salman Rawaf, Gina Agarwal, Demelash Woldeyohannes Handiso, Savita Lasrado, Amir Almasi-Hashiani, Praveen Hoogar, Srinivasa Rao Bolla, Fares Alahdab, Om P Kurmi, Sonali Kochhar, Van C. Lansingh, François Alla, Ali Almasi, Till Bärnighausen, Michael A. Piradov, Zubair Kabir, Boris Bikbov, Philip B. Mitchell, Amin Mousavi Khaneghah, Yahya Safari, Anirudh Kotlo, Jan-Walter De Neve, Biagio Simonetti, Carlos A Castañeda-Orjuela, Kenji Shibuya, GBD 2019 Universal Health Coverage Collaborator, Violante FS, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Department of Public Health, University of Helsinki, Clinicum, Neurologian yksikkö, HUS Neurocenter, HUS Comprehensive Cancer Center, Helsinki University Hospital Area, GBD 2019 Universal Health Coverage Collaborators, Lozano, Rafael, Fullman, Nancy, Mumford, John Everett, Knight, Megan, Barthelemy, Celine M, Abbafati, Cristiana, Abbastabar, Hedayat, Abd-Allah, Foad, Abdollahi, Mohammad, Abedi, Aidin, Abolhassani, Hassan, Abosetugn, Akine Eshete, Abreu, Lucas Guimarãe, Abrigo, Michael R M, Abu Haimed, Abdulaziz Khalid, Abushouk, Abdelrahman I, Adabi, Maryam, Adebayo, Oladimeji M, Adekanmbi, Victor, Adelson, Jaimie, Adetokunboh, Olatunji O, Adham, Davoud, Advani, Shailesh M, Afshin, Ashkan, Agarwal, Gina, Agasthi, Pradyumna, Aghamir, Seyed Mohammad Kazem, Agrawal, Anurag, Ahmad, Tauseef, Akinyemi, Rufus Olusola, Alahdab, Fare, Al-Aly, Ziyad, Alam, Khurshid, Albertson, Samuel B, Alemu, Yihun Mulugeta, Alhassan, Robert Kaba, Ali, Muhammad, Ali, Saqib, Alipour, Vahid, Aljunid, Syed Mohamed, Alla, Françoi, Almadi, Majid Abdulrahman Hamad, Almasi, Ali, Almasi-Hashiani, Amir, Almasri, Nihad A, Al-Mekhlafi, Hesham M, Almulhim, Abdulaziz M, Alonso, Jordi, Al-Raddadi, Rajaa M, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Alvis-Zakzuk, Nelson J, Amini, Saeed, Amini-Rarani, Mostafa, Amiri, Fatemeh, Amit, Arianna Maever L, Amugsi, Dickson A, Ancuceanu, Robert, Anderlini, Deanna, Andrei, Catalina Liliana, Androudi, Sofia, Ansari, Fereshteh, Ansari-Moghaddam, Alireza, Antonio, Carl Abelardo T, Antony, Catherine M, Antriyandarti, Ernoiz, Anvari, Davood, Anwer, Razique, Arabloo, Jalal, Arab-Zozani, Morteza, Aravkin, Aleksandr Y, Aremu, Olatunde, Ärnlöv, Johan, Asaad, Malke, Asadi-Aliabadi, Mehran, Asadi-Pooya, Ali A, Ashbaugh, Charlie, Athari, Seyyed Shamsadin, Atout, Maha Moh'd Wahbi, Ausloos, Marcel, Avila-Burgos, Leticia, Ayala Quintanilla, Beatriz Paulina, Ayano, Getinet, Ayanore, Martin Amogre, Aynalem, Yared Asmare, Aynalem, Getie Lake, Ayza, Muluken Altaye, Azari, Samad, Azzopardi, Peter S, B, Darshan B, Babaee, Ebrahim, Badiye, Ashish D, Bahrami, Mohammad Amin, Baig, Atif Amin, Bakhshaei, Mohammad Hossein, Bakhtiari, Ahad, Bakkannavar, Shankar M, Balachandran, Arun, Balassyano, Shelly, Banach, Maciej, Banerjee, Srikanta K, Banik, Palash Chandra, Bante, Agegnehu Bante, Bante, Simachew Animen, Barker-Collo, Suzanne Lyn, Bärnighausen, Till Winfried, Barrero, Lope H, Bassat, Quique, Basu, Sanjay, Baune, Bernhard T, Bayati, Mohsen, Baye, Bayisa Abdissa, Bedi, Neeraj, Beghi, Ettore, Behzadifar, Masoud, Bekuma, Tariku Tesfaye Tesfaye, Bell, Michelle L, Bensenor, Isabela M, Berman, Adam 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K, Heidari, G, Heidari-Soureshjani, R, Hendrie, D, Herteliu, C, Hird, T, Ho, H, Hole, M, Holla, R, Hollingsworth, B, Hoogar, P, Hopf, K, Horita, N, Hossain, N, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Hsieh, V, Hu, G, Huda, T, Humayun, A, Hwang, B, Iavicoli, I, Ibitoye, S, Ikeda, N, Ilesanmi, O, Ilic, I, Ilic, M, Inbaraj, L, Iqbal, U, Irvani, S, Irvine, C, Islam, M, Islam, S, Islami, F, Iso, H, Iwu, C, Jaafari, J, Jadidi-Niaragh, F, Jafarinia, M, Jahagirdar, D, Jahani, M, Jahanmehr, N, Jakovljevic, M, Janjani, H, Javaheri, T, Jayatilleke, A, Jenabi, E, Jha, R, Jha, V, Ji, J, Jia, P, John-Akinola, Y, Jonas, J, Joukar, F, Jozwiak, J, Jürisson, M, Kabir, Z, Kalankesh, L, Kalhor, R, Kamath, A, Kanchan, T, Kapoor, N, Karami Matin, B, Karanikolos, M, Karimi, S, Kassebaum, N, Katikireddi, S, Kayode, G, Keiyoro, P, Khader, Y, Khammarnia, M, Khan, M, Khan, E, Khang, Y, Khatab, K, Khater, A, Khater, M, Khatib, M, Khayamzadeh, M, Khubchandani, J, Kianipour, N, Kim, Y, Kimokoti, R, Kinfu, Y, Kisa, A, Kissimova-Skarbek, K, Kivimäki, M, Kneib, C, Kocarnik, J, Kochhar, S, Kohler, S, Kopec, J, Korotkova, A, Korshunov, V, Kosen, S, Kotlo, A, Koul, P, Koyanagi, A, Krishan, K, Krohn, K, Kugbey, N, Kulkarni, V, Kumar, G, Kumar, N, Kumar, M, Kurmi, O, Kusuma, D, Kyu, H, La Vecchia, C, Lal, D, Lalloo, R, Landires, I, Lansingh, V, Larsson, A, Lasrado, S, Lau, K, Lauriola, P, Lazarus, J, Ledesma, J, Lee, P, Lee, S, Leever, A, Legrand, K, Leigh, J, Leonardi, M, Li, S, Lim, S, Lim, L, Liu, X, Logroscino, G, Lopez, A, Lopukhov, P, Lotufo, P, Lu, A, Ma, J, Madadin, M, Mahasha, P, Mahmoudi, M, Majeed, A, Malagón-Rojas, J, Maleki, S, Malta, D, Mansouri, B, Mansournia, M, Martini, S, Martins-Melo, F, Martopullo, I, Massenburg, B, Mastrogiacomo, C, Mathur, M, Mcalinden, C, Mckee, M, Medina-Solís, C, Meharie, B, Mehndiratta, M, Mehrabi Nasab, E, Mehri, F, Mehrotra, R, Mekonnen, T, Melese, A, Memiah, P, Mendoza, W, Menezes, R, Mensah, G, Meretoja, T, Meretoja, A, Mestrovic, T, Miazgowski, B, Michalek, I, Mirrakhimov, E, Mirzaei, M, Mirzaei-Alavijeh, M, Mitchell, P, Moazen, B, Moghadaszadeh, M, Mohamadi, E, Mohammad, Y, Mohammad, D, Mohammad Gholi Mezerji, N, Mohammadian-Hafshejani, A, Mohammed, S, Mohammed, J, Mokdad, A, Monasta, L, Mondello, S, Moradi, M, Moradi-Lakeh, M, Moradzadeh, R, Moraga, P, Morgado-da-Costa, J, Morrison, S, Mosapour, A, Mosser, J, Mousavi Khaneghah, A, Muriithi, M, Mustafa, G, Nabhan, A, Naderi, M, Nagarajan, A, Naghavi, M, Naghshtabrizi, B, Naimzada, M, Nangia, V, Nansseu, J, Nayak, V, Nazari, J, Ndejjo, R, Negoi, I, Negoi, R, Neupane, S, Ngari, K, Nguefack-Tsague, G, Ngunjiri, J, Nguyen, C, Nguyen, D, Nguyen, H, Nnaji, C, Nomura, S, Norheim, O, Noubiap, J, Nowak, C, Nunez-Samudio, V, Otoiu, A, Ogbo, F, Oghenetega, O, Oh, I, Okunga, E, Oladnabi, M, Olagunju, A, Olusanya, J, Olusanya, B, Oluwasanu, M, Omar Bali, A, Omer, M, Ong, K, Onwujekwe, O, Ortega-Altamirano, D, Ortiz, A, Ostojic, S, Otstavnov, N, Otstavnov, S, Øverland, S, Owolabi, M, Padubidri, J, Pakhale, S, Palladino, R, Pana, A, Panda-Jonas, S, Pangaribuan, H, Pathak, M, Patton, G, Paudel, S, Pazoki Toroudi, H, Pease, S, Peden, A, Pennini, A, Peprah, E, Pereira, J, Pigott, D, Pilgrim, T, Pilz, T, Pinheiro, M, Piradov, M, Pirsaheb, M, Pokhrel, K, Postma, M, Pourjafar, H, Pourmalek, F, Pourmirza Kalhori, R, Pourshams, A, Prada, S, Pribadi, D, Pupillo, E, Quazi Syed, Z, Radfar, A, Rafiee, A, Rafiei, A, Raggi, A, Rahim, F, Rahman, M, Rajabpour-Sanati, A, Rana, S, Ranabhat, C, Rao, S, Rasella, D, Rashedi, V, Rath, G, Rathi, P, Rawaf, S, Rawaf, D, Rawal, L, Rawassizadeh, R, Razo, C, Renjith, V, Renzaho, A, Reshmi, B, Rezaei, N, Riahi, S, Ribeiro, D, Rickard, J, Roberts, N, Roever, L, Romoli, M, Ronfani, L, Roshandel, G, Rubagotti, E, Rwegerera, G, Sabour, S, Sachdev, P, Saddik, B, Sadeghi, M, Sadeghi, E, Safari, Y, Sagar, R, Sahebkar, A, Sahraian, M, Sajadi, S, Salahshoor, M, Salem, M, Salem, H, Salomon, J, Samadi Kafil, H, Samy, A, Sanabria, J, Santric-Milicevic, M, Saraswathy, S, Sarmiento-Suárez, R, Sarveazad, A, Sathian, B, Sathish, T, Sattin, D, Savic, M, Sawyer, S, Saxena, D, Sbarra, A, Schaeffer, L, Schiavolin, S, Schmidt, M, Schutte, A, Schwebel, D, Schwendicke, F, Seedat, S, Sha, F, Shahabi, S, Shaheen, A, Shaikh, M, Shamsizadeh, M, Shannawaz, M, Sharafi, K, Sharara, F, Sharifi, H, Shaw, D, Sheikh, A, Sheikhtaheri, A, Shetty, B, Shibuya, K, Shiferaw, W, Shigematsu, M, Shin, J, Shiri, R, Shirkoohi, R, Shivakumar, K, Shrime, M, Shuval, K, Siabani, S, Sierpinski, R, Sigfusdottir, I, Sigurvinsdottir, R, Silva, D, Silva, J, Simonetti, B, Simpson, K, Singh, J, Singh, P, Sinha, D, Skryabin, V, Smith, E, Soheili, A, Soltani, S, Soofi, M, Sorensen, R, Soriano, J, Sorrie, M, Soyiri, I, Spurlock, E, Sreeramareddy, C, Stanaway, J, Steel, N, Stein, C, Stokes, M, Sufiyan, M, Suleria, H, Sultan, I, Szumowski, Ł, Tabarés-Seisdedos, R, Tabuchi, T, Tadakamadla, S, Taddele, B, Tadesse, D, Taherkhani, A, Tamiru, A, Tanser, F, Tareque, M, Tarigan, I, Teagle, W, Tediosi, F, Tefera, Y, Tela, F, Tessema, Z, Thakur, B, Titova, M, Tonelli, M, Topor-Madry, R, Topouzis, F, Tovani-Palone, M, Tran, B, Travillian, R, Troeger, C, Tudor Car, L, Uddin, R, Ullah, I, Umeokonkwo, C, Unnikrishnan, B, Upadhyay, E, Uthman, O, Vacante, M, Valdez, P, Varughese, S, Vasankari, T, Vasseghian, Y, Venketasubramanian, N, Violante, F, Vlassov, V, Vollset, S, Vongpradith, A, Vos, T, Waheed, Y, Walters, M, Wamai, R, Wang, H, Wang, Y, Weintraub, R, Weiss, J, Werdecker, A, Westerman, R, Wilner, L, Woldu, G, Wolfe, C, Wu, A, Wulf Hanson, S, Xie, Y, Xu, R, Yahyazadeh Jabbari, S, Yamagishi, K, Yano, Y, Yaya, S, Yazdi-Feyzabadi, V, Yearwood, J, Yeshitila, Y, Yip, P, Yonemoto, N, Younis, M, Yousefi, Z, Yousefinezhadi, T, Yusefzadeh, H, Zadey, S, Zahirian Moghadam, T, Zaidi, S, Zaki, L, Zaman, S, Zamani, M, Zamanian, M, Zandian, H, Zastrozhin, M, Zewdie, K, Zhang, Y, Zhao, X, Zhao, Y, Zheng, P, Zhu, C, Ziapour, A, Zlavog, B, Zodpey, S, Murray, C, Tampere University, Health Sciences, 10922180 - Schutte, Aletta Elisabeth, Lozano, R., Fullman, N., Mumford, J. E., Knight, M., Barthelemy, C. M., Abbafati, C., Abbastabar, H., Abd-Allah, F., Abdollahi, M., Abedi, A., Abolhassani, H., Abosetugn, A. E., Abreu, L. G., Abrigo, M. R. M., Abu Haimed, A. K., Abushouk, A. I., Adabi, M., Adebayo, O. M., Adekanmbi, V., Adelson, J., Adetokunboh, O. O., Adham, D., Advani, S. M., Afshin, A., Agarwal, G., Agasthi, P., Aghamir, S. M. K., Agrawal, A., Ahmad, T., Akinyemi, R. O., Alahdab, F., Al-Aly, Z., Alam, K., Albertson, S. B., Alemu, Y. M., Alhassan, R. K., Ali, M., Ali, S., Alipour, V., Aljunid, S. M., Alla, F., Almadi, M. A. H., Almasi, A., Almasi-Hashiani, A., Almasri, N. A., Al-Mekhlafi, H. M., Almulhim, A. M., Alonso, J., Al-Raddadi, R. M., Altirkawi, K. A., Alvis-Guzman, N., Alvis-Zakzuk, N. J., Amini, S., Amini-Rarani, M., Amiri, F., Amit, A. M. L., Amugsi, D. A., Ancuceanu, R., Anderlini, D., Andrei, C. L., Androudi, S., Ansari, F., Ansari-Moghaddam, A., Antonio, C. A. T., Antony, C. M., Antriyandarti, E., Anvari, D., Anwer, R., Arabloo, J., Arab-Zozani, M., Aravkin, A. Y., Aremu, O., Arnlov, J., Asaad, M., Asadi-Aliabadi, M., Asadi-Pooya, A. A., Athari, S. S., Atout, M. M. W., Ausloos, M., Avila-Burgos, L., Ayala Quintanilla, B. P., Ayano, G., Ayanore, M. A., Aynalem, Y. A., Aynalem, G. L., Ayza, M. A., Azari, S., Azzopardi, P. S., B, D. B., Babaee, E., Badiye, A. D., Bahrami, M. A., Baig, A. A., Bakhshaei, M. H., Bakhtiari, A., Bakkannavar, S. M., Balachandran, A., Banach, M., Banerjee, S. K., Banik, P. C., Bante, A. B., Bante, S. A., Barker-Collo, S. L., Barnighausen, T. W., Barrero, L. H., Bassat, Q., Basu, S., Baune, B. T., Bayati, M., Baye, B. A., Bedi, N., Beghi, E., Behzadifar, M., Bekuma, T. T. T., Bell, M. L., Bensenor, I. M., Berman, A. E., Bernabe, E., Bernstein, R. S., Bhagavathula, A. S., Bhandari, D., Bhardwaj, P., Bhat, A. G., Bhattacharyya, K., Bhattarai, S., Bhutta, Z. A., Bijani, A., Bikbov, B., Bilano, V., Biondi, A., Birihane, B. M., Bockarie, M. J., Bohlouli, S., Bojia, H. A., Bolla, S. R. R., Boloor, A., Brady, O. J., Braithwaite, D., Briggs, A. M., Briko, N. I., Burugina Nagaraja, S., Busse, R., Butt, Z. A., Caetano dos Santos, F. L., Cahuana-Hurtado, L., Camera, L. A., Cardenas, R., Carreras, G., Carrero, J. J., Carvalho, F., Castaldelli-Maia, J. M., Castaneda-Orjuela, C. A., Castelpietra, G., Castro, F., Catala-Lopez, F., Cederroth, C. R., Cerin, E., Chandan, J. S., Chang, A. Y., Charan, J., Chattu, V. K., Chaturvedi, S., Chin, K. L., Cho, D. Y., Choi, J. -Y. J., Christensen, H., Chu, D. -T., Chung, M. T., Ciobanu, L. G., Cirillo, M., Compton, K., Cortesi, P. A., Costa, V. M., Cousin, E., Dahlawi, S. M. A., Damiani, G., Dandona, L., Dandona, R., Darega Gela, J., Darwesh, A. M., Daryani, A., Dash, A. P., Davey, G., Davila-Cervantes, C. A., Davletov, K., De Neve, J. -W., Denova-Gutierrez, E., Deribe, K., Dervenis, N., Desai, R., Dharmaratne, S. D., Dhungana, G. P., Dianatinasab, M., Dias da Silva, D., Diaz, D., Dippenaar, I. N., Do, H. T., Dorostkar, F., Doshmangir, L., Duncan, B. B., Duraes, A. R., Eagan, A. W., Edvardsson, D., El Sayed, I., El Tantawi, M., Elgendy, I. Y., Elyazar, I. R., Eskandari, K., Eskandarieh, S., Esmaeilnejad, S., Esteghamati, A., Ezekannagha, O., Farag, T., Farahmand, M., Faraon, E. J. A., Farinha, C. S. E. S., Farioli, A., Faris, P. S., Faro, A., Fazlzadeh, M., Feigin, V. L., Fernandes, E., Ferrara, P., Feyissa, G. T., Filip, I., Fischer, F., Fisher, J. L., Flor, L. S., Foigt, N. A., Folayan, M. O., Fomenkov, A. A., Foroutan, M., Francis, J. M., Fu, W., Fukumoto, T., Furtado, J. M., Gad, M. M., Gaidhane, A. M., Gakidou, E., Galles, N. C., Gallus, S., Gardner, W. M., Geberemariyam, B. S., Gebrehiwot, A. M., Gebremeskel, L. G., Gebremeskel, G. G., Gesesew, H. A., Ghadiri, K., Ghafourifard, M., Ghashghaee, A., Ghith, N., Gholamian, A., Gilani, S. A., Gill, P. S., Gill, T. K., Ginindza, T. G., Gitimoghaddam, M., Giussani, G., Glagn, M., Gnedovskaya, E. V., Godinho, M. A., Goharinezhad, S., Gopalani, S. V., Goudarzian, A. H., Goulart, B. N. G., Gubari, M. I. M., Guimaraes, R. A., Guled, R. A., Gultie, T., Guo, Y., Gupta, R., Hafezi-Nejad, N., Hafiz, A., Haile, T. G., Hamadeh, R. R., Hameed, S., Hamidi, S., Han, C., Han, H., Handiso, D. W., Hanif, A., Hankey, G. J., Haro, J. M., Hasaballah, A. I., Hasan, M. M., Hashi, A., Hassan, S., Hassan, A., Hassanipour, S., Hassankhani, H., Havmoeller, R. J., Hay, S. I., Hayat, K., Heidari, G., Heidari-Soureshjani, R., Hendrie, D., Herteliu, C., Hird, T. R., Ho, H. C., Hole, M. K., Holla, R., Hoogar, P., Hopf, K. P., Horita, N., Hossain, N., Hosseini, M., Hosseinzadeh, M., Hostiuc, M., Hostiuc, S., Househ, M., Hsieh, V. C. -R., Hu, G., Huda, T. M., Humayun, A., Hwang, B. -F., Iavicoli, I., Ibitoye, S. E., Ikeda, N., Ilesanmi, O. S., Ilic, M. D., Inbaraj, L. R., Iqbal, U., Irvani, S. S. N., Irvine, C. M. S., Islam, M. M., Islam, S. M. S., Islami, F., Iso, H., Iwu, C. J., Jaafari, J., Jadidi-Niaragh, F., Jafarinia, M., Jahagirdar, D., Jahani, M. A., Jahanmehr, N., Jakovljevic, M., Janjani, H., Javaheri, T., Jayatilleke, A. U., Jenabi, E., Jha, R. P., Jha, V., Ji, J. S., Jia, P., John-Akinola, Y. O., Jonas, J. B., Joukar, F., Jozwiak, J. J., Jurisson, M., Kabir, Z., Kalankesh, L. R., Kalhor, R., Kamath, A. M., Kanchan, T., Kapoor, N., Karami Matin, B., Karanikolos, M., Karimi, S. M., Kassebaum, N. J., Katikireddi, S. V., Kayode, G. A., Keiyoro, P. N., Khader, Y. S., Khammarnia, M., Khan, M., Khan, E. A., Khang, Y. -H., Khatab, K., Khater, A. M., Khater, M. M., Khatib, M. N., Khayamzadeh, M., Khubchandani, J., Kianipour, N., Kim, Y. J., Kimokoti, R. W., Kinfu, Y., Kisa, A., Kissimova-Skarbek, K., Kivimaki, M., Kneib, C. J., Kocarnik, J. M., Kochhar, S., Kohler, S., Kopec, J. A., Korotkova, A. V., Korshunov, V. A., Kosen, S., Kotlo, A., Koul, P. A., Koyanagi, A., Krishan, K., Krohn, K. J., Kugbey, N., Kulkarni, V., Kumar, G. A., Kumar, N., Kumar, M., Kurmi, O. P., Kusuma, D., Kyu, H. H., La Vecchia, C., Lacey, B., Lal, D. K., Lalloo, R., Landires, I., Lansingh, V. C., Larsson, A. O., Lasrado, S., Lau, K. M. -M., Lauriola, P., Lazarus, J. V., Ledesma, J. R., Lee, P. H., Lee, S. W. H., Leever, A. T., Legrand, K. E., Leigh, J., Leonardi, M., Li, S., Lim, S. S., Lim, L. -L., Liu, X., Logroscino, G., Lopez, A. D., Lopukhov, P. D., Lotufo, P. A., Lu, A., Ma, J., Madadin, M., Mahasha, P. W., Mahmoudi, M., Majeed, A., Malagon-Rojas, J. N., Maleki, S., Malta, D. C., Mansouri, B., Mansournia, M. A., Martini, S., Martins-Melo, F. R., Martopullo, I., Massenburg, B. B., Mastrogiacomo, C. I., Mathur, M. R., Mcalinden, C., Mckee, M., Medina-Solis, C. E., Meharie, B. G., Mehndiratta, M. M., Mehrabi Nasab, E., Mehri, F., Mehrotra, R., Mekonnen, T., Melese, A., Memiah, P. T. N., Mendoza, W., Menezes, R. G., Mensah, G. A., Meretoja, T. J., Meretoja, A., Mestrovic, T., Miazgowski, B., Michalek, I. M., Mirrakhimov, E. M., Mirzaei, M., Mirzaei-Alavijeh, M., Mitchell, P. B., Moazen, B., Moghadaszadeh, M., Mohamadi, E., Mohammad, Y., Mohammad, D. K., Mohammad Gholi Mezerji, N., Mohammadian-Hafshejani, A., Mohammed, S., Mohammed, J. A., Mokdad, A. H., Monasta, L., Mondello, S., Moradi, M., Moradi-Lakeh, M., Moradzadeh, R., Moraga, P., Morgado-da-Costa, J., Morrison, S. D., Mosapour, A., Mosser, J. F., Mousavi Khaneghah, A., Muriithi, M. K., Mustafa, G., Nabhan, A. F., Naderi, M., Nagarajan, A. J., Naghavi, M., Naghshtabrizi, B., Naimzada, M. D., Nangia, V., Nansseu, J. R., Nayak, V. C., Nazari, J., Ndejjo, R., Negoi, I., Negoi, R. I., Neupane, S., Ngari, K. N., Nguefack-Tsague, G., Ngunjiri, J. W., Nguyen, C. T., Nguyen, D. N., Nguyen, H. L. T., Nnaji, C. A., Nomura, S., Norheim, O. F., Noubiap, J. J., Nowak, C., Nunez-Samudio, V., Otoiu, A., Ogbo, F. A., Oghenetega, O. B., Oh, I. -H., Okunga, E. W., Oladnabi, M., Olagunju, A. T., Olusanya, J. O., Olusanya, B. O., Oluwasanu, M. M., Omar Bali, A., Omer, M. O., Ong, K. L., Onwujekwe, O. E., Ortega-Altamirano, D. V. V., Ortiz, A., Ostojic, S. M., Otstavnov, N., Otstavnov, S. S., Overland, S., Owolabi, M. O., Padubidri, J. R., Pakhale, S., Palladino, R., Pana, A., Panda-Jonas, S., Pangaribuan, H. U., Pathak, M., Patton, G. C., Paudel, S., Pazoki Toroudi, H., Pease, S. A., Peden, A. E., Pennini, A., Peprah, E. K., Pereira, J., Pigott, D. M., Pilgrim, T., Pilz, T. M., Pinheiro, M., Piradov, M. A., Pirsaheb, M., Pokhrel, K. N., Postma, M. J., Pourjafar, H., Pourmalek, F., Pourmirza Kalhori, R., Pourshams, A., Prada, S. I., Pribadi, D. R. A., Pupillo, E., Quazi Syed, Z., Radfar, A., Rafiee, A., Rafiei, A., Raggi, A., Rahim, F., Rahman, M. A., Rajabpour-Sanati, A., Rana, S. M., Ranabhat, C. L., Rao, S. J., Rasella, D., Rashedi, V., Rath, G. K., Rathi, P., Rawaf, S., Rawaf, D. L., Rawal, L., Rawassizadeh, R., Razo, C., Renjith, V., Renzaho, A. M. N., Reshmi, B., Rezaei, N., Riahi, S. M., Ribeiro, D. C., Rickard, J., Roberts, N. L. S., Roever, L., Romoli, M., Ronfani, L., Roshandel, G., Rubagotti, E., Rwegerera, G. M., Sabour, S., Sachdev, P. S., Saddik, B., Sadeghi, M., Sadeghi, E., Safari, Y., Sagar, R., Sahebkar, A., Sahraian, M. A., Sajadi, S. M., Salahshoor, M. R., Salem, M. R. R., Salem, H., Salomon, J., Samadi Kafil, H., Samy, A. M., Sanabria, J., Santric-Milicevic, M. M., Saraswathy, S. Y. I., Sarmiento-Suarez, R., Sartorius, B., Sarveazad, A., Sathian, B., Sathish, T., Sattin, D., Savic, M., Sawyer, S. M., Saxena, D., Sbarra, A. N., Schaeffer, L. E., Schiavolin, S., Schmidt, M. I., Schutte, A. E., Schwebel, D. C., Schwendicke, F., Seedat, S., Sha, F., Shahabi, S., Shaheen, A. A., Shaikh, M. A., Shamsizadeh, M., Shannawaz, M., Sharafi, K., Sharara, F., Sharifi, H., Shaw, D. H., Sheikh, A., Sheikhtaheri, A., Shetty, B. S. K., Shibuya, K., Shiferaw, W. S., Shigematsu, M., Shin, J. I., Shiri, R., Shirkoohi, R., Shivakumar, K. M., Shrime, M. G., Shuval, K., Siabani, S., Sierpinski, R., Sigfusdottir, I. D., Sigurvinsdottir, R., Silva, D. A. S., Silva, J. P., Simonetti, B., Simpson, K. E., Singh, J. A., Singh, P., Sinha, D. N., Skryabin, V. Y., Smith, E. U. R., Soheili, A., Soltani, S., Soofi, M., Sorensen, R. J. D., Soriano, J. B., Sorrie, M. B., Soyiri, I. N., Spurlock, E. E., Sreeramareddy, C. T., Stanaway, J. D., Steel, N., Stein, C., Stokes, M. A., Sufiyan, M. B., Suleria, H. A. R., Sultan, I., Szumowski, L., Tabares-Seisdedos, R., Tabuchi, T., Tadakamadla, S. K., Taddele, B. W., Tadesse, D. B., Taherkhani, A., Tamiru, A. T., Tanser, F. C., Tareque, M. I., Tarigan, I. U., Teagle, W. L., Tediosi, F., Tefera, Y. G. G., Tela, F. G., Tessema, Z. T., Thakur, B., Titova, M. V., Tonelli, M., Topor-Madry, R., Topouzis, F., Tovani-Palone, M. R. R., Tran, B. X., Travillian, R., Troeger, C. E., Tudor Car, L., Uddin, R., Ullah, I., Umeokonkwo, C. D., Unnikrishnan, B., Upadhyay, E., Uthman, O. A., Vacante, M., Valdez, P. R., Varughese, S., Vasankari, T. J., Vasseghian, Y., Venketasubramanian, N., Violante, F. S., Vlassov, V., Vollset, S. E., Vongpradith, A., Vos, T., Waheed, Y., Walters, M. K., Wamai, R. G., Wang, H., Wang, Y. -P., Weintraub, R. G., Weiss, J., Werdecker, A., Westerman, R., Wilner, L. B., Woldu, G., Wolfe, C. D. A., Wu, A. -M., Wulf Hanson, S., Xie, Y., Yahyazadeh Jabbari, S. H., Yamagishi, K., Yano, Y., Yaya, S., Yazdi-Feyzabadi, V., Yearwood, J. A., Yeshitila, Y. G., Yip, P., Yonemoto, N., Younis, M. Z., Yousefi, Z., Yousefinezhadi, T., Yusefzadeh, H., Zadey, S., Zahirian Moghadam, T., Zaidi, S. S., Zaki, L., Zaman, S. B., Zamanian, M., Zandian, H., Zastrozhin, M. S., Zewdie, K. A., Zhang, Y., Zhao, X. -J. G., Zhao, Y., Zheng, P., Zhu, C., Ziapour, A., Zlavog, B. S., Zodpey, S., and Murray, C. J. L.
Subjects: Index (economics), Servicios de Salud, SUSTAINABLE DEVELOPMENT GOALS, 030204 cardiovascular system & hematology, universal health coverage, sustaibale develpment goal, global burden of disease, performance, systematic analysis, Global Burden of Disease, 0302 clinical medicine, Universal Health Insurance, RA0421, 11. Sustainability, Per capita, Medical economics, Disease, 030212 general & internal medicine, 10. No inequality, 11 Medical and Health Sciences, effective coverage of health services, GBD 2019 Universal Health Coverage Collaborators, education.field_of_study, Public health, Medical care, Sjúkdómar, 4. Education, 1. No poverty, Health coverage, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, Hälsovetenskaper, 3142 Public health care science, environmental and occupational health, Health services, 3. Good health, Global burden of disease, Health Expenditures, Humans, World Health Organization, Purchasing power parity, Scale (social sciences), Lýðheilsa, universal health coverag, CANCER SURVIVAL, ACCESS, Human, Heilsuhagfræði, medicine.medical_specialty, Health coverage, GBD, GBD, Universal health, GBD 2019, Population, Health expenditures, 3122 Cancers, Population health, 03 medical and health sciences, Health systems, Heilbrigðisvísindi, SDG 3 - Good Health and Well-being, General & Internal Medicine, Development economics, Health Sciences, medicine, Heilbrigðisstefna, Alþjóðaheilbrigðisstofnunin, QUALITY, Global Burden of Disease Study, education, PROGRESS, Disease burden, Health services accessibility, CARE, Heilbrigðisþjónusta, purl.org/pe-repo/ocde/ford#3.02.00 [https], Health Expenditure, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, 3121 General medicine, internal medicine and other clinical medicine, Morbility, Administración de los Servicios de Salud, Medical policy, Business, Heilbrigðiskerfi
Abstract: Publisher's version (útgefin grein), Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (>= 65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0-100 based on the 2.5th and 97.5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target-1 billion more people benefiting from UHC by 2023-we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45.8 (95% uncertainty interval 44.2-47.5) in 1990 to 60.3 (58.7-61.9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2.6% [1.9-3.3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010-2019 relative to 1990-2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0.79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388.9 million (358.6-421.3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3.1 billion (3.0-3.2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968.1 million [903.5-1040.3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people-the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close-or how far-all populations are in benefiting from UHC., Lucas Guimaraes Abreu acknowledges support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior -Brasil (Capes) -Finance Code 001, Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) and Fundacao de Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG). Olatunji O Adetokunboh acknowledges South African Department of Science & Innovation, and National Research Foundation. Anurag Agrawal acknowledges support from the Wellcome Trust DBT India Alliance Senior Fellowship IA/CPHS/14/1/501489. Rufus Olusola Akinyemi acknowledges Grant U01HG010273 from the National Institutes of Health (NIH) as part of the H3Africa Consortium. Rufus Olusola Akinyemi is further supported by the FLAIR fellowship funded by the UK Royal Society and the African Academy of Sciences. Syed Mohamed Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. Marcel Ausloos, Claudiu Herteliu, and Adrian Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDSUEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. Till Winfried Barnighausen acknowledges support from the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. Juan J Carrero was supported by the Swedish Research Council (2019-01059). Felix Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/MCTES through national funds. Vera Marisa Costa acknowledges support from grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundacao para a Ciencia e a Tecnologia (FCT), IP, under the Norma TransitA3ria DL57/2016/CP1334/CT0006. Jan-Walter De Neve acknowledges support from the Alexander von Humboldt Foundation. Kebede Deribe acknowledges support by Wellcome Trust grant number 201900/Z/16/Z as part of his International Intermediate Fellowship. Claudiu Herteliu acknowledges partial support by a grant co-funded by European Fund for Regional Development through Operational Program for Competitiveness, Project ID P_40_382. Praveen Hoogar acknowledges the Centre for Bio Cultural Studies (CBiCS), Manipal Academy of Higher Education(MAHE), Manipal and Centre for Holistic Development and Research (CHDR), Kalghatgi. Bing-Fang Hwang acknowledges support from China Medical University (CMU108-MF-95), Taichung, Taiwan. Mihajlo Jakovljevic acknowledges the Serbian part of this GBD contribution was co-funded through the Grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. Aruna M Kamath acknowledges funding from the National Institutes of Health T32 grant (T32GM086270). Srinivasa Vittal Katikireddi acknowledges funding from the Medical Research Council (MC_UU_12017/13 & MC_UU_12017/15), Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15) and an NRS Senior Clinical Fellowship (SCAF/15/02). Yun Jin Kim acknowledges support from the Research Management Centre, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/0001). Kewal Krishan acknowledges support from the DST PURSE grant and UGC Center of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India. Manasi Kumar acknowledges support from K43 TW010716 Fogarty International Center/NIMH. Ben Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. Ivan Landires is a member of the Sistema Nacional de InvestigaciA3n (SNI), which is supported by the Secretaria Nacional de Ciencia Tecnologia e Innovacion (SENACYT), Panama. Jeffrey V Lazarus acknowledges support by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III/ESF, European Union [CP18/00074]). Peter T N Memiah acknowledges CODESRIA; HISTP. Subas Neupane acknowledges partial support from the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital. Shuhei Nomura acknowledges support from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). Alberto Ortiz acknowledges support by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. George C Patton acknowledges support from a National Health & Medical Research Council Fellowship. Marina Pinheiro acknowledges support from FCT for funding through program DL 57/2016 -Norma transitA3ria. Alberto Raggi, David Sattin, and Silvia Schiavolin acknowledge support by a grant from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4 -Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). Daniel Cury Ribeiro acknowledges support from the Sir Charles Hercus Health Research Fellowship -Health Research Council of New Zealand (18/111). Perminder S Sachdev acknowledges funding from the NHMRC Australia. Abdallah M Samy acknowledges support from a fellowship from the Egyptian Fulbright Mission Program. Milena M Santric-Milicevic acknowledges support from the Ministry of Education, Science and Technological Development of the Republic of Serbia (Contract No. 175087). Rodrigo Sarmiento-Suarez acknowledges institutional support from University of Applied and Environmental Sciences in Bogota, Colombia, and Carlos III Institute of Health in Madrid, Spain. Maria Ines Schmidt acknowledges grants from the Foundation for the Support of Research of the State of Rio Grande do Sul (IATS and PrInt) and the Brazilian Ministry of Health. Sheikh Mohammed Shariful Islam acknowledges a fellowship from the National Heart Foundation of Australia and Deakin University. Aziz Sheikh acknowledges support from Health Data Research UK. Kenji Shibuya acknowledges Japan Ministry of Education, Culture, Sports, Science and Technology. Joan B Soriano acknowledges support by Centro de Investigacion en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Rafael Tabares-Seisdedos acknowledges partial support from grant PI17/00719 from ISCIII-FEDER. Santosh Kumar Tadakamadla acknowledges support from the National Health and Medical Research Council Early Career Fellowship, Australia. Marcello Tonelli acknowledges the David Freeze Chair in Health Services Research at the University of Calgary, AB, Canada., "Peer Reviewed"
Published: 2020

23. Changes in disease burden in Poland between 1990-2017 in comparison with other Central European countries: A systematic analysis for the Global Burden of Disease Study 2017

Author: Mario Šekerija, Tomislav Mestrovic, Mohsen Naghavi, Sorin Hostiuc, Isidora S. Vujcic, Marcin Korzeń, Bartosz Rudnicki, Bartosz Miazgowski, Marcel Ausloos, Neda Milevska Kostova, Catalina Liliana Andrei, Katarzyna Widecka, Artur Kotwas, Lucjan Szponar, Bogdan Wojtyniak, Claudiu Herteliu, Maria Magdalena Constantin, Radosław Sierpiński, Mihaela Hostiuc, Salvatore Rubino, Jacek Jerzy Jozwiak, Jacek A. Kopec, Eleonora Dubljanin, Alexandra Brazinova, Adrian Pana, Tomasz Nogal, Roman Topor-Madry, Ruxandra Irina Negoi, Justyna Widecka, Tomasz Miazgowski, Mihajlo Jakovljevic, Maria Gańczak, Vesna Zadnik, Maciej Banach, Katarzyna Kissimova-Skarbek, Ionut Negoi, Marta Kożybska, and Zbigniew J. Król
Subjects: Male, Systems Analysis, Pulmonology, 030204 cardiovascular system & hematology, Global Health, Pathology and Laboratory Medicine, Geographical locations, Global Burden of Disease, Self Harm, 0302 clinical medicine, Endocrinology, Sex factors, Risk Factors, Global health, Medicine and Health Sciences, Medicine, Public and Occupational Health, 030212 general & internal medicine, Child, 2. Zero hunger, Aged, 80 and over, Multidisciplinary, Organic Compounds, 1. No poverty, Middle Aged, 3. Good health, Europe, Chemistry, Child, Preschool, Physical Sciences, Female, Quality-Adjusted Life Years, Research Article, Burden of disease, Adult, Cross-Cultural Comparison, Adolescent, Endocrine Disorders, Chronic Obstructive Pulmonary Disease, Science, Lower Back Pain, MEDLINE, Pain, Population health, 03 medical and health sciences, Young Adult, Signs and Symptoms, Life Expectancy, Sex Factors, Diagnostic Medicine, Environmental health, burden of disease, Poland, epidemiology, Mental Health and Psychiatry, Diabetes Mellitus, Humans, European Union, Disease burden, Aged, business.industry, Mortality, Premature, Organic Chemistry, Chemical Compounds, Infant, Newborn, Infant, Quality-adjusted life year, Alcohols, Metabolic Disorders, Poland, People and places, business
Abstract: Background Systematic collection of mortality/morbidity data over time is crucial for monitoring trends in population health, developing health policies, assessing the impact of health programs. In Poland, a comprehensive analysis describing trends in disease burden for major conditions has never been published. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides data on the burden of over 300 diseases in 195 countries since 1990. We used the GBD database to undertake an assessment of disease burden in Poland, evaluate changes in population health between 1990–2017, and compare Poland with other Central European (CE) countries. Methods The results of GBD 2017 for 1990 and 2017 for Poland and CE were used to assess rates and trends in years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs). Data came from cause-of-death registration systems, population health surveys, disease registries, hospitalization databases, and the scientific literature. Analytical approaches have been used to adjust for missing data, errors in cause-of-death certification, and differences in data collection methodology. Main estimation strategies were ensemble modelling for mortality and Bayesian meta-regression for disability. Results Between 1990–2017, age-standardized YLL rates for all causes declined in Poland by 46.0% (95% UI: 43.7–48.2), YLD rates declined by 4.0% (4.2–4.9), DALY rates by 31.7% (29.2–34.4). For both YLLs and YLDs, greater relative declines were observed for females. There was a large decrease in communicable, maternal, neonatal, and nutritional disease DALYs (48.2% ; 46.3–50.4). DALYs due to non-communicable diseases (NCDs) decreased slightly (2.0% ; 0.1–4.6). In 2017, Poland performed better than CE as a whole (ranked fourth for YLLs, sixth for YLDs, and fifth for DALYs) and achieved greater reductions in YLLs and DALYs than most CE countries. In 2017 and 1990, the leading cause of YLLs and DALYs in Poland and CE was ischaemic heart disease (IHD), and the leading cause of YLDs was low back pain. In 2017, the top 20 causes of YLLs and YLDs in Poland and CE were the same, although in different order. In Poland, age-standardized DALYs from neonatal causes, other cardiovascular and circulatory diseases, and road injuries declined substantially between 1990–2017, while alcohol use disorders and chronic liver diseases increased. The highest observed-to- expected ratios were seen for alcohol use disorders for YLLs, neonatal sepsis for YLDs, and falls for DALYs (3.21, 2.65, and 2.03, respectively). Conclusions There was relatively little geographical variation in premature death and disability in CE in 2017, although some between-country differences existed. Health in Poland has been improving since 1990 ; in 2017 Poland outperformed CE as a whole for YLLs, YLDs, and DALYs. While the health gap between Poland and Western Europe has diminished, it remains substantial. The shift to NCDs and chronic disability, together with marked between-gender health inequalities, poses a challenge for the Polish health-care system. IHD is still the leading cause of disease burden in Poland, but DALYs from IHD are declining. To further reduce disease burden, an integrated response focused on NCDs and population groups with disproportionally high burden is needed.
Published: 2020

24. Global, regional, and national burden of congenital heart disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author: Manisha Dubey, Michelle Echko, Mohamad-Hani Temsah, Craig Sable, Jean Jacques Noubiap, Ashish Awasthi, Nicholas J Kassebaum, Lemma Negesa, Molly R Nixon, Cuong Tat Nguyen, Paolo Cortesi, Anita Kar, Gene F. Kwan, Helen E Olsen, Emmanuel Peprah, Ionut Negoi, Trang Huyen Nguyen, Nu Thi Truong, Zoubida Zaidi, Samer Hamidi, Huong Lan Thi Nguyen, Robert G. Weintraub, Simon I. Hay, Christopher Hugo-Hamman, Mohsen Naghavi, Bach Xuan Tran, Lauren B. Wilner, Kathy J. Jenkins, Bistra Zheleva, Tung Thanh Tran, Ali H. Mokdad, Gregory A. Roth, Hagos Tasew Atalay, Shanti Patel, Ibrahim A Khalil, Kidu Gidey Weldegwergs, Son Hoang Nguyen, Marcos Roberto Tovani-Palone, Gerard R. Martin, Liesl Zühlke, Alison Smith, Zulfiqar A Bhutta, Jeffrey A. Towbin, Florian Fischer, Meghan S. Zimmerman, Jackie Lee Anne Boucher, Raman Krishna Kumar, Theo Vos, Long Hoang Nguyen, Chi Linh Hoang, Christopher J L Murray, Robert Reiner, Franz Castro, Kia Vosoughi, Ruxandra Irina Negoi, Desalegn Tadese Mengistu, Zimmerman, M, Smith, A, Sable, C, Echko, M, Wilner, L, Olsen, H, Atalay, H, Awasthi, A, Bhutta, Z, Boucher, J, Castro, F, Cortesi, P, Dubey, M, Fischer, F, Hamidi, S, Hay, S, Hoang, C, Hugo-Hamman, C, Jenkins, K, Kar, A, Khalil, I, Kumar, R, Kwan, G, Mengistu, D, Mokdad, A, Naghavi, M, Negesa, L, Negoi, I, Negoi, R, Nguyen, C, Nguyen, H, Nguyen, L, Nguyen, S, Nguyen, T, Nixon, M, Noubiap, J, Patel, S, Peprah, E, Reiner, R, Roth, G, Temsah, M, Tovani-Palone, M, Towbin, J, Tran, B, Tran, T, Truong, N, Vos, T, Vosoughi, K, Weintraub, R, Weldegwergs, K, Zaidi, Z, Zheleva, B, Zuhlke, L, Murray, C, Martin, G, and Kassebaum, N
Subjects: Heart Defects, Congenital, Pediatrics, medicine.medical_specialty, Adolescent, Heart disease, MED/42 - IGIENE GENERALE E APPLICATA, Psychological intervention, Burden, Global Health, Global Burden of Disease, 03 medical and health sciences, 0302 clinical medicine, Quality of life, 030225 pediatrics, Ductus arteriosus, Prevalence, Developmental and Educational Psychology, medicine, Humans, epidemiology, Disabled Persons, 030212 general & internal medicine, Child, Cause of death, Congenital Heart disease, business.industry, Infant, Newborn, Infant, Articles, medicine.disease, mortality, prevalnce, years lived with disability, medicine.anatomical_structure, Great vessels, Ventricle, Child, Preschool, Pediatrics, Perinatology and Child Health, Life course approach, business, Systematic Reviews as Topic
Abstract: Background: Previous congenital heart disease estimates came from few data sources, were geographically narrow, and did not evaluate congenital heart disease throughout the life course. Completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017, this study aimed to provide comprehensive estimates of congenital heart disease mortality, prevalence, and disability by age for 195 countries and territories from 1990 to 2017. Methods: Mortality estimates were generated for aggregate congenital heart disease and non-fatal estimates for five subcategories (single ventricle and single ventricle pathway congenital heart anomalies; severe congenital heart anomalies excluding single ventricle heart defects; critical malformations of great vessels, congenital valvular heart disease, and patent ductus arteriosus; ventricular septal defect and atrial septal defect; and other congenital heart anomalies), for 1990 through to 2017. All available global data were systematically analysed to generate congenital heart disease mortality estimates (using Cause of Death Ensemble modelling) and prevalence estimates (DisMod-MR 2·1). Systematic literature reviews of all types of congenital anomalies to capture information on prevalence, associated mortality, and long-term health outcomes on congenital heart disease informed subsequent disability estimates. Findings: Congenital heart disease caused 261 247 deaths (95% uncertainty interval 216 567–308 159) globally in 2017, a 34·5% decline from 1990, with 180 624 deaths (146 825–214 178) being among infants (aged
Published: 2020

25. Laparoscopic vs open complete mesocolic excision with central vascular ligation for colon cancer: A systematic review and meta-analysis

Author: Sorin Hostiuc, Ionut Negoi, Mircea Beuran, and Ruxandra Irina Negoi
Subjects: medicine.medical_specialty, business.industry, Colorectal cancer, Gastroenterology, medicine.disease, Surgery, 03 medical and health sciences, 0302 clinical medicine, Text mining, Oncology, 030220 oncology & carcinogenesis, Meta-analysis, Medicine, D3 lymphadenectomy, 030211 gastroenterology & hepatology, Ligation, business
Abstract: Laparoscopic vs open complete mesocolic excision with central vascular ligation for colon cancer: A systematic review and meta-analysis
Published: 2017

26. MicroRNA-21 as a prognostic biomarker in patients with pancreatic cancer – A systematic review and meta-analysis

Author: Mircea Beuran, Ruxandra Irina Negoi, Massimo Sartelli, Ionut Negoi, and Sorin Hostiuc
Subjects: 0301 basic medicine, Oncology, Pathology, medicine.medical_specialty, medicine.medical_treatment, MEDLINE, Subgroup analysis, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Downregulation and upregulation, Pancreatic cancer, Internal medicine, microRNA, Biomarkers, Tumor, medicine, Humans, Chemotherapy, business.industry, General Medicine, Prognosis, medicine.disease, Precision medicine, Pancreatic Neoplasms, MicroRNAs, 030104 developmental biology, 030220 oncology & carcinogenesis, Meta-analysis, Surgery, business
Abstract: Objectives The aim of this systematic review and meta-analysis is to summarize the current knowledge regarding microRNA-21 and to evaluate its prognostic impact in patients with pancreatic cancer. Methods We conducted an electronic literature search to identify all published studies in PubMed/MEDLINE, Scopus and Google Scholar databases from 2000 until August 2016. Results A total of 17 studies involving 1471 patients met the inclusion criteria for the quantitative synthesis. The microRNA-21 upregulation was significantly associated with poorer overall survival, disease-free survival, and progression-free survival. The subgroup analysis revealed that microRNA-21 overexpression has a significant higher prognostic value for patients who receive adjuvant chemotherapy. Increased microRNA-21 was associated with a statistically significant higher rate of metastatic lymph nodes and poorly differentiated tumors. Conclusions MicroRNA-21 upregulation in pancreatic cancer is associated with a significantly poorer overall survival, disease-free survival, and progression-free survival. MicroRNA-21 may be a useful prognostic biomarker, allowing stratification for chemotherapy administration, and being a component of precision medicine in patients with pancreatic cancer.
Published: 2017

27. Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Author: Mohsen Bayati, Arvin Haj-Mirzaian, Mehran Asadi-Aliabadi, Maziar Moradi-Lakeh, Nasir Salam, Mohamad-Hani Temsah, Fatemeh Heydarpour, Davide Rasella, Kavumpurathu Raman Thankappan, Ghulam Mustafa, Sergey Konstantinovitch Vladimirov, Fereshteh Ansari, Dina Nur Anggraini Ningrum, Leonardo Roever, Oghenowede Eyawo, Koustuv Dalal, Ana-Laura Manda, Ritesh G. Menezes, Molly K. Miller-Petrie, Javad Yoosefi Lebni, Gebreamlak Gebremedhn Gebremeskel, Aziz Eftekhari, Oleguer Plana-Ripoll, Jon Wakefield, Sanjay Zodpey, Birhanu Geta, Amaha Kahsay, Edris Hasanpoor, Brijesh Sathian, Kala M. Mehta, Moritz U. G. Kraemer, Saeed Amini, Hesham M. Al-Mekhlafi, Abbas Yadegar, João Pedro Silva, Desmond Kuupiel, Anvar Asadi, Hamid Sharifi, Ebrahim Babaee, Dessalegn Ajema Berbada, Taddese Alemu Zerfu, Ian Davis, Mostafa Qorbani, Fatemeh Rajati, Samer Hamidi, Parvaiz A Koul, Foad Abd-Allah, Mojisola Oluwasanu, Syed Mohamed Aljunid, Elias Merdassa Roro, Mihaela Hostiuc, Robert S. Bernstein, Vahid Yazdi-Feyzabadi, Gebre Teklemariam Demoz, Irina Filip, Mu'awiyyah Babale Sufiyan, Amir Khater, Lidia Morawska, Sangram Kishor Patel, Robert C. Reiner, Joshua O. Akinyemi, Telma Zahirian Moghadam, Ali Akbar Fazaeli, Reza Malekzadeh, Olatunde Aremu, Mohammad Reza Salahshoor, Irfan Ullah, Gabrielle B. Britton, Gelin Xu, Nathaniel J Henry, Thomas R. Hird, Ronny Westerman, Vera Marisa Costa, Reza Assadi, Tiffany K. Gill, Chhabi Lal Ranabhat, Meysam Olfatifar, Sezer Kisa, Grant Rodgers Kemp, Mahmoud Yousefifard, Aleksandra Barac, Simon I. Hay, Walter Mendoza, Mohammad Zamani, Nader Jafari Balalami, Mahdi Safdarian, Manfred S. Green, Mahesh P A, Nahid Neamati, Pallab K. Maulik, Ali H. Mokdad, Joshua Longbottom, Somayeh Bohlouli, Ahmad Daryani, Ibrahim Abdollahpour, Mostafa Hosseini, Deborah Carvalho Malta, Nick Golding, Sheikh Mohammed Shariful Islam, Shirin Nosratnejad, Haidong Wang, Shadi Rahimzadeh, Pushpendra Kumar, Mehdi Noroozi, Andre M. N. 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R., Soofi M., Soriano J.B., Sreeramareddy C.T., Sudaryanto A., Sufiyan M.B., Sykes B.L., Sylaja P.N., Tabares-Seisdedos R., Tabb K.M., Tabuchi T., Taveira N., Temsah M.-H., Terkawi A.S., Tessema Z.T., Thankappan K.R., Thirunavukkarasu S., To Q.G., Tovani-Palone M.R., Tran B.X., Tran K.B., Ullah I., Usman M.S., Uthman O.A., Vahedian-Azimi A., Valdez P.R., van Boven J.F.M., Vasankari T.J., Vasseghian Y., Veisani Y., Venketasubramanian N., Violante F.S., Vladimirov S.K., Vlassov V., Vos T., Vu G.T., Vujcic I.S., Waheed Y., Wakefield J., Wang H., Wang Y., Wang Y.-P., Ward J.L., Weintraub R.G., Weldegwergs K.G., Weldesamuel G.T., Westerman R., Wiysonge C.S., Wondafrash D.Z., Woyczynski L., Wu A.-M., Xu G., Yadegar A., Yamada T., Yazdi-Feyzabadi V., Yilgwan C.S., Yip P., Yonemoto N., Lebni J.Y., Younis M.Z., Yousefifard M., Yousof H.-A.S.A., Yu C., Yusefzadeh H., Zabeh E., Moghadam T.Z., Bin Zaman S., Zamani M., Zandian H., Zangeneh A., Zerfu T.A., Zhang Y., Ziapour A., Zodpey S., Murray C.J.L., and Hay S.I.
Subjects: Survival, RJ101, Mortalidad Infantil, HB, UNDER-5 MORTALITY, Global Health, Pediatrics, 0302 clinical medicine, 3123 Gynaecology and paediatrics, Child death, Infant Mortality, Epidemiology, Global health, Middle income country, Nacimiento vivo, 030212 general & internal medicine, 10. No inequality, Child, POPULATION, Developing world, education.field_of_study, Public health, Multidisciplinary, Geography, Mortality rate, wa_900, 1. No poverty, SUCCESS, Pediatrik, A900 Others in Medicine and Dentistry, 3142 Public health care science, environmental and occupational health, 3. Good health, Child Mortality, Death children, VACCINATION, HEALTH, ws_100, INTERVENTIONS, AFRICA, medicine.medical_specialty, United Nations, General Science & Technology, 030231 tropical medicine, Population, Developing country, Article, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], ITC-HYBRID, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, Social Justice, Recién nacido, Neonatal deaths, medicine, SYSTEMATIC ANALYSIS, Organizational Objectives, Humans, education, Developing Countries, business.industry, Infant, Newborn, Infant, CIVIL REGISTRATION, Paediatrics, Child survival, Newborn, PREVENTION, Infant mortality, wa_320, ws_200, Child mortality, Socioeconomic Factors, ITC-ISI-JOURNAL-ARTICLE, Human medicine, Paediatrics, Public health, Developing world, business, Demography
Abstract: Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations., A high-resolution, global atlas of mortality of children under five years of age between 2000 and 2017 highlights subnational geographical inequalities in the distribution, rates and absolute counts of child deaths by age.
Published: 2019

28. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author: Gregory A Roth, Degu Abate, Kalkidan Hassen Abate, Solomon M Abay, Cristiana Abbafati, Nooshin Abbasi, Hedayat Abbastabar, Foad Abd-Allah, Jemal Abdela, Ahmed Abdelalim, Ibrahim Abdollahpour, Rizwan Suliankatchi Abdulkader, Haftom Temesgen Abebe, Molla Abebe, Zegeye Abebe, Ayenew Negesse Abejie, Semaw F Abera, Olifan Zewdie Abil, Haftom Niguse Abraha, Aklilu Roba Abrham, Laith Jamal Abu-Raddad, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Beyene Meressa Adhena, Mina G Adib, Amha Admasie, Ashkan Afshin, Gina Agarwal, Kareha M Agesa, Anurag Agrawal, Sutapa Agrawal, Alireza Ahmadi, Mehdi Ahmadi, Muktar Beshir Ahmed, Sayem Ahmed, Amani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Mohammad Esmaeil Akbari, Rufus Olusola Akinyemi, Nadia Akseer, Ziyad Al-Aly, Ayman Al-Eyadhy, Rajaa M Al-Raddadi, Fares Alahdab, Khurshid Alam, Tahiya Alam, Animut Alebel, Kefyalew Addis Alene, Mehran Alijanzadeh, Reza Alizadeh-Navaei, Syed Mohamed Aljunid, Ala'a Alkerwi, François Alla, Peter Allebeck, Jordi Alonso, Khalid Altirkawi, Nelson Alvis-Guzman, Azmeraw T Amare, Leopold N Aminde, Erfan Amini, Walid Ammar, Yaw Ampem Amoako, Nahla Hamed Anber, Catalina Liliana Andrei, Sofia Androudi, Megbaru Debalkie Animut, Mina Anjomshoa, Hossein Ansari, Mustafa Geleto Ansha, Carl Abelardo T Antonio, Palwasha Anwari, Olatunde Aremu, Johan Ärnlöv, Amit Arora, Monika Arora, Al Artaman, Krishna K Aryal, Hamid Asayesh, Ephrem Tsegay Asfaw, Zerihun Ataro, Suleman Atique, Sachin R Atre, Marcel Ausloos, Euripide F G A Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Yohanes Ayele, Rakesh Ayer, Peter S Azzopardi, Arefeh Babazadeh, Umar Bacha, Hamid Badali, Alaa Badawi, Ayele Geleto Bali, Katherine E Ballesteros, Maciej Banach, Kajori Banerjee, Marlena S Bannick, Joseph Adel Mattar Banoub, Miguel A Barboza, Suzanne Lyn Barker-Collo, Till Winfried Bärnighausen, Simon Barquera, Lope H Barrero, Quique Bassat, Sanjay Basu, Bernhard T Baune, Habtamu Wondifraw Baynes, Shahrzad Bazargan-Hejazi, Neeraj Bedi, Ettore Beghi, Masoud Behzadifar, Meysam Behzadifar, Yannick Béjot, Bayu Begashaw Bekele, Abate Bekele Belachew, Ezra Belay, Yihalem Abebe Belay, Michelle L Bell, Aminu K Bello, Derrick A Bennett, Isabela M Bensenor, Adam E Berman, Eduardo Bernabe, Robert S Bernstein, Gregory J Bertolacci, Mircea Beuran, Tina Beyranvand, Ashish Bhalla, Suraj Bhattarai, Soumyadeeep Bhaumik, Zulfiqar A Bhutta, Belete Biadgo, Molly H Biehl, Ali Bijani, Boris Bikbov, Ver Bilano, Nigus Bililign, Muhammad Shahdaat Bin Sayeed, Donal Bisanzio, Tuhin Biswas, Brigette F Blacker, Berrak Bora Basara, Rohan Borschmann, Cristina Bosetti, Kayvan Bozorgmehr, Oliver J Brady, Luisa C Brant, Carol Brayne, Alexandra Brazinova, Nicholas J K Breitborde, Hermann Brenner, Paul Svitil Briant, Gabrielle Britton, Traolach Brugha, Reinhard Busse, Zahid A Butt, Charlton S K H Callender, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Mate Car, Rosario Cárdenas, Giulia Carreras, Juan J Carrero, Austin Carter, Félix Carvalho, Carlos A Castañeda-Orjuela, Jacqueline Castillo Rivas, Chris D Castle, Clara Castro, Franz Castro, Ferrán Catalá-López, Ester Cerin, Yazan Chaiah, Jung-Chen Chang, Fiona J Charlson, Pankaj Chaturvedi, Peggy Pei-Chia Chiang, Odgerel Chimed-Ochir, Vesper Hichilombwe Chisumpa, Abdulaal Chitheer, Rajiv Chowdhury, Hanne Christensen, Devasahayam J Christopher, Sheng-Chia Chung, Flavia M Cicuttini, Liliana G Ciobanu, Massimo Cirillo, Aaron J Cohen, Leslie Trumbull Cooper, Paolo Angelo Cortesi, Monica Cortinovis, Ewerton Cousin, Benjamin C Cowie, Michael H Criqui, Elizabeth A Cromwell, Christopher Stephen Crowe, John A Crump, Matthew Cunningham, Alemneh Kabeta Daba, Abel Fekadu Dadi, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Paul I Dargan, Ahmad Daryani, Siddharth K Das, Rajat Das Gupta, José Das Neves, Tamirat Tesfaye Dasa, Aditya Prasad Dash, Adrian C Davis, Nicole Davis Weaver, Dragos Virgil Davitoiu, Kairat Davletov, Fernando Pio De La Hoz, Jan-Walter De Neve, Meaza Girma Degefa, Louisa Degenhardt, Tizta T Degfie, Selina Deiparine, Gebre Teklemariam Demoz, Balem Betsu Demtsu, Edgar Denova-Gutiérrez, Kebede Deribe, Nikolaos Dervenis, Don C Des Jarlais, Getenet Ayalew Dessie, Subhojit Dey, Samath D Dharmaratne, Daniel Dicker, Mesfin Tadese Dinberu, Eric L Ding, M Ashworth Dirac, Shirin Djalalinia, Klara Dokova, David Teye Doku, Christl A Donnelly, E Ray Dorsey, Pratik P Doshi, Dirk Douwes-Schultz, Kerrie E Doyle, Tim R Driscoll, Manisha Dubey, Eleonora Dubljanin, Eyasu Ejeta Duken, Bruce B Duncan, Andre R Duraes, Hedyeh Ebrahimi, Soheil Ebrahimpour, Dumessa Edessa, David Edvardsson, Anne Elise Eggen, Charbel El Bcheraoui, Maysaa El Sayed Zaki, Ziad El-Khatib, Hajer Elkout, Christian Lycke Ellingsen, Matthias Endres, Aman Yesuf Endries, Benjamin Er, Holly E Erskine, Babak Eshrati, Sharareh Eskandarieh, Reza Esmaeili, Alireza Esteghamati, Mahdi Fakhar, Hamed Fakhim, Mahbobeh Faramarzi, Mohammad Fareed, Farzaneh Farhadi, Carla Sofia E sá Farinha, Andre Faro, Maryam S Farvid, Farshad Farzadfar, Mohammad Hosein Farzaei, Valery L Feigin, Andrea B Feigl, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Joao C Fernandes, Alize J Ferrari, Garumma Tolu Feyissa, Irina Filip, Samuel Finegold, Florian Fischer, Christina Fitzmaurice, Nataliya A Foigt, Kyle J Foreman, Carla Fornari, Tahvi D Frank, Takeshi Fukumoto, John E Fuller, Nancy Fullman, Thomas Fürst, João M Furtado, Neal D Futran, Silvano Gallus, Alberto L Garcia-Basteiro, Miguel A Garcia-Gordillo, William M Gardner, Abadi Kahsu Gebre, Tsegaye Tewelde Gebrehiwot, Amanuel Tesfay Gebremedhin, Bereket Gebremichael, Teklu Gebrehiwo Gebremichael, Tilayie Feto Gelano, Johanna M Geleijnse, Ricard Genova-Maleras, Yilma Chisha Dea Geramo, Peter W Gething, Kebede Embaye Gezae, Mohammad Rasoul Ghadami, Reza Ghadimi, Khalil Ghasemi Falavarjani, Maryam Ghasemi-Kasman, Mamata Ghimire, Katherine B Gibney, Paramjit Singh Gill, Tiffany K Gill, Richard F Gillum, Ibrahim Abdelmageed Ginawi, Maurice Giroud, Giorgia Giussani, Shifalika Goenka, Ellen M Goldberg, Srinivas Goli, Hector Gómez-Dantés, Philimon N Gona, Sameer Vali Gopalani, Taren M Gorman, Atsushi Goto, Alessandra C Goulart, Elena V Gnedovskaya, Ayman Grada, Giuseppe Grosso, Harish Chander Gugnani, Andre Luiz Sena Guimaraes, Yuming Guo, Prakash C Gupta, Rahul Gupta, Rajeev Gupta, Tanush Gupta, Reyna Alma Gutiérrez, Bishal Gyawali, Juanita A Haagsma, Nima Hafezi-Nejad, Tekleberhan B Hagos, Tewodros Tesfa Hailegiyorgis, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Alexis J Handal, Graeme J Hankey, Hilda L Harb, Sivadasanpillai Harikrishnan, Josep Maria Haro, Mehedi Hasan, Hadi Hassankhani, Hamid Yimam Hassen, Rasmus Havmoeller, Roderick J Hay, Simon I Hay, Yihua He, Akbar Hedayatizadeh-Omran, Mohamed I Hegazy, Behzad Heibati, Mohsen Heidari, Delia Hendrie, Andualem Henok, Nathaniel J Henry, Claudiu Herteliu, Fatemeh Heydarpour, Pouria Heydarpour, Sousan Heydarpour, Desalegn Tsegaw Hibstu, Hans W Hoek, Michael K Hole, Enayatollah Homaie Rad, Praveen Hoogar, H Dean Hosgood, Seyed Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Peter J Hotez, Damian G Hoy, Thomas Hsiao, Guoqing Hu, John J Huang, Abdullatif Husseini, Mohammedaman Mama Hussen, Susan Hutfless, Bulat Idrisov, Olayinka Stephen Ilesanmi, Usman Iqbal, Seyed Sina Naghibi Irvani, Caleb Mackay Salpeter Irvine, Nazrul Islam, Sheikh Mohammed Shariful Islam, Farhad Islami, Kathryn H Jacobsen, Leila Jahangiry, Nader Jahanmehr, Sudhir Kumar Jain, Mihajlo Jakovljevic, Moti Tolera Jalu, Spencer L James, Mehdi Javanbakht, Achala Upendra Jayatilleke, Panniyammakal Jeemon, Kathy J Jenkins, Ravi Prakash Jha, Vivekanand Jha, Catherine O Johnson, Sarah C Johnson, Jost B Jonas, Ankur Joshi, Jacek Jerzy Jozwiak, Suresh Banayya Jungari, Mikk Jürisson, Zubair Kabir, Rajendra Kadel, Amaha Kahsay, Rizwan Kalani, Manoochehr Karami, Behzad Karami Matin, André Karch, Corine Karema, Hamidreza Karimi-Sari, Amir Kasaeian, Dessalegn H Kassa, Getachew Mullu Kassa, Tesfaye Dessale Kassa, Nicholas J Kassebaum, Srinivasa Vittal Katikireddi, Anil Kaul, Zhila Kazemi, Ali Kazemi Karyani, Dhruv Satish Kazi, Adane Teshome Kefale, Peter Njenga Keiyoro, Grant Rodgers Kemp, Andre Pascal Kengne, Andre Keren, Chandrasekharan Nair Kesavachandran, Yousef Saleh Khader, Behzad Khafaei, Morteza Abdullatif Khafaie, Alireza Khajavi, Nauman Khalid, Ibrahim A Khalil, Ejaz Ahmad Khan, Muhammad Shahzeb Khan, Muhammad Ali Khan, Young-Ho Khang, Mona M Khater, Abdullah T Khoja, Ardeshir Khosravi, Mohammad Hossein Khosravi, Jagdish Khubchandani, Aliasghar A Kiadaliri, Getiye D Kibret, Zelalem Teklemariam Kidanemariam, Daniel N Kiirithio, Daniel Kim, Young-Eun Kim, Yun Jin Kim, Ruth W Kimokoti, Yohannes Kinfu, Adnan Kisa, Katarzyna Kissimova-Skarbek, Mika Kivimäki, Ann 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Razek, Muhammed Magdy Abd El Razek, Dhaval P Maghavani, Marek Majdan, Reza Majdzadeh, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Ana-Laura Manda, Luiz Garcia Mandarano-Filho, Helena Manguerra, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Dadi Marami, Joemer C Maravilla, Wagner Marcenes, Laurie Marczak, Ashley Marks, Guy B Marks, Gabriel Martinez, Francisco Rogerlândio Martins-Melo, Ira Martopullo, Winfried März, Melvin B Marzan, Joseph R Masci, Benjamin Ballard Massenburg, Manu Raj Mathur, Prashant Mathur, Richard Matzopoulos, Pallab K Maulik, Mohsen Mazidi, Colm McAlinden, John J McGrath, Martin McKee, Brian J McMahon, Suresh Mehata, Man Mohan Mehndiratta, Ravi Mehrotra, Kala M Mehta, Varshil Mehta, Tefera C Mekonnen, Addisu Melese, Mulugeta Melku, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Desalegn Tadese Mengistu, Getnet Mengistu, George A Mensah, Seid Tiku Mereta, Atte Meretoja, Tuomo J Meretoja, Tomislav Mestrovic, Haftay Berhane Mezgebe, Bartosz Miazgowski, Tomasz Miazgowski, Anoushka I Millear, Ted R Miller, Molly Katherine Miller-Petrie, G K Mini, Parvaneh Mirabi, Mojde Mirarefin, Andreea Mirica, Erkin M Mirrakhimov, Awoke Temesgen Misganaw, Habtamu Mitiku, Babak Moazen, Karzan Abdulmuhsin Mohammad, Moslem Mohammadi, Noushin Mohammadifard, Mohammed A Mohammed, Shafiu Mohammed, Viswanathan Mohan, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Ghobad Moradi, Maziar Moradi-Lakeh, Mehdi Moradinazar, Paula Moraga, Lidia Morawska, Ilais Moreno Velásquez, Joana Morgado-Da-Costa, Shane Douglas Morrison, Marilita M Moschos, Simin Mouodi, Seyyed Meysam Mousavi, Kindie Fentahun Muchie, Ulrich Otto Mueller, Satinath Mukhopadhyay, Kate Muller, John Everett Mumford, Jonah Musa, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Jean B Nachega, Gabriele Nagel, Aliya Naheed, Azin Nahvijou, Gurudatta Naik, Sanjeev Nair, Farid Najafi, Luigi Naldi, Hae Sung Nam, Vinay Nangia, Jobert Richie Nansseu, Bruno Ramos Nascimento, 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Andre M N Renzaho, Serge Resnikoff, Satar Rezaei, Shahab Rezaeian, Mohammad Sadegh Rezai, Seyed Mohammad Riahi, Antonio Luiz P Ribeiro, Maria Jesus Rios-Blancas, Kedir Teji Roba, Nicholas L S Roberts, Stephen R Robinson, Leonardo Roever, Luca Ronfani, Gholamreza Roshandel, Ali Rostami, Dietrich Rothenbacher, Ambuj Roy, Enrico Rubagotti, Perminder S Sachdev, Basema Saddik, Ehsan Sadeghi, Hosein Safari, Mahdi Safdarian, Sare Safi, Saeid Safiri, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, Nasir Salam, Joseph S Salama, Payman Salamati, Raphael De Freitas Saldanha, Zikria Saleem, Yahya Salimi, Sundeep Santosh Salvi, Inbal Salz, Evanson Zondani Sambala, Abdallah M Samy, Juan Sanabria, Maria Dolores Sanchez-Niño, Damian Francesco Santomauro, Itamar S Santos, João Vasco Santos, Milena M Santric Milicevic, Bruno Piassi Sao Jose, Abdur Razzaque Sarker, Rodrigo Sarmiento-Suárez, Nizal Sarrafzadegan, Benn Sartorius, Shahabeddin Sarvi, Brijesh Sathian, Maheswar Satpathy, Arundhati R 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Sinha, Karen Sliwa, Mari Smith, Badr Hasan Sobaih, Soheila Sobhani, Eugène Sobngwi, Samir S Soneji, Moslem Soofi, Reed J D Sorensen, Joan B Soriano, Ireneous N Soyiri, Luciano A Sposato, Chandrashekhar T Sreeramareddy, Vinay Srinivasan, Jeffrey D Stanaway, Vladimir I Starodubov, Vasiliki Stathopoulou, Dan J Stein, Caitlyn Steiner, Leo G Stewart, Mark A Stokes, Michelle L Subart, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Patrick John Sur, Ipsita Sutradhar, Bryan L Sykes, P N Sylaja, Dillon O Sylte, Cassandra E I Szoeke, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Santosh Kumar Tadakamadla, Ken Takahashi, Nikhil Tandon, Segen Gebremeskel Tassew, Nuno Taveira, Arash Tehrani-Banihashemi, Tigist Gashaw Tekalign, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Omar Temsah, Abdullah Sulieman Terkawi, Manaye Yihune Teshale, Belay Tessema, Gizachew Assefa Tessema, Kavumpurathu Raman Thankappan, Sathish Thirunavukkarasu, Nihal Thomas, Amanda G Thrift, George D Thurston, Binyam Tilahun, Quyen G To, Ruoyan Tobe-Gai, Marcello Tonelli, Roman Topor-Madry, Anna E Torre, Miguel Tortajada-Girbés, Mathilde Touvier, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Khanh Bao Tran, Suryakant Tripathi, Christopher E Troeger, Thomas Clement Truelsen, Nu Thi Truong, Afewerki Gebremeskel Tsadik, Derrick Tsoi, Lorainne Tudor Car, E Murat Tuzcu, Stefanos Tyrovolas, Kingsley N Ukwaja, Irfan Ullah, Eduardo A Undurraga, Rachel L Updike, Muhammad Shariq Usman, Olalekan A Uthman, Selen Begüm Uzun, Muthiah Vaduganathan, Afsane Vaezi, Gaurang Vaidya, Pascual R Valdez, Elena Varavikova, Tommi Juhani Vasankari, Narayanaswamy Venketasubramanian, Santos Villafaina, Francesco S Violante, Sergey Konstantinovitch Vladimirov, Vasily Vlassov, Stein Emil Vollset, Theo Vos, Gregory R Wagner, Fasil Shiferaw Wagnew, Yasir Waheed, Mitchell Taylor Wallin, Judd L Walson, Yanping Wang, Yuan-Pang Wang, Molla Mesele Wassie, Elisabete Weiderpass, Robert G Weintraub, Fitsum Weldegebreal, Kidu Gidey Weldegwergs, Andrea Werdecker, Adhena Ayaliew Werkneh, T Eoin West, Ronny Westerman, Harvey A Whiteford, Justyna Widecka, Lauren B Wilner, Shadrach Wilson, Andrea Sylvia Winkler, Charles Shey Wiysonge, Charles D A Wolfe, Shouling Wu, Yun-Chun Wu, Grant M A Wyper, Denis Xavier, Gelin Xu, Simon Yadgir, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Bereket Yakob, Lijing L Yan, Yuichiro Yano, Mehdi Yaseri, Yasin Jemal Yasin, Gökalp Kadri Yentür, Alex Yeshaneh, Ebrahim M Yimer, Paul Yip, Biruck Desalegn Yirsaw, Engida Yisma, Naohiro Yonemoto, Gerald Yonga, Seok-Jun Yoon, Marcel Yotebieng, Mustafa Z Younis, Mahmoud Yousefifard, Chuanhua Yu, Vesna Zadnik, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Zohreh Zare, Ayalew Jejaw Zeleke, Zerihun Menlkalew Zenebe, Anthony Lin Zhang, Kai Zhang, Maigeng Zhou, Sanjay Zodpey, Liesl Joanna Zuhlke, Mohsen Naghavi, and Christopher J L Murray., Rubagotti, Enrico, Abay, Solomon M., Roth, Gregory, Abd Allah, Foad, Abdela, Jemal, Abbastabar, Hedayat, and Abbasi, Nooshin
Subjects: Overview, Disease, Territory, Causes of death, humanities
Abstract: Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. The Lancet Publishing Group
Published: 2019

29. Antibiotic prophylaxis in gynecological surgery. A literature review

Author: Ionut Negoi, Sorin Paun, Alin Moldoveanu, Arthur Molnar, Sorin Hostiuc, Iuliana Bocicor, Ruxandra Irina Negoi, and Mircea Beuran
Subjects: medicine.medical_specialty, Hysterectomy, business.industry, medicine.drug_class, medicine.medical_treatment, Antibiotics, Obstetrics and Gynecology, Surgery, Discontinuation, medicine.anatomical_structure, Oncology, Vagina, Medicine, Vancomycin, Antibiotic prophylaxis, business, Adverse effect, Gynecological surgery, medicine.drug
Abstract: Gynecological surgical procedures are associated with significant morbidity, and a major impact on the quality of life. The antibiotic prophylaxis should minimize the risk of postoperative infections complications, preventing in the same time the adverse effects of long-term antibiotic usage. The aim of this paper is to detail the current recommendations for antibiotic prophylaxis in gynecological surgical procedures performed by open abdominal or laparoscopic approach. We have performed a review of the English language literature from the PubMed/Medline database using the following search details: (“Antibiotic Prophylaxis”[Mesh]) AND “Gynecologic Surgical Procedures”[Mesh]. We used the similar articles function to find additional secondary resources. Antibiotic prophylaxis should not be performed in elective laparoscopic gynecological procedures without the opening of the uterus or vagina. During hysterectomy for benign or malignant disease, the first dose of antibiotic prophylaxis should be infused one hour prior to skin incision, excepting Vancomycin and Fluoroquinolone that should be started two hours before. The antibiotic should be repeated if the duration of the surgery lasts more than two half-lives of the drug or the intraoperative bleeding is greater than 1500 mL. The antibiotic prophylaxis should be discontinued within the first 24 hours after surgery. Timely administration of adequate antibiotics and a meticulous surgical technique are mandatory for effectively decreasing the risk of postoperative infectious complications. Thorough adherence to international recommendations for antibiotic prophylaxis discontinuation within 24 hours should minimize the adverse events of antibiotic usage.
Published: 2016

30. Extralevator vs conventional abdominoperineal resection for rectal cancer—A systematic review and meta-analysis

Author: Ionut Negoi, Sorin Paun, Mircea Beuran, Sorin Hostiuc, and Ruxandra Irina Negoi
Subjects: medicine.medical_specialty, Colorectal cancer, Perforation (oil well), MEDLINE, Cochrane Library, Perineum, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Blood loss, law, Abdomen, Humans, Medicine, Digestive System Surgical Procedures, Rectal Neoplasms, business.industry, Abdominoperineal resection, General Medicine, medicine.disease, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Meta-analysis, 030211 gastroenterology & hepatology, business
Abstract: Background The aim of this study was to compare the short-term morbidity and long-term oncologic benefits of extralevator abdominoperineal excision (ELAPE) with conventional abdominoperineal resection (CAPR) for patients with rectal cancer. Methods Electronic search of the Cochrane Library, MEDLINE, EMBASE, Korean Journal, and J-EAST database from 2007 until August 2015 was carried out. We considered randomized controlled trials and nonrandomized comparative studies comparing ELAPE with CAPR to be eligible, if they included patients with rectal cancers. Results A total of 1 randomized controlled trials and 10 nonrandomized comparative studies met the inclusion criteria, involving 1,736 patients in the ELAPE group and 1,320 in the CAPR group. The ELAPE was associated with a significantly lower intraoperative perforation rate. There were no differences regarding the circumferential margin involvement, R0 resections, and local recurrence rate. There was less blood loss in ELAPE patients. Conclusions The ELAPE significantly lowered the intraoperative perforation rate, with no benefits regarding circumferential resection margin involvement and local recurrence rate.
Published: 2016

31. WHEN SHOULD CLEARANCE OF THE HEPATODUODENAL LIGAMENT (STATION 12) DURING RADICAL RESECTION FOR GASTRIC CANCER BE PERFORMED

Author: Ionuț Negoi, Sorin Paun, Sorin Hostiuc, Ruxandra Irina Negoi, A Runcanu, and Mircea Beuran
Subjects: medicine.medical_specialty, Common bile duct, business.industry, medicine.medical_treatment, Cancer, Hepatoduodenal ligament, Dissection (medical), medicine.disease, Surgery, medicine.anatomical_structure, Submucosa, medicine, Ligament, Lymphadenectomy, Lymph, business
Abstract: In Western countries gastric cancer continues to remain a biologically aggressive tumor, with poorlong-term oncological outcomes. In Romania, the estimated gastric cancer was the fifth cause ofoncological death in men and the eighth cause of oncological death in women in 2012.The objectiveof the study is to detail when should the hepatoduodenal ligament (station 12) be cleared surgicallyas a part of D2 dissection during radical gastrectomy.We have performed a review of the Englishlanguage literature using PubMed/Medline library. As keywords we used a combination of thefollowing terms: ‘gastrectomy’, ‘stomach’, ‘cancer’, and ‘lymphadenectomy’. According to theJapanese Gastric Cancer Association, the hepatoduodenal ligament includes the lymph nodesstation 12, which are further divided in 12a – along left side of the proper hepatic artery, 12b –right side of the ligament and posterior to the common bile duct, and 12p – posterior to the portalvein. For middle and lower third gastric tumors, station 12a represents the N2 tier, while for upperthird gastric tumors, it represents the N3 tier. Lymph nodes 12b and 12p represent N3, irrespectiveof the tumor location. For middle and lower third gastric tumors the clearance of the lymph nodessurrounding the proper hepatic artery is a part of the D2 dissection. Dissection of the lymph nodessurrounding the proper hepatic artery is a component of the D2 spleen and pancreas preservinglymphadenectomy, for lesions which extend further than submucosa.
Published: 2016

32. Latest progress of research on acute abdominal injuries

Author: Mihaela Vartic, Mircea Beuran, Sorin Paun, Ioan Tanase, Bogdan Stoica, Sorin Hostiuc, Ruxandra Irina Negoi, and Ionut Negoi
Subjects: Abdominal injuries, medicine.medical_specialty, business.industry, MEDLINE, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, Polytrauma, General Medicine, lcsh:RC86-88.9, 030230 surgery, Cochrane Library, medicine.disease, Surgery, Review article, Management, 03 medical and health sciences, Therapeutic approach, 0302 clinical medicine, Blunt, Abdominal trauma, Medicine, business, Intensive care medicine, Medical literature
Abstract: Major abdominal trauma, both blunt and penetrating, is commonly seen nowadays, being particularly difficult to manage due to the frequent altered mental status of the patients and severity of associated injuries. The review article aims to make an uptodate study of the current strategies for therapeutic approach of abdominal injuries in polytrauma setting. Review of the medical literature is up to 2015, by using the PubMed/Medline, Science Direct, Cochrane Library and Web of Science databases. We have used different combinations of the keywords of “abdominal trauma”, “liver”, “spleen”, “renal”, to review the reference list of retrieved articles for further relevant studies. Nowadays, we are facing a major change in abdominal trauma therapeutic approach, due to the continuous extending indications and very high successful rate of selective nonoperative management, completed or not with minimally invasive techniques like angiography and angiographic embolization. New imaging methods offer a high-quality characterization of solid organ injuries, being a secure support for decision algorithm in polytrauma patients. After a continuous decrease in number of laparotomies for trauma, new techniques should be developed for maintaining and developing the trauma surgeons' skills. According to the current standards, for a low morbidity and mortality, the trauma patients may be approached by a multidisciplinary and experienced trauma team. Even if nonoperative management is continuously expanding, this may be applied only by a trained and skillful trauma surgeon, who is able to perform difficult surgical techniques at any moments.
Published: 2016

33. Complex Perineal Trauma with Anorectal Avulsion

Author: Ionut Negoi, Sorin Hostiuc, Sorin Paun, Adelina Cruceru, Mircea Beuran, and Ruxandra Irina Negoi
Subjects: medicine.medical_specialty, medicine.medical_treatment, lcsh:Surgery, Case Report, 030230 surgery, law.invention, Avulsion, 03 medical and health sciences, 0302 clinical medicine, law, Laparotomy, medicine, Pharmacology (medical), Hemoperitoneum, medicine.diagnostic_test, business.industry, Soft tissue, 030208 emergency & critical care medicine, lcsh:RD1-811, medicine.disease, Intensive care unit, Surgery, Anesthesia, Abdominal ultrasonography, Pelvic fracture, medicine.symptom, business, Trauma surgery
Abstract: Introduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock.Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture and massive perineal soft tissue destruction and anorectal avulsion. On arrival, the systolic blood pressure was 85 mm Hg and the hemoglobin was 7.1 g/dL. The patient was transported to the operating room, and perineal lavage, hemostasis, and repacking were performed. After 12 hours in the Intensive Care Unit, the abdominal ultrasonography revealed free peritoneal fluid. We decided emergency laparotomy, and massive hemoperitoneum due to intraperitoneal rupture of pelvic hematoma was confirmed. Pelvic packing controlled the ongoing diffuse bleeding. After 48 hours, the relaparotomy with packs removal and loop sigmoid colostomy was performed. The postoperative course was progressive favorable, with discharge after 70 days and colostomy closure after four months, with no long-term complications.Conclusions. Severe perineal injuries are associated with significant morbidity and mortality. Their management in high volume centers, with experience in colorectal and trauma surgery, allocating significant human and material resources, decreases the early mortality and long-term complications, offering the best quality of life for patients.
Published: 2016

34. A maioria dos cânceres de intestino delgado são revelados por uma complicação

Author: Ruxandra Irina Negoi, Sorin Hostiuc, Sorin Paun, Ionut Negoi, Ioan Tanase, Mircea Beuran, and Bodgan Stoica
Subjects: Male, Emergency Medical Services, Lymphoma, lcsh:Medicine, Gastroenterology, Tertiary Care Centers, Patient Admission, Duodenal Neoplasms, Neoplasms, Prevalence, Medicine, Europe, Eastern, Stromal tumor, Aged, 80 and over, Incidental Findings, Artigo Original, General Medicine, Middle Aged, Neoplasias, Intestine, small/pathology, Adenocarcinoma, Original Article, Female, Gastrointestinal Hemorrhage, Adult, medicine.medical_specialty, Lower gastrointestinal bleeding, Gastrointestinal Stromal Tumors, Perforation (oil well), Carcinoid Tumor, Young Adult, Emergências, Internal medicine, Intestinal Neoplasms, Intestino delgado/patologia, Humans, Duodenal Neoplasm, Aged, Retrospective Studies, Jejunal Neoplasms, business.industry, lcsh:R, medicine.disease, Surgery, Ileal Neoplasms, Intestinal Perforation, Duodenal adenocarcinoma, Upper gastrointestinal bleeding, Emergencies, business, Complication, Intestinal Obstruction
Abstract: Objective To characterize the pattern of primary small bowel cancers in a tertiary East-European hospital. Methods A retrospective study of patients with small bowel cancers admitted to a tertiary emergency center, over the past 15 years. Results There were 57 patients with small bowel cancer, representing 0.039% of admissions and 0.059% of laparotomies. There were 37 (64.9%) men, mean age of 58 years; and 72 years for females. Out of 57 patients, 48 (84.2%) were admitted due to an emergency situation: obstruction in 21 (38.9%), perforation in 17 (31.5%), upper gastrointestinal bleeding in 8 (14.8%), and lower gastrointestinal bleeding in 2 (3.7%). There were 10 (17.5%) duodenal tumors, 21 (36.8%) jejunal tumors and 26 (45.6%) ileal tumors. The most frequent neoplasms were gastrointestinal stromal tumor in 24 patients (42.1%), adenocarcinoma in 19 (33.3%), lymphoma in 8 (14%), and carcinoids in 2 (3.5%). The prevalence of duodenal adenocarcinoma was 14.55 times greater than that of the small bowel, and the prevalence of duodenal stromal tumors was 1.818 time greater than that of the small bowel. Obstruction was the complication in adenocarcinoma in 57.9% of cases, and perforation was the major local complication (47.8%) in stromal tumors. Conclusion Primary small bowel cancers are usually diagnosed at advanced stages, and revealed by a local complication of the tumor. Their surgical management in emergency setting is associated to significant morbidity and mortality rates. RESUMO Objetivo Caracterizar o padrão de neoplasias malignas primárias do intestino delgado em um hospital terciário de Leste Europeu. Métodos Estudo retrospectivo de pacientes com câncer de intestino delgado, internados em um hospital terciário e de emergência, ao longo dos últimos 15 anos. Resultados Foram avaliados 57 pacientes com neoplasias malignas gastrintestinais, o que representou 0,039% das admissões e 0,059% das laparotomias realizadas. Total de 37 (64,9%) pacientes masculinos, média de idade de 58 anos, e de 72 anos para mulheres. Dentre os 57 pacientes, 48 (84,2%) foram internados em situação de emergência: obstrução intestinal em 21 (38,9%), perfuração em 17 (31,5%), hemorragia digestiva alta em 8 (14,8%), e hemorragia digestiva baixa em 2 (3,7%). Houve 10 (17,5%) tumores duodenais, 21 (36,8%) jejunais e 26 (45,6%) ileais. As neoplasias mais frequentes foram tumor estromal gastrintestinal, em 24 (42,1%) pacientes, adenocarcinoma em 19 (33,3%), linfoma em 8 (14%) e carcinoides em 2 (3,5%). A prevalência de adenocarcinoma duodenal foi 14,55 vezes maior do que a do intestino delgado, e a prevalência de tumores estromais duodenais foi 1,818 vez maior do que a do intestino delgado. A obstrução intestinal foi complicação do adenocarcinoma em 57,9% dos casos, e a perfuração foi a principal complicação local (47,8%) dos tumores estromais. Conclusão As neoplasias malignas primárias do intestino delgado foram geralmente diagnosticadas em estado avançado e reveladas por uma complicação local do tumor. O tratamento cirúrgico em situação de emergência está associado à significativa morbimortalidade.
Published: 2015

35. Surgical Anatomy of the Superior Mesenteric Vessels Related to Colon and Pancreatic Surgery: A Systematic Review and Meta-Analysis

Author: Mircea Beuran, Ruxandra Irina Negoi, Sorin Hostiuc, Yosuke Inoue, and Ionut Negoi
Subjects: Colon, lcsh:Medicine, Article, Superior mesenteric vessels, 03 medical and health sciences, Mesenteric Veins, 0302 clinical medicine, Mesenteric Artery, Superior, Colon surgery, medicine, Humans, Mesentery, Superior mesenteric vein, lcsh:Science, Pancreas, Multidisciplinary, business.industry, Right colic vein, lcsh:R, Anatomy, Trunk, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Meta-analysis, Laparoscopy, lcsh:Q, 030211 gastroenterology & hepatology, business, Artery
Abstract: The surgeon dissecting the base of the mesenterium, around the superior mesenteric vein (SMV) and artery, is facing a complex tridimensional vascular anatomy and should be aware of the anatomical variants in this area. The aim of this systematic review is to propose a standardized terminology of the superior mesenteric vessels, with impact in colon and pancreatic resections. We conducted a systematic search in PubMed/MEDLINE and Google Scholar databases up to March 2017. Forty-five studies, involving a total of 6090 specimens were included in the present meta-analysis. The pooled prevalence of the ileocolic, right colic and middle colic arteries was 99.8%, 60.1%, and 94.6%, respectively. The superior right colic vein and Henle trunk were present in 73.9%, and 89.7% of specimens, respectively. In conclusion, the infra-pancreatic anatomy of the superior mesenteric vessels is widely variable. We propose the term Henle trunk to be used for any venous confluence between gastric, pancreatic and colic veins, which drains between the inferior border of the pancreas and up to 20 mm downward on the right-anterior aspect of the SMV. The term gastrocolic trunk should not be synonymous, but a subgroup of the Henle trunk, together with to gastropancreatocolic, gastropancreatic, or colopancreatic trunk.
Published: 2018

36. The epithelial to mesenchymal transition in pancreatic cancer: A systematic review

Author: Ruxandra Irina Negoi, Ionut Negoi, Adriana Daniela Ion, Sorin Hostiuc, Mircea Beuran, Coralia Bleotu, and Sorin Paun
Subjects: Oncology, medicine.medical_specialty, Epithelial-Mesenchymal Transition, Endocrinology, Diabetes and Metabolism, Vimentin, medicine.disease_cause, Metastasis, Cancer stem cell, Pancreatic cancer, Internal medicine, Biomarkers, Tumor, medicine, Humans, Neoplasm Invasiveness, Epithelial–mesenchymal transition, Hepatology, biology, business.industry, Mesenchymal stem cell, Gastroenterology, medicine.disease, Pancreatic Neoplasms, Cell Transformation, Neoplastic, embryonic structures, Neoplastic Stem Cells, biology.protein, Stem cell, business, Carcinogenesis
Abstract: Background/Objectives The present article summarizes and analyzes the current knowledge about the role of the epithelial to mesenchymal transition (EMT) in the systemic invasiveness of pancreatic cancer. Method An electronic search of PubMed/MEDLINE, EMBASE, and the Web of Science was used to identify relevant original articles and reviews. Results The EMT represents a key step during normal embryogenesis. However, increasing evidence reveals its essential role in the local progression and metastasis of pancreatic cancer. Areas of interest are the cross-linking between cells undergoing the EMT and pancreatic cancer stem cells, and the correlation between the EMT and chemoresistance to standard therapies. During carcinogenesis, malignant pancreatic cells at the primary site acquire the ability to undergo the EMT, a transformation associated with increased mobility. The reverse process at secondary sites, the mesenchymal to epithelial transition (MET), has devastating consequences, allowing neoplastic epithelial cells to invade surrounding tissues and spread to distant sites. Consequences of the EMT are the loss of E-cadherin expression and the acquisition of mesenchymal markers including fibronectin or vimentin. Detailed knowledge of the molecular processes underlying the EMT has opened possibilities for new therapeutic agents. These include an EMT approach for patients with early cancers, to prevent invasion and dissemination, and anti-MET therapy for patients with established metastasis. Conclusions The current literature shows a strong correlation between the EMT and the systemic aggressiveness of pancreatic tumors. Individualized therapy, targeting the process of EMT and its cross-linking with cancer stem cells, may increase survival of patients with pancreatic cancer.
Published: 2015

37. Massive lower gastrointestinal bleeding after low anterior resection for middle rectal cancer – case report

Author: Sorin Hostiuc, Ioan Tanase, Ruxandra Irina Negoi, Valentina Negoita, Sorin Paun, Mircea Beuran, Ionut Negoi, Mihaela Vartic, and Bogdan Stoica
Subjects: medicine.medical_specialty, Lower gastrointestinal bleeding, medicine.diagnostic_test, Colorectal cancer, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Colonoscopy, Rectum, General Medicine, Rectal examination, lcsh:RC86-88.9, Postoperative bleeding, medicine.disease, Total mesorectal excision, Surgery, medicine.anatomical_structure, Angioembolization, Angiography, medicine, Anal verge, Radiology, Rectal cancer, business
Abstract: Objective To emphasize the value of emergency diagnostic angiography and angioembolization in massive postoperative bleeding. Methods A case report was presented and electronic search of U.S. National Library of Medicine National Institutes of Health PubMed/MEDLINE, EMBASE, Google Scholar, ISI Web of Knowledge, to identify original articles and reviews about the subject. Results A 55 year-old male patient was addmited for rectal bleeding. ECOG index=2, digital rectal examination revealed the inferior pole of a middle rectal tumor. Colonoscopy exam validated the presence of a middle rectal tumor, 8 cm from the anal verge. CT scan showed rectal wall thickening up to 3 cm, that extends 9 cm proximally, whit infiltration of the perirectal fatty tissue and multiple enlarged lymph nodes up to 12 mm in dimension. There was a laparoscopic converted to open approach, with low anterior resection of the rectum and total mesorectal excision, an end to end stapled colorectal anastomosis and protective loop ileostomy. In the 5th postoperative day a massive lower gastrointestinal bleeding occured, with hypovolemic shock and a decrease in hemoglobin. Emergency angiography was performed. This revealed active bleeding from an internal iliac branch that was successfully angioembolized. Conclusions Angiography with angioembolization is an effective tool in emergency setting, avoiding the morbidity and associated mortality of a surgical reinervention. In early postoperative hemorrhages, only a rapid clinical recognition, a personalized diagnostic workup and an agressive intervention may offer the patient the best chances for cure.
Published: 2015

38. Cardiovascular consequences of myocardial bridging: A meta-analysis and meta-regression

Author: Sorin Hostiuc, Mugurel Constantin Rusu, Ruxandra Irina Negoi, Mihaela Hostiuc, and Ionuț Negoi
Subjects: medicine.medical_specialty, Myocardial Bridging, Ischemia, Hemodynamics, lcsh:Medicine, 030204 cardiovascular system & hematology, Sudden death, Article, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Myocardial infarction, lcsh:Science, Multidisciplinary, business.industry, lcsh:R, Hypertrophic cardiomyopathy, medicine.disease, medicine.anatomical_structure, Cardiovascular Diseases, Meta-analysis, Cardiology, Regression Analysis, lcsh:Q, business, Mace, Artery
Abstract: Myocardial bridging, a congenital abnormality in which a coronary artery tunnels through the myocardial fibres was usually considered a benign condition. Many studies suggested a potential hemodynamic significance of myocardial bridging and some, usually case reports, implied a possible correlation between it and various cardiovascular pathologies like acute myocardial infarction, ventricular rupture, life-threatening arrhythmias, hypertrophic cardiomyopathy, apical ballooning syndrome or sudden death. The main objective of this article is to evaluate whether myocardial bridging may be associated with significant cardiac effects or if it is strictly a benign anatomical variation. To this purpose, we performed a meta-analysis (performed using the inverse variance heterogeneity model) and meta-regression, on scientific articles selected from three main databases (Scopus, Web of Science, Pubmed). The study included 21 articles. MB was associated with major adverse cardiac events - OR = 1.52 (1.01–2.30), and myocardial ischemia OR = 3.00 (1.02–8.82) but not with acute myocardial infarction, cardiovascular death, ischemia identified using imaging techniques, or positive exercise stress testing. Overall, myocardial bridging may have significant cardiovascular consequences (MACE, myocardial ischemia). More studies are needed to reveal/refute a clear association with MI, sudden death or other cardiovascular pathologies.
Published: 2017

39. Surgical Anatomy of the Superior Mesenteric Vessels Related to Pancreaticoduodenectomy: a Systematic Review and Meta-Analysis

Author: Ruxandra Irina Negoi, Yosuke Inoue, Ionut Negoi, Mircea Beuran, and Sorin Hostiuc
Subjects: medicine.medical_specialty, Left gastric vein, Superior mesenteric vessels, Pancreaticoduodenectomy, 03 medical and health sciences, 0302 clinical medicine, Hepatic Artery, Mesenteric Veins, Celiac Artery, Mesenteric Artery, Superior, medicine.artery, medicine, Humans, Superior mesenteric artery, Superior mesenteric vein, Pancreas, Common hepatic artery, business.industry, Portal Vein, Dissection, Gastroenterology, Inferior pancreaticoduodenal artery, Jejunal arteries, Pancreatic Neoplasms, medicine.anatomical_structure, Splenic vein, Splenic Vein, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Surgery, Radiology, business
Abstract: Mesopancreas dissection with central vascular ligation and the superior mesenteric artery (SMA)-first approach represent the cornerstone of current principles for radical resection for pancreatic head cancer. The surgeon dissecting around the SMV and SMA should be aware regarding the anatomical variants in this area. The aims of this systematic review and meta-analysis are to detail the surgical anatomy of the superior mesenteric vessels and to propose a standardized terminology with impact in pancreatic cancer surgery. We conducted a systematic search to identify all published studies in PubMed/MEDLINE and Google Scholar databases from their inception up to March 2017. Seventy-eight studies, involving a total of 18,369 specimens, were included. The prevalence of the mesenteric-celiac trunk, replaced/accessory right hepatic artery (RRHA), common hepatic artery, and SMV inversion was 2.8, 13.2, 2.6, and 4.1%, respectively. The inferior pancreaticoduodenal artery has its origin into the first jejunal artery, SMA, and RRHA, in 58.7, 35.8, and 1.2% of cases, respectively. The SMV lacks a common trunk in 7.5% of cases. The first jejunal vein has a trajectory posterior to the SMA in 71.8% of cases. The left gastric vein drains into the portal vein in 58%, in splenic vein (SV) in 35.6%, and into the SV-PV confluence in 5.8% of cases. Complex pancreaticoduodenal resections require detailed knowledge of the superior mesenteric artery and vein, which is significantly different from the one presented in the classical textbooks of surgery. We are proposing the concept of the first jejunopancreatic vein which impacts the current oncological principles of pancreatic head cancer resection.
Published: 2017

40. Laparoscopic

Author: Ionut, Negoi, Sorin, Hostiuc, Ruxandra Irina, Negoi, and Mircea, Beuran
Subjects: D3 lymphadenectomy, education, Complete mesocolic excision, Meta-Analysis, Colon cancer, Central vascular ligation
Abstract: AIM To compare the effectiveness of laparoscopic complete mesocolic excision (CME) with central vascular ligation (L-CME) with its open (O-CME) counterpart. METHODS We conducted an electronic search of the PubMed/MEDLINE, Excerpta Medica Database, Web of Science Core Collection, Cochrane Center Register of Controlled Trails, Cochrane Database of Systematic Reviews, SciELO, and Korean Journal databases from their inception until May 2017. We considered randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that included patients with colonic cancer comparing L-CME and O-CME. Primary outcomes included the quality of the resected specimen (lymph nodes retrieved, complete mesocolic plane excision, tumor to arterial high tie, resected mesocolon surface). Secondary outcomes included the three-year and five-year overall and disease-free survival rates, recurrence of the disease, surgical data, and postoperative morbidity and mortality. Two authors of the review screened the methodological quality of the eligible trials and independently extracted data from individual studies. RESULTS A total of one RCT and eleven CCTs (four from Europe and seven from Asia) met the inclusion criteria for the current meta-analysis. These studies involved 1619 patients in L-CME and 1477 patients in O-CME. The L-CME was associated with the same quality of the resected specimen, with no differences regarding the retrieved lymphnodes (MD = -1.06, 95%CI: -3.65 to 1.53, P = 0.42), and tumor to high tie distance (MD = 14.26 cm, 95%CI: -4.30 to 32.82, P = 0.13); the surface of the resected mesocolon was higher in the L-CME group (MD = 11.75 cm2, 95%CI: 9.50 to 13.99, P < 0.001). The L-CME was associated with a lower rate of blood transfusions (OR = 0.45, 95%CI: 0.27 to 0.75, P = 0.002), faster recovery of gastrointestinal function, and less postoperative overall complication rate. The L-CME approach was associated with a statistical significant better three-year overall (OR = 2.02, 95%CI: 1.31 to 3.12, P = 0.001, I2 = 28%) and disease-free (OR = 1.45, 95% CI: 1.00 to 2.10, P = 0.05, I2 = 0%) survival. CONCLUSION The laparoscopic approach offers the same quality of the resected specimen as the open approach in complete mesocolic excision with central vascular ligation for colon cancer. The laparoscopic complete mesocolic excision with central vascular ligation is superior in all perioperative results and at least non-inferior in long-term oncological outcomes.
Published: 2017

41. Superior mesenteric artery first approach versus standard pancreaticoduodenectomy: a systematic review and meta-analysis

Author: Sorin Hostiuc, A Runcanu, Mircea Beuran, Ionut Negoi, and Ruxandra Irina Negoi
Subjects: medicine.medical_specialty, Gastroparesis, Time Factors, medicine.medical_treatment, Blood Loss, Surgical, Cochrane Library, law.invention, Pancreaticoduodenectomy, 03 medical and health sciences, Pancreatic Fistula, 0302 clinical medicine, Randomized controlled trial, law, Mesenteric Artery, Superior, Risk Factors, medicine.artery, medicine, Odds Ratio, Humans, Blood Transfusion, Superior mesenteric artery, Hospital Mortality, Chi-Square Distribution, Hepatology, Gastric emptying, business.industry, Liver Neoplasms, Gastroenterology, Perioperative, medicine.disease, Surgery, Pancreatic Neoplasms, Treatment Outcome, Pancreatic fistula, 030220 oncology & carcinogenesis, Meta-analysis, 030211 gastroenterology & hepatology, Radiology, Neoplasm Recurrence, Local, business
Abstract: Background The superior mesenteric artery (SMA) first approach was proposed recently as a new modification of the standard pancreaticoduodenectomy. Increasing evidence showed that a periadventiceal dissection of the SMA with early transection of the inflow during pancreaticoduodenectomy associates better early perioperative results, and setup the scene for long-term oncological benefits. The objectives of the current study are to compare the operative results and long-term oncological outcomes of SMA first approach pancreaticoduodenectomy (SMA-PD) with standard pancreaticoduodenectomy (S-PD). Data Sources Electronic search of the PubMed/MEDLINE, EMBASE, Web of Science and Cochrane Library was performed until July 2015. We considered randomized controlled trials (RCTs) and non-randomized comparative studies (NRCSs) comparing SMA-PD with S-PD to be eligible if they included patients with periampullary cancers. Results A total of one RCT and thirteen NRCSs met the inclusion criteria, involving 640 patients with SMA-PD and 514 patients with S-PD. The SMA-PD was associated with less intraoperative bleeding, less blood transfusions and higher rate of associated venous resections. The pancreatic fistula and delayed gastric emptying had a significantly lower rate in the SMA-PD group. There were no differences between the two approaches regarding overall complications, major complication rates and in-hospital mortality. There was no difference regarding R0 resection rate, and one-, two- or three-year overall survival. The SMA-PD was associated with a lower local, hepatic and extrahepatic metastatic rate. Conclusions The SMA-PD is associated with better perioperative outcomes, such as blood loss, transfusion requirements, pancreatic fistula, and delayed gastric emptying. Although the one-, two- or three-year overall survival rate is not superior, the SMA-PD has a lower local and metastatic recurrence rate.
Published: 2017

42. Intraoperative death due to nodular amyloidosis cardiomyopathy associated with fat pulmonary embolism

Author: Ruxandra Irina Negoi, Dana Sîrbu, Mihai Ceausu, Lacramioara Luca, Sorin Hostiuc, and Adrian Sîrbu
Subjects: medicine.medical_specialty, Pathology, business.industry, Cardiomyopathy, Lumen (anatomy), medicine.disease, Pathology and Forensic Medicine, Pulmonary embolism, Gross examination, Cardiac amyloidosis, Internal medicine, cardiovascular system, medicine, Cardiology, Fat embolism, business, Complication, Cause of death
Abstract: Cardiac amyloidosis is caused by extracellular deposits containing low molecular weight protein subunits arranged in a beta sheet configuration. By gross examination amyloid deposits are identifiable as localized tan, waxy appearing lesions affecting almost always the atria (usually atrial endocardium), valve leaflets, ventricular, but also in the coronary lumen, sometimes leading to severe coronary stenosis. Fat pulmonary embolism is a known complication of femoral fractures, being more frequent in untreated cases compared to those suffering surgical interventions. We present a case in which a female patient with cardiac amyloidosis died on the operating table, the direct cause of death being fat pulmonary emboli, and discuss the involvement of the associated cardiac amyloidosis in thanatogenesys. Key W ords: cardiac amyloidosis, fat embolism, intraoperative death, femoral fracture.
Published: 2013

43. Complex Ebstein's Malformation: Defining Preoperative Cardiac Anatomy and Function

Author: Sorin Hostiuc, Carmen Ginghina, Ionut Negoi, Ioana Ghiorghiu, Florin Filipoiu, Ruxandra Irina Negoi, Alexandru Ispas, and Mihaela Hostiuc
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Tricuspid valve, Preoperative planning, medicine.diagnostic_test, Cardiac anatomy, business.industry, Magnetic resonance imaging, medicine.anatomical_structure, Ventricle, Cardiac magnetic resonance imaging, Internal medicine, medicine, Cardiology, Surgery, Presentation (obstetrics), Cardiology and Cardiovascular Medicine, Medline database, business
Abstract: Introduction: Ebstein's malformation is a congenital malformation of the tricuspid valve and right ventricle, with a highly variable morphology, and clinical presentation, accounting for less than 1% of all congenital heart diseases, and about 40% of congenital malformations of the tricuspid valve. Method: Systematic review of English language literature regarding the morphogenesis and progress of imaging techniques, especially echocardiography and cardiac magnetic resonance imaging, in the preoperative planning of Ebstein's malformation, using the MEDLINE database with the PubMed Entre interface. Results: Technological developments in recent years, with 3D echocardiographic and cardiac magnetic resonance imagingevolution,haveresultedinbetterunderstandingofthemalformedtricuspidvalveandrightventricle in vivo anatomy. Through a better understanding of Ebstein's malformation, there is a continuous trend of surgical techniques favoring tricuspid valve sparing procedures, with a constant decrease in early and late postoperative mortality. Conclusions: Although imaging methods to investigate Ebstein's malformation have continuously evolved, standardization of assessment protocols by 3D echocardiographic imaging, speckle tracking imaging, and cardiac magnetic resonance imaging is required. doi: 10.1111/jocs.12032 (J Card Surg 2013;28:70-81)
Published: 2013

44. Primary Aortoduodenal Fistula: First you Should Suspect it

Author: Sorin Paun, Ionut Negoi, Sorin Hostiuc, Mircea Beuran, and Ruxandra Irina Negoi
Subjects: Male, lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, Duodenum, medicine.medical_treatment, Aortic Diseases, lcsh:Surgery, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Laparotomy, medicine.artery, Intestinal Fistula, medicine, Humans, 030212 general & internal medicine, Aorta, Abdominal, Duodenal Diseases, Vascular Fistula, Aortoduodenal fistula, Aorta, business.industry, Digestive System Fistula, lcsh:RD1-811, General Medicine, Middle Aged, medicine.disease, Extravasation, Abdominal aortic aneurysm, Surgery, medicine.anatomical_structure, lcsh:RC666-701, How to Do It, Radiology, Acute anemia, Upper gastrointestinal bleeding, Gastrointestinal Hemorrhage, Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, business, Aortic Aneurysm, Abdominal
Abstract: A 59 year-old patient was admitted with upper gastrointestinal bleeding. The clinical exam showed mild hypotension and blood samples revealed acute anemia (hemoglobin = 7.5 g/dl). Emergency computed tomography showed an infrarenal abdominal aortic aneurysm and extravasation of the arterial contrast material toward the digestive tract. The patient was transported to the operating room for emergency laparotomy, which showed an aortoduodenal fistula. After proximal and distal aortic vascular control, the two anatomical structures were dissected with duodenorrhaphy, patch repair of the aortic tear and omentum interposition. The postoperative recovery was uneventful, with discharge after 12 days.
Published: 2016

45. Laparoscopic Approach has Benefits in Gynecological Emergencies - Even for Massive Hemoperitoneum

Author: Mircea, Beuran, Ionut, Negoi, Sorin, Hostiuc, Fausto, Catena, Massimo, Sartelli, Ruxandra Irina, Negoi, and Sorin, Paun
Subjects: Adult, Rupture, Spontaneous, Ovariectomy, Pregnancy, Ectopic, Hospitals, University, Ovarian Cysts, Salpingectomy, Treatment Outcome, Pregnancy, Hemoperitoneum, Humans, Female, Laparoscopy, Emergencies, Retrospective Studies
Abstract: The purpose of this study is to compare the laparoscopic with the open approach in hemoperitoneum of gynecological origin.Retrospective study of patients admitted to a tertiary emergency hospital between January 2013 - January 2015.There were 56 patients, 27 in the laparoscopic group (LG) and 28 in the open group (OG). The gynecological emergency was a ruptured ovarian cyst in 20 (74%) versus 17 (59%) cases, and an ectopic pregnancy with tubal rupture in 7 (26%) versus 12 (41%) patients in both the laparoscopic and open approaches, respectively. The main outcome - mean intraoperative hemoglobin decrease - was 1.5 +- 1.2 g/dl in the laparoscopic and 1.9 +-1.4 in the open approach (p=0.344). There were no differences regarding red blood transfusion rate, needs for analgesics, postoperative complications and in-hospital stay.The laparoscopic approach in acute abdomen of gynecologic origin is non-inferior to open surgery.
Published: 2016

46. Response of the Authors to the Letter of the Editor Surgical Anatomy of the Superior Mesenteric Vessels Related to Pancreaticoduodenectomy: a Systematic Review and Meta-Analysis

Author: Ruxandra Irina Negoi, Sorin Hostiuc, Yosuke Inoue, Ionut Negoi, and Mircea Beuran
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, General surgery, Gastroenterology, MEDLINE, Pancreaticoduodenectomy, Superior mesenteric vessels, Pancreatic Neoplasms, 03 medical and health sciences, Pancreatectomy, 0302 clinical medicine, medicine.anatomical_structure, Surgical anatomy, 030220 oncology & carcinogenesis, Meta-analysis, Abdomen, Humans, Medicine, 030211 gastroenterology & hepatology, Surgery, business
Published: 2018

47. Complex Ebstein's malformation: defining preoperative cardiac anatomy and function

Author: Ruxandra Irina, Negoi, Alexandru Teodor, Ispas, Ioana, Ghiorghiu, Florin, Filipoiu, Ionut, Negoi, Mihaela, Hostiuc, Sorin, Hostiuc, and Carmen, Ginghina
Subjects: Ebstein Anomaly, Heart Ventricles, Preoperative Period, Echocardiography, Three-Dimensional, Humans, Tricuspid Valve, Magnetic Resonance Imaging
Abstract: Ebstein's malformation is a congenital malformation of the tricuspid valve and right ventricle, with a highly variable morphology, and clinical presentation, accounting for less than 1% of all congenital heart diseases, and about 40% of congenital malformations of the tricuspid valve.Systematic review of English language literature regarding the morphogenesis and progress of imaging techniques, especially echocardiography and cardiac magnetic resonance imaging, in the preoperative planning of Ebstein's malformation, using the MEDLINE database with the PubMed Entre interface.Technological developments of the recent years, with 3D echocardiographic and cardiac magnetic resonance imaging evolution, have resulted in better understanding of the malformed tricuspid valve and right ventricle in vivo anatomy. Through a better understanding of Ebstein's malformation, there is a continuous trend of surgical techniques favoring tricuspid valve sparing procedures, with a constant decrease in early and late postoperative mortality.Although imaging methods to investigate Ebstein's malformation have continuously evolved, standardization of assessment protocols by 3D echocardiographic imaging, speckle tracking imaging, and cardiac magnetic resonance imaging is required.
Published: 2013

48. Natural orifice translumenal endoscopic surgery (NOTES) second-look peritoneoscopy for staging of limited peritoneal carcinomatosis

Author: Mircea Beuran, Sorin Hostiuc, Ionut Negoi, Sorin Paun, Ruxandra Irina Negoi, Adrian Lobontiu, Alin Moldoveanu, and Florin Filipoiu
Subjects: Laparoscopic surgery, Natural Orifice Endoscopic Surgery, medicine.medical_specialty, business.industry, medicine.medical_treatment, General surgery, Carcinoma, Endoscopic surgery, General Medicine, medicine.disease, Natural orifice, Metastasis, Peritoneal carcinomatosis, Surgery, Peritoneoscopy, Medicine, Humans, In patient, Laparoscopy, Stage (cooking), business, Peritoneal Neoplasms, Neoplasm Staging
Abstract: Background: Over the past decades, staging laparoscopy evolved as a useful tool in multimodality treatment of patients with abdominal malignancies, especially for detection of incurable peritoneal and liver metastasis. Natural orifice translumenal endoscopic surgery (NOTES) is a new, evolving technique which represents the next logical progression in minimally invasive surgery and has theoretical advantages in comparison with standard laparoscopic surgery. A review of the current literature revealed a continuous increasing number of fundamental and clinical studies addressing NOTES approach in multimodal management of oncologic patients. Technical possibility to use this new minimally invasive approach for oncological resection of abdominal malignancies was proved by some investigators. Hypothesis: NOTES can be used as an alternative method for staging patients with limited peritoneal carcinomatosis and may have better results compared to current imaging techniques for small diameter metastatic disease. Conclusions: With the continuous development of the NOTES techniques and technology, the second-look peritoneoscopy by NOTES may become an alternative method for staging in patients with peritoneal carcinomatosis. Nevertheless, NOTES is at a very early stage of its development, and its implementation in oncologic surgery should be made very caution, and only after careful evaluation.
Published: 2012

49. Quality management in general surgery: a review of the literature

Author: Ioan Tanase, Sorin Paun, Sorin Hostiuc, Ruxandra Irina Negoi, Mircea Beuran, Bogdan Stoica, Mihaela Vartic, and Ionut Negoi
Subjects: medicine.medical_specialty, Quality management, Total quality management, business.industry, media_common.quotation_subject, Healthcare, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Mistake, lcsh:RC86-88.9, General Medicine, Trauma, Surgery, Health care, medicine, media_common.cataloged_instance, Quality (business), Operations management, European union, business, General surgery, Quality assurance, Medical literature, media_common
Abstract: Introduction Total quality management is a systematic approach focused on satisfying customers' expectations, identifying problems, analytically solving patient's problems and to implement continuous quality improvement. Method Systematic review of the English language medical literature, using electronic search of the Pubmed, ProQuest and ScienceDirect databases with different combinations of the keywords: total quality management, healthcare, trauma, and minimally invasive surgery. Results The assessment of outcomes in surgery represents a part of the quality assurance of patients' care. Usually, the surgeons have their own set of mental variables that can predict good and bad outcomes Surveys of complication rates and outcome are a poor substitute for quality control. For the reported complications it is impossible to know which complications are real (inherent to surgery and unavoidable) and which are a consequence of a mistake or an error in judgment. For polytrauma patients, optimal outcome requires an initial management fulfilling a high standard of quality assurance. A prerequisite is the availability of adequate resources at all times, including personnel, technical equipment, and special designed emergency room. Conclusions Romanian hospitals need a more aggressive implementation of total quality management policy, in order to maintain their competitiveness on nowadays European Union competitive market.
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50. Mortality after acute trauma: Progressive decreasing rather than a trimodal distribution

Author: Sorin Hostiuc, Ioan Tanase, Gabriel Constantinescu, Ruxandra Irina Negoi, Sorin Paun, Ionut Negoi, Mircea Beuran, and Bogdan Stoica
Subjects: Thorax, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Major trauma, Trauma center, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Polytrauma, lcsh:RC86-88.9, General Medicine, Revised Trauma Score, medicine.disease, Surgery, Major abdominal trauma, Diagnostic peritoneal lavage, medicine, Injury Severity Score, Mortality, business, Cause of death
Abstract: Objective To characterize the pattern of mortality for major trauma patients. Methods Retrospective study of major trauma patients admitted in a Level I trauma center, during the latest 5 years was conducted. Selection criteria included (1) injury severity score (ISS) > 16 and (2) in-hospital death. Results There were 47 patients, with a mean age of 37.2 ± 19.9 years. The mean ISS was 37.6 ± 12.7 and the mean revised trauma score was 4.5 ± 2.2. Computed tomography scan on admission was done in 18 (38%) patients, 20% being hemodynamically unstable ( P = 0.001). The diagnostic peritoneal lavage was performed in 10 (22%) cases, 23.3% being hemodynamically unstable ( P > 0.05). The mean number of intraabdominal injuries was 3. The need for transfusion was 8.2 ± 6.7 units. The mean time to death was 4.9 days. Early death was secondary to hemorrhagic shock (HS) (ISS = 35.2 ± 15.9, P > 0.05, revised trauma score = 3.74 ± 2.70, P = 0.008) and multiple organ failure (ISS = 36.6 ± 14.1, P > 0.05, revised trauma score = 5.94 ± 1.34, P = 0.008) was the cause for later mortality. Combined liver and splenic injuries were found in 13 cases, with secondary death through HS in 5 and multiple system organ failure (MSOF) in 8 cases. Combined liver, splenic and kidney injuries were found in 5 cases (cause of death: HS 2 cases, MSOF 3 cases). A total of 14 patients had associated head, thorax, abdomen and extremity trauma (cause of death: cerebral trauma 6 cases, MSOF 5 cases, HS 2 cases); 5 patients had thorax and abdomen trauma (cause of death: HS 5 cases); 8 patients had thorax, abdomen and extremity trauma (cause of death: MSOF 5 cases, HS 3 cases); 3 patients had abdomen and extremity trauma (HS 2 cases). We did not find a trimodal time distribution for mortality. Conclusions The trimodal time distribution of mortality remains a milestone in trauma education and research. Nevertheless, it must be questioned in the modern and very efficient trauma systems, but still very actual for developing trauma care systems. In conclusion, the pattern of mortality due to major trauma seems decreasing continuously with time rather than presenting high peaks of frequency at some moments.
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