Pub Date : 2024-12-01DOI: 10.1016/j.glmedi.2024.100161
Maham Bilal, Ali Ait Hssain, Abdulqadir J. Nashwan
Iron is a vital trace element for basic human and bacteria processes. Iron metabolism is altered in sepsis, decreasing iron export and increasing iron transport and cell uptake. As a defense against circulating infections, intracellular iron sequestration restricts their availability. Although iron retention has been shown to have protective effects, an upsurge in labile iron may result in oxidative injury and cell death (e.g., pyroptosis and ferroptosis) as the condition worsens. A recent meta-analysis has revealed a correlation between high serum iron levels and intensive care unit mortality. However, low serum iron levels have traditionally been associated with increased mortality rates. This letter highlights the need for further research to re-evaluate this contradictory finding and comprehend sepsis's pathophysiological mechanisms. We emphasize the need for additional knowledge to make serum iron levels a valuable prognostic and diagnostic marker.
{"title":"Revised clinical standards for assessing sepsis: Serum iron level as an emerging biomarker","authors":"Maham Bilal, Ali Ait Hssain, Abdulqadir J. Nashwan","doi":"10.1016/j.glmedi.2024.100161","DOIUrl":"10.1016/j.glmedi.2024.100161","url":null,"abstract":"<div><div>Iron is a vital trace element for basic human and bacteria processes. Iron metabolism is altered in sepsis, decreasing iron export and increasing iron transport and cell uptake. As a defense against circulating infections, intracellular iron sequestration restricts their availability. Although iron retention has been shown to have protective effects, an upsurge in labile iron may result in oxidative injury and cell death (e.g., pyroptosis and ferroptosis) as the condition worsens. A recent meta-analysis has revealed a correlation between high serum iron levels and intensive care unit mortality. However, low serum iron levels have traditionally been associated with increased mortality rates. This letter highlights the need for further research to re-evaluate this contradictory finding and comprehend sepsis's pathophysiological mechanisms. We emphasize the need for additional knowledge to make serum iron levels a valuable prognostic and diagnostic marker.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100161"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.glmedi.2024.100156
Charu Tayal , Rajesh Sharma , Kusum Lata
Background
In India, limited autonomy in maternal reproductive healthcare decision-making remains a persistent issue. This study investigates the impact of women’s autonomy in managing their healthcare on abortion history, knowledge of contraceptive methods, wanted pregnancy, and delivery via caesarean section in India.
Data and methods
The data for this study were extracted from two rounds of the Indian Demographic and Health Survey [DHS (2015–16) and DHS (2019–21)]. Descriptive statistics, logistic regression and time interaction regression model were employed to investigate the association between women’s autonomy in managing their healthcare and access to reproductive healthcare services.
Results
Women whose healthcare decisions were jointly managed with their husband/partner had higher odds of having a wanted pregnancy [OR = 1.64; p<0.01] in 2015–16 and [OR = 1.29; p<0.10] in 2019–21 compared to women who managed healthcare decisions alone. However, the significance of shared healthcare decision-making in predicting a wanted pregnancy diminished between 2015–16 and 2019–21. In 2015–16, the odds of delivery via caesarean section were lower for women who managed their healthcare jointly with their husband/partner [OR = 0.79; p<0.05] and for those whose healthcare decisions were made by someone else [OR = 0.57; p<0.01] compared to women who managed healthcare decisions alone. Additionally, in 2015–16 when healthcare decisions were made by the husband/partner alone, women had significantly lower odds of knowing contraceptive methods [OR = 0.48; p<0.05] compared to when women managed healthcare decisions alone. Furthermore, in each round, women with higher levels of education, health insurance coverage, from wealthier households, and those whose husbands were educated and older at the time of childbirth, had higher odds of having contraceptive knowledge and a wanted pregnancy in India.
Conclusion
In summary, we found that when healthcare decisions were made solely by the husband or partner, women had significantly lower odds of being knowledgeable about contraceptive methods. Furthermore, we found that the odds of delivery via caesarean section were lower when women jointly managed their healthcare with their partner. To achieve Sustainable Development Goal 3.7, which calls for universal access to sexual and reproductive healthcare services, it is crucial to promote informed reproductive choices, enhance contraceptive knowledge, and increase access to reproductive healthcare services in India.
{"title":"Association between women’s autonomy and reproductive health outcomes in India","authors":"Charu Tayal , Rajesh Sharma , Kusum Lata","doi":"10.1016/j.glmedi.2024.100156","DOIUrl":"10.1016/j.glmedi.2024.100156","url":null,"abstract":"<div><h3>Background</h3><div>In India, limited autonomy in maternal reproductive healthcare decision-making remains a persistent issue. This study investigates the impact of women’s autonomy in managing their healthcare on abortion history, knowledge of contraceptive methods, wanted pregnancy, and delivery via caesarean section in India.</div></div><div><h3>Data and methods</h3><div>The data for this study were extracted from two rounds of the Indian Demographic and Health Survey [DHS (2015–16) and DHS (2019–21)]. Descriptive statistics, logistic regression and time interaction regression model were employed to investigate the association between women’s autonomy in managing their healthcare and access to reproductive healthcare services.</div></div><div><h3>Results</h3><div>Women whose healthcare decisions were jointly managed with their husband/partner had higher odds of having a wanted pregnancy [OR = 1.64; p<0.01] in 2015–16 and [OR = 1.29; p<0.10] in 2019–21 compared to women who managed healthcare decisions alone. However, the significance of shared healthcare decision-making in predicting a wanted pregnancy diminished between 2015–16 and 2019–21. In 2015–16, the odds of delivery via caesarean section were lower for women who managed their healthcare jointly with their husband/partner [OR = 0.79; p<0.05] and for those whose healthcare decisions were made by someone else [OR = 0.57; p<0.01] compared to women who managed healthcare decisions alone. Additionally, in 2015–16 when healthcare decisions were made by the husband/partner alone, women had significantly lower odds of knowing contraceptive methods [OR = 0.48; p<0.05] compared to when women managed healthcare decisions alone. Furthermore, in each round, women with higher levels of education, health insurance coverage, from wealthier households, and those whose husbands were educated and older at the time of childbirth, had higher odds of having contraceptive knowledge and a wanted pregnancy in India.</div></div><div><h3>Conclusion</h3><div>In summary, we found that when healthcare decisions were made solely by the husband or partner, women had significantly lower odds of being knowledgeable about contraceptive methods. Furthermore, we found that the odds of delivery via caesarean section were lower when women jointly managed their healthcare with their partner. To achieve Sustainable Development Goal 3.7, which calls for universal access to sexual and reproductive healthcare services, it is crucial to promote informed reproductive choices, enhance contraceptive knowledge, and increase access to reproductive healthcare services in India.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.glmedi.2024.100160
Hazim Muhammad Yousuf Brohi, Muhammad Luqman, Syeda Zainab Fatima Rizvi , Syed Muhammad Sinaan Ali , Mohammad Bilal Abbasi
Infarctions of the artery of Percheron are a rare clinical event, primarily presenting as bilateral thalamic infarcts with varying manifestations. We report an unusual case of a 50-year-old male who presented with sudden loss of consciousness, afebrile hypertension, and a Glasgow Coma Scale (GCS) score of 7/15. Initial laboratory findings were unremarkable, but further investigations revealed bilateral thalamic infarcts on MRI. The patient was managed for stroke with antiplatelet therapy and supportive treatment. He was discharged after improvement in his clinical status; however, he continued to experience persistent bradyphrenia and blepharospasm. During a follow-up visit, the patient was administered a Botox injection, which improved the blepharospasm, emphasizing on the importance of palliative care in addressing long-term sequelae of stroke. This patient exhibited the rare combination of bradyphrenia and blepharospasm. MRI is the investigation of choice in diagnosing AOP infarcts, but timely clinical evaluation is essential to minimize the risk of persistent long-term symptoms. This case of an atypical presentation of blepharospasm and bradyphrenia associated with an AOP infarct highlights the need for further research into the diverse clinical manifestations and underlying mechanisms of these infarctions.
{"title":"Persistent blepharospasm and bradyphrenia following Artery of Percheron infarction","authors":"Hazim Muhammad Yousuf Brohi, Muhammad Luqman, Syeda Zainab Fatima Rizvi , Syed Muhammad Sinaan Ali , Mohammad Bilal Abbasi","doi":"10.1016/j.glmedi.2024.100160","DOIUrl":"10.1016/j.glmedi.2024.100160","url":null,"abstract":"<div><div>Infarctions of the artery of Percheron are a rare clinical event, primarily presenting as bilateral thalamic infarcts with varying manifestations. We report an unusual case of a 50-year-old male who presented with sudden loss of consciousness, afebrile hypertension, and a Glasgow Coma Scale (GCS) score of 7/15. Initial laboratory findings were unremarkable, but further investigations revealed bilateral thalamic infarcts on MRI. The patient was managed for stroke with antiplatelet therapy and supportive treatment. He was discharged after improvement in his clinical status; however, he continued to experience persistent bradyphrenia and blepharospasm. During a follow-up visit, the patient was administered a Botox injection, which improved the blepharospasm, emphasizing on the importance of palliative care in addressing long-term sequelae of stroke. This patient exhibited the rare combination of bradyphrenia and blepharospasm. MRI is the investigation of choice in diagnosing AOP infarcts, but timely clinical evaluation is essential to minimize the risk of persistent long-term symptoms. This case of an atypical presentation of blepharospasm and bradyphrenia associated with an AOP infarct highlights the need for further research into the diverse clinical manifestations and underlying mechanisms of these infarctions.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100160"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The integration of artificial intelligence (AI) into palliative care offers the possibility of improved patient outcomes through enhanced decision-making, personalized care, and reduced healthcare provider burden. However, the use of AI in this sensitive area presents significant ethical challenges which require serious consideration to ensure that technology serves the best interests of patients without compromising their rights or well-being. This narrative review explores the key ethical issues associated with AI in palliative care, with a focus on low-resource settings where these challenges are often intensified. The review examines essential ethical principles such as autonomy, beneficence, non-maleficence, and justice, and identifies critical concerns including data privacy, informed consent, algorithmic bias, and the risk of depersonalizing care. It also highlights the unique difficulties faced in low-resource environments, where the lack of infrastructure and regulatory frameworks can exacerbate these ethical risks. To address these challenges, the review offers actionable recommendations, such as developing context-specific guidelines, promoting transparency and accountability through explainable AI (XAI), and conducting regular ethical audits. Interdisciplinary collaboration is emphasized to ensure that AI systems are ethically designed and implemented, respecting cultural contexts and upholding patient dignity. This study contributes to the ongoing discourse on ethical AI integration in healthcare, indicating the need for careful consideration of ethical principles to ensure that AI enhances rather than undermines the compassionate care at the heart of palliative care. These findings serve as a foundation for future research and policy development in this emerging field.
{"title":"Ethical Challenges in the Integration of Artificial Intelligence in Palliative Care","authors":"Abiodun Adegbesan , Adewunmi Akingbola , Olajide Ojo , Otumara Urowoli Jessica , Uthman Hassan Alao , Uchechukwu Shagaya , Olajumoke Adewole , Owolabi Abdullahi","doi":"10.1016/j.glmedi.2024.100158","DOIUrl":"10.1016/j.glmedi.2024.100158","url":null,"abstract":"<div><div>The integration of artificial intelligence (AI) into palliative care offers the possibility of improved patient outcomes through enhanced decision-making, personalized care, and reduced healthcare provider burden. However, the use of AI in this sensitive area presents significant ethical challenges which require serious consideration to ensure that technology serves the best interests of patients without compromising their rights or well-being. This narrative review explores the key ethical issues associated with AI in palliative care, with a focus on low-resource settings where these challenges are often intensified. The review examines essential ethical principles such as autonomy, beneficence, non-maleficence, and justice, and identifies critical concerns including data privacy, informed consent, algorithmic bias, and the risk of depersonalizing care. It also highlights the unique difficulties faced in low-resource environments, where the lack of infrastructure and regulatory frameworks can exacerbate these ethical risks. To address these challenges, the review offers actionable recommendations, such as developing context-specific guidelines, promoting transparency and accountability through explainable AI (XAI), and conducting regular ethical audits. Interdisciplinary collaboration is emphasized to ensure that AI systems are ethically designed and implemented, respecting cultural contexts and upholding patient dignity. This study contributes to the ongoing discourse on ethical AI integration in healthcare, indicating the need for careful consideration of ethical principles to ensure that AI enhances rather than undermines the compassionate care at the heart of palliative care. These findings serve as a foundation for future research and policy development in this emerging field.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100158"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study assessed the prevalence and likelihood of being up-to-date with cancer screening tests based on sexual orientation among United States (US) adults. It is a secondary analysis of the Health Information National Trends Survey 6, a nationally representative survey of civilian, non-institutionalized adults aged 18 or older living in the United States. A descriptive analysis of the sociodemographic characteristics based on cancer screening was done with a survey-weighted Chi-Squared test. Survey-weighted binomial multivariable logistic regression was used to assess the relationship between sexual orientation and being up-to-date with cancer screening tests. In addition, logistic regression using the backward selection method was also used to evaluate factors associated with not being up-to-date with cancer screening among the sexual minority (SM) population alone. There were 5209 heterosexual individuals (non-SM) and 439 SM individuals (58 lesbian women, 93 gay men, 148 bisexual women, 35 bisexual men, and 105 other SM groups). Approximately 17.5 % of non-SM individuals in the US are up-to-date with cancer screening tests, while 10.9 % of SM people are up-to-date with cancer screening. The prevalences of up-to-date cancer screening among the different SM populations include gay men (7.4 %), lesbian women (12.6 %), bisexual men (8.7 %), bisexual women (9.7 %), and other SM groups (15.5 %). SM people are 1.56 times (CI: 1.06 – 2.91, p<0.03) more likely to not be up-to-date with cancer screening tests compared to non-SM individuals after adjusting for other sociodemographic characteristics. SM individuals who are less than 40 years old (aOR = 4.16, CI: 1.54–11.20, p=0.006), not married (aOR = 2.75, CI: 1.05–7.15, p=0.041), and currently smoke (aOR = 5.60, CI: 1.09–28.85, p=0.040) are more likely not to be up-date with cancer screening. This study provided crucial information that further bridged gaps in cancer disparities among the SM population and provided information that could help define SM-specific interventions to increase the rates of cancer screening among this population.
本研究根据性取向评估了美国成年人中接受最新癌症筛查测试的流行率和可能性。这是一项对美国 18 岁或以上非住院成年人进行的具有全国代表性的调查，即 "第六次全国健康信息趋势调查"（Health Information National Trends Survey 6）的二次分析。通过调查加权 Chi-Squared 检验对基于癌症筛查的社会人口特征进行了描述性分析。调查加权二项多变量逻辑回归用于评估性取向与是否及时进行癌症筛查测试之间的关系。此外，我们还使用反向选择法进行了逻辑回归，以评估仅在性少数群体（SM）中未及时进行癌症筛查的相关因素。共有 5209 名异性恋者（非 SM）和 439 名 SM（58 名女同性恋、93 名男同性恋、148 名双性恋女性、35 名双性恋男性和 105 名其他 SM 群体）。在美国，约有 17.5%的非 SM 人接受了最新的癌症筛查测试，而 10.9%的 SM 人接受了最新的癌症筛查。在不同的 SM 群体中，最新癌症筛查率包括男同性恋者（7.4%）、女同性恋者（12.6%）、双性恋男性（8.7%）、双性恋女性（9.7%）和其他 SM 群体（15.5%）。在调整了其他社会人口特征后，与非 SM 群体相比，SM 群体未及时接受癌症筛查的可能性是后者的 1.56 倍（CI：1.06 - 2.91，p<0.03）。年龄小于 40 岁（aOR = 4.16，CI：1.54-11.20，p=0.006）、未婚（aOR = 2.75，CI：1.05-7.15，p=0.041）和目前吸烟（aOR = 5.60，CI：1.09-28.85，p=0.040）的 SM 更有可能未及时进行癌症筛查。这项研究提供了重要信息，进一步缩小了 SM 群体中癌症差异的差距，并提供了有助于确定 SM 特定干预措施的信息，以提高该群体的癌症筛查率。
{"title":"Cancer screening among sexual minority groups in the United States","authors":"Samuel Tundealao , Anusha Sajja , Tolulope Titiloye , Praise Okunlola , Adedayo Ogunware , Olajumoke Olarewaju","doi":"10.1016/j.glmedi.2024.100159","DOIUrl":"10.1016/j.glmedi.2024.100159","url":null,"abstract":"<div><div>This study assessed the prevalence and likelihood of being up-to-date with cancer screening tests based on sexual orientation among United States (US) adults. It is a secondary analysis of the Health Information National Trends Survey 6, a nationally representative survey of civilian, non-institutionalized adults aged 18 or older living in the United States. A descriptive analysis of the sociodemographic characteristics based on cancer screening was done with a survey-weighted Chi-Squared test. Survey-weighted binomial multivariable logistic regression was used to assess the relationship between sexual orientation and being up-to-date with cancer screening tests. In addition, logistic regression using the backward selection method was also used to evaluate factors associated with not being up-to-date with cancer screening among the sexual minority (SM) population alone. There were 5209 heterosexual individuals (non-SM) and 439 SM individuals (58 lesbian women, 93 gay men, 148 bisexual women, 35 bisexual men, and 105 other SM groups). Approximately 17.5 % of non-SM individuals in the US are up-to-date with cancer screening tests, while 10.9 % of SM people are up-to-date with cancer screening. The prevalences of up-to-date cancer screening among the different SM populations include gay men (7.4 %), lesbian women (12.6 %), bisexual men (8.7 %), bisexual women (9.7 %), and other SM groups (15.5 %). SM people are 1.56 times (CI: 1.06 – 2.91, p<0.03) more likely to not be up-to-date with cancer screening tests compared to non-SM individuals after adjusting for other sociodemographic characteristics. SM individuals who are less than 40 years old (aOR = 4.16, CI: 1.54–11.20, p=0.006), not married (aOR = 2.75, CI: 1.05–7.15, p=0.041), and currently smoke (aOR = 5.60, CI: 1.09–28.85, p=0.040) are more likely not to be up-date with cancer screening. This study provided crucial information that further bridged gaps in cancer disparities among the SM population and provided information that could help define SM-specific interventions to increase the rates of cancer screening among this population.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100159"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/j.glmedi.2024.100155
Joseph A. McMillan , Sri Banerjee , Rafael Gonzales-Lagos , Wayne Harris
<div><h3>Introduction</h3><div>Gun violence (GV), acknowledged as a public health crisis, disproportionately affects urban centers in the United States. However, the precise connections between social factors and GV are not fully understood. This study, leveraging the Cardiff Model approach, evaluates whether there is a statistical and geospatial relationship between social vulnerability index (SVI) and GV.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, we combined Gun Violence Archive (GVA), a dataset of firearm violence (2019–2023), with corresponding census tract level SVIs for three selected cities—Atlanta, GA; St. Louis, MO; and Washington, DC. The GVA was created, due to gaps in government-based data, from daily public records and media by an independent data collection group. Also, the SVI, derived from a place-based index from Centers for Disease Control (CDC), was originally used to evaluate the resiliency of communities to recover from socio-environmental stressors. GV data from these three cities, representative of major urban centers in the United States, were used to conduct various analyses. We used Poisson regression to assess whether nine of the sixteen SVI measures were statistically associated with GV incidents. Furthermore, we examined whether spatial relationships between SVI and GV differ by level of concentrated disadvantage in urban neighborhoods.</div></div><div><h3>Results</h3><div>Out of all GV incidents (10,442), corresponding to 488 census tracts, teenagers ages 12–17 were found to have higher GV rates in St. Louis (12 %) than Atlanta (7.6 %) and Washington DC (10.5 %). Children, ages 0–11, in St. Louis (3.1 %) were involved in more GV incidents than the other two (Washington DC-1.2 % and Atlanta-2.3 %) cities. In the composite model, census tract-level SVIs were statistically significantly associated with GV. Some of the most prominent SVIs, viewed as predictors of GV, included racial-ethnic minority [Incidence Rate Ratio (IRR): 1.02, 95 % CI: 1.01–1.02, p<0.001], 150 % of Federal Poverty Level (FPL) [IRR: 1.00, 95 % CI: 1.00–1.01, p<0.001], and unemployment (IRR: 1.01, p<0.001). Also, many of the SVI variables were found to be significantly associated with GV incidents in each of the three selected cities.</div></div><div><h3>Conclusions</h3><div>In this original study, we found that there was a strong statistically significant association between SVI-related disadvantaged neighborhoods and increased GV incidents. Additionally, we found that the geospatial distribution of GV incidents were more concentrated in neighborhoods with increased vulnerability throughout the three (Atlanta, GA; St. Louis, MO; and Washington, DC) selected cities than those neighborhoods with decreased vulnerability. Unique approaches such as integration of the SVI with gun control legislation, which informs ownership, use, and access to firearms, provides a better strategy to inform the implementation of an inter
导言枪支暴力（GV）是公认的公共卫生危机，对美国城市中心的影响尤为严重。然而，人们对社会因素与枪支暴力之间的确切联系并不完全了解。在这项横断面研究中，我们将枪支暴力数据集 Gun Violence Archive（GVA）（2019-2023 年）与三个选定城市--佐治亚州亚特兰大市、密苏里州圣路易斯市和华盛顿特区--相应的人口普查区级 SVI 相结合。由于政府数据的缺失，一个独立的数据收集小组通过日常公共记录和媒体创建了 GVA。此外，SVI 源自美国疾病控制中心 (CDC) 基于地方的指数，最初用于评估社区从社会环境压力中恢复的复原力。这三个城市是美国主要城市中心的代表，我们使用这三个城市的 GV 数据进行了各种分析。我们使用泊松回归法评估了 16 个 SVI 测量值中的 9 个是否与 GV 事件存在统计学关联。此外，我们还研究了 SVI 与 GV 之间的空间关系是否因城市街区的集中劣势程度而有所不同。结果在所有 GV 事件（10442 起）中，与 488 个人口普查区相对应，圣路易斯 12-17 岁青少年的 GV 发生率（12%）高于亚特兰大（7.6%）和华盛顿特区（10.5%）。圣路易斯市0-11岁儿童卷入GV事件的比例（3.1%）高于其他两个城市（华盛顿特区-1.2%，亚特兰大-2.3%）。在综合模型中，人口普查区一级的 SVI 与 GV 有显著的统计学关联。一些最突出的 SVI 被视为 GV 的预测因素，包括少数种族族裔[发病率比 (IRR)：1.02，95 % CI：1.01-1.02，p<0.001]、联邦贫困线 (FPL) 的 150 % [IRR：1.00，95 % CI：1.00-1.01，p<0.001]和失业率（IRR：1.01，p<0.001）。结论在这项原创性研究中，我们发现与 SVI 相关的弱势社区与 GV 事件增加之间存在统计学意义上的显著关联。此外，我们还发现，在所选的三个城市（佐治亚州亚特兰大市、密苏里州圣路易斯市和华盛顿特区）中，GV 事件在地理空间上的分布更集中于脆弱性增加的社区，而不是脆弱性降低的社区。独特的方法，如将 SVI 与枪支管制立法相结合，为实施卡迪夫模型等跨学科方法提供了更好的策略，而枪支管制立法则为枪支的拥有、使用和获取提供了信息。从公共卫生和犯罪学的角度出发，枪支暴力政策改革将有助于通过提高社区内的社会适应能力来降低枪支暴力的发生率。
{"title":"Social factors related to gun violence in urban United States","authors":"Joseph A. McMillan , Sri Banerjee , Rafael Gonzales-Lagos , Wayne Harris","doi":"10.1016/j.glmedi.2024.100155","DOIUrl":"10.1016/j.glmedi.2024.100155","url":null,"abstract":"<div><h3>Introduction</h3><div>Gun violence (GV), acknowledged as a public health crisis, disproportionately affects urban centers in the United States. However, the precise connections between social factors and GV are not fully understood. This study, leveraging the Cardiff Model approach, evaluates whether there is a statistical and geospatial relationship between social vulnerability index (SVI) and GV.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, we combined Gun Violence Archive (GVA), a dataset of firearm violence (2019–2023), with corresponding census tract level SVIs for three selected cities—Atlanta, GA; St. Louis, MO; and Washington, DC. The GVA was created, due to gaps in government-based data, from daily public records and media by an independent data collection group. Also, the SVI, derived from a place-based index from Centers for Disease Control (CDC), was originally used to evaluate the resiliency of communities to recover from socio-environmental stressors. GV data from these three cities, representative of major urban centers in the United States, were used to conduct various analyses. We used Poisson regression to assess whether nine of the sixteen SVI measures were statistically associated with GV incidents. Furthermore, we examined whether spatial relationships between SVI and GV differ by level of concentrated disadvantage in urban neighborhoods.</div></div><div><h3>Results</h3><div>Out of all GV incidents (10,442), corresponding to 488 census tracts, teenagers ages 12–17 were found to have higher GV rates in St. Louis (12 %) than Atlanta (7.6 %) and Washington DC (10.5 %). Children, ages 0–11, in St. Louis (3.1 %) were involved in more GV incidents than the other two (Washington DC-1.2 % and Atlanta-2.3 %) cities. In the composite model, census tract-level SVIs were statistically significantly associated with GV. Some of the most prominent SVIs, viewed as predictors of GV, included racial-ethnic minority [Incidence Rate Ratio (IRR): 1.02, 95 % CI: 1.01–1.02, p<0.001], 150 % of Federal Poverty Level (FPL) [IRR: 1.00, 95 % CI: 1.00–1.01, p<0.001], and unemployment (IRR: 1.01, p<0.001). Also, many of the SVI variables were found to be significantly associated with GV incidents in each of the three selected cities.</div></div><div><h3>Conclusions</h3><div>In this original study, we found that there was a strong statistically significant association between SVI-related disadvantaged neighborhoods and increased GV incidents. Additionally, we found that the geospatial distribution of GV incidents were more concentrated in neighborhoods with increased vulnerability throughout the three (Atlanta, GA; St. Louis, MO; and Washington, DC) selected cities than those neighborhoods with decreased vulnerability. Unique approaches such as integration of the SVI with gun control legislation, which informs ownership, use, and access to firearms, provides a better strategy to inform the implementation of an inter","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100155"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142705099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-14DOI: 10.1016/j.glmedi.2024.100153
Durre Aden, Nehal Ahmad, Sabina Khan, Rubeena Mohroo
Nodular fasciitis (NF) is a self-limiting neoplasm found in the upper extremities, trunk, head, and neck. NF occurring in the tragus is extremely rare. Its rapid growth and hypercellularity on cytology can mimic malignancy causing diagnostic challenges. Here we present a case of a 39-year-old female presented with a rapidly growing 2×2 cm firm swelling on the right tragus. FNAC showed a cellular lesion with fibroblast-like spindle cells and myofibroblasts in a myxoid background with occasional multinucleated cells, suggesting a benign mesenchymal lesion, likely NF. Surgical excision was performed and histopathology confirmed the diagnosis. The exact aetiology is not known. However, NF is associated with recurrent MYH9:USP6 gene fusions. FNAC smears show hypercellularity with spindle cells, myxoid background, and occasional nuclear overlapping, often leading to confusion with sarcoma.FNAC is a simple, cheaper and minimally invasive diagnostic modality which helps in the diagnosis yet its variable and nonspecific cytomorphologic features at times can lead to misdiagnosis. This case report highlights the diagnostic challenges associated with NF, particularly due to its unusual location in the tragus.
{"title":"Challenges in the cytological diagnosis of nodular fasciitis","authors":"Durre Aden, Nehal Ahmad, Sabina Khan, Rubeena Mohroo","doi":"10.1016/j.glmedi.2024.100153","DOIUrl":"10.1016/j.glmedi.2024.100153","url":null,"abstract":"<div><div>Nodular fasciitis (NF) is a self-limiting neoplasm found in the upper extremities, trunk, head, and neck. NF occurring in the tragus is extremely rare. Its rapid growth and hypercellularity on cytology can mimic malignancy causing diagnostic challenges. Here we present a case of a 39-year-old female presented with a rapidly growing 2×2 cm firm swelling on the right tragus. FNAC showed a cellular lesion with fibroblast-like spindle cells and myofibroblasts in a myxoid background with occasional multinucleated cells, suggesting a benign mesenchymal lesion, likely NF. Surgical excision was performed and histopathology confirmed the diagnosis. The exact aetiology is not known. However, NF is associated with recurrent MYH9:USP6 gene fusions. FNAC smears show hypercellularity with spindle cells, myxoid background, and occasional nuclear overlapping, often leading to confusion with sarcoma.FNAC is a simple, cheaper and minimally invasive diagnostic modality which helps in the diagnosis yet its variable and nonspecific cytomorphologic features at times can lead to misdiagnosis. This case report highlights the diagnostic challenges associated with NF, particularly due to its unusual location in the tragus.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100153"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142705100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-10DOI: 10.1016/j.glmedi.2024.100154
Osama Dukmak , Hamza A. Abdul-Hafez , Hamsa Abed , Najlaa Abdul-Hafez
Herlyn-Werner-Wunderlich syndrome (HWWS) is a rare congenital anomaly typically presenting after menarche, often with symptoms like abdominal pain, vaginal discharge, infertility, or spontaneous abortion. In some cases, HWWS is discovered incidentally on imaging. Here, we report the case of a 19-year-old female with a known history of a congenital single kidney who presented with delayed fertility and an abnormal ultrasound that showed a bicornuate uterus and fluid collection. Further imaging and surgical assessment revealed uterus didelphys, a right transverse vaginal septum, and pyocolpos, consistent with HWWS. Management involved draining the fluid collection, followed by pregnancy-related care. This case emphasizes the importance of routine evaluations and considering a broad differential diagnosis that includes rare congenital anomalies like HWWS. This condition results from a failure of Müllerian duct fusion and can present with various symptoms, including cyclic pelvic pain and hematocolpos due to an obstructed hemivagina. Although our patient was asymptomatic, her HWWS was identified during fertility evaluation, highlighting the challenges of diagnosing congenital anomalies and the need for surgical expertise in their management. HWWS often presents with fertility challenges and requires radiographic imaging for accurate diagnosis, with surgical intervention as the primary treatment approach.
{"title":"Incidental diagnosis of Herlyn-Werner-Wunderlich syndrome complicated with pyocolpos","authors":"Osama Dukmak , Hamza A. Abdul-Hafez , Hamsa Abed , Najlaa Abdul-Hafez","doi":"10.1016/j.glmedi.2024.100154","DOIUrl":"10.1016/j.glmedi.2024.100154","url":null,"abstract":"<div><div>Herlyn-Werner-Wunderlich syndrome (HWWS) is a rare congenital anomaly typically presenting after menarche, often with symptoms like abdominal pain, vaginal discharge, infertility, or spontaneous abortion. In some cases, HWWS is discovered incidentally on imaging. Here, we report the case of a 19-year-old female with a known history of a congenital single kidney who presented with delayed fertility and an abnormal ultrasound that showed a bicornuate uterus and fluid collection. Further imaging and surgical assessment revealed uterus didelphys, a right transverse vaginal septum, and pyocolpos, consistent with HWWS. Management involved draining the fluid collection, followed by pregnancy-related care. This case emphasizes the importance of routine evaluations and considering a broad differential diagnosis that includes rare congenital anomalies like HWWS. This condition results from a failure of Müllerian duct fusion and can present with various symptoms, including cyclic pelvic pain and hematocolpos due to an obstructed hemivagina. Although our patient was asymptomatic, her HWWS was identified during fertility evaluation, highlighting the challenges of diagnosing congenital anomalies and the need for surgical expertise in their management. HWWS often presents with fertility challenges and requires radiographic imaging for accurate diagnosis, with surgical intervention as the primary treatment approach.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100154"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142705101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-05DOI: 10.1016/j.glmedi.2024.100152
Khurram Khaliq Bhinder, Atif Iqbal Rana, Haider Ali, Zahid Amin Khan, Jamshaid Anwar, Ahmad Ammar Afzal, Maria Rauf
Pulmonary pseudoaneurysms (PAPs) are potentially life-threatening entity. Pulmonary pseudoaneurysm (PAP) post-COVID-19 infection is a rare complication with only a few case reports. Here, we describe two such patients who were successfully treated with embolization using pushable coils. Our first patient was a 72-year-old male who presented with massive hemoptysis two months after COVID-19 pneumonia. CT tomography angiography showed a thick-walled cavitary lesion with a bilobed pseudoaneurysm arising from the posterior segmental branch of the right lower lobe pulmonary artery. In our second case, a 66-year-old female presented with hemoptysis two month after COVID-19 infection. Chest CT showed extensive pulmonary opacities. This patient also had a pseudoaneurysm of the posterior segmental branch of the right lower lobe pulmonary artery. Both patients were treated with embolization using pushable coils to achieve occlusion of the pseudoaneurysm and its feeding artery.
{"title":"Treatment of post COVID-19 pulmonary artery pseudoaneurysm: a report of two cases","authors":"Khurram Khaliq Bhinder, Atif Iqbal Rana, Haider Ali, Zahid Amin Khan, Jamshaid Anwar, Ahmad Ammar Afzal, Maria Rauf","doi":"10.1016/j.glmedi.2024.100152","DOIUrl":"10.1016/j.glmedi.2024.100152","url":null,"abstract":"<div><div>Pulmonary pseudoaneurysms (PAPs) are potentially life-threatening entity. Pulmonary pseudoaneurysm (PAP) post-COVID-19 infection is a rare complication with only a few case reports. Here, we describe two such patients who were successfully treated with embolization using pushable coils. Our first patient was a 72-year-old male who presented with massive hemoptysis two months after COVID-19 pneumonia. CT tomography angiography showed a thick-walled cavitary lesion with a bilobed pseudoaneurysm arising from the posterior segmental branch of the right lower lobe pulmonary artery. In our second case, a 66-year-old female presented with hemoptysis two month after COVID-19 infection. Chest CT showed extensive pulmonary opacities. This patient also had a pseudoaneurysm of the posterior segmental branch of the right lower lobe pulmonary artery. Both patients were treated with embolization using pushable coils to achieve occlusion of the pseudoaneurysm and its feeding artery.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-24DOI: 10.1016/j.glmedi.2024.100150
Hassan Karami , Mina Soleimani, Negar Nayerain Jazi, Kiana Navi, Rojina Sajadi, Mohammad Mehdi Fazeli, Golara Pagheh, Samane Ostadhadi Dehkordi
The global emergence of several major viral disease outbreaks over the last two decades represents how infectious diseases alarmingly threaten human health despite significant progress in medical advances in recent years. Therefore, it is essential to address the threat of the next viral pandemic and draw global attention to invest in research, development, and implementation of risk-reduction interventions to harness the benefits of preparedness plans aimed at minimizing the potential spread of viruses to previously affected and even unaffected regions of the world and reducing the burden of future global outbreaks. Here, we discuss six pillars of preparedness including enhancing monitoring and surveillance capabilities, developing diagnostic tools, building a robust and well-resourced healthcare system, developing effective medical countermeasures (Vaccines and treatments), and improving collaboration and financial support at both local and global levels. This letter calls for global preparedness to ensure an effective, timely, and coordinated response to future viral threats with significant importance to public health.
{"title":"The next viral pandemic: A call for global preparedness","authors":"Hassan Karami , Mina Soleimani, Negar Nayerain Jazi, Kiana Navi, Rojina Sajadi, Mohammad Mehdi Fazeli, Golara Pagheh, Samane Ostadhadi Dehkordi","doi":"10.1016/j.glmedi.2024.100150","DOIUrl":"10.1016/j.glmedi.2024.100150","url":null,"abstract":"<div><div>The global emergence of several major viral disease outbreaks over the last two decades represents how infectious diseases alarmingly threaten human health despite significant progress in medical advances in recent years. Therefore, it is essential to address the threat of the next viral pandemic and draw global attention to invest in research, development, and implementation of risk-reduction interventions to harness the benefits of preparedness plans aimed at minimizing the potential spread of viruses to previously affected and even unaffected regions of the world and reducing the burden of future global outbreaks. Here, we discuss six pillars of preparedness including enhancing monitoring and surveillance capabilities, developing diagnostic tools, building a robust and well-resourced healthcare system, developing effective medical countermeasures (Vaccines and treatments), and improving collaboration and financial support at both local and global levels. This letter calls for global preparedness to ensure an effective, timely, and coordinated response to future viral threats with significant importance to public health.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100150"},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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