i) Define children's dietary patterns at three developmental stages-early childhood (1 to <3 years), preschool age (3 to <6 years), and school age (6 to <11 years)-and assess transitions over time; ii) Verify the association between exposure to exclusive breastfeeding and the trajectory of patterns. Cohort study using 2008-2019 data from the Brazilian Food and Nutritional Surveillance System. Standardized markers of previous-day food intake identified dietary patterns. Latent Transition Analysis assessed shifts over time and estimated the effect of exclusive breastfeeding for 3-6 months on dietary pattern transitions. 135,340 children. Two dietary patterns emerged: higher ultra processed food intake and lower ultra processed food intake. Patterns showed notable stability over time. Exclusively breastfed children following a lower ultra processed food pattern in early childhood had 11% higher odds (OR = 1.11, 95% CI = 1.06 - 1.16) of maintaining this pattern at preschool age. Exclusively breastfed children in the lower ultra processed food pattern had a 10% lower likelihood (OR = 0.90, 95% CI = 0.86 - 0.95) of transitioning to a higher ultra processed food pattern at preschool age. Dietary patterns in Brazilian children showed significant stability from early childhood to school age. Exclusive breastfeeding may protect against transitioning to high ultra-processed food patterns.
Wastewater surveillance (WWS) is a valuable public health tool for monitoring infectious diseases. Recent studies suggest its potential for monitoring opioids or other drugs. We evaluated WWS awareness and public acceptance of WWS for respiratory and vector-borne diseases and opioids in the US population. We conducted a nationwide cross-sectional survey in June 2024 among US adults aged ≥18 years. We used quantitative analysis (N = 2024) to assess associations between participants' awareness of and attitudes toward WWS, including how those data should be used. We performed qualitative analysis to identify themes among participants who provided comments about opioids or other illicit drugs (n = 67). Overall, more than half of participants expressed comfort with WWS for respiratory diseases (54.1%), mosquito-borne diseases (57.3%), and opioids or other drugs (51.1%). These percentages were significantly higher (P < .001) among people with awareness of WWS than among those who were unaware of WWS: 70.6% were comfortable with WWS for respiratory diseases and 71.6% were comfortable with WWS for mosquito-borne diseases, while slightly fewer participants were comfortable with WWS for opioids or other drugs (64.8%). Among those unaware of WWS, about half were comfortable with WWS for respiratory diseases (50.8%), mosquito-borne diseases (55.5%), or opioids or other drugs (49.2%). Qualitative analysis highlighted concerns about privacy, changes in law enforcement activity with opioid monitoring, and the possibility of negative community effects. Comfort with WWS activities was higher among those who were aware of WWS than among those who were not. Future efforts could focus on improving public awareness and knowledge of how wastewater data are collected and used to benefit public health.
Chagas disease, caused by Trypanosoma cruzi, is characterized by a complex interplay between parasite persistence and host-driven immunopathology. Although the IL-33/ST2 axis is known to regulate type 2 immunity and tissue repair, its contribution to tissue homeostasis during chronic infection remains poorly understood. Using ST2-deficient (ST2-/-) and wild-type BALB/c mice followed for up to 100 days postinfection, we investigated the role of IL-33/ST2 signaling in coordinating hepato-intestinal response and systemic immunity. ST2 deficiency induced coordinated systemic disturbances, including platelet expansion and hyperalbuminemia. At the tissue level, loss of ST2 exacerbated hepatic inflammation and fibrotic remodeling. In the colon, ST2-/- mice displayed increased nitric oxide production and enhanced parasite clearance, but developed marked structural alterations. Our findings suggest that IL-33/ST2 signaling is associated with regulatory programs. ST2 deficiency was associated with a reduction in patrolling monocytes, suggesting impaired homeostatic endothelial monitoring. This profile also coincided with inflammatory monocyte-derived dendritic cell differentiation and lowered macrophage regulatory activity. This altered profile was associated with amplified IL-12-driven Th1 and cytotoxic T-cell responses while impairing IL-10-associated regulatory niches, resulting in multiorgan inflammation. These findings suggest that IL-33/ST2 signaling may contribute to immunoregulatory balance during T. cruzi infection and identify this axis as a candidate pathway for future mechanistic and therapeutic investigation.
Childhood leukemia is the leading cause of cancerrelated death among children. In Brazil, limited data on pediatric leukemia trends hinder public health strategies. This study analyzed leukemia mortality in individuals aged 0-19years in São Paulo State, Brazil, from 2000 to 2019. An ecological time-series design was applied using official Mortality Information System (SIM/ DATASUS) microdata, identifying leukemia cases through ICD-10 codes C91-C96. Mortality trends were assessed using the Prais- Winsten regression model and Durbin-Watson test, estimating annual percent change (APC) and 95% confidence intervals. Between 2000 and 2019, 3687 deaths occurred (24.34/100,000), with a decreasing trend (APC: -0.017), from 1.69/100,000 in 2000 to 1.21/100,000 in 2019. Mortality was higher among males (56%), white individuals (71%), and adolescents aged 15-19years (30.8%). Acute lymphoblastic leukemia (C910) accounted for 50.8% of deaths, and unspecified septicemia (A419) was the most frequent associated cause (25.8%). SIGNIFICANCE STATEMENT Analyzing pediatric leukemia mortality trends in São Paulo state provides valuable epidemiological evidence to support surveillance, guide public health policies, and identify regional disparities. As one of Brazil's main referral centers, São Paulo offers important insights into the impact of demographic, socioeconomic, and healthcare factors on mortality, contributing to improved prevention and management strategies nationwide. The study of pediatric leukemia mortality helps understand the disease’s epidemiology and trends in São Paulo state, a national reference. Analyzing temporal evolution supports epidemiological surveillance and the development of prevention strategies to reduce mortality. The scarcity of studies on leukemia trends in Brazilian children challenges the creation of effective public health policies and the allocation of resources. Demographic and socioeconomic factors, along with advances in personalized medicine and early detection, influence mortality outcomes. Mortality data analysis reveals patterns and disparities, guiding more effective, targeted strategies to improve outcomes and quality of life for affected children. Understanding São Paulo’s reality is essential to grasp the complexities of pediatric leukemia and foster continued progress in prevention, treatment, and control across Brazil.
In late 2015, an automatic influenza alert system was developed in Goto City, Nagasaki Prefecture, Japan using drug-dispensing data to enable earlier provider response to increased case counts. However, changes in incidence after implementation of this system remain unassessed. An analytical observational study was conducted on influenza surveillance data during 2007-2019. The outcome was the annual cumulative influenza incidence per sentinel site in Nagasaki Prefecture before and after alert system implementation in Goto City in the 2015-2016 season. To evaluate the effect of the system in Goto City, a Poisson generalized linear mixed model was applied. The model included variables for location (Goto City versus other districts in Nagasaki Prefecture), timing (before or after the implementation), and an interaction term between location and timing. Before 2015, the median annual cumulative incidence was 149 cases (interquartile range: 61-320) in Goto City and 284 (162-474) in other districts. Following implementation, annual incidence was 163 (102-274) in Goto and 302 (197-503) elsewhere. The effect of timing variable (before versus after implementation) on annual incidence significantly differed for Goto City sites versus other sites in Nagasaki Prefecture (p for interaction < 0.001). Although annual influenza incidence trended upwards, the increase in Goto City was significantly less than in other districts of Nagasaki Prefecture following alert system implementation. This study suggests the potential effect of a real-time surveillance strategy for settings with comprehensive, computerized dispensing data.
Aquaculture has become the fastest-growing sector of the global food economy, with shrimp representing the most traded seafood commodity worldwide. Intensive production practices and inadequate biosecurity can lead to inappropriate antimicrobial use, potentially resulting in unsafe drug residues in shrimp products for human consumption. The US Food and Drug Administration conducted a targeted surveillance survey to assess veterinary drug residue prevalence in imported aquaculture shrimp from the top three countries exporting shrimp to the United States: India, Ecuador, and Indonesia. A total of 504 retail shrimp samples collected across eight states in the United States during 2021 and 2022 were analyzed using validated methods for multiclass drug residues and other chemical compounds. Veterinary drug residues were detected in 3.7% of samples, primarily nitrofurans (73% of positive samples), along with triphenylmethane dyes, amphenicols, and tetracyclines. Most detected residues exceeded FDA target testing levels and included compounds with known carcinogenic or genotoxic properties. No significant associations were found between residue detection and country of origin, collection year, or product market form. Other chemical compounds assessed were not detected. These findings support risk-based import surveillance strategies and highlight the continued need for monitoring prohibited veterinary drugs in imported seafood.
Metabolic syndrome (MetS) is a major public health concern, yet few studies have jointly applied complementary analytic frameworks to assess overall dietary structure. This study aimed to derive a dietary pattern associated with MetS by combining food-based network analysis and reduced rank regression (RRR). Participants from the China Nutrition and Health Surveillance (2010-2022) were included. Dietary intake was assessed using three-day 24-hour recalls and household condiment weighing. Food network analysis visualized and compared dietary structures of adults with and without MetS. RRR derived a dietary pattern based on six nutrient response variables (magnesium, zinc, calcium, potassium, insoluble fiber, riboflavin) selected for their biological relevance to MetS. Logistic regression evaluated associations between dietary patterns and MetS. Among 3,884 participants (median age 55.5 years), the non-MetS group showed a denser food network than the MetS group. The first RRR-derived pattern (DP1), explaining 40.15% of the variance in nutrient responses, was characterized by higher intakes of vegetables, fungi and algae, soybean products, dairy and beef/lamb, and lower intakes of alcohol, refined grains, and edible oils. DP1 was inversely associated with MetS (OR = 0.93, 95% CI: 0.87-0.99). A significant inverse trend across DP1 quintiles was observed, with the highest quintile showing the strongest protective association (OR = 0.66, 95% CI: 0.50-0.88). A protective dietary pattern for MetS was identified through RRR and contextualized using food network analysis. This nutrient-dense pattern may help prevent MetS, and the integrated approach offers broader structural insight for nutritional epidemiology.
Seasonal influenza vaccination has been shown to reduce the risk of influenza and severe complications among children aged 6 months and older. Since 2010, reported numbers of influenza-associated pediatric deaths among children younger than 18 years have ranged from 37 during the 2011 to 2012 season to 289 during the 2024 to 2025 season. We estimated influenza vaccine effectiveness (VE) against pediatric death from 2016 to 2017 through 2024 to 2025. We conducted a case-cohort analysis comparing current season influenza vaccination status among reported influenza-associated pediatric deaths with survey estimates of influenza vaccination coverage in pediatric age groups. Underlying medical conditions and current seasonal influenza vaccination were obtained from surveillance case reports. We estimated vaccination odds ratios (OR) and 95% CIs from logistic regression comparing influenza vaccination among children who died with vaccination coverage in comparison cohorts. VE was calculated as (1 - OR) × 100. From August 2016 through July 2025, 1234 laboratory-confirmed influenza-associated pediatric deaths were reported among children aged 6 months to 17 years. Of 1086 reported deaths with influenza vaccination information, 124 (23%) of 530 children with underlying medical conditions and 70 (13%) of 556 children without known conditions were fully vaccinated against influenza. Average influenza vaccination coverage in survey cohorts was 49%. VE was 80% (95% CI 75-84) overall, 77% (95% CI 71-82) among children with underlying medical conditions and 87% (95% CI 84-89) among children without known conditions. Influenza vaccination reduced risk of fatal influenza among children with or without known underlying medical conditions.
Positive margins after endoscopic resection of rectal neuroendocrine tumors (NETs) do not always indicate true residual disease. We aimed to identify risk factors for remnant tumors among patients with incompletely resected rectal NETs. We conducted a multicenter retrospective cohort study across 11 tertiary hospitals. Patients who underwent salvage treatment for incompletely resected rectal NETs between January 2010 and December 2023 were retrospectively reviewed. A total of 286 patients were included, and demographic, endoscopic, and pathologic data were analyzed to identify predictors of remnant tumor. The remnant tumor was found in 102 (35.7%) patients. Rates were highest after cold forceps polypectomy (CFP) (63.6%), followed by cold snare polypectomy (32.1%) and conventional endoscopic mucosal resection (EMR) (31.2%). No remnant tumor was observed after modified EMR or endoscopic submucosal dissection (ESD), even in cases with positive or indeterminate margins. On multivariate analysis, CFP (odds ratio [OR], 4.50; 95% confidence interval [CI], 2.33-8.70) and two post-resection scar features-yellowish mucosa (OR, 4.36; 95% CI, 2.26-8.40) and mucosal protrusion (OR, 4.84; 95% CI, 2.17-10.79)-were independent predictors of remnant tumors. The risk rose stepwise with the number of factors: 15.0% (none), 52.6% (one), 78.3% (two), and 87.5% (three) (p for trend < 0.001). Margin-positive rectal NETs resected by modified EMR or ESD may be managed with surveillance. However, CFP or post-resection scars showing yellowish mucosa or mucosal protrusion indicate high residual risk and warrant prompt salvage resection.
Ebola virus disease continues to pose a major public health threat in the Democratic Republic of the Congo, with outbreaks caused by different Ebola virus species, including Bundibugyo virus. We report preliminary information from an ongoing outbreak investigation based on laboratory testing conducted by the National Institute of Biomedical Research. Among suspected cases in Ituri province, 8 of 13 samples tested positive for Ebola virus (Bundibugyo species). The number of deaths reported among suspected cases is still under investigation, and full epidemiological data remain incomplete. These findings highlight the circulation of Bundibugyo virus and emphasize the urgent need to strengthen surveillance, diagnostic capacity, and coordinated outbreak response in affected regions.
Understanding the extent of protection against typhoid fever conferred by naturally occurring typhoid is essential for transmission modeling and vaccine policy development. However, data on the level of protection from natural typhoid against recurrent typhoid episodes are sparse. We analyzed data from a cluster-randomized trial of a typhoid conjugate vaccine conducted in Dhaka, Bangladesh. A cohort of blood culture-confirmed typhoid patients (index cases) and matched controls (1:4 ratio) from the community who had not received the typhoid vaccine were followed for up to six years to identify recurrent typhoid episodes. A recurrent typhoid episode was defined as one occurring more than 30 days after the onset of the initial episode and/or involving a strain with a different antimicrobial resistance profile. Febrile patients who tested negative for Salmonella Typhi through passive surveillance were also evaluated as facility-based controls. Stratified Cox proportional hazards models were used to estimate hazard ratios (HRs) for recurrent typhoid episodes. We identified 13 recurrent episodes among 940 index cases and 12 episodes among 3,760 community-based controls, yielding incidence rates of 741 and 158 per 100,000 person-years, respectively, with an adjusted hazard ratio (aHR) of 3.7; 95%CI: 1.8, 7.9; p<0.001. However, when using facility-based controls to prevent healthcare utilization bias, there was no statistically significant difference between groups (aHR: 1.5, 95%CI: 0.8, 2.8; p=0.160). In this typhoid-endemic population comprising both children and adults, we found no evidence that natural typhoid fever confers protection against recurrent typhoid episodes.
The management of rectal adenocarcinoma requires navigation of complex, branching guideline pathways encompassing neoadjuvant sequencing, surgical approach, organ preservation, and surveillance, yet real-world guideline adherence remains as low as 60-70%. The ability of current-generation large language models (LLMs) to accurately navigate these decision points has not been fully characterized. In this cross-sectional, vignette-based study, 135 clinical questions were constructed from 45 pages of NCCN Rectal Cancer Guidelines (Version 4.2024). ChatGPT-4o was queried using standardized prompts with up to 3 clarifying questions permitted per query. Responses were independently evaluated by two physician raters on a 5-point Likert scale, with potential discrepancies adjudicated by a board-certified surgical oncologist. Primary outcomes were the proportion of responses rated Correct (score ≥ 3) and Accurate (score ≥ 4). Inter-rater reliability was assessed using Cohen's kappa, and subgroup analysis was performed across clinical domains using the Kruskal-Wallis test. Of 135 questions, 127 (94.1%; 95% CI, 88.7-97.0%) were Correct and 121 (89.6%; 95% CI, 83.3-93.7%) were Accurate. One hundred two responses (75.6%) were completely correct without additional prompting. Performance was consistent across clinical domains (Kruskal-Wallis H = 0.530, p = 0.767). Inter-rater agreement was perfect (κ = 1.0). Eight responses (5.9%) contained partially or wholly incorrect information, with errors concentrated in multi-step conditional treatment decision points. ChatGPT-4o demonstrates high concordance with NCCN rectal cancer guidelines across all evaluated clinical domains with notable improvement over prior ChatGPT iterations evaluated by our group. The concentration of errors in complex conditional treatment algorithms suggests that LLMs excel at discrete factual recall but may struggle with multi-step reasoning under clinical uncertainty. Prospective validation using real-world clinical data and comparison with multidisciplinary tumor board recommendations remain necessary prior to clinical integration.
Cardiotoxicity associated with antineoplastic therapies remains an important clinical challenge in modern oncology. Early identification of subclinical cardiac injury may improve cardiovascular surveillance and long-term outcomes in cancer patients. This prospective observational cohort study included 90 adult patients with breast cancer, lymphoma, or lung cancer receiving potentially cardiotoxic therapy. Patients with clinically manifest heart failure, severe arrhythmias, advanced renal disease, recent acute myocardial infarction, untreated severe valvular disease, or other major cardiovascular comorbidities were excluded. High-sensitivity cardiac troponin T (hs-cTnT), NT-proBNP, and soluble ST2 (sST2) were measured at baseline, during treatment, at therapy completion, and at late follow-up. Non-parametric tests were used for repeated-measures and subgroup comparisons. Significant temporal variations were observed for all biomarkers. hs-cTnT increased from 5 [3-8] ng/L at baseline to 15 [10-25] ng/L at T2, while NT-proBNP increased from 120 [80-190] pg/mL to 210 [150-320] pg/mL. sST2 demonstrated a delayed elevation and remained increased at follow-up. Distinct biomarker patterns were observed across malignancy subgroups, with higher hs-cTnT increases in breast cancer, more prominent NT-proBNP elevation in lymphoma, and higher sST2 values in lung cancer. Serial biomarker assessment may provide complementary information on myocardial injury, ventricular stress, and fibrotic remodeling during cancer therapy. The observed biomarker trajectories are suggestive of different biological processes involved in therapy-related cardiotoxicity, but they should be interpreted in conjunction with imaging findings and clinical outcomes.
Background Extrapulmonary tuberculosis (EPTB) accounts for a substantial proportion of tuberculosis diagnoses in low-incidence countries. Comprehensive data on disease localization, associated determinants and clinical outcomes remain limited. Objectives To explore anatomical localization, demographic determinants and clinical outcomes of EPTB in The Netherlands. Methods Using national tuberculosis surveillance data (1993-2022), individuals were categorized as having pulmonary TB (PTB), EPTB-only, or combined EPTB+PTB. Determinants of localization, hospitalization and TB-related mortality were assessed using multinomial and multivariate regression analyses with PTB as reference category. Results Among 34,048 individuals diagnosed with TB, 14,186 (41.7%) had EPTB-only, 16,382 (48.1%) had PTB and 3480 (10.2%) had combined EPTB+PTB. The most frequent EPTB localizations were peripheral lymph node (30.8%) and pleura (25.8%). Secondary extrapulmonary localizations occurred particularly in combined EPTB+PTB. Miliary and meningeal/central nervous system (CNS) TB had the poorest outcomes. Female sex and birth in South Asia or the Horn of Africa were associated with lymph node and intestinal TB. Younger age was associated with primary complex and meningeal/CNS TB and older age with miliary TB. Hospitalization and mortality risks were highest for meningeal/CNS and miliary TB and positively associated with older age, HIV, diabetes and immunosuppressive medication. Across most EPTB localizations, treatment success remained below WHO End TB targets. Conclusion EPTB localization and treatment outcomes in the Netherlands vary by age, sex and country of birth. Severe and disseminated forms continue to contribute substantially to morbidity and mortality. Recognizing localization-specific patterns can support earlier diagnosis and tailored management to improve EPTB outcomes in low-incidence settings.
Rickettsioses and leptospirosis are infectious diseases often underdiagnosed due to limited knowledge about their epidemiology, pathophysiology, and clinical aspects. To characterize the seroprevalence and seroincidence of Rickettsia and Leptospira agents and determine their associated factors in rural areas of Urabá, Antioquia, Colombia. Analysis of seropositivity of a prospective study exploring sociocultural and ecological aspects of Rickettsia and Leptospira infection. A multinomial mixed logistic regression model analysed factors linked to seroprevalent cases, with descriptive analyses of seroincident cases. Concomitant seroprevalence against Rickettsia and Leptospira was 9.38% (95% CI: 6.08%-13.37%). Associated factors included age (ORa = 1.02; 95% CI 1.007-1.03), male gender (ORa = 3.06; 95% CI: 1.75-5.37), fever history (ORa = 1.71; 95% CI: 1.06-2.77), presence of breeding pigs (ORa = 2.29; 95% CI 1.36-3.88), peridomicile yucca crops (ORa = 2.5; 95% CI 1.1-5.62), and deforestation practices (ORa = 1.74; 95% CI 1.06-2.87). Concomitant seroincidence was 1.09% (3/274) (95% CI: 0.29%-4.05%). All seroincident cases were female, median age 31.83 years (IQR: 8.69-56.99), with similar housing characteristics (soil floors, wooden walls, zinc roofs) and exposure to domestic and synanthropic animals. There is evidence of concomitant seroprevalent and seroincident cases against both microorganisms in rural Urabá, Colombia. These findings can improve public health surveillance systems in preventing, detecting, and managing clinical cases caused by these pathogens.
This study examines the prevalence and impact of bullying and sexual harassment among students in nursing and medical education programmes in Sweden. This cross-sectional survey targeted students from 38 universities. A total of 18,582 individuals responded to the questionnaire, yielding a 25% response rate. The sample included students enrolled in nursing (N = 1,083) and medical (N = 431) programmes. Data were analysed using descriptive statistics and two-sample t-tests. Among female students who experienced bullying, higher levels of stress ( t (1188) = 4.91, p < .001), burnout (t(1188) = 5.83, p < .001), and intention to quit studies ( t (1186) = 4.30, p < .001) were reported. Bullied male students showed elevated stress ( t (317) = 3.15, p = .002), burnout ( t (317) = 3.49, p < .001), and intention to quit ( t (316) = 3.67, p < .001). Female students who experienced sexual harassment reported increased stress ( t (1185) = 4.02, p < .001), burnout ( t (1185) = 4.10, p < .001), and intention to quit ( t (1184) = 2.73, p = .006). In contrast, sexually harassed male students reported higher stress ( t (314) = 2.04, p = .042), but no significant differences in burnout ( t (314) = 0.80, p = .425) or intention to quit ( t (314) = 1.86, p = .064). Students from the nursing- and medical programme reported a higher prevalence of bullying and sexual harassment than other students. Given the high prevalence and detrimental effects of bullying and sexual harassment in nursing and medical education, targeted interventions are needed to prevent and address these behaviours.
Road accidents are a significant public health issue and a common cause of death. This article analyzes the main risk factors for road accidents and their impact on road mortality and injury. The most significant of these are speeding, alcohol consumption, and motorcycle use. Age, gender, and mobile phone use while driving are also significant factors. Seasonality, time of day, and road surface quality have a lesser impact on the risk of road accidents. Knowledge of road accident risk factors will enable the implementation of more effective measures to prevent road incidents. This, in turn, will reduce road user fatalities and injuries and reduce the material costs associated with the consequences of road accidents. Дорожно-транспортные происшествия (ДТП) — важная проблема системы здравоохранения и распространённая причина смертности населения. В статье анализируются основные факторы риска ДТП и их влияние на смертность и травматизм на дороге. Наиболее существенные из них — превышение скорости, употребление алкогольных напитков, а также использование в качестве средства передвижения мотоцикла. Кроме того, важно влияние возрастных, гендерных факторов, использование мобильных телефонов за рулём. В меньшей степени на риск возникновения ДТП влияют сезонность, время суток и качество дорожного полотна. Знания о факторах риска ДТП позволят внедрять более эффективные мероприятия в отношении профилактики дорожных инцидентов. Это, в свою очередь, позволит снизить летальность, травматизм участников дорожного движения и уменьшить материальные затраты, связанные с последствиями ДТП.
In the young population, a persistent trend toward an increase in functional gastrointestinal disorders (FGIDs) is observed, with Generation Z representatives showing higher rates. The phenomenon of increased referrals of Generation Z individuals to gastroenterologists for FGIDs is indicative: these conditions account for nearly half of all initial consultations in this age group, driven by a combination of high medical awareness, a tendency toward self-diagnosis, and heightened sensitivity to somatic manifestations of psychoemotional stress. Emotional burnout, resulting from academic and professional workloads amid constant digital engagement, acts as a significant risk factor for reduced adaptive potential and deterioration in somatic and mental health indicators. In adolescents and young adults, multiple concomitant FGIDs are often identified, such as combined irritable bowel syndrome, functional dyspepsia, functional abdominal pain disorders, functional constipation, inflammatory bowel diseases, obesity, and others. FGIDs are frequently classified as disorders of gut-brain interaction (DGBI), reflecting the key role of bidirectional communication between the gut and the brain in their development and their impact on the comorbidity of psychological conditions. Accounting for the specific manifestations of comorbidity in the health status of adolescents and young adults with FGIDs is essential for developing effective treatment and preventive programs. В молодёжной популяции определяется устойчивая тенденция к росту функциональных расстройств желудочно-кишечного тракта (ФР ЖКТ), причём представители поколения Z демонстрируют более высокие показатели. Показателен феномен повышенной обращаемости представителей поколения Z к врачам-гастроэнтерологам по поводу ФР ЖКТ: данные состояния составляют почти половину всех первичных консультаций в данной возрастной группе, что обусловлено сочетанием высокой медицинской информированности, склонности к самодиагностике и повышенной чувствительности к соматическим проявлениям психоэмоционального напряжения. Эмоциональное выгорание, обусловленное академическими и профессиональными нагрузками в условиях постоянной цифровой включённости, выступает значимым фактором риска снижения адаптационного потенциала и ухудшения показателей соматического и ментального здоровья. У подростков и молодёжи часто выявляют несколько сопутствующих ФР ЖКТ, например, сочетанные синдром раздражённого кишечника, функциональная диспепсия, функциональные болевые абдоминальные расстройства, функциональный запор, воспалительные заболевания кишечника, ожирение и др. ФР ЖКТ часто относят к расстройствам взаимодействия кишечника и головного мозга, что отражает ключевую роль двунаправленной коммуникации между кишечником и мозгом в развитии этих расстройств и их влияние на коморбидность психологических состояний. Учёт особенностей проявления коморбидности в состоянии здоровья подростков и молодёжи, имеющих ФР ЖКТ, необходим для построения эффективных лечебно-профилактических программ.
Canine (K9) units are essential in law enforcement and military operations; they are often at higher risk of vector-borne infections due to their working and kennel environments. This study aimed to investigate the prevalence of vector-borne pathogens, including Babesia sp. and Mycoplasma spp., in military/police K9 dogs which visited the Adan veterinary hospital in Baghdad/Iraq in 2016-2017. 61 blood samples were collected on Whatman FTA cards and sent to the University of Veterinary Medicine in Vienna, Austria where they were tested with specific PCRs to get a better understanding about epidemiological situation of these vector-borne pathogens in K9s in Iraq. Two dogs tested positive, one with Babesia sp. and one with Mycoplasma haemocanis, making the prevalence 1.6% (1/61; 95% CI: 0.04-8.8%) for each parasite, the isolates were sequenced, and phylogenetic analysis was done to confirm their lineage with other sequences from the GenBank. This is the first study on vector-borne pathogens in K9s in Iraq and the first molecular record of infection with M. haemocanis in K9s.
This study aims to investigate the incidence of respiratory device-related pressure injuries (RDRPI) in patients hospitalised in chest disease clinics, as well as the associated risk factors and wound characteristics. This prospective, descriptive and cross-sectional study was conducted at a chest disease hospital in a province in western Turkey between February and July 2024. A total of 225 patients who were hospitalised for 24 h or more and used respiratory devices in the chest diseases clinic of the hospital were included in the study. It was found that 32.9% of the patients developed RDRPIs. The study identified that prolonged hospitalisation, low albumin and haemoglobin levels and inappropriate sizing of the respiratory device were associated with an increased risk of developing these injuries. The study found a high incidence of RDRPIs. It is recommended that high-quality evidence-based studies be conducted on the prevention and reduction of these injuries in hospitalised patients, and that institutional strategies be developed to address this issue by targeting modifiable risk factors such as device fit and nutritional status.