Wide-ranging prevalence estimates of psoriatic arthritis (PsA) in patients with psoriasis have been reported.
To assess the prevalence and incidence of PsA in patients with psoriasis.
Two authors ...independently searched 3 databases for studies reporting on the prevalence or incidence of PsA in patients with psoriasis. A proportion meta-analysis was performed to calculate the pooled proportion estimates of PsA in patients with psoriasis.
A total of 266 studies examining 976,408 patients with psoriasis were included. Overall, the pooled proportion (95% confidence interval CI) of PsA among patients with psoriasis was 19.7% (95% CI, 18.5%-20.9%). In children and adolescents (<18 years of age), the pooled prevalence was 3.3% (95% CI, 2.1%-4.9%). The PsA prevalence was 22.7% (95% CI, 20.6%-25.0%) in European patients with psoriasis, 21.5% (95% CI, 15.4%-28.2%) in South American patients with psoriasis, 19.5% (95% CI, 17.1%-22.1%) in North American patients with psoriasis, 15.5% (95% CI, 0.009%-51.5%) in African patients with psoriasis, and 14.0% (95% CI, 95% CI, 11.7%-16.3%) in Asian patients with psoriasis. The prevalence of PsA was 23.8% (95% CI, 20.1%-27.6%) in studies in which the Classification Criteria for Psoriatic Arthritis were applied. The incidence of PsA among patients with psoriasis ranged from 0.27 to 2.7 per 100 person-years.
Between-study heterogeneity may have affected the estimates.
We found that 1 in 4 patients with psoriasis have PsA. With the growing recognition of the Classification Criteria for Psoriatic Arthritis, more homogenous and comparable prevalence estimates are expected to be reported.
Primary liver cancer, the major histology of which is hepatocellular carcinoma (HCC), is the second leading cause of cancer death worldwide. We comprehensively examined recent international trends of ...primary liver cancer and HCC incidence using population‐based cancer registry data. Incidence for all primary liver cancer and for HCC by calendar time and birth cohort was examined for selected countries between 1978 and 2012. For each successive 5‐year period, age‐standardized incidence rates were calculated from Volumes V to XI of the Cancer Incidence in Five Continents (CI5) series using the online electronic databases, CI5plus. Large variations persist in liver cancer incidence globally. Rates of liver cancer remain highest in Asian countries, specifically in the East and South‐East, and Italy. However, rates in these high‐risk countries have been decreasing in recent years. Rates in India and in most countries of Europe, the Americas and Oceania are rising. As the population seroprevalence of hepatitis B virus (HBV) continues to decline, we anticipate rates of HCC in many high‐risk countries will continue to decrease. Treatment of hepatitis C virus (HCV) is likely to bring down rates further in some high‐rate, as well as low‐rate, countries with access to effective therapies. However, such gains in the control of liver cancer are at risk of being reversed by the growing obesity and diabetes epidemics, suggesting diabetes treatment and primary prevention of obesity will be key in reducing liver cancer in the longer‐term.
What's new?
A new analysis of worldwide trends reveals that, between 1978 and 2012, liver cancer rates fell in east Asia and Italy, but rose in India, Europe, and the Americas. In this report, the authors analyzed 35 years of liver cancer incidence, the second leading cause of cancer death worldwide. Using data from the CI5plus database, they calculated incidence rates for 5 year intervals. Although liver cancer rates remained high in east Asia and Italy, they decreased, and are expected to continue to decline as HBV prevalence declines. However, liver cancer rates rose elsewhere, possibly due to increased obesity and diabetes.
The incidence and outcomes of coronavirus disease 2019 (COVID-19) in immunocompromised patients are a matter of debate.
We performed a prospective nationwide study including a consecutive cohort of ...liver transplant patients with COVID-19 recruited during the Spanish outbreak from 28 February to 7 April, 2020. The primary outcome was severe COVID-19, defined as the need for mechanical ventilation, intensive care, and/or death. Age- and gender-standardised incidence and mortality ratios (SIR and SMR) were calculated using data from the Ministry of Health and the Spanish liver transplant registry. Independent predictors of severe COVID-19 among hospitalised patients were analysed using multivariate Cox regression.
A total of 111 liver transplant patients were diagnosed with COVID-19 (SIR = 191.2 95% CI 190.3–192.2). The epidemiological curve and geographic distribution overlapped widely between the liver transplant and general populations. After a median follow-up of 23 days, 96 patients (86.5%) were admitted to hospital and 22 patients (19.8%) required respiratory support. A total of 12 patients were admitted to the ICU (10.8%). The mortality rate was 18%, which was lower than in the matched general population (SMR = 95.5 95% CI 94.2–96.8). Overall, 35 patients (31.5%) met criteria of severe COVID-19. Baseline immunosuppression containing mycophenolate was an independent predictor of severe COVID-19 (relative risk = 3.94; 95% CI 1.59–9.74; p = 0.003), particularly at doses higher than 1,000 mg/day (p = 0.003). This deleterious effect was not observed with calcineurin inhibitors or everolimus and complete immunosuppression withdrawal showed no benefit.
Being chronically immunosuppressed, liver transplant patients have an increased risk of acquiring COVID-19 but their mortality rates are lower than the matched general population. Upon hospital admission, mycophenolate dose reduction or withdrawal could help in preventing severe COVID-19. However, complete immunosuppression withdrawal should be discouraged.
In liver transplant patients, chronic immunosuppression increases the risk of acquiring COVID-19 but it could reduce disease severity. Complete immunosuppression withdrawal may not be justified. However, mycophenolate withdrawal or temporary conversion to calcineurin inhibitors or everolimus until disease resolution could be beneficial in hospitalised patients.
Display omitted
•The incidence of coronavirus disease 2019 (COVID-19) is higher in liver transplant patients.•Mortality rates are lower than those observed in the matched general population.•Immunosuppression withdrawal may not be justified.•Mycophenolate may increase the risk of severe COVID-19 in a dose-dependent manner.•Calcineurin inhibitors and everolimus are not deleterious for COVID-19.
GIXSGUI is a MATLAB toolbox that offers both a graphical user interface and script‐based access to visualize and process grazing‐incidence X‐ray scattering data from nanostructures on surfaces and in ...thin films. It provides routine surface scattering data reduction methods such as geometric correction, one‐dimensional intensity linecut, two‐dimensional intensity reshaping etc. Three‐dimensional indexing is also implemented to determine the space group and lattice parameters of buried organized nanoscopic structures in supported thin films.
Previous meta-analyses of randomized controlled trials (RCTs) of vitamin D supplementation and total cancer incidence and mortality found inconsistent results, and most included trials administered ...generally low doses of vitamin D (≤1100IU/day). We updated the meta-analysis by incorporating recent RCTs that have tested higher doses of vitamin D supplements.
PubMed and Embase were searched from the inception to November 2018. Summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated using a random-effects model.
For total cancer incidence, 10 trials were included 6537 cases; 3–10years of follow-up; 54–135nmol/l of attained levels of circulating 25(OH) vitamin D 25(OH)D in the intervention group. The summary RR was 0.98 (95% CI, 0.93–1.03; P = 0.42; I2 = 0%). The results remained null across subgroups tested, including even when attained 25(OH)D levels exceeded 100nmol/l (RR, 0.95; 95% CI, 0.83–1.09; P = 0.48; I2 = 26%). For total cancer mortality, five trials were included 1591 deaths; 3–10years of follow-up; 54–135nmol/l of attained levels of circulating 25(OH)D in the intervention group. The summary RR was 0.87 (95% CI, 0.79–0.96; P = 0.005; I2 = 0%), which was largely attributable to interventions with daily dosing (as opposed to infrequent bolus dosing). No statistically significant heterogeneity was observed by attained levels of circulating 25(OH)D (Pheterogeneity = 0.83), with RR being 0.88 (95% CI, 0.78–0.98; P = 0.02; I2 = 0%) for ≤100nmol/l and 0.85 (95% CI, 0.70–1.03; P = 0.11; I2 = 0%) for >100nmol/l.
In an updated meta-analysis of RCTs, vitamin D supplementation significantly reduced total cancer mortality but did not reduce total cancer incidence.
The cause of amyotrophic lateral sclerosis (ALS) remains unknown for most of the patients with the disease. Epidemiologic studies can help describe disease burden and examine its potential risk ...factors, providing thereby evidence base for future mechanistic studies. With this review, we aimed to provide a summary of epidemiologic studies published during the past 18 months, which studied the incidence and risk factors for ALS.
An increasing incidence and prevalence of ALS continue to be reported from different parts of the world. Several previously studied risk factors are confirmed as causally related to ALS by Mendelian randomization analysis. The previously known prognostic indicators for ALS appear to be the same across populations.
Provided with the increasing number of patients diagnosed with ALS and the improved societal awareness of the disease, more resources should be allocated to the research and care of ALS. Population-based studies, especially population-based disease registers, should be the priorities in ALS research, and more data from outside Europe are needed in gaining a better global perspective of the disease.
We extend five principles of tax incidence under perfect competition to a general model of imperfect competition. The principles cover (1) the independence of physical and economic incidence, the (2) ...qualitative and (3) quantitative manner in which taxes are split between consumers and producers, (4) the determinants of tax pass-through, and (5) the integration of local incidence to determine the overall division of surplus. We show how these principles can be used to simplify and generalize the analysis of a range of economic questions such as the optimal procurement of new markets and the welfare effects of third-degree price discrimination.
This review aims to examine the prevalence and incidence of postpartum depression among healthy mothers without prior history of depression including postpartum depression and who gave birth to ...healthy full-term infants. A systematic search of ClinicalTrials.gov, CINAHL, EMBASE, PsycINFO, and PubMed was performed for English articles from the inception of the database to November 2017, as well as a manual search of the reference lists of the included articles, and an expert panel was consulted. Across 15,895 articles, 58 articles (N = 37,294 women) were included in the review. The incidence of postpartum depression was 12% 95% CI 0.04–0.20 while the overall prevalence of depression was 17% 95% CI 0.15–0.20 among healthy mothers without a prior history of depression. Prevalence was similar regardless of the type of diagnostic tool used; however, there were statistical differences in the prevalence between different geographical regions, with the Middle-East having the highest prevalence (26%, 95% CI 0.13–0.39) and Europe having the lowest (8%, 95% CI 0.05–0.11). There was no statistical difference in prevalence between different screening time points, but an increasing prevalence was observed beyond six months postpartum. Intervention studies often neglect healthy mothers. This review reports a similar prevalence rate of postpartum depression among mothers without history of depression when compared to mothers with history of depression. Thus, future studies should place equal emphasis on this neglected group of mothers so that targeted interventions and follow-ups can be introduced at appropriate time points.
•Postpartum depression prevalence of 17% amongst healthy mothers.•Highest prevalence in Middle East and Asia compared to Western countries.•Increasing prevalence in time point assessments beyond three months.•No difference in prevalence through self-reports or clinical interviews.
PDF
