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Search Results (643)

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Keywords = Age-Standardized Mortality Rate

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16 pages, 7972 KB  
Article
Trends and Projected Burden of HIV/AIDS in Kazakhstan, 2010–2030: A Comparative Analysis Using GBD 2023 Estimates
by Indira Karibayeva, Gulzar Shah, Nikolay Lunchenkov, Roza Kuanyshbekova, Kuanysh Shonbay and Botagoz Turdaliyeva
Trop. Med. Infect. Dis. 2026, 11(7), 171; https://doi.org/10.3390/tropicalmed11070171 (registering DOI) - 24 Jun 2026
Viewed by 54
Abstract
Background: HIV/AIDS remains a major global public health challenge, with persistent regional disparities in burden and progress toward the UNAIDS 95–95–95 targets. This study assessed temporal trends in the HIV/AIDS burden in Kazakhstan, compared them with Central Asia and global patterns, and projected [...] Read more.
Background: HIV/AIDS remains a major global public health challenge, with persistent regional disparities in burden and progress toward the UNAIDS 95–95–95 targets. This study assessed temporal trends in the HIV/AIDS burden in Kazakhstan, compared them with Central Asia and global patterns, and projected trends through 2030. Methods: We conducted a population-level analysis using Global Burden of Disease 2023 data, examining age-standardized rates (per 100,000) of incidence, prevalence, mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) from 2010 to 2023. Trends were quantified using percent change and average annual percentage change, with projections based on log-linear models. Results: Between 2010 and 2023, prevalence in Kazakhstan increased by 332.1% and incidence by 111.0%, contrasting with the decline in global incidence (−24.7%). Mortality decreased (−32.7%), along with DALYs (−28.8%) and YLLs (−37.1%), while YLDs increased by 135.5%, indicating a shift toward a chronic disease burden. In 2023, Kazakhstan had a lower overall burden than global estimates but showed steeper increases in incidence and prevalence. Age-specific analyses indicated the largest increases among adults aged 30–69 years. Under current trend assumptions, projections suggest continued growth in prevalence and incidence, with modest mortality declines through 2030, though these trajectories do not account for future changes in prevention coverage, treatment access, or policy. Conclusions: Kazakhstan is undergoing a transition toward a chronic HIV epidemic, underscoring the need to strengthen prevention, expand PrEP and testing coverage, and address structural barriers to achieve epidemic control. Full article
(This article belongs to the Special Issue HIV-1 Dynamics and Public Health)
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12 pages, 9158 KB  
Article
National Surveillance-Based Retrospective Ecological Longitudinal Analysis of Stroke Incidence Trends and Health-Screening Indicators in Korea, 2011–2023, with Model-Based Projections to 2028 Using National Health Insurance Service Data
by Hyeran Jung and Minsun Jung
Healthcare 2026, 14(13), 1815; https://doi.org/10.3390/healthcare14131815 (registering DOI) - 23 Jun 2026
Viewed by 109
Abstract
Background: Stroke remains a leading cause of mortality, disability, and health-system burden in Korea’s rapidly aging population. We aimed to describe national stroke incidence trends from 2011 to 2023, characterize ecological associations between stroke incidence and health-screening indicators, and generate model-based projections [...] Read more.
Background: Stroke remains a leading cause of mortality, disability, and health-system burden in Korea’s rapidly aging population. We aimed to describe national stroke incidence trends from 2011 to 2023, characterize ecological associations between stroke incidence and health-screening indicators, and generate model-based projections through 2028 to support health-system planning. Methods: This retrospective ecological longitudinal analysis used three publicly available aggregate national data sources: (1) NHIS annual aggregate statistics on crude and age-standardized stroke incidence, stroke case counts, first-onset vs. recurrent stroke, and case-fatality rates (2011–2023); (2) regional standardized health-awareness survey rates for stroke symptoms, myocardial infarction symptoms, blood pressure, and blood glucose (2017–2025); and (3) national cancer-screening outcome tallies for breast and cervical cancer (2010–2024). All analyses used pre-aggregated annual summary data; individual-level NHIS records were not used. Annual trends were modeled with ordinary least-squares linear regression (n = 13 annual observations). Pearson correlations were computed only for overlapping observation windows. Model-based projections are presented with 95% prediction intervals and are explicitly distinguished from observed NHIS values. This study is purely descriptive and ecological; no causal inference is made. Results: Crude stroke incidence increased from 199.2 to 221.1 per 100,000 (2011–2023; slope +2.32/year, R2 = 0.83), whereas age-standardized incidence declined from 158.3 to 113.2 per 100,000 (slope −3.41/year, R2 = 0.96), a pattern consistent with demographic aging as a contributing factor to growing absolute burden, though formal age-decomposition analysis would be required to confirm this inference. Total cases increased from 99,837 to 113,098; the 30-day case-fatality rate declined from 8.5% to 7.5%. Ecological correlations showed that blood glucose awareness was strongly negatively correlated with age-standardized incidence (r = −0.944, p = 0.001, n = 7), though these are ecological associations and must not be interpreted as individual-level causal relationships. Model-based projections estimate crude incidence near 230.7 (95%PI 219.2–242.2) and age-standardized incidence near 103.2 (95%PI 95.7–110.8) per 100,000 by 2026. Conclusions: Concurrent increase in crude burden and decline in age-standardized incidence reflects demographic aging as the primary driver of Korea’s stroke burden. Projections support integrated cardiovascular prevention, public health education, and age-sensitive service planning. All projections are short-horizon statistical extrapolations intended for policy scenario planning only and must not be interpreted as observed future NHIS outcomes. Full article
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18 pages, 1047 KB  
Article
Influence of Mitral Annular Calcification Assessed by Cardiac Computed Tomography on Procedural and Clinical Outcomes of Transcatheter Aortic Valve Implantation
by Yusuf Ziya Şener, Sadberk Lale Tokgözoğlu, Selin Ardalı Düzgün, Uğur Nadir Karakulak, Ahmet Hakan Ateş, Mehmet Levent Şahiner, Ergün Barış Kaya, Enver Atalar, Necla Özer, Tuncay Hazırolan and Kudret Aytemir
Medicina 2026, 62(6), 1206; https://doi.org/10.3390/medicina62061206 (registering DOI) - 22 Jun 2026
Viewed by 138
Abstract
Background and Objectives: Transcatheter aortic valve implantation (TAVI) is the standard therapy for patients with severe aortic stenosis at intermediate or high surgical risk. Mitral annular calcification (MAC) is frequently observed in this population and has been linked to adverse cardiovascular outcomes. [...] Read more.
Background and Objectives: Transcatheter aortic valve implantation (TAVI) is the standard therapy for patients with severe aortic stenosis at intermediate or high surgical risk. Mitral annular calcification (MAC) is frequently observed in this population and has been linked to adverse cardiovascular outcomes. This study evaluated the association between MAC and TAVI-related complications and mortality, and identified predictors of all-cause mortality and permanent pacemaker implantation (PPI) following TAVI. Materials and Methods: Patients undergoing self-expanding TAVI between January 2010 and June 2020 were retrospectively analyzed. Outcomes included TAVI-related complications, in-hospital and long-term mortality, and predictors of all-cause mortality and PPI. Results: A total of 245 patients (98 men [40%], mean age 76.3 ± 8.3 years) were included. Mean left ventricular ejection fraction was 54.8 ± 11.4%, and aortic valve area was 0.74 ± 0.14 cm2. MAC was present in 148 patients (60.4%). Pericardial effusion (26.4% vs. 12.4%, p = 0.013) and acute kidney injury (21.6% vs. 7.2%, p = 0.005) were significantly more frequent in patients with MAC. PPI was required in 42 patients (17.8%). In-hospital mortality occurred in 14 patients (5.7%), and all-cause mortality was observed in 89 patients (36.3%) during a median follow-up of 23.1 months (IQR, 11.6–44.3). MAC extension into the left ventricular outflow tract was the only independent predictor of PPI (OR: 3.32, p = 0.002). Independent predictors of all-cause mortality included use of renin–angiotensin–aldosterone system blockers (HR: 0.54, p = 0.012), hemoglobin level (HR: 0.79, p = 0.006), severe MAC (HR: 1.94, p = 0.024), and post-TAVI atrial fibrillation (HR: 2.39, p = 0.002). Conclusions: MAC is common in TAVI patients and is associated with increased procedural complications, including higher rates of pericardial effusion and acute kidney injury. Greater MAC severity independently predicts higher all-cause mortality. In addition, MAC extension into the left ventricular outflow tract is an independent predictor of PPI following self-expanding TAVI, emphasizing the importance of comprehensive pre-procedural imaging. Full article
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26 pages, 1294 KB  
Article
Burden and Trends of Genitourinary Cancers Across the Americas: A GBD 2023 Analysis of Regional Socioeconomic Gradients
by José Guzmán-Esquivel, Gustavo A. Hernández-Fuentes, Kayim Pineda-Urbina, Janet Diaz-Martinez, Carlos M. Hernandez-Suarez, Jesús Venegas-Ramírez, Gabriel Ceja-Espíritu, Iram P. Rodríguez-Sánchez, Margarita L. Martinez-Fierro, Idalia Garza-Veloz, Fabian Rojas-Larios, Alejandrina Rodríguez-Hernandez, Daniel A. Montes-Galindo and Iván Delgado-Enciso
Cancers 2026, 18(12), 2016; https://doi.org/10.3390/cancers18122016 (registering DOI) - 22 Jun 2026
Viewed by 233
Abstract
Background/Objectives: Genitourinary cancers represent a major and growing source of cancer burden worldwide; however, important disparities persist across the Americas. This study aimed to evaluate the incidence, mortality, and disability burden of prostate, testicular, bladder, and kidney cancers across 38 countries and territories [...] Read more.
Background/Objectives: Genitourinary cancers represent a major and growing source of cancer burden worldwide; however, important disparities persist across the Americas. This study aimed to evaluate the incidence, mortality, and disability burden of prostate, testicular, bladder, and kidney cancers across 38 countries and territories using Global Burden of Disease (GBD) 2023 estimates, with emphasis on temporal trends and sociodemographic inequalities. Methods: A descriptive ecological study was conducted using Global Burden of Disease (GBD) 2023 estimates. Age-standardized incidence, mortality, and disability-adjusted life year (DALY) rates per 100,000 population were analyzed for prostate, bladder, kidney, and testicular cancers. Burden estimates were obtained from GBD 2023 data, and temporal trend analyses were conducted using age-standardized rates from 2000–2023. Temporal trends were assessed using weighted log-linear regression to estimate annual percentage changes (APCs) based on age-standardized rates from 2000–2023. Results: In 2023, prostate cancer accounted for the greatest genitourinary cancer burden across the Americas, with high incidence concentrated in high-income North America, whereas mortality and DALY rates were disproportionately elevated in Latin America and the Caribbean. Across all cancer types, high-SDI regions consistently exhibited higher incidence but more favorable mortality and disability profiles. Testicular cancer incidence increased across all SDI quintiles, although mortality reductions were mainly observed in high-SDI settings. Bladder and kidney cancers demonstrated similar epidemiological patterns, with declining mortality trends in high-income regions but persistent or increasing burden in lower-SDI countries. Mortality-to-incidence disparities remained substantial across Latin America and the Caribbean, which may reflect differences in healthcare resources, early detection, treatment availability, or other contextual factors not directly captured in the GBD database. National extremes included Bermuda prostate ASIR 170.63 and Dominica DALYs 1423.30 per 100,000. Conclusions: The burden of genitourinary cancers across the Americas remains strongly associated with socioeconomic inequalities. Although higher-resource settings have achieved important reductions in mortality and disability, these gains have not been equitably distributed across the region. Strengthening health system capacity, improving early diagnosis, and ensuring equitable access to evidence-based cancer care are essential to reduce avoidable mortality and improve long-term outcomes throughout the Americas. Full article
(This article belongs to the Special Issue Urological Cancer: Epidemiology and Genetics)
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24 pages, 732 KB  
Systematic Review
Obstetrical and Neonatal Outcomes in Twin Pregnancies Based on Chorionicity: A Systematic Review of ART-Conceived Monochorionic vs. Dichorionic Twins
by Atieh Karimzadeh, Zahra Karimizadeh, Nazila Heidari, Samira Parviziomran, Sepehr Ramezanipour, Amirali Kalantari, Shahdad Farokhmanesh, Ibrahim Alkatout and Leila Allahqoli
J. Clin. Med. 2026, 15(12), 4761; https://doi.org/10.3390/jcm15124761 - 18 Jun 2026
Viewed by 174
Abstract
Background: Assisted reproductive technology (ART) is increasingly utilized worldwide, and approximately 30% of ART pregnancies result in twin gestations. Chorionicity strongly influences perinatal risk, yet its specific impact on ART-conceived twins has not been systematically clarified. Objective: To compare obstetrical and neonatal [...] Read more.
Background: Assisted reproductive technology (ART) is increasingly utilized worldwide, and approximately 30% of ART pregnancies result in twin gestations. Chorionicity strongly influences perinatal risk, yet its specific impact on ART-conceived twins has not been systematically clarified. Objective: To compare obstetrical and neonatal outcomes in assisted ART-conceived monochorionic (MC) versus dichorionic (DC) twin pregnancies and evaluate the impact of chorionicity on maternal and perinatal outcomes. Methods: This systematic review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD42024600292). PubMed, Scopus, and Web of Science were searched through October 2024 for studies comparing obstetrical and neonatal outcomes in ART-conceived monochorionic and dichorionic twin pregnancies. Eligible studies were qualitatively synthesized. Results: Thirty-five studies comprising 15,648 ART-conceived twin pregnancies were included, including 371 monochorionic and 15,277 dichorionic pregnancies. MC pregnancies consistently demonstrated less favorable perinatal outcomes compared with DC pregnancies, including an earlier gestational age at delivery, increased prematurity, lower birth weight, and higher rates of perinatal mortality. By contrast, maternal complications, such as hypertensive disorders, gestational diabetes mellitus, PROM, and cesarean delivery, varied considerably across the studies without a consistent association with chorionicity. The baseline maternal characteristics were generally comparable between the groups. Conclusions: Monochorionicity in ART-conceived twin pregnancies is associated with increased adverse neonatal and perinatal outcomes, particularly prematurity and perinatal mortality, while maternal outcomes appear less clearly influenced by chorionicity. Standardized prospective studies are needed to further clarify the chorionicity-specific risks in ART twin pregnancies. Full article
(This article belongs to the Section Obstetrics & Gynecology)
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13 pages, 503 KB  
Article
Regional Trends and Forecasts of Pancreatic Cancer Incidence in Poland: A Voivodeship-Level Analysis of Risk Factors
by Sławomir Porada, Aleksandra Czerw, Natalia Czerw, Olga Partyka, Monika Pajewska, Tomasz Banaś, Izabela Gąska, Elżbieta Kaczmar, Katarzyna Sygit, Marian Sygit, Paulina Wojtyła-Buciora, Jarosław Drobnik, Piotr Pobrotyn, Dorota Waśko-Czopnik, Tomasz Sowiński, Katarzyna Tejza, Wojciech Homola, Łukasz Strzępek, Mateusz Curyło, Monika Urbaniak, Marcin Mikos, Elżbieta Grochans, Anna M. Cybulska, Daria Schneider-Matyka, Kamila Rachubińska, Ewa Bandurska, Weronika Ciećko, Monika Borzuchowska, Artur Budzyński and Remigiusz Kozlowskiadd Show full author list remove Hide full author list
J. Clin. Med. 2026, 15(12), 4724; https://doi.org/10.3390/jcm15124724 - 18 Jun 2026
Viewed by 140
Abstract
Background: Pancreatic cancer is characterized by increasing incidence and high mortality in Poland and worldwide. The aim of this study was to assess the relationship between selected risk factors and the age-standardized incidence rate of pancreatic cancer at the voivodeship level in Poland, [...] Read more.
Background: Pancreatic cancer is characterized by increasing incidence and high mortality in Poland and worldwide. The aim of this study was to assess the relationship between selected risk factors and the age-standardized incidence rate of pancreatic cancer at the voivodeship level in Poland, and to evaluate the accuracy of a prediction model. Methods: Age-standardized incidence rate data for 16 Polish voivodeships in 2011–2023 were obtained from the Polish National Cancer Registry. The risk factor burden for 2011–2019, expressed as disability-adjusted life years (DALYs) per 100,000 population, was obtained from the System Analysis and Implementation Database of the Polish Ministry of Health. A generalized estimating equation model was constructed to predict the age-standardized incidence rate, with multicollinearity addressed using variance inflation factor analysis. Predictions for 2020–2023 were validated against observed data, and forecasts for 2024–2030 were subsequently calculated. Results: The number of new pancreatic cancer cases in Poland increased in eight out of 16 voivodeships. The highest burden was recorded in the Masovian, Subcarpathian, Świętokrzyskie and Greater Poland voivodeships. Air pollution was positively associated with pancreatic cancer incidence. Predictions for 2020–2023 showed satisfactory agreement with observed data, with the largest discrepancy being equal to 4.1 in terms of the age-standardized incidence rate. Based on the models, the incidence of pancreatic cancer was projected for all of 16 voivodeships through to 2030. Conclusions: Air pollution is associated with the regional burden of pancreatic cancer in Poland. The generalized estimating equation prediction approach demonstrated acceptable accuracy and can support monitoring and public health planning at the voivodeship level. Full article
(This article belongs to the Section Oncology)
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26 pages, 3052 KB  
Article
Beyond the Blue Zones: Healthy Aging and Extreme Longevity in Italy (1982–2025)—An Ecological Analysis of Demographic, Metabolic, and Nutritional Correlates
by Silvana Mirella Aliberti, Daria Nurzynska and Mario Capunzo
Nutrients 2026, 18(12), 1952; https://doi.org/10.3390/nu18121952 - 17 Jun 2026
Viewed by 352
Abstract
Background/Objectives: Italy is among the countries with the highest life expectancy and extreme longevity worldwide, yet marked regional disparities persist. This nationwide ecological study examined temporal trends in population aging and extreme longevity across the 20 Italian regions (1982–2025) and explored regional [...] Read more.
Background/Objectives: Italy is among the countries with the highest life expectancy and extreme longevity worldwide, yet marked regional disparities persist. This nationwide ecological study examined temporal trends in population aging and extreme longevity across the 20 Italian regions (1982–2025) and explored regional correlates non-communicable disease (NCD) mortality and contemporary behavioral/nutritional indicators, with attention to emerging southern hotspots such as Cilento. Methods: Longevity indicators (Aging Tendency, Longevity Index [LI%], Centenarity Index [CI%], 85+ and 90+ ratios) were derived from ISTAT demographic data. Age-standardized mortality rates for five major NCDs (1990–2023) were obtained from WHO HFA-DB. Behavioral and nutritional indicators for adults aged ≥65 years (2024) were extracted from HFA-Italy. Regional associations were assessed using Spearman correlations within an ecological, hypothesis-generating framework. Results: All longevity indicators increased steadily from 1982 to 2025, with northern and central regions showing the highest values. Lower long-term mortality from diabetes mellitus and cerebrovascular diseases showed the strongest regional correlations with higher LI% and CI%. Nutritional profiles were generally more favorable in northern regions. The Cilento area emerged as a notable southern hotspot, displaying longevity indicators comparable to Sardinia and above the regional average. Conclusions: Regional patterns of extreme longevity in Italy reflect the interplay of demographic dynamics, NCD mortality burden, and contemporary lifestyle profiles. While northern regions maintain a clear advantage, specific southern areas such as Cilento demonstrate that favorable longevity outcomes can emerge in diverse macro-regional contexts. These findings highlight the value of regionally tailored strategies to promote healthy aging and reduce geographical disparities. Full article
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18 pages, 45176 KB  
Article
Potential Causal Relationship Between Hypertension and Type 2 Diabetic Nephropathy: Integrating Mendelian Randomization Evidence with Global Burden of Disease 2021 Analysis
by Dongsen Hu, Runze Wang, Pengfei Xie, Yexin Chen, Lili Zhang and Linhua Zhao
Healthcare 2026, 14(12), 1725; https://doi.org/10.3390/healthcare14121725 - 15 Jun 2026
Viewed by 167
Abstract
Background: Hypertension (HTN) and type 2 diabetes mellitus are major global health challenges, and diabetic nephropathy (DN) is a critical complication of diabetes. Although observational studies link HTN to DN progression, causal evidence remains limited. We investigated the potential causal relationship between HTN [...] Read more.
Background: Hypertension (HTN) and type 2 diabetes mellitus are major global health challenges, and diabetic nephropathy (DN) is a critical complication of diabetes. Although observational studies link HTN to DN progression, causal evidence remains limited. We investigated the potential causal relationship between HTN and DN and quantified the global burden of HTN-attributable type 2 diabetic nephropathy (HTN-T2DN). Methods: We integrated two-sample Mendelian randomization (MR), Bayesian weighted MR, and sensitivity analyses with Global Burden of Disease (GBD) 2021 analyses. The burden of HTN-T2DN was assessed from 1990 to 2021 and projected to 2045. Results: MR provided genetic evidence supporting a potential causal role of HTN in DN (inverse-variance weighted odds ratio = 4.219, 95% CI: 1.807–9.853; p = 0.001). Globally, HTN-T2DN deaths increased to 50,689 and DALYs to 1,151,216 in 2021. Females had higher age-standardized mortality and DALY rates than males, and low-middle sociodemographic index (SDI) regions had the highest burden. By 2045, deaths and DALYs were projected to reach 162,392 and 4.04 million, respectively. Conclusions: HTN may play a potential causal role in DN development and progression. Strengthened blood pressure control, early screening, and tailored policies are essential, particularly for women, older adults, and populations in lower-SDI settings. Full article
(This article belongs to the Special Issue Chronic Disease Prevention and Risk Control)
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26 pages, 1720 KB  
Systematic Review
Tailoring Oncofertility to Breast Cancer Subtype: A Systematic Review of Fertility Preservation Strategies in Premenopausal Women
by Maryam Garba Oloriegbe, Olena Bolgova, Rasha Alissa, Aliaa Abdelmeguid, Hamida Garba Oloriegbe, Umaiza Rehan and Volodymyr Mavrych
Cancers 2026, 18(12), 1896; https://doi.org/10.3390/cancers18121896 - 10 Jun 2026
Viewed by 273
Abstract
Introduction: Breast cancer is the most common malignancy in women of reproductive age, and treatment advances have heightened the importance of fertility preservation (FP) for young patients. Despite heterogeneity across subtypes—hormone receptor-positive (HR+), HER2-positive, triple-negative (TNBC), and BRCA1/2-associated—existing guidelines lack subtype-specific FP guidance. [...] Read more.
Introduction: Breast cancer is the most common malignancy in women of reproductive age, and treatment advances have heightened the importance of fertility preservation (FP) for young patients. Despite heterogeneity across subtypes—hormone receptor-positive (HR+), HER2-positive, triple-negative (TNBC), and BRCA1/2-associated—existing guidelines lack subtype-specific FP guidance. Methods: This systematic review compared FP strategies across subtypes, identified subtype-specific challenges, and proposed pathways toward precision oncofertility care. PubMed, Scopus, and Web of Science were searched following PRISMA guidelines for English-language studies from 2004 to 2024. Results: After screening 1837 records, 19 studies met eligibility criteria (2 RCTs, 17 cohort studies); 11 of 17 non-randomized studies were at low overall risk of bias, and 6 at moderate risk due to confounding. Discussion: COS using letrozole- or tamoxifen-modified protocols was feasible, yielding 8–14 mature oocytes per cycle with reduced estradiol exposure suitable for HR+ disease. Evidence was strongest for HR+ patients; TNBC and HER2+ data were more limited, with some studies noting reduced ovarian reserve. GnRH agonists during chemotherapy reduced ovarian failure rates and improved post-treatment recovery, most consistently in hormone receptor-negative disease. BRCA1/2 carriers showed broadly comparable FP outcomes to non-carriers, though BRCA1-positive patients had modestly reduced oocyte yields in some studies with inconsistent results. Conclusions: Among studies with medium-term follow-up (3–5.5 years), no significant increase in recurrence or mortality attributable to FP was identified; long-term data beyond 5 years remain sparse. Substantial heterogeneity precluded meta-analysis; all synthesis is narrative. Standardized outco reporting and larger prospective subtype-stratified studies are required to establish precision oncofertility recommendations. Full article
(This article belongs to the Section Systematic Review or Meta-Analysis in Cancer Research)
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16 pages, 3225 KB  
Article
National Trends and Demographic Disparities in Mortality Involving Co-Recorded Parkinson’s Disease and Dementia in the United States, 1999–2025: A CDC WONDER Analysis
by Hassaan Abid, Sohana Memon, Vishan Das, Kaneez Fatima, Muhammad Mukhlis and Muhammad Vazaym
NeuroSci 2026, 7(3), 66; https://doi.org/10.3390/neurosci7030066 - 10 Jun 2026
Viewed by 351
Abstract
Background: Parkinson’s disease and dementia are major neurodegenerative disorders that substantially contribute to disability, dependency, and mortality worldwide. Although prior CDC WONDER studies have separately evaluated Parkinson’s disease and dementia mortality trends, fewer analyses have examined national mortality patterns in which both conditions [...] Read more.
Background: Parkinson’s disease and dementia are major neurodegenerative disorders that substantially contribute to disability, dependency, and mortality worldwide. Although prior CDC WONDER studies have separately evaluated Parkinson’s disease and dementia mortality trends, fewer analyses have examined national mortality patterns in which both conditions are recorded on death certificates simultaneously over extended time periods. Methods: We analyzed U.S. death certificates from 1999 through 2025 using the CDC WONDER Multiple Cause of Death database, identifying deaths among adults aged ≥45 years in which both Parkinson’s disease (ICD-10 G20) and dementia-related codes (F01, F03, G30, G31) were recorded anywhere on the certificate. This operational definition captures co-recorded diagnoses and does not identify clinically confirmed Parkinson’s disease dementia. Age-adjusted mortality rates (AAMRs) per 100,000 were standardized to the 2000 U.S. standard population, a method that controls for shifts in population age structure over time and allows valid temporal comparisons independent of absolute population growth. Joinpoint regression was used to quantify trends. Sensitivity analyses excluded 2025 provisional data and the COVID-19 period (1999–2019). Results: A total of 337,721 deaths were identified. Overall AAMR increased from 5.75 (95% CI: 5.60–5.90) in 1999 to 11.15 (95% CI: 10.98–11.32) in 2025 (AAPC: 2.07; p = 0.002). A sharp transient increase occurred in 2020, attributable to pandemic-related factors including disproportionate COVID-19 mortality among older adults with neurodegenerative conditions, care disruptions, and changes in death-certificate coding practices. Following this pandemic-era peak, AAMRs declined significantly through 2025 and should be interpreted cautiously given provisional data. Males (AAPC: 2.14), non-Hispanic White individuals (AAPC: 2.29), the Midwest region (AAPC: 2.65), and non-metropolitan areas carried the highest mortality burden. Mortality was greatest among adults aged ≥85 years. Conclusion: Population-level death rates involving co-recorded Parkinson’s disease and dementia demonstrated significant temporal changes over the study period, with marked demographic and geographic disparities. These findings reflect death-certificate surveillance data and cannot establish clinical co-occurrence, causal relationships, or individual disease risk. Full article
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14 pages, 834 KB  
Article
Antimicrobial Central Venous Catheters vs. Uncoated Central Venous Catheters in Reducing Catheter-Related Bloodstream Infections in ICU: A Retrospective, Multicenter Study
by Vincenzo Pota, Francesco Imperatore, Rossella Esposito, Chiara Cafora, Ludovica Golino, Giovanni Liguori, Fiora Silvestro, Maria Beatrice Passavanti, Pasquale Sansone, Maria Caterina Pace and Francesco Coppolino
Medicina 2026, 62(6), 1105; https://doi.org/10.3390/medicina62061105 - 6 Jun 2026
Viewed by 253
Abstract
Background and Objectives: Central venous catheters (CVCs) are widely used in intensive care units (ICUs) but are associated with catheter-related bloodstream infections (CRBSIs), which increase morbidity, mortality, and healthcare costs. Antimicrobial-impregnated catheters, including chlorhexidine–silver sulfadiazine (CSS)-coated CVCs, have been proposed to reduce [...] Read more.
Background and Objectives: Central venous catheters (CVCs) are widely used in intensive care units (ICUs) but are associated with catheter-related bloodstream infections (CRBSIs), which increase morbidity, mortality, and healthcare costs. Antimicrobial-impregnated catheters, including chlorhexidine–silver sulfadiazine (CSS)-coated CVCs, have been proposed to reduce this risk. This study evaluated the effectiveness of CSS-coated CVCs in preventing CRBSIs in ICU patients. Materials and Methods: A retrospective multicenter study was conducted in two ICUs in Naples, Italy. Patients admitted between October and December 2020 who received standard uncoated CVCs (Group A) were compared with patients admitted between October and December 2021 who received CSS-coated CVCs (Group B). Inclusion criteria were age 18–89 years, ICU admission with CVC placement, and negative blood cultures at admission. The primary outcome was the incidence of CRBSI, defined according to microbiological criteria consistent with current guidelines. The secondary outcome was the number of catheter removals due to confirmed CRBSI. Results: A total of 320 patients were included (170 in Group A and 150 in Group B). Baseline demographic characteristics and ICU admission diagnoses were comparable between groups. Microbiologically confirmed CRBSI incidence was significantly lower in Group B than in Group A (6.4% vs. 31.7%, p < 0.0001), corresponding to infection rates of 1.48 vs. 6.95 per 1000 catheter-days, respectively (p < 0.0001). Patients in Group B also required fewer catheter removals due to CRBSI (mean 1.6 vs. 3.2 per patient, p < 0.0001). Logistic regression confirmed a significantly lower risk of CRBSI with CSS-coated CVCs (OR 0.15; 95% CI 0.06–0.32). Conclusions: CSS-coated CVCs were associated with a significant reduction in CRBSI incidence and catheter replacement rates in ICU patients. However, given the retrospective design, univariable analysis, and highly unequal pandemic-related systemic stressors between the two periods, these findings demonstrate a clinical association rather than direct causation, and should be interpreted with caution due to potential residual confounding. Full article
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33 pages, 3973 KB  
Review
Exploring Risk Factors and Sex Differences in Colorectal Cancer: Insights from Current Evidence
by Camilla Cittadini, Elisabetta Iessi, Rosa Vona and Paola Matarrese
Cells 2026, 15(11), 1039; https://doi.org/10.3390/cells15111039 - 5 Jun 2026
Viewed by 1557
Abstract
Colorectal cancer (CRC) is the third most diagnosed malignancy and the second leading cause of cancer-related mortality worldwide. A consistent and epidemiologically well-documented feature of CRC is its sexual dimorphism: age-standardized incidence rates are 33–45% higher in men than in women, and mortality [...] Read more.
Colorectal cancer (CRC) is the third most diagnosed malignancy and the second leading cause of cancer-related mortality worldwide. A consistent and epidemiologically well-documented feature of CRC is its sexual dimorphism: age-standardized incidence rates are 33–45% higher in men than in women, and mortality rates differ by 43–50%. Beyond epidemiology, biological sex influences tumor location, molecular subtype, and clinical outcome. Women more frequently develop right-sided, microsatellite-unstable tumors driven by the CpG island methylator phenotype pathway, whereas men predominantly present with left-sided, chromosomally unstable tumors harboring APC, KRAS, and TP53 mutations. Sex steroid hormones play a central modulatory role: estrogens, primarily via estrogen receptor β (ERβ), exert tumor-suppressive effects on colonic epithelium, whereas androgens promote pro-inflammatory and pro-tumorigenic signaling through androgen receptor (AR)-dependent pathways. The gut microbiome displays sex-specific compositional profiles (‘microgenderome’) and contributes to sex-specific CRC susceptibility through bidirectional interactions with sex hormones, shaping distinct immunological and metabolic microenvironments. Finally, sex influences the pharmacokinetics of fluoropyrimidines, the toxicity of targeted agents, and the response to immune checkpoint inhibitors. This review summarizes current evidence on sex-related differences in CRC epidemiology, molecular pathology, hormonal regulation, gut microbiota composition, and treatment outcomes, highlighting the need to systematically incorporate sex as a biological variable in CRC research and clinical practice. Full article
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30 pages, 2047 KB  
Review
Second Primary Malignancies After Primary Gastric Lymphoma: Incidence, Risk Factors, and Clinical Implications
by Fanny Erika Palumbo, Calogero Vetro, Lucia Gozzo, Davide Giuseppe Castiglione, Paola De Luca and Andrea Duminuco
Hemato 2026, 7(2), 17; https://doi.org/10.3390/hemato7020017 - 22 May 2026
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Abstract
Survivors of primary gastric lymphoma (PGL) face a significantly elevated and persistent risk of developing second primary malignancies (SPMs), with gastric adenocarcinoma representing the most frequent SPM and standardized incidence ratios reaching up to 16-fold above the general population. This excess risk persists [...] Read more.
Survivors of primary gastric lymphoma (PGL) face a significantly elevated and persistent risk of developing second primary malignancies (SPMs), with gastric adenocarcinoma representing the most frequent SPM and standardized incidence ratios reaching up to 16-fold above the general population. This excess risk persists for decades after initial treatment and is associated with increased cause-specific mortality compared to matched primary cancers. Among patients with PGL, approximately 5% develop gastric cancer (with two-thirds being metachronous), and nearly 15% harbor precancerous lesions including atrophic gastritis, intestinal metaplasia, and dysplasia. Beyond gastric malignancies, survivors also experience elevated rates of extra-gastric SPMs, particularly digestive system tumors (43%), respiratory cancers (21%), and urinary tract malignancies (13%). Key risk factors include treatment with immunochemotherapy or radiotherapy, advanced age, male sex, advanced stage at diagnosis, ulcerative-type lymphoma morphology, and persistent Helicobacter pylori (HP) infection. Patients receiving combined chemoradiotherapy demonstrate the highest SPM risk, particularly for gastric and pancreatic cancers. These findings underscore the critical importance of lifelong, risk-adapted surveillance strategies integrating both hematology and gastroenterology follow-up. Annual endoscopic surveillance is recommended for high-risk patients, with intervals adjusted according to lymphoma histology, HP status, and the presence of precancerous gastric lesions. Mandatory HP eradication with confirmation of response is essential for reducing gastric cancer risk. Future research priorities include prospective, standardized studies to better quantify SPM risk, validation of molecular and microbiological biomarkers for individualized risk stratification, and development of predictive models to enable personalized surveillance protocols and improve long-term outcomes in this vulnerable population. Full article
(This article belongs to the Section Lymphomas)
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11 pages, 829 KB  
Article
Safety and Efficacy of Single-Stage Synchronous Bilateral VATS Talc Poudrage for Malignant Pleural Effusion
by Antonio Mazzella, Sara Degiovanni, Elena Mariani, Giorgia Cerretani, Luca Bertolaccini, Monica Casiraghi, Giulia Sedda, Giorgio Lo Iacono and Lorenzo Spaggiari
Cancers 2026, 18(11), 1676; https://doi.org/10.3390/cancers18111676 - 22 May 2026
Cited by 1 | Viewed by 277
Abstract
Backgrounds/Objectives: Malignant pleural effusion (MPE) is a frequent complication of advanced cancer, and talc pleurodesis via video-assisted thoracoscopic surgery (VATS) represents a standard palliative treatment with high efficacy. However, evidence regarding synchronous bilateral pleurodesis in patients with bilateral MPE is limited. This [...] Read more.
Backgrounds/Objectives: Malignant pleural effusion (MPE) is a frequent complication of advanced cancer, and talc pleurodesis via video-assisted thoracoscopic surgery (VATS) represents a standard palliative treatment with high efficacy. However, evidence regarding synchronous bilateral pleurodesis in patients with bilateral MPE is limited. This study evaluates the feasibility, safety, and outcomes of a single-stage bilateral VATS talc pleurodesis approach. Materials and Methods: We retrospectively analyzed patients undergoing synchronous bilateral VATS talc poudrage between 2000 and 2025 at a single tertiary cancer center. Inclusion criteria included adult patients with bilateral MPE, expandable lungs, and suitability for surgery. Preoperative assessment involved imaging and multidisciplinary evaluation. Perioperative data, complications, mortality, and recurrence rates at 30 days and 3 months were collected. Survival and pleural effusion-free survival were estimated using the Kaplan–Meier method. Results: Thirty patients were included (median age 63.2 years). The most common primary tumors were breast (43%), lung (30%), and ovarian cancer (17%). Mean operative time was 78.6 min, with no intraoperative complications. Mean hospital stay was 6 days. Postoperative morbidity included atrial fibrillation (13%) and respiratory failure (6.6%), both managed conservatively. Thirty-day mortality was 3%. Pleural effusion recurrence occurred in 6.6% at 3 months and 10% at 7 months. Mean follow-up was 9.7 months. Conclusions: Synchronous bilateral VATS talc pleurodesis is a feasible and safe procedure in selected patients with bilateral MPE with acceptable morbidity. Further prospective studies are needed to confirm these findings and refine patient selection. Full article
(This article belongs to the Section Cancer Therapy)
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19 pages, 18869 KB  
Article
Burden of Ischemic Heart Disease in Central Asia from 1990 to 2021: A Systematic Analysis of the Global Burden of Disease Study 2021
by Dimash Davletov, Mukhtar Kulimbet, Alisher Makhmutov, Dinmukhammed Osser, Marat Pashimov, Batyrbek Assembekov and Kairat Davletov
Int. J. Environ. Res. Public Health 2026, 23(5), 675; https://doi.org/10.3390/ijerph23050675 - 20 May 2026
Viewed by 342
Abstract
Ischemic heart disease (IHD) remains a leading cause of death globally. This study aims to analyze the burden of IHD in Central Asia and in individual countries of the region from 1990 to 2021, through a comparison of trends in incidence, prevalence, mortality, [...] Read more.
Ischemic heart disease (IHD) remains a leading cause of death globally. This study aims to analyze the burden of IHD in Central Asia and in individual countries of the region from 1990 to 2021, through a comparison of trends in incidence, prevalence, mortality, and disability-adjusted life years. Using data from the Global Burden of Disease (GBD) 2021 study, we extracted annual estimates for the Central Asian region, Kazakhstan, Kyrgyzstan, Uzbekistan, Tajikistan, Turkmenistan, Georgia, Armenia, Azerbaijan, and Mongolia. Metrics were reported as age-standardized rates per 100,000 population. Temporal trends were quantified using Average Annual Percent Change based on joinpoint regression models. A stratification by sex and age groups was done. Central Asia consistently maintained a higher IHD burden than the global average. While global age-standardized incidence rates per 100,000 population fell, Central Asia’s rates per 100,000 population rose from 641.97 in 1990 to 801.56 in 2021. Age-standardized death rates per 100,000 population in the region peaked in the mid-1990s following the dissolution of the Soviet Union but decreased overall from 320.47 in 1990 to 265.51 in 2021. However, this remains significantly higher than the 2021 global rate per 100,000 population of 108.73. Uzbekistan exhibited the highest growth in prevalence and incidence rates per 100,000 population, while Georgia demonstrated the largest reduction in DALYs rates per 100,000 population. Men demonstrated a higher burden across most metrics, although the sex gap narrowed in older populations. Central Asia faces rising incidence rates of IHD and burden levels that far exceed global averages. The significant heterogeneity among countries suggests that region-wide generalizations are insufficient and highlights the critical need for targeted, country-specific prevention programs and health system interventions. Full article
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