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Dermatomal Zosteriform Eruption After Sequential Intralesional Bleomycin and Excision

Moon, June Y; Ratner, Désirée
PMID: 42228616
ISSN: 1524-4725
CID: 6043762

Validation of Brachial Vein Endothelial Transcriptomics to Assess the Coronary Vasculature [Letter]

Garshick, Michael S; Schlamp, Florencia; Boothman, Isabelle; Barret, Tessa; Kazatsker, Filipp; Westby, Gael; Xia, Yuhe; Smilowitz, Nathaniel R; Jelic, Sanja; Hamburg, Naomi; Goldberg, Ira; Berger, Jeffrey S
PMID: 42220240
ISSN: 1524-4571
CID: 6043422

Charting the decline of the fourth wave: US overdose deaths by race, ethnicity and substance involvement

Friedman, Joseph R; Palamar, Joseph J; Ciccarone, Daniel; Gaines, Tommi L; Borquez, Annick; Shover, Chelsea L; Strathdee, Steffanie A
AIMS/OBJECTIVE:To characterize decreases in overdose death rates in the United States (US) between 2023 and 2024 by race/ethnicity, and substance involvement. DESIGN/METHODS:Population-based study of national death records accessed via the Centers for Disease Control and Prevention (CDC) Wide-ranging ONline Data for Epidemiologic Research (WONDER) platform using an underlying cause of death approach. SETTING/METHODS:US. PARTICIPANTS/CASES/METHODS:All individuals who died from drug overdose between January 1999 and December 2024. MEASUREMENTS/METHODS:Annual overdose deaths per 100 000 population. Year of occurrence of overdose death, substance involvement, race/ethnicity of decedents. FINDINGS/RESULTS:After many years of increases, the US overdose death rate dropped 24.4% between 2023 and 2024. Decreases reflected declining illicit fentanyl-involved deaths (with and without stimulant involvement). The fourth wave of the US overdose crisis-defined by deaths involving fentanyl together with stimulants-declined for the first time in 2024. Despite overall decreases, deaths involving stimulants without fentanyl and deaths involving xylazine continued to represent a growing fraction of overdose fatalities. Non-Hispanic Black and African Americans had the largest decrease in death rates in 2023-2024, falling by 29.3% but remaining elevated at 36.0 per 100 000, 1.51 times higher than the national average of 23.7 per 100 000. Non-Hispanic American Indian and Alaska Native individuals had the highest overdose death rates rate in 2024, at 50.8 per 100 000, 2.15 times the national average rate, and experienced a below-average relative decrease of 20.1%. CONCLUSIONS:All four previously defined waves of the US overdose crisis appear to be in decline, as deaths involving illicit fentanyl, with and without stimulants, dropped sharply between 2023 and 2024. Concurrently, the fraction of overdose deaths involving stimulants without fentanyl and those involving xylazine continued to increase. While racial disparities in drug overdose death rates narrowed slightly during this period, large gaps remain, with the highest overdose death rates among American Indian, Alaska Native, and Black individuals.
PMID: 42227062
ISSN: 1360-0443
CID: 6043662

Exploring the effects of mindfulness meditation on resting-state functional connectivity: an overview

Le François, Thomas; Hilberdink, Charlotte E; Guillery-Girard, Bérengère; Leroux, Elise; Delamillieure, Pascal; Tréhout, Maxime; Chételat, Gaël; Haelewyn, Annick; Bui, Eric
Mindfulness meditation has received growing interest in research over the past decades. Mindfulness meditation training (MMT) can be employed as a mental practice to improve cognitive skills such as attention and emotion regulation and may promote well-being. Neuroimaging studies have emerged to understand the effects of MMT on brain functioning. However, no review exists on the effects of MMT on resting-state brain functional connectivity (rsFC) in healthy meditation-naïve adults specifically. We, therefore, aimed to provide an overview of studies that investigated the effects of MMT on rsFC in healthy meditation-naïve adults, as well as their link to cognitive and clinical measures. Several studies reported changes in MMT-induced rsFC within and between regions of the default mode (DMN), salience (SN), and central executive (CEN) networks. Both increases and decreases in rsFC have been observed for brain regions associated with these networks after MMT, each with differential roles in emotion regulation, stress, and cognitive functions. Some studies highlighted associations between changes in rsFC after MMT and modifications in cognitive performance and psycho-affective measures, which may be influenced by MMT-specific characteristics such as practice duration or delivery methods. MMT may induce a reorganization in the brain's functional architecture by altering rsFC within and between these networks and seems to modify processes related to attention, executive memory, emotional regulation, stress, and resilience. Investigating functional connectivity during rest in key brain networks seems a promising approach to understand the effects of mindfulness meditation on overall well-being.
PMID: 42228355
ISSN: 2191-0200
CID: 6043702

Prenatal repair of myelomeningocele is associated with lower need for long-term feeding support

Healy, Jennifer; Liu, Chunyan; Ehrlich, Shelley; Lim, Foong-Yen; Peiro, Jose L; Haberman, Beth; Stevenson, Charles B; Riddle, Stefanie
OBJECTIVE:Infants with myelomeningocele (MMC) are at risk of brainstem dysfunction secondary to symptomatic Chiari II malformation with hindbrain herniation (HH), which can manifest as feeding difficulties including aspiration and dysphagia. This study aims to investigate whether prenatal repair of MMC is associated with improved feeding outcomes compared to postnatal repair. STUDY DESIGN/METHODS:Retrospective observational study of 208 infants with MMC, 105 repaired prenatally and 103 repaired postnatally, from January 2011 to July 2022. Primary outcome was feeding tube at discharge and longitudinally through 12 months corrected gestational age (CGA). RESULTS:9.5% of infants repaired prenatally and 13.6% repaired postnatally required feeding tube at discharge (p = 0.3585). By 53 weeks CGA, the prenatal repair group had decreased odds of requiring feeding tube (0.325 [95% CI 0.121, 0.872]). CONCLUSION/CONCLUSIONS:Prenatal MMC repair was associated with decreased need for long-term feeding support, suggesting a potential functional benefit of prenatal repair related to reversal of HH.
PMCID:13008767
PMID: 40702155
ISSN: 1476-5543
CID: 6043112

Cardioneuroablation for children with syncope

Cohen, Mitchell I; Cohen, Jordan A
PURPOSE OF REVIEW/OBJECTIVE:Children with recurrent syncope with prolonged pauses who have failed traditional therapies may be candidates for a cardioneuroablation as an alternative to pacemaker implantation. This article reviews cardioneuroablation in the pediatric population. RECENT FINDINGS/RESULTS:Cardioneuroablation has been used in adults for cardioinhibitory syncope for more than 2 decades with promising results. Despite the heterogenous patient population and variation in technical approaches to the procedure, between 85 and 90% of patients have a significant reduction in syncope and improvement in quality of life. While the data in children is limited, reports have shown similar success. Catheter ablation of ganglionated plexuses can be performed by ablating in the right or left atrium or both. The long-term effects in disrupting the sympathovagal imbalance remains unknown. SUMMARY/CONCLUSIONS:Cardioneuroablation may be an option for select children with cardioinhibitory syncope who have failed standard medical approaches. Early results of vagal ablation in children have been promising. Future long-term registries following cardioneuroablation is needed.
PMID: 42186407
ISSN: 1531-7080
CID: 6043362

Daraxonrasib or Chemotherapy in Previously Treated Metastatic Pancreatic Cancer

O'Reilly, Eileen M; Wainberg, Zev A; Hendifar, Andrew E; Borad, Mitesh J; Pietrantonio, Filippo; Pant, Shubham; Hammel, Pascal; Cremolini, Chiara; Manji, Gulam A; Oberstein, Paul E; Garrido-Laguna, Ignacio; Springfeld, Christoph; Azad, Nilofer S; Ueno, Makoto; Chui, Stephen Y; Zhang, Ying; Patel, Hina; Lee, Yeonju; Salman, Zeena; Wolpin, Brian M; ,
BACKGROUND:mutations present in more than 90% of cases. Daraxonrasib is an oral RAS(ON) multiselective, tri-complex inhibitor of the active guanosine triphosphate-bound state of mutant and wild-type RAS. METHODS:G12 and overall populations. Safety was also assessed. RESULTS:G12 population was 7.3 months with daraxonrasib and 3.5 months with chemotherapy, and that in the overall population was 7.2 months and 3.6 months, respectively; the hazard ratios were 0.45 and 0.49, respectively (P<0.001 for both comparisons). Adverse events that occurred after the start of treatment were reported in all the patients in the daraxonrasib group and in 97.7% of those in the chemotherapy group; the incidence of adverse events of grade 3 or higher was 61.8% and 69.6%, respectively. Treatment-related adverse events that led to treatment discontinuation occurred in 1.2% of the patients in the daraxonrasib group and in 11.2% of those in the chemotherapy group. CONCLUSIONS:Among patients with previously treated mPDAC, treatment with daraxonrasib led to significantly longer overall survival and progression-free survival than chemotherapy. (Funded by Revolution Medicines; RASolute 302 ClinicalTrials.gov number, NCT06625320.).
PMID: 42223072
ISSN: 1533-4406
CID: 6043482

Complications of PI to PIII hemipelvic resections for intermediate and malignant tumours : a systematic review and meta-analysis

Smolle, Maria A; Wenzl, Florian A; Laitinen, Minna K; Jeys, Lee M; ,; Leithner, Andreas; Abdul Bari, Yunus; Abood, Ahmed; Abraham, John; Acosta, Marthelena; Agarwal, Rishi; Agarwal, Manish; Ajit Singh, Vivek; Akiyama, Toru; Al Farii, Humaid; Aldosari Omar, A; Alfaro, Patricio; Aljuhani, Wazzan; Allison, Daniel; Almashahedi, Mohammed; Alotaibi, Abdullah; Alpan, Bugra; Alshaygy Ibrahim, S; Althunayan, Turki; Andreani, Lorenzo; Andreou, Dimosthenis; Andriandi, Andriandi; Annabell, Lucas; Aponte-Tinao, Luis; Armas, Selma; Aston, William; Aycan Osman, Emre; Baad-Hansen, Thomas; Baird, Charles; Balach, Tessa; Barriga Juan, Alfonso; Barry, Janie; Basile, Georges; Bastoni, Stefano; Basuki Mohammad, Hardian; Bauer, Henrik; Bayliss, Lee; Becker, Ricardo; Bedi, Angad; Benevenia, Joseph; Bengoa, Francisco; Berger, Christina; Bernthal, Nicholas; Binitie, Odion; Bird, Justin E; Bobseit, Abdulrahman; Bodian, Caitlin; Boffano, Michele; Bonilla Huertas, Patricia; Botello, Eduardo; Boyle, Richard; Bramer, Jos; Broekhuis, Demien; Broida, Samuel E; Brown, Danielle; Budny, Tymoteusz; Burke, Zachary; Cabrolier, Jorge; Calvo Haro Jose, Antonio; Campanacci, Domenico Andrea; Cardoso, Rodrigo; Carey Smith, Richard; Casales Fresenga, Nicolas; Ceballos, Oscar; Chan Chung, Ming; Chan, Lester; Choong, Peter; Chrobok, Adam; Chung, Yang-Guk; Ciechanowicz, Dawid; Clara-Altamirano Miguel, Angel; Consuegra, Luis; Courtot, Louis; Crawford, Brooke; Cribb, Gillian; Cuervo-Lozano Carlos, Eduardo; Dammerer, Dietmar; de la Rosa, Pablo; De Paolis, Massimiliano; De Santos de la Fuente Francisco, Javier; de Vaal, Marieke; Deisenhofer, Julian; Delgado, Javier; Deo, Shaneel; Deventer, Niklas; Di Bella, Claudia; Dierselhuis, Edwin; Domson, Gregory; Donati, Davide Maria; Duran-Ciarrochi, Rodolfo; Durr Hans, Roland; Ebeid, Walid; Ehlers, Pierre; El Ghoneimy Ahmed, Mohamed; El Motassime, Alessandro; Eloi Pinto Fabio, Fernando; Endo, Makoto; Epstein, Gadi; Eralp, Levent; Etaiwi, Mahmoud; Eward, Will; Fabbri, Nicola; Faimali, Martina; Farooq, Arbab; Farooque, Khalil; Ferguson, Peter; Ferreira, Nando; Fiorenza, Fabrice; Fonseca de Freitas, Joao; Forsberg Jonathan, A; Fuchs, Bruno; Fujiwara, Tomohiro; Funovics, P T; Fuzy, Edward; Galli Serra, Marcos; Gamie, Zakareya; Garcia Carrasco, Maria; Gaston Czar, Louie; Georges, Basile; Ghert, Michelle; Ghert, Michelle; Ghosh, Kanishka; Giardina Fabio, Luca; Gomez Mier Luis, Carlos; Gomez-Mascard, Anne; Gomez-Sierra, Maria Antonia; Goodman Mthethwa, Phakamani; Gortzak, Yair; Goulding, Krista; Gracia, Isidro; Green, Natalie; Griffin, Anthony; Guedes, Alex; Gulia, Ashish; Gupta, Sanjay; Guzman, Maurice; Hardes, Jendrik; Hasan Yusuf, O; Havard, Hel; Haydon, Rex; Hegde, Prateek; Hernandez Lopez, Adriana; Herrera, David; Hesla, Asle; Hess, Matthew; Hilton, Thomas; Hirschmann, Adam; Hobusch, Gerhard; Hongsaprabhas, Chindanai; Hornicek, Francis; Hosking, Keith; Houdek, Matthew T; Hsu, Megan; Idowu, Oluwaseyi; Idulhaq, Mujaddid; Ippolito, Joseph; Iwata, Shintaro; Jagiello, Jake; Jeys, Lee; Johan, Muhammad Phetrus; Johnson, Luke; Johnston, Andy; Joo, Min Wook; Jutte, Paul; Jääskeläinen, Anna-Stina; Kaldas, Kadri; Kapanci, Bilal; Karaca Mustafa, Onur; Kawai, Akira; Kemp, Alysia; Khal Adyb-, Adrian; Khan, Zeeshan; Khan Zainab, Aqeel; Kim, Han-Soo; Klopper, Schalk; Kobayashi, Eisuke; Kobayashi, Hiroshi; Kontogeorgakos, Vasileios; Kotrych, Daniel; Krishnamurthy Anjan, Venkataraman; Kunisada, Toshiyuki; Kurisunkal, Vineet; Kyte, Richard; Laitinen, Minna; Laubscher, Maritz; Lazarides, Alexander; Le Nail, Louis-Romee; Lee Francis, Y; Legosz, Pawel; Lehner, Burkhard; Leithner, Andreas; Leone, Gianpaolo; Lewis Valerae, O; Li, Binghao; Liikanen, Hanna; Lin, Peng; Linda, Zwelithini; Lindsay, Sarah; Lozano Calderon, Santiago; Lutomia Lumbasi, Mark; MacDonald, Jonathan; Malina, Mario; Marais, Len; Mascard, Eric; Mattei, Jean-Camille; McCullough, Louise; McMahon, Sam; Medellin Rincon Manuel, Ricardo; Mediavilla Santos, Lidya; Meijer, Diederik; Meijer Johannes, Gerard; Miller, Ben; Molloy, Allan; Moriel Garcesco Diego, Jesus; Morris, Guy; Morris Carol, D; Morse-Sanyal, Ashlyn; Mottard, Sophie; Munir Hashim, Ahmad; Murcia, Miguel; Müller, Michelle; Nakayama, Robert; Narhari, Prashant; Nasar, Ali; Nayak, Prakash; Neugebauer, Johannes; Nieminen, Jyrki; Ntombela, Philani; Nystrom, Lukas; O'Toole, Gary; Ogura, Koichi; Oliveira, Vania; Olivier, André; Omar, Mohamed; Omran Hasan, Yusuf; Ortiz-Cruz, Eduardo; Ozaki, Shuhei; Ozaki, Toshifumi; Pala, Elisa; Palmerini, Emanuela; Panchwagh, Yogesh; Papagelopoulos, Panayiotis; Papagelopoulos, Dimitra; Paraliticci, Giovanni; Gibbs C, Parker; Parry, Michael; Peiró, Ana; Perera, Jonathan; Petersen, Michael Moerk; Phakathi, Oatile; Phimolsarnti, Rapin; Phiri, Tshepang; Pinto Santander, Nicolas; Ploegmakers, Joris; Pollock, Robin; Powell, Gerard; Pruthi, Manish; Puhaindran, Mark; Puri, Ajay; Quirion, Julia; Rabin, Eden; Rachbauer, Anna; Radhakrishnan, Sanjeevan; Raja, Anand; Rajalbandi, Rohit; Rajani, Rajiv; Rajasekaran Raja, Bhaskara; Rajkovic, Stanislav; Ramkumar, Dipak; Rankin, Kenneth; Ras El Abiad Mejia, Alejandro; Rasappan, Kumaran; Redl, Malena; Rose Peter, S; Rosenberg, Andrew; Ruggieri, Pietro; Russell, Michael; Salcedo, German; Saleh, Ahmad; Sambri, Andrea; Saputra Rhyan, Darma; Scanferia, Roberto; Scharschmidt, Thomas; Schubert, Thomas; Scoccianti, Guido; Segura, Florencio; Sellevold, Simen; Rajasekaran, Shanmuganthan; Shehadeh, Ahmad; Shreemal, Bhim; Shumelinsky, Félix; Siddiqi Muhammad, Ather; Silveri, Claudio; Sinnaeve, Friedl; Smolle, Maria Anna; Snyman, Franz; Solomons, Michael; Sommerville, Scott; Sood Sahil, Sood; Spense Mariel, Eliana; Spiegel, Christian; Spiguel, Andre; Staals, Eric; Stavropoulos, Nikolaos; Steadman, Peter; Stern, Sydney; Stevenson, Jonathan; Stoppiello, Pablo; Sullivan Mikaela, H; Szostakowski, Bartlomiej; Szostakowski, Bartek; Tang, Xiaodong; Thippesamy Pushpa, B; Thorkildsen, Joachim; Tootsi, Kaspar; Torner Rubies, Ferran; Tosyali, Koray; Traub, Frank; Trent Jonathan, C; Trikoupis, Ioannis; Tsagkozis, Panagiotis; Tuntarattanapong, Pakjai; Ullah, Farman; Ulrich, Marisa N; Vainio, Veli-Matti; Valencia, Juan; van de Sande, Michiel; Van Der Geest, Ingrid; van der Wal, Robert; Velez Villa, Roberto; Verbeke, Léonie; Verspoor Floortje, G M; Versteeg, Anne; Vicatos, George; Virk Jagandeep, Singh; Visgauss, Julia; Vyrva, Oleg; Wafa, Hazem; Wan Faisham Numan Wan, Ismail; Wang Patrick, Qi; Wei, Ran; Wennergren, David; Werier, Joel; Weschenfelder, Wolfram; Williams, Nadine; Wunder, Jay; Yildiz Huseyin, Yusuf; Yonamine, Eduardo; Yonezawa, Hirotaka; Yousuf, Maitham; Zainul Abidin, Suraya; Zamora, Tomas; Zuckerman, Lee; Zumarraga Juan, Pablo; Özger, Harzem; Özkan, Korhan; Triganjananun, Chanonta; Aguirre, Marcela; Alaqeel, Motaz; Alaseem, Abdulrahman; Alexander, Kate; Ardelt, Melanie; Baeza, Pablo; Banse, Xavier; Franks, Daniel; Baydar, Semay; Doshi, Arpan; Bruschi, Alessandro; Buist, Mirka; Busse, Tilmann; Carrasco, María; Castan, Ashley; Chang, Liang; Charoenlap, Chris; Chaustre, Florez; Chin, Janet; Pate, Matthew; Olson, Daniel; Cornu, Olivier; Farris, Clayton; de, Lima; Demir, Eren; Docquier, Pierre-Louis; Duivenvoorden, Myléne; Farman, Ullah; Flint, Michael; García-Huidobro, Gabriel; Gazendam, Aaron; Golovina, Yanina; Gomez M Luis, Carlos; González-Browne, Catalina; Gonzalez-Saldivar, Juan Carlos; González-Motta, Alejandro; Gosheger, Georg; Gouin, Francois; Graydon, Andrew; Hesham, Amr; Hohensteiner, Anna; Igbinoba, Bright; Joyce, David; Letson, Douglas; Tepper, Sarah; Jung, Beatrice; Jungels, Christiane; Jutte, Willem; Khan Zainab, Aqeel; Khaouam, Nader; Krebbekx, Gitte; Lacroix, Valérie; Lee, Jewoo; Lee, Minpyo; Machado, Pau; Majirija, Edgar; Malyk, Roman; Mthethwa Phakamani, G; Muñoz-Montecinos, Carlos; Quirland, Camila; Ramirez, Maria; O'Reilly-Harbidge, Sarah; Oktayana, Made Dolly; Olusunmade, Opeyemi; Pang, Grant; Stubbe, Chris; Parizzia, Walter; Pinheiro, Rafael; Prabowo, Yuni; Ramkumar Dipak, B; Rizzo, Arianna; Samy, Ahmed; Sánchez-Maldonado, Maria; Sundin, Nathalia; Suntaxi, Basantes; Tandon, Nikhil; Terrarossa, Bruno; Trullols, Laura; Tsoi, Kim; Zaghloul, Ahmed
AIMS/UNASSIGNED:Surgical management of intermediate and malignant tumours in the pelvis is complex. Complications are frequent and either related to the surgery itself or to post-surgical failure of the reconstruction technique. This systematic review and meta-analysis aims at analyzing all reported complications following PI to PIII pelvic resections for intermediate and malignant tumours. METHODS/UNASSIGNED:Based on a systematic literature search on PubMed adhering to the PRISMA guidelines, 1,683 study records were identified, of which we included 90 original studies published until 22 July 2025. Overall complication rates were assessed with random-effects meta-analysis. Differences in complication rates between reconstruction types (i.e. megaprosthetic, mostly biological, none) were evaluated with meta regression analysis. RESULTS/UNASSIGNED:Data on 2,199 patients (1,250 males (57%)) with mainly PI to PIII pelvic resections were analyzed. The most common reconstruction types were custom-made implants (21%; n = 451) and ice-cream cone prostheses (14%; n = 312). Pooled rates of infections, wound healing problems, nerve injuries, and deep vein thrombosis (DVT) amounted to 15% (95% CI 12% to 18%), 13% (95% CI 10% to 15%), 7% (95% CI 5% to 9%), and 4% (95% CI 2% to 6%), respectively. Further, pooled implant revision/removal and secondary external hemipelvectomy rates were 14% (95% CI 11% to 17%) and 4% (95% CI 3% to 5%). Mostly biological reconstructions were associated with higher rates of nerve injuries (p < 0.001), construct failures (p = 0.010), and secondary implant revision/removal (p = 0.003) compared to megaprosthetic reconstruction. Further, biological reconstructions were associated with increased secondary external hemipelvectomy rates compared to megaprosthetic reconstructions (p = 0.005) or no reconstructions (p = 0.001). CONCLUSION/UNASSIGNED:Treatment of pelvic malignancies is challenging, with technically demanding resections and complex reconstructions. Across all reconstruction techniques following sacrum-sparing pelvic resections, infections and wound healing problems are the most common complications, yet there is also a considerable proportion of patients with neurovascular complications and DVTs.
PMCID:13222729
PMID: 42219227
ISSN: 2633-1462
CID: 6043392

Global burden of enteric infectious diseases, diarrhoeal diseases, and corresponding aetiologies, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023

,
BACKGROUND:Enteric infectious diseases claim more than 1 million lives annually and are among the top ten causes of death in children younger than 5 years. Remarkable global investment has been dedicated to enteric infectious disease prevention and control; however, the shifting global health landscape is testing the continuance of progress. To evaluate the current status and guide future interventions, we present the latest epidemiological estimates of enteric infectious diseases from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 and assess progress towards the Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD) mortality target of fewer than 20 deaths per 100 000 children younger than 5 years by 2025. METHODS:We quantified the incidence, mortality, and disability-adjusted life-years (DALYs) of enteric infectious diseases by age, sex, and year across 204 countries and territories from 1990 to 2023. In GBD 2023, the following were considered under the category of enteric infectious diseases: diarrhoeal diseases, enteric fever (typhoid and paratyphoid), invasive non-typhoidal Salmonella spp (iNTS) infections, and other intestinal infectious diseases. We also examined 15 aetiologies contributing to diarrhoeal diseases. Incidence and prevalence were estimated with DisMod-MR (version 2.1), a Bayesian meta-regression tool, drawing on data from systematic reviews, population-based surveys, claims data, and hospital sources. Cause-specific mortality was modelled with Cause of Death Ensemble Modelling based on data from sources including vital registration, mortality surveillance, verbal autopsy, and minimally invasive tissue sampling. Years of life lost and years lived with disability were computed and combined to derive DALYs. For aetiology-specific estimation, population-attributable fractions (PAFs) for 15 pathogens were derived with a counterfactual framework. Point estimates and 95% uncertainty intervals (UIs) were generated from 250 draws from the posterior distribution. FINDINGS/RESULTS:In 2023, enteric infectious diseases resulted in an estimated 1·27 million (95% UI 0·963-1·68) deaths globally, declining from 3·69 million (3·04-4·56) in 1990. The global age-standardised mortality rate (ASMR) decreased from 74·1 (62·0-92·9) per 100 000 population to 16·4 (12·6-21·3) per 100 000 population during the same period. Diarrhoeal diseases accounted for most deaths in 2023 (1·11 million [0·811-1·54]), followed by enteric fever and iNTS. South Asia and sub-Saharan Africa remained the most affected regions in 2023, with 599 000 (441 000-882 000) and 501 000 (373 000-648 000) deaths due to enteric infectious diseases, respectively, predominantly from diarrhoeal disease. Rotavirus was the leading cause of all-age diarrhoeal disease deaths (PAF 16·3% [12·0-21·5]), followed by norovirus (10·2% [2·4-17·0]) and Shigella spp (9·3% [5·4-15·2]). Among children younger than 5 years, PAFs of deaths due to diarrhoeal diseases were 40·2% (32·5-48·5) for rotavirus, 24·0% (15·1-36·7) for Shigella spp, and 23·4% (13·7-34·3) for adenovirus. Across 204 countries and territories, 141 met the GAPPD mortality target in 2023. The driving aetiologies among countries that did not meet the target in 2023 varied slightly by GBD super-region, but the highest or second-highest number of deaths in children younger than 5 years were consistently attributed to rotavirus. Astrovirus and sapovirus, newly included in GBD 2023, were responsible for 24 600 (6290-49 000) and 18 800 (4650-44 400) deaths, respectively, in 2023, mainly in children younger than 5 years. INTERPRETATION/CONCLUSIONS:Our findings show that mortality and ASMRs of enteric infectious diseases declined substantially between 1990 and 2023. This decline is consistent with the expansion of public health measures and broader socioeconomic development. However, the burden in 2023 remains considerably high, with the highest mortality concentrated in sub-Saharan Africa and south Asia. Considering that more than a quarter of all countries had yet to meet the GAPPD mortality target in 2023, sustained efforts are needed to address the persistent burden in affected countries and to adapt to the changing global health landscape. FUNDING/BACKGROUND:Gates Foundation.
PMID: 42229499
ISSN: 1474-4457
CID: 6043792

Evaluation and treatment of pericardial disease in immune-mediated inflammatory diseases

Bonaventura, Aldo; Garshick, Michael; Malandrino, Danilo; Tangianu, Flavio; Youngstein, Taryn; Abbate, Antonio; Weber, Brittany N
Pericardial disease is common in patients with immune-mediated inflammatory diseases (IMIDs), especially in systemic lupus erythematosus. Pericardial disease may present as an asymptomatic pericardial effusion or acute and recurrent pericarditis, and may sometimes lead to complications (cardiac tamponade and constrictive pericarditis). Pathophysiology of pericarditis in IMIDs is likely related to the underlying immune dysregulation. Diagnosis of IMID-related pericarditis relies on general diagnostic criteria, supported by inflammatory biomarkers and non-invasive multimodality imaging. Initial management of IMID-related pericarditis overlaps with idiopathic pericarditis (nonsteroidal anti-inflammatory drugs and colchicine) together with treatment of the underlying IMID. Glucocorticoids are used in cases of poor response to first-line treatments. The use of immunosuppressive therapies is driven by the underlying IMID and systemic organ involvement beyond the pericardium. Multi-disciplinary care collaboration between cardiologists, radiologists, internists, and rheumatologists is pivotal to develop an appropriate, common treatment plan based on the individual features of each patient with IMIDs.
PMID: 42225844
ISSN: 1462-0332
CID: 6043632