SummaryBackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data.MethodsWe estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting.FindingsGlobally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1–4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0–8·4) while the total sum of global YLDs increased from 562 mil...
IMPORTANCE Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning. OBJECTIVE To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 32 cancers in 195 countries and territories from 1990 to 2015. EVIDENCE REVIEW Cancer mortality was estimated using vital registration system data, cancer registry incidence data (transformed to mortality estimates using separately estimated mortality to incidence [MI] ratios), and verbal autopsy data. Cancer incidence was calculated by dividing mortality estimates through the modeled MI ratios. To calculate cancer prevalence, MI ratios were used to model survival. To calculate YLDs, prevalence estimates were multiplied by disability weights. The YLLs were estimated by multiplying age-specific cancer deaths by the reference life expectancy. DALYs were estimated as the sum of YLDs and YLLs. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Countries were categorized by SDI quintiles to summarize results. FINDINGS In 2015, there were 17.5 million cancer cases worldwide and 8.7 million deaths. Between 2005 and 2015, cancer cases increased by 33%, with population aging contributing 16%, population growth 13%, and changes in age-specific rates contributing 4%. For men, the most common cancer globally was prostate cancer (1.6 million cases). Tracheal, bronchus, and lung cancer was the leading cause of cancer deaths and DALYs in men (1.2 million deaths and 25.9 million DALYs). For women, the most common cancer was breast cancer (2.4 million cases). Breast cancer was also the leading cause of cancer deaths and DALYs for women (523 000 deaths and 15.1 million DALYs). Overall, cancer caused 208.3 million DALYs worldwide in 2015 for both sexes combined. Between 2005 and 2015, age-standardized incidence rates for all cancers combined increased in 174 of 195 countries or territories. Age-standardized death rates (ASDRs) for all cancers combined decreased within that timeframe in 140 of 195 countries or territories. Countries with an increase in the ASDR due to all cancers were largely located on the African continent. Of all cancers, deaths between 2005 and 2015 decreased significantly for Hodgkin lymphoma (−6.1% [95% uncertainty interval (UI), −10.6% to −1.3%]). The number of deaths also decreased for esophageal cancer, stomach cancer, and chronic myeloid leukemia, although these results were not statistically significant. CONCLUSION AND RELEVANCE As part of the epidemiological transition, cancer incidence is expected to increase in the future, further straining limited health care resources. Appropriate allocation of resources for cancer prevention, early diagnosis, and curative and palliative care requires detailed knowledge of the local burden of cancer. The GBD 2015 study results demonstrate that progress is possible in the war against ca...
Background and Purpose: Investigation of the seasonal pattern of brucellosis occurrence may help us to determine the etiology of disease. Seasonal pattern of brucellosis in different parts of Iran has been reported by several studies. Combining the results of these studies provide a reliable estimation of a total seasonal pattern of this zoonosis disease. This study aims to determine the overall pattern of brucellosis in Iran using meta-analysis method. Materials and Methods:Relevant evidence was identified searching the national and international databanks. Eligible articles were entered into the final meta-analysis after comprehensive review of evidence as well as quality assessment. We also calculated the standard error of the incidence according to binomial distribution formula. Because of the significant heterogeneity observed between the results, random effects model was used to combine the results. All data analyses were conducted using Stata software. Results:In total, 26 studies were entered into this systematic review including 17,311 subjects.Incidences (95% confidence intervals) of brucellosis in Iran during spring, summer, autumn and winter were estimated as of 34.4% (30.3-38.6), 33.2% (30.7-35.7), 16.4% (13.3-19.5) and 14.9% (12.7-17.1), respectively. Conclusion:This meta-analysis showed that the highest incidences of brucellosis are occurred during spring and summer, while the lowest incidences are occurred during winter and autumn.
Infertility is a worldwide concern which has a variety of causes. This study was aimed to investigate the prevalence of infertility in women with genital tuberculosis. A search of PubMed, Science Direct, Scopus, Google Scholar and Cochrane databases (from 1990 to the present, date of last search February 2016) was performed using the keywords tuberculosis, genital tuberculosis, female genital, bacteriological, histological, infertility, primary infertility, secondary infertility, fallopian tube diseases, Asherman syndrome, women genital tract, fertility outcome, reproductive outcome, Â prevalence, rate, percent in order to identify the studies which have reported the prevalence of infertility in women with genital tuberculosis. Data were extracted, and a meta-analysis was done. Seven studies were identified. The prevalence of infertility among women with genital TB with 95% confidence interval was 70.67% (58.30-83.03). Also, the prevalence of primary infertility and secondary infertility among genital tuberculosis cases were 75.70% (69.03-82.36) and 24.30% (17.64-30.97), respectively. The prevalence of infertility in women with genital tuberculosis is high. Therefore, prevention and treatment of genital tuberculosis can be considered as a way to reduce the infertility rate.
Introduction: Fall is the most common and serious problem that occurs in Aged ,which has significant effects on their health and quality of life.The purpose of this study was to determine the relationship between fear of falls and depression in Aged diabetic patients in Amol hospitals. Method: This is a descriptive-analytic study that was conducted in 2018. The corpus of study involved 191 Aged diabetic patients aged 60 years and over. Sampling method was available. The instrument for data collection was demographic characteristics, FES-I scales, a fifteen-item questionnaire GDS and AMT and ADL. Data analysis was done by using descriptive and inferential tests and was shown via SPSS software. Results: Most participants (50.3%) were female. The average age of participants was 70.4 ± 6.6 years. Based on the findings, the average of fear of falling was (25 ± 8.7) and average of depression was (6.7 ± 2.1). The results of Spearman's correlation coefficient showed a significant positive correlation between fear of falling and depression (P = 0.001, r = 0.234). So that the fear of falls of the Aged were increased, their depression also increased. Conclusion: The results of this study showed that there is a significant relationship between the fear of falling and depression in Aged people. So, psychological treatments and exercise should be done to reduce their fear of falling.
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