This study aimed to identify the current patterns of cancer incidence and estimate the projected cancer incidence and mortality between 2020 and 2035 in Korea.Data on cancer incidence cases were extracted from the Korean Statistical Information Service from 2000 to 2017, and data on cancer-related deaths were extracted from the National Cancer Center from 2000 to 2018. Cancer cases and deaths were classified according to the International Classification of Diseases, 10th edition. For the current patterns of cancer incidence, age-standardized incidence rates (ASIRs) and age-standardized mortality rates were investigated using the 2000 mid-year estimated population aged over 20 years and older. A joinpoint regression model was used to determine the 2020 to 2035 trends in cancer.Overall, cancer cases were predicted to increase from 265 299 in 2020 to 474 085 in 2035 (growth rate: 1.8%). The greatest increase in the ASIR was projected for prostate cancer among male (7.84 vs. 189.53 per 100 000 people) and breast cancer among female (34.17 vs. 238.45 per 100 000 people) from 2000 to 2035. Overall cancer deaths were projected to increase from 81 717 in 2020 to 95 845 in 2035 (average annual growth rate: 1.2%). Although most cancer mortality rates were projected to decrease, those of breast, pancreatic, and ovarian cancer among female were projected to increase until 2035.These up-to-date projections of cancer incidence and mortality in the Korean population may be a significant resource for implementing cancer-related regulations or developing cancer treatments.
Abstract Aims Increased blood pressure (BP) and decreased heart rate (HR) are signs of stabilization in patients admitted for acute HF. Changes in BP and HR during admission and their correlation with outcomes were assessed in hospitalized patients with heart failure (HF) with reduced ejection fraction (HFrEF). Methods A novel modified reverse shock index (mRSI), defined as the ratio between changes in systolic BP and HR during admission, was devised, and its prognostic value in the early outcomes of acute HF was assessed using the Korean Acute HF registry. Results Among 2697 patients with HFrEF (mean age 65.8 ± 14.9 years, 60.6% males), patients with mRSI ≥1.25 at discharge were significantly younger and were more likely to have de novo HF. An mRSI ≥1.25 was associated with a significantly lower incidence of 60‐day and 180‐day all‐cause mortality [hazard ratio (HR) 0.49, 95% confidence interval (CI) 0.31–0.77; HR 0.62, 95% CI 0.45–0.85, respectively], compared with 1 ≤ mRSI < 1.25 (all P < 0.001). Conversely, an mRSI <0.75 was associated with a significantly higher incidence of 60‐day and 180‐day all‐cause mortality (adjusted HR 2.08, 95% CI 1.19–3.62; HR 2.24, 95% CI 1.53–3.27; all P < 0.001). The benefit associated with mRSI ≥1.25 was consistent in sub‐group analyses. The correlation of mRSI and outcomes were also consistent regardless of admission SBP, presence of atrial fibrillation, or use of beta blockers at discharge. Conclusions In patients hospitalized for HFrEF, the mRSI was a significant predictor of early outcomes. The mRSI could be used as a tool to assess patient status and guide physicians in treating patients with HFrEF.
Abstract Background The coronavirus disease of 2019 (COVID‐19) is a global pandemic with over 266 million cases and 5 million deaths worldwide. Anti‐COVID‐19 vaccinations have had exceptional success in subduing the incidence, prevalence, and disease severity of COVID‐19, but rare cases of myocarditis have been reported after COVID‐19 vaccinations. Hypothesis Myocarditis occurring after COVID‐19 mRNA vaccinations have distinguishable clinical characteristics. They usually have a favorable prognosis. Methods We performed a systematic literature search on PUBMED and MEDLINE database from inception to December 5, 2021. Studies were analyzed based on predetermined eligibility criteria. Results A total of 57 studies containing 275 cases of COVID‐19 vaccine‐associated myocarditis were catalogued. Mean age was 26.7 years and male to female ratio was 14:1. For 86.9% of patients, myocarditis occurred after the second dose. Average time to onset and length of hospitalization were 3.7 and 3.9 days, respectively. Prognosis was largely benign, but there was a 1.1% reported mortality. Chest pain (95.2%), elevation of troponin (100%), and ST elevation on electrocardiography (68.5%) were common. Nonsteroidal anti‐inflammatory drugs (81.4%) were the most used medication, followed by colchicine (33.1%). Conclusions Patients with COVID‐19 vaccine‐associated myocarditis are usually younger males presenting with chest pain 3–4 days after receiving their second dose of COVID vaccine. Diagnosis is made by exclusion of all other etiologies. Given significant population benefit from COVID‐19 vaccination, physicians should continue to encourage vaccination while remaining vigilant of the very rare occurrence of myocarditis following COVID‐19 vaccination.
Summary Background Allergic respiratory conditions have been associated with increased susceptibility to viral infection due to impaired interferon ( IFN )‐related immune responses, but the mechanisms for reinforcement of mucosal immunity against viral infection in allergic diseases are largely unknown. Objectives To determine whether IFN induction would be impaired in allergic nasal mucosa and to identify whether higher loads of influenza A virus ( IAV ) in allergic nasal mucosa could be controlled with IFN treatment. Methods Influenza A virus mRNA , viral titres and IFN expression were compared in IAV ‐infected normal human nasal epithelial ( NHNE , N = 10) and allergic rhinitis nasal epithelial ( ARNE , N = 10) cells. We used in vivo model of allergic rhinitis ( BALB /c mice, N = 10) and human nasal mucosa from healthy volunteers (N = 72) and allergic rhinitis patients (N = 29) to assess the induction of IFN s after IAV infection. Results Influenza A virus mRNA levels and viral titres were significantly higher in ARNE compared with NHNE cells. IFN ‐β and IFN‐λs were induced in NHNE and ARNE cells up to 3 days after IAV infection. Interestingly, induction of IFN ‐λs mRNA levels and the amount of secreted proteins were considerably lower in ARNE cells. The mean IFN ‐λs mRNA level was also significantly lower in the nasal mucosa of AR patients, and we found that recombinant IFN ‐λ treatment attenuated viral mRNA levels and viral titres in IAV ‐infected ARNE cells. In vivo AR mouse exhibited higher viral load after IAV infection, but intranasal inoculation of IFN ‐λ completely decreased IAV protein expression and viral titre in nasal mucosa of IAV ‐infected AR mouse. Conclusion Higher susceptibility of the allergic nasal mucosa to IAV may depend on impairment of type III IFN induction, and type III IFN is a key mechanistic link between higher viral loads and control of IAV infection in allergic nasal mucosa.
Intravascular imaging with either intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during percutaneous coronary intervention (PCI) is associated with improved outcomes, but these techniques have previously been underutilized in the real world. We aimed to examine the change in utilization of intravascular imaging-guided PCI over the past decade in the United States and assess the association between intravascular imaging and clinical outcomes following PCI for myocardial infarction (MI). We surveyed the National Inpatient Sample from 2008 to 2019 to calculate the number of PCIs for MI guided by IVUS or OCT. Temporal trends were analyzed using Cochran-Armitage trend test or simple linear regression for categorical or continuous outcomes, respectively. Multivariable logistic regression was used to compare outcomes following PCI with and without intravascular imaging. A total of 2,881,746 PCIs were performed for MI. The number of IVUS-guided PCIs increased by 309.9 % from 6,180 in 2008 to 25,330 in 2019 (P-trend < 0.001). The percentage of IVUS use in PCIs increased from 3.4 % in 2008 to 8.7 % in 2019 (P-trend < 0.001). The number of OCT-guided PCIs increased 548.4 % from 246 in 2011 to 1,595 in 2019 (P-trend < 0.001). The percentage of OCT guidance in all PCIs increased from 0.0 % in 2008 to 0.6 % in 2019 (P-trend < 0.001). Intravascular imaging-guided PCI was associated with lower odds of in-hospital mortality (adjusted odds ratio 0.66, 95 % confidence interval 0.60–0.72, p < 0.001). Although the number of intravascular imaging-guided PCIs have been increasing, adoption of intravascular imaging remains poor despite an association with lower mortality.
BackgroundTAVI has emerged as an important treatment modality in severe aortic stenosis. With expanding indication of TAVI, understanding long-term outcomes after TAVI is critical.MethodsRandomized controlled trials (RCTs) and propensity-score-matched observational studies comparing TAVI with SAVR were stratified to low, intermediate, or high surgical risk using STS-PROM or logistic EuroSCORE. All-cause mortality was grouped into the following intervals: perioperative to 30 days, 1 year, 2 to 3 years, and 4 to 5 years. Random effects meta-analysis and mixed-effects logistic meta-regression were performed.ResultsSeven RCTs and 29 propensity-score-matched studies were included. In low surgical-risk, TAVI was associated with higher risk of all-cause mortality at 1 year (RR 1.12, p<0.01) and 5 years (RR 1.44, p=0.03). In intermediate surgical-risk, TAVI was associated with lower risk of all-cause mortality at 5 years (RR 1.21, p=0.05), but not at 30 days, 1 year, and 3 years. In high surgical-risk, TAVI was associated with higher risk of all-cause mortality at 3 years (RR 1.49, p=0.03). Meta-regression to time revealed increasing trend of all-cause mortality in all surgical risks combined (p<0.01) and in low surgical-risk patients (p<0.01) (Figure 1).ConclusionsDisclosuresD. Y. Park Nothing to disclose. S. An Nothing to disclose. A. Vij Nothing to disclose. BackgroundTAVI has emerged as an important treatment modality in severe aortic stenosis. With expanding indication of TAVI, understanding long-term outcomes after TAVI is critical. TAVI has emerged as an important treatment modality in severe aortic stenosis. With expanding indication of TAVI, understanding long-term outcomes after TAVI is critical. MethodsRandomized controlled trials (RCTs) and propensity-score-matched observational studies comparing TAVI with SAVR were stratified to low, intermediate, or high surgical risk using STS-PROM or logistic EuroSCORE. All-cause mortality was grouped into the following intervals: perioperative to 30 days, 1 year, 2 to 3 years, and 4 to 5 years. Random effects meta-analysis and mixed-effects logistic meta-regression were performed. Randomized controlled trials (RCTs) and propensity-score-matched observational studies comparing TAVI with SAVR were stratified to low, intermediate, or high surgical risk using STS-PROM or logistic EuroSCORE. All-cause mortality was grouped into the following intervals: perioperative to 30 days, 1 year, 2 to 3 years, and 4 to 5 years. Random effects meta-analysis and mixed-effects logistic meta-regression were performed. ResultsSeven RCTs and 29 propensity-score-matched studies were included. In low surgical-risk, TAVI was associated with higher risk of all-cause mortality at 1 year (RR 1.12, p<0.01) and 5 years (RR 1.44, p=0.03). In intermediate surgical-risk, TAVI was associated with lower risk of all-cause mortality at 5 years (RR 1.21, p=0.05), but not at 30 days, 1 year, and 3 years. In high surgical-risk, TAVI was associated with higher risk of all-cause mortality at 3 years (RR 1.49, p=0.03). Meta-regression to time revealed increasing trend of all-cause mortality in all surgical risks combined (p<0.01) and in low surgical-risk patients (p<0.01) (Figure 1). Seven RCTs and 29 propensity-score-matched studies were included. In low surgical-risk, TAVI was associated with higher risk of all-cause mortality at 1 year (RR 1.12, p<0.01) and 5 years (RR 1.44, p=0.03). In intermediate surgical-risk, TAVI was associated with lower risk of all-cause mortality at 5 years (RR 1.21, p=0.05), but not at 30 days, 1 year, and 3 years. In high surgical-risk, TAVI was associated with higher risk of all-cause mortality at 3 years (RR 1.49, p=0.03). Meta-regression to time revealed increasing trend of all-cause mortality in all surgical risks combined (p<0.01) and in low surgical-risk patients (p<0.01) (Figure 1). Conclusions DisclosuresD. Y. Park Nothing to disclose. S. An Nothing to disclose. A. Vij Nothing to disclose. D. Y. Park Nothing to disclose. S. An Nothing to disclose. A. Vij Nothing to disclose.
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