Objective: We aimed to compare cardiovascular (CV) events, all-cause mortality, and CV mortality rates among adults with and without diabetes in countries with differing levels of income.
Research Design And Methods: The Prospective Urban Rural Epidemiology (PURE) study enrolled 143,567 adults aged 35-70 years from 4 high-income countries (HIC), 12 middle-income countries (MIC), and 5 low-income countries (LIC). The mean follow-up was 9.0 ± 3.0 years.
Results: Among those with diabetes, CVD rates (LIC 10.3, MIC 9.2, HIC 8.3 per 1,000 person-years, < 0.001), all-cause mortality (LIC 13.8, MIC 7.2, HIC 4.2 per 1,000 person-years, < 0.001), and CV mortality (LIC 5.7, MIC 2.2, HIC 1.0 per 1,000 person-years, < 0.001) were considerably higher in LIC compared with MIC and HIC. Within LIC, mortality was higher in those in the lowest tertile of wealth index (low 14.7%, middle 10.8%, and high 6.5%). In contrast to HIC and MIC, the increased CV mortality in those with diabetes in LIC remained unchanged even after adjustment for behavioral risk factors and treatments (hazard ratio [95% CI] 1.89 [1.58-2.27] to 1.78 [1.36-2.34]).
Conclusions: CVD rates, all-cause mortality, and CV mortality were markedly higher among those with diabetes in LIC compared with MIC and HIC with mortality risk remaining unchanged even after adjustment for risk factors and treatments. There is an urgent need to improve access to care to those with diabetes in LIC to reduce the excess mortality rates, particularly among those in the poorer strata of society.
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http://dx.doi.org/10.2337/dc20-0886 | DOI Listing |
Gynecol Oncol Rep
December 2024
Gynecologic Oncology Division, CHU de Quebec, L'Hôtel-Dieu de Quebec, Laval University, Quebec City, Quebec, Canada.
Objective: We assessed the global distribution and academic, administrative and research outcomes of international fellows (IFs) trained in Canadian gynecologic oncology (GO) programs.
Methods: A web-based survey was sent to IFs who completed GO training in Canada. Using the Web of science database, we identified the publication list, citation record and H-index of IFs and classified them according to their region of practice: high-income countries (HIC), middle income countries (MIC), and low-income countries (LIC).
BMJ Paediatr Open
June 2024
Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Sind, Pakistan.
Background: Knowledge about multisystem inflammatory syndrome in children (MIS-C) is evolving, and evidence-based standardised diagnostic and management protocols are lacking. Our review aims to summarise the clinical and diagnostic features, management strategies and outcomes of MIS-C and evaluate the variances in disease parameters and outcomes between high-income countries (HIC) and middle-income countries (MIC).
Methods: We searched four databases from December 2019 to March 2023.
Reprod Biomed Online
August 2024
Department of Obstetrics and Gynecology, The Clinical and Translational Research Center, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Research Question: Do patterns of the menstrual cycle, menstrual pain and the use of medication for menstrual pain differ between young women from high-income countries (HIC) and middle-income countries (MIC)?
Design: A multinational, multicentre, cross-sectional study using pen-and-paper questionnaires was conducted between 2016 and 2021 to assess patterns of the menstrual cycle, menstrual pain and the use of medication for menstrual pain. Various parameters were evaluated to identify high-risk factors for severe menstrual pain in women from two HIC (n = 1550) and nine MIC (n = 7139).
Results: From a total of 9114 young women, 4920 medical students (HIC n = 696, MIC n = 4224) and 3769 nursing students (HIC n = 854, MIC n = 2915) were included in this study.
PLoS One
April 2024
Psychiatry Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
People with mental illness tend to present low levels of physical activity and high levels of sedentary behavior. The study aims to compare these levels in mental illness patients, exploring the role of socioeconomic development and treatment setting. This cross-sectional study used accelerometers and the Simple Physical Activity Questionnaire (SIMPAQ) to assess physical activity and sedentary behavior in mental illness individuals living in 23 countries.
View Article and Find Full Text PDFJ Clin Epidemiol
June 2024
Universidad de los Andes, Cra. 7 #116-5, Bogotá, Colombia.
Objective: Successful implementation of stroke rehabilitation guidelines demands high-quality practice standards tailored to targeted sociodemographic contexts. The primary objective is to determine the quality differences in post-stroke rehabilitation practice guidelines (PGs), when comparing high-income countries (HIC) and low or middle-income countries (LMIC).
Study Design And Setting: We conducted a scoping review of PGs in English or Spanish, published between 2012 and 2021, and providing recommendations on post-stroke rehabilitation.
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