Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

doi:10.1016/S0140-6736(17)32154-2

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Journal Article•DOI•

NAFLD and cardiovascular diseases: a clinical review.

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Philipp Kasper¹, Anna Martin¹, Sonja Lang², Fabian Kütting¹, Tobias Goeser¹, Münevver Demir³, Hans-Michael Steffen¹ - Show less +3 more•Institutions (3)

University of Cologne¹, University of California, Los Angeles², Charité³

01 Jul 2021-Clinical Research in Cardiology

TL;DR: The underlying pathophysiological mechanisms linking NAFLD and CVD are described, the role ofNAFLD as a metabolic dysfunction associated cardiovascular risk factor is discussed, and common cardiovascular manifestations in NAFLd patients are focused on.

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Abstract: Non-alcoholic fatty liver DISEASE (NAFLD) is the most common chronic liver disease in Western countries and affects approximately 25% of the adult population. Since NAFLD is frequently associated with further metabolic comorbidities such as obesity, type 2 diabetes mellitus, or dyslipidemia, it is generally considered as the hepatic manifestation of the metabolic syndrome. In addition to its potential to cause liver-related morbidity and mortality, NAFLD is also associated with subclinical and clinical cardiovascular disease (CVD). Growing evidence indicates that patients with NAFLD are at substantial risk for the development of hypertension, coronary heart disease, cardiomyopathy, and cardiac arrhythmias, which clinically result in increased cardiovascular morbidity and mortality. The natural history of NAFLD is variable and the vast majority of patients will not progress from simple steatosis to fibrosis and end stage liver disease. However, patients with progressive forms of NAFLD, including non-alcoholic steatohepatitis (NASH) and/or advanced fibrosis, as well as NAFLD patients with concomitant types 2 diabetes are at highest risk for CVD. This review describes the underlying pathophysiological mechanisms linking NAFLD and CVD, discusses the role of NAFLD as a metabolic dysfunction associated cardiovascular risk factor, and focuses on common cardiovascular manifestations in NAFLD patients.

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216 citations

Journal Article•DOI•

Socioeconomic status and stroke incidence, prevalence, mortality, and worldwide burden: an ecological analysis from the Global Burden of Disease Study 2017

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Abolfazl Avan¹, Hadi Digaleh², Mario Di Napoli, Saverio Stranges³, Réza Behrouz⁴, Golnaz Shojaeianbabaei¹, Amin Amiri¹, Reza Tabrizi⁵, Naghmeh Mokhber¹, Naghmeh Mokhber³, J. David Spence³, J. David Spence⁶, Mahmoud Reza Azarpazhooh - Show less +9 more•Institutions (6)

Mashhad University of Medical Sciences¹, Shahid Beheshti University of Medical Sciences and Health Services², University of Western Ontario³, University of Texas Health Science Center at San Antonio⁴, Shiraz University of Medical Sciences⁵, Robarts Research Institute⁶

24 Oct 2019-BMC Medicine

TL;DR: Almost half of stroke-related deaths are attributable to poor management of modifiable risk factors, and thus potentially preventable; thus, screening of people from low SES at higher stroke risk is crucial.

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Abstract: Socioeconomic status (SES) is associated with stroke incidence and mortality. Distribution of stroke risk factors is changing worldwide; evidence on these trends is crucial to the allocation of resources for prevention strategies to tackle major modifiable risk factors with the highest impact on stroke burden. We extracted data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. We analysed trends in global and SES-specific age-standardised stroke incidence, prevalence, mortality, and disability-adjusted life years (DALYs) lost from 1990 to 2017. We also estimated the age-standardised attributable risk of stroke mortality associated with common risk factors in low-, low-middle-, upper-middle-, and high-income countries. Further, we explored the effect of age and sex on associations of risk factors with stroke mortality from 1990 to 2017. Despite a growth in crude number of stroke events from 1990 to 2017, there has been an 11.3% decrease in age-standardised stroke incidence rate worldwide (150.5, 95% uncertainty interval [UI] 140.3–161.8 per 100,000 in 2017). This has been accompanied by an overall 3.1% increase in age-standardised stroke prevalence rate (1300.6, UI 1229.0–1374.7 per 100,000 in 2017) and a 33.4% decrease in age-standardised stroke mortality rate (80.5, UI 78.9–82.6 per 100,000 in 2017) over the same time period. The rising trends in age-standardised stroke prevalence have been observed only in middle-income countries, despite declining trends in age-standardised stroke incidence and mortality in all income categories since 2005. Further, there has been almost a 34% reduction in stroke death rate (67.8, UI 64.1–71.1 per 100,000 in 2017) attributable to modifiable risk factors, more prominently in wealthier countries. Almost half of stroke-related deaths are attributable to poor management of modifiable risk factors, and thus potentially preventable. We should appreciate societal barriers in lower-SES groups to design tailored preventive strategies. Despite improvements in general health knowledge, access to healthcare, and preventative strategies, SES is still strongly associated with modifiable risk factors and stroke burden; thus, screening of people from low SES at higher stroke risk is crucial.

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215 citations

Journal Article•DOI•

Community-acquired bacterial meningitis.

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Diederik van de Beek, Matthijs C. Brouwer, Rodrigo Hasbun, Uwe Koedel¹, Cynthia G. Whitney², Eelco F. M. Wijdicks³ - Show less +2 more•Institutions (3)

Ludwig Maximilian University of Munich¹, National Center for Immunization and Respiratory Diseases², Mayo Clinic³

03 Nov 2016

TL;DR: Despite advances in treatment and vaccinations, community-acquired bacterial meningitis remains one of the most important infectious diseases worldwide and the growing emergence of drug resistance as well as shifts in the distribution of serotypes and groups are fuelling further development of new vaccines and treatment strategies.

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Abstract: Meningitis is an inflammation of the meninges and subarachnoid space that can also involve the brain cortex and parenchyma. It can be acquired spontaneously in the community - community-acquired bacterial meningitis - or in the hospital as a complication of invasive procedures or head trauma (nosocomial bacterial meningitis). Despite advances in treatment and vaccinations, community-acquired bacterial meningitis remains one of the most important infectious diseases worldwide. Streptococcus pneumoniae and Neisseria meningitidis are the most common causative bacteria and are associated with high mortality and morbidity; vaccines targeting these organisms, which have designs similar to the successful vaccine that targets Haemophilus influenzae type b meningitis, are now being used in many routine vaccination programmes. Experimental and genetic association studies have increased our knowledge about the pathogenesis of bacterial meningitis. Early antibiotic treatment improves the outcome, but the growing emergence of drug resistance as well as shifts in the distribution of serotypes and groups are fuelling further development of new vaccines and treatment strategies. Corticosteroids were found to be beneficial in high-income countries depending on the bacterial species. Further improvements in the outcome are likely to come from dampening the host inflammatory response and implementing preventive measures, especially the development of new vaccines.

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215 citations

Journal Article•DOI•

The Lancet Commission on diabetes: using data to transform diabetes care and patient lives

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Juliana C.N. Chan, Lee Ling Lim¹, Nicholas J. Wareham², Jonathan E. Shaw³, Trevor J. Orchard⁴, Ping Zhang⁵, Eric S.H. Lau¹, Björn Eliasson⁶, Alice P.S. Kong¹, Majid Ezzati⁷, Carlos A. Aguilar-Salinas, Margaret McGill⁸, Naomi S. Levitt⁹, Guang Ning¹⁰, Wing-Yee So¹, Jean Adams², Paula A Bracco¹¹, Nita G. Forouhi², Gabriel Andrew Gregory¹², Jingchuan Guo⁴, Xinyang Hua¹³, Emma Louise Klatman, Dianna J. Magliano³, Boon-Peng Ng⁵, David Ogilvie², Jenna Panter², Meda E. Pavkov⁵, Hui Shao⁵, Nigel Unwin², Martin White², Constance Wou², Ronald C.W. Ma¹, Maria Inês Schmidt¹¹, Ambady Ramachandran, Yutaka Seino, Peter H. Bennett¹⁴, Brian Oldenburg¹⁵, Juan José Gagliardino¹⁶, Andrea O.Y. Luk¹, Philip Clarke¹³, Graham D. Ogle¹⁷, Melanie J. Davies¹⁸, Rury R. Holman¹³, Edward W. Gregg⁷, Edward W. Gregg⁵ - Show less +41 more•Institutions (18)

The Chinese University of Hong Kong¹, University of Cambridge², Baker IDI Heart and Diabetes Institute³, University of Pittsburgh⁴, Centers for Disease Control and Prevention⁵, Sahlgrenska University Hospital⁶, Imperial College London⁷, Royal Prince Alfred Hospital⁸, University of Cape Town⁹, Shanghai Jiao Tong University¹⁰, Universidade Federal do Rio Grande do Sul¹¹, University of Sydney¹², University of Oxford¹³, National Institutes of Health¹⁴, University of Melbourne¹⁵, National University of La Plata¹⁶, National Health and Medical Research Council¹⁷, University of Leicester¹⁸

19 Dec 2020-The Lancet

214 citations

Journal Article•DOI•

Opioid use disorder.

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John Strang¹, John Strang², Nora D. Volkow³, Louisa Degenhardt⁴, Matthew Hickman⁵, Kimberly Johnson⁶, George F. Koob⁷, Brandon D.L. Marshall⁸, Mark W. Tyndall⁹, Sharon L. Walsh¹⁰ - Show less +6 more•Institutions (10)

South London and Maudsley NHS Foundation Trust¹, King's College London², National Institute on Drug Abuse³, National Drug and Alcohol Research Centre⁴, University of Bristol⁵, University of South Florida⁶, National Institutes of Health⁷, Brown University⁸, University of British Columbia⁹, University of Kentucky¹⁰

09 Jan 2020

TL;DR: The risk factors of opioid use disorder, together with its epidemiology, mechanisms, diagnosis and treatment, are discussed, including community preventive strategies, harm reduction interventions to reduce adverse sequelae from ongoing use and mutual aid groups.

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Abstract: Opioid use disorder (OUD) is a chronic relapsing disorder that, whilst initially driven by activation of brain reward neurocircuits, increasingly engages anti-reward neurocircuits that drive adverse emotional states and relapse. However, successful recovery is possible with appropriate treatment, although with a persisting propensity to relapse. The individual and public health burdens of OUD are immense; 26.8 million people were estimated to be living with OUD globally in 2016, with >100,000 opioid overdose deaths annually, including >47,000 in the USA in 2017. Well-conducted trials have demonstrated that long-term opioid agonist therapy with methadone and buprenorphine have great efficacy for OUD treatment and can save lives. New forms of the opioid receptor antagonist naltrexone are also being studied. Some frequently used approaches have less scientifically robust evidence but are nevertheless considered important, including community preventive strategies, harm reduction interventions to reduce adverse sequelae from ongoing use and mutual aid groups. Other commonly used approaches, such as detoxification alone, lack scientific evidence. Delivery of effective prevention and treatment responses is often complicated by coexisting comorbidities and inadequate support, as well as by conflicting public and political opinions. Science has a crucial role to play in informing public attitudes and developing fuller evidence to understand OUD and its associated harms, as well as in obtaining the evidence today that will improve the prevention and treatment interventions of tomorrow. The ongoing epidemic of opioid use disorder includes, in addition to increasing global use of illicitly manufactured heroin and other opioids, a public health crisis aggravated by the over-prescribing of opioid pain medications, in North America particularly. This Primer by Strang, Volkow and colleagues discusses the risk factors of opioid use disorder, together with its epidemiology, mechanisms, diagnosis and treatment.

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213 citations