Purpose: The use of direct oral anticoagulants (DOACs) is challenging in fragile patients, including those with cancer, chronic kidney disease (CKD), and old age. We aimed to compare the safety of DOACs in terms of bleeding complications in these patients. Methods: Using hospital data from 2013 to 2019, we compared the risk of bleeding and major bleeding, including intracranial bleeding, any bleeding requiring transfusion, and all-cause bleeding, in patients with venous thromboembolism (VTE) who were naïve to DOAC (n = 12,369) and warfarin (n = 4,123). Hazard ratios (HRs) for the clinical outcomes were analyzed using Cox regression analysis, with warfarin as a reference. Results: The study included 4,078 eligible patients, predominantly female (54.1%), with a mean age of 62.5 years. DOACs were the primary treatment in 74.1% of the patients. DOAC treatment was associated with lower all-cause mortality compared to warfarin (HR, 0.799; 95% confidence interval [CI], 0.707–0.904). Although rates of recurrent VTE or major bleeding did not significantly differ between the groups, DOAC-treated patients had lower bleeding risk (HR, 0.562; 95% CI, 0.393–0.805; P = 0.002). The individual DOAC drugs did not differ significantly in terms of composite outcomes, recurrence, or bleeding events. Conclusion DOAC showed comparable outcomes with warfarin in the fragile patient population.

Purpose: The use of direct oral anticoagulants (DOACs) is challenging in fragile patients, including those with cancer, chronic kidney disease (CKD), and old age. We aimed to compare the safety of DOACs in terms of bleeding complications in these patients. Methods: Using hospital data from 2013 to 2019, we compared the risk of bleeding and major bleeding, including intracranial bleeding, any bleeding requiring transfusion, and all-cause bleeding, in patients with venous thromboembolism (VTE) who were naïve to DOAC (n = 12,369) and warfarin (n = 4,123). Hazard ratios (HRs) for the clinical outcomes were analyzed using Cox regression analysis, with warfarin as a reference. Results: The study included 4,078 eligible patients, predominantly female (54.1%), with a mean age of 62.5 years. DOACs were the primary treatment in 74.1% of the patients. DOAC treatment was associated with lower all-cause mortality compared to warfarin (HR, 0.799; 95% confidence interval [CI], 0.707–0.904). Although rates of recurrent VTE or major bleeding did not significantly differ between the groups, DOAC-treated patients had lower bleeding risk (HR, 0.562; 95% CI, 0.393–0.805; P = 0.002). The individual DOAC drugs did not differ significantly in terms of composite outcomes, recurrence, or bleeding events. Conclusion DOAC showed comparable outcomes with warfarin in the fragile patient population.

As many countries implement different programs aimed at eliminating malaria, attention should be given to asymptomatic carriers that may interrupt the progress. This was a community-based cross-sectional study conducted in Tanzania from December 2022 to July 2023 within 4 villages from each of the 3 regions, Geita and Kigoma, which are high malaria transmission, and Arusha, which is low transmission. Malaria was diagnosed in asymptomatic individuals aged 1 year and older using the malaria rapid diagnostic test and light microscope. A total of 2,365 of 3,489 (67.9%) participants were enrolled from high-transmission villages. The overall prevalence was 25.5% and 15.8% by malaria rapid diagnostic test and light microscope, respectively. Using the respective tools, the prevalence was significantly higher at 35.6% (confidence interval (CI)=23.6–49.9) and 23.1% (CI=16.2–35.1) in the high-transmission regions (Geita and Kigoma) compared with 2.9% (CI=1.1–3.5) and 1.1% (CI=0.7–1.8) in the low-transmission region (Arusha). Children younger than 15 years and males accounted for the greatest proportion of infections. In the study area, the prevalence of asymptomatic cases was higher than that of reported symptomatic cases in health facilities. We hypothesize that these parasite reservoirs may contribute to the persistence of malaria in the country. Therefore, to achieve comprehensive malaria control in the country, the surveillance and screening of asymptomatic malaria cases are vital.

As many countries implement different programs aimed at eliminating malaria, attention should be given to asymptomatic carriers that may interrupt the progress. This was a community-based cross-sectional study conducted in Tanzania from December 2022 to July 2023 within 4 villages from each of the 3 regions, Geita and Kigoma, which are high malaria transmission, and Arusha, which is low transmission. Malaria was diagnosed in asymptomatic individuals aged 1 year and older using the malaria rapid diagnostic test and light microscope. A total of 2,365 of 3,489 (67.9%) participants were enrolled from high-transmission villages. The overall prevalence was 25.5% and 15.8% by malaria rapid diagnostic test and light microscope, respectively. Using the respective tools, the prevalence was significantly higher at 35.6% (confidence interval (CI)=23.6–49.9) and 23.1% (CI=16.2–35.1) in the high-transmission regions (Geita and Kigoma) compared with 2.9% (CI=1.1–3.5) and 1.1% (CI=0.7–1.8) in the low-transmission region (Arusha). Children younger than 15 years and males accounted for the greatest proportion of infections. In the study area, the prevalence of asymptomatic cases was higher than that of reported symptomatic cases in health facilities. We hypothesize that these parasite reservoirs may contribute to the persistence of malaria in the country. Therefore, to achieve comprehensive malaria control in the country, the surveillance and screening of asymptomatic malaria cases are vital.

As many countries implement different programs aimed at eliminating malaria, attention should be given to asymptomatic carriers that may interrupt the progress. This was a community-based cross-sectional study conducted in Tanzania from December 2022 to July 2023 within 4 villages from each of the 3 regions, Geita and Kigoma, which are high malaria transmission, and Arusha, which is low transmission. Malaria was diagnosed in asymptomatic individuals aged 1 year and older using the malaria rapid diagnostic test and light microscope. A total of 2,365 of 3,489 (67.9%) participants were enrolled from high-transmission villages. The overall prevalence was 25.5% and 15.8% by malaria rapid diagnostic test and light microscope, respectively. Using the respective tools, the prevalence was significantly higher at 35.6% (confidence interval (CI)=23.6–49.9) and 23.1% (CI=16.2–35.1) in the high-transmission regions (Geita and Kigoma) compared with 2.9% (CI=1.1–3.5) and 1.1% (CI=0.7–1.8) in the low-transmission region (Arusha). Children younger than 15 years and males accounted for the greatest proportion of infections. In the study area, the prevalence of asymptomatic cases was higher than that of reported symptomatic cases in health facilities. We hypothesize that these parasite reservoirs may contribute to the persistence of malaria in the country. Therefore, to achieve comprehensive malaria control in the country, the surveillance and screening of asymptomatic malaria cases are vital.

As many countries implement different programs aimed at eliminating malaria, attention should be given to asymptomatic carriers that may interrupt the progress. This was a community-based cross-sectional study conducted in Tanzania from December 2022 to July 2023 within 4 villages from each of the 3 regions, Geita and Kigoma, which are high malaria transmission, and Arusha, which is low transmission. Malaria was diagnosed in asymptomatic individuals aged 1 year and older using the malaria rapid diagnostic test and light microscope. A total of 2,365 of 3,489 (67.9%) participants were enrolled from high-transmission villages. The overall prevalence was 25.5% and 15.8% by malaria rapid diagnostic test and light microscope, respectively. Using the respective tools, the prevalence was significantly higher at 35.6% (confidence interval (CI)=23.6–49.9) and 23.1% (CI=16.2–35.1) in the high-transmission regions (Geita and Kigoma) compared with 2.9% (CI=1.1–3.5) and 1.1% (CI=0.7–1.8) in the low-transmission region (Arusha). Children younger than 15 years and males accounted for the greatest proportion of infections. In the study area, the prevalence of asymptomatic cases was higher than that of reported symptomatic cases in health facilities. We hypothesize that these parasite reservoirs may contribute to the persistence of malaria in the country. Therefore, to achieve comprehensive malaria control in the country, the surveillance and screening of asymptomatic malaria cases are vital.

Purpose: The use of direct oral anticoagulants (DOACs) is challenging in fragile patients, including those with cancer, chronic kidney disease (CKD), and old age. We aimed to compare the safety of DOACs in terms of bleeding complications in these patients. Methods: Using hospital data from 2013 to 2019, we compared the risk of bleeding and major bleeding, including intracranial bleeding, any bleeding requiring transfusion, and all-cause bleeding, in patients with venous thromboembolism (VTE) who were naïve to DOAC (n = 12,369) and warfarin (n = 4,123). Hazard ratios (HRs) for the clinical outcomes were analyzed using Cox regression analysis, with warfarin as a reference. Results: The study included 4,078 eligible patients, predominantly female (54.1%), with a mean age of 62.5 years. DOACs were the primary treatment in 74.1% of the patients. DOAC treatment was associated with lower all-cause mortality compared to warfarin (HR, 0.799; 95% confidence interval [CI], 0.707–0.904). Although rates of recurrent VTE or major bleeding did not significantly differ between the groups, DOAC-treated patients had lower bleeding risk (HR, 0.562; 95% CI, 0.393–0.805; P = 0.002). The individual DOAC drugs did not differ significantly in terms of composite outcomes, recurrence, or bleeding events. Conclusion DOAC showed comparable outcomes with warfarin in the fragile patient population.

As many countries implement different programs aimed at eliminating malaria, attention should be given to asymptomatic carriers that may interrupt the progress. This was a community-based cross-sectional study conducted in Tanzania from December 2022 to July 2023 within 4 villages from each of the 3 regions, Geita and Kigoma, which are high malaria transmission, and Arusha, which is low transmission. Malaria was diagnosed in asymptomatic individuals aged 1 year and older using the malaria rapid diagnostic test and light microscope. A total of 2,365 of 3,489 (67.9%) participants were enrolled from high-transmission villages. The overall prevalence was 25.5% and 15.8% by malaria rapid diagnostic test and light microscope, respectively. Using the respective tools, the prevalence was significantly higher at 35.6% (confidence interval (CI)=23.6–49.9) and 23.1% (CI=16.2–35.1) in the high-transmission regions (Geita and Kigoma) compared with 2.9% (CI=1.1–3.5) and 1.1% (CI=0.7–1.8) in the low-transmission region (Arusha). Children younger than 15 years and males accounted for the greatest proportion of infections. In the study area, the prevalence of asymptomatic cases was higher than that of reported symptomatic cases in health facilities. We hypothesize that these parasite reservoirs may contribute to the persistence of malaria in the country. Therefore, to achieve comprehensive malaria control in the country, the surveillance and screening of asymptomatic malaria cases are vital.

Venous thromboembolism (VTE), a severe condition comprising deep vein thrombosis and pulmonary embolism, requires prompt treatment. Traditional therapies include heparin, low-molecular-weight heparin, and warfarin. Direct oral anticoagulants (DOACs) such as dabigatran, rivaroxaban, apixaban, and edoxaban has revolutionized VTE management. Clinical trials show that DOACs are as effective as traditional anticoagulants in preventing recurrent VTE, with similar or lower rates of major bleeding. However, DOAC use is complex in vulnerable populations—those with comorbidities, chronic kidney disease, cancer, and advanced age—due to higher VTE and bleeding risks from polypharmacy and altered pharmacokinetics. Trials have shown promising results for DOACs, but these studies often include few patients from these high-risk groups. Moreover, while DOACs are validated for atrial fibrillation, these findings may not apply directly to patients with VTE due to different dosing. In this study, we aimed to address this gap by reviewing the literature on the efficacy and safety of DOACs in these vulnerable populations.

Clonorchis sinensis, which causes clonorchiasis, is prevalent in East Asian countries and poses notable health risks, including bile duct complications. Although praziquantel is the primary treatment for the disease, the emerging resistance among trematodes highlights the need for alternative strategies. Understanding the nutrient uptake mechanisms in trematodes, including C. sinensis, is crucial for developing future effective treatments. This study aimed to characterize the function of C. sinensis glucose transporter 4 (CsGTP4) and determine its role in nutrient uptake employing synthesized cDNA of adult C. sinensis worms. The functional characterization of CsGTP4 involved injecting its cRNA into Xenopus laevis oocytes and analyzing the deoxy-D-glucose uptake levels. The results demonstrated that deoxy-D-glucose uptake depended on the deoxy-D-glucose incubation and CsGTP4 expression time, but not sodium-dependent. The concentration-dependent uptake followed the Michaelis–Menten equation, with a Km value of 2.7 mM and a Vmax value of 476 pmol/oocyte/h based on the Lineweaver–Burk analysis. No uptake of radiolabeled α-ketoglutarate, p-aminohippurate, taurocholate, arginine, or carnitine was observed. The uptake of deoxy-D-glucose by CsGTP4 was significantly inhibited by unlabeled glucose and galactose in a concentration-dependent manner. It was significantly inhibited under strongly acidic and basic conditions. These insights into the glucose uptake kinetics and pH dependency of CsGTP4 provide a deeper understanding of nutrient acquisition in trematodes. This study contributes to the development of novel antiparasitic agents, addressing a considerable socioeconomic challenge in affected regions.