Objectives: Hip fracture is a global public concern exhibiting high mortality rates but often underrecognized. We compared the mortality rates, risk, and secular trend of hip fractures with common cancers in females and males, aiming to call attention to hip fractures. Methods: In 2010–2020, 193,767 patients with the first diagnosed hip fractures and the top 5 prevalent cancers in each sex and aged 50 years and above were included. Age-standardized mortality rates were adjusted to the WHO Standard Population and the sex-specific relative risk of mortality was computed using Cox proportional hazards models, adjusted for potential confounders. The trend analyses used joinpoint regression to compute annual percent changes in age-standardized mortality rates. Results The 1-year and 5-year age-standardized mortality rates and sex-specific mortality risk of hip fracture are greater than those of breast cancer (hazard ratio [HR]: 0.93, 95% confidence interval [CI]: 0.90 to 0.97) and thyroid cancer (HR: 0.55, 95% CI: 0.47 to 0.64) in females and prostate cancer (HR: 0.56, 95% CI: 0.53 to 0.58) in males. Moreover, mortality rates in lung cancer, male liver cancer, female breast cancer, and male prostate cancer have decreased in the past decade. For hip fracture, the mortality rates have significantly decreased in females, while in males, we observed only a decreasing trend in 1-year hip fracture mortality, not in 5-year Conclusions: Hip fractures exhibit higher mortality compared to female breast and thyroid cancers and male prostate cancer. More attention is needed to enhance the management and prevention of hip fractures.

Objectives: Hip fracture is a global public concern exhibiting high mortality rates but often underrecognized. We compared the mortality rates, risk, and secular trend of hip fractures with common cancers in females and males, aiming to call attention to hip fractures. Methods: In 2010–2020, 193,767 patients with the first diagnosed hip fractures and the top 5 prevalent cancers in each sex and aged 50 years and above were included. Age-standardized mortality rates were adjusted to the WHO Standard Population and the sex-specific relative risk of mortality was computed using Cox proportional hazards models, adjusted for potential confounders. The trend analyses used joinpoint regression to compute annual percent changes in age-standardized mortality rates. Results The 1-year and 5-year age-standardized mortality rates and sex-specific mortality risk of hip fracture are greater than those of breast cancer (hazard ratio [HR]: 0.93, 95% confidence interval [CI]: 0.90 to 0.97) and thyroid cancer (HR: 0.55, 95% CI: 0.47 to 0.64) in females and prostate cancer (HR: 0.56, 95% CI: 0.53 to 0.58) in males. Moreover, mortality rates in lung cancer, male liver cancer, female breast cancer, and male prostate cancer have decreased in the past decade. For hip fracture, the mortality rates have significantly decreased in females, while in males, we observed only a decreasing trend in 1-year hip fracture mortality, not in 5-year Conclusions: Hip fractures exhibit higher mortality compared to female breast and thyroid cancers and male prostate cancer. More attention is needed to enhance the management and prevention of hip fractures.

Objectives: Hip fracture is a global public concern exhibiting high mortality rates but often underrecognized. We compared the mortality rates, risk, and secular trend of hip fractures with common cancers in females and males, aiming to call attention to hip fractures. Methods: In 2010–2020, 193,767 patients with the first diagnosed hip fractures and the top 5 prevalent cancers in each sex and aged 50 years and above were included. Age-standardized mortality rates were adjusted to the WHO Standard Population and the sex-specific relative risk of mortality was computed using Cox proportional hazards models, adjusted for potential confounders. The trend analyses used joinpoint regression to compute annual percent changes in age-standardized mortality rates. Results The 1-year and 5-year age-standardized mortality rates and sex-specific mortality risk of hip fracture are greater than those of breast cancer (hazard ratio [HR]: 0.93, 95% confidence interval [CI]: 0.90 to 0.97) and thyroid cancer (HR: 0.55, 95% CI: 0.47 to 0.64) in females and prostate cancer (HR: 0.56, 95% CI: 0.53 to 0.58) in males. Moreover, mortality rates in lung cancer, male liver cancer, female breast cancer, and male prostate cancer have decreased in the past decade. For hip fracture, the mortality rates have significantly decreased in females, while in males, we observed only a decreasing trend in 1-year hip fracture mortality, not in 5-year Conclusions: Hip fractures exhibit higher mortality compared to female breast and thyroid cancers and male prostate cancer. More attention is needed to enhance the management and prevention of hip fractures.

Objectives: Hip fracture is a global public concern exhibiting high mortality rates but often underrecognized. We compared the mortality rates, risk, and secular trend of hip fractures with common cancers in females and males, aiming to call attention to hip fractures. Methods: In 2010–2020, 193,767 patients with the first diagnosed hip fractures and the top 5 prevalent cancers in each sex and aged 50 years and above were included. Age-standardized mortality rates were adjusted to the WHO Standard Population and the sex-specific relative risk of mortality was computed using Cox proportional hazards models, adjusted for potential confounders. The trend analyses used joinpoint regression to compute annual percent changes in age-standardized mortality rates. Results The 1-year and 5-year age-standardized mortality rates and sex-specific mortality risk of hip fracture are greater than those of breast cancer (hazard ratio [HR]: 0.93, 95% confidence interval [CI]: 0.90 to 0.97) and thyroid cancer (HR: 0.55, 95% CI: 0.47 to 0.64) in females and prostate cancer (HR: 0.56, 95% CI: 0.53 to 0.58) in males. Moreover, mortality rates in lung cancer, male liver cancer, female breast cancer, and male prostate cancer have decreased in the past decade. For hip fracture, the mortality rates have significantly decreased in females, while in males, we observed only a decreasing trend in 1-year hip fracture mortality, not in 5-year Conclusions: Hip fractures exhibit higher mortality compared to female breast and thyroid cancers and male prostate cancer. More attention is needed to enhance the management and prevention of hip fractures.

Objectives: Hip fracture is a global public concern exhibiting high mortality rates but often underrecognized. We compared the mortality rates, risk, and secular trend of hip fractures with common cancers in females and males, aiming to call attention to hip fractures. Methods: In 2010–2020, 193,767 patients with the first diagnosed hip fractures and the top 5 prevalent cancers in each sex and aged 50 years and above were included. Age-standardized mortality rates were adjusted to the WHO Standard Population and the sex-specific relative risk of mortality was computed using Cox proportional hazards models, adjusted for potential confounders. The trend analyses used joinpoint regression to compute annual percent changes in age-standardized mortality rates. Results The 1-year and 5-year age-standardized mortality rates and sex-specific mortality risk of hip fracture are greater than those of breast cancer (hazard ratio [HR]: 0.93, 95% confidence interval [CI]: 0.90 to 0.97) and thyroid cancer (HR: 0.55, 95% CI: 0.47 to 0.64) in females and prostate cancer (HR: 0.56, 95% CI: 0.53 to 0.58) in males. Moreover, mortality rates in lung cancer, male liver cancer, female breast cancer, and male prostate cancer have decreased in the past decade. For hip fracture, the mortality rates have significantly decreased in females, while in males, we observed only a decreasing trend in 1-year hip fracture mortality, not in 5-year Conclusions: Hip fractures exhibit higher mortality compared to female breast and thyroid cancers and male prostate cancer. More attention is needed to enhance the management and prevention of hip fractures.

Using prostate-specific antigen (PSA) for prostate cancer (PCa) screening led to overinvestigation and overdiagnosis of indolent PCa. We aimed to investigate the value of prostate health index (PHI) and magnetic resonance imaging (MRI) prostate in an Asian PCa screening program. Men aged 50-75 years were prospectively recruited from a community-based PSA screening program. Men with PSA 4.0-10.0 ng ml -1 had PHI result analyzed. MRI prostate was offered to men with PSA 4.0-50.0 ng ml -1 . A systematic prostate biopsy was offered to men with PSA 4.0-9.9 ng ml -1 and PHI ≥35, or PSA 10.0-50.0 ng ml -1 . Additional targeted prostate biopsy was offered if they had PI-RADS score ≥3. Clinically significant PCa (csPCa) was defined as the International Society of Urological Pathology (ISUP) grade group (GG) ≥2 or ISUP GG 1 with involvement of ≥30% of total systematic cores. In total, 12.8% (196/1536) men had PSA ≥4.0 ng ml -1 . Among 194 men with PSA 4.0-50.0 ng ml -1 , 187 (96.4%) received MRI prostate. Among them, 28.3% (53/187) had PI-RADS ≥3 lesions. Moreover, 7.0% (107/1536) men were indicated for biopsy and 94.4% (101/107) men received biopsy. Among the men received biopsy, PCa, ISUP GG ≥2 PCa, and csPCa was diagnosed in 42 (41.6%), 24 (23.8%), and 34 (33.7%) men, respectively. Compared with PSA/PHI pathway in men with PSA 4.0-50.0 ng ml -1 , additional MRI increased diagnoses of PCa, ISUP GG ≥2 PCa, and csPCa by 21.2% (from 33 to 40), 22.2% (from 18 to 22), and 18.5% (from 27 to 32), respectively. The benefit of additional MRI was only observed in PSA 4.0-10.0 ng ml -1 , and the number of MRI needed to diagnose one additional ISUP GG ≥2 PCa was 20 in PHI ≥35 and 94 in PHI <35. Among them, 45.4% (89/196) men with PSA ≥4.0 ng ml -1 avoided unnecessary biopsy with the use of PHI and MRI. A screening algorithm with PSA, PHI, and MRI could effectively diagnose csPCa while reducing unnecessary biopsies. The benefit of MRI prostate was mainly observed in PSA 4.0-9.9 ng ml -1 and PHI ≥35 group. PHI was an important risk stratification step for PCa screening.
Humans ; Male ; Early Detection of Cancer/methods* ; East Asian People ; Image-Guided Biopsy/methods* ; Magnetic Resonance Imaging/methods* ; Prostate/pathology* ; Prostate-Specific Antigen ; Prostatic Neoplasms/pathology* ; Retrospective Studies ; Middle Aged ; Aged

INTRODUCTIONTreatment of acute lymphoblastic leukaemia (ALL) using intensive chemotherapy has resulted in high cure rates but also substantial morbidity. Infective complications represent a significant proportion of treatment-related toxicity. The objective of this study was to describe the microbiological aetiology and clinical outcome of episodes of chemotherapy-induced febrile neutropaenia in a cohort of children treated for ALL at our institution.

MATERIALS AND METHODSPatients with ALL were treated with either the HKSGALL93 or the Malaysia-Singapore (Ma-Spore) 2003 chemotherapy protocols. The records of 197 patients who completed the intensive phase of treatment, defined as the period of treatment from induction, central nervous system (CNS)-directed therapy to reinduction from June 2000 to January 2010 were retrospectively reviewed.

RESULTSThere were a total of 587 episodes of febrile neutropaenia in 197 patients, translating to an overall rate of 2.98 episodes per patient. A causative pathogen was isolated in 22.7% of episodes. An equal proportion of Gram-positive bacteria (36.4%) and Gram-negative bacteria (36.4%) were most frequently isolated followed by viral pathogens (17.4%), fungal pathogens (8.4%) and other bacteria (1.2%). Fungal organisms accounted for a higher proportion of clinically severe episodes of febrile neutropaenia requiring admission to the high-dependency or intensive care unit (23.1%). The overall mortality rate from all episodes was 1.5%.

CONCLUSIONFebrile neutropaenia continues to be of concern in ALL patients undergoing intensive chemotherapy. The majority of episodes will not have an identifiable causative organism. Gram-positive bacteria and Gram-negative bacteria were the most common causative pathogens identified. With appropriate antimicrobial therapy and supportive management, the overall risk of mortality from febrile neutropaenia is extremely low.

Candidiasis ; epidemiology ; Chemotherapy-Induced Febrile Neutropenia ; epidemiology ; microbiology ; Child ; Cohort Studies ; Escherichia coli Infections ; epidemiology ; Gram-Negative Bacterial Infections ; epidemiology ; Gram-Positive Bacterial Infections ; epidemiology ; Humans ; Influenza, Human ; epidemiology ; Klebsiella Infections ; epidemiology ; Mycoses ; epidemiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Pseudomonas Infections ; epidemiology ; Retrospective Studies ; Singapore ; epidemiology ; Staphylococcal Infections ; epidemiology ; Virus Diseases ; epidemiology

Adolescent ; Adult ; Drug and Narcotic Control ; trends ; Humans ; Male ; Paranoid Disorders ; etiology ; Plant Poisoning ; prevention & control ; psychology ; Product Packaging ; legislation & jurisprudence ; trends ; Psychotropic Drugs ; pharmacology ; Salvia ; adverse effects ; chemistry ; Street Drugs ; adverse effects ; legislation & jurisprudence