Epidemiologia, Volume 6, Issue 2 (June 2025) – 4 articles

Background/Objectives: The aim of this study was to quantify and analyze the incidence and epidemiology of kidney infarctions between 2012 and 2022 in Germany. Methods: We analyzed and extracted data from the national database of federal health reporting. Incidence rates were calculated and stratified by gender and age. Statistical analysis involved linear regression to assess correlations between incidence, age, and reporting year, with significance determined using F-tests and Student’s t-tests. Results: From 2012 to 2022, 7983 cases of kidney infarction (4769 male, 3214 female) were identified. The mean incidence was 8.81 per million per year, higher in males (10.7) than females (6.99). Incidence peaked among individuals aged 50–59 years. A significant decrease in incidence over the study period was observed, particularly among males (−2.49 per million per year) compared to females (−0.87 per million per year). Linear regression showed a significant correlation between incidence and age (F(1,6) = 131, p < 0.001) and a significant overall incidence decrease over time (F(1,9) = 40.5, p < 0.001). Conclusions: This study provides the first nationwide epidemiological data on kidney infarction in a Western country. The downward trend, especially among males, may be due to the improved management of risk factors like atherosclerosis and atrial fibrillation, e.g., through an increase in the prescription of direct anticoagulatory agents. Despite the decrease, kidney infarction remain a significant cause of acute kidney injury. Further research is needed to understand these trends and improve preventive strategies. Full article

Background/Objectives: Sparse data exist identifying racial/ethnic outcome disparities among patients with lung cancer, specifically regarding healthcare utilization patterns, such as emergency department visits and outpatient follow-ups. We aimed to utilize our large, multicenter, and ethnically diverse integrated health system to assess for such disparities among patients undergoing pulmonary resections for lung cancer. Methods: The cohort comprised all patients undergoing pulmonary resections for lung cancer at our integrated health system from 1 January 2016 to 31 December 2020. Outcomes including the length of stay (LOS), 30-day return to the emergency department (30d-ED), 30-day readmission, 30- and 90-day outpatient appointments, and 30- and 90-day overall mortality were compared by race/ethnicity. Multivariable logistic and linear models adjusted for age, sex, body mass index (BMI), Charlson Comorbidity Index scores, procedure approach, neighborhood deprivation index (NDI), cancer stage, receipt of adjuvant chemotherapy, and insurance. Results: Of the 645 included patients, non-Hispanic White patients tended to be older and live in the least deprived neighborhoods. Among each race/ethnicity, the percentage of patients insured by Medicaid was highest among Asian patients. On bivariate analysis, only the outcome of surgical outpatient appointments within 30 days had differing distributions by race/ethnicity with no other significant associations between race/ethnicity and other outcomes; however, multivariable analysis showed Asian patients having lower odds of 30d-ED (adjusted odds ratio 0.51; 95% CI 0.27–0.98) while those with Medicaid insurance had higher odds of 30d-ED (adjusted odds ratio 3.29; 95% CI 1.26–8.59). Conclusions: Despite parity across clinical outcomes, some patient encounter-related differences still exist within our system. To better understand racial/ethnic disparities in care, systems must track such disparities in addition to clinical outcomes. Full article

Objectives: This study aimed to evaluate the prognostic impact of coinfections and other clinical factors on mortality in melioidosis patients, providing a comprehensive analysis through systematic review and meta-analysis. Methods: A systematic search was conducted in PubMed, Embase, Scopus, and other sources for studies published from their inception to August 2023. Studies reporting mortality outcomes in melioidosis patients with and without coinfections were included. Mixed-effects logistic regression models were used to estimate the causal association of each prognostic factor on the outcome. Directed acyclic graphs (DAGs) were used to guide confounding adjustment, and missing data were handled using multiple imputations. Results: A total of 346 studies involving 509 patients were analyzed. Coinfections were observed in 10.8% of patients with tuberculosis and Leptospira spp. being the most common. Disseminated disease significantly increased the odds of death (OR 4.93, 95% CI: 2.14–11.37, p < 0.001). Coinfections were associated with a higher mortality rate, but the association was not statistically significant (OR 2.70, 95% CI: 0.53–13.90, p = 0.172). Sensitivity analyses confirmed the robustness of the findings. Other factors, including diabetes mellitus and agricultural occupation, were evaluated for their associations with mortality. Conclusions: Disseminated melioidosis remains a significant factor influencing prognosis. Although less common, coinfections may contribute to worsen patient outcomes, emphasizing the importance of immediate and accurate diagnosis and comprehensive management. Full article

Background: Respiratory syncytial virus (RSV) is a common respiratory virus that can cause serious illness in infants and the elderly. Vaccines for RSV have recently been introduced and have been shown to reduce the severity of the disease. However, there has been limited examination of how viral dynamics differ between vaccinated and unvaccinated individuals. Methods: Here, we use data from the MVA-BN-RSV Phase II vaccine study to quantify the dynamical differences between vaccinated and unvaccinated patients challenged with RSV. We use an ordinary differential equation model of within host viral dynamics to fit viral load data. Results: We find statistically significant differences in viral clearance rate and basic reproduction number. We also find that vaccinated patients experience a higher response variance than the placebo group. Conclusions: While the differences in viral clearance and basic reproduction number are promising, the high variability in response to the vaccine could leave many vaccinated patients without adequate protection. Full article