Ibrahim Hassan

Vascular disorders of the intestine remain important contributors to gastrointestinal mortality in the United States. Despite advances in diagnostic imaging and endovascular therapy with improved outcomes, national trends in age-adjusted mortality rates (AAMR) and disparities across demographic and geographic groups have not been fully characterized. We obtained mortality data for vascular intestinal disorders from the CDC WONDER database (1999–2024) using ICD-10 code K55. Rates were age-adjusted to the 2000 US standard and per 100,000 person-years. Analyses stratified data by sex, race/ethnicity, US region, and urbanization. Joinpoint regression identified trend periods and estimated annual percent changes (APC); the overall trend was summarized by the average annual percent change (AAPC). From 1999 to 2024, there were 214,372 recorded deaths from vascular disorders of the intestine. The overall AAMR declined from 3.27 (95% confidence interval: 3.20–3.34) in 1999 to 1.82 (1.78–1.86) in 2024 (AAPC: −2.33%). Among women, rates fell from 3.53 to 1.97 (AAPC: −2.35%), and among men from 2.84 to 1.63 (AAPC: −2.21%). By race/ethnicity, Black or African American individuals experienced a decrease from 3.95 to 2.35 (AAPC: −2.16%), Hispanics from 2.60 to 1.58 (AAPC: −2.49%), and Whites from 3.25 to 1.88 (AAPC: −2.17%). Regionally, the Northeast saw the steepest decline from 3.05 to 1.79 (AAPC: −2.50), followed by the West from 3.19 to 1.69 (AAPC: −2.47%), the South from 3.40 to 1.88 (AAPC: −2.34%), and the Midwest from 3.37 to 1.97 (AAPC: −2.11%). Both urban and rural areas demonstrated a pronounced decline (3.26 to 1.70, AAPC: −3.16%, and 3.39 to 2.43, AAPC: −1.58%, respectively). Mortality due to vascular disorders of the intestine in the US has declined substantially from 1999 to 2024 across all major demographic and geographic subgroups. However, the pace of decline has varied; most notably, urban populations and the Northeast experienced the greatest reductions. Persistent disparities in mortality among ethnic groups and in various geographical settings highlight the need for targeted prevention strategies, timely diagnosis, and equitable access to advanced vascular interventions.

Aims: Obesity, particularly visceral adiposity, is a key driver of cardiovascular mortality (CVM), yet conventional measures such as body mass index (BMI) inadequately capture fat distribution. The Body Roundness Index (BRI) is a novel anthropometric measure integrating waist circumference and height to better reflect body shape and visceral fat. This study examined the association between BRI and CVM in U.S. adults and across sociodemographic subgroups. Methods and results: We analysed data from 31 351 adults (median age 43 yrs, 50% females) aged ≥20 years in NHANES 1999–2018, excluding those with prior cardiovascular disease or cancer. BRI was computed using a validated equation and categorized into quintiles (Q3 as reference). The primary outcome was CVM; secondary outcomes included all-cause, heart disease, and cerebrovascular mortality. Weighted Cox proportional hazards and restricted cubic spline (RCS) models evaluated associations after adjustment for demographic, behavioural, and clinical factors. Subgroup and sensitivity analyses tested consistency and effect modification. During a median follow-up of 10.1 years (IQR: 5.3–14.9 years), 883 cardiovascular deaths occurred. In fully adjusted models, participants in the highest BRI quintile had a 54% higher risk of CVM (HR, 1.54; 95% CI, 1.13–2.08; P = 0.006) vs. Q3. This risk remained high even among those with normal BMI. RCS analysis indicated a modest U-shaped association. Stronger effects were observed among middle-aged adults (45–64 years) and those with higher educational attainment. Conclusion: Higher BRI is independently associated with increased cardiovascular mortality, particularly among middle aged adults and those with normal BMI, underscoring its potential as a practical, noninvasive tool for cardiovascular risk stratification. Incorporating BRI into clinical and public health assessment may improve identification of individuals at elevated risk.

Introduction: Clinical pharmacists specializing in infectious diseases support physicians and nurses in medication-related decisions. Evaluating healthcare providers’ satisfaction with these services is essential for assessing interdisciplinary collaboration. Aim: To assess the level of satisfaction among physicians and nurses with clinical pharmacist services at a tertiary infectious disease hospital in Kuwait. Method: A cross-sectional survey was conducted from October 2023 to September 2024 at the Infectious Disease Hospital (IDH). Physicians and nurses from four inpatient wards completed validated questionnaires assessing satisfaction with clinical pharmacist interactions. Data was gathered through self-administered questionnaires specific to each physician or nurse. Results: Twenty-two physicians and thirty-eight nurses completed surveys, with most expressing high satisfaction with clinical pharmacist collaboration. About 86% of physicians felt pharmacists improved overall care, though 41% were unsure about their involvement in discharge decisions, and 27% were unsure about medication routes. Over 90% of nurses agreed pharmacists enhanced care and provided valuable medication information, though around 11% were uncertain about specific training roles. Conclusion: Most participants expressed high satisfaction with the involvement of clinical pharmacists at the infectious diseases hospital in Kuwait, indicating strong interprofessional relationships. Although direct clinical outcomes were not assessed, the high satisfaction suggests effective collaboration that could enhance patient care. Further research with larger populations and varied settings is needed to understand perceptions among nurses and physicians better, and to evaluate the clinical impact.