Okelue E. Okobi

The complex connection between some infectious illnesses and some psychiatric disorders is an important area of study, with infections known to cause a diverse range of psychiatric symptoms. This association poses significant challenges for physicians in differentiating between mental illnesses induced by infections and those stemming from underlying psychiatric conditions. This study systematically synthesizes literature from various databases that explain the relationship between certain infectious diseases and specific psychiatric disorders. The systematic review explores mechanisms such as neuroinflammation, direct central nervous system (CNS) infection, and the interaction between the immune system and psychiatric conditions. The study examines various infectious pathogens, including viruses, bacteria, parasites, prion diseases, and fungi. An analysis of these findings is presented in the study's discussion section, along with a review of therapeutic methods such as drug use and psychological treatment. The review emphasizes the need for multidisciplinary teamwork and thorough clinical examinations in managing psychiatric symptoms caused by infections. It also highlights the significant role of public health measures in mitigating the impact of psychiatric diseases related to infectious illnesses. The study finds that current therapeutic methods include pharmacological and psychological treatments, which can effectively manage these conditions. The study has concluded that psychiatric manifestations are prevalent across various infectious diseases, including those caused by viruses, bacteria, parasites, and fungi. Key mechanisms identified include neuroinflammation, direct infection of the CNS, and the immuno-psychiatric interface, all of which contribute to the development of psychiatric symptoms. The future of managing these complex conditions lies in a comprehensive approach that combines clinical, therapeutic, and public health strategies.

BackgroundCardiovascular diseases (CVDs), including coronary artery disease, heart attacks, strokes, and hypertension, are the leading cause of global morbidity and mortality. Despite advancements in diagnostic techniques, treatment protocols, and public health initiatives, the prevalence of CVD continues to rise. Hence, understanding trends of predisposing factors for CVD and current treatment modalities such as medication use and frequency of hospitalization is essential for developing effective interventions and improving public health strategies. This study leverages Behavioral Risk Factor Surveillance System (BRFSS) data to analyze these trends among adults older than 18 years.MethodsData were sourced from the BRFSS database, analyzing CVD patterns from 2019 to 2021. The study included adults with high cholesterol or blood pressure, coronary heart disease, stroke, and heart failure. Data analysis utilized age-adjusted prevalence, mortality, and hospitalization rates.ResultsThe analysis of the BRFSS data revealed several key trends in CVD patterns from 2019 to 2021. There was a statistically significant increase (p<0.05) in the age-adjusted prevalence of adults taking medication for high cholesterol, rising from 28.9% to 31%, and for controlling high blood pressure, increasing from 57.7% to 60.4%. From 2019 to 2021, coronary heart disease mortality increased from 360,900 to 382,820, while stroke deaths rose from 150,005 to 162,890. Trends show rising mortality for both conditions despite missing data for some years. Mortality rates for coronary heart disease and stroke also rose and were statistically significant (p<0.05), with coronary heart disease mortality increasing from 88 to 92.8 cases per 100,000, and stroke mortality from 37 to 41.1 cases per 100,000. Hospitalization rates for heart failure among Medicare beneficiaries aged 65 and older initially decreased in 2020, likely due to the COVID-19 pandemic impacting hospital admissions, but rose again in 2021 as healthcare-seeking behaviors normalized. Significant gender and racial disparities were observed, with higher mortality rates among males (127.4 per 100,000) and Black, non-Hispanic individuals (110.5 per 100,000).ConclusionsThis study highlights the increasing medication use for cholesterol and blood pressure among adults older than 18 years, yet mortality rates for coronary heart disease and stroke persist. Significant gender and racial disparities in medication use and mortality rates were observed. These findings underscore the need for targeted public health intervention towards improving medication adherence and addressing social determinants of health, to reduce CVD burden and enhance health equity across diverse populations.

Despite advancements in human immunodeficiency virus (HIV) treatment and prevention, disparities in pre-exposure prophylaxis (PrEP) uptake and viral suppression persist across different demographics. This study analyzes data from America’s HIV Epidemic Analysis Dashboard (AHEAD) National Database to identify and understand these disparities based on age, gender, and race/ethnicity. In this study, we utilized the AHEAD National Database, which tracks HIV indicators across various demographics, including age, gender, and race/ethnicity. Data from 2017 to 2022 were analyzed to assess trends in PrEP uptake and viral suppression rates. Viral suppression was defined as having less than 200 copies of HIV per milliliter of blood. Data analyses were conducted to identify disparities and trends over time. The study has found notable disparities in PrEP uptake and viral suppression. From 2017 to 2022, PrEP prescriptions significantly increased from 13.20% to 36% of those eligible, rising from 161,185 to 437,425. During the same period, viral suppression rates among people with HIV rose from 63.10% to 65.10%, with the total number of individuals achieving viral suppression growing from 538,414 to 663,121. Younger individuals and males had higher uptake rates compared to females. Racial and ethnic disparities were also evident, with higher PrEP uptake and viral suppression rates among White and multiracial individuals compared to Black/African American and Hispanic/Latino populations. Viral suppression rates generally improved across all groups but remained lower for marginalized communities. In conclusion, while there has been overall progress in PrEP uptake and viral suppression, significant disparities persist. Targeted interventions are needed to address these gaps, particularly among marginalized racial and ethnic groups and underserved age demographics. Continued monitoring and tailored public health strategies are essential for achieving equitable HIV care and prevention.

Obesity is a significant public health issue in the United States, contributing to a range of chronic conditions and premature mortality. This study analyzes patterns in obesity-related deaths from 2010 to 2020 using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database to identify trends and demographic disparities. A retrospective analysis was conducted using the CDC WONDER Database, focusing on mortality data associated with specific International Classification of Diseases, Tenth Revision (ICD-10) codes for obesity (E66.0, E66.1, E66.2, E66.8, and E66.9). Data were extracted for the period from January 1, 2010, to December 31, 2020. Mortality rates per 100,000 population were calculated and analyzed across different demographic groups, including age, gender, and race/ethnicity. The analysis revealed an overall increase in obesity-related mortality rates, rising from 1.8 per 100,000 in 2010 to 3.1 per 100,000 in 2020. Age-specific mortality rates showed a significant increase in older age groups, with the highest rates observed in individuals aged 55-64 years (6.4 per 100,000) and 65-74 years (7.2 per 100,000). Gender disparities were evident, with higher mortality rates in males (3.4 per 100,000) compared to females (2.8 per 100,000) by the end of the study period. Racial disparities were also noted, with Black or African American individuals experiencing the highest mortality rates (4.3 per 100,000). The study highlights a concerning upward trend in obesity-related mortality in the United States over the past decade, with notable disparities based on age, gender, and race. These findings underscore the need for targeted public health interventions and policies aimed at reducing obesity prevalence and its associated mortality. Further research should explore the underlying causes and contributing factors to these trends to develop effective strategies for obesity management and prevention. Among the notable strengths of this study include the observation that it leveraged a comprehensive and decade-long countrywide database with detailed and up-to-date ICD-10 codes and demographic data to offer in-depth insights into obesity-related disparities and mortality trends in the United States. Nevertheless, the findings of this study have been limited by its increased focus on the United States' data, depending only on mortality records devoid of consideration of morbidity, alongside the lack of detailed data on lifestyle factors and comorbid conditions.

The fast-increasing obesity prevalence rates in children, youths, and adults in the last decade have made obesity prevention a global public health priority. The primary objective of this study is to evaluate the various obesity prevention strategies and guidelines implemented in the United States and Canada. Thus, for this study, a systematic review was performed on various online databases including PubMed, Scopus, Google Scholar, and MEDLINE. The decision to study the obesity prevention strategies in Canada and the United States is a result of the high prevalence rates of obesity in the two countries, alongside the numerous prevention interventions that have been executed to prevent obesity. Additionally, the systematic review used robust methodology that followed the Cochrane guidance and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only studies published between 2014 and 2024, drawn from listed databases, were included in this systematic review. The quality of the included studies was evaluated using the appraisal tool for cross-sectional studies, with the studies being rated moderate to high quality. Therefore, a total of 15 studies met the inclusion criteria and were reviewed. The findings indicate that various obesity prevention interventions have been implemented across the United States and Canada, with diverse degrees of success in obesity prevention and management. Food labeling, regular exercises, portion size regulation, school-based intervention strategies, early childhood Intervention programs, and sugar-sweetened beverage taxation were found to be effective interventions for preventing obesity in children and adults. Based on the findings, there is a need to ensure full execution of the different interventions to ensure significant reduction in obesity prevalence, as well as prevention of obesity in different populations.

Background: Understanding knowledge of human immunodeficiency virus (HIV) status and timely linkage to care are crucial for improving health outcomes among individuals living with HIV. This study analyzes trends in HIV knowledge status and linkage to care using data from America’s HIV Epidemic Analysis Dashboard (AHEAD) National Database.Methods: A retrospective database analysis was conducted utilizing the AHEAD National Database, focusing on individuals diagnosed with HIV from 2017 to 2022. Key variables included knowledge of HIV status and the percentage of individuals who received medical care within one month of diagnosis. Descriptive statistics were employed to assess trends over the years, while demographic differences were analyzed based on age, gender, race, and transmission risk.Results: The incidence of new HIV infections in the United States has gradually declined from 37,000 in 2017 to 31,800 in 2022. Between 2017 and 2022, the percentage of people with HIV receiving medical care within one month of diagnosis increased from 77.80% to 81.60%. The actual number of individuals linked to care peaked at 27,479 in 2019 but dropped to 23,419 in 2020. However, by 2022, the number had risen to 29,753, reflecting improvements in linkage efforts. Additionally, the number of individuals aware of their positive HIV status increased from 988,546 in 2017 to 1,079,751 in 2022, with the estimated percentage reaching 87.20%. Although this indicates progress in awareness initiatives, the increase remains gradual. Disparities in care linkage across demographics, particularly among younger individuals and racial minorities, highlight the need for targeted interventions to improve overall outcomes and access to care.Conclusions: The findings highlight significant progress in knowledge status and linkage to care among people living with HIV. Despite improvements, achieving the goal of 95% linkage to care by 2025 remains a challenge, particularly for specific demographic groups. Enhanced public health strategies and targeted outreach efforts are essential for addressing these disparities and improving overall health outcomes.

Background: Obesity among adolescents is a significant public health concern. This study analyzes the prevalence of obesity among adolescents using data from the National Survey of Children’s Health (NSCH). The analysis focuses on the impact of race and socioeconomic variables on obesity rates.Objective: This study aimed to examine how race and socioeconomic factors, including income level, insurance status, and adverse childhood experiences, influence obesity prevalence among adolescents.Methods: Data were extracted from the NSCH for adolescents aged 10-17 years, defining obesity as a body mass index (BMI) of or above the 95th percentile (n = 3,344). Furthermore, for this study, the researchers utilized SPSS version 26 software for data analysis. The analysis focused on obesity prevalence by race (Hispanic, Black non-Hispanic, and White non-Hispanic) and socioeconomic factors, including family income relative to the federal poverty level (FPL), insurance status, and adverse childhood experiences. Obesity was assessed by reporting prevalence estimates and confidence intervals (CIs).Results: Among adolescents aged 10-17 years (n = 23,452 ), the overall prevalence of obesity was 16.6% (CI: 15.6%-17.7%), overweight 15.2% (CI: 14.3-16.1%), normal weight 60.9% (CI: 59.6%-62.2%), and underweight 7.3% (CI: 6.5%-8.1%). Stating that the overall n at the beginning helps the reader to assess the study population and the percentages are more impactful in communicating the severity of the problem or outcome. We found significant disparities in obesity prevalence among different racial and socioeconomic groups. Racial disparities in obesity prevalence were evident, with 773 Hispanic adolescents having the highest obesity prevalence at 21.9%, followed by 330 Black non-Hispanic adolescents at 21.3%. Socioeconomic status was inversely related to obesity prevalence; among 647 adolescents from households with income at 0-99% of the FPL, the obesity prevalence was 22.5%, while 1,630 had a normal weight prevalence of 53.2%. For 3,150 insured adolescents, the obesity prevalence was 16.6%, and 14,481 had a normal weight prevalence of 61.3%. A total of 1,121 adolescents with two or more adverse childhood experiences (ACEs) had a 22.4% obesity prevalence.Conclusion: The study highlights significant racial and socioeconomic disparities in adolescent obesity rates. Higher obesity prevalence is associated with lower income levels, lack of insurance, and adverse childhood experiences. These findings suggest the need for targeted interventions addressing these disparities to improve adolescent health outcomes. The targeted interventions are essential, as they will aid in addressing the observed disparities by tackling factors contributing to obesity within the demographic group. Through the execution of the targeted interventions, we can customize resources and strategies to the adolescent population's needs, ascertaining an increasingly equitable approach to lowering obesity prevalence rates and enhancing the health outcomes in adolescents.

This review paper explores the synergistic effects of obesity, hypertension (HTN), and hyperlipidemia on cardiovascular health by integrating pathophysiological and clinical perspectives. Obesity, characterized by excessive body fat, HTN, defined by elevated blood pressure, and hyperlipidemia, indicated by high blood lipid levels, are globally prevalent conditions that significantly increase the risk of cardiovascular diseases (CVDs). The interplay between these conditions exacerbates cardiovascular risk through mechanisms such as chronic inflammation, insulin resistance, endothelial dysfunction, arterial stiffness, and atherogenesis. This review synthesizes epidemiological evidence and highlights the prevalence and co-occurrence of these conditions, with an emphasis on their combined impact on cardiovascular health. The literature search encompassed various databases, and data extraction included key study characteristics and outcomes. The findings underscore the importance of integrated management strategies, involving lifestyle interventions, pharmacological treatments, and regular monitoring, to mitigate the heightened cardiovascular risk posed by these conditions. In addition, the various public health implications are addressed, advocating for community-based interventions and policy changes. Future research directions may include exploring novel therapeutic approaches, personalized medicine strategies, and longitudinal studies to enhance the understanding and management of the synergistic effects of obesity, HTN, and hyperlipidemia on cardiovascular health.

The purpose of this review is to explore the relationship between weight loss (WL), specifically reductions in body mass index (BMI), and increases in testosterone levels. Obesity and excess body fat are linked to reduced testosterone levels, which can lead to metabolic dysfunctions, reduced libido, and diminished muscle mass. To attain this purpose, this review will summarize current evidence on how weight reduction interventions, including dietary changes, exercise, and bariatric surgery, affect testosterone production in overweight and obese individuals. WL, particularly through fat reduction, has a positive influence on testosterone levels. Both moderate and significant reductions in BMI are associated with notable increases in serum testosterone levels. Dietary interventions, particularly low-carbohydrate and Mediterranean diets, have been linked to increased testosterone production in men with obesity. Exercise, particularly resistance training, has also been shown to improve hormonal profiles by lowering fat mass and boosting testosterone levels. Additionally, bariatric surgery has been identified as one of the most effective methods for increasing testosterone in morbidly obese individuals, with improvements sustained over time. The findings have indicated that there is strong evidence that WL, particularly through reductions in BMI, leads to increased testosterone levels. This relationship is mediated by improvements in insulin sensitivity, reduced inflammation, and lower levels of aromatase activity (the enzyme that converts testosterone to estrogen in fat tissue). Effective interventions, including diet, exercise, and bariatric surgery, have the potential to restore hormonal balance, improving overall health outcomes for men with obesity or higher BMI. Further research is needed to optimize interventions and explore long-term benefits.

Hypertension (HTN) remains a major cause of mortality and morbidity globally and is normally accompanied by multimorbidity, which makes its management increasingly difficult and multifaceted. In addition to being considered a vital intervention empowering patients by ensuring they are actively involved in their care and enhancing HTN management, several studies have disclosed that self-blood pressure monitoring (SBPM) is highly effective when utilized jointly with other interventions. However, the effectiveness of SBPM varies in instances of multimorbidity. This systematic review aims to evaluate the effectiveness of SBPM in reducing clinic BP in persons with HTN and multimorbidity. To realize the study objectives, an in-depth literature search and systematic review were performed on articles drawn from various virtual databases, including PubMed, SCOPUS, Medline, Google Scholar, and Embase. Randomized controlled trials (RCTs), cohort studies, clinical trials, and reviews focused on SBPM were selected and included. As a result, 12 studies met the inclusion criteria and were included based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. As such, SBPM was found to be effective in lowering BP regardless of the existence of HTN-related comorbidities; however, SBPM was only effective in instances of comorbidities that included stroke and obesity and upon combination with other high-intensity co-interventions.