The American journal of medicine
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To verify whether the trend of AMI mortality throughout the different months of the year may have recently changed in the US due to the coronavirus disease 2019 (COVID-19) pandemic and climate changes. ⋯ Healthcare systems should allocate resources effectively during winter to manage this seasonal burden.
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We examined data from 17,498 physicians-in-training who reported on 92,662 months of work over a 20 year study interval that included three major revisions to work hour limits. Extended duration shifts (≥24 hours; EDS) are much less common than they used to be. On average, first-year resident physicians (PGY1s) currently work a total of 4 EDS per year and 3 EDS per month during months in which any EDS are worked. ⋯ More senior resident physicians (PGY2+) have observed concurrent reductions despite their exclusion from the ACGME guidelines limiting EDS. Resident physicians across all levels of training in surgical programs continue to work more EDS than those in medical programs. Similarly, resident physicians on Intensive Care Unit (ICU) rotations work these shifts more frequently compared to other rotations.
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Gastrointestinal (GI) cancers account for one-third of global cancer mortality, with nearly half being preventable. This study updates the global burden of GI cancers attributed to major risk factors: smoking, alcohol, and metabolic disturbances. ⋯ From 2000 to 2021, GI cancer mortality increased substantially, driven primarily by obesity and alcohol. Lower SDI countries are increasingly contributing to the global GI cancer mortality burden. Immediate interventions are necessary to mitigate this growing burden.