58601
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Dacal E, Saugar JM, de Lucio A, Hernández-de-Mingo M, Robinson E, Köster PC, Aznar-Ruiz-de-Alegría ML, Espasa M, Ninda A, Gandasegui J, Sulleiro E, Moreno M, Salvador F, Molina I, Rodríguez E, Carmena D. Prevalence and molecular characterization of Strongyloides stercoralis, Giardia duodenalis, Cryptosporidium spp., and Blastocystis spp. isolates in school children in Cubal, Western Angola. Parasit Vectors 2018; 11:67. [PMID: 29378626 PMCID: PMC5789528 DOI: 10.1186/s13071-018-2640-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/11/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Human infections by the gastrointestinal helminth Strongyloides stercoralis and the enteric protozoans Giardia duodenalis, Cryptosporidium spp. and Blastocystis spp. are not formally included in the list of 20 neglected tropical diseases prioritised by the World Health Organization. Although largely underdiagnosed and considered of lower public health relevance, these infections have been increasingly demonstrated to cause significant morbidity and even mortality globally, particularly among children living in resource-poor settings. METHODS In this cross-sectional survey the prevalence, frequency and molecular diversity of S. stercoralis, G. duodenalis, Cryptosporidium spp. and Blastocystis spp. were investigated in a school children population in the province of Benguela (Angola). A total of 351 stool samples were collected during January to June 2015. The presence of S. stercoralis and G. duodenalis was confirmed by qPCR methods. Giardia duodenalis assemblages and sub-assemblages were determined by multilocus sequence-based genotyping of the glutamate dehydrogenase and β-giardin genes of the parasite. Detection and identification of Cryptosporidium and Blastocystis species and subtypes was carried out by amplification and sequencing of a partial fragment of the small-subunit ribosomal RNA gene of both protozoan. Analyses of risk factors potentially associated with the transmission of these pathogens were also conducted. RESULTS Prevalences of S. stercoralis, G. duodenalis, Cryptosporidium spp., and Blastocystis spp. were estimated at 21.4% (95% CI: 17.1-25.7%), 37.9% (95% CI: 32.8-43.0%), 2.9% (95% CI: 1.1-4.5%) and 25.6% (95% CI: 21.18-30.2%), respectively. Overall, 64.1% (225/351) of the children were infected by at least one of the pathogens investigated. Sequence analyses of the 28 G. duodenalis isolates that were successfully genotyped allowed the identification of sub-assemblages AI (14.3%), AII (14.3%), BIII (7.1%) and BIV (25.0%). Discordant typing results AII/AIII and BIII/BIV were identified in 7.1% and 14.3% of the isolates, respectively. A total of five additional isolates (17.9%) were identified as assemblage B. Three Cryptosporidium species including C. hominis (70%), C. parvum (20%) and C. canis (10%) were found circulating in the children population under study. A total of 75 Blastocystis isolates were assigned to the subtypes ST1 (30.7%), ST2 (30.7%), ST3 (36.0%), ST5 (1.3%) and ST7 (1.3%), respectively. Children younger than seven years of age had significantly higher risk of infections by protozoan enteropathogens (PRR: 1.35, P < 0.01), whereas being underweight seemed to have a protective effect against these infections (PRR: 0.74, P = 0.005). CONCLUSIONS The burden of disease attributable to human strongyloidiasis, giardiosis, cryptosporidiosis and blastocystosis in Angola is considerably higher than initially estimated in previous surveys. Surveillance and control of these infections should be jointly tackled with formally considered neglected tropical diseases in order to maximize effort and available resources. Our data also demonstrate the added value of using molecular diagnostic methods in high transmission areas.
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Affiliation(s)
- Elena Dacal
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
| | - José M. Saugar
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
| | - Aida de Lucio
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
| | - Marta Hernández-de-Mingo
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
| | - Elena Robinson
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
| | - Pamela C. Köster
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
| | | | - Mateu Espasa
- 0000 0001 0675 8654grid.411083.fMicrobiology Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Passeig de la Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Arlette Ninda
- Hospital Nossa Senhora da Paz, Cubal, Benguela, Angola
| | - Javier Gandasegui
- 0000 0001 2180 1817grid.11762.33Biomedical Research Institute of Salamanca - Research Center for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, Paseo de San Vicente 58-182, 37007 Salamanca, Spain
| | - Elena Sulleiro
- 0000 0001 0675 8654grid.411083.fMicrobiology Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Passeig de la Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | | | - Fernando Salvador
- 0000 0001 0675 8654grid.411083.fInfectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Passeig de la Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Israel Molina
- 0000 0001 0675 8654grid.411083.fInfectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Passeig de la Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Esperanza Rodríguez
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
| | - David Carmena
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
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58602
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Boateng D, Agyemang C, Beune E, Meeks K, Smeeth L, Schulze MB, Addo J, de-Graft Aikins A, Galbete C, Bahendeka S, Danquah I, Agyei-Baffour P, Owusu-Dabo E, Mockenhaupt FP, Spranger J, Kengne AP, Grobbee DE, Klipstein-Grobusch K. Cardiovascular disease risk prediction in sub-Saharan African populations - Comparative analysis of risk algorithms in the RODAM study. Int J Cardiol 2018; 254:310-315. [PMID: 29407113 DOI: 10.1016/j.ijcard.2017.11.082] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 11/03/2017] [Accepted: 11/22/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND Validated absolute risk equations are currently recommended as the basis of cardiovascular disease (CVD) risk stratification in prevention and control strategies. However, there is no consensus on appropriate equations for sub-Saharan African populations. We assessed agreement between different cardiovascular risk equations among Ghanaian migrant and home populations with no overt CVD. METHODS The 10-year CVD risks were calculated for 3586 participants aged 40-70years in the multi-centre RODAM study among Ghanaians residing in Ghana and Europe using the Framingham laboratory and non-laboratory and Pooled Cohort Equations (PCE) algorithms. Participants were classified as low, moderate or high risk, corresponding to <10%, 10-20% and >20% respectively. Agreement between the risk algorithms was assessed using kappa and correlation coefficients. RESULTS 19.4%, 12.3% and 5.8% were ranked as high 10-year CVD risk by Framingham non-laboratory, Framingham laboratory and PCE, respectively. The median (25th-75th percentiles) estimated 10-year CVD risk was 9.5% (5.4-15.7), 7.3% (3.9-13.2) and 5.0% (2.3-9.7) for Framingham non-laboratory, Framingham laboratory and PCE, respectively. The concordance between PCE and Framingham non-laboratory was better in the home Ghanaian population (kappa=0.42, r=0.738) than the migrant population (kappa=0.24, r=0.732) whereas concordance between PCE and Framingham laboratory was better in migrant Ghanaians (kappa=0.54, r=0.769) than the home population (kappa=0.51, r=0.758). CONCLUSION CVD prediction with the same algorithm differs for the migrant and home populations and the interchangeability of Framingham laboratory and non-laboratory algorithms is limited. Validation against CVD outcomes is needed to inform appropriate selection of risk algorithms for use in African ancestry populations.
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Affiliation(s)
- Daniel Boateng
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands; School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Charles Agyemang
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands
| | - Erik Beune
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands
| | - Karlijn Meeks
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands
| | - Liam Smeeth
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Juliet Addo
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies, University of Ghana, Legon, Ghana
| | - Cecilia Galbete
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Silver Bahendeka
- Mother Kevin Postgraduate Medical School - Uganda Martyrs University, Kampala, Uganda
| | - Ina Danquah
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitaetsmedizin Berlin, corporate member of Freie Universitaet Berlin & Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Peter Agyei-Baffour
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Frank P Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité - Universitaetsmedizin Berlin, corporate member of Freie Universitaet Berlin & Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Joachim Spranger
- Charité Center for Cardiovascular Research (CCR), Charité - Universitaetsmedizin Berlin, corporate member of Freie Universitaet Berlin & Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andre P Kengne
- Non-communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Diederick E Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands; Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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58603
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Goldberg EM, Pigott D, Shirude S, Stanaway J, Hay SI, Vos T. Underestimation of the global burden of schistosomiasis - Authors' reply. Lancet 2018; 391:308. [PMID: 29413043 DOI: 10.1016/s0140-6736(18)30124-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Ellen M Goldberg
- Institute for Health Metrics and Evaluation, Seattle, WA 98121, USA
| | - David Pigott
- Institute for Health Metrics and Evaluation, Seattle, WA 98121, USA
| | - Shreya Shirude
- Institute for Health Metrics and Evaluation, Seattle, WA 98121, USA
| | - Jeffrey Stanaway
- Institute for Health Metrics and Evaluation, Seattle, WA 98121, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, Seattle, WA 98121, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, Seattle, WA 98121, USA.
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58604
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Kleinert S, Horton R. After asthma: airways diseases need a new name and a revolution. Lancet 2018; 391:292-294. [PMID: 28911917 DOI: 10.1016/s0140-6736(17)32205-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 08/03/2017] [Indexed: 11/21/2022]
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58605
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King CH, Galvani AP. Underestimation of the global burden of schistosomiasis. Lancet 2018; 391:307-308. [PMID: 29413041 DOI: 10.1016/s0140-6736(18)30098-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 11/20/2017] [Indexed: 02/02/2023]
Affiliation(s)
- Charles H King
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.
| | - Alison P Galvani
- Center for Infectious Disease Modeling and Analysis (CIDMA), Yale School of Public Health, New Haven, CT, USA
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58606
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Alhazzani AA, Mahfouz AA, Abolyazid AY, Awadalla NJ, Aftab R, Faraheen A, Khalil SN. Study of Stroke Incidence in the Aseer Region, Southwestern Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E215. [PMID: 29373563 PMCID: PMC5858284 DOI: 10.3390/ijerph15020215] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 01/12/2018] [Accepted: 01/22/2018] [Indexed: 11/16/2022]
Abstract
Recent data regarding first-stroke incidence in Saudi Arabia in general and in the Aseer region in particular are scarce and even lacking. The aim of this work was to study the first-time stroke incidence in the Aseer region, southwestern Saudi Arabia. All first-stroke patients admitted to all hospitals in the Aseer region over a one-year period (January through December 2016) were included. Stroke patients outside the Aseer region were excluded from the study. The incidence per 100,000 patients and the concomitant 95% CI (Confidence Intervals) were computed. The present study included 1249 first-time stroke patients and calculated an overall minimal incidence rate of hospitalized first-time stroke of 57.64 per 100,000 persons per year (95% CI: 57.57-57.70). A steady increase was noticed depending on the patients' age, reaching a figure of 851.81 (95% CI: 849.2-854.5) for those patients aged 70 years and more. Overall, the incidence rate for females (48.14; 95% CI: 48.04-48.24) was lower compared to males (65.52; 95% CI: 65.1-66.0). Taking into consideration the expected rise of the elderly because of the prominent medical services provided by the Saudi government, leading to a subsequent change in the horizontal and vertical age distribution structure of the population, an increase in the number of stroke patients is expected. It is suggested to establish a nationwide stroke surveillance system in the Kingdom, with the objective to report, analyze, and maintain an updated overview of the stroke status in Saudi Arabia.
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Affiliation(s)
- Adel A Alhazzani
- Department of Internal Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
| | - Ahmed A Mahfouz
- Department of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria 21511, Egypt.
| | - Ahmed Y Abolyazid
- Department of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
- Department of Community Medicine, College of Medicine, Mansoura University, Mansoura 35516, Egypt.
| | - Nabil J Awadalla
- Department of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
- Department of Community Medicine, College of Medicine, Mansoura University, Mansoura 35516, Egypt.
| | - Razia Aftab
- Department of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
| | - Aesha Faraheen
- Department of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
| | - Shamsun Nahar Khalil
- Department of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
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58607
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Hoare E, Dash SR, Jennings GL, Kingwell BA. Sex-Specific Associations in Nutrition and Activity-Related Risk Factors for Chronic Disease: Australian Evidence from Childhood to Emerging Adulthood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020214. [PMID: 29373561 PMCID: PMC5858283 DOI: 10.3390/ijerph15020214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 01/17/2018] [Accepted: 01/23/2018] [Indexed: 11/16/2022]
Abstract
Global assessments of burden of disease suggests there are sex differences in risk factors for chronic disease, including overweight/obesity, dietary patterns and habitual physical activity. Given that prevention efforts aim to target such factors to reduce disease risk, the age at which sex differences may occur is of particular interest. Early life to young adulthood is the optimal time for intervention, with lifestyle habits typically forming during this period. This study aimed to identify the sex differences in risk factors for chronic disease during childhood (5-9 years), adolescence (10-17 years) and emerging adulthood (18-25 years) in a large population-representative Australian sample. Among children in this study (n = 739), no sex-related differences were observed. Among adolescents (n = 1304), females were more likely than males to meet daily fruit and vegetable recommendations (12.9% vs. 7.5%; OR = 1.84, 95% CI = 1.16, 2.93, p < 0.05). Among emerging adults (n = 909), females were less likely to be overweight/obese (30.1% vs. 39.8%; OR = 0.65, 95% CI = 0.44, 0.95, p < 0.05) and more likely to meet physical activity recommendations (52.1% vs. 42.3%; OR = 1.44, 95% CI = 1.01, 2.06, p < 0.05). These findings suggest that sex differences for risk factors of chronic disease occur during adolescence and emerging adulthood, although the differences are not consistent across age periods. From adolescence onwards, it appears that females exhibit lower risk factors than males and a life span approach to risk factor monitoring is warranted.
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Affiliation(s)
- Erin Hoare
- Metabolic and Vascular Physiology, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia.
- Food and Mood Centre, Centre for Innovation in Mental and Physical Health and Clinical Treatment, School of Medicine, Faculty of Health, Deakin University, Melbourne, VIC 3004, Australia.
| | - Sarah R Dash
- Metabolic and Vascular Physiology, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia.
| | - Garry L Jennings
- Metabolic and Vascular Physiology, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia.
- Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia.
| | - Bronwyn A Kingwell
- Metabolic and Vascular Physiology, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia.
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58608
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Vandevijvere S, Mackay S, Swinburn B. Measuring and stimulating progress on implementing widely recommended food environment policies: the New Zealand case study. Health Res Policy Syst 2018; 16:3. [PMID: 29370804 PMCID: PMC5785861 DOI: 10.1186/s12961-018-0278-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 01/09/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Monitoring the degree of implementation of widely recommended food environment policies by national governments is an important part of stimulating progress towards better population nutritional health. METHODS The Healthy Food Environment Policy Index (Food-EPI) was applied for the second time in New Zealand in 2017 (initially applied in 2014) to measure progress on implementation of widely recommended food environment policies. A national panel of 71 independent (n = 48) and government (n = 23) public health experts rated the extent of implementation of 47 policy and infrastructure support good practice indicators by the Government against international best practice, using an extensive evidence document verified by government officials. Experts proposed and prioritised concrete actions needed to address the critical implementation gaps identified. RESULTS Inter-rater reliability was good (Gwet's AC2 > 0.8). Approximately half (47%) of the indicators were rated as having 'low' or 'very little, if any' implementation compared to international benchmarks, a decrease since 2014 (60%). A lower proportion of infrastructure support (29%) compared to policy (70%) indicators were rated as having 'low' or 'very little, if any' implementation. The experts recommended 53 actions, prioritising nine for immediate implementation; three of those prioritised actions were the same as in 2014. The vast majority of experts agreed that the Food-EPI is likely to contribute to beneficial policy change and increased their knowledge about food environments and policies. CONCLUSION The Food-EPI has the potential to increase accountability of governments to implement widely recommended food environment policies and reduce the burden of obesity and diet-related diseases.
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Affiliation(s)
- Stefanie Vandevijvere
- The University of Auckland, School of Population Health, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Sally Mackay
- The University of Auckland, School of Population Health, Private Bag 92019, Auckland, 1142, New Zealand
| | - Boyd Swinburn
- The University of Auckland, School of Population Health, Private Bag 92019, Auckland, 1142, New Zealand
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58609
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Dudley L, Mukinda F, Dyers R, Marais F, Sissolak D. Mind the gap! Risk factors for poor continuity of care of TB patients discharged from a hospital in the Western Cape, South Africa. PLoS One 2018; 13:e0190258. [PMID: 29370162 PMCID: PMC5784914 DOI: 10.1371/journal.pone.0190258] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 12/11/2017] [Indexed: 12/01/2022] Open
Abstract
Background TB patients discharged from hospitals in South Africa experience poor continuity of care, failing to continue TB treatment at other levels of care. Factors contributing to poor continuity of TB care are insufficiently described to inform interventions. Objective To describe continuity of care and risk factors in TB patients discharged from a referral hospital in the Western Cape, South Africa. Design This retrospective observational study used routine information to describe continuity of care and risk factors in TB patients discharged from hospital. Results 788 hospitalized TB patients were identified in 6 months. Their median age was 32 years, 400 (51%) were male, and 653 (83%) were urban. A bacteriological TB test was performed for 74%, 25% were tested for HIV in hospital, and 32% of all TB patients had documented evidence of HIV co-infection. Few (13%) were notified for TB; 375 (48%) received TB medication; 284 (36%) continued TB treatment after discharge; 91 (24%) had a successful TB treatment outcome, and 166 (21%) died. Better continuity of care was associated with adults, urban residence, bacteriological TB tests in hospital and TB medication on discharge. Fragmented hospital TB data systems did not provide continuity with primary health care information systems. Conclusions Discharged TB patients experienced poor continuity of care, with children, rural patients, those not tested for TB in hospital or discharged without TB medication at greatest risk. Suboptimal quality of hospital TB care and a fragmented hospital information system without linkages to other levels underpinned poor continuity of care.
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Affiliation(s)
- Lilian Dudley
- Division of Health Systems and Public Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Global Health, Harvard Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Fidele Mukinda
- Division of Health Systems and Public Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Robin Dyers
- Division of Health Systems and Public Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Health, Western Cape Provincial Government, Cape Town, South Africa
| | - Frederick Marais
- Division of Health Systems and Public Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Health, Western Cape Provincial Government, Cape Town, South Africa
| | - Dagmar Sissolak
- Department of Infection Control, Medical disaster control and Environmental health control, Department of Public Health, Berlin Central, Germany
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58610
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Siroux V, Crestani B. Is chronic exposure to air pollutants a risk factor for the development of idiopathic pulmonary fibrosis? Eur Respir J 2018; 51:13993003.02663-2017. [DOI: 10.1183/13993003.02663-2017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 11/05/2022]
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58611
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Frieden TR, Jaffe MG. Saving 100 million lives by improving global treatment of hypertension and reducing cardiovascular disease risk factors. J Clin Hypertens (Greenwich) 2018; 20:208-211. [PMID: 29370471 DOI: 10.1111/jch.13195] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Marc G Jaffe
- Resolve to Save Lives, New York, NY, USA.,Kaiser Permanente South, San Francisco Medical Center South, San Francisco, CA, USA
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58612
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Martin-Sanchez D, Fontecha-Barriuso M, Sanchez-Niño MD, Ramos AM, Cabello R, Gonzalez-Enguita C, Linkermann A, Sanz AB, Ortiz A. Cell death-based approaches in treatment of the urinary tract-associated diseases: a fight for survival in the killing fields. Cell Death Dis 2018; 9:118. [PMID: 29371637 PMCID: PMC5833412 DOI: 10.1038/s41419-017-0043-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/26/2017] [Accepted: 10/05/2017] [Indexed: 02/06/2023]
Abstract
Urinary tract-associated diseases comprise a complex set of disorders with a variety of etiologic agents and therapeutic approaches and a huge global burden of disease, estimated at around 1 million deaths per year. These diseases include cancer (mainly prostate, renal, and bladder), urinary tract infections, and urolithiasis. Cell death plays a key role in the pathogenesis and therapy of these conditions. During urinary tract infections, invading bacteria may either promote or prevent host cell death by interfering with cell death pathways. This has been studied in detail for uropathogenic E. coli (UPEC). Inhibition of host cell death may allow intracellular persistence of live bacteria, while promoting host cell death causes tissue damage and releases the microbes. Both crystals and urinary tract obstruction lead to tubular cell death and kidney injury. Among the pathomechanisms, apoptosis, necroptosis, and autophagy represent key processes. With respect to malignant disorders, traditional therapeutic efforts have focused on directly promoting cancer cell death. This may exploit tumor-specific characteristics, such as targeting Vascular Endothelial Growth Factor (VEGF) signaling and mammalian Target of Rapamycin (mTOR) activity in renal cancer and inducing survival factor deprivation by targeting androgen signaling in prostate cancer. An area of intense research is the use of immune checkpoint inhibitors, aiming at unleashing the full potential of immune cells to kill cancer cells. In the future, this may be combined with additional approaches exploiting intrinsic sensitivities to specific modes of cell death such as necroptosis and ferroptosis. Here, we review the contribution of diverse cell death mechanisms to the pathogenesis of urinary tract-associated diseases as well as the potential for novel therapeutic approaches based on an improved molecular understanding of these mechanisms.
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Affiliation(s)
- Diego Martin-Sanchez
- Research Institute-Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain
- IRSIN, Madrid, Spain
- REDINREN, Madrid, Spain
| | - Miguel Fontecha-Barriuso
- Research Institute-Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain
- IRSIN, Madrid, Spain
- REDINREN, Madrid, Spain
| | - Maria Dolores Sanchez-Niño
- Research Institute-Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain
- IRSIN, Madrid, Spain
- REDINREN, Madrid, Spain
| | - Adrian M Ramos
- Research Institute-Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain
- IRSIN, Madrid, Spain
- REDINREN, Madrid, Spain
| | - Ramiro Cabello
- Research Institute-Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain
| | | | - Andreas Linkermann
- Department of Internal Medicine III, Division of Nephrology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
| | - Ana Belén Sanz
- Research Institute-Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain.
- IRSIN, Madrid, Spain.
- REDINREN, Madrid, Spain.
| | - Alberto Ortiz
- Research Institute-Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain.
- IRSIN, Madrid, Spain.
- REDINREN, Madrid, Spain.
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58613
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Richard SA, McCormick BJJ, Seidman JC, Rasmussen Z, Kosek MN, Rogawski ET, Petri W, Bose A, Mduma E, Maciel BLL, Chandyo RK, Bhutta Z, Turab A, Bessong P, Mahfuz M, Caulfield LE, On Behalf Of The Mal-Ed Network Investigators. Relationships among Common Illness Symptoms and the Protective Effect of Breastfeeding in Early Childhood in MAL-ED: An Eight-Country Cohort Study. Am J Trop Med Hyg 2018; 98:904-912. [PMID: 29380724 PMCID: PMC5930868 DOI: 10.4269/ajtmh.17-0457] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Children in low-income countries experience multiple illness symptoms in early childhood. Breastfeeding is protective against diarrhea and respiratory infections, and these illnesses are thought to be risk factors of one another, but these relationships have not been explored simultaneously. In the eight-site MAL-ED study, 1,731 infants were enrolled near birth and followed for 2 years. We collected symptoms and diet information through twice-weekly household visits. Poisson regression was used to determine if recent illness history was associated with incidence of diarrhea or acute lower respiratory infections (ALRI), accounting for exclusive breastfeeding. Recent diarrhea was associated with higher risk of incident diarrhea after the first 6 months of life (relative risk [RR] 1.10, 95% confidence interval [CI] 1.04, 1.16) and with higher risk of incident ALRI in the 3- to 5-month period (RR 1.23, 95% CI 1.03, 1.47). Fever was a consistent risk factor for both diarrhea and ALRI. Exclusive breastfeeding 0-6 months was protective against diarrhea (0-2 months: RR 0.39, 95% CI 0.32, 0.49; 3-5 months: RR 0.83, 95% CI 0.75, 0.93) and ALRI (3-5 months: RR 0.81, 95% CI 0.68, 0.98). Children with recent illness who were exclusively breastfed were half as likely as those not exclusively breastfed to experience diarrhea in the first 3 months of life. Recent illness was associated with greater risk of new illness, causing illnesses to cluster within children, indicating that specific illness-prevention programs may have benefits for preventing other childhood illnesses. The results also underscore the importance of exclusive breastfeeding in the first 6 months of life for disease prevention.
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Affiliation(s)
- Stephanie A Richard
- Fogarty International Center/National Institutes of Health, Bethesda, Maryland
| | | | - Jessica C Seidman
- Fogarty International Center/National Institutes of Health, Bethesda, Maryland
| | - Zeba Rasmussen
- Fogarty International Center/National Institutes of Health, Bethesda, Maryland
| | | | | | | | | | | | | | | | | | - Ali Turab
- Aga Khan University, Karachi, Pakistan
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58614
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Akhavan Rezayat A, Dadgar Moghadam M, Ghasemi Nour M, Shirazinia M, Ghodsi H, Rouhbakhsh Zahmatkesh MR, Tavakolizadeh Noghabi M, Hoseini B, Akhavan Rezayat K. Association between smoking and non-alcoholic fatty liver disease: A systematic review and meta-analysis. SAGE Open Med 2018; 6:2050312117745223. [PMID: 29399359 PMCID: PMC5788091 DOI: 10.1177/2050312117745223] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 10/16/2017] [Indexed: 12/17/2022] Open
Abstract
Background/aims Non-alcoholic fatty liver disease is one of the most common chronic liver diseases. Some risk factors are known to influence the development of non-alcoholic fatty liver disease, but the effect of tobacco smoking on the progression of non-alcoholic fatty liver disease is controversial. The main goal of this systematic review and meta-analysis is to investigate the association between smoking and non-alcoholic fatty liver disease. Method Electronic databases (PubMed, Scopus, and ISI Web of Science) were searched to find published articles on non-alcoholic fatty liver disease and smoking until December 2016. All relevant studies were screened by inclusion and exclusion criteria and compatible studies were chosen. The Newcastle-Ottawa Scale was used to assess the methodological quality of eligible articles. Subsequently, information was gathered based on the following: author, publication year, keywords, country, inclusion and exclusion criteria, main results, study design, conclusion, and confounder variables (age, body mass index, gender, ethnicity, and diabetes). Finally, analyses were performed using Comprehensive Meta-Analysis Software. Results Data were extracted from 20 observational studies (9 cross-sectional, 6 case-control, 4 cohort studies, and 1 retrospective cohort study). A significant association was observed between smoking and non-alcoholic fatty liver disease with a pooled odds ratio of 1.110 (95% confidence interval, 1.028-1.199), p-value = 0.008. The statistical heterogeneity was medium with an I2 of 40.012%, p-heterogeneity = 0.074. Also there was a significant relation between non-alcoholic fatty liver disease and passive smoking with a pooled odds ratio of 1.380 (95% confidence interval, 1.199-1.588; p-value = 0.001; I2 = 59.41; p-heterogeneity = 0.117). Conclusion Our meta-analysis demonstrated that smoking is significantly associated with non-alcoholic fatty liver disease. Further prospective studies exploring the underlying mechanisms of this association should be pursued. Also passive smoking increases the risk of non-alcoholic fatty liver disease about 1.38-fold. The effects of smoking cigarettes on active smokers (current smoker, former smoker, and total smoker) are less than passive smokers. Further studies are needed to compare the of effects of passive and active smoking on non-alcoholic fatty liver disease.
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Affiliation(s)
- Arash Akhavan Rezayat
- Gastroenterology and Hepatology Research Center, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Malihe Dadgar Moghadam
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Ghasemi Nour
- Gastroenterology and Hepatology Research Center, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Matin Shirazinia
- Gastroenterology and Hepatology Research Center, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Ghodsi
- Gastroenterology and Hepatology Research Center, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Rouhbakhsh Zahmatkesh
- Gastroenterology and Hepatology Research Center, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Benyamin Hoseini
- Gastroenterology and Hepatology Research Center, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kambiz Akhavan Rezayat
- Gastroenterology and Hepatology Research Center, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
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58615
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Direct Detection of Shigella in Stool Specimens by Use of a Metagenomic Approach. J Clin Microbiol 2018; 56:JCM.01374-17. [PMID: 29118177 PMCID: PMC5786726 DOI: 10.1128/jcm.01374-17] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/02/2017] [Indexed: 02/04/2023] Open
Abstract
The underestimation of Shigella species as a cause of childhood diarrhea disease has become increasingly apparent with quantitative PCR (qPCR)-based diagnostic methods versus culture. We sought to confirm qPCR-based detection of Shigella via a metagenomics approach. Three groups of samples were selected from diarrheal cases from the Global Enteric Multicenter Study: nine Shigella culture-positive and qPCR-positive (culture+ qPCR+) samples, nine culture-negative but qPCR-positive (culture− qPCR+) samples, and nine culture-negative and qPCR-negative (culture− qPCR−) samples. Fecal DNA was sequenced using paired-end Illumina HiSeq, whereby 3.26 × 108 ± 5.6 × 107 high-quality reads were generated for each sample. We used Kraken software to compare the read counts specific to “Shigella” among the three groups. The proportions of Shigella-specific nonhuman sequence reads between culture+ qPCR+ (0.65 ± 0.42%) and culture− qPCR+ (0.55 ± 0.31%) samples were similar (Mann-Whitney U test, P = 0.627) and distinct from the culture− qPCR− group (0.17 ± 0.15%, P < 0.05). The read counts of sequences previously targeted by Shigella/enteroinvasive Escherichia coli (EIEC) qPCR assays, namely, ipaH, virA, virG, ial, ShET2, and ipaH3, were also similar between the culture+ qPCR+ and culture− qPCR+ groups and distinct from the culture− qPCR− groups (P < 0.001). Kraken performed well versus other methods: its precision and recall of Shigella were excellent at the genus level but variable at the species level. In summary, metagenomic sequencing indicates that Shigella/EIEC qPCR-positive samples are similar to those of Shigella culture-positive samples in Shigella sequence composition, thus supporting qPCR as an accurate method for detecting Shigella.
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58616
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Sithara T, Dhanya BP, Arun KB, Sini S, Dan M, Kokkuvayil Vasu R, Nisha P. Zerumbone, a Cyclic Sesquiterpene from Zingiber zerumbet Induces Apoptosis, Cell Cycle Arrest, and Antimigratory Effects in SW480 Colorectal Cancer Cells. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2018; 66:602-612. [PMID: 29276946 DOI: 10.1021/acs.jafc.7b04472] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Zerumbone isolated from the rhizomes of Zingiber zerumbet was investigated for the mechanisms by which it exhibits antiproliferative activity in colorectal cancer cells (SW480). The results indicated that the zerumbone suppressed cell growth and enhanced cell apoptosis. Exposure to zerumbone induced generation of reactive oxygen species, reduced the cellular antioxidant status, decreased mitochondrial membrane potential, and activated caspase 3, caspase 8, and caspase 9 (p < 0.001). It was also found that there was a decrease in the expression of Bcl 2 and elevation of Bax (p < 0.001) on exposure to zerumbone. Furthermore, treatment with 50, 75, and 100 μM zerumbone resulted in cell cycle arrest at the G2/M phase with a value of 17.2 ± 0.1, 19.63 ± 0.25, and 26.66 ± 0.25, respectively, and also distorted the microfilament network and effectively inhibited cellular migration.
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Affiliation(s)
- Thomas Sithara
- Agro Processing and Technology Division, National Institute for Interdisciplinary Science and Technology (CSIR-NIIST) , Thiruvananthapuram, Kerala 695019, India
- Academy of Scientific and Innovative Research (AcSIR) , New Delhi 110001, India
| | - B P Dhanya
- Chemical Sciences and Technology Division, National Institute for Interdisciplinary Science and Technology (CSIR-NIIST) , Thiruvananthapuram, Kerala 695019, India
- Academy of Scientific and Innovative Research (AcSIR) , New Delhi 110001, India
| | - K B Arun
- Agro Processing and Technology Division, National Institute for Interdisciplinary Science and Technology (CSIR-NIIST) , Thiruvananthapuram, Kerala 695019, India
| | - Suresh Sini
- Agro Processing and Technology Division, National Institute for Interdisciplinary Science and Technology (CSIR-NIIST) , Thiruvananthapuram, Kerala 695019, India
| | - Mathew Dan
- Plant Genetic Resource Division, Jawaharlal Nehru Tropical Botanic Garden and Research Institute (JNTBGRI) , Palode, Thiruvananthapuram, Kerala 695562, India
| | - Radhakrishnan Kokkuvayil Vasu
- Chemical Sciences and Technology Division, National Institute for Interdisciplinary Science and Technology (CSIR-NIIST) , Thiruvananthapuram, Kerala 695019, India
- Academy of Scientific and Innovative Research (AcSIR) , New Delhi 110001, India
| | - P Nisha
- Agro Processing and Technology Division, National Institute for Interdisciplinary Science and Technology (CSIR-NIIST) , Thiruvananthapuram, Kerala 695019, India
- Academy of Scientific and Innovative Research (AcSIR) , New Delhi 110001, India
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58617
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58618
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Dietary patterns are associated with child, maternal and household-level characteristics and overweight/obesity among young Samoan children. Public Health Nutr 2018; 21:1243-1254. [DOI: 10.1017/s1368980017003913] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AbstractObjectiveAmong young Samoan children, diet may not be optimal: in 2015, 16·1 % of 24–59-month-olds were overweight/obese, 20·3 % stunted and 34·1 % anaemic. The present study aimed to identify dietary patterns among 24–59-month-old Samoan children and evaluate their association with: (i) child, maternal and household characteristics; and (ii) nutritional status indicators (stunting, overweight/obesity, anaemia).DesignA community-based, cross-sectional study. Principal component analysis on 117 FFQ items was used to identify empirical dietary patterns. Distributions of child, maternal and household characteristics were examined by factor score quintiles. The regression of nutritional status indicators v. these quintiles was performed using logistic regression models.SettingTen villages on the Samoan island of Upolu.SubjectsA convenience sample of mother–child pairs (n 305).ResultsTwo dietary patterns, modern and neo-traditional, emerged. The modern pattern was loaded with ‘westernized’ foods (red meat, condiments and snacks). The neo-traditional pattern included vegetables, local starches, coconuts, fish and poultry. Following the modern diet was associated with urban residence, greater maternal educational attainment, higher socio-economic status, lower vitamin C intake and higher sugar intake. Following the neo-traditional diet was associated with rural residence, lower socio-economic status, higher vitamin C intake and lower sugar intake. While dietary patterns were not related to stunting or anaemia, following the neo-traditional pattern was positively associated with child overweight/obesity (adjusted OR=4·23, 95 % CI 1·26, 14·17, for the highest quintile, P-trend=0·06).ConclusionsFurther longitudinal monitoring and evaluation of early childhood growth and development are needed to understand the influences of early diet on child health in Samoa.
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58619
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Rodrigues TC, Oliveira MLS, Soares-Schanoski A, Chavez-Rico SL, Figueiredo DB, Gonçalves VM, Ferreira DM, Kunda NK, Saleem IY, Miyaji EN. Mucosal immunization with PspA (Pneumococcal surface protein A)-adsorbed nanoparticles targeting the lungs for protection against pneumococcal infection. PLoS One 2018; 13:e0191692. [PMID: 29360883 PMCID: PMC5779684 DOI: 10.1371/journal.pone.0191692] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 01/09/2018] [Indexed: 11/22/2022] Open
Abstract
Burden of pneumonia caused by Streptococcus pneumoniae remains high despite the availability of conjugate vaccines. Mucosal immunization targeting the lungs is an attractive alternative for the induction of local immune responses to improve protection against pneumonia. Our group had previously described the development of poly(glycerol adipate-co-ω-pentadecalactone) (PGA-co-PDL) polymeric nanoparticles (NPs) adsorbed with Pneumococcal surface protein A from clade 4 (PspA4Pro) within L-leucine microcarriers (nanocomposite microparticles—NCMPs) for mucosal delivery targeting the lungs (NP/NCMP PspA4Pro). NP/NCMP PspA4Pro was now used for immunization of mice. Inoculation of this formulation induced anti-PspA4Pro IgG antibodies in serum and lungs. Analysis of binding of serum IgG to intact bacteria showed efficient binding to bacteria expressing PspA from clades 3, 4 and 5 (family 2), but no binding to bacteria expressing PspA from clades 1 and 2 (family 1) was observed. Both mucosal immunization with NP/NCMP PspA4Pro and subcutaneous injection of the protein elicited partial protection against intranasal lethal pneumococcal challenge with a serotype 3 strain expressing PspA from clade 5 (PspA5). Although similar survival levels were observed for mucosal immunization with NP/NCMP PspA4Pro and subcutaneous immunization with purified protein, NP/NCMP PspA4Pro induced earlier control of the infection. Conversely, neither immunization with NP/NCMP PspA4Pro nor subcutaneous immunization with purified protein reduced bacterial burden in the lungs after challenge with a serotype 19F strain expressing PspA from clade 1 (PspA1). Mucosal immunization with NP/NCMP PspA4Pro targeting the lungs is thus able to induce local and systemic antibodies, conferring protection only against a strain expressing PspA from the homologous family 2.
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Affiliation(s)
| | | | | | | | - Douglas B. Figueiredo
- Laboratório Especial de Desenvolvimento de Vacinas, Instituto Butantan, São Paulo, SP, Brazil
| | - Viviane M. Gonçalves
- Laboratório Especial de Desenvolvimento de Vacinas, Instituto Butantan, São Paulo, SP, Brazil
| | - Daniela M. Ferreira
- Respiratory Infection Group, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Nitesh K. Kunda
- Formulation and Drug Delivery Research, School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Imran Y. Saleem
- Formulation and Drug Delivery Research, School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Eliane N. Miyaji
- Laboratório de Bacteriologia, Instituto Butantan, São Paulo, SP, Brazil
- * E-mail:
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58620
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Global Mortality Burden of Cirrhosis and Liver Cancer Attributable to Injection Drug Use, 1990-2016: An Age-Period-Cohort and Spatial Autocorrelation Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15010170. [PMID: 29361804 PMCID: PMC5800269 DOI: 10.3390/ijerph15010170] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 01/19/2018] [Accepted: 01/20/2018] [Indexed: 12/19/2022]
Abstract
We analyzed the temporal and spatial variations in mortality burden of cirrhosis and liver cancer attributable to injection drug use (IDU) from 1990 to 2016. Mortality data of IDU-attributable cirrhosis and IDU-attributable liver cancer on the global and national scales from 1990 to 2016 were collected from the Global Burden of Disease (GBD) studies. Age-period-cohort (APC) model analysis was used to analyze the global mortality trends of target disease, and spatial autocorrelation analysis based on Geographic Information System was applied to illustrate the clusters of the most epidemic countries. Globally, from 1990 to 2015, mortality rates (age-standardized, per 100,000) of IDU-attributable cirrhosis increased continually from 1.5 to 1.9, while from 0.4 to 0.9 for IDU-attributable liver cancer. The APC model analysis indicated that the increases of mortality were mainly driven by period effects, with the mortality risk increasing by 6.82-fold for IDU-attributable cirrhosis and 3.08-fold for IDU-attributable liver cancer. The spatial analysis suggested that IDU-attributable cirrhosis mortality were geographically clustered from 1990 to 2016, and hot spots were mainly located in less well developed countries of Latin America, East and Central Europe and Central Asia. Our study provides epidemiological evidence for global interventions against advanced liver disease among injection drug users (IDUs).
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58621
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Abstract
In 2016, the World Health Organization (WHO) recommended point-of-use fortification of complementary foods with iron-containing micronutrient powders to improve iron status and reduce anaemia in children at risk of anaemia. This recommendation continues to be debated. In a recent trial among Kenyan children aged 12-36 months, we found no evidence that daily point-of-use fortification was efficacious in improving haemoglobin concentration or plasma iron markers. An updated meta-analysis indicated that, on average, in an arbitrarily selected setting and with adherence as obtained under trial conditions, one may expect a small increase in haemoglobin concentration in preschool children, with the upper limit of the 95% CI virtually excluding an effect beyond 5.5 g/L. In the present paper, we elaborate on the interpretation of these findings and the meta-analyses that formed the basis for the WHO guidelines. In particular, we draw attention to the phenomenon that small group differences in the distribution of continuous outcomes (haemoglobin concentration, ferritin concentrations) can give a false impression of relatively large effects on the prevalence of the dichotomised outcomes (anaemia, iron deficiency).Please see related articles: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0839-z , https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0867-8.
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58622
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Isaura ER, Chen YC, Yang SH. The Association of Food Consumption Scores, Body Shape Index, and Hypertension in a Seven-Year Follow-Up among Indonesian Adults: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15010175. [PMID: 29361793 PMCID: PMC5800274 DOI: 10.3390/ijerph15010175] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 01/11/2018] [Accepted: 01/20/2018] [Indexed: 12/18/2022]
Abstract
Aims: The concept of food security and its association with chronic diseases are both well-established. During the years within the scope of the study, there was a significant increase in the body shape index (ABSI) of Indonesian adults. This study tested the hypothesis that the association between food security and chronic diseases is mediated, in part, by ABSI. Methods: Data was obtained from 2156 Indonesian adults using the Indonesia Family Life Survey (IFLS) in 2007 and 2014. Longitudinal study participants were interviewed face-to-face for dietary intake data using the food frequency questionnaire (FFQ). Food security, a concept developed by the World Food Programme (WFP), was calculated based on a food consumption score analysis using the FFQ. A generalized estimating equation (GEE) and a Sobel–Goodman test were used to test the hypothesis in this study. Results: The food consumption score was negatively associated with ABSI. It was also negatively associated with systolic blood pressure (p < 0.001). In a formal mediation analysis, ABSI significantly mediated the pathway between the food consumption score and systolic blood pressure (p < 0.001). Conclusions: The effect of food security on hypertension is mediated through body shape. Strategies to improve the prevention of hypertension among adults may need to take the ABSI and food security, along with nutrition education, into account.
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Affiliation(s)
- Emyr Reisha Isaura
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11041, Taiwan.
| | - Yang-Ching Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11041, Taiwan.
- Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei 10341, Taiwan.
| | - Shwu-Huey Yang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11041, Taiwan.
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 11041, Taiwan.
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58623
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Chowdhury S, Dey S, Smith KR. Ambient PM 2.5 exposure and expected premature mortality to 2100 in India under climate change scenarios. Nat Commun 2018; 9:318. [PMID: 29358713 PMCID: PMC5778135 DOI: 10.1038/s41467-017-02755-y] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 12/20/2017] [Indexed: 01/20/2023] Open
Abstract
Premature mortality from current ambient fine particulate (PM2.5) exposure in India is large, but the trend under climate change is unclear. Here we estimate ambient PM2.5 exposure up to 2100 by applying the relative changes in PM2.5 from baseline period (2001-2005) derived from Coupled Model Inter-comparison Project 5 (CMIP5) models to the satellite-derived baseline PM2.5. We then project the mortality burden using socioeconomic and demographic projections in the Shared Socioeconomic Pathway (SSP) scenarios. Ambient PM2.5 exposure is expected to peak in 2030 under the RCP4.5 and in 2040 under the RCP8.5 scenario. Premature mortality burden is expected to be 2.4-4 and 28.5-38.8% higher under RCP8.5 scenario relative to the RCP4.5 scenario in 2031-2040 and 2091-2100, respectively. Improved health conditions due to economic growth are expected to compensate for the impact of changes in population and age distribution, leading to a reduction in per capita health burden from PM2.5 for all scenarios except the combination of RCP8.5 exposure and SSP3.
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Affiliation(s)
- Sourangsu Chowdhury
- Centre for Atmospheric Sciences, Indian Institute of Technology, Delhi, 110016, India.
| | - Sagnik Dey
- Centre for Atmospheric Sciences, Indian Institute of Technology, Delhi, 110016, India
| | - Kirk R Smith
- School of Public Health, University of California Berkeley, Berkeley, CA, 94720, USA.,Collaborative Clean Air Policy Centre Delhi, Delhi, 110003, India
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58624
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Flood D, Garcia P, Douglas K, Hawkins J, Rohloff P. Screening for chronic kidney disease in a community-based diabetes cohort in rural Guatemala: a cross-sectional study. BMJ Open 2018; 8:e019778. [PMID: 29358450 PMCID: PMC5781190 DOI: 10.1136/bmjopen-2017-019778] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 11/03/2017] [Accepted: 11/24/2017] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Screening is a key strategy to address the rising burden of chronic kidney disease (CKD) in low-income and middle-income countries. However, there are few reports regarding the implementation of screening programmes in resource-limited settings. The objectives of this study are to (1) to share programmatic experiences implementing CKD screening in a rural, resource-limited setting and (2) to assess the burden of renal disease in a community-based diabetes programme in rural Guatemala. DESIGN Cross-sectional assessment of glomerular filtration rate (GFR) and urine albumin. SETTING Central Highlands of Guatemala. PARTICIPANTS We enrolled 144 adults with type 2 diabetes in a community-based CKD screening activity carried out by the sponsoring institution. OUTCOME MEASURES Prevalence of renal disease and risk of CKD progression using Kidney Disease: Improving Global Outcomes definitions and classifications. RESULTS We found that 57% of the sample met GFR and/or albuminuria criteria suggestive of CKD. Over half of the sample had moderate or greater increased risk for CKD progression, including nearly 20% who were classified as high or very high risk. Hypertension was common in the sample (42%), and glycaemic control was suboptimal (mean haemoglobin A1c 9.4%±2.5% at programme enrolment and 8.6%±2.3% at time of CKD screening). CONCLUSIONS The high burden of renal disease in our patient sample suggests an imperative to better understand the burden and risk factors of CKD in Guatemala. The implementation details we share reveal the tension between evidence-based CKD screening versus screening that can feasibly be delivered in resource-limited global settings.
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Affiliation(s)
- David Flood
- Wuqu’ Kawoq, Santiago Sacatepéquez, Sacatepéquez, Guatemala
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Pablo Garcia
- Wuqu’ Kawoq, Santiago Sacatepéquez, Sacatepéquez, Guatemala
| | - Kate Douglas
- Wuqu’ Kawoq, Santiago Sacatepéquez, Sacatepéquez, Guatemala
| | | | - Peter Rohloff
- Wuqu’ Kawoq, Santiago Sacatepéquez, Sacatepéquez, Guatemala
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, USA
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58625
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Chaemsaithong P, Leung TY, Sahota D, Cheng YKY, Leung WC, Lo TK, Poon LCY. Body mass index at 11–13 weeks’ gestation and pregnancy complications in a Southern Chinese population: a retrospective cohort study. J Matern Fetal Neonatal Med 2018; 32:2056-2068. [PMID: 29301455 DOI: 10.1080/14767058.2018.1424824] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Piya Chaemsaithong
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China
| | - Tak Yeung Leung
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China
| | - Daljit Sahota
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China
| | - Yvonne Kwun Yue Cheng
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China
| | - Wing Cheong Leung
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, China
| | - Tsz Kin Lo
- Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, China
| | - Liona Chiu Yee Poon
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China
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58626
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Brett FM, Kearney H. Neuropathology correlates of cognitive assessments. Ir J Med Sci 2018; 187:835-844. [PMID: 29349556 DOI: 10.1007/s11845-017-1733-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 12/14/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Alzheimer's disease and other dementias are the fourth largest contributors to neurological disability and the second largest contributor to deaths from neurological disease. Described in the 1980s as 'the silent epidemic' these disorders principally, though not exclusively, affect persons 80 years or older, and in developed countries, this 'old old' population continues to grow. Definitive diagnosis of the underlying cause of the neurodegenerative disease relies on neuropathological evaluation.` AIMS: Herein, we review the sampling methods, analysis and interpretation of both pathological and immunocytochemical techniques in the diagnostic assessment of neurodegenerative disease. FINDINGS Neurodegenerative disorders are characterised by accumulation of pathologically altered protein in the human brain, and in some cases, in the peripheral tissues. Whilst it is suggested that a comprehensive review of the patient's clinical history, cognition and behaviour, together with a full clinical examination and radiological analysis, should lead to a high degree of confidence in the clinical diagnosis, the view persists that underlying pathology can only be predicted on clinical grounds especially in Alzheimer's disease, vascular brain injury and diffuse Lewy body disease with only limited accuracy. CONCLUSIONS Neuropathological assessment of well characterised clinical cases provides accurate data on the prevalence of neurodegenerative diseases. This will aid future biomarker, neuroimaging studies and clinical trials focussed on population based cohorts.
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Affiliation(s)
- Francesca M Brett
- Department of Clinical Neurological Sciences, Royal College of Surgeons, Dublin, Ireland. .,School of Medicine, Trinity College, Dublin, Ireland.
| | - Hugh Kearney
- Department of Clinical Neurological Sciences, Royal College of Surgeons, Dublin, Ireland
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58627
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58628
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Tabassum R, Froeschl G, Cruz JP, Colet PC, Dey S, Islam SMS. Untapped aspects of mass media campaigns for changing health behaviour towards non-communicable diseases in Bangladesh. Global Health 2018; 14:7. [PMID: 29347986 PMCID: PMC5774160 DOI: 10.1186/s12992-018-0325-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 01/09/2018] [Indexed: 11/10/2022] Open
Abstract
In recent years, non-communicable diseases (NCDs) have become epidemic in Bangladesh. Behaviour changing interventions are key to prevention and management of NCDs. A great majority of people in Bangladesh have low health literacy, are less receptive to health information, and are unlikely to embrace positive health behaviours. Mass media campaigns can play a pivotal role in changing health behaviours of the population. This review pinpoints the role of mass media campaigns for NCDs and the challenges along it, whilst stressing on NCD preventive programmes (with the examples from different countries) to change health behaviours in Bangladesh. Future research should underpin the use of innovative technologies and mobile phones, which might be a prospective option for NCD prevention and management in Bangladesh.
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Affiliation(s)
- Reshman Tabassum
- Department of Management, Faculty of Business and Law, Deakin University, Melbourne, Australia
| | - Guenter Froeschl
- Center for International Health, Medical Center of the University of Munich (LMU), Munich, Germany.,Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | | | | | | | - Sheikh Mohammed Shariful Islam
- Non-Communicable Diseases Initiative, International Center for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh. .,The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia. .,Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, Australia.
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58629
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[Prevention of cardiovascular diseases]. Herz 2018; 43:87-100. [PMID: 29335743 DOI: 10.1007/s00059-017-4669-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The incidence of cardiovascular diseases can be reduced by the early detection and targeted treatment of risk factors and subclinical forms of the disease. Primary prevention provides several opportunities for successful interventions. In addition to a drug-based therapy, especially life style-modifying measures, such as physical activity, normalization of body weight, consistent nicotine abstinence and the consideration of psychosocial aspects represent core components of prevention programs. Healthcare data indicate that risk factors still often remain undetected and that the full potential of risk factor management has not yet been fully exploited at a population level. Especially motivation of patients and adherence to therapy represent key elements of successful prevention efforts.
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58630
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Recurrent wheezing in neonatal pneumonia is associated with combined infection with Respiratory Syncytial Virus and Staphylococcus aureus or Klebsiella pneumoniae. Sci Rep 2018; 8:995. [PMID: 29343795 PMCID: PMC5772642 DOI: 10.1038/s41598-018-19386-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 12/14/2017] [Indexed: 11/14/2022] Open
Abstract
Both viral and bacterial infections can be associated with wheezing episodes in children; however, information regarding combined infections with both viral and bacterial pathogens in full term neonates is limited. We sought to investigate the effects of viral–bacterial codetection on pneumonia severity and recurrent wheezing. A retrospective cohort study was conducted on neonates admitted to our hospital with pneumonia from 2009 to 2015. Of 606 total cases, 341 were diagnosed with RSV only, and 265 were diagnosed with both RSV and a potential bacterial pathogen. The leading four species of bacteria codetected with RSV were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Enterobacter cloacae. Neonates with RSV and a potential bacterial pathogen were significantly more likely to have worse symptoms, higher C-reactive protein values and more abnormal chest x-ray manifestations with Bonferroni correction for multiple comparisons (P < 0.01). On Cox regression analysis, an increased risk of recurrent wheezing was found for neonates positive for RSV–Staphylococcus aureus and RSV–Klebsiella pneumoniae. Our findings indicate that the combination of bacteria and RSV in the neonatal airway is associated with more serious clinical characteristics. The presence of RSV and Staphylococcus aureus or Klebsiella pneumoniae may provide predictive markers for wheeze.
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58631
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Mohammedi K, Chalmers J, Herrington W, Li Q, Mancia G, Marre M, Poulter N, Rodgers A, Williams B, Perkovic V, Coresh J, Woodward M. Associations between body mass index and the risk of renal events in patients with type 2 diabetes. Nutr Diabetes 2018; 8:7. [PMID: 29343817 PMCID: PMC5851426 DOI: 10.1038/s41387-017-0012-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 06/22/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND/OBJECTIVES We aimed to evaluate the relationship between BMI and the risk of renal disease in patients with type 2 diabetes in the Action in Diabetes and Vascular Disease: PreterAx and DiamicroN Modified-Release Controlled Evaluation (ADVANCE) study. SUBJECTS/METHODS Participants were divided into six baseline BMI categories: <18.5 (underweight, n = 58); ≥18.5 to <25 (normal, n = 2894); ≥25 to <30 (overweight, n = 4340); ≥30 to <35 (obesity grade 1, n = 2265); ≥35 to <40 (obesity grade 2, n = 744); and ≥40 kg/m2 (obesity grade 3, n = 294); those underweight were excluded. The composite outcome "major renal event" was defined as development of new macroalbuminuria, doubling of creatinine, end stage renal disease, or renal death. These outcomes and development of new microalbuminuria were considered individually as secondary endpoints. RESULTS During 5-years of follow-up, major renal events occurred in 487 (4.6%) patients. The risk increased with higher BMI. Multivariable-adjusted HRs (95% CIs), compared to normal weight, were: 0.91 (0.72-1.15) for overweight; 1.03 (0.77-1.37) for obesity grade 1; 1.42 (0.98-2.07) for grade 2; and 2.16 (1.34-3.48) for grade 3 (p for trend = 0.006). These findings were similar across subgroups by randomised interventions (intensive versus standard glucose control and perindopril-indapamide versus placebo). Every additional unit of BMI over 25 kg/m2 increased the risk of major renal events by 4 (1-6)%. Comparable results were observed with the risk of secondary endpoints. CONCLUSIONS Higher BMI is an independent predictor of major renal events in patients with type 2 diabetes. Our findings encourage weight loss to improve nephroprotection in these patients.
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Affiliation(s)
- Kamel Mohammedi
- The George Institute for Global Health, University of Sydney, Sydney, Australia
- INSERM, UMRS 1138, Centre de Recherche des Cordeliers, Paris, France
- Department of Diabetology, Endocrinology and Nutrition, Assistance Publique Hôpitaux de Paris, Bichat Hospital, DHU FIRE, Paris, France
| | - John Chalmers
- The George Institute for Global Health, University of Sydney, Sydney, Australia.
| | - William Herrington
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Qiang Li
- The George Institute for Global Health, University of Sydney, Sydney, Australia
| | - Giuseppe Mancia
- The University of Milan-Bicocca and Istituto Auxologico Italiano, Milan, Italy
| | - Michel Marre
- INSERM, UMRS 1138, Centre de Recherche des Cordeliers, Paris, France
- Department of Diabetology, Endocrinology and Nutrition, Assistance Publique Hôpitaux de Paris, Bichat Hospital, DHU FIRE, Paris, France
- Sorbonne Paris Cité, UFR de Médecine, University Paris Diderot, Paris, France
| | - Neil Poulter
- The International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College, London, UK
| | - Anthony Rodgers
- The George Institute for Global Health, University of Sydney, Sydney, Australia
| | - Bryan Williams
- Institute of Cardiovascular Sciences, University College London (UCL) and NIHR UCL Hospitals Biomedical Research Centre, London, UK
| | - Vlado Perkovic
- The George Institute for Global Health, University of Sydney, Sydney, Australia
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Mark Woodward
- The George Institute for Global Health, University of Sydney, Sydney, Australia
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- The George Institute for Global Health, University of Oxford, Oxford, UK
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58632
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Zhou X, Xu X, Li J, Hu D, Hu T, Yin W, Fan Y, Zhang X. Oral health in China: from vision to action. Int J Oral Sci 2018; 10:1. [PMID: 29343681 PMCID: PMC5944598 DOI: 10.1038/s41368-017-0006-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 12/01/2017] [Indexed: 02/05/2023] Open
Abstract
Chinese president Xi Jinping made clear at the National Health and Wellness Conference that health is the prerequisite for people's all-around development and a precondition for the sustainable development of China. Oral health is an indispensable component of overall health in humans. However, the long neglect of oral health in overall health agendas has made oral diseases an increasing concern. With this perspective, we described the global challenges of oral diseases, with an emphasis on the challenges faced by China. We also described and analyzed the recently released health policies of the Chinese government, which aim to guide mid-term and long-term oral health promotion in China. More importantly, we called for specific actions to fulfill the larger goal of oral health for the nation. The implementation of primordial prevention efforts against oral diseases, the integration of oral health into the promotion of overall health, and the management of oral diseases in conjunction with other chronic non-communicable diseases with shared risk factors were highly recommended. In addition, we suggested the reform of standard clinical residency training, the development of domestic manufacturing of dental equipment and materials, the revitalization traditional Chinese medicine for the prevention and treatment of oral diseases, and integration of oral health promotion into the Belt and Road Initiative. We look forward to seeing a joint effort from all aspects of the society to fulfill the goal of Healthy China 2030 and ensure the oral health of the nation.
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Affiliation(s)
- Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Xin Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiyao Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Deyu Hu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Tao Hu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wei Yin
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yujiang Fan
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
| | - Xingdong Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
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58633
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Shim JW, Madsen JR. VEGF Signaling in Neurological Disorders. Int J Mol Sci 2018; 19:ijms19010275. [PMID: 29342116 PMCID: PMC5796221 DOI: 10.3390/ijms19010275] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/06/2018] [Accepted: 01/10/2018] [Indexed: 12/19/2022] Open
Abstract
Vascular endothelial growth factor (VEGF) is a potent growth factor playing diverse roles in vasculogenesis and angiogenesis. In the brain, VEGF mediates angiogenesis, neural migration and neuroprotection. As a permeability factor, excessive VEGF disrupts intracellular barriers, increases leakage of the choroid plexus endothelia, evokes edema, and activates the inflammatory pathway. Recently, we discovered that a heparin binding epidermal growth factor like growth factor (HB-EGF)—a class of EGF receptor (EGFR) family ligands—contributes to the development of hydrocephalus with subarachnoid hemorrhage through activation of VEGF signaling. The objective of this review is to entail a recent update on causes of death due to neurological disorders involving cerebrovascular and age-related neurological conditions and to understand the mechanism by which angiogenesis-dependent pathological events can be treated with VEGF antagonisms. The Global Burden of Disease study indicates that cancer and cardiovascular disease including ischemic and hemorrhagic stroke are two leading causes of death worldwide. The literature suggests that VEGF signaling in ischemic brains highlights the importance of concentration, timing, and alternate route of modulating VEGF signaling pathway. Molecular targets distinguishing two distinct pathways of VEGF signaling may provide novel therapies for the treatment of neurological disorders and for maintaining lower mortality due to these conditions.
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Affiliation(s)
- Joon W Shim
- Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA.
| | - Joseph R Madsen
- Department of Neurosurgery, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA.
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58634
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Mutyambizi C, Pavlova M, Chola L, Hongoro C, Groot W. Cost of diabetes mellitus in Africa: a systematic review of existing literature. Global Health 2018; 14:3. [PMID: 29338746 PMCID: PMC5771003 DOI: 10.1186/s12992-017-0318-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 12/29/2017] [Indexed: 01/14/2023] Open
Abstract
Background There is an increasing recognition that non communicable diseases impose large economic costs on households, societies and nations. However, not much is known about the magnitude of diabetes expenditure in African countries and to the best of our knowledge no systematic assessment of the literature on diabetes costs in Africa has been conducted. The aim of this paper is to capture the evidence on the cost of diabetes in Africa, review the methods used to calculate costs and identify areas for future research. Methods A desk search was conducted in Pubmed, Medline, Embase, and Science direct as well as through other databases, namely Google Scholar. The following eligibility criteria were used: peer reviewed English articles published between 2006 and 2016, articles that reported original research findings on the cost of illness in diabetes, and studies that covered at least one African country. Information was extracted using two data extraction sheets and results organized in tables. Costs presented in the studies under review are converted to 2015 international dollars prices (I$). Results Twenty six articles are included in this review. Annual national direct costs of diabetes differed between countries and ranged from I$3.5 billion to I$4.5 billion per annum. Indirect costs per patient were generally higher than the direct costs per patient of diabetes. Outpatient costs varied by study design, data source, perspective and healthcare cost categories included in the total costs calculation. The most commonly included healthcare items were drug costs, followed by diagnostic costs, medical supply or disposable costs and consultation costs. In studies that reported both drug costs and total costs, drug costs took a significant portion of the total costs per patient. The highest burden due to the costs associated with diabetes was reported in individuals within the low income group. Conclusion Estimation of the costs associated with diabetes is crucial to make progress towards meeting the targets laid out in Sustainable Development Goal 3 set for 2030. The studies included in this review show that the presence of diabetes leads to elevated costs of treatment which further increase in the presence of complications. The cost of drugs generally contributed the most to total direct costs of treatment. Various methods are used in the estimation of diabetes healthcare costs and the costs estimated between countries differ significantly. There is room to improve transparency and make the methodologies used standard in order to allow for cost comparisons across studies. Electronic supplementary material The online version of this article (10.1186/s12992-017-0318-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chipo Mutyambizi
- Population Health, Health Systems and Innovation, Human Sciences Research Council, HSRC Building, 134 Pretorius Street, Pretoria, 0002, South Africa.
| | - Milena Pavlova
- Department of Health Services Research; CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Lumbwe Chola
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Charles Hongoro
- Population Health, Health Systems and Innovation, Human Sciences Research Council, HSRC Building, 134 Pretorius Street, Pretoria, 0002, South Africa
| | - Wim Groot
- Department of Health Services Research; CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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58635
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Al-Mallah MH, Sakr S, Al-Qunaibet A. Cardiorespiratory Fitness and Cardiovascular Disease Prevention: an Update. Curr Atheroscler Rep 2018; 20:1. [PMID: 29340805 DOI: 10.1007/s11883-018-0711-4] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE OF REVIEW Cardiovascular diseases account for nearly one third of all deaths globally. Improving exercise capacity and cardiorespiratory fitness (CRF) has been an important target to reduce cardiovascular events. In addition, the American Heart Association defined decreased physical activity as the fourth risk factor for coronary artery disease. Multiple large cohort studies have evaluated the impact of CRF on outcomes. In this review, we will discuss the role of CRF in reducing cardiovascular morbidity and mortality. RECENT FINDINGS Recent data suggest that CRF has an important role in reducing not only cardiovascular and all-cause mortality, but also incident myocardial infarction, hypertension, diabetes, atrial fibrillation, heart failure, and stroke. Most recently, its role in cancer prevention started to emerge. CRF protective effects have also been seen in patients with prior comorbidities like prior coronary artery disease, heart failure, depression, end-stage renal disease, and stroke. The prognostic value of CRF has been demonstrated in various patient populations and cardiovascular conditions. Higher CRF is associated with improved survival and decreased incidence of cardiovascular diseases (CVD) and other comorbidities including hypertension, diabetes, heart failure, and atrial fibrillation.
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Affiliation(s)
- Mouaz H Al-Mallah
- King Abdulaziz Cardiac Center, Ministry of National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 22490, Riyadh, 11426, Kingdom of Saudi Arabia. .,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia. .,King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.
| | - Sherif Sakr
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Ada Al-Qunaibet
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia
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58636
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Wang J, Wang B, Liang M, Wang G, Li J, Zhang Y, Huo Y, Cui Y, Xu X, Qin X. Independent and combined effect of bilirubin and smoking on the progression of chronic kidney disease. Clin Epidemiol 2018; 10:121-132. [PMID: 29391834 PMCID: PMC5774486 DOI: 10.2147/clep.s150687] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Objective Whether serum bilirubin and cigarette smoking affect the risk of renal function decline remains inconclusive. We aimed to test the independent and combined effects of bilirubin and cigarette smoking on the progression of chronic kidney disease (CKD) in hypertensive adults. Methods The study population consisted of 12,633 patients in the renal sub-study of the China Stroke Primary Prevention Trial. The primary outcome was progression of CKD, defined as a decrease in estimated glomerular filtration rate (eGFR) of ≥30% and to a level of <60 mL/min/1.73 m2 if baseline eGFR was ≥60 mL/min/1.73 m2, or a decrease in eGFR of ≥50% if baseline eGFR was <60 mL/min/1.73 m2, or end-stage renal disease. The secondary outcomes included 1) rapid decline in renal function and 2) annual rate of eGFR decline. Results The median follow-up duration was 4.4 years. Cigarette smoking had no significant effect on the progression of CKD (odds ratio [OR]: 1.11, 95% confidence interval [95% CI]: 0.78-1.57). However, a significantly lower risk of the primary event (OR: 0.72, 95% CI: 0.55-0.95) was found in participants in tertile 3 compared to those in tertiles 1-2 for total bilirubin (TBiL) levels. More importantly, there was an interaction between TBiL and smoking status on the primary outcome (P for interaction =0.013). Among ever smokers, TBiL levels had no significant effect on the primary outcome. However, among never smokers, higher TBiL levels were significantly associated with a lower risk of the primary outcome (tertile 3 vs 1-2; OR: 0.53, 95% CI: 0.36-0.78). Similar trends were observed for direct bilirubin and secondary outcomes. Conclusion Among hypertensive patients, bilirubin was inversely associated with the progression of CKD in never smokers, but not in ever smokers.
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Affiliation(s)
- Jiancheng Wang
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Binyan Wang
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou.,Institute for Biomedicine, Anhui Medical University, Hefei
| | - Min Liang
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Guobao Wang
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou
| | | | | | | | - Yimin Cui
- Department of Pharmacy, Peking University First Hospital, Beijing
| | - Xiping Xu
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou.,Beijing Advanced Innovation Center for Food Nutrition and Human Health, Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xianhui Qin
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou
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58637
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Affiliation(s)
- Erin Russell
- Assistant Editor (Russell), Deputy Editor (Patrick), CMAJ
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58638
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Chen WT, Chou KH, Lee PL, Hsiao FJ, Niddam DM, Lai KL, Fuh JL, Lin CP, Wang SJ. Comparison of gray matter volume between migraine and "strict-criteria" tension-type headache. J Headache Pain 2018; 19:4. [PMID: 29335889 PMCID: PMC5768588 DOI: 10.1186/s10194-018-0834-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 01/02/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Despite evidently distinct symptoms, tension-type headache (TTH) and migraine are highly comorbid and exhibit many similarities in clinical practice. The purpose of this study was to investigate whether both types of headaches are similar in brain morphology. METHODS Consecutive patients with TTH and age- and sex-matched patients with migraine and healthy controls were enrolled for brain magnetic resonance imaging examination. Patients with TTH were excluded if they reported any headache features or associated symptoms of migraine. Changes in gray matter (GM) volume associated with headache diagnosis (TTH vs. migraine) and frequency (episodic vs. chronic) were examined using voxel-based morphometry. The correlation with headache profile and the discriminative ability between TTH and migraine were also investigated for these GM changes. RESULTS In comparison with controls (n = 43), the patients with TTH (25 episodic and 24 chronic) exhibited a GM volume increase in the anterior cingulate cortex, supramarginal gyrus, temporal pole, lateral occipital cortex, and caudate. The patients with migraine (31 episodic and 25 chronic) conversely exhibited a GM volume decrease in the orbitofrontal cortex. These GM changes did not correlate with any headache profile. A voxel-wise 2 × 2 factorial analysis further revealed the substantial effects of headache types and frequency in the comparison of GM volume between TTH and migraine. Specifically, the migraine group (vs. TTH) had a GM decrease in the superior and middle frontal gyri, cerebellum, dorsal striatum, and precuneus. The chronic group (vs. episodic group) otherwise demonstrated a GM decrease in the bilateral insula and anterior cingulate cortex. In receiver operating characteristic analysis, the GM volumes of the left superior frontal gyrus and right cerebellum V combined had good discriminative ability for distinguishing TTH and migraine (area under the curve = 0.806). CONCLUSIONS TTH and migraine are separate headache disorders with different characteristics in relation to GM changes. The major morphological difference between the two types of headaches is the relative GM decrease of the prefrontal and cerebellar regions in migraine, which may reflect a higher allostatic load associated with this disabling headache.
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Affiliation(s)
- Wei-Ta Chen
- Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. .,Brain Research Center, National Yang-Ming University, Taipei, Taiwan. .,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Kun-Hsien Chou
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Lin Lee
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Fu-Jung Hsiao
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - David M Niddam
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Lin Lai
- Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Po Lin
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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58639
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Tsivgoulis G, Patousi A, Pikilidou M, Birbilis T, Katsanos AH, Mantatzis M, Asimis A, Papanas N, Skendros P, Terzoudi A, Karamanli A, Kouroumichakis I, Zebekakis P, Maltezos E, Piperidou C, Vadikolias K, Heliopoulos I. Stroke Incidence and Outcomes in Northeastern Greece: The Evros Stroke Registry. Stroke 2018; 49:288-295. [PMID: 29335330 DOI: 10.1161/strokeaha.117.019524] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 11/17/2017] [Accepted: 11/30/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND PURPOSE Data are scarce on both stroke incidence rates and outcomes in Greece and in rural areas in particular. We performed a prospective population-based study evaluating the incidence of first-ever stroke in the Evros prefecture, a region of a total 147 947 residents located in North Eastern Greece. METHODS Adult patients with first-ever stroke were registered during a 24-month period (2010-2012) and followed up for 12 months. To compare our stroke incidence with that observed in other studies, we standardized our incidence rate data according to the European Standard Population, World Health Organization, and Segi population. We also applied criteria of data quality proposed by the Monitoring Trends and Determinants in Cardiovascular Disease project. Stroke diagnosis and classification were performed using World Health Organization criteria on the basis of neuroimaging and autopsy data. RESULTS We prospectively documented 703 stroke cases (mean age: 75±12 years; 52.8% men; ischemic stroke: 80.8%; intracerebral hemorrhage: 11.8%; subarachnoid hemorrhage: 4.4%; undefined: 3.0%) with a total follow-up time of 119 805 person-years. The unadjusted and European Standard Population-adjusted incidences of all strokes were 586.8 (95% confidence interval [CI], 543.4-630.2) and 534.1 (95% CI, 494.6-573.6) per 100 000 person-years, respectively. The unadjusted incidence rates for ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage were 474.1 (95% CI, 435-513), 69.3 (95% CI, 54-84), and 25.9 (95% CI, 17-35) per 100 000 person-years, respectively. The corresponding European Standard Population-adjusted incidence rates per 100 000 person-years were 425.9 (95% CI, 390.9-460.9), 63.3 (95% CI, 49.7-76.9), and 25.8 (95% CI, 16.7-34.9) for ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage, respectively. The overall 28-day case fatality rate was 21.3% (95% CI, 18.3%-24.4%) for all strokes and was higher in hemorrhagic strokes than ischemic stroke (40.4%, 95% CI, 31.3%-49.4% versus 16.2%, 95% CI, 13.2%-19.2%). CONCLUSIONS This is the largest to date population-based study in Greece documenting one of the highest stroke incidences ever reported in South Europe, highlighting the need for efficient stroke prevention and treatment strategies in Northeastern Greece.
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Affiliation(s)
- Georgios Tsivgoulis
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.).
| | - Athanasia Patousi
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Maria Pikilidou
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Theodosis Birbilis
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Aristeidis H Katsanos
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Michalis Mantatzis
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Aristeidis Asimis
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Nikolaos Papanas
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Panagiotis Skendros
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Aikaterini Terzoudi
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Aikaterini Karamanli
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Ioannis Kouroumichakis
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Pantelis Zebekakis
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Efstratios Maltezos
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Charitomeni Piperidou
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Konstantinos Vadikolias
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
| | - Ioannis Heliopoulos
- From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.)
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58640
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Liver Cancer Mortality at National and Provincial Levels in Iran Between 1990 and 2015: A Meta Regression Analysis. HEPATITIS MONTHLY 2018. [DOI: 10.5812/hepatmon.62009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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58641
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Airflow limitation in people living with HIV and matched uninfected controls. Thorax 2018; 73:431-438. [DOI: 10.1136/thoraxjnl-2017-211079] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 12/13/2017] [Accepted: 12/22/2017] [Indexed: 11/03/2022]
Abstract
IntroductionWhether HIV influences pulmonary function remains controversial. We assessed dynamic pulmonary function in people living with HIV (PLWHIV) and uninfected controls.MethodsA total of 1098 PLWHIV from the Copenhagen Co-morbidity in HIV infection study and 12 161 age-matched and sex-matched controls from the Copenhagen General Population Study were included. Lung function was assessed using FEV1 and FVC, while airflow limitation was defined by the lower limit of normal (LLN) of FEV1/FVC and by FEV1/FVC<0.7 with FEV1predicted <80% (fixed). Logistic and linear regression models were used to determine the association between HIV and pulmonary function adjusting for potential confounders (including smoking and socioeconomic status).ResultsIn predominantly white men with mean (SD) age of 50.6 (11.1) the prevalence of airflow limitation (LLN) was 10.6% (95% CI 8.9% to 12.6%) in PLWHIV and 10.6% (95% CI 10.0 to 11.1) in uninfected controls. The multivariable adjusted OR for airflow limitation defined by LLN for HIV was 0.97 (0.77–1.21, P<0.78) and 1.71 (1.34–2.16, P<0.0001) when defined by the fixed criteria. We found no evidence of interaction between HIV and cumulative smoking in these models (P interaction: 0.25 and 0.17 for LLN and fixed criteria, respectively). HIV was independently associated with 197 mL (152–242, P<0.0001) lower FEV1 and 395 mL (344–447, P<0.0001) lower FVC, and 100 cells/mm3 lower CD4 nadir was associated with 30 mL (7–52, P<0.01) lower FEV1 and 51 mL (24–78, P<0.001) lower FVC.ConclusionHIV is a risk factor for concurrently decreased FEV1 and FVC. This excess risk is not explained by smoking or socioeconomic status and may be mediated by prior immunodeficiency.Trial registration numberNCT02382822.
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58642
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Affiliation(s)
- Tikki Pang
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore 259772.
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58643
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Gayet-Ageron A, Prieto-Merino D, Ker K, Shakur H, Ageron FX, Roberts I. Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: a meta-analysis of individual patient-level data from 40 138 bleeding patients. Lancet 2018; 391:125-132. [PMID: 29126600 PMCID: PMC5773762 DOI: 10.1016/s0140-6736(17)32455-8] [Citation(s) in RCA: 209] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 08/25/2017] [Accepted: 08/31/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Antifibrinolytics reduce death from bleeding in trauma and post-partum haemorrhage. We examined the effect of treatment delay on the effectiveness of antifibrinolytics. METHODS We did an individual patient-level data meta-analysis of randomised trials done with more than 1000 patients that assessed antifibrinolytics in acute severe bleeding. We identified trials done between Jan 1, 1946, and April 7, 2017, from MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, PubMed, Popline, and the WHO International Clinical Trials Registry Platform. The primary measure of treatment benefit was absence of death from bleeding. We examined the effect of treatment delay on treatment effectiveness using logistic regression models. We investigated the effect of measurement error (misclassification) in sensitivity analyses. This study is registered with PROSPERO, number 42016052155. FINDINGS We obtained data for 40 138 patients from two randomised trials of tranexamic acid in acute severe bleeding (traumatic and post-partum haemorrhage). Overall, there were 3558 deaths, of which 1408 (40%) were from bleeding. Most (884 [63%] of 1408) bleeding deaths occurred within 12 h of onset. Deaths from post-partum haemorrhage peaked 2-3 h after childbirth. Tranexamic acid significantly increased overall survival from bleeding (odds ratio [OR] 1·20, 95% CI 1·08-1·33; p=0·001), with no heterogeneity by site of bleeding (interaction p=0·7243). Treatment delay reduced the treatment benefit (p<0·0001). Immediate treatment improved survival by more than 70% (OR 1·72, 95% CI 1·42-2·10; p<0·0001). Thereafter, the survival benefit decreased by 10% for every 15 min of treatment delay until 3 h, after which there was no benefit. There was no increase in vascular occlusive events with tranexamic acid, with no heterogeneity by site of bleeding (p=0·5956). Treatment delay did not modify the effect of tranexamic acid on vascular occlusive events. INTERPRETATION Death from bleeding occurs soon after onset and even a short delay in treatment reduces the benefit of tranexamic acid administration. Patients must be treated immediately. Further research is needed to deepen our understanding of the mechanism of action of tranexamic acid. FUNDING UK NIHR Health Technology Assessment programme, Pfizer, BUPA Foundation, and J P Moulton Charitable Foundation (CRASH-2 trial). London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation (WOMAN trial).
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Affiliation(s)
- Angèle Gayet-Ageron
- Clinical Trials Unit, London School of Hygiene & Tropical Medicine, London, UK; Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland
| | - David Prieto-Merino
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Katharine Ker
- Clinical Trials Unit, London School of Hygiene & Tropical Medicine, London, UK
| | - Haleema Shakur
- Clinical Trials Unit, London School of Hygiene & Tropical Medicine, London, UK
| | - François-Xavier Ageron
- Clinical Trials Unit, London School of Hygiene & Tropical Medicine, London, UK; Department of Emergency Medicine-Northern French Alps Emergency Network, Annecy Genevois Hospital, Annecy, France
| | - Ian Roberts
- Clinical Trials Unit, London School of Hygiene & Tropical Medicine, London, UK.
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58644
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Sinha J, Duffull SB, Al-Sallami HS. A Review of the Methods and Associated Mathematical Models Used in the Measurement of Fat-Free Mass. Clin Pharmacokinet 2018; 57:781-795. [DOI: 10.1007/s40262-017-0622-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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58645
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Affiliation(s)
- Daniel S Reich
- From the Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda (D.S.R.), and the Departments of Neurology and Neuroscience, Johns Hopkins School of Medicine, Baltimore (P.A.C.) - both in Maryland; and the Department of Neurology, Mayo Clinic, Rochester, MN (C.F.L.)
| | - Claudia F Lucchinetti
- From the Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda (D.S.R.), and the Departments of Neurology and Neuroscience, Johns Hopkins School of Medicine, Baltimore (P.A.C.) - both in Maryland; and the Department of Neurology, Mayo Clinic, Rochester, MN (C.F.L.)
| | - Peter A Calabresi
- From the Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda (D.S.R.), and the Departments of Neurology and Neuroscience, Johns Hopkins School of Medicine, Baltimore (P.A.C.) - both in Maryland; and the Department of Neurology, Mayo Clinic, Rochester, MN (C.F.L.)
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58646
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Restrepo MI, Reyes LF. Pneumonia as a cardiovascular disease. Respirology 2018; 23:250-259. [PMID: 29325222 DOI: 10.1111/resp.13233] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 08/05/2017] [Indexed: 01/08/2023]
Abstract
Community-acquired pneumonia (CAP) is an important cause of death around the globe. Up to 30% of patients admitted to hospital for CAP develop cardiovascular complications (i.e. new/worsening heart failure, new/worsening arrhythmias, myocardial infarctions and/or strokes), acutely and up to 10 years thereafter. Cardiac complications result from complex interactions between preexisting conditions, relative ischaemia, upregulation of the sympathetic system, systemic inflammation and direct pathogen-mediated damage to the cardiovascular system. The exact mechanisms underlying the direct host-pathogen interactions are of great interest to identify potential therapeutic and preventative targets for CAP. In this review, we summarize the epidemiological data, risk factors and the pathogen-driven cardiovascular damage affecting patients with CAP.
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Affiliation(s)
- Marcos I Restrepo
- Division of Pulmonary Diseases and Critical Care Medicine, South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Medicine, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Luis F Reyes
- Division of Pulmonary Diseases and Critical Care Medicine, South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Medicine, University of Texas Health at San Antonio, San Antonio, TX, USA
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58647
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Yu Y, Lv Y, Yao B, Duan L, Zhang X, Xie L, Chang C. A novel prescription pedometer-assisted walking intervention and weight management for Chinese occupational population. PLoS One 2018; 13:e0190848. [PMID: 29324808 PMCID: PMC5764333 DOI: 10.1371/journal.pone.0190848] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 12/20/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND AIM Information technology has been previously used for the research and practice of health promotion. Appropriate and effective health promotion methods used by professional groups remain to be investigated. This study aimed to assess the feasibility and effectiveness of a weight management program among the Chinese occupational population using and a novel information technology exercise prescription. STUDY DESIGN AND PARTICIPANTS A 3-month open, self-monitored intervention trial, involving individualized pedometer-assisted exercise prescription and a one-time targeted dietary guidance prior to exercise was conducted on the Chinese occupational population aged 18-65 years in China from 2015 to 2016. Data were collected from March 2015 to May 2016 and analyzed from June 2016 to August 2016. Participants were also asked to synchronize exercise data of the pedometer to the Internet-based Health System Center daily (at least weekly), by connecting to the personal computer (PC) using a USB cable or via Bluetooth. RESULTS Eligible participants included 802 Chinese occupational persons, and 718 of them followed exercise interventions with 89.5% (718/802) adherence to the exercise programs. Of them, 688 participants completed the program with 85.8% (688/802) adherence to the exercise program and their data were analyzed. Weight decreased by 2.2% among all overweight/obese participants, with 1.8% reduction in waist circumference and 3.3% reduction in body fat percentage (p< 0.001). Weight and body fat percentage in normal-weight individuals decreased by 0.7% and 2.5%, respectively (p < 0.01). A weight gain of 1.0% was observed in all underweight participants (p< 0.05), and 68.2% (208/305) of overweight/obese participants experienced weight loss, with an average reduction of 3.5%, with 20.2% (42/208) of them achieving weight loss ≥5%. Blood pressure and fasting serum glucose decreased significantly in both the overweight/obese and the normal-weight individuals (p < 0.05). The incidence of hypertension was significantly lower and lifestyle behavior significantly improved (p < 0.05). CONCLUSION The prescription pedometer-assisted walking intervention can effectively improve exercise adherence and manage weight. This approach was also effective in controlling the risk factors of weight-related chronic diseases. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR) ChiCTR-OOh-16010229.
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Affiliation(s)
- Yingxiang Yu
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Yiran Lv
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Bin Yao
- Descom Information Technology (Beijing) Co. Ltd., Beijing, China
| | - Liguang Duan
- Descom Information Technology (Beijing) Co. Ltd., Beijing, China
| | - Xiaoyuan Zhang
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Lan Xie
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Cuiqing Chang
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
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58648
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Mahesh PA. Molecular biology tools for precision medicine in managing lung cancer. Lung India 2018; 35:1-3. [PMID: 29319025 PMCID: PMC5760860 DOI: 10.4103/lungindia.lungindia_470_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- P A Mahesh
- Department of Pulmonary Medicine, JSS Medical College, JSS University, Mysore, Karnataka, India
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58649
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Affiliation(s)
- Peter J Hotez
- Texas Children's Hospital Center for Vaccine Development, Department of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas; Department of Biology, Baylor University, Waco, Texas; James A Baker III Institute of Public Policy, Rice University, Houston, Texas; Scowcroft Institute of International Affairs, Bush School of Government and Public Policy, Texas A&M University, College Station, Texas
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58650
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van Dammen L, Wekker V, van Oers AM, Mutsaerts MAQ, Painter RC, Zwinderman AH, Groen H, van de Beek C, Muller Kobold AC, Kuchenbecker WKH, van Golde R, Oosterhuis GJE, Vogel NEA, Mol BWJ, Roseboom TJ, Hoek A. Effect of a lifestyle intervention in obese infertile women on cardiometabolic health and quality of life: A randomized controlled trial. PLoS One 2018; 13:e0190662. [PMID: 29324776 PMCID: PMC5764284 DOI: 10.1371/journal.pone.0190662] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 12/13/2017] [Indexed: 01/26/2023] Open
Abstract
Background The prevalence of obesity, an important cardiometabolic risk factor, is rising in women. Lifestyle improvements are the first step in treatment of obesity, but the success depends on factors like timing and motivation. Women are especially receptive to advice about lifestyle before and during pregnancy. Therefore, we hypothesize that the pre-pregnancy period provides the perfect window of opportunity to improve cardiometabolic health and quality of life of obese infertile women, by means of a lifestyle intervention. Methods and findings Between 2009–2012, 577 infertile women between 18 and 39 years of age, with a Body Mass Index of ≥ 29 kg/m2, were randomized to a six month lifestyle intervention preceding infertility treatment, or to direct infertility treatment. The goal of the intervention was 5–10% weight loss or a BMI < 29 kg/m2. Cardiometabolic outcomes included weight, waist- and hip circumference, body mass index, systolic and diastolic blood pressure, fasting glucose and insulin, HOMA-IR, hs-CRP, lipids and metabolic syndrome. All outcomes were measured by research nurses at randomization, 3 and 6 months. Self-reported quality of life was also measured at 12 months. Three participants withdrew their informed consent, and 63 participants discontinued the intervention program. Intention to treat analysis was conducted. Mixed effects regression models analyses were performed. Results are displayed as estimated mean differences between intervention and control group. Weight (-3.1 kg 95% CI: -4.0 to -2.2 kg; P < .001), waist circumference (-2.4 cm 95% CI: -3.6 to -1.1 cm; P < .001), hip circumference (-3.0 95% CI: -4.2 to -1.9 cm; P < .001), BMI (-1.2 kg/m2 95% CI: -1.5 to -0.8 kg/m2; P < .001), systolic blood pressure (-2.8 mmHg 95% CI: -5.0 to -0.7 mmHg; P = .01) and HOMA-IR (-0.5 95% CI: -0.8 to -0.1; P = .01) were lower in the intervention group compared to controls. Hs-CRP and lipids did not differ between groups. The odds ratio for metabolic syndrome in the intervention group was 0.53 (95% CI: 0.33 to 0.85; P < .01) compared to controls. Physical QoL scores were higher in the lifestyle intervention group (2.2 95% CI: 0.9 to 3.5; P = .001) while mental QoL scores did not differ. Conclusions In obese infertile women, a lifestyle intervention prior to infertility treatment improves cardiometabolic health and self-reported physical quality of life (LIFEstyle study: Netherlands Trial Register: NTR1530).
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Affiliation(s)
- Lotte van Dammen
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Vincent Wekker
- Department of Obstetrics and Gynecology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health research institute, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
- * E-mail:
| | - Anne M. van Oers
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Meike A. Q. Mutsaerts
- Department of General Practice, University Medical Centre Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - Rebecca C. Painter
- Department of Obstetrics and Gynecology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Aeilko H. Zwinderman
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health research institute, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Henk Groen
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Cornelieke van de Beek
- Department of Obstetrics and Gynecology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Anneke C. Muller Kobold
- Department of Laboratory Medicine, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | | | - Ron van Golde
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht University, Maastricht, the Netherlands
| | | | - Niels E. A. Vogel
- Department of Obstetrics and Gynecology, Martini Hospital, Groningen, the Netherlands
| | - Ben Willem J. Mol
- Department of Obstetrics and Gynecology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health research institute, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
- Department of General Practice, University Medical Centre Utrecht, University of Utrecht, Utrecht, the Netherlands
- Department of Laboratory Medicine, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
- Department of Obstetrics and Gynecology, Isala Clinics, Zwolle, the Netherlands
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht University, Maastricht, the Netherlands
- Department of Obstetrics and Gynecology, St. Antonius Hospital, Nieuwegein, the Netherlands
- Department of Obstetrics and Gynecology, Martini Hospital, Groningen, the Netherlands
- School of Medicine, Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Tessa J. Roseboom
- Department of Obstetrics and Gynecology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health research institute, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Annemieke Hoek
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
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