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Suresh S, Perret JL, Walters EH, Abramson MJ, Bowatte G, Lodge C, Lowe A, Erbas B, Thomas P, Hamilton GS, Chang AB, Dharmage SC, Bui DS. Disease burden, comorbidities and antecedents of chronic cough phenotypes in Australian adults. Pulmonology 2023:S2531-0437(23)00154-X. [PMID: 37743172 DOI: 10.1016/j.pulmoe.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES While adult chronic cough has high burden, its phenotypes, particularly those without aetiologically related underlying conditions, are understudied. We investigated the prevalence, lung function and comorbidities of adult chronic cough phenotypes. METHODS Data from 3608 participants aged 53 years from the Tasmanian Longitudinal Health Study (TAHS) were included. Chronic cough was defined as cough on most days for >3 months in a year. Chronic cough was classified into "explained cough" if there were any one of four major cough-associated conditions (asthma, COPD, gastroesophageal reflux disease or rhinosinusitis) or "unexplained cough" if none were present. Adjusted regression analyses investigated associations between these chronic cough phenotypes, lung function and non-respiratory comorbidities at 53 years. RESULTS The prevalence of chronic cough was 10% (95%CI 9.1,11.0%) with 46.4% being "unexplained". Participants with unexplained chronic cough had lower FEV1/FVC (coefficient: -1.2% [95%CI:-2,3, -0.1]) and increased odds of comorbidities including obesity (OR=1.6 [95%CI: 1.2, 2.3]), depression (OR=1.4 [95%CI: 1.0, 2.1]), hypertension (OR=1.7 [95%CI: 1.2, 2.4]) and angina, heart attack or myocardial infarction to a lesser extent, compared to those without chronic cough. Participants with explained chronic cough also had lower lung function than both those with unexplained chronic cough and those without chronic cough. CONCLUSIONS Chronic cough is prevalent in middle-age and a high proportion is unexplained. Unexplained cough contributes to poor lung function and increased comorbidities. Given unexplained chronic cough is not a symptom of major underlying respiratory conditions it should be targeted for better understanding in both clinical settings and research.
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Affiliation(s)
- S Suresh
- University of Melbourne Medical School, Parkville, Victoria, Australia; Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - J L Perret
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - E H Walters
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia; School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - M J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - G Bowatte
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - C Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - A Lowe
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - B Erbas
- School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - P Thomas
- Prince of Wales' Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - G S Hamilton
- Monash Lung, Sleep, Allergy and Immunology, Monash Health, Clayton, Australia; School of Clinical Sciences, Monash University, Clayton, Australia
| | - A B Chang
- Dept of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia; NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - S C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia; NHMRC-CRE Centre for Air pollution, Energy and Health Research, Australia
| | - D S Bui
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Oguz-Akarsu E, Sirin NG, Artug T, Erbas B, Orhan EK, Idrisoğlu HA, Ketenci A, Baslo MB, Oge AE. Automatic detection of F-waves and F-MUNE in Two Types of Motor Neuron Diseases. Muscle Nerve 2022; 65:422-432. [PMID: 35020950 DOI: 10.1002/mus.27494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 01/02/2022] [Accepted: 01/06/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION/AIMS Motor unit number estimation by F-waves (F-MUNE) is an uncommonly used MUNE technique. The aim of this study was to analyze the sensitivity of F-MUNE values elicited with newly developed software in motor neuron diseases. METHODS F-waves were recorded by 300 submaximal stimuli from abductor digiti minimi (ADM) and abductor pollicis brevis (APB) muscles of 35 patients with amyotrophic lateral sclerosis, 18 with previous poliomyelitis, and 20 controls. The software extracted the surface motor unit action potentials (sMUAP) and calculated the F-MUNE values. CMAP Scans were also recorded to obtain step% and MScanFit. RESULTS sMUAP amplitudes were higher and F-MUNE values were lower in both muscles of the patients than in controls. F-MUNE values were able to distinguish the patients from controls. Significant correlations were found between F-MUNE and MScanFit in patient groups. DISCUSSION The new F-MUNE software gave promising results in revealing motor unit loss caused by motor neuron diseases.
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Affiliation(s)
- Emel Oguz-Akarsu
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey.,Department of Neurology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Nermin Gorkem Sirin
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tugrul Artug
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Izmir Democracy University, Izmir, Turkey
| | - Bahar Erbas
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey.,Department of Pharmacology, Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey
| | - Elif Kocasoy Orhan
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Halil Atilla Idrisoğlu
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Aysegul Ketenci
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Baris Baslo
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Emre Oge
- Departments of Neurology and Clinical Neurophysiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Abdelsalam S, Van Den Boom W, Dietze P, Erbas B, Higgs P. Adequate Analgesia and Oral Care Attendance in Opiate Dependent Individuals. J Dent Res 2020; 99:1406. [PMID: 32755428 DOI: 10.1177/0022034520948450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- S Abdelsalam
- Department of Public Health, La Trobe University College of Science Health and Engineering, Bundoora, Victoria, Australia
| | - W Van Den Boom
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia
| | - P Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia
| | - B Erbas
- Department of Public Health, La Trobe University College of Science Health and Engineering, Bundoora, Victoria, Australia
| | - P Higgs
- Department of Public Health, La Trobe University College of Science Health and Engineering, Bundoora, Victoria, Australia
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Kesim-Sahin O, Sirin NG, Erbas B, Artug T, Oguz-Akarsu E, Kocasoy-Orhan E, Baslo MB, Mammadova N, Emekli U, Oge AE. Compound muscle action potential scan and MScanFit motor unit number estimation during Wallerian degeneration after nerve transections. Muscle Nerve 2020; 62:239-246. [PMID: 32415858 DOI: 10.1002/mus.26923] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Compound muscle action potential (CMAP) scan and MScanFit have been used to understand the consequences of denervation and reinnervation. This study aimed to monitor these parameters during Wallerian degeneration (WD) after acute nerve transections (ANT). METHODS Beginning after urgent surgery, CMAP scans were recorded at 1-2 day intervals in 12 patients with ANT of the ulnar or median nerves, by stimulating the distal stump (DS). Stimulus intensities (SI), steps, returners, and MScanFit were calculated. Studies were grouped according to the examination time after ANT. Results were compared with those of 27 controls. RESULTS CMAP amplitudes and MScanFit progressively declined, revealing a positive correlation with one another. SIs were higher in WD groups than controls. Steps appeared or disappeared in follow-up scans. The late WD group had higher returner% than the early WD and control groups. CONCLUSIONS MScanFit can monitor neuromuscular dysfunction during WD. SIs revealed excitability changes in DS.
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Affiliation(s)
- Ozlem Kesim-Sahin
- Departments of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nermin Gorkem Sirin
- Departments of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Bahar Erbas
- Departments of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.,Department of Pharmacology, Istanbul Bilim University, Istanbul, Turkey
| | - Tugrul Artug
- Departments of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.,Department of Electrical and Electronics Engineering, Istanbul Arel University, Istanbul, Turkey
| | - Emel Oguz-Akarsu
- Departments of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Elif Kocasoy-Orhan
- Departments of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Baris Baslo
- Departments of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nermin Mammadova
- Department of Reconstructive and Plastic Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ufuk Emekli
- Department of Reconstructive and Plastic Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Emre Oge
- Departments of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Oguz Akarsu E, Sirin NG, Kocasoy Orhan E, Erbas B, Dede HO, Baslo MB, Idrisoglu HA, Oge AE. Repeater F-waves in amyotrophic lateral sclerosis: Electrophysiologic indicators of upper or lower motor neuron involvement? Clin Neurophysiol 2019; 131:96-105. [PMID: 31760213 DOI: 10.1016/j.clinph.2019.09.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 09/08/2019] [Accepted: 09/25/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To extract insight about the mechanism of repeater F-waves (Frep) by exploring their correlation with electrophysiologic markers of upper and lower motor neuron dysfunction in amyotrophic lateral sclerosis (ALS). METHODS The correlations of Frep parameters with clinical scores and the results of neurophysiological index (NI), MScanfit MUNE, F/M amplitude ratio (F/M%), single and paired-pulse transcranial magnetic stimulation (TMS), and triple stimulation technique (TST) studies, recorded from abductor digiti minimi (ADM) and abductor pollicis brevis (APB) muscles of 35 patients with ALS were investigated. RESULTS Frep parameters were correlated with NI and MScanfit MUNE in ADM muscle and F/M% in both muscles. None of the Frep parameters were correlated with clinical scores or TST and TMS measures. While the CMAP amplitudes were similar in the two recording muscles, there was a more pronounced decrease of F-wave persistence in APB, probably heralding the subsequent split hand phenomenon. CONCLUSION Our findings suggest that the presence and density of Freps are primarily related to the degree of lower motor neuron loss and show no correlation with any of the relatively extensive set of parameters for upper motor neuron dysfunction. SIGNIFICANCE Freps are primarily related to lower motor neuron loss in ALS.
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Affiliation(s)
- Emel Oguz Akarsu
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey.
| | - Nermin Gorkem Sirin
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
| | - Elif Kocasoy Orhan
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
| | - Bahar Erbas
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey; Demiroglu Bilim University, Faculty of Medicine, Department of Pharmacology, Istanbul, Turkey
| | - Hava Ozlem Dede
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
| | - Mehmet Baris Baslo
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
| | - Halil Atilla Idrisoglu
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
| | - Ali Emre Oge
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
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Sirin NG, Oguz Akarsu E, Kocasoy Orhan E, Erbas B, Artug T, Dede HO, Baslo MB, Idrisoglu HA, Oge AE. Parameters derived from compound muscle action potential scan for discriminating amyotrophic lateral sclerosis‐related denervation. Muscle Nerve 2019; 60:400-408. [DOI: 10.1002/mus.26644] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 07/13/2019] [Accepted: 07/16/2019] [Indexed: 12/11/2022]
Affiliation(s)
- N. Gorkem Sirin
- Department of Neurology, Istanbul Faculty of MedicineIstanbul University Istanbul Turkey
| | - Emel Oguz Akarsu
- Department of Neurology, Istanbul Faculty of MedicineIstanbul University Istanbul Turkey
| | - Elif Kocasoy Orhan
- Department of Neurology, Istanbul Faculty of MedicineIstanbul University Istanbul Turkey
| | - Bahar Erbas
- Department of Neurology, Istanbul Faculty of MedicineIstanbul University Istanbul Turkey
| | - Tugrul Artug
- Electrical and Electronics EngineeringIstanbul Arel University Istanbul Turkey
| | - H. Ozlem Dede
- Department of Neurology, Istanbul Faculty of MedicineIstanbul University Istanbul Turkey
| | - M. Baris Baslo
- Department of Neurology, Istanbul Faculty of MedicineIstanbul University Istanbul Turkey
| | - Halil A. Idrisoglu
- Department of Neurology, Istanbul Faculty of MedicineIstanbul University Istanbul Turkey
| | - A. Emre Oge
- Department of Neurology, Istanbul Faculty of MedicineIstanbul University Istanbul Turkey
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Kesim-Sahin O, Erbas B, Sirin NG, Artug T, Oguz-Akarsu E, Kocasoy-Orhan E, Mammadova N, Emekli U, Oge AE. O-29 CMAP scan and MScanFit MUNE during Wallerian degeneration after nerve transactions. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.04.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Cerebral amyloid angiopathy (CAA) is a common but often asymptomatic disease, characterized by the deposition of amyloid proteins within brain parenchyma and leptomeningeal-cortical vessels. It can occur as a sporadic disorder or accompany Alzheimer disease (AD). The usual presentation of CAA is spontaneous lobar hemorrhage, Unlike CAA, cerebral amyloid angiopathy-related inflammation (CAA-ri), a subtype of CAA, can show various presentations and responds to steroid (or immuno suppressive) treatment. We report a patient with mixed dementia who showed subacute progression in cognitive impairment and had a mass lesion on brain magnetic resonance imaging (MRI). The lesion was identified as CAA related inflammation and the cognitive status of the patient improved significantly after steroid treatment. In this case report, we aimed to emphasize that CAA-ri is one of the possible diagnoses that should be considered in demented patients with rapid cognitive deterioration and showing brain lesions resembling neoplasms on the MRI. Therefore, steroids or other immunosuppresive treatments, which may lead to a dramatic clinical improvement, could be administered without delay.
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Affiliation(s)
- Hakan Silek
- Yeditepe University Hospital, Department of Neurology, Istanbul, Turkey
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Papamichael MM, Katsardis C, Lambert K, Tsoukalas D, Koutsilieris M, Erbas B, Itsiopoulos C. Efficacy of a Mediterranean diet supplemented with fatty fish in ameliorating inflammation in paediatric asthma: a randomised controlled trial. J Hum Nutr Diet 2018; 32:185-197. [PMID: 30378203 DOI: 10.1111/jhn.12609] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Childhood asthma is the most common respiratory disorder worldwide, being associated with increased morbidity and a decreased quality of life. Omega-3 fatty acids have anti-inflammatory and immunomodulating properties; however, their efficacy in asthma is controversial. The present study aimed to examine the efficacy of a Mediterranean diet supplemented with a high omega-3 'fatty' fish intake in Greek asthmatic children. METHODS A single-centred, 6-month, parallel randomised controlled trial compared the consumption of a Mediterranean diet supplemented with two meals of 150 g of cooked fatty fish weekly (intervention) with the usual diet (control) with respect to pulmonary function in children (aged 5-12 years) with mild asthma. Pulmonary function was assessed using spirometry and bronchial inflammation by fractional exhaled nitric oxide analysis. RESULTS Sixty-four children (52% male, 48% female) successfully completed the trial. Fatty fish intake increased in the intervention group from 17 g day-1 at baseline to 46 g day-1 at 6 months (P < 0.001). In the unadjusted analysis, the effect of the intervention was of borderline significance (P = 0.06, β = -11.93; 95% confidence interval = -24.32 to 0.46). However, after adjusting for age, sex, body mass index and regular physical activity, a significant effect was observed (P = 0.04, β = -14.15 ppb; 95% confidence interval = -27.39 to -0.91). No difference was observed for spirometry, asthma control and quality of life scores. CONCLUSIONS A Mediterranean diet supplemented with two fatty fish meals per week might be a potential strategy for reducing airway inflammation in childhood asthma. Future robust clinical trials are warranted to replicate and corroborate these findings.
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Affiliation(s)
- M M Papamichael
- Department of Rehabilitation, Nutrition & Sport, School of Allied Health, La Trobe University, Melbourne, VIC, Australia
| | - Ch Katsardis
- National & Kapodistrian University of Athens, Athens, Greece
| | - K Lambert
- Department of Public Health, School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
| | - D Tsoukalas
- European Institute of Nutritional Medicine, Rome, Italy
| | - M Koutsilieris
- National & Kapodistrian University of Athens, Athens, Greece
| | - B Erbas
- Department of Public Health, School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
| | - C Itsiopoulos
- Department of Rehabilitation, Nutrition & Sport, School of Allied Health, La Trobe University, Melbourne, VIC, Australia
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Erbas B, Shrestha SK, Dharmage SC, Katelaris C, Davies J, Abramson MJ. The effects of Air Pollution on asthma Hospital admissions in Adelaide, South Australia, 2003-2013: time series and case-crossover analysis. Clin Exp Allergy 2018; 46:1623-1624. [PMID: 27797423 DOI: 10.1111/cea.12847] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- B Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia
| | - S K Shrestha
- School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia
| | - S C Dharmage
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia
| | - C Katelaris
- School of Medicine, University of Western Sydney, Sydney, NSW, Australia
| | - J Davies
- Institute of Health and Biomedical Innovation, Queensland University of Technology, South Brisbane, Qld, Australia
| | - M J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
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Erbas B, Jazayeri M, Lambert KA, Katelaris CH, Prendergast LA, Tham R, Parrodi MJ, Davies J, Newbigin E, Abramson MJ, Dharmage S. Outdoor pollen is a trigger of child and adolescent asthma emergency department presentations: A systematic review and meta-analysis. Allergy 2018; 73:1632-1641. [PMID: 29331087 DOI: 10.1111/all.13407] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the context of increased asthma exacerbations associated with climatic changes such as thunderstorm asthma, interest in establishing the link between pollen exposure and asthma hospital admissions has intensified. Here, we systematically reviewed and performed a meta-analysis of studies on pollen and emergency department (ED) attendance. METHODS A search for studies with appropriate search strategy in MEDLINE, EMBASE, Web of Science and CINAHL was conducted. Each study was assessed for quality and risk of bias. The available evidence was summarized both qualitatively and meta-analysed using random-effects models when moderate heterogeneity was observed. RESULTS Fourteen studies were included. The pollen taxa investigated differed between studies, allowing meta-analysis only of the effect of grass pollen. A statistically significant increase in the percentage change in the mean number of asthma ED presentations (MPC) (pooled results from 3 studies) was observed for an increase in 10 grass pollen grains per cubic metre of exposure 1.88% (95% CI = 0.94%, 2.82%). Time series studies showed positive correlations between pollen concentrations and ED presentations. Age-stratified studies found strongest associations in children aged 5-17 years old. CONCLUSION Exposure to ambient grass pollen is an important trigger for childhood asthma exacerbations requiring ED attendance. As pollen exposure is increasingly a problem especially in relation to thunderstorm asthma, studies with uniform measures of pollen and similar analytical methods are necessary to fully understand its impact on human health.
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Affiliation(s)
- B. Erbas
- School of Psychology and Public Health; La Trobe University; Bundoora Vic. Australia
| | - M. Jazayeri
- Department of Mathematics and Statistics; La Trobe University; Bundoora Vic. Australia
| | - K. A. Lambert
- School of Psychology and Public Health; La Trobe University; Bundoora Vic. Australia
| | - C. H. Katelaris
- Department of Medicine, Immunology and Allergy; Campbelltown Hospital; Western Sydney University; Campbelltown NSW Australia
| | - L. A. Prendergast
- Department of Mathematics and Statistics; La Trobe University; Bundoora Vic. Australia
| | - R. Tham
- Allergy and Lung Health Unit; Melbourne School of Population and Global Health; University of Melbourne; Melbourne Vic. Australia
| | - M. J. Parrodi
- School of Psychology and Public Health; La Trobe University; Bundoora Vic. Australia
| | - J. Davies
- Institute of Health and Biomedical Innovation; Queensland University of Technology; South Brisbane Qld Australia
| | - E. Newbigin
- School of Biosciences; University of Melbourne; Melbourne Vic. Australia
| | - M. J. Abramson
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine; Monash University; Melbourne Vic. Australia
| | - S. C. Dharmage
- Allergy and Lung Health Unit; Melbourne School of Population and Global Health; University of Melbourne; Melbourne Vic. Australia
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Abstract
BACKGROUND The evidence is mixed on the use of long chain Omega-3 fatty acids in the prevention and management of childhood asthma. METHODS We conducted a systematic search and meta-analysis investigating the role of fish intake, the main dietary source of long chain omega-3 fatty acids, on asthma in children. RESULTS A total of 1119 publications were identified. Twenty-three studies on fish intake in association with childhood asthma were included in the final review. In 15 of 23 studies, early introduction of fish (6-9 months) and regular consumption (at least once a week) improved asthma symptoms and reduced risk in children 0-14 years as compared to no fish consumption; 6 of 23 showed no effect and 2 of 23 studies suggest adverse effects. Meta-analysis revealed an overall "beneficial effect" for "all fish" intake on "current asthma" [OR: 0.75; 95%CI: 0.60-0.95] and "current wheeze" [OR: 0.62; 95%CI: 0.48-0.80] in children up to 4.5 years old. An overall protective effect of "fatty fish" intake as compared to "no fish" intake in children 8-14 years old was also observed [OR: 0.35; 95%CI: 0.18-0.67]. CONCLUSION This meta-analysis suggests that introduction of fish early in life (6-9 months) and regular consumption of all fish (at least once a week) reduces asthma and wheeze in children up to 4.5 years old, while fatty fish intake may be beneficial in older children. Future well-designed clinical trials are recommended to confirm the promising findings documented in this literature analysis.
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Affiliation(s)
- M M Papamichael
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, VIC, Australia
| | - S K Shrestha
- Research Centre for Integrated Development (RECID), Nepal, Nepal
| | - C Itsiopoulos
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, VIC, Australia
| | - B Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
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Artug T, Oguz-Akarsu E, Sirin NG, Erbas B, Kocasoy-Orhan E, Dede HO, Mehdikhanova L, Goker I, Baslo MB, Idrisoglu HA, Oge AE. S101. A novel automatized F-wave MUNE method: A preliminary analysis. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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14
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Oguz-Akarsu E, Sirin NG, Erbas B, Kocasoy-Orhan E, Dede HO, Mehdikhanova L, Baslo MB, Idrisoglu HA, Oge AE. F52. Repeater F-waves: Electrophysiologic manifestations of upper or lower motor neuron involvement? Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Silek H, Erbas B. Cerebral amyloid angiopathy related Inflammation presenting as steroid responsive brain mass. Turk Neurosurg 2018. [DOI: 10.5137/1019-5149.jtn.22592-18.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lambert KA, Bowatte G, Tham R, Lodge C, Prendergast L, Heinrich J, Abramson MJ, Dharmage SC, Erbas B. Residential greenness and allergic respiratory diseases in children and adolescents - A systematic review and meta-analysis. Environ Res 2017; 159:212-221. [PMID: 28803150 DOI: 10.1016/j.envres.2017.08.002] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/02/2017] [Accepted: 08/02/2017] [Indexed: 05/25/2023]
Abstract
BACKGROUND The aetiology of allergic respiratory disease in children is not yet fully understood. Environmental factors are believed to play a major part. The amount of green vegetation surrounding the home (residential greenness) has been recently identified as a potentially important exposure OBJECTIVES: Our goal was to provide a systematic review and quantitative summary of the evidence regarding the relationship between residential greenness and allergic respiratory diseases in children. METHODS Peer-reviewed literature published prior to 1 March 2017 was systematically searched using nine electronic databases. Meta-analyses were conducted if at least three studies published risk estimates for the same outcome and exposure measures. RESULTS We included 11 articles across broad outcomes of asthma and allergic rhinitis. Reported effects were inconsistent with varying measures to define residential greenness. Only limited meta-analysis could be conducted, with the pooled odds ratios for asthma (OR 1.01 95%CI 0.93, 1.09; I2 68.1%) and allergic rhinitis (OR 0.99 95%CI 0.87, 1.12; I2 72.9%) being significantly heterogeneous. CONCLUSIONS Inconsistencies between the studies were too large to accurately assess the association between residential greenness and allergic respiratory disease. A standardised global measure of greenness which accounts for seasonal variation at a specific relevant buffer size is needed to create a more cohesive body of evidence and for future examination of the effect of residential greenness on allergic respiratory diseases.
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Affiliation(s)
- K A Lambert
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - G Bowatte
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - R Tham
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - C Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - L Prendergast
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
| | - J Heinrich
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Center, Ludwig Maximilians University, Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
| | - M J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - S C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - B Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
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Medek D, Katelaris C, Erbas B, Lampugnani ER, Newbiggin E, Haberle S, Huete A, Beggs PJ, Ebert B, van Klinken R, Davies JM. P56: IMPLEMENTATION OF THE AUSPOLLEN PARTNERSHIP PROJECT AND PRE-EVALUATION SURVEY OF USER PERCEPTION OF THE VALUE OF LOCAL POLLEN INFORMATION. Intern Med J 2017. [DOI: 10.1111/imj.56_13578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- D Medek
- Australian National University; Canberra Australia
| | - C Katelaris
- Campbelltown Hospital & Western Sydney University; Sydney Australia
| | - B Erbas
- LaTrobe University; Melbourne Australia
| | | | - E Newbiggin
- The University of Melbourne; Melbourne Australia
| | - S Haberle
- Australian National University; Canberra Australia
| | - A Huete
- University of Technology Sydney; Sydney Australia
| | - PJ Beggs
- Macquarie University; Sydney Australia
| | - B Ebert
- Bureau of Meteorology; Melbourne Australia
| | - R van Klinken
- Commonwealth Scientific and Industrial Research Organisation; Brisbane Australia
| | - JM Davies
- Queensland University of Technology & Metro North Hospital and Health Service; Brisbane Australia
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Davies JM, Erbas B, Simunovic M, Al Kouba J, Milic A. P57: REVIEW OF EVIDENCE AND GAPS IN KNOWLEDGE ON THUNDERSTORM ASTHMA EPIDEMICS AND PUBLIC HEALTH IMPLICATIONS. Intern Med J 2017. [DOI: 10.1111/imj.57_13578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- JM Davies
- Queensland University of Technology & Metro North Hospital and Health Service; Brisbane Australia
| | - B Erbas
- LaTrobe University; Melbourne Australia
| | - M Simunovic
- Queensland University of Technology & Metro North Hospital and Health Service; Brisbane Australia
| | - J Al Kouba
- Queensland University of Technology & Metro North Hospital and Health Service; Brisbane Australia
| | - A Milic
- Queensland University of Technology & Metro North Hospital and Health Service; Brisbane Australia
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19
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Waidyatillake NT, Stoney R, Thien F, Lodge CJ, Simpson JA, Allen KJ, Abramson MJ, Erbas B, Svanes C, Dharmage SC, Lowe AJ. Breast milk polyunsaturated fatty acids: associations with adolescent allergic disease and lung function. Allergy 2017; 72:1193-1201. [PMID: 28027401 DOI: 10.1111/all.13114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND It has been hypothesized that n-3 PUFA in breast milk may assist immune and lung development. There are very limited data on possible long-term effects on allergic disease and lung function. The aim was to investigate associations of n-3 and n-6 PUFA levels in colostrum and breast milk with allergic disease and lung function at ages 12 and 18 years. METHODS Polyunsaturated fatty acids were measured in 194 colostrum samples and in 118 three-month expressed breast milk samples from mothers of children enrolled in the Melbourne Atopy Cohort (MACS) Study, a high-risk birth cohort study. Associations with allergic diseases, skin prick tests and lung function assessed at 12 and 18 years were estimated using multivariable regression. RESULTS Higher levels of n-3 but not n-6 PUFAs in colostrum were associated with a trend towards increased odds of allergic diseases, with strong associations observed for allergic rhinitis at 12 (OR = 5.69[95% CI: 1.83,17.60] per weight%) and 18 years (4.43[1.46,13.39]) and eczema at 18 years (9.89[1.44, 68.49]). Higher levels of colostrum n-3 PUFAs were associated with reduced sensitization (3.37[1.18, 9.6]), mean FEV1 (-166 ml [-332, -1]) and FEV1 /FVC ratio (-4.6%, [-8.1, -1.1]) at 12 years. CONCLUSION Higher levels of colostrum n-3 PUFAs were associated with increased risks of allergic rhinitis and eczema up to 18 years, and sensitization and reduced lung function at 12 years. As residual confounding may have caused these associations, they should be replicated, but these results could indicate that strategies that increase maternal n-3 PUFA intake may not aid in allergic disease prevention.
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Affiliation(s)
- N. T. Waidyatillake
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Melbourne Australia
| | - R. Stoney
- Department of Nutrition and Dietetics; Redland Hospital and Wynnum Health Service; Metro South Health; Brisbane Australia
| | - F. Thien
- Respiratory Medicine; Eastern Health Box Hill Hospital; Monash University; Melbourne Australia
| | - C. J. Lodge
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Melbourne Australia
- Murdoch Childrens Research Institute; Melbourne Australia
| | - J. A. Simpson
- Biostatistics Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Melbourne Australia
| | - K. J. Allen
- Murdoch Childrens Research Institute; Melbourne Australia
- Department of Allergy; Royal Childrens Hospital; Melbourne Australia
- Department of Paediatrics; The University of Melbourne; Melbourne Australia
| | - M. J. Abramson
- School of Public Health and Preventive Medicine; Monash University; Melbourne Australia
| | - B. Erbas
- School of Psychology and Public Health; La Trobe University; Melbourne Australia
| | - C. Svanes
- Centre for International Health; University of Bergen; Bergen Norway
- Department of Occupational Medicine; Haukeland University Hospital; Bergen Norway
| | - S. C. Dharmage
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Melbourne Australia
- Murdoch Childrens Research Institute; Melbourne Australia
| | - A. J. Lowe
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; The University of Melbourne; Melbourne Australia
- Murdoch Childrens Research Institute; Melbourne Australia
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20
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Panjari M, Koplin JJ, Dharmage SC, Peters RL, Gurrin LC, Sawyer SM, McWilliam V, Eckert JK, Vicendese D, Erbas B, Matheson MC, Tang MLK, Douglass J, Ponsonby AL, Dwyer T, Goldfeld S, Allen KJ. Nut allergy prevalence and differences between Asian-born children and Australian-born children of Asian descent: a state-wide survey of children at primary school entry in Victoria, Australia. Clin Exp Allergy 2016; 46:602-9. [PMID: 26728850 DOI: 10.1111/cea.12699] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 11/30/2015] [Accepted: 01/01/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Asian infants born in Australia are three times more likely to develop nut allergy than non-Asian infants, and rates of challenge-proven food allergy in infants have been found to be unexpectedly high in metropolitan Melbourne. To further investigate the risk factors for nut allergy, we assessed the whole-of-state prevalence distribution of parent-reported nut allergy in 5-year-old children entering school. METHODS Using the 2010 School Entrant Health Questionnaire administered to all 5-year-old children in Victoria, Australia, we assessed the prevalence of parent-reported nut allergy (tree nut and peanut) and whether this was altered by region of residence, socio-economic status, country of birth or history of migration. Prevalence was calculated as observed proportion with 95% confidence intervals (CI). Risk factors were evaluated using multivariable logistic regression and adjusted for appropriate confounders. RESULTS Parent-reported nut allergy prevalence was 3.1% (95% CI 2.9-3.2) amongst a cohort of nearly 60 000 children. It was more common amongst children of mothers with higher education and socio-economic index and less prevalent amongst children in regional Victoria than in Melbourne. While children born in Australia to Asian-born mothers (aOR 2.67, 95% CI 2.28-3.27) were more likely to have nut allergy than non-Asian children, children born in Asia who subsequently migrated to Australia were at decreased risk of nut allergy (aOR 0.1, 95% CI 0.03-0.31). CONCLUSION Migration from Asia after the early infant period appears protective for the development of nut allergy. Additionally, rural regions have lower rates of nut allergy than urban areas.
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Affiliation(s)
- M Panjari
- The Murdoch Childrens Research Institute, Parkville, Vic., Australia
| | - J J Koplin
- The Murdoch Childrens Research Institute, Parkville, Vic., Australia.,The Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Vic., Australia
| | - S C Dharmage
- The Murdoch Childrens Research Institute, Parkville, Vic., Australia.,The Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Vic., Australia
| | - R L Peters
- The Murdoch Childrens Research Institute, Parkville, Vic., Australia.,The Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia
| | - L C Gurrin
- The Murdoch Childrens Research Institute, Parkville, Vic., Australia.,The Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Vic., Australia
| | - S M Sawyer
- The Murdoch Childrens Research Institute, Parkville, Vic., Australia.,The Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Vic., Australia
| | - V McWilliam
- The Murdoch Childrens Research Institute, Parkville, Vic., Australia.,The Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia.,The Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Vic., Australia
| | - J K Eckert
- The Murdoch Childrens Research Institute, Parkville, Vic., Australia
| | - D Vicendese
- La Trobe University, Bundoora, Vic., Australia
| | - B Erbas
- La Trobe University, Bundoora, Vic., Australia
| | - M C Matheson
- The Murdoch Childrens Research Institute, Parkville, Vic., Australia.,The Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Vic., Australia
| | - M L K Tang
- The Murdoch Childrens Research Institute, Parkville, Vic., Australia.,The Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia.,The Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Vic., Australia
| | - J Douglass
- The Department of Clinical Immunology and Allergy, Royal Melbourne Hospital, University of Melbourne, Parkville, Vic., Australia
| | - A-L Ponsonby
- The Murdoch Childrens Research Institute, Parkville, Vic., Australia
| | - T Dwyer
- The Murdoch Childrens Research Institute, Parkville, Vic., Australia.,George Institute for Global Health, United Kingdom School of Psychology and Public Health, University of Oxford, Oxford, UK
| | - S Goldfeld
- The Murdoch Childrens Research Institute, Parkville, Vic., Australia.,The Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia.,The Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Vic., Australia
| | - K J Allen
- The Murdoch Childrens Research Institute, Parkville, Vic., Australia.,The Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia.,The Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Vic., Australia.,Institute of Inflammation and Repair, University of Manchester, Manchester, UK
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21
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Bowatt G, Lodge CJ, Lowe AJ, Erbas B, Perret J, Abramson MJ, Matheson MC, Dharmage SC. Author Reply. Allergy 2016; 70:1352. [PMID: 27731612 DOI: 10.111/all.12611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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22
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Uresin Y, Erbas B, Ozek M, Ozkök E, Gürol AO. Losartan may prevent the elevation of plasma glucose, corticosterone and catecholamine levels induced by chronic stress. J Renin Angiotensin Aldosterone Syst 2016; 5:93-6. [PMID: 15295722 DOI: 10.3317/jraas.2004.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Introduction Stress is a stimulus that activates the hypothalamic pituitary adrenal (HPA) axis and sympathetic nervous system (SNS). Increased activity of the SNS causes to increment or impairment in blood pressure, heart rate, body temperature and plasma glucose and adrenocorticotrophic hormone (ACTH) levels. Angiotensin II (Ang II), which is a product of the renin-angiotensin system (RAS), is an important factor affecting the activity of the SNS and responses to stress. We suggest that the blockade of Ang II may be worthwhile in the prevention and treatment of diabetes mellitus and cardiovascular diseases affected by stress. Therefore, we investigated the effects of immobilisation stress on blood glucose, norepinephrine (NE), epinephrine (E) and corticosterone levels and the effects of an Ang II receptor antagonist, losartan, on these parameters. Materials and methods The rats were kept in small cylindrical cages for 60 min/day for 10 consecutive days to perform chronic immobilisation stress. Losartan (10 mg/kg) was given daily by gavage to Losartan (L) and Losartan + Chronic Stress (L+CS) groups. Control (C) and Chronic Stress (CS) P groups received an equal volume of saline daily by gavage for 10 days. After the last stress regimen, blood samples were collected for plasma glucose, NE, E and corticosteroid measurements. Results Plasma glucose, NE, E and corticosterone levels in the CS Group increased significantly compared with the C group. In Group L+CS, the plasma glucose, NE, E and corticosterone levels decreased significantly vs. Group CS. In Group L there was no significant difference vs. Group C. Conclusion It can be speculated that chronic blockade of RAS may decrease the excess sympathetic responses to stress in cardiovascular diseases and prevent the likely development of Type II diabetes mellitus.
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Affiliation(s)
- Yağiz Uresin
- Istanbul Faculty of Medicine, Department of Pharmacology and Clinical Pharmacology, Istanbul University, Capa, Turkey.
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23
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Alduraywish SA, Lodge CJ, Campbell B, Allen KJ, Erbas B, Lowe AJ, Dharmage SC. The march from early life food sensitization to allergic disease: a systematic review and meta-analyses of birth cohort studies. Allergy 2016; 71:77-89. [PMID: 26466117 DOI: 10.1111/all.12784] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND There is growing evidence for an increase in food allergies. The question of whether early life food sensitization, a primary step in food allergies, leads to other allergic disease is a controversial but important issue. Birth cohorts are an ideal design to answer this question. OBJECTIVES We aimed to systematically investigate and meta-analyse the evidence for associations between early food sensitization and allergic disease in birth cohorts. METHODS MEDLINE and SCOPUS databases were searched for birth cohorts that have investigated the association between food sensitization in the first 2 years and subsequent wheeze/asthma, eczema and/or allergic rhinitis. We performed meta-analyses using random-effects models to obtain pooled estimates, stratified by age group. RESULTS The search yielded fifteen original articles representing thirteen cohorts. Early life food sensitization was associated with an increased risk of infantile eczema, childhood wheeze/asthma, eczema and allergic rhinitis and young adult asthma. Meta-analyses demonstrated that early life food sensitization is related to an increased risk of wheeze/asthma (pooled OR 2.9; 95% CI 2.0-4.0), eczema (pooled OR 2.7; 95% CI 1.7-4.4) and allergic rhinitis (pooled OR 3.1; 95% CI 1.9-4.9) from 4 to 8 years. CONCLUSION Food sensitization in the first 2 years of life can identify children at high risk of subsequent allergic disease who may benefit from early life preventive strategies. However, due to potential residual confounding in the majority of studies combined with lack of follow-up into adolescence and adulthood, further research is needed.
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Affiliation(s)
- S. A. Alduraywish
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; University of Melbourne; Melbourne Vic. Australia
- Department of Family and Community Medicine; King Saud University; Riyadh Saudi Arabia
| | - C. J. Lodge
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; University of Melbourne; Melbourne Vic. Australia
- Murdoch Children's Research Institute; Melbourne Vic. Australia
| | - B. Campbell
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; University of Melbourne; Melbourne Vic. Australia
| | - K. J. Allen
- Murdoch Children's Research Institute; Melbourne Vic. Australia
- Department of Allergy; Royal Children Hospital; Melbourne Vic. Australia
| | - B. Erbas
- Department of Public Health; School of Psychology & Public Health; La Trobe University; Melbourne Vic. Australia
| | - A. J. Lowe
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; University of Melbourne; Melbourne Vic. Australia
- Murdoch Children's Research Institute; Melbourne Vic. Australia
| | - S. C. Dharmage
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; Melbourne School of Population and Global Health; University of Melbourne; Melbourne Vic. Australia
- Murdoch Children's Research Institute; Melbourne Vic. Australia
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24
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Fuertes E, Heinrich J, Bowatte G, Lodge CJ, Lowe AJ, Erbas B, Perret J, Abramson MJ, Matheson MC, Dharmage SC. The influence of childhood traffic-related air pollution exposure on asthma, allergy and sensitization. Allergy 2015; 70:1350-1. [PMID: 26404518 DOI: 10.1111/all.12611] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- E. Fuertes
- Institute of Epidemiology I; Helmholtz Zentrum München - German Research Center for Environmental Health; Neuherberg Germany
| | - J. Heinrich
- Institute of Epidemiology I; Helmholtz Zentrum München - German Research Center for Environmental Health; Neuherberg Germany
| | - G. Bowatte
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Melbourne Vic. Australia
| | - C. J. Lodge
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Melbourne Vic. Australia
- Murdoch Children Research Institute; Melbourne Vic. Australia
| | - A. J. Lowe
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Melbourne Vic. Australia
- Murdoch Children Research Institute; Melbourne Vic. Australia
| | - B. Erbas
- School of Psychology and Public Health; La Trobe University; Melbourne Vic. Australia
| | - J. Perret
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Melbourne Vic. Australia
| | - M. J. Abramson
- School of Public Health & Preventive Medicine; Monash University; Melbourne Vic. Australia
| | - M. C. Matheson
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Melbourne Vic. Australia
| | - S. C. Dharmage
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Melbourne Vic. Australia
- Murdoch Children Research Institute; Melbourne Vic. Australia
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Bowatte G, Lodge CJ, Lowe AJ, Erbas B, Perret J, Abramson MJ, Matheson MC, Dharmage SC. Reply: To PMID 25495759. Allergy 2015; 70:1352. [PMID: 26668861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Kupik O, Tuncel M, Kiratli P, Akpinar M, Altundag K, Demirkazik F, Erbas B. 716 Predictive value of dynamic and dual 18 FDG PET/CT parameters in the assessment of neoadjuvant chemotherapy response in locally advanced breast cancer: A comparative study with contrast enhanced dynamic MRI. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30386-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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27
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Bowatte G, Lodge C, Lowe AJ, Erbas B, Perret J, Abramson MJ, Matheson M, Dharmage SC. The influence of childhood traffic-related air pollution exposure on asthma, allergy and sensitization: a systematic review and a meta-analysis of birth cohort studies. Allergy 2015; 70:245-56. [PMID: 25495759 DOI: 10.1111/all.12561] [Citation(s) in RCA: 297] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2014] [Indexed: 10/24/2022]
Abstract
The impact of early childhood traffic-related air pollution (TRAP) exposure on development of asthma and allergies remains unclear. Birth cohort studies are the best available study design to answer this question, but the evidence from such studies has not been synthesized to date. We conducted a systematic review and meta-analyses of published birth cohort studies to understand the association between early childhood TRAP exposure, and subsequent asthma, allergies and sensitization. Increased longitudinal childhood exposure to PM2.5 and black carbon was associated with increasing risk of subsequent asthma in childhood (PM2.5 : OR 1.14, 95%CI 1.00 to 1.30 per 2 μg/m(3) and black carbon: OR 1.20, 95%CI 1.05 to 1.38 per 1 × 10(-5) m(-1) ). Also, early childhood exposure to TRAP was associated with development of asthma across childhood up to 12 years of age. The magnitude of these associations increased with age, and the pattern was prominent for PM2.5 . Increasing exposure to PM2.5 was associated with sensitization to both aero- and food allergens. There was some evidence that TRAP was associated with eczema and hay fever. In summary, exposure to TRAP was related to asthma and allergic diseases. However, the substantial variability across studies warrants long-term birth cohort studies with regular repeated follow-ups to confirm these findings.
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Affiliation(s)
- G. Bowatte
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Melbourne Vic. Australia
| | - C. Lodge
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Melbourne Vic. Australia
| | - A. J. Lowe
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Melbourne Vic. Australia
| | - B. Erbas
- School of Public Health and Human Biosciences; Department of Public Health; La Trobe University; Melbourne Vic. Australia
| | - J. Perret
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Melbourne Vic. Australia
| | - M. J. Abramson
- School of Public Health & Preventive Medicine; Monash University; Melbourne Vic. Australia
| | - M. Matheson
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Melbourne Vic. Australia
| | - S. C. Dharmage
- Allergy and Lung Health Unit; Centre for Epidemiology and Biostatistics; School of Population and Global Health; The University of Melbourne; Melbourne Vic. Australia
- Murdoch Children Research Institute; Melbourne Vic. Australia
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Kupik O, Tuncel M, Demirkazik F, Akpinar M, Altundag K, Erbas B. Dynamic 18FDG PET/CT and dynamic contrast enhanced MRI of locally advanced breast cancer. Cancer Imaging 2014. [PMCID: PMC4242675 DOI: 10.1186/1470-7330-14-s1-p14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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29
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Erbas B, Lowe AJ, Lodge CJ, Matheson MC, Hosking CS, Hill DJ, Vicendese D, Allen KJ, Abramson MJ, Dharmage SC. Persistent pollen exposure during infancy is associated with increased risk of subsequent childhood asthma and hayfever. Clin Exp Allergy 2013; 43:337-43. [PMID: 23414542 DOI: 10.1111/cea.12071] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 11/10/2012] [Accepted: 11/14/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Few studies have focused on pollen exposure and asthma in children. None have examined associations between persistent exposure to pollen in infancy and aeroallergen sensitisation and asthma in childhood. OBJECTIVES To examine the association between higher ambient levels of pollen in the first 3-6 months of life and risk of eczema, sensitization to food and aeroallergens at 2 years and asthma or hayfever at age 6-7 years combined. METHODS Using a birth cohort of 620 infants with a family history of allergic disease born between 1990 and 1994, we examined risk of eczema or allergic sensitization (SPT > 3 mm to at least one of cow's milk, egg white, peanut, house dust-mite, rye grass, and cat dander) by age 2 and asthma or hayfever at age 6-7. Daily ambient levels of pollen were measured during this period. RESULTS Cumulative exposure to pollen concentrations up to 6 months was associated with aeroallergen sensitization with the highest risk occurring at 3 months (aOR = 1.34, 95% CI 1.06-1.72). Cumulative exposure to pollen up to 3 months was also associated with hayfever (aOR = 1.14, 95% CI 1.009-1.29) and between 4 and 6 months exposure with asthma only (aOR=1.35, 95% CI 1.07-1.72). CONCLUSION Persistent pollen exposure in infancy appears to increase the risk of asthma and hayfever in children. These results support the hypothesis that there is a critical window of opportunity in early development which may be important for modification of allergic outcomes.
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Affiliation(s)
- B Erbas
- School of Public Health, La Trobe University, Melbourne, VIC, Australia
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Ozdemir D, Dagdelen S, Kiratli P, Tuncel M, Erbas B, Erbas T. Changing clinical characteristics of thyroid carcinoma at a single center from Turkey: before and after the Chernobyl disaster. MINERVA ENDOCRINOL 2012; 37:267-274. [PMID: 22766893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM The aim of the study was to determine the possible role of Chernobyl disaster on changing clinical features of thyroid carcinoma (TC) in a moderately iodine deficient region. METHODS We retrospectively reviewed demographical features, presenting symptoms, tumor size, histopathological diagnosis and distant metastates in 160 patients with TC diagnosed between 1990-2007. We compared our findings with the database of 118 TC patients diagnosed between 1970-1990 in the same center. RESULTS There were 123 female (76.9%) and 37 (23.1%) male patients with a mean age of 44.89±14.84. Sex distribution and age at diagnosis were similar between 1970-1990 and 1990-2007 (P=0.77 and P=0.42, respectively). Histopathological diagnoses were papillary in 114 (73.1%), follicular in 22 (14.1%), medullary in 9 (5.8%), hurthle cell in 7 (4.5%) and anaplastic TC in 4 (2.6%) patients. We observed a marked increase in papillary TC (P<0.001) and marked decreases in follicular (P<0.001) and anaplastic TC (P=0.01) compared to the period between 1970-1990. Thyroid microcarcinomas accounted for 27.1% and 37.1% of carcinomas in 1970-1990 and 1990-2007, respectively (P<0.05). CONCLUSION We showed that incidence of papillary TC increased and incidences of follicular and anaplastic TC decreased in a period that might be affected by Chernobyl fallout in a moderately iodine deficient area. Presenting symptoms of TC have changed and microcarcinomas are diagnosed more frequently compared to past. Further large scale trials are needed to find out whether Chernobyl disaster has role on changing characteristic of TC in countries that are not very near but also not very far from Chernobyl such as Turkey.
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MESH Headings
- Adenocarcinoma, Follicular/diagnosis
- Adenocarcinoma, Follicular/epidemiology
- Adenocarcinoma, Follicular/prevention & control
- Adult
- Algorithms
- Carcinoma, Medullary/diagnosis
- Carcinoma, Medullary/epidemiology
- Carcinoma, Medullary/prevention & control
- Carcinoma, Papillary/diagnosis
- Carcinoma, Papillary/epidemiology
- Carcinoma, Papillary/prevention & control
- Chernobyl Nuclear Accident
- Female
- Humans
- Incidence
- Male
- Middle Aged
- Neoplasms, Radiation-Induced/diagnosis
- Neoplasms, Radiation-Induced/epidemiology
- Neoplasms, Radiation-Induced/prevention & control
- Retrospective Studies
- Risk Factors
- Thyroid Neoplasms/diagnosis
- Thyroid Neoplasms/epidemiology
- Thyroid Neoplasms/prevention & control
- Time Factors
- Turkey/epidemiology
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Affiliation(s)
- D Ozdemir
- Department of Endocrinology and Metabolism, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
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Erbas B, Akram M, Dharmage SC, Tham R, Dennekamp M, Newbigin E, Taylor P, Tang MLK, Abramson MJ. The role of seasonal grass pollen on childhood asthma emergency department presentations. Clin Exp Allergy 2012; 42:799-805. [PMID: 22515396 DOI: 10.1111/j.1365-2222.2012.03995.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Few studies have focused on the role of grass pollen on asthma emergency department (ED) presentations among children. None have examined whether a dose-response effect exists between grass pollen levels and these asthma exacerbations. OBJECTIVES To examine the association between increasing ambient levels of grass pollen and asthma ED presentations in children. To determine whether these associations are seen only after a thunderstorm, or whether grass pollen levels have a consistent influence on childhood asthma ED visits during the season. METHODS A short time series ecological study was conducted for asthma presentations to ED among children in Melbourne, Victoria, and grass pollen, meteorological and air quality measurements recorded during the selected 2003 period. A semi-parametric Poisson regression model was used to examine dose-response associations between daily grass pollen levels and mean daily ED attendance for asthma. RESULTS A smoothed plot suggested a dose-response association. As ambient grass pollen increased to about 19 grains/m(3) , the same day risk of childhood ED presentations also increased linearly (P < 0.001). Grass pollen levels were also associated with an increased risk in asthma ED presentations on the following day (lag 1, P < 0.001). CONCLUSION This is the first study to establish a clear relationship between increased risk of childhood asthma ED attendance and levels of ambient grass pollen below 20 grains/m(3) , independent of any impact of thunderstorm-associated asthma. These findings have important implications for patient care, such as asthma management programs that notify the general public regarding periods of high grass pollen exposure, as well as defining the timing of initiation of pollen immunotherapy.
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Affiliation(s)
- B Erbas
- School of Public Health, La Trobe University, Melbourne, VIC, Australia.
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Erbas B, Akram M, Dharmage S, Tham R, Dennekamp M, Newbigin E, Taylor P, Tang M, Abramson M. The Role of Seasonal Grass Pollen on Childhood Asthma Emergency Department Presentations. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Volkan-Salanci B, Tulumen E, Kiratli P, Oksuzoglu B, Guler N, Tokgozoglu L, Erbas B, Alikasifoglu M. 1073 The relation between the change of functional cardiac parameters and single nucleotide polymorphisms in Glutathione S transferase P1 and Carbonyl reductase3 genes after doxorubicin chemotherapy. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70366-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Erbas T, Erbas B, Kabakci G, Aksöyek S, Koray Z, Gedik O. Plasma big-endothelin levels, cardiac autonomic neuropathy, and cardiac functions in patients with insulin-dependent diabetes mellitus. Clin Cardiol 2009; 23:259-63. [PMID: 10763073 PMCID: PMC6655115 DOI: 10.1002/clc.4960230407] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The alteration of endothelin (ET) levels in diabetic patients with cardiac autonomic neuropathy (CAN) has not been studied extensively and its correlation with cardiac function parameters has not been discussed. HYPOTHESIS The aim of the present study was to discuss the correlation between the degree of cardiac autonomic neuropathy, plasma big-ET levels, and cardiac functions in diabetic patients who were clinically free of cardiovascular disease. METHODS Twenty subjects (32.1 +/- 7.8 years, 11 men, 9 women) with insulin-dependent diabetes mellitus (IDDM) were studied to evaluate the relationship between circulating big-endothelin (big-ET1) levels, CAN, and cardiac functions. The severity of CAN was scored according to Ewing's criteria. Cardiac functions were assessed using Doppler echocardiography. RESULTS Left ventricular systolic function in the patient group was within normal limits and comparable with the values of the control group (n = 10). The mean E/A values of diabetics with CAN (1.15 +/- 0.33, p = 0.004) and without CAN (1.34 +/- 0.17) were significantly lower than those of controls (1.57 +/- 0.27). Diabetics with CAN had significantly higher big-ET1 values (81.1 +/- 94 pg/ml) compared with others (12.4 +/- 5.9 and 21.1 +/- 17.7 pg/ml, p = 0.04). Circulating big-ET1 levels showed a significant correlation with E/A values in the control group (p = 0.01, r = -0.7) and with peak A values (p = 0.003, r = 0.64) in diabetics. The CAN score correlated negatively with E/A values (p = 0.01, r = 0.54). CONCLUSIONS High big-ET levels might have an important role in the pathogenesis or consequences of diastolic dysfunction in diabetics with CAN. Their role in cardiac autonomic neuropathy and diastolic dysfunction should be investigated further.
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Affiliation(s)
- T Erbas
- Hacettepe University, Medical School, Department of Endocrinology, Ankara, Turkey
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Dharmage SC, Erbas B, Jarvis D, Wjst M, Raherison C, Norbäck D, Heinrich J, Sunyer J, Svanes C. Do childhood respiratory infections continue to influence adult respiratory morbidity? Eur Respir J 2008; 33:237-44. [PMID: 19010990 DOI: 10.1183/09031936.00062907] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of the present study was to examine the influence of childhood respiratory infections on adult respiratory health. In 1992-1994, the European Community Respiratory Health Survey recruited community based samples of 20-44-yr-old people from 48 centres in 22 countries. Study participants completed questionnaires and underwent lung function testing. On average, 8.9 yrs later, 29 centres re-investigated their samples using similar methods. Mixed effects models comprising an estimate for the random variation between centres were used to evaluate the relevant associations. In total, 9,175 patients participated in both studies, of whom 10.9% reported serious respiratory infections (SRI) before 5 yrs of age and 2.8% reported hospitalisation for lung disease (HLD) before 2 yrs if age. SRI was associated with current wheeze (odds ratio (OR) 1.9, 95% confidence interval (CI) 1.7-2.2), asthma (OR 2.5, 95% CI 2.2-3.1), and lower forced expiratory volume in one second (FEV(1); 89 mL; 95% CI 54-126), forced vital capacity (FVC; 49 mL; 95% CI 8-90) and FEV(1)/FVC ratio (-1.2%; 95% CI -1.8- -0.6). Childhood respiratory infections were also associated with new asthma (OR 1.5, 95% CI 1.03-2.0), new wheeze (OR 1.5, 95% CI 1.0-2.4) and persistent wheeze (OR 2.2, 95% CI 1.4-3.6) but not with a decline in lung function. Similar findings were observed for HDL. These associations were significantly consistent across centres. SRI was associated with lower FEV(1) when excluding ever asthmatics and current wheezers. The impact of early infections was significantly larger in subjects exposed to maternal or active smoking. The impact of childhood respiratory infections on the respiratory system may not only last into adulthood but also influence development and persistence of adult respiratory morbidity.
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Affiliation(s)
- S C Dharmage
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, The University of Melbourne, Level 1, 723, Swanston Street, Carlton, VIC 3052, Australia.
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Erbas B, Sıdan R, Sabırlı S, Gurol A, Midi I, Uresin Y. EFFECT OF RENIN-ANGIOTENSIN SYSTEM BLOCKADE ON LEPTIN, ADIPONECTIN, RESISTIN AND INSULIN LEVELS IN PATIENTS WITH METABOLIC SYNDROME. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70521-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Erbas B, Chang JH, Dharmage S, Ong EK, Hyndman R, Newbigin E, Abramson M. Do levels of airborne grass pollen influence asthma hospital admissions? Clin Exp Allergy 2007; 37:1641-7. [PMID: 17877763 DOI: 10.1111/j.1365-2222.2007.02818.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The effects of environmental factors and ambient concentrations of grass pollen on allergic asthma are yet to be established. OBJECTIVE We sought to estimate the independent effects of grass pollen concentrations in the air over Melbourne on asthma hospital admissions for the 1992-1993 pollen season. METHODS Daily grass pollen concentrations were monitored over a 24-h period at three stations in Melbourne. The outcome variable was defined as all-age asthma hospital admissions with ICD9-493 codes. The ambient air pollutants were average daily measures of ozone, nitrogen dioxide and sulphur dioxide, and the airborne particle index representing fine particulate pollution. Semi-parametric Poisson regression models were used to estimate these effects, adjusted for air temperature, humidity, wind speed, rainfall, day-of-the-week effects and seasonal variation. RESULTS Grass pollen was a strong independent non-linear predictor of asthma hospital admissions in a multi-pollutant model (P=0.01). Our data suggest that grass pollen had an increasing effect on asthma hospital admissions up to a threshold of 30 grains/m3, and that the effect remains stable thereafter. CONCLUSION Our findings suggest that grass pollen levels influence asthma hospital admissions. High grass pollen days, currently defined as more than 50 grains/m3, are days when most sensitive individuals will experience allergic symptoms. However, some asthmatic patients may be at a significant risk even when airborne grass pollen levels are below this level. Patients with pollen allergies and asthma would be advised to take additional preventive medication at lower ambient concentrations.
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Affiliation(s)
- B Erbas
- Centre for Molecular Environmental Genetic Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Vic., Australia.
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Abstract
Based on American studies lifetime prevalence of 'Pathological Gambling' (ICD-10, F 63.0) in Germany can be estimated at 0.5 %. That means about 400,000 gamblers requiring treatment. Epidemiological studies showed that only a little proportion is actually seeking treatment. Reliable knowledge about treatment prevalence does not exist for Germany. The study at hand using secondary data was performed to validate the estimation of the 'Deutsche Suchthilfestatistik' regarding inpatient and outpatient treatment prevalence in 'Pathological Gambling' with data from service providers (cost unit). The analysis proves the estimation of the German Addiction Statistics ('Deutsche Suchthilfestatistik') that the inpatient treatment prevalence has considerably risen. In spite of the consideration that treatment of pathological gambling is not limited to specialized hospitals there is still a considerable gap between estimated prevalence and treatment prevalence.
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Affiliation(s)
- S Queri
- Bayerische Akademie für Suchtfragen in Forschung und Praxis e.V., München.
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Ozgen Kiratli P, Erbas B. A possible cause of misinterpretation on radionuclide imaging: Chilaiditi's syndrome. Rev Esp Med Nucl 2007; 26:46-9. [PMID: 17286948 DOI: 10.1016/s0212-6982(07)75280-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The authors of this work present two patients, diagnosed with lymphoma and prostate cancer, referred to nuclear medicine department for a gallium-67 scan and a bone scan, respectively. The abnormal accumulation of the radioactivity gave rise suspicion for possible other pathologies. Successive computed tomographic imaging revealed that the patients had had Chilaiditi's syndrome. The authors present these cases to draw attention for the possibility of misinterpretation of the scans due to distribution of radioactivity in this syndrome.
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Affiliation(s)
- P Ozgen Kiratli
- Department of Nuclear Medicine, Hacettepe University Hospital, Department of Nuclear Medicine, Sihhiye, Ankara. Turkey.
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Bornschein S, Erbas B, Borelli S, Emminger C, Hesse J, Pilz J, Schwarzkopf-Steinhauser G, Wenzl H, Kunze D, Borelli C. [Working hours and job satisfaction among physicians in hospitals and general practice in Munich. Results of an anonymous questionnaire]. Gesundheitswesen 2006; 68:535-44. [PMID: 17039432 DOI: 10.1055/s-2006-927070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE In autumn 2004 the local association of physicians (Arztlicher Kreis- und Bezirksverband München) performed a survey among employed physicians in Munich on working hours and working conditions. The aim of the study was to assess the extent to which the German law on working hours is actually implemented in employed physicians, and to obtain information about their work satisfaction. METHODS A questionnaire was sent to all employed physicians in hospitals and medical practices. Participants were asked to give anonymous information and send it back per mail. RESULTS In total, 2450 out of 5461 physicians took part in the survey. 45% reported that their working hours do not meet the German law on working hours of 1994. 44.4% stated that overtime is not fully recognized by their employers. 43.5% think the job would become more attractive if the law was implemented. 63.3% expect an income loss with the implementation. 53.7% are thinking about quitting their job. For 59.9% the burden of long working hours is an important reason for this. Women are more likely to be given a limited employment contract than men, and their overtime is more rarely recognized in full. CONCLUSION Many employed physicians in Munich are dissatisfied with their job. The high burden of long working hours is a main reason for this.
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Abstract
OBJECTIVE Long-term antiepileptic drug (AED) use has been associated with bone disease, but many previous studies have been limited by inadequate control subjects. We used a cotwin affected sib-pair model to investigate this issue. METHODS The authors studied 31 female twin (15 monozygous and 16 dizygous) and four sibling pairs (< 3 years age difference) aged 21 to 75 years, in which one member had > 12 months of AED treatment. Areal bone mineral density (ABMD, g/cm2) was measured at the lumbar spine (LS), total hip (TH), femoral neck (FN), and total forearm (FA). Three primary a priori defined subgroups were analyzed: a) use for > 2 years, b) use of enzyme-inducing AEDs, or c) age older than 40 years. RESULTS For all pairs (n = 35), there were no significant within-pair differences in any ABMD measure. However, in Subgroup a (n = 27), there was a within-pair difference at the FA (0.513 vs 0.534, -3.9%, p = 0.016). In Subgroup b (n = 29), there was also a within-pair difference at the FA for AED user vs nonuser (0.508 vs 0.529, -3.8%, p = 0.010). In Subgroup c (n = 15), there were within-pair differences at the FA (0.492 vs 0.524, -6.1%, p = 0.017) and the LS (0.884 vs 0.980, -9.8%, p = 0.036). CONCLUSIONS Patients using AEDs for > 2 years, in particular those taking enzyme-inducing AEDs and those older than 40 years, have significantly lower bone mineral density at clinically relevant fracture risk sites.
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Affiliation(s)
- S J Petty
- The University of Melbourne, Department of Neurology, The Royal Melbourne Hospital, Victoria, Australia
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Ates T, Langer B, Erbas B, Tretter F, Wehner B. Evaluierung von Arbeitsprojekten bei Drogenabhängigen im Rahmen einer Kosten-Nutzen-Analyse. Gesundheitswesen 2005; 67:159-62. [PMID: 15747208 DOI: 10.1055/s-2005-857884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this study is to make a cost-benefit-analysis for integration projects helping drug addicts and substitutes to reintegrate into society. The study is intended to contribute to a better allocation of resources under the trade-off-situation that only a limited number of integration projects can be realized due to budget limitations. This pilot study represents an economic evaluation of health activities on integration based on the example of study projects offered by Mudra e. V. As a result the study showed that the evaluated projects are economically advantageous during the investigated research period. Furthermore, the study contains a non-monetary analysis of intangible effects which shows significant improvements in quality of life. Although the results are substantial, further research is mandatory focussing on the economic benefits of integration projects.
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Affiliation(s)
- T Ates
- Institut für Volkswirtschaftslehre, Universität Augsburg.
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Fletcher AS, Erbas B, Kavanagh AM, Hart S, Rodger A, Gertig DM. Use of hormone replacement therapy (HRT) and survival following breast cancer diagnosis. Breast 2005; 14:192-200. [PMID: 15927828 DOI: 10.1016/j.breast.2004.08.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2004] [Accepted: 08/30/2004] [Indexed: 10/25/2022] Open
Abstract
Although hormone replacement therapy (HRT) use has been associated with breast cancers that have better prognostic features, it is not clear whether this leads to improved survival. We studied a cohort of 4022 postmenopausal women diagnosed with breast cancer between 1993 and 2000, who attended a mammographic screening program, among whom 312 deaths subsequently occurred. Proportional hazards models were used to examine survival from breast cancer and all-causes among HRT users and non-users. The multivariate hazard ratio for HRT use was 0.64 (95% CI: 0.41-1.00) for breast cancer deaths and 0.69 (95% CI: 0.49-0.96) for all-cause mortality. This was attenuated by grade (HR 0.71; 95% CI: 0.45-1.10). HRT use at diagnosis was associated with modestly improved survival from breast cancer that appeared in part to be explained by the influence of HRT on tumour grade, although we cannot exclude the possibility of confounding by factors associated with the choice to use HRT.
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Affiliation(s)
- A S Fletcher
- Department of Public Health, School of Population Health, Centre for Genetic Epidemiology, The University of Melbourne, 723 Swaston Street, Carlton, Vic 3053, Melbourne, Australia.
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Ates T, Erbas B, Langer B, Tretter F, Wehner B. Evaluierung von Arbeitsprojekten bei Drogenabhängigen – Ansätze einer Kosten-Nutzen-Betrachtung. Gesundheitswesen 2004. [DOI: 10.1055/s-2004-833847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Erbas B, Chang P, Kavanagh AM, Gertig DM. Trends and predictors of size and grade for ductal carcinoma in situ (DCIS) in BreastScreen Victoria. Breast Cancer Res 2004. [PMCID: PMC3300379 DOI: 10.1186/bcr838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Schousboe K, Visscher PM, Erbas B, Kyvik KO, Hopper JL, Henriksen JE, Heitmann BL, Sørensen TIA. Twin study of genetic and environmental influences on adult body size, shape, and composition. Int J Obes (Lond) 2004; 28:39-48. [PMID: 14610529 DOI: 10.1038/sj.ijo.0802524] [Citation(s) in RCA: 132] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To investigate the genetic and environmental influences on adult body size, shape, and composition in women and men, and to assess the impact of age. MATERIALS AND METHODS In this cross-sectional study of 325 female and 299 male like-sex healthy twin pairs, on average 38 y old (18-67 y), we determined zygosity by DNA similarity, and performed anthropometry and bioelectrical impedance analysis of body composition. The contribution to the total phenotypic variance of genetic, common environment, and individual environment was estimated in multivariate analysis using the FISHER program. Further, these variance components were analysed as linear functions of age. RESULTS In both women and men genetic contributions were significant for all phenotypes. Heritability for body mass index was 0.58 and 0.63; for body fat%, 0.59 and 0.63; for total skinfolds, 0.61 and 0.65; for extremity skinfolds 0.65 and 0.62; for truncal skinfolds, 0.50 and 0.69; for suprailiac skinfolds, 0.49 and 0.48; for waist circumference, 0.48 and 0.61; for hip, 0.52 and 0.58; for lean body mass/height2, 0.61 and 0.56; and for height, 0.81 and 0.69, respectively. There was no strong evidence of common environmental effects under the assumptions of no nonadditive effect. The pattern of age trends was inconsistent. However, when significant there was a decrease in heritability with advancing age. DISCUSSION These findings suggest that adult body size, shape, and composition are highly heritable in both women and men, although a decreasing tendency is seen with advancing age.
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Affiliation(s)
- K Schousboe
- The Danish Twin Registry, Epidemiology, Institute of Public Health, University of Southern Denmark, Denmark.
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Abstract
BACKGROUND Data visualisation has become an integral part of statistical modelling. METHODS We present visualisation methods for preliminary exploration of time-series data, and graphical diagnostic methods for modelling relationships between time-series data in medicine. We use exploratory graphical methods to better understand the relationship between a time-series reponse and a number of potential covariates. Graphical methods are also used to examine any remaining information in the residuals from these models. RESULTS We applied exploratory graphical methods to a time-series data set consisting of daily counts of hospital admissions for asthma, and pollution and climatic variables. We provide an overview of the most recent and widely applicable data-visualisation methods for portraying and analysing epidemiological time series. DISCUSSION Exploratory graphical analysis allows insight into the underlying structure of observations in a data set, and graphical methods for diagnostic purposes after model-fitting provide insight into the fitted model and its inadequacies.
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Affiliation(s)
- B Erbas
- Department of Public Health, The University of Melbourne, VIC, Australia
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Reimer B, Erbas B, Lobbichler K, Truckenbrodt R, Gartner-Kothe U, Kapeller N, Hansen M, Fingerle V, Wilske B, von Sonnenburg F. Seroprevalence of Borrelia infection in occupational tick-exposed people in Bavaria (Germany). Int J Med Microbiol 2002; 291 Suppl 33:215. [PMID: 12141748 DOI: 10.1016/s1438-4221(02)80055-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- B Reimer
- Department of Infectious Diseases and Tropical Medicine, Ludwig Maximilian University of Munich, Germany.
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Yildirir A, Kabakci G, Can I, Erbas B. Men with coronary artery disease have lower levels of androgens than men with normal coronary angiograms. Eur Heart J 2001; 22:612-3. [PMID: 11259151 DOI: 10.1053/euhj.2000.2365] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Affiliation(s)
- I Peksoy
- Department of Nuclear Medicine, Hacettepe University Medical School, Ankara, Turkey.
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