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Guðmundsdóttir SL, Berger C, Macdonald H, Adachi JD, Hopman WM, Kaiser SM, Kovacs CS, Davison KS, Morin SN, Goltzman D, Prior JC. Sedentary behavior does not predict low BMD nor fracture-population-based Canadian Multicentre Osteoporosis Study. J Bone Miner Res 2024; 39:231-240. [PMID: 38477796 DOI: 10.1093/jbmr/zjae004] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 11/03/2023] [Accepted: 11/10/2023] [Indexed: 03/14/2024]
Abstract
Sedentary behavior (SB) or sitting is associated with multiple unfavorable health outcomes. Bone tissue responds to imposed gravitational and muscular strain with there being some evidence suggesting a causal link between SB and poor bone health. However, there are no population-based data on the longitudinal relationship between SB, bone change, and incidence of fragility fractures. This study aimed to examine the associations of sitting/SB (defined as daily sitting time), areal BMD (by DXA), and incident low trauma (fragility) osteoporotic fractures (excluding hands, feet, face, and head). We measured baseline (1995-7) and 10-yr self-reported SB, femoral neck (FN), total hip (TH), and lumbar spine (L1-L4) BMD in 5708 women and 2564 men aged 25 to 80+ yr from the population-based, nationwide, 9-center Canadian Multicentre Osteoporosis Study. Incident 10-yr fragility fracture data were obtained from 4624 participants; >80% of fractures were objectively confirmed by medical records or radiology reports. Vertebral fractures were confirmed by qualitative morphological methods. All analyses were stratified by sex. Multivariable regression models assessed SB-BMD relationships; Cox proportional models were fit for fracture risk. Models were adjusted for age, height, BMI, physical activity, and sex-specific covariates. Women in third/fourth quartiles had lower adjusted FN BMD versus women with the least SB (first quartile); women in the SB third quartile had lower adjusted TH BMD. Men in the SB third quartile had lower adjusted FN BMD than those in SB first quartile. Neither baseline nor stable 10-yr SB was related to BMD change nor to incident fragility fractures. Increased sitting (SB) in this large, population-based cohort was associated with lower baseline FN BMD. Stable SB was not associated with 10-yr BMD loss nor increased fragility fracture. In conclusion, habitual adult SB was not associated with subsequent loss of BMD nor increased risk of fracture.
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Affiliation(s)
- Sigríður Lára Guðmundsdóttir
- School of Education, Department of Health Promotion, Sport and Leisure Studies, University of Iceland, 101 Reykjavik, Iceland
| | - Claudie Berger
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC H3H 2R9, Canada
| | - Heather Macdonald
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2A1, Canada
- Active Aging Research Team, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Jonathan D Adachi
- Department of Medicine, McMaster University, Hamilton, ON L8N 3Z5, Canada
| | - Wilma M Hopman
- Kingston General Hospital Research Institute, Kingston Health Sciences Centre, Kingston, ON K7L 2V7, Canada
- Department of Public Health Sciences, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Stephanie M Kaiser
- Department of Medicine, Dalhousie University, Halifax, NS B3H 2Y9, Canada
| | - Christopher S Kovacs
- Discipline of Medicine/Endocrinology, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL A1B 3V6, Canada
| | | | - Suzanne N Morin
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC H3H 2R9, Canada
- Department of Medicine, McGill University Health Center, Montreal, QC H4A 3J1, Canada
| | - David Goltzman
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC H3H 2R9, Canada
- Department of Medicine, McGill University Health Center, Montreal, QC H4A 3J1, Canada
| | - Jerilynn C Prior
- Division of Endocrinology, Department of Medicine, Centre for Menstrual Cycle and Ovulation Research, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
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DeLeire T, Mitchell JM, De La Cruz L, Isaacs C. Nonclinical factors associated with the treatment of older women with newly diagnosed low-grade ductal carcinoma in situ. Cancer 2024; 130:1041-1051. [PMID: 37987170 PMCID: PMC10939947 DOI: 10.1002/cncr.35124] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/30/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Ductal carcinoma in situ (DCIS) is the most common form of noninvasive breast cancer and is associated with an excellent prognosis. As a result, there is concern about overdiagnosis and overtreatment of DCIS because most patients with DCIS are treated as though they have invasive breast cancer and undergo either breast-conserving surgery (BCS)-most commonly followed by radiation therapy (RT)-or mastectomy. Little research to date has focused on nonclinical factors influencing treatments for DCIS. METHODS Population-based data were analyzed from five state cancer registries (California, Florida, New Jersey, New York, and Texas) on women aged 65 years and older newly diagnosed with DCIS during the years 2003 to 2014 using a retrospective cohort design and multinominal logistic modeling. The registry records with Medicare enrollment data and fee-for-service claims to obtain treatments (BCS alone, BCS with RT, or mastectomy) were merged. Surgeon practice structure was identified through physician surveys and internet searches. RESULTS Patients of surgeons employed by cancer centers or health systems were less likely to receive BCS with RT or mastectomy than patients of surgeons in single specialty or multispecialty practices. There also was substantial geographic variation in treatments, with patients in New York, New Jersey, and California being less likely to receive BCS with RT or mastectomy than patients in Texas or Florida. CONCLUSIONS These findings suggest nonclinical factors including the culture of the practice and/or financial incentives are significantly associated with the types of treatment received for DCIS. Increasing awareness and targeted efforts to educate physicians about DCIS management among older women with low-grade DCIS could reduce patient harm and yield substantial cost savings.
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Affiliation(s)
- Thomas DeLeire
- McCourt School of Public Policy, Georgetown University, Washington, District of Columbia, USA
| | - Jean M. Mitchell
- McCourt School of Public Policy, Georgetown University, Washington, District of Columbia, USA
| | - Lucy De La Cruz
- School of Medicine, Georgetown University, Washington, District of Columbia, USA
| | - Claudine Isaacs
- School of Medicine, Georgetown University, Washington, District of Columbia, USA
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Wiernik E, Renuy A, Kab S, Steg PG, Goldberg M, Zins M, Caligiuri G, Bouchard P, Carra MC. Prevalence of self-reported severe periodontitis: Data from the population-based CONSTANCES cohort. J Clin Periodontol 2024. [PMID: 38430050 DOI: 10.1111/jcpe.13969] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 02/12/2024] [Accepted: 02/18/2024] [Indexed: 03/03/2024]
Abstract
AIM To assess the prevalence of severe periodontitis based on the population-based CONSTANCES cohort using a validated self-reported questionnaire. MATERIALS AND METHODS Individuals were selected from the adult population in France using a random sampling scheme. Analyses were restricted to those invited in 2013-2014 who completed the periodontal health questionnaire at the 2017 follow-up. The risk of severe periodontitis was assessed using the periodontal screening score (PESS) and weighting coefficients were applied to provide representative results in the general French population. RESULTS The study included 19,859 participants (9204 men, mean age: 52.8 ± 12.6 years). Based on a PESS ≥ 5, 7106 participants were at risk of severe periodontitis, corresponding to a weighted prevalence of 31.6% (95% confidence interval: 30.6%-32.7%). This prevalence was higher among participants aged 55 and over, those with lower socio-economic status as well as current smokers, e-cigarette users and heavy drinkers. Among individuals at risk of severe periodontitis, only 18.8% (17.3%-20.4%) thought they had gum disease, although 50.5% (48.6%-52.5%) reported that their last dental visit was less than 6 months. CONCLUSIONS The present survey indicates that (1) self-reported severe periodontitis is highly prevalent with marked disparities between groups in the general French adult population, and (2) periodontitis could frequently be under-diagnosed given the low awareness.
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Affiliation(s)
- Emmanuel Wiernik
- UMS 011 Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Paris, France
| | - Adeline Renuy
- UMS 011 Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Paris, France
| | - Sofiane Kab
- UMS 011 Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Paris, France
| | - Philippe Gabriel Steg
- UFR de Médecine, Université Paris-Cité, Paris, France
- Cardiology Department, AP-HP, Hôpital Bichat, Paris, France
- Laboratory for Vascular Translational Science, INSERM U1148, Paris, France
- Institut Universitaire de France, Paris, France
| | - Marcel Goldberg
- UMS 011 Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Paris, France
| | - Marie Zins
- UMS 011 Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Paris, France
- UFR de Médecine, Université Paris-Cité, Paris, France
| | - Giuseppina Caligiuri
- UFR de Médecine, Université Paris-Cité, Paris, France
- Cardiology Department, AP-HP, Hôpital Bichat, Paris, France
- Laboratory for Vascular Translational Science, INSERM U1148, Paris, France
| | - Philippe Bouchard
- UFR of Odontology, Université Paris Cité, Paris, France
- URP 2496, Montrouge, France
| | - Maria Clotilde Carra
- UMS 011 Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Paris, France
- UFR of Odontology, Université Paris Cité, Paris, France
- Service of Odontology, Rothschild Hospital (AP-HP) and Department of Periodontology, UFR of Odontology, Université Paris Cité, Paris, France
- INSERM-Sorbonne Paris Cité Epidemiology and Statistics Research Centre, Paris, France
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Kriegbaum M, Lind BS, Grand MK, Andersen CL. The Copenhagen Primary Care Laboratory (CopLab) Database. Clin Epidemiol 2024; 16:155-163. [PMID: 38444401 PMCID: PMC10913898 DOI: 10.2147/clep.s437123] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/22/2024] [Indexed: 03/07/2024] Open
Abstract
Background The Copenhagen General Practice Laboratory (CGPL) was founded in 1922 to provide paraclinical analyses to the primary health-care sector in Copenhagen. At the end of 2015, CGPL was closed and the CopLab database was established to make CGPL data available for research. Methods We isolated tests performed at the CGPL with clinically relevant test results. The database was linked to national registers containing health, social, and demographic information. Results are presented with descriptive statistics showing counts, percentages, medians, and interquartile ranges (IQR). Results The CopLab database includes 1,373,643 unique individuals from primary care with test results from laboratory analyses of blood/urine/semen as well as cardiac and lung function tests collected by CGPL from greater Copenhagen from 2000 to 2015. The CopLab database holds nearly all test results requested by general practitioners throughout years 2000 to 2015 for residents in the greater Copenhagen area. The median age of the individuals was 51 years and 59.7% were females. Each individual has a median of 4 requisitions. More than 1 million participants are currently alive and living in Denmark and may be followed in national registries such as the Danish National Patient Registry, Laboratory Database, National Prescription Database etc.
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Affiliation(s)
- Margit Kriegbaum
- The Copenhagen Primary Care Laboratory (CopLab) Database, Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Bent Struer Lind
- Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark
| | - Mia Klinten Grand
- The Copenhagen Primary Care Laboratory (CopLab) Database, Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Christen Lykkegaard Andersen
- The Copenhagen Primary Care Laboratory (CopLab) Database, Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Haematology, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark
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Alari A, Ranzani O, Olmos S, Milà C, Rico A, Ballester J, Basagaña X, Dadvand P, Duarte-Salles T, Nieuwenhuijsen M, Vivanco-Hidalgo RM, Tonne C. Short-term exposure to air pollution and hospital admission after COVID-19 in Catalonia: the COVAIR-CAT study. Int J Epidemiol 2024; 53:dyae041. [PMID: 38514998 DOI: 10.1093/ije/dyae041] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND A growing body of evidence has reported positive associations between long-term exposure to air pollution and poor COVID-19 outcomes. Inconsistent findings have been reported for short-term air pollution, mostly from ecological study designs. Using individual-level data, we studied the association between short-term variation in air pollutants [nitrogen dioxide (NO2), particulate matter with a diameter of <2.5 µm (PM2.5) and a diameter of <10 µm (PM10) and ozone (O3)] and hospital admission among individuals diagnosed with COVID-19. METHODS The COVAIR-CAT (Air pollution in relation to COVID-19 morbidity and mortality: a large population-based cohort study in Catalonia, Spain) cohort is a large population-based cohort in Catalonia, Spain including 240 902 individuals diagnosed with COVID-19 in the primary care system from 1 March until 31 December 2020. Our outcome was hospitalization within 30 days of COVID-19 diagnosis. We used individual residential address to assign daily air-pollution exposure, estimated using machine-learning methods for spatiotemporal prediction. For each pandemic wave, we fitted Cox proportional-hazards models accounting for non-linear-distributed lagged exposure over the previous 7 days. RESULTS Results differed considerably by pandemic wave. During the second wave, an interquartile-range increase in cumulative weekly exposure to air pollution (lag0_7) was associated with a 12% increase (95% CI: 4% to 20%) in COVID-19 hospitalizations for NO2, 8% (95% CI: 1% to 16%) for PM2.5 and 9% (95% CI: 3% to 15%) for PM10. We observed consistent positive associations for same-day (lag0) exposure, whereas lag-specific associations beyond lag0 were generally not statistically significant. CONCLUSIONS Our study suggests positive associations between NO2, PM2.5 and PM10 and hospitalization risk among individuals diagnosed with COVID-19 during the second wave. Cumulative hazard ratios were largely driven by exposure on the same day as hospitalization.
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Affiliation(s)
- Anna Alari
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Otavio Ranzani
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sergio Olmos
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carles Milà
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Alex Rico
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Joan Ballester
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
| | - Xavier Basagaña
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Payam Dadvand
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Cathryn Tonne
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Mitchell JM, DeLeire T, Isaacs C. Adherence to hormonal therapy after surgery among older women with ductal carcinoma in situ: Implications for breast cancer-related adverse health events. Cancer 2024; 130:107-116. [PMID: 37751195 DOI: 10.1002/cncr.35009] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/26/2023] [Accepted: 08/08/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Evidence from randomized clinical trials (RCTs) shows that receipt of hormonal therapy after surgery for estrogen receptor-positive ductal carcinoma in situ (DCIS) reduces the risk of DCIS and contralateral invasive breast cancer (IBC) but not death from breast cancer. RCTs examined homogeneous samples, and therefore whether this evidence can be generalized to diverse populations is unclear. METHODS Population-based data from four state cancer registries (California, New Jersey, New York, and Texas) were analyzed on women aged 65 years and older newly diagnosed with DCIS who underwent surgery with or without radiation during the years 2006-2013. Registry records were merged with Medicare enrollment in Parts A and/or B and D (prescription drugs) and associated claims. Whether adherence to hormonal therapy was associated with adverse breast cancer-related health events was analyzed. RESULTS Achieving excellent adherence did not affect death from breast cancer. In contrast, the risk of developing a subsequent breast tumor was 6.24 percentage points (breast-conserving surgery [BCS] with radiation therapy [RT]) and 10.54 percentage points (BCS alone) lower for women with excellent versus low adherence (p < .00001). For excellent versus good adherence, the reduced risk among women who had BCS with and without RT was approximately 3 and 5 percentage points, respectively. A similar pattern emerged for the risk of IBC among women who achieved excellent versus good or low adherence, whereas good versus low adherence comparisons were not significant. CONCLUSIONS This analysis of a diverse population-based cohort of women with DCIS demonstrates that achieving excellent adherence to hormonal therapy is critical to minimizing the occurrence of developing subsequent breast tumors. PLAIN LANGUAGE SUMMARY Our analysis of a diverse population-based cohort of women with ductal carcinoma in situ demonstrates that achieving excellent adherence to hormonal therapy is critical to minimizing the occurrence of developing subsequent breast tumors.
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Affiliation(s)
- Jean M Mitchell
- McCourt School of Public Policy, Georgetown University, Washington, DC, USA
| | - Thomas DeLeire
- McCourt School of Public Policy, Georgetown University, Washington, DC, USA
| | - Claudine Isaacs
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
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Shaaban AN, Andersson F, Peña S, Caspersen IH, Magnusson C, Orsini N, Karvonen S, Magnus P, Hergens MP, Galanti MR. The Association Between Tobacco Use and Risk of COVID-19 Infection and Clinical Outcomes in Sweden: A Population-Based Study. Int J Public Health 2023; 68:1606175. [PMID: 38098982 PMCID: PMC10720900 DOI: 10.3389/ijph.2023.1606175] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
Background: The association between tobacco use and COVID-19 is controversial. During the early course of the pandemic, limited testing prevented studying a wide spectrum of clinical manifestations. Objective: To examine the potential causal association between tobacco use and COVID-19 during the second wave (1 October 2020-30 June 2021) of the pandemic in Stockholm, Sweden. Methods: A population-based cohort study was conducted in the Stockholm region of Sweden, with information on tobacco use collected prior to the pandemic. Adjusted relative risks (RR) of COVID-19 and 95% confidence intervals (CI) were calculated, contrasting current smokers and snus users to non-users of tobacco. Results: Compared with non-users of tobacco, current smokers had a lower risk of COVID-19 (RR 0.78, 95% CI = 0.75-0.81) and of hospitalisation for the disease. Current snus users had a higher risk of COVID-19. Heavy smokers and snus users had longer hospital stays than non-users of tobacco. Conclusion: Tobacco use may have a different impact on the risk of being infected with SARS-CoV-2 and the risk of developing severe clinical manifestations. Further research is needed to determine the underlying mechanisms.
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Affiliation(s)
- A. N. Shaaban
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - F. Andersson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm, Sweden
| | - S. Peña
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - I. H. Caspersen
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - C. Magnusson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm, Sweden
| | - N. Orsini
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm, Sweden
| | - S. Karvonen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - P. Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - M. P. Hergens
- Unit for Communicable Disease Control, Stockholm, Sweden
- Infectious Diseases Unit, Department of Medicine Solna, Karolinska Institutet, Solna, Sweden
| | - M. R. Galanti
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm, Sweden
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Gagliotti C, Banchelli F, De Paoli A, Buttazzi R, Narne E, Ricchizzi E, Schievano E, Bellio S, Pitter G, Tonon M, Canziani LM, Rolli M, Tacconelli E, Berti E, Russo F, Moro ML. The incidence and risk factors of selected drug prescriptions and outpatient care after SARS-CoV-2 infection in low-risk subjects: a multicenter population-based cohort study. Front Public Health 2023; 11:1241401. [PMID: 37860802 PMCID: PMC10582710 DOI: 10.3389/fpubh.2023.1241401] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/20/2023] [Indexed: 10/21/2023] Open
Abstract
Background Knowledge about the dynamics of transmission of SARS-CoV-2 and the clinical aspects of COVID-19 has steadily increased over time, although evidence of the determinants of disease severity and duration is still limited and mainly focused on older adult and fragile populations. Methods The present study was conceived and carried out in the Emilia-Romagna (E-R) and Veneto Regions, Italy, within the context of the EU's Horizon 2020 research project called ORCHESTRA (Connecting European Cohorts to increase common and effective response to SARS-CoV-2 pandemic) (www.orchestra-cohort.eu). The study has a multicenter retrospective population-based cohort design and aimed to investigate the incidence and risk factors of access to specific healthcare services (outpatient visits and diagnostics, drug prescriptions) during the post-acute phase from day-31 to day-365 after SARS-CoV-2 infection, in a healthy population at low risk of severe acute COVID-19. The study made use of previously recorded large-scale healthcare data available in the administrative databases of the two Italian Regions. The statistical analysis made use of methods for competing risks. Risk factors were assessed separately in the two Regions and results were pooled using random effects meta-analysis. Results There were 35,128 subjects in E-R and 88,881 in Veneto who were included in the data analysis. The outcome (access to selected health services) occurred in a high percentage of subjects in the post-acute phase (25% in E-R and 21% in Veneto). Outpatient care was observed more frequently than drug prescriptions (18% vs. 12% in E-R and 15% vs. 10% in Veneto). Risk factors associated with the outcome were female sex, age greater than 40 years, baseline risk of hospitalization and death, moderate to severe acute COVID-19, and acute extrapulmonary complications. Conclusion The outcome of interest may be considered as a proxy for long-term effects of COVID-19 needing clinical attention. Our data suggest that this outcome occurs in a substantial percentage of cases, even among a previously healthy population with low or mild severity of acute COVID-19. The study results provide useful insights into planning COVID-19-related services.
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Affiliation(s)
- Carlo Gagliotti
- Department of Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Italy
| | - Federico Banchelli
- Department of Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Italy
| | | | - Rossella Buttazzi
- Department of Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Italy
| | | | - Enrico Ricchizzi
- Department of Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Italy
| | | | | | | | - Michele Tonon
- Directorate of Prevention, Food Safety, and Veterinary Public Health, Venezia, Italy
| | | | - Maurizia Rolli
- Department of Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Italy
| | - Evelina Tacconelli
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Elena Berti
- Department of Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Italy
| | - Francesca Russo
- Directorate of Prevention, Food Safety, and Veterinary Public Health, Venezia, Italy
| | - Maria Luisa Moro
- Department of Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Italy
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Ferreira PCL, Zhang Y, Snitz B, Chang CCH, Bellaver B, Jacobsen E, Kamboh MI, Zetterberg H, Blennow K, Pascoal TA, Villemagne VL, Ganguli M, Karikari TK. Plasma biomarkers identify older adults at risk of Alzheimer's disease and related dementias in a real-world population-based cohort. Alzheimers Dement 2023; 19:4507-4519. [PMID: 36876954 PMCID: PMC10480336 DOI: 10.1002/alz.12986] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/12/2023] [Accepted: 01/15/2023] [Indexed: 03/07/2023]
Abstract
INTRODUCTION Plasma biomarkers-cost effective, non-invasive indicators of Alzheimer's disease (AD) and related disorders (ADRD)-have largely been studied in clinical research settings. Here, we examined plasma biomarker profiles and their associated factors in a population-based cohort to determine whether they could identify an at-risk group, independently of brain and cerebrospinal fluid biomarkers. METHODS We measured plasma phosphorylated tau181 (p-tau181), neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and amyloid beta (Aβ)42/40 ratio in 847 participants from a population-based cohort in southwestern Pennsylvania. RESULTS K-medoids clustering identified two distinct plasma Aβ42/40 modes, further categorizable into three biomarker profile groups: normal, uncertain, and abnormal. In different groups, plasma p-tau181, NfL, and GFAP were inversely correlated with Aβ42/40, Clinical Dementia Rating, and memory composite score, with the strongest associations in the abnormal group. DISCUSSION Abnormal plasma Aβ42/40 ratio identified older adult groups with lower memory scores, higher dementia risks, and higher ADRD biomarker levels, with potential implications for population screening. HIGHLIGHTS Population-based plasma biomarker studies are lacking, particularly in cohorts without cerebrospinal fluid or neuroimaging data. In the Monongahela-Youghiogheny Healthy Aging Team study (n = 847), plasma biomarkers associated with worse memory and Clinical Dementia Rating (CDR), apolipoprotein E ε4, and greater age. Plasma amyloid beta (Aβ)42/40 ratio levels allowed clustering participants into abnormal, uncertain, and normal groups. Plasma Aβ42/40 correlated differently with neurofilament light chain, glial fibrillary acidic protein, phosphorylated tau181, memory composite, and CDR in each group. Plasma biomarkers can enable relatively affordable and non-invasive community screening for evidence of Alzheimer's disease and related disorders pathophysiology.
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Affiliation(s)
- Pamela C. L Ferreira
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Yingjin Zhang
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Beth Snitz
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Chung-Chou H. Chang
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15213, USA
- Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Bruna Bellaver
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Erin Jacobsen
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - M. Ilyas Kamboh
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Mölndal, 431 41, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, 431 41, Sweden
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
- UK Dementia Research Institute at UCL, London, WC1N 3BG, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, HKG, China
- UW Department of Medicine, School of Medicine and Public Health, Madison, WI, 53726, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Mölndal, 431 41, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, 431 41, Sweden
| | - Tharick A. Pascoal
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Victor L. Villemagne
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Mary Ganguli
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Thomas K. Karikari
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Mölndal, 431 41, Sweden
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Geraets AFJ, Köhler S, Vergoossen LWM, Backes WH, Stehouwer CD, Verhey FRJ, Jansen JFA, van Sloten TT, Schram MT. The association of white matter connectivity with prevalence, incidence and course of depressive symptoms: The Maastricht Study. Psychol Med 2023; 53:5558-5568. [PMID: 36069192 PMCID: PMC10493191 DOI: 10.1017/s0033291722002768] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/27/2022] [Accepted: 08/08/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Altered white matter brain connectivity has been linked to depression. The aim of this study was to investigate the association of markers of white matter connectivity with prevalence, incidence and course of depressive symptoms. METHODS Markers of white matter connectivity (node degree, clustering coefficient, local efficiency, characteristic path length, and global efficiency) were assessed at baseline by 3 T MRI in the population-based Maastricht Study (n = 4866; mean ± standard deviation age 59.6 ± 8.5 years, 49.0% women; 17 406 person-years of follow-up). Depressive symptoms (9-item Patient Health Questionnaire; PHQ-9) were assessed at baseline and annually over seven years of follow-up. Major depressive disorder (MDD) was assessed with the Mini-International Neuropsychiatric Interview at baseline only. We used negative binominal, logistic and Cox regression analyses, and adjusted for demographic, cardiovascular, and lifestyle risk factors. RESULTS A lower global average node degree at baseline was associated with the prevalence and persistence of clinically relevant depressive symptoms [PHQ-9 ⩾ 10; OR (95% confidence interval) per standard deviation = 1.21 (1.05-1.39) and OR = 1.21 (1.02-1.44), respectively], after full adjustment. On the contrary, no associations were found of global average node degree with the MDD at baseline [OR 1.12 (0.94-1.32) nor incidence or remission of clinically relevant depressive symptoms [HR = 1.05 (0.95-1.17) and OR 1.08 (0.83-1.41), respectively]. Other connectivity measures of white matter organization were not associated with depression. CONCLUSIONS Our findings suggest that fewer white matter connections may contribute to prevalent depressive symptoms and its persistence but not to incident depression. Future studies are needed to replicate our findings.
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Affiliation(s)
- Anouk F. J. Geraets
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
- Alzheimer Centrum Limburg, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
- Alzheimer Centrum Limburg, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Laura WM Vergoossen
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Walter H. Backes
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Coen D.A. Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Frans RJ Verhey
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
- Alzheimer Centrum Limburg, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Jacobus FA Jansen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Thomas T. van Sloten
- Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Miranda T. Schram
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
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Simonet C, Mahlknecht P, Marini K, Seppi K, Gill A, Bestwick JP, Lees AJ, Giovannoni G, Schrag A, Noyce AJ. The Emergence and Progression of Motor Dysfunction in Individuals at Risk of Parkinson's Disease. Mov Disord 2023; 38:1636-1644. [PMID: 37317903 DOI: 10.1002/mds.29496] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND PREDICT-PD is a United Kingdom population-based study aiming to stratify individuals for future Parkinson's disease (PD) using a risk algorithm. METHODS A randomly selected, representative sample of participants in PREDICT-PD were examined using several motor assessments, including the motor section of the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS)-III, at baseline (2012) and after an average of 6 years of follow-up. We checked for new PD diagnoses in participants seen at baseline and examined the association between risk scores and incident sub-threshold parkinsonism, motor decline (increasing ≥5 points in MDS-UPDRS-III) and single motor domains in the MDS-UPDRS-III. We replicated analyses in two independent datasets (Bruneck and Parkinson's Progression Markers Initiative [PPMI]). RESULTS After 6 years of follow-up, the PREDICT-PD higher-risk group (n = 33) had a greater motor decline compared with the lower-risk group (n = 95) (30% vs. 12.5%, P = 0.031). Two participants (both considered higher risk at baseline) were given a diagnosis of PD during follow-up, with motor signs emerging between 2 and 5 years before diagnosis. A meta-analysis of data from PREDICT-PD, Bruneck, and PPMI showed an association between PD risk estimates and incident sub-threshold parkinsonism (odds ratio [OR], 2.01 [95% confidence interval (CI), 1.55-2.61]), as well as new onset bradykinesia (OR, 1.69 [95% CI, 1.33-2.16]) and action tremor (OR, 1.61 [95% CI, 1.30-1.98]). CONCLUSIONS Risk estimates using the PREDICT-PD algorithm were associated with the occurrence of sub-threshold parkinsonism, including bradykinesia and action tremor. The algorithm could also identify individuals whose motor examination experience a decline over time. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Cristina Simonet
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Philipp Mahlknecht
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Kathrin Marini
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Klaus Seppi
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Aneet Gill
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Jonathan P Bestwick
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Andrew J Lees
- Reta Lila Weston Institute of Neurological Studies, University College London Queen Square Institute of Neurology, London, United Kingdom
| | - Gavin Giovannoni
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- Blizard Institute, Queen Mary University, London, United Kingdom
| | - Anette Schrag
- Reta Lila Weston Institute of Neurological Studies, University College London Queen Square Institute of Neurology, London, United Kingdom
| | - Alastair J Noyce
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
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12
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Korva-Gurung I, Kubin AM, Ohtonen P, Hautala N. Visual Outcomes of Anti-VEGF Treatment on Neovascular Age-Related Macular Degeneration: A Real-World Population-Based Cohort Study. Pharmaceuticals (Basel) 2023; 16:927. [PMID: 37513839 PMCID: PMC10384898 DOI: 10.3390/ph16070927] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/21/2023] [Accepted: 06/25/2023] [Indexed: 07/30/2023] Open
Abstract
Neovascular age-related macular degeneration (nAMD) leads to visual impairment if not treated promptly. Intravitreal anti-VEGF drugs have revolutionized nAMD treatment in the past two decades. We evaluated the visual outcomes of anti-VEGF treatment in nAMD. A real-life population-based cohort study. The data included parameters for age, sex, age at diagnosis, laterality, chronicity, symptoms, visual outcomes, lens status, and history of intravitreal injections. A total of 1088 eyes (827 patients) with nAMD were included. Visual acuity was stable or improved in 984 eyes (90%) after an average of 36 ± 25 months of follow-up. Bevacizumab was the first-line drug in 1083 (99.5%) eyes. Vision improved ≥15 ETDRS letters in 377 (35%), >5 ETDRS letters in 309 (28%), and was stable (±5 ETDRS letters) in 298 (27%) eyes after anti-VEGF treatment. The loss of 5 ≤ 15 ETDRS letters in 44 (4%) eyes and ≥15 ETDRS letters in 60 (6%) eyes was noted. At the diagnosis of nAMD, 110 out of 827 patients (13%) fulfilled the criteria for visual impairment, whereas 179 patients (22%) were visually impaired after the follow-up. Improvement or stabilization in vision was noted in 90% of the anti-VEGF-treated eyes with nAMD. In addition, anti-VEGF agents are crucial in diminishing nAMD-related visual impairment.
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Affiliation(s)
- Ida Korva-Gurung
- Research Unit of Clinical Medicine and Medical Research Center, Department of Ophthalmology, Oulu University Hospital and University of Oulu, 90029 Oulu, Finland
| | - Anna-Maria Kubin
- Research Unit of Clinical Medicine and Medical Research Center, Department of Ophthalmology, Oulu University Hospital and University of Oulu, 90029 Oulu, Finland
- Medical Research Center, PEDEGO Research Unit, Department of Ophthalmology, Oulu University Hospital and University of Oulu, 90029 Oulu, Finland
| | - Pasi Ohtonen
- Research Service Unit, 90220 Oulu, Finland
- The Research Unit of Surgery, Anesthesia and Intensive Care, Oulu University Hospital and University of Oulu, 90029 Oulu, Finland
| | - Nina Hautala
- Research Unit of Clinical Medicine and Medical Research Center, Department of Ophthalmology, Oulu University Hospital and University of Oulu, 90029 Oulu, Finland
- Medical Research Center, PEDEGO Research Unit, Department of Ophthalmology, Oulu University Hospital and University of Oulu, 90029 Oulu, Finland
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13
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Sidorchuk A, Engström K, Möller J, Gémes K. Predictors of beverage-specific, alcohol consumption trajectories: A Swedish population-based cohort study. Nordisk Alkohol Nark 2023; 40:233-249. [PMID: 37255610 PMCID: PMC10225962 DOI: 10.1177/14550725221124386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/22/2022] [Indexed: 09/30/2023] Open
Abstract
Aim: The aim of the study was to examine whether changes in alcohol consumption over time differ according to beverage types, and to what extent socioeconomic, lifestyle and health-related factors predict beverage-specific trajectories in Sweden. Study design: We included participants from the Stockholm Public Health Cohort who were surveyed repeatedly in 2002, 2010 and 2014. Alcohol consumption trajectories were constructed for 13,152 individuals with valid information on amount and frequency of drinking. Preferred beverage types (i.e., beer, wine or spirits) were defined based on the most consumed beverages. Multinomial logistic regression was used to quantify individual predictors of different trajectories, overall and by beverage type. Results: Overall 56.9% of respondents were women, the mean age was 49.2 years, SD (13.1). Wine was cited as the preferred beverage for 72.4% of participants, and stable moderate drinking was the most common trajectory regardless of beverage type (68.2%, 54.9% and 54.2% in individuals with wine, beer and spirits as preferred beverages, respectively). Associations between drinking trajectories and baseline lifestyle factors did not differ by beverage type. Lower socioeconomic position (SEP) was associated with unstable moderate wine drinking (for unskilled manual SEP: adjusted odds ratio [aOR] 1.54, 95% confidence interval [CI] 1.23, 1.93), unstable heavy beer drinking (for skilled manual SEP: aOR 1.99, 95% CI 1.14, 3.52; and unskilled manual SEP: aOR 1.72, 95% CI 1.05, 2.82), and former beer drinking trajectory (for skilled manual SEP: aOR 1.81; 95% CI 1.21, 2.72; and unskilled manual SEP: aOR 1.66; 95% CI 1.17, 2.37). Conclusion: Lower SEP was associated with unstable heavy drinking of beer, former beer drinking, and unstable moderate wine drinking trajectories indicating that targeted alcohol prevention programmes need to focus on these groups.
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Affiliation(s)
- Anna Sidorchuk
- Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
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Shaaban AN, Andersson F, Magnusson C, Orsini N, Caspersen IH, Peña S, Karvonen S, Magnus P, Galanti MR. Does misclassification of former tobacco smokers explain the 'smoker's paradox' in the risk of COVID-19? Insights from the Stockholm Public Health Cohort. Scand J Public Health 2023:14034948231174279. [PMID: 37165603 PMCID: PMC10183343 DOI: 10.1177/14034948231174279] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND The association between tobacco smoking and the risk of COVID-19 and its adverse outcomes is controversial, as studies reported contrasting findings. Bias due to misclassification of the exposure in the analyses of current versus non-current smoking could be a possible explanation because former smokers may have higher background risks of the disease due to co-morbidity. The aim of the study was to investigate the extent of this potential bias by separating non-, former, and current smokers when assessing the risk or prognosis of diseases. METHODS We analysed data from 43,400 participants in the Stockholm Public Health Cohort, Sweden, with information on smoking obtained prior to the pandemic. We estimated the risk of COVID-19, hospital admissions and death for (a) former and current smokers relative to non-smokers, (b) current smokers relative to non-current smokers, that is, including former smokers; adjusting for potential confounders (aRR). RESULTS The aRR of a COVID-19 diagnosis was elevated for former smokers compared with non-smokers (1.07; 95% confidence interval (CI) =1.00-1.15); including hospital admission with any COVID-19 diagnosis (aRR= 1.23; 95% CI = 1.03-1.48); or with COVID-19 as the main diagnosis (aRR=1.23, 95% CI= 1.01-1.49); and death within 30 days with COVID-19 as the main or a contributory cause (aRR=1.40; 95% CI=1.00-1.95). Current smoking was negatively associated with risk of COVID-19 (aRR=0.79; 95% CI=0.68-0.91). CONCLUSIONS
Separating non-smokers from former smokers when assessing the disease risk or prognosis is essential to avoid bias. However, the negative association between current smoking and the risk of COVID-19 could not be entirely explained by misclassification.
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Affiliation(s)
- Ahmed N Shaaban
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Filip Andersson
- Department of Global Public Health, Karolinska Institutet, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Region, (CES), Sweden
| | - Cecilia Magnusson
- Department of Global Public Health, Karolinska Institutet, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Region, (CES), Sweden
| | - Nicola Orsini
- Department of Global Public Health, Karolinska Institutet, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Region, (CES), Sweden
| | - Ida H Caspersen
- Centre for Fertility and Health, Norwegian Institute of Public Health, Norway
| | | | | | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Norway
| | - Maria R Galanti
- Department of Global Public Health, Karolinska Institutet, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Region, (CES), Sweden
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Shoji-Asahina A, Nakatani E, Imaichi Y, Ohata E, Oshima M, Miyakoshi A, Miyake H, Ichikawa Y, Dote H, Ubukata N, Funaki D, Urano T. Risk factors, treatment and survival rates of late-onset acquired haemophilia A: A cohort study from the Shizuoka Kokuho Database. Haemophilia 2023; 29:799-808. [PMID: 37096498 DOI: 10.1111/hae.14793] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/01/2023] [Accepted: 04/12/2023] [Indexed: 04/26/2023]
Abstract
INTRODUCTION Acquired haemophilia A (AHA) is a rare disease. The risk factors have yet to be studied. AIM We aimed to identify risk factors for late-onset AHA in Japan. METHODS A population-based cohort study was conducted using data from the Shizuoka Kokuho Database. The study population was defined as individuals aged ≥60 years. Cause-specific Cox regression analysis was performed to calculate hazard ratios. RESULTS Of 1,160,934 registrants, there were 34 patients with newly diagnosed AHA. The mean follow-up period was 5.6 years, and the incidence of AHA was 5.21 per million person-years. Myocardial infarction, diabetes mellitus, solid tumors, antimicrobial agents, phenytoin and anti-dementia drugs, which showed significant differences in the univariate analysis, were excluded from the multivariable analysis because of the small number of cases. Multivariable regression analysis showed that the presence of Alzheimer's disease (hazard ratio [HR]:4.28, 95% confidence interval [CI]:1.67-10.97) and rheumatic disease (HR:4.65, 95% CI:1.79-12.12) increased the risk of AHA development. CONCLUSION We found that comorbid Alzheimer's disease is a risk factor of AHA incidence in the general population. Our findings provide insight into the etiology of AHA, and the proof of the coexistence of Alzheimer's disease may support the recent notion that Alzheimer disease is an autoimmune disease.
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Affiliation(s)
- Aya Shoji-Asahina
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, Japan
- Department of Clinical Laboratory, Japanese Red Cross Shizuoka Hospital, Aoi-ku, Shizuoka, Japan
| | - Eiji Nakatani
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, Japan
| | - Yutaro Imaichi
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, Japan
| | - Emi Ohata
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, Japan
| | - Michiko Oshima
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, Japan
| | - Akinori Miyakoshi
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, Japan
| | - Hiromu Miyake
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, Japan
| | - Yoshikazu Ichikawa
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, Japan
| | - Hisashi Dote
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, Japan
| | - Nanako Ubukata
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, Japan
| | - Daito Funaki
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, Japan
| | - Tetsumei Urano
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, Japan
- Department of Medical Physiology, Hamamatsu University School of Medicine, Higashi-ku, Hamamatsu, Japan
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Mol B, van Munster KN, Bogaards JA, Weersma RK, Inderson A, de Groof EJ, Rossen NGM, Ponsioen W, Turkenburg M, van Erpecum KJ, Poen AC, Spanier BWM, Beuers UHW, Ponsioen CY. Health-related quality of life in patients with primary sclerosing cholangitis: A longitudinal population-based cohort study. Liver Int 2023; 43:1056-1067. [PMID: 36779848 DOI: 10.1111/liv.15542] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/14/2023]
Abstract
BACKGROUND & AIMS Data regarding health-related quality of life (HRQoL) in primary sclerosing cholangitis (PSC) are sparse and have only been studied cross-sectionally in a disease which runs a fluctuating and unpredictable course. We aim to describe HRQoL longitudinally by using repeated measurements in a population-based cohort. METHODS Every 3 months from May 2017 up to August 2020, patients received digital questionnaires at home. These included the EQ-5D, 5-D Itch, patient-based SCCAI and patient-based HBI. The SF-36, measuring HRQoL over eight dimensions as well as a physical component summary (PCS) and mental component summary (MCS) score, was sent annually. Data were compared with Dutch reference data and a matched IBD disease control from the population-based POBASIC cohort. Mixed-effects modelling was performed to identify factors associated with HRQoL. RESULTS Three hundred twenty-eight patients completed 2576 questionnaires. A significant reduction of small clinical relevance in several mean HRQoL scores was found compared with the Dutch reference population: 46.4 versus 48.0, p = .018 for PCS and 47.5 versus 50.5, p = .004 for MCS scores. HRQoL outcomes were significantly negatively associated with coexisting active IBD (PCS -12.2, p < .001 and MCS -12.0, p < .001), which was not the case in case of quiescent IBD. Decreasing HRQoL scores were also negatively associated with increasing age (PCS -0.1 per 10 years, p = .002), female sex (PCS -2.8, p < .001), diagnosis of AIH overlap (PCS -3.7, p = .059), end-stage liver disease (PCS -3.7, p = .015) and presence of itch (PCS -9.2, p < .001 and MCS -3.1, p = .078). The odds of reporting a clinically relevant reduction in EQ-5D scores showed seasonal variation, being lowest in summer (OR = 0.48 relative to spring, p = .037). In patients with liver transplant, HRQoL outcomes were comparable to the Dutch general population. CONCLUSIONS PSC patients report impaired HRQoL of small clinical relevance compared with the general population. After liver transplantation, HRQoL scores are at comparable levels to the general population. HRQoL scores are associated with potentially modifiable factors such as itch and IBD activity.
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Affiliation(s)
- Bregje Mol
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, Location AMC, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, the Netherlands
| | - Kim N van Munster
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, Location AMC, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, the Netherlands
| | - Johannes A Bogaards
- Department of Epidemiology and Data Science, Amsterdam University Medical Centre, location AMC, Amsterdam, the Netherlands
| | - Rinse K Weersma
- Department of Gastroenterology and Hepatology, University Medical Centre Groningen, Groningen, the Netherlands
| | - Akin Inderson
- Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, the Netherlands
| | - E Joline de Groof
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, Location AMC, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, the Netherlands
| | - Noortje G M Rossen
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, Location AMC, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, the Netherlands
| | - Willemijn Ponsioen
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, Location AMC, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, the Netherlands
| | - Maud Turkenburg
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, Location AMC, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, the Netherlands
| | - Karel J van Erpecum
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Alexander C Poen
- Department of Gastroenterology and Hepatology, Isala Hospital, Zwolle, the Netherlands
| | - B W Marcel Spanier
- Department of Gastroenterology and Hepatology, Rijnstate Hospital, Arnhem, the Netherlands
| | - Ulrich H W Beuers
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, Location AMC, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, the Netherlands
| | - Cyriel Y Ponsioen
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, Location AMC, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, the Netherlands
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17
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Zhao H, Zhuo L, Sun Y, Shen P, Lin H, Zhan S. Thiazolidinedione use is associated with reduced risk of dementia in patients with type 2 diabetes mellitus: A retrospective cohort study. J Diabetes 2023; 15:97-109. [PMID: 36660897 PMCID: PMC9934955 DOI: 10.1111/1753-0407.13352] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/27/2022] [Accepted: 12/21/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) and dementia cause heavy health burden in mainland China, where few studies have investigated the association between glucose-lowering agents and dementia risk. We aimed to assess the association between use of thiazolidinediones (TZDs) and dementia incidence in a mainland Chinese population with T2DM. METHODS A retrospective cohort of T2DM patients who were new users of TZDs or alpha glucosidase inhibitors (AGIs) was assembled using the Yinzhou Regional Health Care Database. A Cox model with inverse probability of treatment weighting (IPTW) for controlling potential founding was applied to estimate the hazard ratio (HR) of the association between use of TZDs and dementia risk. RESULTS A total of 49 823 new users of AGIs and 12 752 new users of TZDs were included in the final cohort. In the primary analysis, the incidence of dementia was 195.7 and 78.2 per 100 000 person-years in users of AGIs and TZDs respectively. TZD use was associated with a reduced risk of incident dementia after adjusting for potential confounding using IPTW, with a HR of 0.51 (95% CI, 0.38-0.67). The results in various subgroup analyses and sensitivity analyses were consistent with the findings of the primary analysis. CONCLUSIONS Use of TZDs is associated with a decreased risk of dementia incidence in a mainland Chinese population with T2DM.
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Affiliation(s)
- Houyu Zhao
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
| | - Lin Zhuo
- Research Center of Clinical EpidemiologyPeking University Third HospitalBeijingChina
| | - Yexiang Sun
- Yinzhou District Center for Disease Control and PreventionNingboChina
| | - Peng Shen
- Yinzhou District Center for Disease Control and PreventionNingboChina
| | - Hongbo Lin
- Yinzhou District Center for Disease Control and PreventionNingboChina
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
- Research Center of Clinical EpidemiologyPeking University Third HospitalBeijingChina
- Center for Intelligent Public Health, Institute for Artificial IntelligencePeking UniversityBeijingChina
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18
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Niemelä M, Kiviniemi A, Ikäheimo TM, Tulppo M, Korpelainen R, Jämsä T, Farrahi V. Compositional association of 24-h movement behavior with incident major adverse cardiac events and all-cause mortality. Scand J Med Sci Sports 2023; 33:641-650. [PMID: 36630572 DOI: 10.1111/sms.14315] [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: 10/28/2022] [Revised: 01/02/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
Cardiovascular disease (CVD) causes a high disease burden. Physical activity (PA) reduces CVD morbidity and mortality. We aimed to determine the relationship between the composition of moderate-to-vigorous PA (MVPA), light PA (LPA), sedentary behavior (SB), and sleep during midlife to the incidence of major adverse cardiac events (MACE) and all-cause mortality at a 7-year follow-up. The study population consisted of Northern Finland Birth Cohort 1966 members who participated in the 46-year follow-up in 2012 and were free of MACE (N = 4147). Time spent in MVPA, LPA, and SB was determined from accelerometer data. Sleep time was self-reported. Hospital visits and deaths were obtained from national registers. Participants were followed until December 31, 2019, or first MACE occurrence (acute myocardial infarction, unstable angina pectoris, stroke, hospitalization due to heart failure, or death due to CVD), death from another cause, or censoring. Cox proportional hazards model was used to estimate hazard ratios of MACE incidence and all-cause mortality. Isotemporal time reallocations were used to demonstrate the dose-response association between time spent in behaviors and outcome. The 24-h time composition was significantly associated with incident MACE and all-cause mortality. More time in MVPA relative to other behaviors was associated with a lower risk of events. Isotemporal time reallocations indicated that the greatest risk reduction occurred when MVPA replaced sleep. Higher MVPA associates with a reduced risk of incident MACE and all-cause mortality after accounting for the 24-h movement composition and confounders. Regular engagement in MVPA should be encouraged in midlife.
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Affiliation(s)
- Maisa Niemelä
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.,Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland
| | - Antti Kiviniemi
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.,Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
| | - Tiina M Ikäheimo
- Department of Community Medicine, University of Tromso, Tromso, Norway.,Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Mikko Tulppo
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
| | - Raija Korpelainen
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.,Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland.,Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Timo Jämsä
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Vahid Farrahi
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
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19
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Robsahm TE, Tsuruda KM, Hektoen HH, Storås AH, Cook MB, Hurwitz LM, Langseth H. Applying recommended definition of aggressive prostate cancer: a validation study using high-quality data from the Cancer Registry of Norway. Acta Oncol 2023; 62:8-14. [PMID: 36762472 PMCID: PMC10301241 DOI: 10.1080/0284186x.2023.2175331] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/27/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND The Prostate Cancer Cohort Consortium (PC3) Working Group proposed a definition for aggressive prostate cancer (PC) for aetiologic epidemiologic research. We aimed to validate this definition as well as a second approach utilising only information on stage at diagnosis. METHODS First primary PCs diagnosed 2004 - 2009 in the population-based Janus Serum Bank (JSB) cohort were identified by linkage to the population-based Cancer Registry of Norway (CRN) (n = 3568). The CRN and Norwegian Prostate Cancer Registry provided clinicopathological data for these cases. Approach 1 classified PC as aggressive if it was clinically T4, or N1, or M1, or had a Gleason score ≥8 at diagnosis (as proposed). Approach 2 classified PC as aggressive if CRN stage at diagnosis was 'regional spread' or 'distant metastases'. Both approaches were validated by calculating the sensitivity and positive predictive value (PPV) against PC-death within 10 years of diagnosis. RESULTS Overall, 555 died from PC within 10 years. Approach 1 classified 24.7% of cases as aggressive and 13.6% were unclassified due to missing information. Approach 2 classified 19.6% as aggressive and 29% were unclassified. Sensitivity was highest for Approach 1 (0.76, 95% CI: 0.72 - 0.80 vs 0.69, 95% CI: 0.64 - 0.73), while PPVs were similar for both approaches (0.43, 95% CI: 0.40 - 0.46 and 0.40, 95% CI: 0.36 - 0.44). We observed similarly high sensitivity and higher PPVs than those reported by the PC3 Working Group. CONCLUSIONS The proposed definition of aggressive PC was applicable and valid in the JSB cohort. Stage at diagnosis can be useful if data on cTNM or Gleason score is unavailable.
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Affiliation(s)
- TE Robsahm
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - KM Tsuruda
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - HH Hektoen
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Cancer Genetics, Institute for Cancer Research, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - AH Storås
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - MB Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - LM Hurwitz
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - H Langseth
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
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20
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Makuza JD, Jeong D, Binka M, Adu PA, Cua G, Yu A, Velásquez García HA, Alvarez M, Wong S, Bartlett S, Karim ME, Yoshida EM, Ramji A, Krajden M, Janjua NZ. Impact of Hepatitis B Virus Infection, Non-alcoholic Fatty Liver Disease, and Hepatitis C Virus Co-infection on Liver-Related Death among People Tested for Hepatitis B Virus in British Columbia: Results from a Large Longitudinal Population-Based Cohort Study. Viruses 2022; 14. [PMID: 36423186 DOI: 10.3390/v14112579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022] Open
Abstract
Data on the contribution of hepatitis B virus (HBV) infection and related comorbidities to liver-related mortality in Canada are limited. We assessed the concurrent impact of HBV infection, non-alcoholic fatty liver disease (NAFLD), and hepatitis C virus (HCV) coinfection on liver-related deaths in British Columbia (BC), Canada. We used data from the BC Hepatitis Testers Cohort (BC-HTC). We used Fine-Gray multivariable sub-distributional hazards models to assess the effect of HBV, NAFLD, and HCV coinfection on liver-related mortality, while adjusting for confounders and competing mortality risks. The liver-related mortality rate was higher among people with HBV infection than those without (2.57 per 1000 PYs (95%CI: 2.46, 2.69) vs. 0.62 per 1000 PYs (95%CI: 0.61, 0.64), respectively). Compared with the HBV negative groups, HBV infection was associated with increased liver-related mortality risk in almost all of the subgroups: HBV mono-infection (adjusted subdistribution hazards ratio (asHR) of 3.35, 95% CI 3.16, 3.55), NAFLD with HBV infection, (asHR 12.5, 95% CI 7.08, 22.07), and HBV/HCV coinfection (asHR 8.4, 95% CI 7.62, 9.26). HBV infection is associated with a higher risk of liver-related mortality, and has a greater relative impact on people with NAFLD and those with HCV coinfection. The diagnosis and treatment of viral and fatty liver disease are required to mitigate liver-related morbidity and mortality.
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21
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Stark I, Rai D, Lundberg M, Culpin I, Nordström SI, Ohlis A, Magnusson C. Autism and self-harm: A population-based and discordant sibling study of young individuals. Acta Psychiatr Scand 2022; 146:468-477. [PMID: 35867636 DOI: 10.1111/acps.13479] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/17/2022] [Accepted: 07/18/2022] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Self-harm among young autistic individuals is a clinical challenge, and the risk of premature death by suicide is strongly increased in this group. Using the advantage of total-population and family-based data, we investigated whether autism per se is a risk factor for self-harm independently of psychiatric comorbidities and how it differs from self-harm in non-autistic individuals. METHODS We used The Stockholm Youth Cohort, a total-population register study, including all residents in Stockholm County aged 0-17 years between 2001 and 2011.Study participants were followed from age 10 to 27 for hospital admissions because of self-harm. We used modified Poisson regression to calculate relative risks (RR) using robust standard error to derive 95% confidence intervals (CI). RESULTS In all, 410,732 individuals were included in the cohort (9,070 with a diagnosis of autism). Autistic individuals had a fivefold increased adjusted relative risk of self-harm (RR 5.0 [95% CI 4.4-5.6]). The risk increase was more pronounced for autism without intellectual disability and particularly high for self-cutting 10.2 [7.1-14.7] and more violent methods 8.9 [5.2-15.4]. The association between autism and self-harm was independent of, but clearly exacerbated by comorbid psychiatric conditions. It was of similar magnitude as risks linked to these conditions per se, and not explained by shared familial factors. CONCLUSION Self-harm severe enough to present to medical services is as common in autistic youth as in those with depression or ADHD. Potentially more lethal methods are more likely to be used of autistic self-harmers.
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Affiliation(s)
- Isidora Stark
- Karolinska Institutet, Department of Global Public Health, Stockholm, Sweden
| | - Dheeraj Rai
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Michael Lundberg
- Karolinska Institutet, Department of Global Public Health, Stockholm, Sweden
| | - Iryna Culpin
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, Bristol, UK.,Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | | | - Anna Ohlis
- Karolinska Institutet, Department of Global Public Health, Stockholm, Sweden
| | - Cecilia Magnusson
- Karolinska Institutet, Department of Global Public Health, Stockholm, Sweden
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22
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Ribaldi F, Rolandi E, Vaccaro R, Colombo M, Battista Frisoni G, Guaita A. The clinical heterogeneity of subjective cognitive decline: a data-driven approach on a population-based sample. Age Ageing 2022; 51:6770075. [PMID: 36273347 DOI: 10.1093/ageing/afac209] [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: 02/04/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND subjective cognitive decline (SCD) refers to the subjective experience of cognitive decline in the absence of detectable cognitive impairment. SCD has been largely studied as a risk condition for cognitive decline. Empirical observations suggest that persons with SCD are heterogeneous, including individuals with early Alzheimer's disease and others with psychological vulnerabilities and/or physical comorbidity. The semiology of SCD is still in its infancy, and the features predicting cognitive decline are poorly defined. The present study aims to identify subgroups of SCD using a data-driven approach and study their clinical evolution across 8 years. METHODS the study population is the InveCe.Ab population-based cohort, including cognitively unimpaired people aged 70-74 years and followed for 8 years. Hierarchical cluster analysis (HCA) was carried out to identify distinct SCD subgroups based on nine clinical and cognitive features. Longitudinal changes by baseline SCD status were estimated using linear mixed models for cognitive decline and Cox proportional-hazard model for all-cause dementia risk. RESULTS out of 956 individuals, 513 were female (54%); and the mean age was 72.1 (SD = 1.3), education was 7.2 (3.3), and 370 (39%) reported cognitive complaints (SCD). The HCA resulted in two clusters (SCD1 and SCD2). SCD2 were less educated and had more comorbidities, cardiovascular risk and depressive symptoms than SCD1 and controls. SCD2 presented steeper cognitive decline (Mini-Mental State Examination; β = -0.31) and increased all-cause dementia risk (hazard-ratio = 3.4). CONCLUSIONS at the population level, basic clinical information can differentiate individuals with SCD at higher risk of developing dementia, underlining the heterogeneous nature of this population even in a sample selected for a narrow age range, in a specific geographic area.
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Affiliation(s)
- Federica Ribaldi
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland.,Department of Rehabilitation and Geriatrics, Geneva Memory Center, Geneva University Hospitals, Geneva, Switzerland
| | - Elena Rolandi
- "Golgi Cenci" Foundation, Corso San Martino 10, Abbiategrasso 20081, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia 27100, Italy
| | - Roberta Vaccaro
- "Golgi Cenci" Foundation, Corso San Martino 10, Abbiategrasso 20081, Italy
| | - Mauro Colombo
- "Golgi Cenci" Foundation, Corso San Martino 10, Abbiategrasso 20081, Italy
| | - Giovanni Battista Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland.,Department of Rehabilitation and Geriatrics, Geneva Memory Center, Geneva University Hospitals, Geneva, Switzerland
| | - Antonio Guaita
- "Golgi Cenci" Foundation, Corso San Martino 10, Abbiategrasso 20081, Italy
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23
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Sifaki-Pistolla D, Poimenaki V, Fotopoulou I, Saloustros E, Mavroudis D, Vamvakas L, Lionis C. Significant Rise of Colorectal Cancer Incidence in Younger Adults and Strong Determinants: 30 Years Longitudinal Differences between under and over 50s. Cancers (Basel) 2022; 14. [PMID: 36230718 DOI: 10.3390/cancers14194799] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: There is evidence in the recent literature that the incidence patterns of colorectal cancer (CRC) have changed considerably over the years, tending to rise rapidly in individuals under 50 years old compared with those over 50 years. The current study aimed to assess the incidence of CRC in Crete from 1992−2021 and compare them among younger and older adults. (2) Methods: Data on malignant neoplasms of colon, rectosigmoid junction, and rectum have been extracted from the database of the Regional Cancer Registry of Crete. (3) Results: The number of these cases for the period 1992−2021 was 3857 (n = 2895 colon and n = 962 rectum). The mean age-specific incidence rate (ASpIR/100,000/year) of colon cancer patients <50 years was 7.2 (95% CI 5.1−9.7), while for patients ≥50 years the ASpIR was 149 (95% CI 146.2−153.4). ASpIR presented a 29.6% increase from 2001 to 2011 in the age group of 20−34 years and further increase is expected from 2022−2030 (projected change, 42.8%). The main risk factors were the pack years (p = 0.01), alcohol consumption (0.02), and farmer occupation (0.04), especially during 2012−2021. (4) Conclusions: We confirmed an increased incidence of CRC in young adults <50 in a European population with low cancer incidence in the past and a worrisome prediction for the near future. The observed trends clearly indicate that starting CRC screening at an earlier age may be essential.
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Ruedlinger J, Cid-Ossandón V, Huidobro A, Van De Wyngard V, Vargas C, Ferreccio C. Processed meat consumption and associated factors in Chile: A cross-sectional study nested in the MAUCO cohort. Front Public Health 2022; 10:960997. [PMID: 36062116 PMCID: PMC9436317 DOI: 10.3389/fpubh.2022.960997] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/01/2022] [Indexed: 01/24/2023] Open
Abstract
Processed meat consumption is increasing in Latin America. While in developed countries processed meat consumption has been associated with cardiovascular diseases and cancer, our region lacks data associated to its consumption and health impact. We characterized processed meat intake and associated factors in a population-based cohort of a Chilean agricultural county, MAUCO. We analyzed baseline dietary data of 7,841 participants, 4,358 women and 3,483 men (38-77 years), who answered an adapted Mediterranean index food frequency questionnaire. Eight percent of the participants presented high processed meat consumption (≥5 times per week). We explored associations of processed meat consumption with participant characteristics using multinomial logistic regression models. Main factors associated with higher consumption were being men, younger and currently employed, and having a high intake (>4 times per week) of red meat (Odds ratio, 2.71, 95% CI 2.10-3.48), butter/cream (1.96, 1.60-2.41), whole-fat dairy products (1.32, 1.04-1.67) and a high intake (≥1 time per day) of sugary snacks/sweets (2.49, 2.04-3.03) and sugary drinks (1.97, 1.63-2.38). Processed meat consumption associated to chronic diseases, particularly cardiovascular disease (Prevalence ratio, 2.28, 95% CI 1.58-3.29). Obesity mediated this association in a proportion of 5.0%, whereas for diabetes the proportion was 13.9%. In this population, processed meat was associated with other unhealthy dietary and lifestyle factors, as well as with chronic diseases, particularly cardiovascular disease.
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Affiliation(s)
- Jenny Ruedlinger
- Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Vicente Cid-Ossandón
- Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrea Huidobro
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile
- Facultad de Medicina, School of Medicine, Universidad Católica del Maule, Talca, Chile
| | - Vanessa Van De Wyngard
- Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudio Vargas
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Matemáticas y Ciencias de la Computación, Facultad de Ciencias, Universidad de Santiago de Chile, Santiago, Chile
| | - Catterina Ferreccio
- Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile
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25
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Bedene A, Lijfering WM, Arbous MS, Rosendaal FR, Dahan A, van Dorp ELA. Association between prescription opioid use and unplanned intensive care unit admission and mortality in the adult population of the Netherlands: a registry study. Br J Anaesth 2022; 129:254-262. [PMID: 35752474 DOI: 10.1016/j.bja.2022.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 01/03/2022] [Revised: 05/11/2022] [Accepted: 05/14/2022] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Opioid overdoses are increasing in the Netherlands, and there may be other harms associated with prescription opioid use. We investigated the relationship between prescription opioid use and unplanned ICU admission and death. METHODS This is an analysis of linked government registries of the adult Dutch population (age ≥18 years) alive on January 1, 2018. The co-primary outcomes were ICU admission and death up to 1 year. Crude event rates and event-specific adjusted hazard rates (aHRs) with 95% confidence intervals (CIs) were calculated using multivariable analysis for people with and without exposure to an opioid prescription. RESULTS We included 13 813 173 individuals, of whom 32 831 were admitted to the ICU and 152 259 died during the 1 year follow-up. Rates of ICU admission and death amongst people who reimbursed an opioid prescription were 5.87 and 62.2 per 1000 person-years, and rates of ICU admission and death in those without a prescription were 2.03 and 6.34, respectively. Exposed individuals had a higher rate of both ICU admission (aHR 2.53; 95% CI: 2.45-2.60) and death (aHR 7.11; 95% CI: 7.02-7.19) compared with unexposed individuals. Both outcomes were more frequent amongst prescription opioid users across a range of subgroups. CONCLUSIONS The rate of ICU admission and death was higher amongst prescription opioid users than non-users in the full cohort and in subgroups. These findings represent an important public health concern.
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Affiliation(s)
- Ajda Bedene
- Department of Anesthesiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Willem M Lijfering
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - M Sesmu Arbous
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Intensive Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Albert Dahan
- Department of Anesthesiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Eveline L A van Dorp
- Department of Anesthesiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
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Cheng VK, Hasegawa M, Hattori T, Ito N, Linn E, Cheng K, Hughes-Austin J, Masuda K, Sudo A. Prevalence of radiographic hip dysplasia in Japanese population-based study. Mod Rheumatol 2022; 32:438-443. [PMID: 33910453 DOI: 10.1080/14397595.2021.1918884] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 04/11/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The purpose of this study was to measure the indices of radiographic developmental dysplasia of the hip (DDH) in a cross-sectional study of an elderly Japanese population. METHODS Hip radiographs of 427 informed, voluntary Japanese community-dwelling individuals (279 female and 148 male) aged 50-96 years-old were obtained from Miyagawa village in Japan through a health screening. The hip radiographs were measured by a custom-written, semi-automated MATLAB program. The center edge (CE) angle, acetabular roof obliquity (ARO), acetabular head index (AHI), and minimum joint space width (mJSW) were measured. We examined the associations between gender, side-of-hip, and age group on radiographic DDH and hip osteoarthritis (OA). RESULTS The mean CE angle was 31.0°. The mean ARO was 5.8°. The mean AHI was 88.2%. The mean mJSW was 4.0 mm. Of the total population, 29.9% had DDH and 4.0% had hip OA. Of those who had hip OA, 41.2% were secondary OA, and 58.8% were primary OA. The relationship between DDH and OA was not significant. CONCLUSION DDH is unlikely to be an important cause of hip OA in the present population-based study.
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Affiliation(s)
- Veronica K Cheng
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA
| | - Masahiro Hasegawa
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Tetsuya Hattori
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Naoya Ito
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Erikka Linn
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA
| | - Kevin Cheng
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA
| | - Jan Hughes-Austin
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA
| | - Koichi Masuda
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
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Trama A, Vener C, Lasalvia P, Bernasconi A. Late Mortality, Subsequent Malignant Neoplasms and Hospitalisations in Long-Term Survivors of Adolescent and Young Adult Hematological Cancers. Front Oncol 2022; 12:823115. [PMID: 35280767 PMCID: PMC8913709 DOI: 10.3389/fonc.2022.823115] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 01/24/2022] [Indexed: 11/05/2022] Open
Abstract
Background Increased success in the treatment of hematological cancers contributed to the increase of 5-year survival for most adolescent and young adults (AYAs) with these tumours. However, as 5-year survival increased, it became clear that AYA long-term survivors were at increased risk for severe late effects. Moreover, limited information on long-term cancer impact is available for AYAs, since most studies focused on children and adolescents. We aimed to assess various long-term outcomes on AYA survivors of hematological cancers. Methods We selected patients diagnosed with a first primary hematological cancer between 1997 and 2006, in the Italian nationwide population-based cohort of AYA cancer survivors (i.e. alive at least 5 years after cancer diagnosis). Long-term outcomes of interest were: second malignant neoplasms (SMNs), hospitalizations and overall mortality. We calculated standardized incidence ratios (SIRs), standardized hospitalization rate ratios (SHRs) and standardized mortality rate ratios (SMRs). To study morbidity patterns over time, we modeled observed incidence rates by fitting flexible parametric models for nonlinear patterns and we used linear regression for linear patterns. Results The study cohort included 5,042 AYA hematological cancer survivors of which 1,237 and 3,805 had a leukaemia and lymphoma diagnosis, respectively. AYA survivors were at substantially increased risk for SMN (SIR=2.1; 95%CI=1.7; 2.6), hospitalisation (SHR=1.5; 95%CI=1.5; 1.6), and mortality (SMR=1.4; 95%CI=1.2; 1.6) with differences between leukaemia and lymphoma survivors. The highest excess risks of hospitalisations were for infectious diseases, respiratory diseases, and diseases of blood and blood-forming organs. The morbidity pattern differs over time by morbidity type. Conclusions Our results support the need for strict follow-up plans for survivors, and call for further study to better personalised follow-up plans for AYA cancer survivors.
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Affiliation(s)
- Annalisa Trama
- Evaluative Epidemiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Claudia Vener
- Oncology and Haemato-Oncology Department, University of Milan, Milan, Italy
| | - Paolo Lasalvia
- Evaluative Epidemiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alice Bernasconi
- Evaluative Epidemiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy,*Correspondence: Alice Bernasconi,
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von Krüchten R, Lorbeer R, Müller-Peltzer K, Rospleszcz S, Storz C, Askani E, Kulka C, Schuppert C, Rathmann W, Peters A, Bamberg F, Schlett CL, Mujaj B. Association between Adipose Tissue Depots and Dyslipidemia: The KORA-MRI Population-Based Study. Nutrients 2022; 14:797. [PMID: 35215449 DOI: 10.3390/nu14040797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/08/2022] [Accepted: 02/11/2022] [Indexed: 12/26/2022] Open
Abstract
Obesity increases the risk of cardiovascular diseases (CVD), however, whether adipose tissue relates to dyslipidemia, and consequently to cardiovascular events remains unknown. Thus, we investigated the association of adipose tissue with circulating lipoproteins and triglycerides (TG) in subjects without CVD. 384 participants from the KORA-MRI study (mean age 56.2 ± 9.2 years; 41.9% female) underwent whole-body 3T-MRI. Visceral (VAT) and subcutaneous adipose tissue (SAT) derived from T1-DIXON-sequence using a semi-automatic algorithm. Total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and TG were measured. Linear regression was applied to examine the relationships between adipose tissue, circulating lipoproteins, and TG, adjusting for risk factors. VAT was associated with total cholesterol (per SD increase) (ß = 0.39, p < 0.001). Total adipose tissue (TAT) and VAT were inversely associated with HDL (ß = -0.09, p = 0.009; ß = -0.14, p < 0.001), and positively associated with LDL (ß = 0.32, p < 0.001; ß = 0.37, p < 0.001). All adipose tissues were associated with TG (ß = 0.20, p < 0.001; ß = 0.27, p < 0.001; ß = 0.11, p = 0.004). Stratified analysis by sex and body mass index (BMI) was confirmatory in women and in individuals with BMI < 30. Our results suggest that adipose tissue plays an important role in increasing CVD risk independent of BMI, whereas gender imbalance may be explained by accurate characterization and quantification of adipose tissue.
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Tahaei H, Gignac F, Pinar A, Fernandez-Barrés S, Romaguera D, Vioque J, Santa-Marina L, Subiza-Pérez M, Llop S, Soler-Blasco R, Arija V, Salas-Salvadó J, Tardón A, Riaño-Galán I, Sunyer J, Guxens M, Julvez J. Omega-3 Fatty Acid Intake during Pregnancy and Child Neuropsychological Development: A Multi-Centre Population-Based Birth Cohort Study in Spain. Nutrients 2022; 14:nu14030518. [PMID: 35276877 PMCID: PMC8838693 DOI: 10.3390/nu14030518] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/17/2022] [Accepted: 01/20/2022] [Indexed: 12/05/2022] Open
Abstract
Background: There are few studies that look at the intake of all types of omega-3 polyunsaturated fatty acids (n-3 PUFAs) during the different stages of pregnancy along with a long-term neuropsychological follow-up of the child. This study aims to explore the association between maternal n-3 PUFA intake during two periods of pregnancy and the child’s neuropsychological scores at different ages. Methods: Prospective data were obtained for 2644 pregnant women recruited between 2004 and 2008 in population-based birth cohorts in Spain. Maternal n-3 PUFA intake during the first and third trimester of pregnancy was estimated using validated food frequency questionnaires. Child neuropsychological functions were assessed using Bayley Scales of Infant Development version one (BSID) at 1 year old, the McCarthy Scale of Children’s Abilities (MSCA) at 4 years old, and the Attention Network Test (ANT) at 7 years old. Data were analysed using multivariate linear regression models and adjusted for potential covariates, such as maternal social class, education, cohort location, alcohol consumption, smoking, breastfeeding duration, and energy intake. Results: Compared to participants in the lowest quartile (<1.262 g/day) of n-3 PUFA consumption during the first trimester, those in the highest quartile (>1.657 g/day) had a 2.26 points (95% confidence interval (CI): 0.41, 4.11) higher MSCA general cognitive score, a 2.48 points (95% CI: 0.53, 4.43) higher MSCA verbal score, and a 2.06 points (95% CI: 0.166, 3.95) higher MSCA executive function score, and a 11.52 milliseconds (95% CI: −22.95, −0.09) lower ANT hit reaction time standard error. In the third pregnancy trimester, the associations were weaker. Conclusions: Positive associations between n-3 PUFA intake during early pregnancy and child neuropsychological functions at 4 and 7 years of age were found, and further clinical research is needed to confirm these findings.
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Affiliation(s)
- Hana Tahaei
- ISGlobal, 08003 Barcelona, Spain; (H.T.); (F.G.); (A.P.); (S.F.-B.); (D.R.); (J.S.); (M.G.)
| | - Florence Gignac
- ISGlobal, 08003 Barcelona, Spain; (H.T.); (F.G.); (A.P.); (S.F.-B.); (D.R.); (J.S.); (M.G.)
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain
| | - Ariadna Pinar
- ISGlobal, 08003 Barcelona, Spain; (H.T.); (F.G.); (A.P.); (S.F.-B.); (D.R.); (J.S.); (M.G.)
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain;
| | | | - Dora Romaguera
- ISGlobal, 08003 Barcelona, Spain; (H.T.); (F.G.); (A.P.); (S.F.-B.); (D.R.); (J.S.); (M.G.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Jesus Vioque
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 46020 Alicante, Spain;
- Centro de Investigacion Biomedica en Red Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (L.S.-M.); (M.S.-P.); (A.T.); (I.R.-G.)
| | - Loreto Santa-Marina
- Centro de Investigacion Biomedica en Red Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (L.S.-M.); (M.S.-P.); (A.T.); (I.R.-G.)
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013 San Sebastian, Spain
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, 20014 San Sebastian, Spain
| | - Mikel Subiza-Pérez
- Centro de Investigacion Biomedica en Red Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (L.S.-M.); (M.S.-P.); (A.T.); (I.R.-G.)
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, 20014 San Sebastian, Spain
| | - Sabrina Llop
- Epidemiology and Environmental Health Joint Research Unit, FISABIO—Universitat Jaume I—Universitat de València, 46020 Valencia, Spain; (S.L.); (R.S.-B.)
| | - Raquel Soler-Blasco
- Epidemiology and Environmental Health Joint Research Unit, FISABIO—Universitat Jaume I—Universitat de València, 46020 Valencia, Spain; (S.L.); (R.S.-B.)
| | - Victoria Arija
- Universitat Rovira i Virgili (URV), Nutrition and Mental Health Research Group (NUTRISAM), 43201 Reus, Spain;
| | - Jordi Salas-Salvadó
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain;
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- Universitat Rovira i Virgili (URV), Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, 43201 Reus, Spain
| | - Adonina Tardón
- Centro de Investigacion Biomedica en Red Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (L.S.-M.); (M.S.-P.); (A.T.); (I.R.-G.)
- Departamento de Medicina, Universidad de Oviedo, 33006 Oviedo, Spain
- IUOPA-ISPA, Avda. Hospital Universitario s/n, 33011 Oviedo, Spain
| | - Isolina Riaño-Galán
- Centro de Investigacion Biomedica en Red Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (L.S.-M.); (M.S.-P.); (A.T.); (I.R.-G.)
- IUOPA-ISPA, Avda. Hospital Universitario s/n, 33011 Oviedo, Spain
- Servicio de Pediatría, Endocrinología Pediátrica, HUCA, Roma Avenue S/n, 33001 Oviedo, Spain
| | - Jordi Sunyer
- ISGlobal, 08003 Barcelona, Spain; (H.T.); (F.G.); (A.P.); (S.F.-B.); (D.R.); (J.S.); (M.G.)
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain
- Centro de Investigacion Biomedica en Red Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (L.S.-M.); (M.S.-P.); (A.T.); (I.R.-G.)
| | - Monica Guxens
- ISGlobal, 08003 Barcelona, Spain; (H.T.); (F.G.); (A.P.); (S.F.-B.); (D.R.); (J.S.); (M.G.)
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain
- Centro de Investigacion Biomedica en Red Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (L.S.-M.); (M.S.-P.); (A.T.); (I.R.-G.)
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, 3015 CN Rotterdam, The Netherlands
| | - Jordi Julvez
- ISGlobal, 08003 Barcelona, Spain; (H.T.); (F.G.); (A.P.); (S.F.-B.); (D.R.); (J.S.); (M.G.)
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain;
- Centro de Investigacion Biomedica en Red Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (L.S.-M.); (M.S.-P.); (A.T.); (I.R.-G.)
- Correspondence:
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Shaw JF, Mulpuru S, Kendzerska T, Moloo H, Martel G, Eskander A, Lalu MM, McIsaac DI. Association between frailty and patient outcomes after cancer surgery: a population-based cohort study. Br J Anaesth 2022; 128:457-464. [PMID: 35034792 DOI: 10.1016/j.bja.2021.11.035] [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: 06/29/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Frailty is associated with poor postoperative outcomes, but existing data do not describe frailty's interaction with tumour characteristics at the time of cancer surgery. Our objective was to estimate the association between frailty and long-term survival, and to explore any interaction with tumour stage and grade. METHODS This was a population-based cohort study conducted using linked provincial health administrative data in Ontario, Canada (2009-20). Using a cancer registry, we identified adults having elective cancer surgery. Frailty was measured using a validated index (range 0-1; higher score=greater frailty). Associations between frailty and long-term postoperative survival (primary outcome) were estimated using proportional hazards regression. Secondary outcomes were length of stay, discharge destination, days alive at home, and healthcare costs. RESULTS We identified and included 52 012 patients. Mean frailty score was 0.13 (standard deviation 0.07). During follow-up, 19 378 (37.3%) patients died. After adjustment for risk factors, each 10% increase in frailty was associated with a 1.60-fold relative decrease in survival (95% confidence interval: 1.56-1.64). The frailty-survival association was strongest for patients with lower stage and grade cancers. Increased frailty was associated with longer hospital stays (3 days), fewer days alive and at home (42 days yr-1), more frequent discharge to a nursing facility (2.38-fold), and increased healthcare costs ($6048). CONCLUSIONS Patient frailty is associated with decreased long-term survival after cancer surgery. The association is stronger for early-stage and -grade cancers, which would otherwise have a better survival prognosis.
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Affiliation(s)
- Julia F Shaw
- University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Sunita Mulpuru
- University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Division of Respirology, Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - Tetyana Kendzerska
- University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Division of Respirology, Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada; ICES (formerly Institute for Clinical Evaluative Sciences), Ottawa, ON, Canada
| | - Husein Moloo
- University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Surgery, The Ottawa Hospital, Ottawa, ON, Canada; ICES (formerly Institute for Clinical Evaluative Sciences), Ottawa, ON, Canada
| | - Guillaume Martel
- University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Surgery, The Ottawa Hospital, Ottawa, ON, Canada
| | - Antoine Eskander
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Department of Otolaryngology-Head & Neck Surgery, Toronto, ON, Canada
| | - Manoj M Lalu
- University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada; ICES (formerly Institute for Clinical Evaluative Sciences), Ottawa, ON, Canada
| | - Daniel I McIsaac
- University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada; ICES (formerly Institute for Clinical Evaluative Sciences), Ottawa, ON, Canada.
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Asai Y, Tsutsui S, Yoshimura N, Hashizume H, Iidaka T, Horii C, Kawaguchi H, Nakamura K, Tanaka S, Yoshida M, Yamada H. Relationship Between Age-Related Spinopelvic Sagittal Alignment and Low Back Pain in Adults of Population-Based Cohorts: The ROAD Study. J Pain Res 2022; 15:33-38. [PMID: 35027845 PMCID: PMC8752869 DOI: 10.2147/jpr.s339712] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/07/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose The demand for surgical correction in elderly patients with adult spinal deformity (ASD) has recently increased with the growth of the aging population. Age-related changes in spinopelvic sagittal alignment have been recently reported; thus, sagittal realignment should consider age-related changes. This study aimed to investigate the relationship between age-specific sagittal spinopelvic radiographic parameters and low back pain (LBP) to support the establishment of age-specific realignment targets for patients with ASD. Materials and Methods A population-based cohort consisting of 1461 subjects (466 men and 995 women) was used. The participants were divided into five groups based on their age: (1) younger than 50 years, (2) 50–59 years, (3) 60–69 years, (4) 70–79 years, and (5) 80 years and older. Standing lateral whole-spine radiographs were assessed to measure lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), and sagittal vertical axis (SVA). In addition, all participants were asked if they had LBP or not, using the following question: “Have you experienced LBP on most days during the past month and/or now?”. Results The crucial parameter associated with LBP was the mismatch between PI and LL (PI-LL). The mean values of all the radiographic parameters increased with age. PI-LL and PT reached 11.5° and 25.6°, respectively, for women without LBP in the super-aged group (age >80 years), which did not lie in the range of optimal values reported in the previous literature. Conclusion A new optimal age-related target may be needed for the management of patients with ASD.
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Affiliation(s)
- Yoshiki Asai
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Shunji Tsutsui
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Hashizume
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Toshiko Iidaka
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chiaki Horii
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Kawaguchi
- Department of Orthopedic Surgery, Tokyo Neurological Center, Tokyo, Japan
| | - Kozo Nakamura
- Department of Orthopedic Surgery, Towa Hospital, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Munehito Yoshida
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroshi Yamada
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
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Enguita-Germán M, Tamayo I, Galbete A, Librero J, Cambra K, Ibáñez-Beroiz B. Effect of Physical Activity on Cardiovascular Event Risk in a Population-Based Cohort of Patients with Type 2 Diabetes. Int J Environ Res Public Health 2021; 18:ijerph182312370. [PMID: 34886096 PMCID: PMC8657417 DOI: 10.3390/ijerph182312370] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/01/2022]
Abstract
Cardiovascular disease (CVD) is the most common cause of morbidity and mortality among patients with type 2 diabetes (T2D). Physical activity (PA) is one of the few modifiable factors that can reduce this risk. The aim of this study was to estimate to what extent PA can contribute to reducing CVD risk and all-cause mortality in patients with T2D. Information from a population-based cohort including 26,587 patients with T2D from the Navarre Health System who were followed for five years was gathered from electronic clinical records. Multivariate Cox regression models were fitted to estimate the effect of PA on CVD risk and all-cause mortality, and the approach was complemented using conditional logistic regression models within a matched nested case–control design. A total of 5111 (19.2%) patients died during follow-up, which corresponds to 37.8% of the inactive group, 23.9% of the partially active group and 12.4% of the active group. CVD events occurred in 2362 (8.9%) patients, which corresponds to 11.6%, 10.1% and 7.6% of these groups. Compared with patients in the inactive group, and after matching and adjusting for confounders, the OR of having a CVD event was 0.84 (95% CI: 0.66–1.07) for the partially active group and 0.71 (95% CI: 0.56–0.91) for the active group. A slightly more pronounced gradient was obtained when focused on all-cause mortality, with ORs equal to 0.72 (95% CI: 0.61–0.85) and 0.50 (95% CI: 0.42–0.59), respectively. This study provides further evidence that physically active patients with T2D may have a reduced risk of CVD-related complications and all-cause mortality.
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Affiliation(s)
- Mónica Enguita-Germán
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
| | - Ibai Tamayo
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
| | - Arkaitz Galbete
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
- Departamento de Estadística, Universidad Pública de Navarra (UPNA), 31008 Pamplona, Spain
| | - Julián Librero
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
| | - Koldo Cambra
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
- Departamento de Salud, Gobierno Vasco, 01006 Vitoria-Gasteiz, Spain
| | - Berta Ibáñez-Beroiz
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
- Correspondence:
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Bosman A, Campos-Obando N, Medina-Gomez C, Voortman T, Uitterlinden AG, Zillikens MC. Serum Phosphate, BMI, and Body Composition of Middle-Aged and Older Adults: A Cross-Sectional Association Analysis and Bidirectional Mendelian Randomization Study. J Nutr 2021; 152:276-285. [PMID: 34601595 PMCID: PMC8754515 DOI: 10.1093/jn/nxab351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/20/2021] [Accepted: 09/24/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Observational studies have reported associations between serum phosphate and BMI in specific clinical settings, but the nature of this relation in the general population is unclear. OBJECTIVES The aim of this study was twofold: to investigate the association between serum phosphate and BMI and body composition, as well as to explore evidence of causality through a bidirectional one-sample Mendelian randomization (MR) in the population-based Rotterdam Study (RS). METHODS Observational associations between phosphate (mg/dL) and BMI, lean mass, and fat percentage (fat%), estimated by DXA, were analyzed using multivariable regression models in 9202 participants aged 45-100 y from 3 RS cohorts. The role of serum leptin was examined in a subgroup of 1089 participants. For MR analyses, allele scores with 6 single-nucleotide polymorphisms (SNPs) for phosphate and 905 SNPs for BMI were constructed in 7983 participants. RESULTS Phosphate was inversely associated with BMI in the total population (β: -0.89; 95% CI: -1.17, -0.62), and stronger in women (β: -1.92; 95% CI: -2.20, -1.65) than in men (β: -0.37; 95% CI: -0.68, -0.06) (P-interaction < 0.05). Adjustment for leptin did not change results in men. In women, adjustment for leptin attenuated the association, but it was not abolished (β: -0.94; 95% CI: -1.45, -0.42). Phosphate was inversely associated with fat%, but not with lean mass, in both sexes. MR analyses suggested a causal effect of BMI on serum phosphate (β: -0.01; 95% CI: -0.02, 0.00) but not vice versa. CONCLUSIONS Serum phosphate was inversely associated with BMI and fat% in a population-based study of middle-aged and older adults, with a stronger effect in women than in men. Adjusting for leptin attenuated this relation in women only. MR results suggest a causal effect of BMI on phosphate but not vice versa. An underlying sex dimorphism in phosphate homeostasis should be further explored.
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Affiliation(s)
| | | | - Carolina Medina-Gomez
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Björkander S, Du L, Zuo F, Ekström S, Wang Y, Wan H, Sherina N, Schoutens L, Andréll J, Andersson N, Georgelis A, Bergström A, Marcotte H, Kull I, Hammarström L, Melén E, Pan-Hammarström Q. SARS-CoV-2-specific B- and T-cell immunity in a population-based study of young Swedish adults. J Allergy Clin Immunol 2021; 149:65-75.e8. [PMID: 34695490 PMCID: PMC8536496 DOI: 10.1016/j.jaci.2021.10.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/24/2021] [Accepted: 10/18/2021] [Indexed: 12/01/2022]
Abstract
Background Young adults are now considered major spreaders of coronavirus disease 2019 (COVID-19) disease. Although most young individuals experience mild to moderate disease, there are concerns of long-term adverse health effects. The impact of COVID-19 disease and to which extent population-level immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exists in young adults remain unclear. Objective We conducted a population-based study on humoral and cellular immunity to SARS-CoV-2 and explored COVID-19 disease characteristics in young adults. Methods We invited participants from the Swedish BAMSE (Barn [Children], Allergy Milieu, Stockholm, Epidemiology) birth cohort (age 24-27 years) to take part in a COVID-19 follow-up. From 980 participants (October 2020 to June 2021), we here present data on SARS-CoV-2 receptor-binding domain–specific IgM, IgA, and IgG titers measured by ELISA and on symptoms and epidemiologic factors associated with seropositivity. Further, SARS-CoV-2–specific memory B- and T-cell responses were detected for a subpopulation (n = 108) by ELISpot and FluoroSpot. Results A total of 28.4% of subjects were seropositive, of whom 18.4% were IgM single positive. One in 7 seropositive subjects was asymptomatic. Seropositivity was associated with use of public transport, but not with sex, asthma, rhinitis, IgE sensitization, smoking, or body mass index. In a subset of representative samples, 20.7% and 35.0% had detectable SARS-CoV-2 specific B- and T-cell responses, respectively. B- and T-cell memory responses were clearly associated with seropositivity, but T-cell responses were also detected in 17.2% of seronegative subjects. Conclusions Assessment of IgM and T-cell responses may improve population-based estimations of SARS-CoV-2 infection. The pronounced surge of both symptomatic and asymptomatic infections among young adults indicates that the large-scale vaccination campaign should be continued.
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Affiliation(s)
- Sophia Björkander
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Likun Du
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Fanglei Zuo
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Center of Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Yating Wang
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Hui Wan
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Natalia Sherina
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Lisanne Schoutens
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Juni Andréll
- Science for Life Laboratory, Department of Biochemistry and Biophysics, Stockholm University, Stockholm, Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Antonios Georgelis
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Center of Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Center of Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Harold Marcotte
- Division of Clinical Immunology and Transfusion Medicine, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
| | - Inger Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Lennart Hammarström
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Erik Melén
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
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Weimers P, Ankersen DV, Løkkegaard ECL, Burisch J, Munkholm P. Occurrence of Colorectal Cancer and the Influence of Medical Treatment in Patients With Inflammatory Bowel Disease: A Danish Nationwide Cohort Study, 1997 to 2015. Inflamm Bowel Dis 2021; 27:1795-1803. [PMID: 33409534 DOI: 10.1093/ibd/izaa340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The risk of colorectal cancer (CRC) for patients with inflammatory bowel disease (IBD) has previously been investigated with conflicting results. We aimed to investigate the incidence and risk of CRC in IBD, focusing on its modification by treatment. METHODS All patients with incident IBD (n = 35,908) recorded in the Danish National Patient Register between 1997 and 2015 (ulcerative colitis: n = 24,102; Crohn's disease: n = 9739; IBD unclassified: n = 2067) were matched to approximately 50 reference individuals (n = 1,688,877). CRC occurring after the index date was captured from the Danish Cancer Registry. Exposure to medical treatment was divided into categories including none, systemic 5-aminosalicylates, immunomodulators, and biologic treatment. The association between IBD and subsequent CRC was investigated by Cox regression and Kaplan-Meier estimates. RESULTS Of the IBD patients, 330 were diagnosed with CRC, resulting in a hazard ratio (HR) of 1.15 (95% confidence interval [CI], 1.03-1.28) as compared with the reference individuals. However, when excluding patients diagnosed with CRC within 6 months of their IBD diagnosis, the HR decreased to 0.80 (95% CI, 0.71-0.92). Patients with ulcerative colitis receiving any medical treatment were at significantly higher risk of developing CRC than patients with ulcerative colitis who were not given medical treatment (HR, 1.35; 95% CI, 1.01-1.81), whereas a similar effect of medical treatment was not observed in patients with Crohn's disease or IBD unclassified. CONCLUSIONS Medical treatment does not appear to affect the risk of CRC in patients with IBD. The overall risk of developing CRC is significantly increased in patients with IBD as compared with the general population. However, when excluding patients diagnosed with CRC within 6 months of their IBD diagnosis, the elevated risk disappears.
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Affiliation(s)
- Petra Weimers
- Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark
| | - Dorit Vedel Ankersen
- Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark
| | | | - Johan Burisch
- Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark
| | - Pia Munkholm
- Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark
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Yoon SY, Heo SJ, Kim YW, Yang SN, Moon HI. Ankylosing Spondylitis: A Risk Factor for Parkinsonism-A Nationwide Population-Based Study. J Parkinsons Dis 2021; 12:353-360. [PMID: 34602503 DOI: 10.3233/jpd-212878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Ankylosing spondylitis (AS) is an immune-mediated, chronic inflammatory rheumatic disorder. The etiology of Parkinson's disease (PD) is multifactorial; however, inflammation is receiving an increasing amount of attention as an underlying cause of the neurodegenerative process of PD. OBJECTIVE We performed a nationwide longitudinal, population-based matched cohort study to assess the association with the later development of parkinsonism in Korea. METHODS This study was conducted using records from the Health Insurance Review and Assessment Service database. The cumulative incidence rate of PD was estimated. Fine-Gray subdistribution hazard models were used to identify hazards associated with PD development based on the presence of AS. Exposure to anti-inflammatory drugs was measured and analyzed to determine the protective effect of these medications. Additionally, the hazard ratio (HR) for atypical parkinsonism was estimated. RESULTS The results of the Fine-Gray subdistribution hazard model revealed that the HR for PD development in the AS group was 1.82 (95%confidence interval [CI], 1.38-2.39, p < 0.001). A significant decrease in PD development was observed in patients with AS taking non-steroidal anti-inflammatory drugs (NSAIDs). The HR for atypical parkinsonism in the AS group was 3.86 (95%CI, 1.08-13.78, p < 0.05). CONCLUSION We found that AS was associated with an increased risk of PD and atypical parkinsonism. NSAIDs used for AS control have some protective effects against PD. Further studies assessing whether biological treatment mitigates PD risk in patients with high activity are warranted.
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Affiliation(s)
- Seo Yeon Yoon
- Department of Physical Medicine & Rehabilitation, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Seok-Jae Heo
- Department of Biostatistics and Computing, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Yong Wook Kim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Nam Yang
- Department of Physical Medicine & Rehabilitation, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Hyun-Im Moon
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Gyeonggi-do, Republic of Korea
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Linkens AMA, Houben AJHM, Kroon AA, Schram MT, Berendschot TTJM, Webers CAB, van Greevenbroek M, Henry RMA, de Galan B, Stehouwer CDA, Eussen SJMP, Schalkwijk CG. Habitual intake of dietary advanced glycation end products is not associated with generalized microvascular function-the Maastricht Study. Am J Clin Nutr 2021; 115:444-455. [PMID: 34581759 PMCID: PMC8827096 DOI: 10.1093/ajcn/nqab302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/24/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Endogenously formed advanced glycation end products (AGEs) may be important drivers of microvascular dysfunction and the microvascular complications of diabetes. AGEs are also formed in food products, especially during preparation methods involving dry heat. OBJECTIVES We aimed to assess cross-sectional associations between dietary AGE intake and generalized microvascular function in a population-based cohort. METHODS In 3144 participants of the Maastricht Study (mean ± SD age: 60 ± 8 y, 51% men) the dietary AGEs Nε-(carboxymethyl)lysine (CML), Nε-(1-carboxyethyl)lysine (CEL), and Nδ-(5-hydro-5-methyl-4-imidazolon-2-yl)-ornithine (MG-H1) were estimated using the combination of our ultra-performance LC-tandem MS dietary AGE database and an FFQ. Microvascular function was determined in the retina as flicker light-induced arteriolar and venular dilation and as central retinal arteriolar and venular equivalents, in plasma as a z score of endothelial dysfunction biomarkers (soluble vascular adhesion molecule 1 and soluble intracellular adhesion molecule 1, soluble E-selectin, and von Willebrand factor), in skin as the heat-induced skin hyperemic response, and in urine as 24-h albuminuria. Associations were evaluated using multiple linear regression adjusting for demographic, cardiovascular, lifestyle, and dietary factors. RESULTS Overall, intakes of CML, CEL, and MG-H1 were not associated with the microvascular outcomes. Although higher intake of CEL was associated with higher flicker light-induced venular dilation (β percentage change over baseline: 0.14; 95% CI: 0.02, 0.26) and lower plasma biomarker z score (β: -0.04 SD; 95% CI: -0.08, -0.00 SD), the effect sizes were small and their biological relevance can be questioned. CONCLUSIONS We did not show any strong association between habitual intake of dietary AGEs and generalized microvascular function. The contribution of dietary AGEs to generalized microvascular function should be further assessed in randomized controlled trials using specifically designed dietary interventions.
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Affiliation(s)
- Armand M A Linkens
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Alfons J H M Houben
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Abraham A Kroon
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Tos T J M Berendschot
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, Netherlands
| | - Carroll A B Webers
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, Netherlands
| | - Marleen van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Ronald M A Henry
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands,Heart and Vascular Center, Maastricht University Medical Center, Maastricht, Netherlands
| | - Bastiaan de Galan
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Simone J M P Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands,Department of Epidemiology, Maastricht University, Maastricht, Netherlands,CAPHRI School for Care and Public Health Research Unit, Maastricht University, Maastricht, Netherlands
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Gallo F, Kalpouzos G, Laukka EJ, Wang R, Qiu C, Bäckman L, Marseglia A, Fratiglioni L, Dekhtyar S. Cognitive Trajectories and Dementia Risk: A Comparison of Two Cognitive Reserve Measures. Front Aging Neurosci 2021; 13:737736. [PMID: 34512313 PMCID: PMC8424183 DOI: 10.3389/fnagi.2021.737736] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives Cognitive reserve (CR) is meant to account for the mismatch between brain damage and cognitive decline or dementia. Generally, CR has been operationalized using proxy variables indicating exposure to enriching activities (activity-based CR). An alternative approach defines CR as residual variance in cognition, not explained by the brain status (residual-based CR). The aim of this study is to compare activity-based and residual-based CR measures in their association with cognitive trajectories and dementia. Furthermore, we seek to examine if the two measures modify the impact of brain integrity on cognitive trajectories and if they predict dementia incidence independent of brain status. Methods We used data on 430 older adults aged 60+ from the Swedish National Study on Aging and Care in Kungsholmen, followed for 12 years. Residual-based reserve was computed from a regression predicting episodic memory with a brain-integrity index incorporating six structural neuroimaging markers (white-matter hyperintensities volume, whole-brain gray matter volume, hippocampal volume, lateral ventricular volume, lacunes, and perivascular spaces), age, and sex. Activity-based reserve incorporated education, work complexity, social network, and leisure activities. Cognition was assessed with a composite of perceptual speed, semantic memory, letter-, and category fluency. Dementia was clinically diagnosed in accordance with DSM-IV criteria. Linear mixed models were used for cognitive change analyses. Interactions tested if reserve measures modified the association between brain-integrity and cognitive change. Cox proportional hazard models, adjusted for brain-integrity index, assessed dementia risk. Results Both reserve measures were associated with cognitive trajectories [β × time (top tertile, ref.: bottom tertile) = 0.013; 95% CI: –0.126, –0.004 (residual-based) and 0.011; 95% CI: –0.001, 0.024, (activity-based)]. Residual-based, but not activity-based reserve mitigated the impact of brain integrity on cognitive decline [β (top tertile × time × brain integrity) = –0.021; 95% CI: –0.043, 0.001] and predicted 12-year dementia incidence, after accounting for the brain-integrity status [HR (top tertile) = 0.23; 95% CI: 0.09, 0.58]. Interpretation The operationalization of reserve based on residual cognitive performance may represent a more direct measure of CR than an activity-based approach. Ultimately, the two models of CR serve largely different aims. Accounting for brain integrity is essential in any model of reserve.
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Affiliation(s)
- Federico Gallo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russia.,Centre for Neurolinguistics and Psycholinguistics, Vita-Salute San Raffaele University, Milan, Italy
| | - Grégoria Kalpouzos
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Erika J Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Rui Wang
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden.,Department of Medicine and Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Chengxuan Qiu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Lars Bäckman
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Anna Marseglia
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Serhiy Dekhtyar
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Sit G, Letellier N, Iwatsubo Y, Goldberg M, Leynaert B, Nadif R, Ribet C, Roche N, Roquelaure Y, Varraso R, Zins M, Descatha A, Le Moual N, Dumas O. Occupational Exposures to Organic Solvents and Asthma Symptoms in the CONSTANCES Cohort. Int J Environ Res Public Health 2021; 18:ijerph18179258. [PMID: 34501848 PMCID: PMC8431091 DOI: 10.3390/ijerph18179258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 01/17/2023]
Abstract
Solvents are used in many workplaces and may be airway irritants but few studies have examined their association with asthma. We studied this question in CONSTANCES (cohort of ‘CONSulTANts des Centres d’Examens de Santé’), a large French cohort. Current asthma and asthma symptom scores were defined by participant-reported respiratory symptoms, asthma medication or attacks, and the sum of 5 symptoms, in the past 12 months, respectively. Lifetime exposures to 5 organic solvents, paints and inks were assessed by questionnaire and a population-based Job-Exposure Matrix (JEM). Cross-sectional associations between exposures and outcomes were evaluated by gender using logistic and negative binomial regressions adjusted for age, smoking habits and body mass index. Analyses included 115,757 adults (54% women, mean age 47 years, 9% current asthma). Self-reported exposure to ≥1 solvent was significantly associated with current asthma in men and women, whereas using the JEM, a significant association was observed only in women. Significant associations between exposures to ≥1 solvent and asthma symptom score were observed for both self-report (mean score ratio, 95%CI, women: 1.36, 1.31–1.42; men: 1.34, 1.30–1.40) and JEM (women: 1.10, 1.07–1.15; men: 1.14, 1.09–1.18). Exposure to specific solvents was significantly associated with higher asthma symptom score. Occupational exposure to solvents should be systematically sought when caring for asthma.
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Affiliation(s)
- Guillaume Sit
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
| | - Noémie Letellier
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps, Institution of Oceanography, UC San Diego, La Jolla, CA 92093, USA;
| | - Yuriko Iwatsubo
- Santé publique France Direction Santé Environnement Travail, 94415 Saint-Maurice, France;
| | - Marcel Goldberg
- Population-Based Epidemiological Cohorts Unit, INSERM UMS 11, 94807 Villejuif, France; (M.G.); (C.R.); (M.Z.)
- Faculty of Medicine, University of Paris, 75006 Paris, France
| | - Bénédicte Leynaert
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
| | - Rachel Nadif
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
| | - Céline Ribet
- Population-Based Epidemiological Cohorts Unit, INSERM UMS 11, 94807 Villejuif, France; (M.G.); (C.R.); (M.Z.)
| | - Nicolas Roche
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
- APHP Centre—Université de Paris, Hôpital et Institut Cochin, Service de Pneumologie, 75014 Paris, France
| | - Yves Roquelaure
- UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)—UMR_S1085, F-49000 Angers, France;
| | - Raphaëlle Varraso
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
| | - Marie Zins
- Population-Based Epidemiological Cohorts Unit, INSERM UMS 11, 94807 Villejuif, France; (M.G.); (C.R.); (M.Z.)
- Faculty of Medicine, University of Paris, 75006 Paris, France
| | - Alexis Descatha
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
- UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)—UMR_S1085, F-49000 Angers, France;
| | - Nicole Le Moual
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
- Correspondence:
| | - Orianne Dumas
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
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Linardon J, Greenwood CJ, Fuller-Tyszkiewicz M, Macdonald JA, Spry E, Hutchinson DM, Youssef GJ, Sanson A, Wertheim EH, McIntosh JE, Le Grange D, Letcher P, Olsson CA. Young adult mental health sequelae of eating and body image disturbances in adolescence. Int J Eat Disord 2021; 54:1680-1688. [PMID: 34240437 DOI: 10.1002/eat.23575] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE There has been interest in the antecedents and mental health impacts of eating and body image disturbances in adolescence. Less is known about longer-term mental health impacts into young adulthood, as longitudinal studies with data spanning this developmental period are rare. We capitalize on mental health data collected across adolescence and young adulthood from a population-based cohort study that has been following >2000 Australian children and their families from infancy to young adulthood. METHOD This sample comprised 1,568 participants who completed the Eating Disorder Inventory drive for thinness and bulimic behavior (the severity of binge-purge patterns) subscales, and a modified version of the body dissatisfaction subscale in mid-adolescence (15-16 years), or the Depression Anxiety Stress Scales in young adulthood (19-20, 23-24, and 27-28 years). RESULTS After adjusting for baseline demographic and prior mental health factors (<13 years of age), all three indices of eating and body image disturbances in adolescence predicted each mental health outcome in young adulthood. Mental health risks associated with adolescent body dissatisfaction and bulimic behavior scores remained stable across young adulthood, with men having more pronounced problems associated with bulimic behavior scores than women. In contrast, mental health risks associated with adolescent drive for thinness scores diminished across this period similarly for men and women. DISCUSSION Findings suggest that adolescent eating and body image disturbances may have long-term mental health impacts that extend into young adulthood. This underscores the need for early preventative intervention, and longer-term monitoring and support for body image and eating disturbances.
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Affiliation(s)
- Jake Linardon
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Christopher J Greenwood
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Matthew Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Elizabeth Spry
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Delyse M Hutchinson
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia.,National Drug and Alcohol Research Centre, The University of New South Wales, Randwick, New South Wales, Australia
| | - George J Youssef
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Ann Sanson
- Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Eleanor H Wertheim
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Jennifer E McIntosh
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, Eating Disorders Program, University of California, San Francisco, San Francisco, California, USA
| | - Primrose Letcher
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia
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Yu YH, Filion KB, Reynier P, Platt RW, Yu OHY, Grandi SM. Use of levothyroxine among pregnant women with subclinical hypothyroidism in the United Kingdom: A population-based assessment. Pharmacol Res Perspect 2021; 9:e00848. [PMID: 34390215 PMCID: PMC8363773 DOI: 10.1002/prp2.848] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 07/10/2021] [Indexed: 12/17/2022] Open
Abstract
Our study aimed to describe levothyroxine prescription patterns and trends over time among pregnant women with subclinical hypothyroidism (SCH) in the United Kingdom. We used data from the Clinical Practice Research Datalink linked to its Pregnancy Register and the Hospital Episode Statistics database from 1998 to 2017. The study population included women with a diagnosis of SCH or an abnormal thyroid‐simulated hormone (TSH) level one year prior to or during pregnancy. We compared characteristics between women who received a prescription for levothyroxine during pregnancy and those who did not. We further described the timing, dose, duration, and temporal trends of levothyroxine prescriptions. Our cohort included 6,757 pregnancies from 6,287 women with SCH, of whom 10% received levothyroxine during pregnancy. Among women who received levothyroxine, most received their first prescription during the first trimester (median gestational age: 7 weeks; interquartile range [IQR]: 0, 16) with a median daily dosage of 50 mcg (IQR: 50, 73). Levothyroxine prescription varied over time, decreasing from 23% of pregnant women in 1998 to 7.5% in 2003, remaining stable until 2014, and increasing to 12.5% in 2016. Smoking, diabetes, polycystic ovary syndrome, infertility, timing of SCH diagnosis, age, TSH level at diagnosis, and general practice regions were associated with prescription. Few women with SCH received levothyroxine during pregnancy, and treatment varied by patient characteristics and geographical regions. These results highlight the need to increase awareness among healthcare providers and will guide future studies that explore barriers to initiating levothyroxine treatment for women with SCH during pregnancy.
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Affiliation(s)
- Ya-Hui Yu
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.,Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Kristian B Filion
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.,Departments of Medicine and of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Pauline Reynier
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Robert W Platt
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.,Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Oriana H Y Yu
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.,Division of Endocrinology, Jewish General Hospital, Montreal, Quebec, Canada
| | - Sonia M Grandi
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.,Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
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42
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Rodavsky G, Sheiner E, Walfisch A, Gutvirtz G, Hermon N, Landau D, Wainstock T. Meconium stained amniotic fluid exposure and long-term respiratory morbidity in the offspring. Pediatr Pulmonol 2021; 56:2328-2334. [PMID: 33730429 DOI: 10.1002/ppul.25357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/07/2021] [Accepted: 02/16/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Meconium stained amniotic fluid (MSAF) is a well-established risk factor for neonatal short-term respiratory complications. Little is known regarding the long-term morbidity. We investigated the possible association between MSAF and offspring respiratory morbidity. METHODS A population-based, cohort study of singleton deliveries occurring between 1991 and 2014 at a sole regional tertiary medical center was performed. Incidence of offspring respiratory related hospitalizations up to the age of 18 years were evaluated and compared to unexposed offspring. A Kaplan-Meier survival curve was used to compare cumulative respiratory morbidity incidence, and a Cox proportional hazards model was used to control for confounders. RESULTS During the study period 242,342 deliveries met the inclusion criteria. Of them, 14.7% (n = 35,609) were complicated with MSAF. Incidence of respiratory-related hospitalizations was significantly lower in children exposed to MSAF as compared to the unexposed group (4.5% vs. 4.9%, respectively; p < .01). Specifically, hospitalizations involving pneumonitis were significantly less common among the MSAF group (odds ratio, 0.35; 95% confidence interval [95% CI], 0.13-0.96; p = .03). The Kaplan-Meier survival curve demonstrated significantly lower total cumulative respiratory morbidity rates in the MSAF exposed group (log rank p < .01). In the Cox model, controlled for clinically relevant confounders, MSAF exhibited an independent and significant protective effect on long-term childhood respiratory morbidity (aHR, 0.91; 95% CI, 0.86-0.96; p < .01). CONCLUSIONS Fetal exposure to MSAF during labor appears to be associated with lower rates of long-term respiratory related hospitalizations in the offspring. Changes in offspring microbiome, as well as functional and anatomical modulations possibly resulting from MSAF exposure, might offer a plausible explanation of our findings.
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Affiliation(s)
- Gal Rodavsky
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Asnat Walfisch
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gil Gutvirtz
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Narkis Hermon
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Daniella Landau
- Department of Neonatology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Tamar Wainstock
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Pose E, Pera G, Torán P, Gratacós-Ginès J, Avitabile E, Expósito C, Díaz A, Graupera I, Rubio AB, Ginès P, Fabrellas N, Caballeria L. Interaction between metabolic syndrome and alcohol consumption, risk factors of liver fibrosis: A population-based study. Liver Int 2021; 41:1556-1564. [PMID: 33595176 DOI: 10.1111/liv.14830] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Alcohol and metabolic syndrome (MS) coexist frequently as cofactors of liver disease. Previous studies suggest a deleterious effect of MS in advanced alcohol-related liver disease (ArLD). However, it is unknow whether MS can increase the risk of liver fibrosis in early stages of ArLD. The aim of this study was to investigate the effect of MS on liver fibrosis in subjects with alcohol consumption from a population-based cohort. METHODS The number of subjects include 1760(58%) of 3014 who were randomly selected from the community consumed alcohol and were classified as current drinkers, divided in moderate (n = 1222) or high-risk drinkers (n = 275) (>21 units/week men, >14 units/week women for high-risk drinkers), or former drinkers (n = 263). Liver fibrosis was estimated by measuring liver stiffness(LS) with transient elastography (TE). RESULTS Prevalence of significant LS using cutoff values of TE of 8 and 9.1kPa was increased in high-risk compared with moderate or former drinkers and lifetime abstainers. In subjects with alcohol consumption, LS was associated with male gender, AST, ALT, years of consumption, and MS. In high-risk drinkers, MS and intensity of consumption were the only factors associated with significant LS (OR 3.7 and 4.6 for LS ≥ 8 kPa and 3.9 and 9.2 kPa for LS ≥ 9.1 kPa, respectively). Presence of significant liver fibrosis in the liver biopsy was higher among high-risk as compared with moderate or former drinkers. CONCLUSION MS increases the risk of liver fibrosis in subjects with alcohol consumption. Among high-risk drinkers, only MS and consumption of high amount of alcohol are associated with risk of liver fibrosis.
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Affiliation(s)
- Elisa Pose
- Liver Unit, Hospital Clínic, Barcelona, Spain.,Institut d'Investigacions Biomèdiques, August Pi i Sunyer, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain.,Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Guillem Pera
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain.,Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP J Gol), Barcelona, Spain
| | - Pere Torán
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain.,Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP J Gol), Barcelona, Spain
| | | | - Emma Avitabile
- Liver Unit, Hospital Clínic, Barcelona, Spain.,Institut d'Investigacions Biomèdiques, August Pi i Sunyer, Barcelona, Spain
| | - Carmen Expósito
- Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP J Gol), Barcelona, Spain
| | - Alba Díaz
- Pathological Department, Hospital Clínic, Barcelona, Spain
| | - Isabel Graupera
- Liver Unit, Hospital Clínic, Barcelona, Spain.,Institut d'Investigacions Biomèdiques, August Pi i Sunyer, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain.,Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Ana B Rubio
- Liver Unit, Hospital Clínic, Barcelona, Spain.,Institut d'Investigacions Biomèdiques, August Pi i Sunyer, Barcelona, Spain
| | - Pere Ginès
- Liver Unit, Hospital Clínic, Barcelona, Spain.,Institut d'Investigacions Biomèdiques, August Pi i Sunyer, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain.,Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Núria Fabrellas
- Institut d'Investigacions Biomèdiques, August Pi i Sunyer, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain.,Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Llorenç Caballeria
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain.,Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP J Gol), Barcelona, Spain
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Airagnes G, Lemogne C, Le Faou AL, Matta J, Romanello L, Wiernik E, Melchior M, Goldberg M, Limosin F, Zins M. Do the associations between the use of electronic cigarettes and smoking reduction or cessation attempt persist after several years of use? Longitudinal analyses in smokers of the CONSTANCES cohort. Addict Behav 2021; 117:106843. [PMID: 33581677 DOI: 10.1016/j.addbeh.2021.106843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION We examined whether duration of electronic cigarette (e-cigarette) use could be associated with smoking reduction or cessation attempt. METHODS 5,409 current smokers at baseline enrolled in the French CONSTANCES cohort in 2015 or 2016 were included. Duration of e-cigarette use was categorized as follows: never; former user for more than one year; former user for less than one year; new user for less than one year; return to use for less than one year; regular use for one to two years; regular use for more than two years. Two outcomes were considered at one-year of follow-up: change in the number of cigarettes per day and cessation attempt. RESULTS Compared to never users, former users had an increase in the number of cigarettes per day at follow-up (B = 0.95[95%CI:0.57-1.33] and B = 1.03[95%CI:0.47-1.59] for former users of more than one year and less than one year, respectively). Compared to never users, all categories of current users had a decrease in the number of cigarettes per day (B = -3.31[95%CI:-4.07;-2.54] and B = -4.18[95%CI:-5.06;-3.29] for new users of less than one year and users of more than two years, respectively). Compared to never users, former users had a decreased likelihood of cessation attempt (OR = 0.80[95%CI:0.67-0.95] and OR = 0.77[95%CI:0.60-0.99] for former users of more than one year and less than one year, respectively). Compared to never users, all categories of current users had an increased likelihood of cessation attempt (OR = 3.12[95%CI:2.32;4.19] and OR = 3.36[95%CI:2.39;4.72] for new users of less than one year and users of more than two years, respectively). CONCLUSIONS E-cigarette use was associated with smoking reduction and cessation attempt for individuals who have used it for less than one year and additional benefits are expected to occur with a longer duration of use. Former users of e-cigarettes had poorer outcomes than those who have never used them.
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Affiliation(s)
- Guillaume Airagnes
- AP-HP. Centre-University of Paris, Department of Psychiatry and Addictology, Paris, France; INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France; University of Paris, Faculty of Medicine, Paris, France.
| | - Cédric Lemogne
- AP-HP. Centre-University of Paris, Department of Psychiatry and Addictology, Paris, France; University of Paris, Faculty of Medicine, Paris, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Anne-Laurence Le Faou
- AP-HP. Centre-University of Paris, Department of Psychiatry and Addictology, Paris, France; University of Paris, Faculty of Medicine, Paris, France
| | - Joane Matta
- INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France
| | - Lucile Romanello
- INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France
| | - Emmanuel Wiernik
- INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Marcel Goldberg
- INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France
| | - Frédéric Limosin
- AP-HP. Centre-University of Paris, Department of Psychiatry and Addictology, Paris, France; University of Paris, Faculty of Medicine, Paris, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Marie Zins
- INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France; University of Paris, Faculty of Medicine, Paris, France
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45
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Stang CD, Turcano P, Mielke MM, Josephs KA, Bower JH, Ahlskog JE, Boeve BF, Martin PR, Upadhyaya SG, Savica R. Incidence and Trends of Progressive Supranuclear Palsy and Corticobasal Syndrome: A Population-Based Study. J Parkinsons Dis 2021; 10:179-184. [PMID: 31594251 DOI: 10.3233/jpd-191744] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Few studies have investigated the incidence of PSP and CBS in the population. OBJECTIVE To examine the incidence of and trends in progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) in a population-based cohort of residents of Olmsted County, MN. METHODS We used the 1991-2005 population-based, Olmsted County Parkinsonism-cohort study, defined via the Rochester Epidemiology Project. A movement-disorder specialist reviewed medical records, to confirm PSP and CBS diagnoses. RESULTS We identified 21 patients with these diagnoses 1991-2005 : 18 (85.7%), PSP; 3 (14.3%), CBS. The median diagnosis age was 78 (range: 66-88). 13/21 (62.0%) were male. MRI was performed pre-diagnosis in 11 patients (8 PSP and 3 CBD); 10 showed atrophy consistent with clinical diagnoses. We observed concordance between clinical and pathological diagnoses in two PSP patients who underwent autopsy. Combined incidence for PSP and CBS in Olmsted County was 3.1 per 100,000 person-years (2.6 per 100,000 person-years, PSP; 0.4 per 100,000 person-years, CBS). Incidence was higher in men (4.5, 95% CI, 2.0-7.0) than women (1.8, 95% CI, 0.5-2.9). A combined, significant trend of increasing incidence was observed between 1991 and 2005 (B=0.69, 95% CI 0.42, 0.96, p<0.001). Median time from symptom onset to death among both groups was 6 years (range PSP, 1-10 years; range CBS, 3-8 years). CONCLUSIONS The combined incidence for PSP and CBS was 3.1 per 100,000 person-years, higher in men than women. We observed a significant increase in both PSP and CBS, likely due to advancing imaging technology and improved diagnostic ability among physicians.
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Affiliation(s)
- Cole D Stang
- Mayo Clinic Department of Neurology, Rochester, MN, USA
| | | | - Michelle M Mielke
- Mayo Clinic Department of Health Sciences Research, Rochester, MN, USA
| | | | - James H Bower
- Mayo Clinic Department of Neurology, Rochester, MN, USA
| | | | | | - Peter R Martin
- Mayo Clinic Department of Health Sciences Research, Rochester, MN, USA
| | | | - Rodolfo Savica
- Mayo Clinic Department of Neurology, Rochester, MN, USA.,Mayo Clinic Department of Health Sciences Research, Rochester, MN, USA
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Weimers P, Vedel Ankersen D, Lophaven S, Bonderup OK, Münch A, Løkkegaard ECL, Munkholm P, Burisch J. Disease Activity Patterns, Mortality, and Colorectal Cancer Risk in Microscopic Colitis: A Danish Nationwide Cohort Study, 2001 to 2016. J Crohns Colitis 2021; 15:594-602. [PMID: 33049029 DOI: 10.1093/ecco-jcc/jjaa207] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS The disease course of microscopic colitis [MC], encompassing collagenous colitis [CC] and lymphocytic colitis [LC], is not well known. In a Danish nationwide cohort, we evaluated the disease activity patterns as well as the risk of colorectal cancer [CRC] and mortality based on disease severity. METHODS All incident MC patients [n = 14 302] with a recorded diagnosis of CC [n = 8437] or LC [n = 5865] in the Danish Pathology Register, entered between 2001 and 2016, were matched to 10 reference individuals [n = 142 481]. Incident cases of CRC after the index date were captured from the Danish Cancer Registry. Mortality data were ascertained from the Danish Registry of Causes of Death, and information about treatment was obtained from the Danish National Prescription Registry. The risk of CRC and mortality analyses were investigated by Cox regression and Kaplan-Meier estimates. RESULTS We identified a self-limiting or transient disease course in 70.6% of LC patients and in 59.9% of CC patients, p <0.001. Less than 5% of MC patients experienced a budesonide-refractory disease course and were treated with immunomodulators or biologic treatment. A total of 2926 [20.5%] MC patients and 24 632 [17.3%] reference individuals died during the study period. MC patients with a severe disease had a relative risk [RR] of mortality of 1.41 (95% confidence interval [CI]: 1.32-1.50) compared with reference individuals. Only 90 MC patients were diagnosed with CRC during follow-up, corresponding to an RR of 0.48 [95% CI: 0.39-0.60]. CONCLUSIONS A majority of MC patients experience an indolent disease course with a lower risk of developing CRC compared with the background population.
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Affiliation(s)
- Petra Weimers
- Department of Gastroenterology, North Zealand University Hospital, Capital Region, Denmark
| | - Dorit Vedel Ankersen
- Department of Gastroenterology, North Zealand University Hospital, Capital Region, Denmark
| | - Søren Lophaven
- Omicron Aps, Department of Statistics, Roskilde, Denmark
| | | | - Andreas Münch
- Department of Gastroenterology and Hepatology, Linköping University Hospital, Linköping, Sweden.,Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | | | - Pia Munkholm
- Department of Gastroenterology, North Zealand University Hospital, Capital Region, Denmark
| | - Johan Burisch
- Department of Gastroenterology, North Zealand University Hospital, Capital Region, Denmark
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Airagnes G, Lemogne C, Goldberg M, Limosin F, Zins M. The role of being a former smoker in the association between electronic cigarette and alcohol use. Addiction 2021; 116:973-975. [PMID: 33220093 DOI: 10.1111/add.15343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/19/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Guillaume Airagnes
- Department of Psychiatry and Addictology, AP-HP. Centre-Université de Paris, Paris, France
- INSERM, UMS011, Population-based Epidemiological Cohorts, Villejuif, France
- Faculty of Medicine, University of Paris, Paris, France
| | - Cédric Lemogne
- Department of Psychiatry and Addictology, AP-HP. Centre-Université de Paris, Paris, France
- Faculty of Medicine, University of Paris, Paris, France
- INSERM, UMR_S1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP), Université de Paris, Paris, France
| | - Marcel Goldberg
- INSERM, UMS011, Population-based Epidemiological Cohorts, Villejuif, France
| | - Frédéric Limosin
- Department of Psychiatry and Addictology, AP-HP. Centre-Université de Paris, Paris, France
- Faculty of Medicine, University of Paris, Paris, France
- INSERM, UMR_S1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP), Université de Paris, Paris, France
| | - Marie Zins
- INSERM, UMS011, Population-based Epidemiological Cohorts, Villejuif, France
- Faculty of Medicine, University of Paris, Paris, France
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Cao Y, DiPiro N, Krause JS. Association of Secondary Health Conditions With Future Chronic Health Conditions Among Persons With Traumatic Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2021; 26:283-289. [PMID: 33536734 DOI: 10.46292/sci20-00020] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Secondary health conditions (SHC) are physical and mental health conditions that are causally related to disabilities. Studies have found that SHC increase risk of negative health outcomes among people with traumatic spinal cord injury (TSCI). However, little has been done to assess the association of SHC with the risk of chronic health conditions (CHC) after TSCI. Objectives To identify the prevalence of CHC in adults with TSCI, changes in CHC at follow-up, and the associations of baseline SHC with future CHC. Methods Participants included 501 adults with TSCI of at least 1-year duration, identified through a population-based surveillance system. Baseline and follow-up self-report assessments were completed. We measured seven SHC: fatigue, spasticity, pain, pressure ulcers, subsequent injury, fracture, and anxiety disorder, and measured seven CHC: diabetes, heart attack, coronary artery disease, stroke, cancer, hypertension, and high blood cholesterol. Control variables included gender, race/ethnicity, age at injury, years post injury, injury severity, smoking status, binge drinking, and taking prescription medication. We implemented a Poisson regression model for the multivariate analyses. Results The total number of CHC, the percentage of participants having at least one CHC, and prevalence of three individual CHC (diabetes, cancer, and high cholesterol) increased from baseline to follow-up. After controlling for demographic, injury characteristics, and behavioral factors, pain interference and anxiety disorder at baseline were associated with the total number of CHC at follow-up. Conclusion CHC are common among adults with TSCI and increase significantly over time. Pain and anxiety disorders appear to be risk factors for future CHC.
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Affiliation(s)
- Yue Cao
- College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
| | - Nicole DiPiro
- College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
| | - James S Krause
- College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
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Seiermann AU, Al-Mufti H, Waid JL, Wendt AS, Sobhan S, Gabrysch S. Women's fasting habits and dietary diversity during Ramadan in rural Bangladesh. Matern Child Nutr 2021; 17:e13135. [PMID: 33522117 PMCID: PMC8189200 DOI: 10.1111/mcn.13135] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 11/30/2020] [Accepted: 12/09/2020] [Indexed: 01/01/2023]
Abstract
Little is known about fasting practices and dietary changes during Ramadan in low‐ and lower‐middle‐income countries. Although pregnant women are exempt from fasting, they may still fast. This is of interest as dietary habits during pregnancy may affect the development of the unborn child. In a community‐based sample of young women in rural Sylhet division, Bangladesh, we described fasting practices and beliefs (n = 852). We also examined reported food group consumption and minimally adequate dietary diversity for women (MDD‐W) by Ramadan occurrence (n = 1,895) and by fasting adherence (n = 558) using logistic regression with Hindu women as a seasonal control. During Ramadan in 2018, 78% of pregnant Muslim women fasted every day. Over 80% of Muslim women believe that they should fast during pregnancy and over 50% expect positive health effects on the mother and the unborn child. We found strong evidence that Muslim women have more diverse diets during Ramadan, with higher odds of MDD‐W (OR [95% CI]: 5.0 [3.6, 6.9]) and increased consumption of pulses, dairy, fruit, and large fish. Dietary diversity increased to a lesser extent on non‐fasting days during Ramadan. Ramadan appears to improve dietary quality in both fasting and non‐fasting Muslim women in a rural population in Bangladesh. These results help to interpret findings from studies on Ramadan during pregnancy on later‐life outcomes and thus contribute to a better understanding of intrauterine influences of maternal nutrition on healthy child development.
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Affiliation(s)
- Andrea U Seiermann
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Hudaalrahman Al-Mufti
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Nineveh Directorate of Health, Ministry of Health, Nineveh, Iraq
| | - Jillian L Waid
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Bangladesh Country Office, Helen Keller International, Dhaka, Bangladesh.,Research Department 2, Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - Amanda S Wendt
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Research Department 2, Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - Shafinaz Sobhan
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Research Department 2, Potsdam Institute for Climate Impact Research, Potsdam, Germany.,Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sabine Gabrysch
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Research Department 2, Potsdam Institute for Climate Impact Research, Potsdam, Germany.,Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
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50
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Ghanchi A, Rahshenas M, Bonnet D, Derridj N, LeLong N, Salomon LJ, Goffinet F, Khoshnood B. Prevalence of Growth Restriction at Birth for Newborns With Congenital Heart Defects: A Population-Based Prospective Cohort Study EPICARD. Front Pediatr 2021; 9:676994. [PMID: 34123973 PMCID: PMC8192794 DOI: 10.3389/fped.2021.676994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 04/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives: Congenital heart defects (CHD) and growth restriction at birth are two major causes of childhood and adult morbidity and mortality. The aim of this study was to assess the overall risk of growth restriction at birth, as measured by its imperfect proxy small (< 10th percentile) for gestational age (SGA), for newborns with CHD. Methods: Using data from a population-based cohort of children born with CHD, we assessed the risk of growth restriction at birth using SGA and severe SGA (3rd percentile). To compare the odds of SGA and severe SGA across five specific major CHD, we used ordinal logistic regression using isolated, minor (non-operated) ventricular septal defect (VSD) as the control group. Results: The overall proportion of SGA for "isolated" CHD (i.e., those not associated with other anomalies) was 13% (95% CI, 12-15%), which is 30% higher than what would be expected in the general population (i.e., 10%). The risk of severe SGA was 5% (95% CI, 4-6%) as compared with the expected 3% in the general population. There were substantial differences in the risk of overall SGA and more so severe SGA across the different CHD. The highest risk of SGA occurred for Tetralogy of Fallot (adjusted OR 2.7, 95% CI, 1.3-5.8) and operated VSD (adjusted OR 2.1, 95% CI, 1.1-3.8) as compared with the control group of minor (non-operated) VSD. Conclusion: The overall risks of both SGA and severe SGA were higher in isolated CHD than what would be expected in the general population with substantial differences across the subtypes of CHD. These results may provide a clue for understanding the underlying mechanisms of the relation between alterations in fetal circulation associated with different types of CHD and their effects on fetal growth.
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Affiliation(s)
- Ali Ghanchi
- Université de Paris, CRESS, INSERM, INRA, Paris, France.,Service d'Obstétrique - Maternité, Chirurgie Médecine et Imagerie Fœtales. APHP. Hôpital Necker Enfants Malades, Paris, France
| | | | - Damien Bonnet
- Department of Pediatric Cardiology, M3C-Necker. APHP. Hôpital Necker-Enfants Malades, Paris, France.,University of Paris, Paris, France
| | - Neil Derridj
- Université de Paris, CRESS, INSERM, INRA, Paris, France.,Department of Pediatric Cardiology, M3C-Necker. APHP. Hôpital Necker-Enfants Malades, Paris, France
| | | | - Laurent J Salomon
- Service d'Obstétrique - Maternité, Chirurgie Médecine et Imagerie Fœtales. APHP. Hôpital Necker Enfants Malades, Paris, France.,University of Paris, Paris, France
| | - Francois Goffinet
- Université de Paris, CRESS, INSERM, INRA, Paris, France.,Port-Royal Maternity Unit, Cochin Hospital, APHP, Paris, France
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