Yin, Geping; Chen, Ming; Yang, Shujun; Li, Juan; Zhu, Tongyu; Zhao, Xiaoli
Patients' selection criteria, effectiveness, and safety of radiofrequency thermal ablation (RFTA) therapy for uterine myomas (UM) were assessed using a 10-year retrospective cohort study. From July 2001 to July 2011, a total of 1216 patients treated for UM were divided into 2 groups. Group A consisted of 476 premenopause patients, average age 36.5 ± 8.5 years, average number of myomas 1.7 ± 0.9, and average diameter of myomas 4.5 ± 1.5 cm, and group B consisted of 740 menopause patients, average age 48.5 ± 3.5 years, average number of myomas 2.6 ± 1.3, and average diameter of myomas 5.0 ± 2.5 cm. Average follow-up period was 36.5 ± 11.5 months. At 1, 3, 6, 12, and 24 months after RFTA, average diameters of myomas in group A were 3.8, 3.0, 2.7, 2.4, and 2.2 cm, respectively, and 47.7% (227 of 476) of patients had tumor trace at 12 months after RFTA. In group B, the results were 4.7, 3.7, 3.3, 2.3, and 2.3 cm, respectively, and 58.8% (435 of 740) of patients had tumor trace at 12 months after RFTA. Three months after treatment, myoma volumes were significantly reduced in both the groups (P < .01), and group B had higher rate of tumor trace at 12 months after RFTA than group A (P < .05). Clinical symptoms and health-related quality-of-life outcome (HRQL) were significantly improved after RFTA in both groups and the postoperative recurrence rate of UM was significantly higher in group A at 10.7% (51 of 476) than group B at 2.4% (18 of 740; P < .05). Radiofrequency thermal ablation is an excellent minimally invasive treatment for UM smaller than 5.0 cm in diameter.
Klonsky, E. David; Kotov, Roman; Bakst, Shelly; Rabinowitz, Jonathan; Bromet, Evelyn J.
Little is known about the longitudinal relationship of hopelessness to attempted suicide in psychotic disorders. This study addresses this gap by assessing hopelessness and attempted suicide at multiple time-points over 10 years in a first-admission cohort with psychosis (n = 414). Approximately one in five participants attempted suicide during…
Visudtibhan, Anannit; Tuntiyathorn, Lochana; Vaewpanich, Jarin; Sukjit, Prapasri; Khongkatithum, Chaiyos; Thampratankul, Lunliya; Chiemchanya, Surang; Visudhiphan, Pongsakdi
Childhood acute disseminated encephalomyelitis (ADEM) is a demyelinating disease with variable clinical courses and outcomes. Its evolution to multiple sclerosis in Asian children is yet to be determined. Medical records, investigation results and magnetic resonance imaging of brain of Thai children aged less than 15 years with initial diagnosis of ADEM at a referral university hospital in Thailand from January 1997 to December 2006 were reviewed. Clinical course and the outcome were finalized by telephone interview, self-report questionnaire, and/or neurological examination by December 2008. Modified Rankin Score was applied for determination of disability. MRI findings were categorized along with the locations and number of areas of abnormalities shown by T2-weight and FLAIR. 16 patients consisting of 5 boys and 11 girls (age-range 1-14 years, mean 6.9 ± 3.6 years, median 6 years) were identified. Nine patients had cranial nerve dysfunctions including one child with optic neuropathy. One patient died with confirmed pathological diagnosis of ADEM. Among the remaining 15, who were followed from 2 to 10 years (mean 5.8 years), 13 and 3 patients were classified into monophasic ADEM and multiple sclerosis, respectively. Ten of 13 with final diagnosis of ADEM had complete recovery. There was no association between number of lesions or location in the initial MRI and the outcome and final diagnosis. ADEM in Thai children had similar clinical presentation and outcome to previous studies in Western countries. ADEM can occasionally evolve to multiple sclerosis in Thai children as being shown in previous reports from other Asian countries.
Appel-da-Silva, Marcelo Campos; Miozzo, Suelen Aparecida da Silva; Dossin, Isabella de Azevedo; Tovo, Cristiane Valle; Branco, Fernanda; de Mattos, Angelo Alves
AIM To determine the incidence of hepatocellular carcinoma (HCC) and the impact of HCC surveillance on early diagnosis and survival of cirrhotic outpatients. METHODS In this retrospective cohort study, cirrhotic outpatients undergoing HCC surveillance between March 2005 and March 2014 were analyzed. Exclusion criteria were HIV coinfection; previous organ transplantation; diagnosis of HCC at first consultation; missing data in the medical chart; and less than 1 year of follow-up. Surveillance was carried out every six months using ultrasound and serum alpha-fetoprotein determination. Ten-year cumulative incidence and survival were estimated through Kaplan-Meier analysis. RESULTS Four hundred and fifty-three patients were enrolled, of which 57.6% were male. Mean age was 55 years. Hepatitis C virus and heavy use of alcohol were the main etiologic agents of cirrhosis. HCC was diagnosed in 75 patients (16.6%), with an estimated cumulative incidence of 2.6% in the 1st year, 15.4% in the 5th year, and 28.8% in the 10th year. Median survival was estimated at 17.6 mo in HCC patients compared to 234 mo in non-HCC patients (P < 0.001). Early-stage HCC was more often detected in patients who underwent surveillance every 6 mo or less (P = 0.05). However, survival was not different between patients with early stage vs non-early stage tumors [HR = 0.54 (0.15-1.89), P = 0.33]. CONCLUSION HCC is a frequent complication in patients with cirrhosis and adherence to surveillance programs favors early diagnosis. PMID:28028370
Wu, Chieh-Hsin; Tsai, Tai-Hsin; Zhang, Zi-Hao; Liu, Wei; Wu, Ming-Kung; Chang, Chih-Hui; Kuo, Keng-Liang
Whether traumatic brain injury (TBI) is causally related to substance related disorder (SRD) is still debatable, especially in persons with no history of mental disorders at the time of injury. This study analyzed data in the Taiwan National Health Insurance Research Database for 19,109 patients aged ≥18 years who had been diagnosed with TBI during 2000–2010. An additional 19,109 randomly selected age and gender matched patients without TBI (1 : 1 ratio) were enrolled in the control group. The relationship between TBI and SRD was estimated with Cox proportional hazard regression models. During the follow-up period, SRD developed in 340 patients in the TBI group and in 118 patients in the control group. After controlling for covariates, the overall incidence of SRD was 3.62-fold higher in the TBI group compared to the control group. Additionally, patients in the severe TBI subgroup were 9.01 times more likely to have SRD compared to controls. Notably, patients in the TBI group were prone to alcohol related disorders. The data in this study indicate that TBI is significantly associated with the subsequent risk of SRD. Physicians treating patients with TBI should be alert to this association to prevent the occurrence of adverse events. PMID:27774322
Charvat, Hadrien; Sasazuki, Shizuka; Inoue, Manami; Iwasaki, Motoki; Sawada, Norie; Shimazu, Taichi; Yamaji, Taiki; Tsugane, Shoichiro
Gastric cancer is a particularly important issue in Japan, where incidence rates are among the highest observed. In this work, we provide a risk prediction model allowing the estimation of the 10-year cumulative probability of gastric cancer occurrence. The study population consisted of 19,028 individuals from the Japanese Public Health Center cohort II who were followed-up from 1993 to 2009. A parametric survival model was used to assess the impact on the probability of gastric cancer of clinical and lifestyle-related risk factors in combination with serum anti-Helicobacter pylori antibody titres and pepsinogen I and pepsinogen II levels. Based on the resulting model, cumulative probability estimates were calculated and a simple risk scoring system was developed. A total of 412 cases of gastric cancer occurred during 270,854 person-years of follow-up. The final model included (besides the biological markers) age, gender, smoking status, family history of gastric cancer and consumption of highly salted food. The developed prediction model showed good predictive performance in terms of discrimination (optimism-corrected c-index: 0.768) and calibration (Nam and d'Agostino's χ(2) test: 14.78; p values = 0.06). Estimates of the 10-year probability of gastric cancer occurrence ranged from 0.04% (0.02, 0.1) to 14.87% (8.96, 24.14) for men and from 0.03% (0.02, 0.07) to 4.91% (2.71, 8.81) for women. In conclusion, we developed a risk prediction model for gastric cancer that combines clinical and biological markers. It might prompt individuals to modify their lifestyle habits, attend regular check-up visits or participate in screening programmes.
Choi, Moonjung; Kim, Sung Soo
Although numerous population-based studies have reported the prevalences and risk factors for pterygium, information regarding the incidence of pterygium is scarce. This population-based cohort study aimed to evaluate the South Korean incidence and prevalence of pterygium. We retrospectively obtained data from a nationally representative sample of 1,116,364 South Koreans in the Korea National Health Insurance Service National Sample Cohort (NHIS-NSC). The associated sociodemographic factors were evaluated using multivariable Cox regression analysis, and the hazard ratios and confidence intervals were calculated. Pterygium was defined based on the Korean Classification of Diseases code, and surgically removed pterygium was defined as cases that required surgical removal. We identified 21,465 pterygium cases and 8,338 surgically removed pterygium cases during the study period. The overall incidences were 2.1 per 1,000 person-years for pterygium and 0.8 per 1,000 person-years for surgically removed pterygium. Among subjects who were ≥40 years old, the incidences were 4.3 per 1,000 person-years for pterygium and 1.7 per 1,000 person-years for surgically removed pterygium. The overall prevalences were 1.9% for pterygium and 0.6% for surgically removed pterygium, and the prevalences increased to 3.8% for pterygium and 1.4% for surgically removed pterygium among subjects who were ≥40 years old. The incidences of pterygium decreased according to year. The incidence and prevalence of pterygium were highest among 60–79-year-old individuals. Increasing age, female sex, and living in a relatively rural area were associated with increased risks of pterygium and surgically removed pterygium in the multivariable Cox regression analysis. Our analyses of South Korean national insurance claims data revealed a decreasing trend in the incidence of pterygium during the study period. PMID:28346495
Lim, Tae-Seok; Yun, Jae-Seung; Cha, Seon-Ah; Song, Ki-Ho; Yoo, Ki-Dong; Ahn, Yu-Bae; Park, Yong-Moon; Ko, Seung-Hyun
Background/Aims Elevated lipoprotein(a) (Lp[a]) level is known to be a risk factor for cardiovascular disease (CVD). However, the data that has been reported on the association between the Lp(a) level and CVD in type 2 diabetes has been limited and incoherent. The aim of this study was to investigate the relationship between the Lp(a) concentration and new onset CVD in type 2 diabetes. Methods From March 2003 to December 2004, patients with type 2 diabetes without a prior history of CVD were consecutively enrolled. CVD was defined as the occurrence of coronary artery disease or ischemic stroke. Cox proportional hazards models were used to identify the associations between the Lp(a) and CVD after adjusting for confounding variables. Results Of the 1,183 patients who were enrolled, 833 participants were evaluated with a median follow-up time of 11.1 years. A total of 202 participants were diagnosed with CVD (24.2%). The median Lp(a) level for 1st and 4th quartile group was 5.4 (3.5 to 7.1) and 55.7 mg/dL (43.1 to 75.3). Compared with patients without CVD, those with CVD were older, had a longer duration of diabetes and hypertension, and used more insulin and angiotensin converting enzyme inhibitors/angiotensin receptor blockers at baseline. A Cox hazard regression analysis revealed that the development of CVD was significantly associated with serum Lp(a) level (hazard ratio, 1.92; 95% confidence interval [CI], 1.26 to 2.92; p < 0.001, comparing the 4th vs. 1st quartile of Lp[a]). Conclusions Elevated Lp(a) level was an independent predictable risk factor for CVD in type 2 diabetes. Other cardiovascular risk factors should be treated more intensively in type 2 diabetic patients with high Lp(a) levels. PMID:27756118
Hamai, Satoshi; Nakashima, Yasuharu; Mashima, Naohiko; Yamamoto, Takuaki; Kamada, Tomomi; Motomura, Goro; Imai, Hiroshi; Fukushi, Jun-Ichi; Miura, Hiromasa; Iwamoto, Yukihide
No previous studies comparing the clinical wear rates of the two different kinds of cross-linked ultra-high-molecular-weight polyethylene (XLPE), annealed and remelted, are available. We compared the creep and steady wear rates of 36 matched pairs (72 hips in total) adjusting for baseline characteristics with propensity score matching techniques. Zirconia femoral heads with 26-mm diameter were used in all cases. The femoral-head cup penetration was measured digitally on radiographs. Significantly greater creep (p=0.006) was detected in the remelted (0.234mm) than annealed (0.159mm) XLPE. However, no significant difference (p=0.19) was found between the steady wear rates (0.003 and 0.008mm/year, respectively) of the annealed and remelted XLPE. Multiple regression analyses showed that remelted XLPE is significant independent variable (p<0.001) that is positively associated with creep. However, the patient age and body weight, cup size, the liner thickness, cup inclination, follow-up periods, and postoperative Merle d'Aubigné hip score had no significant effects (p>0.05) on the steady wear rates. No patients exhibited above the osteolysis threshold of 0.1mm/year, progressive radiolucencies, osteolysis, or polyethylene fracture. This propensity-matched cohort study document no significant difference in wear resistant performances of annealed and remelted XLPE over an average period of 10 years.
Hiatt, Keith L.; Rash, Clarence E.; Watters, Raymond W.; Adams, Mark S.
A collaborative occupational health study has been undertaken by Headquarters Army Aviation, Middle Wallop, UK, and the U.S. Army Aeromedical Research Laboratory, Fort Rucker, Alabama, to determine if the use of the Integrated Helmet and Display Sighting System (IHADSS) monocular helmet-mounted display (HMD) in the Apache AH Mk 1 attack helicopter has any long-term (10-year) effect on visual performance. The test methodology consists primarily of a detailed questionnaire and an annual battery of vision tests selected to capture changes in visual performance of Apache aviators over their flight career (with an emphasis on binocular visual function). Pilots using binocular night vision goggles serve as controls and undergo the same methodology. Currently, at the midpoint of the study, with the exception of a possible colour discrimination effect, there are no data indicating that the long-term use of the IHADSS monocular HMD results in negative effects on vision.
Somers, Julian M; Moniruzzaman, Akm; Rezansoff, Stefanie N
Objectives Little research has investigated the role of migration as a potential contributor to the spatial concentration of homeless people with complex health and social needs. In addition, little is known concerning the relationship between possible migration and changes in levels of service use over time. We hypothesised that homeless, mentally ill individuals living in a concentrated urban setting had migrated from elsewhere over a 10-year period, in association with significant increases in the use of public services. Setting Recruitment was concentrated in the Downtown Eastside neighbourhood of Vancouver, Canada. Participants Participants (n=433) met criteria for chronic homelessness and serious mental illness, and provided consent to access administrative data. Methods Linked administrative data were used to retrospectively examine geographic relocation as well as rates of health, justice, and social welfare service utilisation in each of the 10 years prior to recruitment. Generalised estimating equations were used to estimate the effect of migration on service use. Results Over a 10-year period there was significant movement into Vancouver's Downtown Eastside neighbourhood (from 17% to 52% of the cohort). During the same period, there were significant annual increases in community medical services (adjusted rate ratio (ARR) per year=1.08; 95% CI 1.06 to 1.10), hospital admissions (ARR=1.08; 95% CI 1.04 to 1.11), criminal convictions (ARR=1.08; 95% CI 1.03 to 1.13), and financial assistance payments (ARR=1.04; 95% CI 1.03 to 1.06). Migration was significantly associated with financial assistance, but not with other types of services. Conclusions Significant increases in service use over a 10-year period coincided with significant migration into an urban area where relevant services were concentrated. These results highlight opportunities for early intervention in spatially diverse neighbourhoods to interrupt trajectories marked by worsening health and
Background The association between self-rated health (SRH) and mortality is well documented in the literature, but studies on the subject among young adults in Latin America are rare, as are those evaluating this association using repeated SRH measures, beyond the baseline measurement. This study aims to evaluate the association between SRH evaluated at three data collection stages and mortality. Methods Cox regression models were used to examine the association between SRH (Very good, Good, Fair/Poor) varying over time and mortality, over a 10 year period, in a cohort of non-faculty civil servants at a public university in Rio de Janeiro, Brazil (Pró-Saúde Study, n = 4009, men = 44.4%). Results About 40% of the population changed their self-rating over the course of follow-up. After adjustment for self-reported physician-diagnosed chronic diseases and other covariates, men who reported “Fair/Poor” SRH showed relative hazard of death of 2.13 (CI95% 1.03-4.40) and women, 3.43 (CI95% 1.23-9.59), as compared with those who reported “Very good” SRH. Conclusions In a population of young adults, our findings reinforce the role of SRH as a predictor of mortality, even controlling for objective measures of health. PMID:22905737
Bhaskaran, Krishnan; Edwards, Emma; Lee, Helen; Chaturvedi, Nishi; Smeeth, Liam; Douglas, Ian
Objectives To describe trends in the incidence and prevalence of diabetic retinopathy (DR) in the UK by diabetes type, age, sex, ethnicity, deprivation, region and calendar year. Design Cohort study using the Clinical Practice Research Datalink (CPRD). Setting UK primary care. Participants 7.7 million patients ≥12 contributing to the CPRD from 2004 to 2014. Primary and secondary outcome measures Age-standardised prevalence and incidence of diabetes, DR and severe DR (requiring photocoagulation) by calendar year and population subgroup. Relative risk of developing DR and severe DR by population subgroup. Results The prevalence of DR was 48.4% in the population type 1 diabetes mellitus (T1DM) (14 846/30 657) and 28.3% (95 807/338 390) in the population with type 2 diabetes mellitus (T2DM). Prevalence of DR remained stable in people with T2DM and decreased in people with T1DM. Screening for DR increased over time for patients with T2DM and remained static for patients with T1DM Incidence of DR increased in parallel with the incidence of T2DM in both diabetic populations. Among patients with T2DM, relative risk of DR varied significantly by region, was increased for older age groups and in men compared with women, with risk of severe DR increased in South Asian groups and more deprived groups. Relative risk of DR for patients with T1DM varied by age and region, but not by gender, ethnic group or deprivation. Conclusions This is the largest study to date examining the burden of DR in the UK. Regional disparities in incidence may relate to differences in screening delivery and disease ascertainment. Evidence that deprivation and ethnicity are associated with a higher risk of severe DR highlights a significant potential health inequality. Findings from this study will have implications for professionals working in the diabetes and sight loss sectors, particularly to inform approaches for diagnosis of retinopathy and campaigning to better tackle the disease for
Li, Hui; Cui, Ying; Zhu, Yanan; Yan, Haiying; Xu, Wenge
This study aimed to determine the association between the clinical reference range of serum glycated hemoglobin A1c (HbA1c) and thyrotropin (TSH) and the risk of coronary heart disease (CHD) in non-diabetic and euthyroid patients. We examined baseline HbA1c and TSH in 538 healthy participants, and then analyzed the associations and potential value of these indicators for predicting CHD using Cox proportional hazard and support vector machine analyses. During the median follow-up of 120 months, 39 participants later developed CHD. The baseline HbA1c and TSH within the reference range were positively associated with CHD risk. No correlation and interaction were found between the baseline HbA1c and TSH for the development of CHD. Disease event-free survival varied among participants with different baseline HbA1c quintiles, whereas disease event-free survival was similar for different TSH tertiles. The combination of these baselines showed sensitivity of 87.2%, specificity of 92.7%, and accuracy of 92.3% for identifying the participants who will later develop CHD. Relatively high but clinically normal HbA1c and TSH levels may increase the risk of CHD. Therefore, the combination of these indicators can serve as a biomarker for identifying healthy individuals from those who would later develop CHD. PMID:28345646
Li, Hui; Cui, Ying; Zhu, Yanan; Yan, Haiying; Xu, Wenge
This study aimed to determine the association between the clinical reference range of serum glycated hemoglobin A1c (HbA1c) and thyrotropin (TSH) and the risk of coronary heart disease (CHD) in non-diabetic and euthyroid patients. We examined baseline HbA1c and TSH in 538 healthy participants, and then analyzed the associations and potential value of these indicators for predicting CHD using Cox proportional hazard and support vector machine analyses. During the median follow-up of 120 months, 39 participants later developed CHD. The baseline HbA1c and TSH within the reference range were positively associated with CHD risk. No correlation and interaction were found between the baseline HbA1c and TSH for the development of CHD. Disease event-free survival varied among participants with different baseline HbA1c quintiles, whereas disease event-free survival was similar for different TSH tertiles. The combination of these baselines showed sensitivity of 87.2%, specificity of 92.7%, and accuracy of 92.3% for identifying the participants who will later develop CHD. Relatively high but clinically normal HbA1c and TSH levels may increase the risk of CHD. Therefore, the combination of these indicators can serve as a biomarker for identifying healthy individuals from those who would later develop CHD.
Choi, Jin Bong; Moon, Hyong Woo; Park, Young Hyun; Bae, Woong Jin; Cho, Hyuk Jin; Hong, Sung-Hoo; Lee, Ji Youl; Kim, Sae Woong; Han, Kyung-Do; Ha, U-Syn
Purpose: We examined the association between obesity and prostate cancer both with and without diabetic patients included in the analysis using nationally representative data of the Korean population from the National Health Insurance System (NHIS). Materials and Methods: Of the 424,712 participants who underwent health examinations in 2002-2008, 139,519 men ≥40 years old and without prostate cancer were followed from the beginning of 2002 to the end of 2012. Multivariate adjusted Cox regression analysis was conducted to examine the hazard ratio (HR) and 95% confidence interval (CI) for the association between prostate cancer and body mass index (BMI) both with and without diabetes. Results: The HR for prostate cancer according to the existence of diabetes was stratified by BMI in both age- and multivariable-adjusted models. In the population without diabetes, the HR for prostate cancer significantly increased as BMI increased beyond the reference range in a model adjusted for age and multiple variables; however, the increase in the HR was small. In the population with diabetes, the HR for prostate cancer significantly increased as BMI increased from < 18.5 kg/m2 to within the reference range (18.5 to 22.9) in the multivariable-adjusted model. In addition, a marked decrease in HR in the population with BMI of < 18.5 kg/m2 was seen compared to the reference or higher BMI population. Conclusion: This population-based study shows the evidence of association between obesity and development of prostate cancer, and the risk increases vary according to the change of BMI category and the existence of diabetes. PMID:27877221
Richards, Tara N; Jennings, Wesley G; Tomsich, Elizabeth; Gover, Angela
In this study, survival analysis is used to examine time to rearrest for both domestic violence and nondomestic violence crimes among a cohort of domestic violence offenders (N = 286) over a 10-year period. In addition, risk factors for rearrest such as demographic, offending history, and batterer treatment variables are examined to determine their influence on domestic and nondomestic violence recidivism. Overall, the results suggest that approximately half of domestic violence offenders are rearrested. Furthermore, among those who are rearrested, they are rearrested fairly quickly and for generalized (both domestic and nondomestic violence offenses) versus specialized offending. Risk factors associated with both types of rearrest included age, marriage, and domestic violence offense history. Several additional risk factors were unique to rearrest type. Study limitations are explicitly stated and policy implications are discussed.
Stanford, Joseph B.; Murtaugh, Maureen A.; Greenwood, Jessica L.J.; Gren, Lisa H.; Hegmann, Kurt T.; Thiese, Matthew S.
Objective To ascertain worker health characteristics and psychosocial factors associated with changes in body weight and total cholesterol (TC) among two production operation populations. Methods We performed descriptive and predictive analysis of questionnaire data and biomedical measurements from two prospective cohort studies. Our key outcomes were changes in weight, and TC over 5–10 years between baseline and exit assessments. Results 146 subjects were analyzed. Increases in weight were associated with belief in being overweight and baseline overweight and obesity. Increases in TC levels were associated with female gender, belief that TC levels were “not good,” and feeling depressed. Conclusion Most of the reported associations with increases in weight and TC levels are amenable to interventions and may be a target for workplace intervention programs. PMID:26147542
Svefors, Pernilla; Rahman, Anisur; Ekström, Eva-Charlotte; Khan, Ashraful Islam; Lindström, Emma; Persson, Lars Åke; Ekholm Selling, Katarina
Background Few studies in low-income settings analyse linear growth trajectories from foetal life to pre-adolescence. The aim of this study is to describe linear growth and stunting from birth to 10 years in rural Bangladesh and to analyse whether maternal and environmental determinants at conception are associated with linear growth throughout childhood and stunting at 10 years. Methods and Findings Pregnant women participating in the MINIMat trial were identified in early pregnancy and a birth cohort (n = 1054) was followed with 19 growth measurements from birth to 10 years. Analyses of baseline predictors and mean height-for-age Z-scores (HAZ) over time were modelled using GLMM. Logistic regression analysis was used to investigate the associations between baseline predictors and stunting (HAZ<-2) at 10 years. HAZ decreased to 2 years, followed by an increase up to 10 years, while the average height-for-age difference in cm (HAD) to the WHO reference median continued to increase up to 10 years. Prevalence of stunting was highest at 2 years (50%) decreasing to 29% at 10 years. Maternal height, maternal educational level and season of conception were all independent predictors of HAZ from birth to pre-adolescence (p<0.001) and stunting at 10 years. The highest probability to be stunted at 10 years was for children born by short mothers (<147.5 cm) (ORadj 2.93, 95% CI: 2.06–4.20), mothers with no education (ORadj 1.74, 95% CI 1.17–2.81) or those conceived in the pre-monsoon season (ORadj 1.94, 95% CI 1.37–2.77). Conclusions Height growth trajectories and prevalence of stunting in pre-adolescence showed strong intergenerational associations, social differentials, and environmental influence from foetal life. Targeting women before and during pregnancy is needed for the prevention of impaired child growth. PMID:26934484
Kehoe, S. H.; Krishnaveni, G. V.; Veena, S. R.; Hill, J. C.; Osmond, C.; Kiran; Coakley, P.; Karat, S. C.; Fall, C. H. D.
There is evidence of a reduction in children’s physical activity in India in the last decade. Our objective was to assess whether size and body composition at birth are associated with physical activity in school-aged children. Children from a prospective observational cohort study born in Mysore, South India between 1997 and 1998 (n = 663) had neonatal anthropometric measurements made within 72 h of delivery [weight, mid-upper arm circumference (MUAC), chest, abdomen and head circumference, crown–heel, crown–buttock and leg length, triceps and subscapular skinfolds]. At 6–10 years, children (n = 449) were asked to wear AM7164 or GT1M Actigraph accelerometers for 7 days. Body composition was measured within 6 months of activity monitoring. Arm muscle area at birth and time of activity monitoring was calculated from MUAC and skinfold measurements. Activity outcome measures were: mean accelerometer counts per minute (cpm); counts per day and proportion of time spent in moderate and vigorous activity. The mean (S.D.) number of days with ≥500 min of recorded accelerometer data was 7.0 (1.1). Linear regression models showed no significant associations between any of the neonatal anthropometric measures and the activity variables. Body fat percentage at 7.5 years was negatively associated with all activity variables (B = −4.69, CI: −7.31, −2.07 for mean cpm). In conclusion, this study showed no associations between body size and skinfold thickness at birth and objectively measured physical activity in childhood. PMID:24098836
Nong, Qingjiao; Zhang, Yiyi; Guallar, Eliseo; Zhong, Qiuan
This study was to evaluate the association of urine arsenic with predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk in U.S. adults with hypertension. Cross-sectional analysis was conducted in 1570 hypertensive adults aged 40–79 years in the 2003–2012 National Health and Nutrition Examination Survey (NHANES) with determinations of urine arsenic. Predicted 10-year ASCVD risk was estimated by the Pooled Cohort Equations, developed by the American College of Cardiology/American Heart Association in 2013. For men, after adjustment for sociodemographic factors, urine dilution, ASCVD risk factors and organic arsenic intake from seafood, participants in the highest quartiles of urine arsenic had higher 10-year predicted ASCVD risk than in the lowest quartiles; the increases were 24% (95% confidence interval (CI): 2%, 53%) for total arsenic, 13% (95% CI: 2%, 25%) for dimethylarsinate and 22% (95% CI: 5%, 40%) for total arsenic minus arsenobetaine separately. For women, the corresponding increases were 5% (95% CI: −15%, 29%), 10% (95% CI: −8%, 30%) and 0% (95% CI: −15%, 19%), respectively. Arsenic exposure, even at low levels, may contribute to increased ASCVD risk in men with hypertension. Furthermore, our findings suggest that particular circumstances need urgently to be considered while elucidating cardiovascular effects of low inorganic arsenic levels. PMID:27828001
Schiros, Chun G; Denney, Thomas S; Gupta, Himanshu
Objectives To evaluate the individual and interacting impacts of the continuous variables (age, total cholesterol (total-C), high-density lipoprotein cholesterol (HDL-C) and systolic blood pressure(BP)) on 10-year atherosclerotic cardiovascular disease (ASCVD) risk and better understand the pattern of predicted 10-year risk with change of each variable using recently published new pooled cohort equations. Design Simulation analysis was performed across the whole range of the boundary limits suggested for the continuous variables for groupings based on race and gender in the pooled cohort 10-year risk equations. Setting Computer-based simulation analysis. Participants Data were generated by simulation using prespecified variable ranges. Intervention Data simulation and visual display of the hazard analysis. Main outcome measures Interactions of age with other variables were analysed using multidimensional visualisation and hazard analysis. Results In African–American females, due to the interaction of age with HDL-C, treated BP and untreated BP, increasing age may not always increase 10-year risk. Furthermore, in the same cohort, increasing HDL-C level may result in higher 10-year risk for older individuals. For Caucasian females, due to square of Ln (age) term in the equation, the age-risk curve does not monotonically increase with age. The vertex is within the given age range of 40–79 years for a certain range of total-C and HDL-C, indicating that age may not always result in increased predicted 10-year risk. Conclusions The new pooled cohort equations are sophisticated as they take into account the interactions of the continuous variables in predicting 10-year risk. We find situations where the estimated 10-year risk does not follow the general secular trends. The impact of such interesting patterns may be substantial and therefore further exploration is needed as it has direct implications in clinical management for primary prevention. PMID:25941176
This article examines the methods and dynamics of packaging multiple sources of wage and nonwage income as a means of making ends meet over a 10-year period among a sample of displaced steelworkers who lost jobs as a result of plant closings in the 1980s and then experienced extensive downward mobility. The study tracked changes in the respondents' income and employment over a decade, the dynamics of their use of social services, their pooling of a variety of income sources, and the use of social assistance to supplement low wages. The study found that among this sample income packaging was a universal economic strategy and that use of social services did not affect later employment and earnings.
Jang, Yong Hyun; Park, Kyung Hea; Kim, Sang Lim; Lim, Hyun Jung; Lee, Weon Ju; Lee, Seok-Jong
Background Alopecia areata (AA) is an organ-specific autoimmune disease that typically occurs in young adults. AA in the elderly is relatively rare, thus little data have been reported. Objective This study aimed to understand the clinical characteristics of AA in the elderly. Methods We performed a 10-year retrospective study of AA in the elderly who visited our dermatologic clinic from January 2002 to December 2011. A clinical review of medical records and telephone interviews were performed by two dermatologists. Results Among 1,761 patients with newly diagnosed AA, 61 (3.5%) were older than 60 years at the first visit. Among those who completed a telephone interview, 74.3% (26/35) had less than 50% of scalp-localized hair loss. There was no association between the extent of AA and hair graying (p=0.679). Favorable therapeutic response was observed in 62.9% (22/35) of cases. Conclusion AA in the elderly shows mild disease severity and favorable treatment response. There is no association between graying and the extent of AA. However, the influence of aging on the pathogenesis of AA in the elderly deserves further investigation. PMID:26273157
Lima-Costa, M. Fernanda; Macinko, James; Mambrini, Juliana Vaz de Melo; Cesar, Cibele C.; Peixoto, Sérgio V.; Magalhães, Wagner C. S.; Horta, Bernardo L.; Barreto, Mauricio; Castro-Costa, Erico; Firmo, Josélia O. A.; Proietti, Fernando A.; Leal, Thiago Peixoto; Rodrigues, Maira R.; Pereira, Alexandre; Tarazona-Santos, Eduardo
Background Self-rated health (SRH) has strong predictive value for mortality in different contexts and cultures, but there is inconsistent evidence on ethnoracial disparities in SRH in Latin America, possibly due to the complexity surrounding ethnoracial self-classification. Materials/Methods We used 370,539 Single Nucleotide Polymorphisms (SNPs) to examine the association between individual genomic proportions of African, European and Native American ancestry, and ethnoracial self-classification, with baseline and 10-year SRH trajectories in 1,311 community dwelling older Brazilians. We also examined whether genomic ancestry and ethnoracial self-classification affect the predictive value of SRH for subsequent mortality. Results European ancestry predominated among participants, followed by African and Native American (median = 84.0%, 9.6% and 5.3%, respectively); the prevalence of Non-White (Mixed and Black) was 39.8%. Persons at higher levels of African and Native American genomic ancestry, and those self-identified as Non-White, were more likely to report poor health than other groups, even after controlling for socioeconomic conditions and an array of self-reported and objective physical health measures. Increased risks for mortality associated with worse SRH trajectories were strong and remarkably similar (hazard ratio ~3) across all genomic ancestry and ethno-racial groups. Conclusions Our results demonstrated for the first time that higher levels of African and Native American genomic ancestry—and the inverse for European ancestry—were strongly correlated with worse SRH in a Latin American admixed population. Both genomic ancestry and ethnoracial self-classification did not modify the strong association between baseline SRH or SRH trajectory, and subsequent mortality. PMID:26680774
Voas, Robert B.; Tippetts, A. Scott; Grosz, Milton
Background Interlocks reduce driving-under-the-influence (DUI) recidivism by 64%, but offenders resist installing them, preferring to risk driving while their driver’s licenses are revoked. One method of motivating offenders to install an interlock is require it for reinstatement of their driver’s license. This report updates an earlier evaluation of the administrative reinstatement interlock program (ARIP) procedure implemented in Florida in 2002. Method Driver records and interlock program records covering 120,000 DUI offenders were followed over 10 years. The flow through the sanction system—conviction, reinstatement, interlock program, and postinterlock period—is described. Logistical regression was used to identify the characteristics of offenders who installed interlocks, and survival analysis was used to evaluate the recidivism of offenders in the various stages in the ARIP. Results At any given time, approximately one third of the convicted offenders were serving their license-revocation periods. Half of the offenders who completed their revocation periods remain unqualified for reinstatement because they do not fulfill other requirements. ARIP offenders who do qualify for reinstatement and install interlocks have lower recidivism rates while the devices are on their vehicles. Conclusions After 10 years, Florida’s ARIP is a mature system that succeeds in forcing all offenders in the program who qualify for reinstatement to install an interlock for at least 6 months. However, half of all offenders who complete their mandatory revocation period are either unable to, or choose not to, qualify for reinstatement. PMID:23442206
Leak, D; Eydt, J N
Over a 10-year period 130 patients with drug-resistant cardiac arrhythmias associated mainly with coronary artery disease and its complications were treated with amiodarone. The drug controlled all the tachyarrhythmias associated with the Wolff-Parkinson-White syndrome, 95% of the ventricular arrhythmias, including recurrent ventricular tachycardia and fibrillation, and 92% of the supraventricular arrhythmias. The maximum duration of therapy was 111 months and the mean 34 months. Side effects occurred in 34% of the patients, and there was one withdrawal from therapy per 15.3 patient-years of treatment. The commonest cause of withdrawal was nausea, which was significantly related (p less than 0.01) to a drug interaction with digoxin and diuretics. Reversible neurologic complications occurred in eight patients (6%), and acute myositis was recognized for the first time. Pulmonary infiltration developed in four patients (3%), who were receiving 600 mg of amiodarone per day. The rates of side effects and of withdrawal from therapy differed significantly between the patients whose maintenance doses were 600 and 200 mg/d, at 59% v. 6% (p less than 0.01) and 32% v. 0% (p less than 0.05) respectively. Thus, amiodarone is a very effective antiarrhythmic that can be administered over long periods with acceptable rates of side effects and withdrawal provided the minimal effective dose is used; 400 mg/d or less is desirable. PMID:3948063
Tan, Ngiap Chuan; Nguyen, Hai V; Lye, Weng Kit; Sankari, Usha; Nadkarni, Nivedita V
Research on asthma costs often focuses on estimating average asthma costs. Trends in asthma costs and patterns of medication use, especially for those who have been followed up and under treatment, have received much less attention. This study's objective was to document asthma costs over time for asthma patients who are enrolled in an asthma care programme in Singapore and to identify its predictors, using a 10-year longitudinal dataset.The study population comprised different cohorts of 939 asthma patients entering the programme at different times during 2004-2013. Average asthma costs were estimated and the trends over time examined graphically, within and across patient cohorts. Regression analyses were conducted to examine cost predictors, with a focus on the relationship between risk factors at programme enrolment and subsequent asthma costs.The results indicate that 10-year average annual asthma cost was GBP 341 per patient. The main drivers of costs were asthma medications and consultation fees. Use of combined inhaled corticosteroid/long-acting β-agonist medications increased over time, but this was accompanied by declines in controller drug use, doctor visits and total asthma drug costs. Obesity, smoking and asthma severity were the main predictors of subsequent asthma costs, especially for females.
Dong, L; Hu, S Y; Zhang, Q; Feng, R M; Zhang, L; Zhao, X L; Ma, J F; Shi, S D; Zhang, X; Pan, Q J; Zhang, W H; Qiao, Y L; Zhao, F H
Objective: To evaluate the dynamic variation of genotypes distribution of human papillomavirus (HPV) over 10-year follow-up in a cervical cancer screening cohort. Methods: Based on the Shanxi Province Cervical Cancer Screening Study Ⅰ cohort, we detected HPV genotypes on the well-preserved exfoliated cervical cells from women who were tested HPV positive from year 2005 to year 2014 using reverse linear probe hybridization assay. The changes of prevalence of type-specific HPV over time among the overall population were estimated using linear mixed models. The association between the type-specific HPV and cervical intraepithelial neoplasia grade 2 or worse (CIN2 +) was calculated by linear Chi-square test. Finally, the trends of multiple infections of HPV with the increase of the age were analyzed. Results: During the cervical cancer screening of the overall population from 2005 to 2014, the most common genotypes among the population were HPV16 and 52. The prevalence of HPV16 decreased over time from 4.6% in 2005 to 2.2% in 2010 and 2014 (F=8.125, P<0.001). The prevalence of HPV52 remained pretty stable and HPV33, 51 and 58 slightly decreased then apparently increased. Further stratification analysis by pathological lesions showed the same trend of the HPV prevalence for the histology normal women with the overall population. Of note, for those women with the cervical intraepithelial neoplasia (CIN2 +), the detection rate of HPV16 decreased from 65.22% in 2005 to 41.03% in 2010 and finally to 31.58% in 2014 (χ(2)=4.420, P=0.036) and that of HPV33 substantially increased. No significant variation was found for other types of HPV. Multiple infection rate varied with the growing age of the women. Conclusions: The genotypes prevalence of HPV tended to vary over time during cervical cancer screening in the context of regular screening combining with immediate treatment for those CIN2 + women. HPV16 prevalence significantly decreased over time, which indicated that the
Luther, Anil; Kumar, Amit; Negi, Kamal Nabh Rai
Peripheral arterial pseudoaneurysms are quite common in Northern India (Punjab Province) and thus a common presenting complaint of varied etiology. The objective of this study was to evaluate the clinical outcome of patients presenting with peripheral arterial pseudoaneurysms of varied etiology. Retrospective analysis of medical records of patients with diagnosis of peripheral arterial pseudoaneurysm from 1 May 2001 to 30 October 2009 was done. In the prospective period from 1 November 2009 to 30 April 2011, the patients were personally examined by the authors and followed up till discharge from the hospital and subsequently at 2 weeks, 1 month, 3 months, and 6 months postdischarge from the hospital. We studied 50 patients (13 in the prospective group and 37 in the retrospective study group). Intravenous drug abuse (26 cases) followed by trauma (nine cases) was the commonest etiology. Femoral artery was the commonest artery involved (37 cases). A pulsatile mass with localized tenderness was the commonest presentation. All patients underwent surgical treatment with 36 (72 %) patients undergoing ligation and excision of the pseudoaneurysm. Six (12 %) patients underwent revascularization with reverse saphenous vein graft. Five (10 %) patients underwent primary repair, and three (6 %) patients were managed by putting a synthetic ePTFE graft. Postoperative wound infection was seen in 18 (36 %) patients, and 33 (66 %) patients had an uneventful recovery. In pseudoaneurysms, surgical repair at the early instance carries a favorable prognosis. If feasible, reverse saphenous vein grafting is the best conduit for repair. Synthetic vascular graft (ePTFE) can be used in case autologous saphenous vein is not available. Excision and ligation is safe, and we recommend it as the treatment of choice for infected arterial pseudoaneurysms.
Prasher, V.; Gomez, G.
Background: The natural history of thyroid function in adults with Down syndrome (DS) is unknown. Method: This study investigated annual thyroid function tests in 200 adults with DS over a 10-year period. Results: Transient and persistent thyroid dysfunction was common. The 5- and 10-year incidence of definite hypothyroidism was 0.9%-1.64% and…
Munro, Nicholas P.; Sundaram, Subramnian K.; Weston, Philip; Fairley, Lesley; Harrison, Simon C.W.; Forman, David; Chahal, Rohit
Purpose: We have previously reported on the mortality, morbidity, and 5-year survival of 458 patients who underwent radical radiotherapy or surgery for invasive bladder cancer in Yorkshire from 1993 to 1996. We aim to present the 10-year outcomes of these patients and to reassess factors predicting survival. Methods and Materials: The Northern and Yorkshire Cancer Registry identified 458 patients whose cases were subjected to Kaplan-Meier all-cause survival analyses, and a retrospective casenote analysis was undertaken on 398 (87%) for univariate and multivariate Cox proportional hazards modeling. Additional proportional hazards regression modeling was used to assess the statistical significance of variables on overall survival. Results: The ratio of radiotherapy to cystectomy was 3:1. There was no significant difference in overall 10-year survival between those who underwent radiotherapy (22%) and radical cystectomy (24%). Univariate analyses suggested that female sex, performance status, hydronephrosis and clinical T stage, were associated with an inferior outcome at 10 years. Patient age, tumor grade, treatment delay, and caseload factors were not significant. Multivariate analysis models were created for 0-2 and 2-10 years after treatment. There were no significant differences in treatment for 0-2 years; however, after 2 years follow-up there was some evidence of increased survival for patients receiving surgery compared with radiotherapy (hazard ratio 0.66, 95% confidence interval: 0.44-1.01, p = 0.06). Conclusions: a 10-year minimum follow-up has rarely been reported after radical treatment for invasive bladder cancer. At 10 years, there was no statistical difference in all-cause survival between surgery and radiotherapy treatment modalities.
Castillo, Jose M.; Curtis, Michael J.; Tan, Sim Yin
Concerns regarding whether a sufficient supply of school psychologists exists have been evident for decades. Studies have predicted that school psychology would face a critical personnel shortage that would peak in 2010, but continue into the foreseeable future. The current study is a 10-year follow-up investigation based on previously published…
Pechter, Ülle; Raag, Mait; Ots-Rosenberg, Mai
Chronic kidney disease (CKD) patients not yet in dialysis can benefit from increased physical activity; however, the safety and outcomes of aquatic exercise have not been investigated in observational studies. The aim of this study was to analyze association of 10 years of regularly performed aquatic exercise with the study endpoint--that is, all-cause death or start of dialysis. Consecutive CKD patients were included in the study in January 2002. The exercise group (n=7) exercised regularly under the supervision of physiotherapist for 10 years; the control group (n=9), matched in terms of age and clinical parameters, remained sedentary. Low-intensity aerobic aquatic exercise was performed regularly twice a week; 32 weeks or more of exercise therapy sessions were conducted annually. None of the members of the aquatic exercise group reached dialysis or died in 10 years. In the sedentary control group, 55% reached the study endpoint--renal replacement therapy (n=2) or all-cause death (n=3). Occurrence of the study endpoint, compared using the exact multinomial test with unconditional margins, was statistically significantly different (P-value: 0.037) between the study groups. Regular supervised aquatic exercise arrested CKD progression. There was a statistically significant difference between the sedentary group and the exercise group in reaching renal replacement therapy or all-cause death in a follow-up time of 10 years.
Al-Eyadhy, Ayman A.; Temsah, Mohamad-Hani; Alhaboob, Ali A. N.; Aldubayan, Abdulmalik K.; Almousa, Nasser A.; Alsharidah, Abdulrahman M.; Alangari, Mohammed I.; Alshaya, Abdulrahman M.
OBJECTIVES: To describe the change in the management, and outcome of children with acute severe asthma (ASA) admitted to Pediatric Intensive Care Unit (PICU) at tertiary institute, as compared to previously published report in 2003. METHODS: This is a retrospective observational study. All consecutive pediatric ASA patients who were admitted to PICU during the study period were included. The data were extracted from PICU database and medical records. The Cohort in this study (2013 Cohort) was compared with the Cohort of ASA, which was published in 2003 from the same institution (2003 Cohort). RESULTS: In comparison to previous 2003 Cohort, current Cohort (2013) revealed higher mean age (5.5 vs. 3.6 years; P ≤ 0.001), higher rate of PICU admission (20.3% vs. 3.6%; P ≤ 0.007), less patients who received maintenance inhaled steroids (43.3% vs. 62.4%; P ≤ 0.03), less patients with pH <7.3 (17.9% vs. 42.9%; P ≤ 0.001). There were more patients in 2013 Cohort who received: Inhaled Ipratropium bromide (97% vs. 68%; P ≤ 0.001), intravenous magnesium sulfate (68.2% vs. none), intravenous salbutamol (13.6% vs. 3.6%; P ≤ 0.015), and noninvasive ventilation (NIV) (35.8% vs. none) while no patients were treated with theophylline (none vs. 62.5%). The median length of stay (LOS) was 2 days while mean LOS was half a day longer in the 2013 Cohort. None of our patients required intubation, and there was no mortality. CONCLUSION: We observed slight shift toward older age, considerably increased the rate of PICU admission, increased utilization of Ipratropium bromide, magnesium sulfate, and NIV as important modalities of treatment. PMID:26664561
Mehta, Supriya D.; Donovan, Brock; Weber, Kathleen M.; Cohen, Mardge; Ravel, Jacques; Gajer, Pawel; Gilbert, Douglas; Burgad, Derick; Spear, Greg T.
Background We identified predominant vaginal microbiota communities, changes over time, and how this varied by HIV status and other factors in a cohort of 64 women. Methods Bacterial DNA was extracted from reposited cervicovaginal lavage samples collected annually over an 8–10 year period from Chicago Women’s Interagency HIV Study participants: 22 HIV-negative, 22 HIV-positive with stable infection, 20 HIV-positive with progressive infection. The vaginal microbiota was defined by pyrosequencing of the V1/V2 region of the 16S rRNA gene. Scheduled visits included Bacterial vaginsosis (BV) screening; clinically detected cases were referred for treatment. Hierarchical clustering identified bacterial community state types (CST). Multinomial mixed effects modeling determined trends over time in CST, by HIV status and other factors. Results The median follow-up time was 8.1 years (range 5.5–15.3). Six CSTs were identified. The mean relative abundance (RA) of Lactobacillus spp. by CST (with median number of bacterial taxa) was: CST-1–25.7% (10), CST-2–27.1% (11), CST-3–34.6% (9), CST-4–46.8% (9), CST-5–57.9% (4), CST-6–69.4% (2). The two CSTs representing the highest RA of Lactobacillus and lowest diversity increased with each additional year of follow-up (CST-5, adjusted odds ratio (aOR) = 1.62 [95% CI: 1.34–1.94]; CST-6, aOR = 1.57 [95 CI: 1.31–1.89]), while the two CSTs representing lowest RA of Lactobacillus and higher diversity decreased with each additional year (CST-1, aOR = 0.89 [95% CI: 0.80–1.00]; CST-2, aOR = 0.86 [95% CI: 0.75–0.99]). There was no association between HIV status and CST at baseline or over time. CSTs representing lower RA of Lactobacillus were associated with current cigarette smoking. Conclusions The vaginal microbial community significantly improved over time in this cohort of women with HIV and at high risk for HIV who had regular detection and treatment referral for BV. PMID:25675346
Reininghaus, Ulrich; Dutta, Rina; Dazzan, Paola; Doody, Gillian A; Fearon, Paul; Lappin, Julia; Heslin, Margaret; Onyejiaka, Adanna; Donoghue, Kim; Lomas, Ben; Kirkbride, James B; Murray, Robin M; Croudace, Tim; Morgan, Craig; Jones, Peter B
The excess mortality in people with psychotic disorders is a major public health concern, but little is known about the clinical and social risk factors which may predict this health inequality and help inform preventative strategies. We aimed to investigate mortality in a large epidemiologically characterized cohort of individuals with first-episode psychosis compared with the general population and to determine clinical and social risk factors for premature death. All 557 individuals with first-episode psychosis initially identified in 2 areas (Southeast London and Nottinghamshire, United Kingdom) were traced over a 10-year period in the ӔSOP-10 study. Compared with the general population, all-cause (standardized mortality ratio [SMR] 3.6, 95% confidence interval [CI] 2.6-4.9), natural-cause (SMR 1.7, 95% CI 1.0-2.7) and unnatural-cause (SMR 13.3, 95% CI 8.7-20.4) mortality was very high. Illicit drug use was associated with an increased risk of all-cause mortality (adj. rate ratio [RR] 2.31, 95% CI 1.06-5.03). Risk of natural-cause mortality increased with a longer time to first remission (adj. RR 6.61, 95% CI 1.33-32.77). Family involvement at first contact strongly reduced risk of unnatural-cause mortality (adj. RR 0.09, 95% CI 0.01-0.69). Our findings suggest that the mortality gap in people with psychotic disorders remains huge and may be wider for unnatural-cause mortality than previously reported. Efforts should now focus on further understanding and targeting these tractable clinical and social risk factors of excess mortality. Early intervention and dual diagnosis services may play a key role in achieving more rapid remission and carer involvement and addressing substance use problems to reduce excess mortality in psychosis.
Vohra, P K; Giorgini, R J; Sobel, E; Japour, C J; Villalba, M A; Rostkowski, T
A comparative retrospective study of 48 open heel spur surgeries and 20 endoscopic plantar fasciotomies was conducted involving 59 patients over a 10-year period. There was a significant reduction in heel pain at the time of follow-up (average, 3 years) for both groups. Overall, 85% of procedures were associated with patient satisfaction with the results, and patients said that they would recommend heel spur surgery for relief of severe heel pain in 94% of cases. Factors influencing the postoperative outcome, such as duration of preoperative symptoms, extent of conservative care, and obesity, are discussed.
Teta, M J; Benson, L O; Vitale, J N
Men assigned to units producing ethylene oxide by the chlorohydrin or direct oxidation processes and to other departments using ethylene oxide in two chemical plants were followed up for mortality from 1940 to 1988 (n = 1896). Based on findings from a previous study of these workers to the end of 1978, which identified confounding exposures, workers assigned to one unit with low ethylene oxide exposure potential were excluded (n = 278). Average duration of exposure was over five years and average follow up was 27 years, with all subjects at least 10 years from first exposure. The data did not support associations of ethylene oxide with all cancer types combined, leukaemia, non-Hodgkin's lymphoma, or brain, pancreatic, or stomach cancers. There were also no duration-response trends. The standardised mortality ratio (SMR) for total cancer was 86 (95% confidence interval 71-104) and did not increase for those hired the earliest and with long duration assignments. The results of this 10 year update and those of other recent studies of ethylene oxide workers do not confirm findings from animal studies and are not consistent with the earliest results reported among ethylene oxide workers. PMID:8398856
García-Ruiz, Pedro J; Del Val, Javier; Fernández, Ignacio Mahillo; Herranz, Antonio
The causes and mechanism behind motor complications in Parkinson disease (PD) are still a subject of debate. Several factors including age at onset, evolution in years, and initial medication can influence the onset and severity of motor complications in PD.We studied patients with recent diagnosis of PD who were followed up prospectively for 10 years. Analysis included the progression of these patients, as measured by the Unified Parkinson Disease Rating Scale scores and the presence of motor complications (motors fluctuations, dyskinesias, and gait freezing) over time. The patient group was studied as a whole and by subgroups classified according to age at onset, initial treatment, and sex.By the end of the first decade, most patients exhibited dyskinesias (91%), motor fluctuations (62%), and freezing of gait (68%). An association was found between several patients' characteristics and presence of motor complications by 5 years, though not after 10 years of follow up. The apparition of motor fluctuations was mainly related to initial treatment (odds ratio [OR], 3.87). The development of dyskinesias was linked to initial treatment (OR, 8.31), age at onset (OR, 0.90), and sex (OR, 12.87).
Liu, Jianghong; Cao, Siyuan; Chen, Zehang; Raine, Adrian; Hanlon, Alexandra; Ai, Yuexian; Zhou, Guoping; Yan, Chonghuai; Leung, Patrick W; McCauley, Linda; Pinto-Martin, Jennifer
The China Jintan Child Cohort study began in 2004 with 1656 pre-school participants and a research focus on studying the impact of environmental exposures, such as lead, on children’s neurobehavioural outcomes. This population cohort now includes around 1000 of the original participants, who have been assessed three times over a period of 10 years. Since the original IJE cohort profile publication in 2010, participants have experienced a critical developmental transition from pre-school to school age and then adolescence. The study has also witnessed an increase in breadth and depth of data collection from the original aim of risk assessment. This cohort has added new directions to investigate the mechanisms and protective factors for the relationship between early health factors and child physical and mental health outcomes, with an emphasis on neurobehavioural consequences. The study now encompasses 11 domains, composed of repeated measures of the original variables and new domains of biomarkers, sleep, psychophysiology, neurocognition, personality, peer relationship, mindfulness and family dynamics. Depth of evaluation has increased from parent/teacher report to self/peer report and intergenerational family report. Consequently, the cohort has additional directions to include: (i) classmates of the original cohort participants for peer relationship assessment; and (ii) parental and grandparental measures to assess personality and dynamics within families. We welcome interest in our study and ask investigators to contact the corresponding author for additional information on data acquisition. PMID:26323725
Lipinski, Paul; Knochenmus, Darwin D.
Water needs of the population of Indian Wells Valley, Calif., must be met through further development of ground-water resources. Studies show that annual ground-water pumpage there has increased since 1945 and has exceeded mean annual recharge since 1966. Continued and increased stress on the aquifer system of the valley is expected because population in the valley is predicted to double by 1998 and triple by 2020, based on 1977 population figures. The U.S. Geological Survey proposes a 10-year program to develop a data base to aid in evaluation of future water-management alternatives. A study plan has been developed that describes present and potential problems and objectives of the program, and outlines work items to be undertaken in the study area. (USGS)
Ramkumar, Prem N; Farber, Joseph; Arnouk, Johnny; Varner, Kevin E; Mcculloch, Patrick C
Ballet dancers are high-performance athletes who are particularly susceptible to a wide variety of musculoskeletal injuries. However, they are relatively understudied, and data on their injury rates are lacking. This retrospective study features the largest aggregate data on professional ballet dancers to date and aims to identify the most common diagnoses and areas of injury in this unique population to better direct preventative and clinical practices. The study encompassed a 10-year period from January 2000 to December 2010 of dancers from a single company. Data regarding the dancers' age, gender, location of injury, and diagnosis were collected from workers' compensation claims, company records, and medical records maintained by the treating doctors. These were analyzed to determine metrics on injury incidence, frequency, and diagnosis. Over the 10-year span, 574 injuries occurred. There were approximately 52 dancers per year for a total of 153 who danced at least one complete season during the study period. The average age was 27, and 53% were female. Given turnover with retirement and replacements, the total number of dancer-years was 520, indicating an injury incidence per annum of 1.10 (574 injuries per 520 dancer-years). The most common locations of injury were foot and ankle and the lumbar spine, with the three most common diagnoses making up greater than a third (37%) of the total. As the current largest study in professional ballet, the findings set the benchmark metrics for musculoskeletal injury to the foot, ankle, and lumbar spine sites. Future studies should aim to identify injury risk factors and modalities for prevention of these injuries.
Lieneck, Cristian; Nowicki, Michael
A dynamic health care industry continues to call upon health care leaders to possess not one but multiple competencies. Inherent personality characteristics of leaders often play a major role in personal as well as organizational success to include those in health care finance positions of responsibility. A replication study was conducted to determine the Myers-Briggs personality-type differences between practicing health care finance professionals in 2014, as compared with a previous 2003 study. Results indicate a significant shift between both independent samples of health care finance professionals over the 10-year period from original high levels of introversion to that of extraversion, as well as higher sensing personality preferences, as compared with the original sample's high level of intuition preferences. Further investigation into the evolving role of the health care finance manager is suggested, while continued alignment of inherent, personal characteristics is suggested to meet ongoing changes in the industry.
Stojadinović, Saša; Svrkota, Igor; Petrović, Dejan; Denić, Miodrag; Pantović, Radoje; Milić, Vitomir
Mining, especially underground coal mining, has always been a dangerous occupation. Injuries, unfortunately, even those resulting in death, are one of the major occupational risks that all miners live with. Despite the fact that all workers are aware of the risk, efforts must be and are being made to increase the safety of mines. Injury monitoring and data analysis can provide us with valuable data on the causes of accidents and enable us to establish a correlation between the conditions in the work environment and the number of injuries, which can further lead to proper preventive measures. This article presents the data on the injuries in Serbian coal mines during a 10-year period (2000-2009). The presented results are only part of an ongoing study whose aim is to assess the safety conditions in Serbian coal mines and classify them according to that assessment.
Castelnuovo, Barbara; Kiragga, Agnes; Mubiru, Frank; Kambugu, Andrew; Kamya, Moses; Reynolds, Steven J
Introduction The majority of studies from resource-limited settings only report short-term virological outcomes of patients on antiretroviral treatment (ART). We aim to describe the long-term durability of first-line ART and identify factors associated with long-term virological outcomes. Methods At the Infectious Diseases Institute in Kampala, Uganda, 559 adult patients starting ART in 2004 were enrolled into a research cohort and monitored with viral load (VL) testing every six months for 10 years. We report the proportion and cumulative probability of 1) achieving virologic suppression (at least one VL <400 copies/ml); 2) experiencing virologic failure in patients who achieved suppression (two consecutive VLs >1000 copies/ml or one VL >5000, for those without a subsequent one); 3) treatment failure (not attaining virologic suppression or experiencing virologic failure). We used Cox regression methods to determine the characteristics associated with treatment failure. We included gender, baseline age, WHO stage, body mass index, CD4 count, propensity score for initial ART regimen, VL, time-dependent CD4 count and adherence. Results Of the 559 patients enrolled, 472 (84.8%) had at least one VL (67 died, 13 were lost to follow-up, 4 transferred, 2 had no VL available); 73.6% started on d4T/3TC/nevirapine and 26.4% on AZT/3TC/efavirenz. Patients in the two groups had similar characteristics, except for the higher proportion of patients in WHO Stage 3/4 and higher VL in the efavirenz-based group. Four hundred thirty-nine (93%) patients achieved virologic suppression with a cumulative probability of 0.94 (confidence interval (CI): 0.92–0.96); 74/439 (16.9%) experienced virologic failure with a cumulative probability of 0.18 (CI: 0.15–0.22). In the multivariate analysis, initial d4T/3TC/nevirapine regimen (hazard ratio (HR): 3.02; CI: 3.02 (1.66–5.44, p<0.001)) and baseline VL ≥5 log10 copies/ml (HR: 2.29; CI: 1.29–4.04) were associated with treatment
Youn, Young Hoon; Kim, Hyeon Chang; Lim, Hyun Chul; Park, Jae Jun; Kim, Jie-Hyun; Park, Hyojin
Background/Aims A limited number of studies are available regarding the long-term natural history of post-infectious irritable bowel syndrome (PI-IBS). We aimed to investigate the long-term clinical course of PI-IBS. Methods A prospective cohort study was conducted from a 2001 shigellosis outbreak in a Korean hospital with about 2000 employees. A cohort of 124 hospital employees who were infected by Shigella sonnei due to contaminated food in the cafeteria, and 105 sex- and age-matched, non-infected, controls were serially followed for their bowel symptoms by questionnaire surveys for 10 years. Results The Shigella-infected cohort showed significantly higher odds ratio for irritable bowel syndrome (IBS) at 1-year (11.90; 95% CI, 1.49–95.58) and 3-year (3.93; 95% CI, 1.20–12.86) follow-up, compared to their controls. However, corresponding odds ratio for PI-IBS was not significantly increased at 5-year (1.88; 95% CI, 0.64–5.54) and 8-year (1.87; 95% CI, 0.62–5.19) follow-up. At 10-year follow-up survey, the prevalence of IBS was similar for the Shigella-infected cohort and their controls (23.3% versus 19.7%, P = 0.703). Risk factors which were independently associated with PI-IBS among the Shigella-infected cohort included younger age, previous history of functional bowel disorder, and longer duration of diarrhea at baseline. Conclusions Patients who were infected by Shigella sonnei experienced significantly increased risk of IBS until 3 years after shigellosis, and modestly increased risk until 8 years, but showed similar risk of IBS with uninfected controls at 10 years post-infection. PI-IBS is quite a chronic disorder, and follows a long-term natural course. PMID:26908484
Myint, Sithu; Rerkamnuaychoke, Budsaba; Peonim, Vichan; Riengrojpitak, Suda; Worasuwannarak, Wisarn
Even though there have been previously published reports on firearm injuries in various countries, the incidence and pattern of death from firearm injuries in Thailand have not been studied before. In present study, 149 fatal firearm injuries from 2002 to 2011 were reviewed. At total of 7126 autopsies, fatal firearm injuries comprised of 2.09% (n = 149) of total autopsies cases. Among those victims, 136 were male (91.3%), 13 (8.7%) were female. The youngest age of victim was 10 years and the oldest was 79 years. Mean age of the victims was 33.79 years and median age was 30 years. Outdoor incident was the most common scene of crime. Night time incident (18:00 PM-05:59 AM) was higher than day time one. Most of the cases occurred in week ends (n = 52). Homicide (77.2%) was the most frequent manner of death. Head/face and chest were the most common sites of entrance. The autopsy report also study on entrance wound, range and types of projectiles. Blood alcohol concentration was examined in 122 cases and 38 victims showed positive results, 11 cases revealed using of illegal substances in blood and urine analysis. This study also included the association between manner of death and other factors. Age group, time of incidence, place of incidence, number of entrance wound and range showed statistically significant association with manner of death.
Tidwell, Vincent Carroll; Passell, Howard David; Castillo, Cesar; Moreland, Barbara
calculating water withdrawal and consumption for current and planned electric power generation; projected water demand from competing use sectors; and, surface and groundwater availability. WECC's long range planning is organized according to two target planning horizons, a 10-year and a 20-year. This study supports WECC in the 10-year planning endeavor. In this case the water implications associated with four of WECC's alternative future study cases (described below) are calculated and reported. In future phases of planning we will work with WECC to craft study cases that aim to reduce the thermoelectric footprint of the interconnection and/or limit production in the most water stressed regions of the West.
Chettri, Reshma; Gurung, Jiwan; Singh, Bisu
Objective: The present study had been undertaken to investigate the sociodemographic profile of individuals who had committed suicide in Sikkim which may throw light on the vulnerable groups. Materials and Methods: Ten-year suicide data (2006–2015) obtained from Police Headquarters, Crime Branch, Gangtok, have been statistically evaluated to study the sociodemographic profile. Results: The results showed that out of 1604 suicide cases recorded for the past 10 years, 1051 were males (65.5%) and 553 (34.5%) were females. Suicide was found to be common among the age group of 21–30 years (24.4%), Rai community (15.8%), population of rural areas (82.6%), and among the population of eastern districts (50.6%). Hanging (94.8%) was found to be the most common method adopted for suicide. Conclusion: The study provides preliminary information about the vulnerable groups for suicide in the state which may be vital for taking necessary steps for its prevention shortly. PMID:28197004
Eloy, Ph; Grenier, J; Pirlet, A; Poirrier, A L; Stephens, J S; Rombaux, Ph
A fungal ball consists of a dense conglomerate of fungal hyphae growing at the surface of the sinus mucosa without tissue infiltration. The maxillary sinus is by far the most commonly involved paranasal sinus cavity followed by the sphenoid sinus. The present study is a retrospective study of 25 consecutive cases treated during the last 10 years in the two hospitals be- longing to the Catholic University of Louvain (CHU Mont-Godinne and UCL Saint Luc). We report the symptomatology, the imaging and discuss the different surgical managements. We conclude that the clinician must have a high index of suspicion when dealing with a unilateral rhinosinusitis persisting despite a maximal and well conducted medical treatment. This is particularly so in elderly women when associated with facial pain and post nasal drip, particularly when the computed tomography shows an unilateral opacity of the sphenoid sinus with or without a sclerosis or an erosion of the bony walls, a polyp in the sphenoethmoidal recess or a hyperdensity mimicking a foreign body. An endonasal endoscopic sphenoidotomy is the treatment of choice in most cases, allowing good ventilation of the sinus and radical removal of all the fungal concretion. A biopsy of the sinus mucosa adjacent to fungal elements is of upmost important to confirm the non- invasiveness of the fungi within the tissue. Antifungal medication is not required in uncomplicated forms. All host factors producing some degree of immunosuppression must be corrected when present and must alert the clinician to rule out any forms of invasive disease.
Haikonen, Kari; Lillsunde, Pirjo M; Lunetta, Philippe; Lounamaa, Anne; Vuola, Jyrki
The aim of this study was to examine fire-related injuries leading to inpatient care in Finland. The Finnish National Hospital Discharge Register (2000-2009) and a sample of 222 patients from the Helsinki Burn Centre who sustained flame burns was used. During the 10-years study period, the incidence of fire-related injuries with inpatient care was approximately 5.6 per 100000 persons-years (n=295; males 74%, females 26%). Approximately three quarters involved burns and the remaining cases were mostly combustion gas poisonings. Burns declined from 5.4 in 2000 to 4.0 per 100000 person-years in 2009. The decline was accounted for by young people primarily. Socio-economic features and smoking habits differ between the injured and general population. House fire victims were mainly middle aged and older, while injures involving flammable substances, campfires, etc., were mostly associated with young people. House fires caused the worst damage in terms of Total Body Surface Area burned and inhalation burns. Significantly more people die on the scene of the incident than during the hospital care. Targeting preventive measures in particular at older people and those with a tendency for alcohol abuse and smoking could potentially reduce the burden of the most severe flame burns.
Arve, Seija; Lavonius, Sirkku; Savikko, Niina; Lehtonen, Aapo; Isoaho, Hannu
Although otherwise extensively researched, one aspect of social functioning in older people that has received less attention is its association with staying at home for as long as possible. This 10-year follow-up examines factors of social functioning that support older people's independent living in their own homes and that reduce the risk of mortality. The data were collected in 1991 by a postal questionnaire that was sent to all residents of Turku, Finland, born in 1920. A physical examination was also conducted. Ten years later, in 2001, the mortality rate of this population was determined. The data were examined statistically. Female gender reduced the risk of mortality. In addition, daily outdoor activities, and not needing help (from different sources) were associated with a reduced risk of mortality. No need for help and a more positive attitude towards life reduced the risk of mortality of women. There were found only non-significant trends for men. Having plans for the future also reduced the risk of mortality. The findings of this study offer useful clues for planning the services provided by home health care personnel. In planning these services it is important that home health care workers take into account the differences between women and men customers: men may need and want different things from the home health care service than women do.
Johnson, M J; Lucas, G L; Dusek, J K; Henning, C E
A single surgeon's consecutive series of 50 arthroscopically repaired meniscal tears in 48 patients was retrospectively reviewed. None of these patients had concomitant ligament damage to the knee. The average follow-up period was 10 years, 9 months. Criteria for clinical success included 1) history of pain of grade 1 or less and absence of locking, catching, or giving way; 2) a physical examination demonstrating no significant effusion and a painless and negative jump sign; and 3) no subsequent surgical procedures on the repaired meniscus. Patient satisfaction was quite high, although clinical confirmation was possible in only 38 knees, indicating a clinical success rate of 76%. Bilateral standing radiographs were obtained on these 38 operated knees and were evaluated using Fairbank's classification. Evaluation of the radiographs revealed that 8% of the operated knees had minimal joint changes, as compared with 3% in the contralateral, nonoperated knee. This study demonstrates that arthroscopic meniscal repair in knees with isolated meniscal tears has the potential for a long-term successful clinical and radiographic outcome.
Hser, Y-I; Evans, E; Li, L; Metchik-Gaddis, A; Messina, N
This study examined children of substance-abusing mothers approximately 10 years after mothers' admission to drug abuse treatment, and identified maternal characteristics that may be risk factors for child behavior problems on the Child Behavior Checklist. Data were obtained from 396 mothers who were included in a sample consecutively admitted to 44 treatment programs in 13 California counties during 2000-2002. The Addiction Severity Index was administered at both intake and follow-up. Each mother reported on one child 6-17 years of age. All of the children had been exposed to drugs, either in utero or postnatally. At follow-up about 22% of the children demonstrated borderline or clinical range problem behaviors. Child behavior problems were related significantly to the mothers' ethnicity (lower among Hispanics relative to white), and problem severity in family/social relationship and mental health, marginally related to her prior medical/health problem, and not related to severity of alcohol, drug, legal and employment problems. Assisting mothers to address their family/social relationship and psychological problems may have an added value to prevent or reduce behavioral problems of their children.
Lima, Joao; Diez-Roux, Ana; Jorgensen, Neal W.; McClelland, Robyn L.
Background/Objectives Predictors of healthy aging have not been well-studied using longitudinal data with demographic, clinical, subclinical, and genetic information. The objective was to identify predictors of poor health outcome at 10 years of follow-up in the Multi-Ethnic Study of Atherosclerosis (MESA). Design Prospective cohort study. Setting Population-based sample from 6 U.S. communities. Participants 4,355 participants In the MESA Study. Measurements Poor health outcome at 10 years of follow-up was defined as having died or having clinical cardiovascular disease, depression, cognitive impairment, chronic obstructive pulmonary disease, or cancer other than non-melanoma skin cancer. Absolute risk regression was used to estimate risk differences in the outcome adjusting for demographic variables, clinical and behavioral risk factors, subclinical cardiovascular disease, and ApoE genotype. Models were weighted to account for selective attrition. Results Mean age at 10 years of follow-up was 69.5 years; 1,480 participants had a poor health outcome, 2,157 participants were in good health, and 718 were unknown. Older age, smoking, not taking a statin, hypertension, diabetes, and higher coronary calcium score were associated with higher probability of poor health outcome. After multivariable adjustment, participants in the lowest income and educational categories had 7 to 14% greater absolute risk of poor health outcome at 10 years of follow-up compared to those in the next highest categories of income or education (P = 0.002 for both). Those in the lowest categories of both income and education had 21% greater absolute risk of poor health outcome compared to those in the highest categories of both income and education. Conclusions Low income and educational level predict poor health outcome at 10 years of follow-up in an aging cohort, independent of clinical and behavioral risk factors and subclinical cardiovascular disease. PMID:27875557
Dunlop, Rosemary; Burns, Ailsa; Bermingham, Suzanne
Explored links between self-image, family structure (divorced or intact), parent-child relations, and gender at 3 intervals over 10 years during adolescence to early adulthood. Results suggest a consistent relationship between high parental care, low overprotective control, and better self-image scores with a stronger effect among subjects from…
Does an early childhood program have an influence on its participants that is detectable 10 years later? The answer is "yes". This research managed to detect differences between children of Ethiopian origin who had immigrated to Israel. It also managed to generalize and conceptualize these differences and provide an explanation of them:…
Brunet, Jennifer; Valette, Xavier; Ivascau, Calin; Lehoux, Philippe; Sauneuf, Bertrand; Dalibert, Yves; Masson, Romain; Sabatier, Remi; Buklas, Dimitrios; Seguin, Amélie; Terzi, Nicolas; du Cheyron, Damien; Parienti, Jean-Jacques; Daubin, Cedric
We aimed to identify factors associated with hospital mortality among patients receiving extracorporeal life support (ECLS). All consecutive patients treated with ECLS for refractory cardiac arrest or shock in the Caen University Hospital in northwestern France during the last decade were included in a retrospective cohort study. Sixty-four patients were included: 29 with refractory cardiac arrest and 35 with refractory shock. The main reasons for ECLS were acute coronary syndrome (n = 23) and severe poisoning caused by drug intoxication (n = 19). At ECLS initiation, the left ventricular ejection fraction was 16% (±11). Initial blood test results were arterial pH = 7.19 (±0.20) and plasma lactate = 8.02 (±5.88) mmol/L. Forty (63%) patients died including 33 under ECLS. In a multivariate analysis, two factors were independently associated with survival: drug intoxication as the reason for ECLS (adjusted odds ratio [AOR], 0.07; 95% confidence intervals [CI], 0.01-0.28; p < 0.001) and arterial pH (an increase of 0.1 point [AOR, 0.013; 95% CI, <0.001-0.27; p < 0.01]). This study supports early ECLS as a last resort therapeutic option in a highly selected group of patients with refractory cardiac arrest or shock, in particular before profound acidosis occurs and when the cause is reversible.
Mercieca, K; Shevade, B; Anand, N
Purpose To report the outcomes of combined phacoemulsification and -deep sclerectomy (phaco-DS) from a single UK centre over a 10-year period. Methods Retrospective analysis of phaco-DS data extracted from an ongoing glaucoma surgery database within Calderdale and Huddersfield NHS Trust. Two hundred and ninety-six eyes of 282 patients were included. Data included patient demographics, pre- and postoperative intraocular pressure (IOP), use of mitomycin C (MMC), spacer device implantation, and follow-up details including surgical success rates. IOP success criteria were: (A) IOP <19 mm Hg and/or 20% decrease from baseline and (B) IOP <16 mm Hg and/or 30% drop from baseline. Results Mean follow-up was 63.5±35.3 months. MMC was applied in 145 eyes (49%). Kaplan–Meier success rates in all eyes for criteria A were 89.1% and 80% with glaucoma medications (qualified success) and 81.2% and 68.3% without medications (unqualified success) at 2 and 5 years, respectively. Qualified success for criteria B was 72.4 and 61.4% and unqualified rates were 67.2 and 55.2% for the same time periods. Repeated-measures ANOVA showed significantly lower IOP in the phaco-DS with MMC group up to 3 years postoperatively (P=0.002). Cox's proportional hazards for criteria B, however, showed no significant effect of MMC application in the long term (P=0.2). Increasing age and laser goniopuncture were positively associated with success, whereas the absence of spacer devices was negatively associated. At last follow-up, 20% of eyes were on glaucoma medications. Complication rates were low with hypotony rates of 0.68%. Conclusions This study confirms the long-term safety and efficacy of phaco-DS as a primary glaucoma procedure. PMID:26337945
Goldberg, Marcel; Leclerc, Annette; Zins, Marie
The original GAZEL cohort was composed of 20 625 employees of the French national gas and electricity companies (15 011 male employees then aged 40 to 50 years and 5614 women between 35 and 50 years old) at its inception in 1989. A Cohort Profile article was published in 2007. By the end of 2013, participants were aged 60-75, and almost all of them retired during follow-up. Accordingly, the main focus of research in the past decade was devoted to the study of the persistent, long-term effects of occupational exposures after retirement; of the transition between professionally active life and retirement; and on determinants of early ageing. Accordingly, in addition to the health, behavioural and social data collected yearly since the beginning of the follow-up, new data were thus collected on cognitive complaints, cognitive and physical functioning, limitations in daily activities, time use and social relationships of retirees. This update presents the main findings of research within the GAZEL Cohort Study during the past 7 years. Any research group, in France or elsewhere, can submit a research proposal to work on the GAZEL cohort. To do this, interested researchers should contact one of the principal investigators of the GAZEL Cohort Study.
Scheiman, Simeon; Moghaddas, Hossein S; Björnstig, Ulf; Bylund, Per-Olof; Saveman, Britt-Inger
Bicycles are a common mode of transportation and injured bicyclists cause a substantial burden on the medical sector. In Sweden, about half of fatally injured bicyclists are 65 years or older. This study analyzes the injury mechanisms, injuries, and consequences among bicyclists 65 years or older and compare with younger bicyclists (< or =64) and older adults as passenger car drivers, to give a basis for an injury preventive discussion for this age group. Umeå University Hospital's primary catchments area had 142,000 inhabitants in 2006. Nearly all injured road users in the well-defined geographic area are treated at this hospital and a 10-year data set (N=456) of injured bicyclists aged 65+ from the hospital's continuous injury registration (1997-2006) was analyzed. The results show that the annual injury incidence was 2.4 and 2.2 per 1000 men and women, respectively, aged 65 or older. For men the incidence rate was constant in the three age groups 65-74, 75-84 and 85+, while it decreased strongly for women. The incidence rate for old adults as passenger car drivers and younger bicyclists was 1.0 and 4.6, respectively. Most frequent injury mechanisms were falls when getting on or off a bicycle (20%) and by potholes or irregularities on the ground, edge of a sidewalk, or similar (13%). Only 6% were hit by cars, trucks, or buses. Half of the injured suffered fractures or dislocations, and 10% suffered concussion or more serious intracranial injuries. Getting on or off the bicycle caused most fractures (especially a high fraction of the hip and femur fractures) and resulted in 27% of all inpatient days in hospital. Three individuals died. One-third of the injured were treated as inpatients for a total of 1413 days (on average 9 days), with 69% of the days being caused by fractures. The cost for out- and inpatient acute treatment was approximately USD 4700 (SEK 33,000) per injured. The results merit an interest for this target group; bicycle injuries among older
Shalev, I; Moffitt, T E; Sugden, K; Williams, B; Houts, R M; Danese, A; Mill, J; Arseneault, L; Caspi, A
There is increasing interest in discovering mechanisms that mediate the effects of childhood stress on late-life disease morbidity and mortality. Previous studies have suggested one potential mechanism linking stress to cellular aging, disease and mortality in humans: telomere erosion. We examined telomere erosion in relation to children's exposure to violence, a salient early-life stressor, which has known long-term consequences for well-being and is a major public-health and social-welfare problem. In the first prospective-longitudinal study with repeated telomere measurements in children while they experienced stress, we tested the hypothesis that childhood violence exposure would accelerate telomere erosion from age 5 to age 10 years. Violence was assessed as exposure to maternal domestic violence, frequent bullying victimization and physical maltreatment by an adult. Participants were 236 children (49% females; 42% with one or more violence exposures) recruited from the Environmental-Risk Longitudinal Twin Study, a nationally representative 1994-1995 birth cohort. Each child's mean relative telomere length was measured simultaneously in baseline and follow-up DNA samples, using the quantitative PCR method for T/S ratio (the ratio of telomere repeat copy numbers to single-copy gene numbers). Compared with their counterparts, the children who experienced two or more kinds of violence exposure showed significantly more telomere erosion between age-5 baseline and age-10 follow-up measurements, even after adjusting for sex, socioeconomic status and body mass index (B=-0.052, s.e.=0.021, P=0.015). This finding provides support for a mechanism linking cumulative childhood stress to telomere maintenance, observed already at a young age, with potential impact for life-long health.
Maló, Paulo; Gonçalves, Yolande; Lopes, Armando; Ferro, Ana
Purpose. To report the long-term outcome at 10 years of fixed prosthetic rehabilitation supported by dental implants with anodically oxidized surfaces in immediate function. Materials and Methods. This retrospective cohort study included 75 consecutive patients (44 females and 31 males; 14 bruxers; 21 smokers; 14 systemic compromised), with average age of 60 years, rehabilitated with 264 implants. Outcome measures were implant cumulative survival rates (calculated through life tables) and marginal bone level at 10 years. Results. Twenty-one patients with 66 implants (25%) were lost to follow-up. Six patients lost 12 implants (MkIII implants: n = 9; MkIV implants: n = 3). The overall implant cumulative survival rate at 10 years was 95.2% (maxilla: 95.6%; mandible: 94.7%). The average (standard deviation) marginal bone level at 10 years was 1.96 mm (1.50 mm), with 1.92 mm (1.31 mm) for the maxilla and 2.00 mm (1.71 mm) for the mandible, with a significant difference between nonsmokers (average = 1.60 mm) and smokers (average = 2.95 mm). Conclusions. Within the limitations of this study, it can be concluded that fixed prosthetic rehabilitation supported by implants with anodically oxidized surface in immediate function is a viable and safe treatment option for both jaws. PMID:28119922
Berger, Claudie; Joseph, Lawrence; Zhou, Wei; Prior, Jerilynn C.; Towheed, Tanveer; Anastassiades, Tassos; Adachi, Jonathan D.; Hanley, David A.; Papadimitropoulos, Emmanuel A.; Kirkland, Susan; Kaiser, Stephanie M.; Josse, Robert G.; Goltzman, David
Purpose To prospectively assess changes in health-related quality of life (HRQOL) over 10 years, by age and sex, and to compare measured within-person change to estimates of change based on cross-sectional data. Methods Participants in the Canadian Multicentre Osteoporosis Study completed the 36-item short form (SF-36) in 1995/1997 and 2005/2007. Mean within-person changes for domain and summary components were calculated for men and women separately, stratified by 10-year age groups. Projected changes based on published age- and sex-stratified cross-sectional data were also calculated. Mean differences between the two methods were then estimated, along with the 95 % credible intervals of the differences. Results Data were available for 5,569/9,423 (59.1 %) of the original cohort. Prospectively collected 10-year changes suggested that the four physically oriented domains declined in all but the youngest group of men and women, with declines in the elderly men exceeding 25 points. The four mentally oriented domains tended to improve over time, only showing substantial declines in vitality and role emotional in older women, and all four domains in older men. Cross-sectional estimates identified a similar pattern of change but with a smaller magnitude, particularly in men. Correspondence between the two methods was generally high. Conclusions Changes in HRQOL may be minimal over much of the life span, but physically oriented HRQOL can decline substantially after middle age. Although clinically relevant declines were more evident in prospectively collected data, differences in 10-year age increments of cross-sectional data may be a reasonable proxy for longitudinal changes, at least in those under 65 years of age. Results provide additional insight into the natural progression of HRQOL in the general population. PMID:24925754
Trallero, G.; Casas, I.; Tenorio, A.; Echevarria, J. E.; Castellanos, A.; Lozano, A.; Breña, P. P.
A total of 15,662 clinical samples were analysed for enterovirus (EV) isolation in cell cultures during a 10-year period (1988-97). Furthermore, 210 isolates of EV obtained in primary laboratories within Spain from patients with meningitis were characterized. The total number of EV typed was 758, including 727 non-polio EV and 31 Sabin-like (SL) polioviruses. Twenty-eight EV serotypes were represented. Echoviruses comprised 90% (653/727) of fully typed non-polio EV. The four most prevalent serotypes were echovirus 30, echovirus 9, echovirus 6 and echovirus 4. Echovirus 30 was the main serotype associated with meningitis. Echovirus 9 was the aetiological agent in 20 outbreaks of meningitis while the occurrence of echovirus 6 was localized in 1 year (1997). Coxsackieviruses A and B occurred in 3 and 7% of the non-polio EV respectively. Coxsackievirus B5 presented the relative greater abundance. This paper examines the epidemiology of EV in Spain to serotype level over a 10-year period with special attention to non-polio EV associated with meningitis. PMID:10982074
Connelly, Roxanne; Platt, Lucinda
The UK Millennium Cohort Study (MCS) is an observational, multidisciplinary cohort study that was set up to follow the lives of children born at the turn of the new century. The MCS is nationally representative and 18 552 families (18 827 children) were recruited to the cohort in the first sweep. There have currently been five main sweeps of data collection, at ages 9 months and 3, 5, 7 and 11 years. A further sweep of data collection is planned for age 14 years. A range of health-related data have been collected as well as measures concerning child development, cognitive ability and educational attainment. The data also include a wealth of information describing the social, economic and demographic characteristics of the cohort members and their families. In addition, the MCS data have been linked to administrative data resources including health records. The MCS provides a unique and valuable resource for the analysis of health outcomes and health inequalities. The MCS data are freely available to bona fide researchers under standard access conditions via the UK Data Service (http://ukdataservice.ac.uk) and the MCS website provides detailed information on the study (http://www.cls.ioe.ac.uk/mcs).
Al-Maawali, Almundher; Blaser, Susan; Yoon, Grace
Hereditary ataxias associated with cerebellar atrophy are a heterogeneous group of disorders. Selection of appropriate clinical and genetic tests for patients with cerebellar atrophy poses a diagnostic challenge. Neuroimaging is a crucial initial investigation in the diagnostic evaluation of ataxia in childhood, and the presence of cerebellar atrophy helps guide further investigations. We performed a detailed review of 300 patients with confirmed cerebellar atrophy on magnetic resonance imaging over a 10-year period. A diagnosis was established in 47% of patients: Mitochondrial disorders were most common, followed by the neuronal ceroid lipofuscinoses, ataxia telangectasia, and late GM2-gangliosidosis. We review the common causes of cerebellar atrophy in childhood and propose a diagnostic approach based on correlating specific neuroimaging patterns with clinical and genetic diagnoses. PMID:22764178
Local descriptive norms for overweight/obesity and physical inactivity, features of the built environment, and 10-year change in glycosylated haemoglobin in an Australian population-based biomedical cohort.
Carroll, Suzanne J; Paquet, Catherine; Howard, Natasha J; Coffee, Neil T; Taylor, Anne W; Niyonsenga, Theo; Daniel, Mark
Descriptive norms vary between places. Spatial variation in health-related descriptive norms may predict individual-level health outcomes. Such relationships have rarely been investigated. This study assessed 10-year change in glycosylated haemoglobin (HbA1c) in relation to local descriptive norms for overweight/obesity (n = 1890) and physical inactivity (n = 1906) in models accounting for features of the built environment. HbA1c was measured three times over 10 years for a population-based biomedical cohort of adults in Adelaide, South Australia. Environmental exposures were expressed for cohort participants using 1600 m road-network buffers centred on participants' residential address. Local descriptive norms (prevalence of overweight/obesity [body mass index ≥25 kg/m(2)] and of physical inactivity [<150 min/week]) were aggregated from responses to a separate geocoded population survey. Built environment measures were public open space (POS) availability (proportion of buffer area) and walkability. Separate sets of multilevel models analysed different predictors of 10-year change in HbA1c. Each model featured one local descriptive norm and one built environment variable with area-level education and individual-level covariates (age, sex, employment status, education, marital status, and smoking status). Interactions between local descriptive norms and built environment measures were assessed. HbA1c increased over time. POS availability and local descriptive norms for overweight/obesity and physical inactivity were each associated with greater rates of HbA1c increase. Greater walkability was associated with a reduced rate of HbA1c increase, and reduced the influence of the overweight/obesity norm on the rate of increase in HbA1c. Local descriptive health-related norms and features of the built environment predict 10-year change in HbA1c. The impact of local descriptive norms can vary according to built environment features. Little researched thus far
Lee, Hancheol; Kim, Tae-Hoon; Baek, Yong-Soo; Uhm, Jae-Sun; Pak, Hui-Nam; Lee, Moon-Hyoung
Background and Objectives The change of in-hospital and out-hospital treatments, and hospital costs for atrial fibrillation (AF) were not well known in rapidly aging Asian countries. This study is to examine the trends of AF management and outcomes in Korea. Subjects and Methods In the sample cohort from Korean National Health Insurance Data Sample Cohort (K-NHID-Sample Cohort) from 2004 through 2013, we identified patients with AF and hospital visit records using Korean Classification of Diseases, 6th Revision (KCD-6). Hospital cost, prescribed medications, radiofrequency catheter ablation (RFCA), morbidity and mortality were identified. Results AF-related hospitalization and outpatient clinic visits increased by 2.19 and 3.06-fold, respectively. While the total cost increased from 3.6 to 11.3 billion won (p<0.001), the mean cost per patient increased from 0.68 to 0.83 million won (p<0.001). Although the mean CHA2DS2-VASc score increased from 3.5 to 4.4 in the total AF population, the proportion of patients who receive anticoagulation therapy with warfarin showed no significant change for the decade. The proportion of hospitalization for RFCA was increased (0.4% to 1.1%, p<0.001). All-cause mortality (6.7% to 5.0%), cardiovascular mortality (1.4% to 1.1%) and stroke-related death (1.3% to 0.8%) showed a modest decrease from 2004 to 2013. Conclusion During the last decade, AF-related hospitalization and outpatient clinic visits have increased with the increase of many other comorbidities, whereas the rate of anticoagulation did not improved. Although mortality in patients with AF showed a modest decrease from 2004 to 2013, proper anticoagulation therapy is warranted for the improvement of public health. PMID:28154592
Stubleski, Jordan; Salihovic, Samira; Lind, Lars; Lind, P Monica; van Bavel, Bert; Kärrman, Anna
Poly- and perfluoroalkyl substances (PFASs) are a group of man-made fluorinated chemicals which have, at background levels, been associated with negative health effects in humans. Thus far, most human biomonitoring studies have evaluated the general change in PFAS concentration over time by continuously testing various individuals. This is one of the few studies to report the longitudinal trend of a range of PFAS concentrations in humans. In addition, this is the first known longitudinal study to include a large background level exposed cohort of both men and women with the same age and location who were repeatedly sampled from 2001 to 2014. The longitudinal change in concentration of eight PFASs detected in serum collected from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) cohort were determined and compared to results from general population studies. The sex-dependent changes in PFAS concentrations over time were also assessed. Serum was sampled from the same individuals at ages 70 (collection period 2001-2004), 75 (2006-2009) and 80 (2011-2014,). Eight (C6-11) of fourteen (C4-13) analyzed PFASs were usually detected in over 75% of individuals and assessed using a random effects (mixed) model. In the 579 individuals attending all three examinations, PFOSA and PFOS concentrations significantly decreased, while the remaining six PFASs significantly increased between ages 70 and 75. However, between ages 75 and 80 all PFAS concentrations significantly decreased. Overall from age 70 to 80, concentrations of PFHxS, PFUnDA, PFNA, and PFDA showed a significant increase (7% to 34%), whereas concentrations of PFOSA, PFHpA, PFOS, and PFOA (-75% to -27%) significantly decreased. Over time PFHxS concentrations increased more among women, while PFHpA concentrations showed a greater decrease among men. From age 70 to age 80, spanning from 2001-2004 to 2011-2014, the PIVUS cohort showed decreases in circulating levels of some PFASs phased out of
Tambalis, Konstantinos D; Panagiotakos, Demosthenes B; Georgousopoulou, Ekavi N; Mellor, Duane D; Chrysohoou, Christina; Kouli, Georgia-Maria; Tousoulis, Dimitrios; Stefanadis, Christodoulos; Pitsavos, Christos
The aim of the study was to examine the effects of physical activity (PA) level on 10-year cardiovascular disease (CVD) incidence, taking into consideration several clinical and lifestyle risk factors along with the potential moderating role of gender. An analysis was undertaken on data from the ATTICA prospective cohort study (10-year follow-up, 2002-2012), which followed a Greek adult population (aged 18-89years). A total n=317 of fatal and nonfatal CVD events occurred among the 2020 participants. After adjusting for the lifestyle and clinical risk factors as potential confounders, odds ratio (ORs) of CVD risk of individuals who reported being sufficiently active and highly active were decreased by 58% (95% CI: 0.30, 0.58) and 70% (95% CI: 0.15, 0.56), when compared to those who were inactive/insufficiently active, respectively. Men had nearly two-fold increase in risk of CVD (95% CI: 1.62, 2.18) versus women. Stratified analysis by gender, revealed that sufficiently active men, had 52% (95% CI: 0.24, 0.97) reduced risk of CVD incidence when compared to inactive males, while, for women, the role of PA lost significance following adjusting for lifestyle factors. The current data suggests a beneficial effect of even moderate physical activity levels on 10-year incidence of CVD, reinforcing the importance of physically activity, especially for men.
Srivastava, Amresh Kumar; Stitt, Larry; Thakar, Meghana; Shah, Nilesh; Chinnasamy, Gurusamy
Background The outcome of first episode schizophrenia has several determinants. Socioecological factors, particularly living conditions, migration, community and culture, not only affect the level of risk but also the outcome. Mega cities around the world show a unique socioecological condition that has several challenges for mental health. The present study reports on the long-term status of patients with schizophrenia in such a mega city: Mumbai, India. Aim This study aims to reveal the long-term outcome of patients suffering from schizophrenia with special reference to clinical symptoms and social functioning. Methods The cohort for this study was drawn from a 10-year follow-up of first episode schizophrenia. Patients having completed 10 years of consistent treatment after first hospitalisation were assessed on psychopathological and recovery criteria. Clinical as well as social parameters of recovery were evaluated. Descriptive statistics with 95% confidence intervals are provided. Results Of 200 patients recruited at the beginning of this study, 122 patients (61%) were present in the city of Mumbai at the end of 10-year follow-up study period. Among 122 available patients, 101 patients (50.5%) were included in the assessment at the end of 10-year follow-up study period, 6 patients (3.0%) were excluded from the study due to changed diagnosis, and 15 patients (7.5%) were excluded due to admission into long-term care facilities. This indicates that 107 out of 122 available patients (87.7%) were living in the community with their families. Out of 101 (50.5%) patients assessed at the end of 10 years, 61 patients (30.5%) showed improved recovery on the Clinical Global Impression Scale, 40 patients (20%) revealed no improvement in the recovery, 43 patients (72.9%) were able to live independently, and 24 patients (40%) were able to find employment. Conclusion With 10 years of treatment, the recovery rate among schizophrenia patients in Mumbai was 30.5%. Among the
The Multi-Ethnic Study of Atherosclerosis Air Pollution Study (MESA Air) was the first U.S. research study to measure directly how long-term exposure to air pollution contributes to the development of heart disease.
Shaw, Jon A.; Egeland, Janice A.; Endicott, Jean; Allen, Cleona R.; Hostetter, Abram M.
Objective: Prospective study of well children at risk of bipolarity to identify the frequency and pattern of potentially prodromal symptoms/behaviors for bipolar disorder type I (BPI) disorder. Method: A total of 110 at-risk children with a BPI parent and 112 children with well parents were studied. Ten-year data collection used structured and…
Diamond, Lisa M.
Debates persist over whether bisexuality is a temporary stage of denial or transition, a stable "3rd type" of sexual orientation, or a heightened capacity for sexual fluidity. The present study uses 5 waves of longitudinal data collected from 79 lesbian, bisexual, and "unlabeled" women to evaluate these models. Both the "3rd orientation" and…
Clouatre, Elsa; Gomez, Manuel; Banfield, Joanne M; Jeschke, Marc G
Work-related burn injuries contribute to a quarter of all burns in the USA. In 2009, the provincial Workplace Safety and Insurance Board reported 64,824 work-related injuries that resulted in time lost, 1188 injuries (2%) were a result of burns. There were two previous studies performed at a regional burn centre (1984-1990 and 1998-2000) that examined incidence and characteristics of work-related burns. There was no significant change between these two groups. The purpose of this study was to identify the recent pattern of work-related burns from 2001 to 2010 and to compare it to the previous studies. During the study period, 1427 patients were admitted for an acute injury to the regional burn centre. Of these, 330 were due to a work-related incident (23%). The mean age of patients was 40.5±11.9 years, 95% were male. The mean total body surface area burn was 11.9±16.2%. The most common mechanism of injury was flame (32.7%) followed by electrical (27%) and scald (19.7%), inhalation injury was present in 4.8% of patients and the mortality was 1.8%. Our study shows a significant decrease in the incidence in work-related burns treated at the regional burn centre (23.1% vs. 28.2% vs. 30.2%, p<0.01), flame burns have now become the leading cause of injury, there was a significant reduction in inhalation injury (4.8% vs. 23% vs. 14.8%, p<0.00001), and mortality over time (1.8% vs. 4% vs. 6.7% p=0.02). These findings strongly suggest a change in the cause of work-related burns, improvement in burn care, and that prevention strategies may have been more effective.
Gay, J. D. L.
Of 136 patients studied at an average of 10.6 years after a distal radial fracture, 37.6% of the 109 women and 7.4% of the 27 men suffered a subsequent fracture. “Osteoporosis-related” fractures accounted for the majority of subsequent fractures sustained by the women. The prognostic significance of distal radial fracture in the adult female is discussed. PMID:4842567
Norton, J A; Doppman, J L; Jensen, R T
Since 1980, 73 patients with Zollinger-Ellison syndrome (ZES) without radiographic evidence of liver metastases were studied on a prospective protocol including medical management of gastric acid hypersecretion, extensive radiographic tumor localization, and exploratory surgery to find and resect gastrinoma for potential cure. Each patient had gastric acid hypersecretion effectively controlled with either H2-blockers or omeprazole. Patients were divided prospectively into two groups, with all patients undergoing the same preoperative localization studies and extensive laparotomy. In contrast to group 1 (1980-1986) (36 patients), group 2 (1987-Oct. 1990) (37 patients) also underwent additional procedures (transillumination and duodenotomy) at surgery to find duodenal gastrinomas. Preoperative imaging studies localized tumor in 38 (52%) patients, and portal venous sampling for gastrin determinations was positive in 49 (67%) patients. Gastrinomas were found and resected in 57 (78%) patients. Significantly more gastrinomas (92% of patients) were found in group 2 than in group 1 patients (64%) (p less than 0.01). This increase was due to increased numbers of duodenal gastrinomas in group 2 than in group 1 patients (43% versus 11%; p less than 0.01). The increased ability to find duodenal gastrinomas did not significantly improve the immediate disease-free rate, which was 58% for all patients. Duodenal primary gastrinomas were found to have a significantly greater incidence of metastases (55%) and a significantly shorter disease-free interval (12 months) than pancreatic gastrinomas (22% and 84 months, respectively) suggesting that duodenal gastrinomas may be more malignant and not more frequently curable than pancreatic gastrinomas. Operations were performed with no deaths and 11% morbidity rate. Long-term follow-up showed that 50% of patients initially rendered disease free would develop recurrent disease by 5 years. Survival was excellent for all patients, and none
Russell, P.; Livingston, J.; Schmid, B.; Redemann, J.; Ramirez, S.; Zhang, Q.
In 1996 the NASA Ames Airborne Tracking Sunphotometers (AATS) began a decade of campaigns with major focus on tropospheric aerosols over the oceans, including comparisons to spaceborne retrievals. (This followed an 11-year period starting in 1985 that focused primarily on studies of stratospheric aerosols, smoke plumes, and atmospheric correction of land imagery.) Bridging the gap between coastal, surface-based or shipborne measurements, and satellite observations, the airborne sunphotometer measurements have provided important insights into the spectral properties of aerosols and their spatial distribution, often with an emphasis on observations over the dark ocean. Among the many contributions afforded by the airborne sunphotometer data alone are measurements of the vertical structure of spectral aerosol extinction derived from vertical profiles of aerosol optical depth, validation of over-ocean satellite retrievals of aerosol properties and studies of the spatial variability of aerosols at varying spatial scales down to a few hundred meters. In conjunction with other airborne sensors, the sunphotometer data have been used to assess aerosol absorbing properties and the direct aerosol radiative forcing of climate. In recent field campaigns, the airborne sunphotometer observations have been increasingly coordinated with satellite observations, providing among other things a dual view of oceanic aerosols in regions not usually accessible to other measurement techniques. In this paper, we will provide an overview of the AATS-based findings regarding aerosols over the ocean in field campaigns such as TARFOX, ACE-2, ACE-Asia, SAFARI, CLAMS, EVE, INTEX-A and INTEX-B. We will focus on those AATS observations that either validated or complemented satellite-based aerosol retrievals for a specific science objective, thereby shedding light on the question of consistency between suborbital and spaceborne aerosol observations over the ocean.
Zhu, Xiaoling; Pan, Jisheng; Yu, Zhiming; Wang, Yanhua; Cai, Limin; Zheng, Shuyun
The aim of the present study was to evaluate the incidence, epidemiological, clinical and therapeutic features of patients with pemphigus vulgaris in China. We retrospectively investigated a total of 221 patients with pemphigus vulgaris. The parameters including age at diagnosis/onset, sex, diagnostic methods, hospitalizations, side-effects with different treatments, pemphigus vulgaris-associated diseases, the therapeutic features and duration of follow up were evaluated. The male : female ratio was 1:1.40. The incidence rate was obviously higher in two age groups, 31-40 years and 41-50 years. The mean age at onset was 44.19 ± 21.45 years. The majority of patients (56.56%) presented the mucocutaneous type. In addition, we found that various doses of corticosteroids (including the mean initial dose, maximum control dose, total dose before reducing and hospitalized total dose) exhibited statistical differences between only corticosteroids and corticosteroids-immunosuppressant groups in mild, moderate and severe pemphigus vulgaris (P < 0.05). Our survey suggested that pemphigus vulgaris most frequently occurred in the 41-50-year age group in China and the majority of patients manifested mucocutaneous lesions. Importantly, the incidence rate in females was higher than in males. The patients who needed combined immunosuppressant treatment, usually needed higher doses of corticosteroids initially, to control the disease and over the total course of treatment.
Koffman, Jonathan; Ho, Yuen King; Davies, Joanna; Gao, Wei; Higginson, Irene J.
Background Ageing is a growing issue for people from UK black, Asian and minority ethnic (BAME) groups. The health experiences of these groups are recognised as a ‘tracer’ to measure success in end of life patient-preferred outcomes that includes place of death (PoD). Aim To examine patterns in PoD among BAME groups who died of cancer. Material and Methods Mortality data for 93,375 cancer deaths of those aged ≥65 years in London from 2001–2010 were obtained from the UK Office for National Statistics (ONS). Decedent's country of birth was used as a proxy for ethnicity. Linear regression examined trends in place of death across the eight ethnic groups and Poisson regression examined the association between country of birth and place of death. Results 76% decedents were born in the UK, followed by Ireland (5.9%), Europe(5.4%) and Caribbean(4.3%). Most deaths(52.5%) occurred in hospital, followed by home(18.7%). During the study period, deaths in hospital declined with an increase in home deaths; trend for time analysis for those born in UK(0.50%/yr[0.36–0.64%]p<0.001), Europe (1.00%/yr[0.64–1.30%]p<0.001), Asia(1.09%/yr[0.94–1.20%]p<0.001) and Caribbean(1.03%/yr[0.72–1.30%]p<0.001). However, time consistent gaps across the geographical groups remained. Following adjustment hospital deaths were more likely for those born in Asia(Proportion ratio(PR)1.12[95%CI1.08–1.15]p<0.001) and Africa(PR 1.11[95%CI1.07–1.16]p<0.001). Hospice deaths were less likely for those born in Asia(PR 0.73 [0.68–0.80] p<0.001), Africa (PR 0.83[95%CI0.74–0.93]p<0.001), and ‘other’ geographical regions (PR0.90[95% 0.82–0.98]p<0.001). Home deaths were less likely for those born in the Caribbean(PR0.91[95%CI 0.85–0.98]p<0.001). Conclusions Location of death varies by country of birth. BAME groups are more likely to die in a hospital and less likely to die at home or in a hospice. Further investigation is needed to determine whether these differences result from
Hans, Didier; Durosier, Claire; Kanis, John A; Johansson, Helena; Schott-Pethelaz, Anne-Marie; Krieg, Marc-Antoine
This study aimed to develop a hip screening tool that combines relevant clinical risk factors (CRFs) and quantitative ultrasound (QUS) at the heel to determine the 10-yr probability of hip fractures in elderly women. The EPISEM database, comprised of approximately 13,000 women 70 yr of age, was derived from two population-based white European cohorts in France and Switzerland. All women had baseline data on CRFs and a baseline measurement of the stiffness index (SI) derived from QUS at the heel. Women were followed prospectively to identify incident fractures. Multivariate analysis was performed to determine the CRFs that contributed significantly to hip fracture risk, and these were used to generate a CRF score. Gradients of risk (GR; RR/SD change) and areas under receiver operating characteristic curves (AUC) were calculated for the CRF score, SI, and a score combining both. The 10-yr probability of hip fracture was computed for the combined model. Three hundred seven hip fractures were observed over a mean follow-up of 3.2 yr. In addition to SI, significant CRFs for hip fracture were body mass index (BMI), history of fracture, an impaired chair test, history of a recent fall, current cigarette smoking, and diabetes mellitus. The average GR for hip fracture was 2.10 per SD with the combined SI + CRF score compared with a GR of 1.77 with SI alone and of 1.52 with the CRF score alone. Thus, the use of CRFs enhanced the predictive value of SI alone. For example, in a woman 80 yr of age, the presence of two to four CRFs increased the probability of hip fracture from 16.9% to 26.6% and from 52.6% to 70.5% for SI Z-scores of +2 and -3, respectively. The combined use of CRFs and QUS SI is a promising tool to assess hip fracture probability in elderly women, especially when access to DXA is limited.
Cohort studies play an important role in the quantitation of cancer risk among occupationally exposed individuals. Properly conducted cohort studies can develop important data on the age, time, and exposure dependence of cancer risk. Such information allows identification of possible selection effects which may be present and allows generalization of risk estimates to other exposure circumstances.
Fotouhi, Akbar; Hashemi, Hassan; Shariati, Mohammad; Emamian, Mohammad Hassan; Yazdani, Kamran; Jafarzadehpur, Ebrahim; Koohian, Hassan; Khademi, Mohammad Reza; Hodjatjalali, Kamran; Kheirkhah, Ahmad; Chaman, Reza; Malihi, Sarvenaz; Mirzaii, Mehdi; Khabazkhoob, Mehdi
The Shahroud Eye Cohort Study was set up to determine the prevalence and incidence of visual impairment and major eye conditions in the 40-64-year-old population of Shahroud as a Middle Eastern population. The first phase of the study was conducted in 2009-10. Using random cluster sampling, 6311 Shahroud inhabitants were invited for ophthalmologic examinations; of these, 5190 participants completed phase 1 (participation rate of 82.2%). All participants were interviewed to collect data on participants' demographics, occupation status, socioeconomic status, history of smoking, and medical and ophthalmic history, as well as history of medication, and the quality and duration of their insurance. DNA and plasma samples, as well as four dots of whole blood were collected from participants. Extensive optometric and ophthalmologic examinations were performed for each participant, including lensometry of current glasses, testing near and far visual acuity; determining objective and subjective refraction; eye motility; cycloplegic refraction; colour vision test; slit-lamp biomicroscopy and intraocular pressure measurement; direct and indirect fundoscopy; perimetry test; ocular biometry; corneal topography; lens and fundus photography; and the Schirmer's (1008 participants) and tear breakup time tests (1013 participants). The study data are available for collaborative research at Noor Ophthalmology Research Center, Tehran, Iran.
Shannon, Chevis N; Carr, Kevin R; Tomycz, Luke; Wellons, John C; Tulipan, Noel
Studies comparing alternatives to ventriculoperitoneal (VP) shunting for treatment of hydrocephalus have often relied upon data from an earlier era that may not be representative of contemporary shunt survival outcomes. We sought to determine the shunt survival rate of our cohort and compare our results to previously published shunt survival and endoscopic third ventriculostomy (ETV) success rates. We identified 95 patients between 1 and 18 years of age, who underwent initial VP shunt placement between January 2001 and December 2010. Our study shows a shunt survival rate of 85% at 6 months and 79% at 2 years, for initial shunts in pediatric patients over 1 year of age in this cohort. The overall infection rate was 3%. This compares favorably with published success rates of ETV at similar time points as well as with the rate of infection. This suggests that ventricular shunting remains a viable alternative to ETV in the older child.
Pedrazzoni, M; Girasole, G; Giusti, A; Barone, A; Pioli, G; Passeri, G; Palummeri, E; Bianchi, G
The aim of the study was to estimate the absolute risk of fracture in a sample of postmenopausal women with the Italian version of FRAX®, using femoral neck bone mineral density (BMD) and 3 internationally validated clinical risk factors (CRFs) (history of fragility fracture, family history of hip fracture, current smoking). We retrospectively studied 9586 women (mean age 64.1 yr) examined in three osteoporosis centers from Northern Italy over two years (2001-2002). The risk of major osteoporotic (clinical spine, hip, forearm and humerus) and hip fractures was estimated using the online version of the FRAX algorithm adapted for Italy. The median 10-year risk was 7.5% for osteoporotic fracture and 1.7% for hip fracture. 25% of subjects had a 10-year risk ≥ 12.1% for osteoporotic fracture and ≥ 4.1% for hip fracture. The median 10-year risk of fracture increased with the number of prevalent CRFs. For major osteoporotic fractures risk rose from 6.3% to 10.9%, 21.4% and 40.9% with 1, 2 and 3 prevalent CRFs, respectively. For hip fractures the corresponding figures were: 1.3%, 2.7%, 7.0% and 21.9%, respectively. However, it must be emphasized that in 2 out of 3 women, none of the CRFs examined was present and the assessment of risk was limited to age and BMD. Our data provide the first description of the effect of the combination of BMD, age and CRFs on fracture risk stratification in a large sample of Italian postmenopausal women using FRAX®. The results are a useful starting point to define criteria for the application of FRAX® in clinical practice in Italy.
Zubrick, Stephen R.; Taylor, Catherine L.; Christensen, Daniel
Aims Oral language is the foundation of literacy. Naturally, policies and practices to promote children’s literacy begin in early childhood and have a strong focus on developing children’s oral language, especially for children with known risk factors for low language ability. The underlying assumption is that children’s progress along the oral to literate continuum is stable and predictable, such that low language ability foretells low literacy ability. This study investigated patterns and predictors of children’s oral language and literacy abilities at 4, 6, 8 and 10 years. The study sample comprised 2,316 to 2,792 children from the first nationally representative Longitudinal Study of Australian Children (LSAC). Six developmental patterns were observed, a stable middle-high pattern, a stable low pattern, an improving pattern, a declining pattern, a fluctuating low pattern, and a fluctuating middle-high pattern. Most children (69%) fit a stable middle-high pattern. By contrast, less than 1% of children fit a stable low pattern. These results challenged the view that children’s progress along the oral to literate continuum is stable and predictable. Findings Multivariate logistic regression was used to investigate risks for low literacy ability at 10 years and sensitivity-specificity analysis was used to examine the predictive utility of the multivariate model. Predictors were modelled as risk variables with the lowest level of risk as the reference category. In the multivariate model, substantial risks for low literacy ability at 10 years, in order of descending magnitude, were: low school readiness, Aboriginal and/or Torres Strait Islander status and low language ability at 8 years. Moderate risks were high temperamental reactivity, low language ability at 4 years, and low language ability at 6 years. The following risk factors were not statistically significant in the multivariate model: Low maternal consistency, low family income, health care card
Uribe, América G; McGwin, Gerald; Reveille, John D; Alarcón, Graciela S
Recently, there has been an awareness of the variable phenotypic expression of numerous disorders between individuals from different ethnicities, systemic lupus erythematosus (SLE) one of them. These disparities probably arise from the interaction between genetic and non-genetic (environmental, socioeconomic-demographic, cultural and behavioral) factors. To delineate the influence of these factors on SLE outcome, we established a multiethnic (Hispanic, African American and Caucasian) United States (US) early cohort (<5 years disease duration). Ten years later, interesting data have emerged from the LUMINA (Lupus in Minorities: Nature vs. nurture) cohort. For example, African Americans and Hispanics from Texas have a more severe disease than Caucasians and Hispanics from Puerto Rico. Lack of private insurance, acute SLE onset, expression of HLA-DRB1*01 (DR1) and C4A*3 alleles were associated with higher disease activity, whereas age, the number of American College of Rheumatology criteria met, disease activity, corticosteroid use and abnormal illness behaviors were consistent predictors of damage. In turn, damage and poverty were found to predict mortality. We now plan to apply new approaches (genetic admixture) to deconfound the complex interaction between genetic and non-genetic factors influencing SLE outcome. These data may have impact on the development of policies aimed at eliminating health disparities in the US.
Paalman, C H; van Leeuwen, F E; Aaronson, N K; de Boer, A G E M; van de Poll-Franse, L; Oldenburg, H S A; Schaapveld, M
Background: Little is known about employment outcomes after breast cancer (BC) beyond the first years after treatment. Methods: Employment outcomes were compared with a general population comparison group (N=91 593) up to 10 years after BC for 26 120 patients, diagnosed before age 55 between 2000–2005, with income and social benefits data from Statistics Netherlands. Treatment effects were studied in 14 916 patients, with information on BC recurrences and new cancer events. Results: BC survivors experienced higher risk of losing paid employment (Hazard Ratio (HR): 1.6, 95% Confidence Interval (95% CI) 1.4–1.8) or any work-related event up to 5–7 years (HR 1.5, 95% CI 1.3–1.6) and of receiving disability benefits up to 10 years after diagnosis (HR 2.0, 95% CI 1.6–2.5), with higher risks for younger patients. Axillary lymph node dissection increased risk of disability benefits (HR 1.5, 95% CI 1.4–1.7) or losing paid employment (HR 1.3, 95% CI 1.2–1.5) during the first 5 years of follow-up. Risk of disability benefits was increased among patients receiving mastectomy and radiotherapy (HR 1.2; 95% CI 1.1–1.3) and after chemotherapy (HR 1.7; 95% CI 1.5–1.9) during the first 5 years after diagnosis. Conclusions: BC treatment at least partly explains the increased risk of adverse employment outcomes up to 10 years after BC. PMID:26757424
Kyrou, Ioannis; Kollia, Natasa; Panagiotakos, Demosthenes; Georgousopoulou, Ekavi; Chrysohoou, Christina; Tsigos, Constantine; Randeva, Harpal S; Yannakoulia, Mary; Stefanadis, Christodoulos; Papageorgiou, Charalabos; Pitsavos, Christos
Background Chronic stress frequently manifests with anxiety and/or depressive symptomatology and may have detrimental cardiometabolic effects over time. As such, recognising the potential links between stress-related psychological disorders and cardiovascular disease (CVD) is becoming increasingly important in cardiovascular epidemiology research. The primary aim of this study was to explore prospectively potential associations between clinically relevant depressive symptomatology and anxiety levels and the 10-year CVD incidence among apparently healthy Greek adults. Design A population-based, health and nutrition prospective survey. Methods In the context of the ATTICA Study (2002-2012), 853 adult participants without previous CVD history (453 men (45 ± 13 years) and 400 women (44 ± 18 years)) underwent psychological evaluations through validated, self-reporting depression and anxiety questionnaires. Results After adjustment for multiple established CVD risk factors, both reported depression and anxiety levels were positively and independently associated with the 10-year CVD incidence, with depression markedly increasing the CVD risk by approximately fourfold (adjusted odds ratio (95% confidence interval) 3.6 (1.3, 11) for depression status; 1.03 (1.0, 1.1) for anxiety levels). Conclusions Our findings indicate that standardised psychological assessments focusing on depression and anxiety should be considered as an additional and distinct aspect in the context of CVD preventive strategies that are designed and implemented by health authorities at the general population level.
Ostiguy, Caroline S; Ellenbogen, Mark A; Hodgins, Sheilagh
A comparison of offspring of parents with bipolar disorder (OBD) and offspring of parents with no mental disorder (ONMD) showed that parents' neuroticism was associated with internalizing and externalizing problems among their children. The present study examined whether parents' neuroticism predicted poor interpersonal functioning among offspring 10 years later and whether the problems observed in middle childhood mediated the association between parents' neuroticism and offspring functioning. When offspring were in middle childhood, parents completed the revised NEO Personality Inventory and rated the child's behavior on the Child Behavior Checklist. Ten years later, 65 OBD and 59 ONMD completed interviews assessing mental disorders and interpersonal and noninterpersonal functioning. High neuroticism and low agreeableness in parents predicted poor interpersonal functioning in their offspring in late adolescence-early adulthood. The offspring's externalizing and internalizing problems in middle childhood partially mediated the association between parents' personality and offspring interpersonal functioning. Moreover, the association between parents' neuroticism and offspring internalizing problems was stronger among the OBD than the ONMD. Overall, the results suggested an intergenerational transmission of risk whereby high neuroticism and low agreeableness in parents were associated with behavioral problems among offspring in middle childhood that, in turn, predicted poor interpersonal functioning 10 years later.
Haas, Gerda-Maria; Bertsch, Thomas; Schwandt, Peter
Although childhood overweight and obesity are increasing worldwide, some countries report trends for stabilization. However, the trend for the potentially atherogenic components of the metabolic syndrome (MetS) in children and adolescents is not well understood. Therefore, the purpose of this study was to analyze the trend of the five components of over 10 years in 2228 first graders aged 6 years. Waist circumference (WC) remained mainly unchanged between 1994 and 2003 whereas the other four components continuously decreased. In boys and girls mean values of triglycerides (-25.9% and -28.6%, resp.), HDL cholesterol (-19.8% and -23.4%, resp.), fasting glucose (-7.3% and -9%, resp.), systolic (-3.8% and -4.1%, resp.), and diastolic (-10.2% and -9.7%, resp.) blood pressure significantly decreased. Whereas the prevalence of abdominal adiposity was stable at baseline and after 10 years (-1% in boys and +2% in girls), the prevalence of hypertension, hypertriglyceridemia, low HDL-C, and glucose was very low without any trend.
Hart, Robert; Hermsmeyer, Jeffrey T.; Sethi, Rajiv K.; Norvell, Daniel C.
Study Design Systematic review. Clinical Questions (1) Has the proportion and number of randomized controlled trials (RCTs) as an indicator of quality of evidence regarding lumbar fusion increased over the past 10 years? (2) Is there a difference in the proportion of RCTs among the four primary fusion diagnoses (degenerative disk disease, spondylolisthesis, deformity, and adjacent segment disease) over the past 10 years? (3) Is there a difference in the type and quality of clinical outcomes measures reported among RCTs over time? (4) Is there a difference in the type and quality of adverse events measures reported among RCTs over time? (5) Are there changes in fusion surgical approach and techniques over time by diagnosis over the past 10 years? Methods Electronic databases and reference lists of key articles were searched from January 1, 2004, through December 31, 2013, to identify lumbar fusion RCTs. Fusion studies designed specifically to evaluate recombinant human bone morphogenetic protein-2 or other bone substitutes, revision surgery studies, nonrandomized comparison studies, case reports, case series, and cost-effectiveness studies were excluded. Results Forty-two RCTs between January 1, 2004, and December 31, 2013, met the inclusion criteria and form the basis for this report. There were 35 RCTs identified evaluating patients diagnosed with degenerative disk disease, 4 RCTs evaluating patients diagnosed with degenerative spondylolisthesis, and 3 RCTs evaluating patients with a combination of degenerative disk disease and degenerative spondylolisthesis. No RCTs were identified evaluating patients with deformity or adjacent segment disease. Conclusions This structured review demonstrates that there has been an increase in the available clinical database of RCTs using patient-reported outcomes evaluating the benefit of lumbar spinal fusion for the diagnoses of degenerative disk disease and degenerative spondylolisthesis. Gaps remain in the
Carvalho-Queiroz, Claudia; Johansson, Maria A.; Persson, Jan-Olov; Jörtsö, Evelina; Kjerstadius, Torbjörn; Nilsson, Caroline; Saghafian-Hedengren, Shanie; Sverremark-Ekström, Eva
Early-life infections with persistent Epstein–Barr virus (EBV) and cytomegalovirus (CMV) are delayed in affluent countries, probably due to alterations in early environmental exposures, such as maternal age, siblings, and day-care attendance. We have previously reported that the timing of EBV and CMV contraction is related both to allergic sensitization and changes in functional competence of immune cells, while the presence/absence of lactobacilli [Lactobacillus (L.) casei, L. paracasei, and L. rhamnosus] or Staphylococcus (S.) aureus in feces is related to the risk for allergy. Here, we used the same prospective longitudinal birth cohort of children to investigate early-life environmental exposures and their influence on EBV and CMV contraction over time. Since gut microbes also belong to this category of early exposures, we investigated their association with herpesvirus contraction. Our results show that these two viruses are acquired with different kinetics and that EBV and CMV seroprevalence at 10 years of age was 47 and 57%, respectively. We also observed that a delayed EBV or CMV infection was associated with older maternal age [time ratio (TR) 1.14, 95% confidence interval (CI) 1.07–1.21, Padj < 0.001 and TR 1.09, CI 1.03–1.16, Padj = 0.008, respectively]. Further, we present the novel finding that S. aureus colonization reduced the time to CMV acquisition (TR 0.21, CI 0.06–0.78, Padj = 0.02). Together, these findings suggest that there is a relationship between timing of herpesvirus acquisition and early-life immune modulating exposures, which interestingly also includes the early infant gut microbiota. PMID:27630978
Panagiotakos, Demosthenes; Georgousopoulou, Ekavi; Notara, Venetia; Pitaraki, Evangelia; Kokkou, Eleni; Chrysohoou, Christina; Skoumas, Yannis; Metaxa, Vassiliki; Pitsavos, Christos; Stefanadis, Christodoulos
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, and educational level seems to be an important determinant of the disease occurrence. The aim of this work was to investigate the association between education status and 10-year incidence of CVD, controlling for various socio-demographic lifestyle and clinical factors. From May 2001 to December 2002, 1514 men and 1528 women (>18 years) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, Greece, were enrolled. In 2011-2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD was defined according to WHO-ICD-10 criteria. Education status was measured in years of schooling. The 10-year incidence of CVD was 15.7% [95% confidence intervals (CI) 14.1%-17.4%], 19.7% in men and 11.7% in women (Pgender < 0.001). Age-and gender-adjusted analyses revealed that those with low education (<9 years of schooling) were 1.52 times more likely (95% CI 1.03-2.23%) to have CVD compared with those with high education (>12 years of schooling). People in the low education group had higher prevalence of hypertension, diabetes and dyslipidaemias, were more likely to be smokers and sedentary, had less healthy dietary habits, as compared with those in the high education group. When controlling for participants' medical history, smoking, dietary and lifestyle habits, low education was no longer significantly associated with CVD, illustrating the mediating effect of clinical and behavioural factors in the link between education and disease. It was of interest that low education status interacted with alcohol drinking, enhancing the adverse effect of low education on CVD risk (relative risk 1.44, 95% CI 0.94%-2.20%), after various adjustments made. In this study, it was concluded that low educational level was associated with increased CVD risk. This was
Serrano Sánchez, Rafael Fernando; Correa Posada, Juan Rafael; Molano, Adriana Carolina; Guevara, Oscar A
Introduction: Children present with flatfoot from birth and it resolves along infancy. There have been several risk factors identified for the development of flatfoot: male sex, young age, overweight and obesity. The prevalence of flatfoot decreases with age. The aim of this study was to determine the prevalence of flatfoot in two different populations with different social, cultural and geographically characteristics in Colombia. Methods: This is a cross sectional study made on school children between 3 to 10 years of age, from several schools in Bogota and Barranquilla. From 940 total children 60% were from Bogota. Flatfoot was diagnosed according to physical exam. Results: We found a global prevalence of flatfoot of 15.7%, distributed 20.8% in Bogota and 7.9% in Barranquilla. The children from 3 to 5 years had a prevalence of 30.9%, decreasing significantly after this age. It was found that children 3 to 5 years old from Bogota had a prevalence of flatfoot of 38.3% while children from Barranquilla only 17.3%, decreasing significantly in children older than 6 years. In the multivariate analysis we found an association between flatfoot with age, city, gender and body mass index. Discussion: We found a bigger prevalence of flatfoot in the population of Bogota compared to Barranquilla suggesting an influence of social, cultural and racial factors in the development of flatfoot. The diminished prevalence of flatfoot in children over 6 years of age suggest that therapeutic measures before this age are not recommended. PMID:24893055
Duren, Dana L.; Sherwood, Richard J.; Choh, Audrey C.; Czerwinski, Stefan A.; Chumlea, Wm. Cameron; Lee, Miryoung; Sun, Shumei S.; Demerath, Ellen W.; Siervogel, Roger M.; Towne, Bradford
The genetic influences on bone mass likely change throughout the life span, but most genetic studies of bone mass regulation have focused on adults. There is, however, a growing awareness of the importance of genes influencing the acquisition of bone mass during childhood on lifelong bone health. The present investigation examines genetic influences on childhood bone mass by estimating the residual heritabilities of different measures of second metacarpal bone mass in a sample of 600 10-year-old participants from 144 families in the Fels Longitudinal Study. Bivariate quantitative genetic analyses were conducted to estimate genetic correlations between cortical bone mass measures, and measures of bone growth and development. Using a maximum likelihood-based variance components method for pedigree data, we found a residual heritability estimate of 0.71 for second metacarpal cortical index. Residual heritability estimates for individual measures of cortical bone (e.g., lateral cortical thickness, medial cortical thickness) ranged from 0.47 to 0.58, at this pre-pubertal childhood age. Low genetic correlations were found between cortical bone measures and both bone length and skeletal age. However, after Bonferonni adjustment for multiple testing, ρG was not significantly different from 0 for any of these pairs of traits. Results of this investigation provide evidence of significant genetic control over bone mass largely independent of maturation while bones are actively growing and before rapid accrual of bone that typically occurs during puberty. PMID:17056310
Jow, Tiffany; Brown, Alia; Goldberg, David J
The use and success of high-energy, short-pulse, Q-switched lasers for tattoo removal has been well demonstrated. Three types of lasers are currently commercially available for tattoo removal: the Q-switched ruby laser (694 nm), the Q-switched alexandrite laser (755 nm) and the Q-switched Nd:YAG laser (532 nm and 1064 nm). Multiple parameters such as tattoo type, color, location, and patient skin type dictate which laser is optimal in each patient. Despite the demonstrated efficacy of these modalities, there are few papers that address some of the long-term issues of tattoo removal, such as patient compliance, and how these issues impact on the success rates of optimal tattoo removal treatments. In this retrospective study, 10-year data from a single center are presented. Our data include parameters such as clearance rates, number of treatments, wavelength of the utilized laser, and fluence and spot-size setting. In addition, potential complications such as scarring, hypopigmentation, and pain were analyzed. Finally, we examine the patient compliance that accompanied tattoo removal and the reasons behind the typically low success rates for total tattoo clearance.
Noorollahian, Morteza; Nematy, Mohsen; Dolatian, Atiyeh; Ghesmati, Hengameh; Akhlaghi, Saeed; Khademi, Gholam Reza
Background: Oral-facial clefts including cleft lip and palate are the most common congenital malformations of the head and neck. Environmental factors such as maternal hormonal disorders, use of psychiatric medications, vitamin and folic acid deficiency, hypoxia, cigarette smoking and maternal obesity and overweight can affect the incidence of these disorders. In Iran, one of the associated problems is a lack of accurate statistics regarding the present status of the patients, which can cause a disturbance in the health programmes of Ministry of Health and Medical Education. The aim of this study was to report the status of 398 cases of cleft lip and palate in Sheikh and Imam Reza Hospitals of Mashhad over a 10-year period. Materials and Methods: This retrospective descriptive study was performed using data collection method and included the evaluation of the recorded files and completing the data forms. In this study, the file records of 398 patients referring to Mashhad Sheikh and Imam Reza (P.U.H) Hospitals were studied, from the beginning of 2002 to the end of 2011; the obtained data from the files were collected and classified. Results: The highest frequency was related to cleft palate alone (40.7%); frequencies were lower regarding the cleft lip and palate and cleft lip alone (34.41% and 24.87%, respectively). Approximately, half of the patients were from rural areas of the city and had articulation disorders. Most of the patients were the first-born children of the family and their parents were consanguineously married; about one-third of the patients had a family history of the disease. Conclusion: According to the results of the present study, cleft lip is more frequent in males and cleft palate is more prevalent in females; the obtained results are consistent with the global statistics. PMID:26712297
Kauffmann, F; Tager, I B; Muñoz, A; Speizer, F E
Familial factors related to lung function between six and 10 years of age have been studied among 1,160 children whose both parents were examined in 1975 in the French PAARC (Pollution Atmosphérique et Affections Respiratoires Chroniques) Cooperative Study. The three indices FVC (forced vital capacity), FEV1 (forced expiratory volume in one second), and FEF25-75 (forced expiratory flow between 25 and 75 per cent of the vital capacity) were studied after adjustment for sex, town, age, and height (and weight for children's FVC and FEV1). Maternal (but not paternal) smoking was associated with a significant decrease in FEV1 and FEF25-75, but not in FVC. Familial resemblance was observed for all indices between children and parents and between siblings. None of the environmental factors considered (i.e., parental smoking or education) or body habitus explained the familial resemblance observed. Conversely, after taking into account the aggregation between siblings, associations between children's lung function and parental characteristics (smoking, lung function) remained significant. Parental-children correlations exhibited an increasing temporal trend with increasing age of the children. All but one correlation for FVC, FEV1, and FEF25-75 residuals of children with mothers' residuals were higher in the oldest age group compared with the youngest age group at the 0.10 level. Furthermore, correlations between siblings of opposite sex were significantly lower than correlations between siblings of like sex, especially for FEV1/FVC and FEF25-75/FVC. Results suggest that different growth patterns between boys and girls may be a critical factor in the study of lung function familial resemblance.
Evans, Jennifer L; Tsui, Judith I; Hahn, Judith A; Davidson, Peter J; Lum, Paula J; Page, Kimberly
This study examined associations between mortality and demographic and risk characteristics among young injection drug users in San Francisco, California, and compared the mortality rate with that of the population. A total of 644 young (<30 years) injection drug users completed a baseline interview and were enrolled in a prospective cohort study, known as the UFO ("U Find Out") Study, from November 1997 to December 2007. Using the National Death Index, the authors identified 38 deaths over 4,167 person-years of follow-up, yielding a mortality rate of 9.1 (95% confidence interval: 6.6, 12.5) per 1,000 person-years. This mortality rate was 10 times that of the general population. The leading causes of death were overdose (57.9%), self-inflicted injury (13.2%), trauma/accidents (10.5%), and injection drug user-related medical conditions (13.1%). Mortality incidence was significantly higher among those who reported injecting heroin most days in the past month (adjusted hazard ratio = 5.8, 95% confidence interval: 1.4, 24.3). The leading cause of death in this group was overdose, and primary use of heroin was the only significant risk factor for death observed in the study. These findings highlight the continued need for public health interventions that address the risk of overdose in this population in order to reduce premature deaths.
Evans, Jennifer L.; Tsui, Judith I.; Hahn, Judith A.; Davidson, Peter J.; Lum, Paula J.; Page, Kimberly
This study examined associations between mortality and demographic and risk characteristics among young injection drug users in San Francisco, California, and compared the mortality rate with that of the population. A total of 644 young (<30 years) injection drug users completed a baseline interview and were enrolled in a prospective cohort study, known as the UFO (“U Find Out”) Study, from November 1997 to December 2007. Using the National Death Index, the authors identified 38 deaths over 4,167 person-years of follow-up, yielding a mortality rate of 9.1 (95% confidence interval: 6.6, 12.5) per 1,000 person-years. This mortality rate was 10 times that of the general population. The leading causes of death were overdose (57.9%), self-inflicted injury (13.2%), trauma/accidents (10.5%), and injection drug user-related medical conditions (13.1%). Mortality incidence was significantly higher among those who reported injecting heroin most days in the past month (adjusted hazard ratio = 5.8, 95% confidence interval: 1.4, 24.3). The leading cause of death in this group was overdose, and primary use of heroin was the only significant risk factor for death observed in the study. These findings highlight the continued need for public health interventions that address the risk of overdose in this population in order to reduce premature deaths. PMID:22227793
Chen, Chuan-Yu; Liang, Hsin-Yi; Chang, Chia-Ming; Lin, Ju-Hwa; Chang, Tsung-Kai; Tsai, Hui-Ju
Increased attention has been paid to tic disorders clinically, yet relatively few studies have probed potential factors that account for the occurrence of tic disorders in the general population. In this study, we used data derived from the Taiwan's National Health Insurance Research Database to examine an array of factors related to the diagnosis of tic disorders and to further probe gender heterogeneity in clinical manifestation. Poisson regression analyses were applied to model the effects of birth cohort, period, and age, separately, on tic disorders. A total of 880 newly diagnosed tic disorders were identified from 2002 to 2009 among 100,516 youngsters in the study dataset who were born between 1997 and 2005. The results showed that a significant increase in the adjusted incidence rate ratio (IRR) was observed when age increased, with the highest adjusted IRR found at age 8-9 years. Compared to the time period from 2002 to 2005, an elevated IRR was found in the time period from 2006 to 2009 (adjusted IRR: 1.37; 95% CI: 1.05-1.80). Boys tended to be more likely to receive their initial diagnosis from psychiatrists and have higher comorbid attention-deficit/hyperactivity disorder (ADHD), as compared with their girl counterparts. In conclusion, the findings indicate that the effects of age and period, respectively, influence the occurrence of newly diagnosed tic disorders. Gender difference and higher frequent comorbid ADHD in boys than in girls were observed in this study.
Varga, Tibor V.; Sonestedt, Emily; Shungin, Dmitry; Koivula, Robert W.; Hallmans, Göran; Escher, Stefan A.; Barroso, Inês; Nilsson, Peter; Melander, Olle; Orho-Melander, Marju; Renström, Frida; Franks, Paul W.
Recent genome-wide meta-analyses identified 157 loci associated with cross-sectional lipid traits. Here we tested whether these loci associate (singly and in trait-specific genetic risk scores [GRS]) with longitudinal changes in total cholesterol (TC) and triglyceride (TG) levels in a population-based prospective cohort from Northern Sweden (the GLACIER Study). We sought replication in a southern Swedish cohort (the MDC Study; N = 2,943). GLACIER Study participants (N = 6,064) were genotyped with the MetaboChip array. Up to 3,495 participants had 10-yr follow-up data available in the GLACIER Study. The TC- and TG-specific GRSs were strongly associated with change in lipid levels (β = 0.02 mmol/l per effect allele per decade follow-up, P = 2.0×10−11 for TC; β = 0.02 mmol/l per effect allele per decade follow-up, P = 5.0×10−5 for TG). In individual SNP analysis, one TC locus, apolipoprotein E (APOE) rs4420638 (β = 0.12 mmol/l per effect allele per decade follow-up, P = 2.0×10−5), and two TG loci, tribbles pseudokinase 1 (TRIB1) rs2954029 (β = 0.09 mmol/l per effect allele per decade follow-up, P = 5.1×10−4) and apolipoprotein A-I (APOA1) rs6589564 (β = 0.31 mmol/l per effect allele per decade follow-up, P = 1.4×10−8), remained significantly associated with longitudinal changes for the respective traits after correction for multiple testing. An additional 12 loci were nominally associated with TC or TG changes. In replication analyses, the APOE rs4420638, TRIB1 rs2954029, and APOA1 rs6589564 associations were confirmed (P≤0.001). In summary, trait-specific GRSs are robustly associated with 10-yr changes in lipid levels and three individual SNPs were strongly associated with 10-yr changes in lipid levels. PMID:24922540
Varga, Tibor V; Sonestedt, Emily; Shungin, Dmitry; Koivula, Robert W; Hallmans, Göran; Escher, Stefan A; Barroso, Inês; Nilsson, Peter; Melander, Olle; Orho-Melander, Marju; Renström, Frida; Franks, Paul W
Recent genome-wide meta-analyses identified 157 loci associated with cross-sectional lipid traits. Here we tested whether these loci associate (singly and in trait-specific genetic risk scores [GRS]) with longitudinal changes in total cholesterol (TC) and triglyceride (TG) levels in a population-based prospective cohort from Northern Sweden (the GLACIER Study). We sought replication in a southern Swedish cohort (the MDC Study; N = 2,943). GLACIER Study participants (N = 6,064) were genotyped with the MetaboChip array. Up to 3,495 participants had 10-yr follow-up data available in the GLACIER Study. The TC- and TG-specific GRSs were strongly associated with change in lipid levels (β = 0.02 mmol/l per effect allele per decade follow-up, P = 2.0 × 10(-11) for TC; β = 0.02 mmol/l per effect allele per decade follow-up, P = 5.0 × 10(-5) for TG). In individual SNP analysis, one TC locus, apolipoprotein E (APOE) rs4420638 (β = 0.12 mmol/l per effect allele per decade follow-up, P = 2.0 × 10(-5)), and two TG loci, tribbles pseudokinase 1 (TRIB1) rs2954029 (β = 0.09 mmol/l per effect allele per decade follow-up, P = 5.1 × 10(-4)) and apolipoprotein A-I (APOA1) rs6589564 (β = 0.31 mmol/l per effect allele per decade follow-up, P = 1.4 × 10(-8)), remained significantly associated with longitudinal changes for the respective traits after correction for multiple testing. An additional 12 loci were nominally associated with TC or TG changes. In replication analyses, the APOE rs4420638, TRIB1 rs2954029, and APOA1 rs6589564 associations were confirmed (P ≤ 0.001). In summary, trait-specific GRSs are robustly associated with 10-yr changes in lipid levels and three individual SNPs were strongly associated with 10-yr changes in lipid levels.
Cho, Nam H; Oh, Tae Jung; Kim, Kyoung Min; Choi, Sung Hee; Lee, Jae Ho; Park, Kyong Soo; Jang, Hak Chul; Kim, Jong Yeol; Lee, Hong Kyu; Lim, Soo
Neck circumference, a proxy for upper-body fat, may be a unique fat depot that indicates metabolic risk beyond whole body fat. We investigated whether neck circumference is associated with development of diabetes mellitus (DM) in a subset of data with Korean Genome and Epidemiology Study (n = 3521, age range = 42-71 years). Nondiabetic subjects at the baseline were categorized into 4 groups (Q1-Q4) according to their neck circumference. Parameters related with β-cell function and insulin resistance including Epworth sleepiness scale and snoring habit were examined. The development of DM was confirmed biannually based on a 75-g oral glucose tolerance test. Over the 10 years, 2623 (74.5%) among 3521 subjects were followed-up. Among them, 632 (24.1%) developed DM. The incidence of DM increased from 17.6% in Q1 to 18.2% in Q2, to 25.4% in Q3, and to 36.0% in Q4 (P < 0.001). After adjusting for most risk factors related with DM, the relative risks of DM development were 0.989 (95% confidence interval, 0.638-1.578), 1.660 (1.025-2.687), and 1.746 (1.037-2.942) in men and 0.939 (0.540-1.769), 1.518 (0.808-2.853), and 2.077 (1.068-4.038) in women in Q2, Q3, and Q4, respectively when compared to Q1. This finding indicates negative impact from large neck circumference in the development of DM.
Ning, Hsiao-Chen; Lin, Chia-Ni; Chiu, Daniel Tsun-Yee; Chang, Yung-Ta; Wen, Chiao-Ni; Peng, Shu-Yu; Chu, Tsung-Lan; Yu, Hsin-Ming; Wu, Tsu-Lan
Background Accurate patient identification and specimen labeling at the time of collection are crucial steps in the prevention of medical errors, thereby improving patient safety. Methods All patient specimen identification errors that occurred in the outpatient department (OPD), emergency department (ED), and inpatient department (IPD) of a 3,800-bed academic medical center in Taiwan were documented and analyzed retrospectively from 2005 to 2014. To reduce such errors, the following series of strategies were implemented: a restrictive specimen acceptance policy for the ED and IPD in 2006; a computer-assisted barcode positive patient identification system for the ED and IPD in 2007 and 2010, and automated sample labeling combined with electronic identification systems introduced to the OPD in 2009. Results Of the 2000345 specimens collected in 2005, 1023 (0.0511%) were identified as having patient identification errors, compared with 58 errors (0.0015%) among 3761238 specimens collected in 2014, after serial interventions; this represents a 97% relative reduction. The total number (rate) of institutional identification errors contributed from the ED, IPD, and OPD over a 10-year period were 423 (0.1058%), 556 (0.0587%), and 44 (0.0067%) errors before the interventions, and 3 (0.0007%), 52 (0.0045%) and 3 (0.0001%) after interventions, representing relative 99%, 92% and 98% reductions, respectively. Conclusions Accurate patient identification is a challenge of patient safety in different health settings. The data collected in our study indicate that a restrictive specimen acceptance policy, computer-generated positive identification systems, and interdisciplinary cooperation can significantly reduce patient identification errors. PMID:27494020
Amaddeo, F; Bisoffi, G; Micciolo, R; Piccinelli, M; Tansella, M
The relationship between the lunar cycle and the frequency of contact with community-based psychiatric services was assessed using the South Verona Psychiatric Case Register data. For each day of the study period (January 1982-December 1991) we recorded the number of contacts made by South Verona residents with psychiatric services and the corresponding day of the lunar cycle. First, the synodic month was divided into four interval phases (usually called new moon, first quarter, full moon and third quarter), and interphase differences in the mean number of contacts were tested using one-way analysis of variance. Second. the null hypothesis of no relationship between the lunar cycle and the frequency of contact with psychiatric services was tested against the alternative hypothesis of a sinusoidal distribution according to the lunar phase. The average number of contacts with psychiatric services on each day of the lunar cycle over the 10-year period was obtained and a sine-wave curve was fitted to the data. Both for total and drop-in contacts, no significant differences in mean number of contacts were found between the four interval phases of the synodic month (new moon, first quarter, full moon and third quarter). Similarly, no significant results were found by setting the expected surge in consultations at 1-3 days after the full moon and the period of the sine-wave curve equal to 30 days. When the period of the sine-wave curve was allowed to vary in order to fit the data best, none of the statistical tests reached the level of significance required to dismiss the possibility of false-positive results. These findings did not support the theory that a relationship exists between the lunar cycle and the frequency of contact with community-based psychiatric services.
Westrupp, Elizabeth M; Rose, Natalie; Nicholson, Jan M; Brown, Stephanie J
Rates of child exposure to inter-parental conflict are high and appear to be increasing, with at least one million Australian children affected annually. To-date, there is no established prevalence for inter-parental conflict that includes the more common but less severe forms for young families in the wider Australian community. The current study aims were to examine the prevalence, persistence, and the individual, family and socio-economic context of inter-parental conflict. Data were from four waves of the Baby (n = 4,898) and Kindergarten (n = 4,182) cohorts of the Longitudinal Study of Australian Children. Verbal and physical inter-parental conflict was measured using the Argumentative Relationship Scale. More than 1 in 3 mothers (35-36%) reported any verbal and/or physical conflict. Prevalence of verbal conflict at each wave (10-13%) was higher than physical conflict (4-10%), with low co-occurrence (1-3%). Report of inter-parental conflict at one wave only was most common (19%); although 13% of mothers reported conflict at two waves; and 5-6% reported persistent conflict across three or more waves. Social disadvantage was consistently associated with report at one-wave only and persistent inter-parental conflict. Extrapolated to the Australian population, an estimated 1.9 million children are likely to be affected by inter-parental conflict within any 6 years of the early-to-middle childhood period. Establishing accurate prevalence and understanding the social context of the less severe but most common forms of inter-parental conflict will allow family and child support services to allocate finite resources more effectively and develop targeted interventions to promote children's positive development.
Kamulegeya, Adriane; Kalyanyama, Boniphace M
Background Neoplasms of the oral maxillofacial area are an interesting entity characterized by differences in nomenclature and classification at different centers. We report neoplastic histopathological diagnoses seen at the departments of oral maxillofacial surgery of Muhimbili and Mulago referral hospitals in Tanzania and Uganda respectively over a 10-year period. Methods We retrieved histopathological reports archived at the departments of oral maxillofacial surgery of Muhimbili and Mulago referral hospitals in Tanzania and Uganda respectively over a 10-year period from June 1989–July 1999. Results In the period between June 1989 and July 1999, 565 and 1298 neoplastic oro-facial cases were retrieved of which 284 (50.53%) and 967 (74.54%) were malignant neoplasms at Muhimbili and Mulago hospitals respectively. Overall 67.28% of the diagnoses recorded were malignant with Kaposi's sarcoma (21.98%), Burkiits lymphoma (20.45%), and squamous cell carcinoma (15.22%) dominating that group while ameloblastoma (9.23%), fibromas (7.3%) and pleomorphic adenoma (4.95%) dominated the benign group. The high frequency of malignancies could be due to inclusion criteria and the clinical practice of selective histopathology investigation. However, it may also be due to higher chances of referrals in case of malignancies. Conclusion There is need to reexamine the slides in these two centers in order to bring them in line with the most recent WHO classification so as to allow for comparison with reports from else where. PMID:18651958
Ritter, Philipp S; Höfler, Michael; Wittchen, Hans-Ulrich; Lieb, Roselind; Bauer, Michael; Pfennig, Andrea; Beesdo-Baum, Katja
There is ample data suggesting that individuals with bipolar disorder more frequently suffer from disturbed sleep even when euthymic. Since sleep is a process that is crucial for affective homeostasis, disturbed sleep in healthy individuals may be a risk factor for the subsequent onset of bipolar disorder. Utilizing data from a large cohort of adolescents and young adults, this study tests the hypothesis that disturbed sleep constitutes a risk factor for the later onset of bipolar disorder. A representative community sample of N = 3021 adolescents and young adults (baseline age 14-24) was assessed using the standardized Composite International Diagnostic Interview and followed-up prospectively up to 3 times over up to 10 years. Disturbed sleep at baseline was quantified utilizing the corresponding items from the self-report inventory SCL-90-R. The compound value (insomnia-score) as an ordinal parameter for the severity of sleep disturbances was used to assess associations with the incidence of bipolar disorder among participants free of major mental disorder at baseline (N = 1943) using odds ratios (OR) from logistic regressions. Analyses were adjusted for age, gender, parental mood disorder and lifetime alcohol or cannabis dependence. Poor sleep quality significantly increased the risk for the subsequent development of bipolar disorder (OR = 1.75; p = 0.001). Regarding individual sleep items, trouble falling asleep and early morning awakening were predictive for the subsequent onset of bipolar disorder. Disturbed sleep in persons otherwise free of major mental disorders appears to confer an increased risk for the subsequent onset of bipolar disorder.
Pikhart, Hynek; Kubinova, Ruzena; Malyutina, Sofia; Pajak, Andrzej; Besala, Agnieszka; Bell, Steven; Peasey, Anne; Marmot, Michael; Bobak, Martin
Background: Physical functioning (PF) is an essential domain of older persons’ health and quality of life. Health behaviors are the main modifiable determinants of PF. Cross-sectionally, alcohol consumption appears to be linked to better PF, but longitudinal evidence is mixed and very little is known about alcohol consumption and longitudinal PF trajectories. Methods: We conducted longitudinal analyses of 28,783 men and women aged 45–69 years from Novosibirsk (Russia), Krakow (Poland), and seven towns of the Czech Republic. At baseline, alcohol consumption was measured by a graduated frequency questionnaire and problem drinking was evaluated using the CAGE questionnaire. PF was assessed using the Physical Functioning Subscale of the SF-36 instrument at baseline and three subsequent occasions. Growth curve modeling was used to estimate the associations between alcohol consumption and PF trajectories over 10-year follow-up. Results: PF scores declined during follow-up in all three cohorts. Faster decline in PF over time was found in Russian female frequent drinkers, Polish female moderate drinkers, and Polish male regular heavy drinkers, in comparison with regular and/or light-to-moderate drinkers. Nondrinking was associated with a faster decline compared with light drinking only in Russian men. Problem drinking and past drinking were not related to the decline rate of PF. Conclusions: This large longitudinal study in Central and Eastern European populations with relatively high alcohol intake does not strongly support the existence of a protective effect of alcohol on PF trajectories; if anything, it suggests that alcohol consumption is associated with greater deterioration in PF over time. PMID:26748094
Eurich, Dean T; Marrie, Thomas J; Minhas-Sandhu, Jasjeet K; Majumdar, Sumit R
Objective To determine the attributable risk of community acquired pneumonia on incidence of heart failure throughout the age range of affected patients and severity of the infection.Design Cohort study.Setting Six hospitals and seven emergency departments in Edmonton, Alberta, Canada, 2000-02.Participants 4988 adults with community acquired pneumonia and no history of heart failure were prospectively recruited and matched on age, sex, and setting of treatment (inpatient or outpatient) with up to five adults without pneumonia (controls) or prevalent heart failure (n=23 060).Main outcome measures Risk of hospital admission for incident heart failure or a combined endpoint of heart failure or death up to 2012, evaluated using multivariable Cox proportional hazards analyses.Results The average age of participants was 55 years, 2649 (53.1%) were men, and 63.4% were managed as outpatients. Over a median of 9.9 years (interquartile range 5.9-10.6), 11.9% (n=592) of patients with pneumonia had incident heart failure compared with 7.4% (n=1712) of controls (adjusted hazard ratio 1.61, 95% confidence interval 1.44 to 1.81). Patients with pneumonia aged 65 or less had the lowest absolute increase (but greatest relative risk) of heart failure compared with controls (4.8% v 2.2%; adjusted hazard ratio 1.98, 95% confidence interval 1.5 to 2.53), whereas patients with pneumonia aged more than 65 years had the highest absolute increase (but lowest relative risk) of heart failure (24.8% v 18.9%; adjusted hazard ratio 1.55, 1.36 to 1.77). Results were consistent in the short term (90 days) and intermediate term (one year) and whether patients were treated in hospital or as outpatients.Conclusion Our results show that community acquired pneumonia substantially increases the risk of heart failure across the age and severity range of cases. This should be considered when formulating post-discharge care plans and preventive strategies, and assessing downstream episodes of
Duvekot, Jorieke; Hoopen, Leontine W.; Slappendel, Geerte; van der Ende, Jan; Verhulst, Frank C.; van der Sijde, Ad; Greaves-Lord, Kirstin
This paper provides an overview of the design and cohort characteristics of the Social Spectrum Study: a clinical cohort study that used a two-phase sampling design to identify children at risk for ASD. After screening 1281 children aged 2.5-10 years who had been consecutively referred to one of six mental health services in the Netherlands,…
Ozsungur, Berna; Foto-Özdemir, Dilşad; Ozusta, Seniz; Topçu, Meral; Topaloğlu, Haluk
Conversion disorder (CD) in children remains a major challenge both in pediatric and mental health clinics and is still a prevalent psychiatric disorder in developing countries. The authors describe a 10-year-old boy with the complaints of inability to walk, speak or eat, excessive drooling, urinary and fecal incontinence, disturbance from light and sound, and expression of needs only by eye movements. The patient diagnosed with CD was followed by the Department of Child and Adolescent Psychiatry with play therapy, individual psychotherapy and family therapy. At the end of three months, the patient was discharged. This is one of the most challenging cases of CD in children. The most important aim of the treatment is to understand the need for conversion symptoms and to constitute a healthy psychological environment for the child rather than to remove the physical symptoms.
Healthy food baskets have been used around the world for a variety of purposes, including: examining the difference in cost between healthy and unhealthy food; mapping the availability of healthy foods in different locations; calculating the minimum cost of an adequate diet for social policy planning; developing educational material on low cost eating and examining trends on food costs over time. In Australia, the Illawarra Healthy Food Basket was developed in 2000 to monitor trends in the affordability of healthy food compared to average weekly wages and social welfare benefits for the unemployed. It consists of 57 items selected to meet the nutritional requirements of a reference family of five. Bi-annual costing from 2000-2009 has shown that the basket costs have increased by 38.4% in the 10-year period, but that affordability has remained relatively constant at around 30% of average household incomes.
BACKGROUND: This paper presents reliability and validity analyses of physical activity-related psychosocial questionnaires completed by 8- to 10-year-old African-American girls at baseline and follow-up assessments of pilot intervention studies in the Girls health Enrichment Multi-site Study (GEMS)....
Kirby, A.; Woodward, A.; Jackson, S.; Wang, Y.; Crawford, M. A.
Despite the increased interest in the effects of omega-3 supplementation on childrens' learning and behaviour, there are a lack of controlled studies of this kind that have utilised a typically developing population. This study investigated the effects of omega-3 supplementation in 450 children aged 8-10 years old from a mainstream school…
van Schoor, A. N.; Naude, H.; van Rensburg, M.; Pretorius, E.; Boon, J. M.
This article presents a case study indicating that "Herpes simplex" virus (HSV) encephalitis may cause permanent learning disabilities due to damage to the temporal lobes as it discusses the results of a case study extending over 10 years to determine the long-term effects on both the anatomy of the brain and the intellectual functioning of the…
van Schoor, A. N.; Naude, H.; van Rensburg, M.; Pretorius, E.; Boon, J. M.
This article presents a case study indicating that "Herpes simplex" virus (HSV) encephalitis may cause permanent learning disabilities due to damage to the temporal lobes, as it discusses the results of a case study extending over 10 years to determine the long-term effects on both the anatomy of the brain and the intellectual functioning of the…
White, William L.; Kelly, John F.; Stout, Robert L.; Carter, Rebecca R.; Tonigan, J. Scott
This study investigates the 10-year course and impact of AA-related helping (AAH), step-work, and meeting attendance on long-term outcomes. Data were derived from 226 treatment-seeking alcoholics recruited from an outpatient site in Project MATCH and followed for 10 years post-treatment. Alcohol consumption, AA participation, and other-oriented behavior were assessed at baseline, end of the 3-month treatment period, and one year, three years, and 10 years post-treatment. Controlling for explanatory baseline and time-varying variables, results showed significant direct effects of AAH and meeting attendance on reduced alcohol outcomes and a direct effect of AAH on improved other-oriented interest. PMID:23327504
Crowe, Remle P; Bentley, Melissa A; Levine, Roger
Crowe RP , Bentley MA , Levine R . The Longitudinal Emergency Medical Technician (EMT) Attributes and Demographics Study (LEADS): the first 10 years and a look at public perception of Emergency Medical Services (EMS). Prehosp Disaster Med. 2016;31(Suppl. 1):s1-s6.
Horta, Bernardo Lessa; Gigante, Denise P; Gonçalves, Helen; dos Santos Motta, JanainaVieira; Loret de Mola, Christian; Oliveira, Isabel O; Barros, Fernando C; Victora, Cesar G
In this manuscript, we update the profile of the 1982 Pelotas Birth Cohort Study.In 1982, 5914 live births whose families lived in the urban are of Pelotas were enrolled in the cohort. In 2012–13, we tried to locate the whole original cohort; 3701 participants were interviewed who, added to the 325 known deaths, represented a follow-up rate of 68.1%. In contrast to the previous home interviews, in this wave all participants were invited to visit the research clinic to be interviewed and examined. The visit was carried out at a mean age of 30.2 years and mainly focused on four categories of outcomes: (i) mental health; (ii) body composition; (iii) precursors of complex chronic diseases; and (iv) human capital. Requests for collaboration by outside researchers are welcome. PMID:25733577
Horta, Bernardo Lessa; Gigante, Denise P; Gonçalves, Helen; dos Santos Motta, JanainaVieira; Loret de Mola, Christian; Oliveira, Isabel O; Barros, Fernando C; Victora, Cesar G
In this manuscript, we update the profile of the 1982 Pelotas Birth Cohort Study.In 1982, 5914 live births whose families lived in the urban are of Pelotas were enrolled in the cohort. In 2012-13, we tried to locate the whole original cohort; 3701 participants were interviewed who, added to the 325 known deaths, represented a follow-up rate of 68.1%. In contrast to the previous home interviews, in this wave all participants were invited to visit the research clinic to be interviewed and examined. The visit was carried out at a mean age of 30.2 years and mainly focused on four categories of outcomes: (i) mental health; (ii) body composition; (iii) precursors of complex chronic diseases; and (iv) human capital. Requests for collaboration by outside researchers are welcome.
Nelson, Mark R
Objective To examine survival of individuals exposed to the “mummy's curse” reputedly associated with the opening of the tomb of Tutankhamen in Luxor, Egypt, between February 1923 and November 1926. Design Retrospective cohort study. Participants 44 Westerners identified by Howard Carter as present in Egypt at the specified dates, 25 of whom were potentially exposed to the curse. Main outcome measures Length of survival after date of potential exposure. Results In the 25 people exposed to the curse the mean age at death was 70 years (SD 12) compared with 75 (13) in those not exposed (P=0.87 for difference). Survival after the date of exposure was 20.8 (15.2) v 28.9 (13.6) years respectively (P=0.95 for difference). Female sex was a predictor for survival (P=0.02). Conclusions There was no significant association between exposure to the mummy's curse and survival and thus no evidence to support the existence of a mummy's curse. What is already known on this topicThe methods of evidence based medicine have not been used to investigate the reality of the “mummy's curse”The arguments against the curse have been as anecdotal as the contemporary newspapers that reported itWhat this study addsThere was no association between potential exposure to the mummy's curse during the excavation of Tutankamen's tomb and death within 10 yearsNo evidence was found for the existence of a mummy's curse PMID:12493675
Nordahl, Helene; Hvidtfeldt, Ulla Arthur; Diderichsen, Finn; Rod, Naja Hulvej; Osler, Merete; Frederiksen, Birgitte Lidegaard; Prescott, Eva; Tjønneland, Anne; Lange, Theis; Keiding, Niels; Andersen, Per Kragh; Andersen, Ingelise
The Social Inequality in Cancer (SIC) cohort study was established to determine pathways through which socioeconomic position affects morbidity and mortality, in particular common subtypes of cancer. Data from seven well-established cohort studies from Denmark were pooled. Combining these cohorts provided a unique opportunity to generate a large study population with long follow-up and sufficient statistical power to develop and apply new methods for quantification of the two basic mechanisms underlying social inequalities in cancer-mediation and interaction. The SIC cohort included 83 006 participants aged 20-98 years at baseline. A wide range of behavioural and biological risk factors such as smoking, physical inactivity, alcohol intake, hormone replacement therapy, body mass index, blood pressure and serum cholesterol were assessed by self-administered questionnaires, physical examinations and blood samples. All participants were followed up in nationwide demographic and healthcare registries. For those interested in collaboration, further details can be obtained by contacting the Steering Committee at the Department of Public Health, University of Copenhagen, at firstname.lastname@example.org.
Sourander, Andre; Multimaki, Petteri; Santalahti, Paivi; Parkkola, Kai; Haavisto, Antti; Helenius, Hans; Nikolakaros, Georgios; Piha, Jorma; Tamminen, Tuula; Moilanen, Irma; Kumpulainen, Kirsti; Aronen, Eeva T.; Linna, Sirkka-Liisa; Puura, Kaija; Almqvist, Fredrik
Objective: To study prevalence and factors associated with mental health service use among 18-year-old adolescent boys. Method: Predictors at age 8 and factors at age 18 associated with mental health service use during the preceding 12 months were studied in a general population sample of 2,316 Finnish boys born in 1981 attending military call-up…
Wilens, Timothy E.; Martelon, MaryKate; Joshi, Gagan; Bateman, Clancey; Fried, Ronna; Petty, Carter; Biederman, Joseph
Objective: High rates of substance-use disorders (SUD) have been found in samples of adolescents and adults with attention-deficit/hyperactivity disorder (ADHD). Predictors of SUD in children with ADHD who are at risk for the development of SUDs remain understudied. The main aims of this study were to identify clinically meaningful characteristics…
Curtis, Guy J.; Vardanega, Lucia
Are more students cheating on assessment tasks in higher education? Despite ongoing media speculation concerning increased "copying and pasting" and ghostwritten assignments produced by "paper mills", few studies have charted historical trends in rates and types of plagiarism. Additionally, there has been little comment from…
Arshad, Hafiz Muhammad Sharjeel; Tetangco, Eula; Shah, Natasha; Kabir, Christopher; Raddawi, Hareth
Background Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in the United States. Although studies have been performed on malignancy behavior in African Americans and Caucasians, scant data are present on other minority racial groups. Methods A retrospective single center study was performed where 1,860 patient charts with a diagnosis of CRC from January 1, 2004 to December 31, 2014 were reviewed. Data collected on each patient included age, gender, ethnicity, primary site and histological stage at the time of diagnosis. Survival time over the course of 5 years was documented for patients from January 1, 2004 to December 31, 2009. Comparisons were made amongst different racial groups for the above mentioned factors. Results Study population consisted of 27.09% African Americans, 65.61% Caucasians, 3.86% Hispanics, 0.54% South Asians, 1.03% Arabs, 0.54% Asians and 0.22% American Indians. Mean age of CRC presentation was found to be significantly different (P < 0.05) between the three largest racial groups: 71 years for Caucasians, 69 years for African Americans, and 61 years for Hispanics. African Americans (27.09%) and Hispanics (28.79%) presented predominantly at stage IV in comparison to other racial groups. Caucasians presented predominantly at stage III (24.84%). The rectum was the most common site of CRC across all racial groups with the exception of Asians, where sigmoid colon was the predominant site (30%). Adenocarcinoma remained the predominant cancer type in all groups. Hispanics had relatively higher incidence rate of carcinoid tumor (12.68%). Survival time analysis showed that Caucasians tend to have better survival probability over 5 years after initial diagnosis as compared to African Americans and Hispanic (P < 0.05). Conclusion There is lack of studies performed on minority racial groups in North America. Our study highlighted some important clinical differences of CRC presentation in different racial groups which are not
Capell, H A; Murphy, E A; Hunter, J A
Rheumatoid arthritis remains a chronic disabling disorder in which medical and surgical intervention may provide amelioration but not cure. In this study a cohort of 123 rheumatoid patients were followed for a period of 10 years from the time of prescription of their initial second-line agent. The workload involved in managing articular, extra-articular and intercurrent disease in these patients has been documented and outcome in relation to continued use of 'disease modifying' therapy evaluated. At 10 years 24 patients (20 per cent) had died and 7 (5 per cent) were not traced; of the 92 (75 per cent) who were assessed, three had become wheelchairbound, two for reasons other than rheumatoid arthritis. Seventy-one per cent of patients required joint surgery, 36 per cent management of peptic ulcer and 45 per cent experienced major episodes of sepsis. Analysis of the results in the 92 patients who were evaluated at 10 years showed significant improvement in Ritchie articular index, pain score, morning stiffness, haemoglobin, platelets, ESR, total globulins, IgG and IgM. Grip strength and Lee functional index showed a trend towards deterioration which did not reach significance. Sixty-seven (73 per cent) of the 92 patients remained on a second- or third-line agent at 10 years (median duration of treatment 107 months); 25 (27 per cent) were not receiving such therapy (median duration of second- and third-line therapy 13 months). The group remaining on treatment showed significant improvement similar to that of the total study group. Those not on treatment improved only for articular index; Lee functional index deteriorated significantly. There was a correlation between area under the curve for ESR over 10 years and radiological progression of disease in hands (r = 0.29, p = 0.026) and in knees and hips (r = 0.3748, p = 0.012) over the 10 year period. Radiographic score correlated well with Lee functional index at the outset and at 10 years and also with the change in
Haveman-Nies, Annemien; de Groot, Lisette P G M; Burema, Jan; Cruz, José A Amorim; Osler, Merete; van Staveren, Wija A
The single and combined effects of three healthy lifestyle behaviors-nonsmoking, being physically active, and having a high-quality diet-on survival were investigated among older people in the SENECA Study. This European longitudinal study started with baseline measurements in 1988-1989 and lasted until April 30, 1999. The study population consisted of 631 men and 650 women aged 70-75 years from Belgium, Denmark, Italy, The Netherlands, Portugal, Spain, and Switzerland. A lifestyle score was calculated by adding the scores of the lifestyle factors physical activity, dietary quality, and smoking habits. The single lifestyle factors and the lifestyle score were related to mortality. Even at ages 70-75 years, the unhealthy lifestyle behaviors smoking, having a low-quality diet, and being physically inactive were singly related to an increased mortality risk (hazard ratios ranged from 1.2 to 2.1). The risk of death was further increased for all combinations of two unhealthy lifestyle behaviors. Finally, men and women with all three unhealthy lifestyle behaviors had a three- to fourfold increase in mortality risk. These results underscore the importance of a healthy lifestyle, including multiple lifestyle factors, and the maintenance of it with advancing age.
Justice, Amy C.; Dombrowski, Elizabeth; Conigliaro, Joseph; Fultz, Shawn L.; Gibson, Deborah; Madenwald, Tamra; Goulet, Joseph; Simberkoff, Michael; Butt, Adeel A.; Rimland, David; Rodriguez-Barradas, Maria C.; Gibert, Cynthia L.; Oursler, Kris Ann K.; Brown, Sheldon; Leaf, David A.; Goetz, Matthew B.; Bryant, Kendall
Background The Veterans Aging Cohort Study (VACS) is a study of human immunodeficiency virus (HIV) infected and uninfected patients seen in infectious disease and general medical clinics. VACS includes the earlier 3 and 5 site studies (VACS 3 and VACS 5) as well as the ongoing 8 site study. Objectives We sought to provide background and context for analyses based upon VACS data, including study design and rationale as well as its basic protocol and the baseline characteristics of the enrolled sample. Research Design We undertook a prospectively consented multisite observational study of veterans in care with and without HIV infection. Measures Data were derived from patient and provider self report, telephone interviews, blood and DNA samples, focus groups, and full access to the national VA “paperless” electronic medical record system. Results More than 7200 veterans have been enrolled in at least one of the studies. The 8 site study (VACS) has enrolled 2979 HIV-infected and 3019 HIV-uninfected age–race–site matched comparators and has achieved stratified enrollment targets for race/ethnicity and age and 99% of its total target enrollment as of October 30, 2005. Participants in VACS are similar to other veterans receiving care within the VA. VACS participants are older and more predominantly black than those reported by the Centers for Disease Control. Conclusions VACS has assembled a rich, in-depth, and representative sample of veterans in care with and without HIV infection to conduct longitudinal analyses of questions concerning the association between alcohol use and related comorbid and AIDS-defining conditions. PMID:16849964
Land, Larry F.
Some of the topics identified for special study include: (1) The potential of saline water entering the freshwater zone from the downdip boundary; (2) the possibility of water leaking into the aquifer from an overlying aquifer; (3) the effects of urbanization on ground-water quality in local areas; (4) the movement and dissipation of a recharge water plume; (5) the influx of water from the Glen Rose Formation; (6) the effects of the fault barriers, regional dense bed, and irregular geologic framework on ground-water flow patterns; (7) natural recharge-discharge relationships; (8) the aquifer stage-storage relationship; (9) natural water-quality evolution; and (10) a refinement of the hydrogeologic framework in a local area.
Chen, Chao-Ming; Lin, Hsi-Hsien; Hung, Shih-Chieh; Huang, Tung-Fu; Chen, Wei-Ming; Liu, Chien-Lin; Chen, Tain-Hsiung
Septic arthritis is the most rapidly destructive joint disease, but its early diagnosis remains challenging; delayed or inadequate treatment, even by expert physicians, can lead to irreversible joint destruction. Between 25% and 50% of patients develop irreversible loss of joint function, which is especially concerning in elderly patients. To understand the factors influencing the outcome of septic arthritis, the authors reviewed patients aged older than 50 years who had undergone debridement surgery for primary septic arthritis at their institution between 1998 and 2008. Ninety-two patients (92 knees) were enrolled in the study; 14 did not meet inclusion criteria and were excluded from the final analysis. Of the 78 included patients, 7 underwent arthrodesis, 22 underwent total knee arthroplasty, 19 were indicated for total knee arthroplasty for severe knee joint osteoarthritis but did not undergo surgery by the end of this study, and the remaining 30 had no or mild symptoms of osteoarthrosis and did not receive any surgical procedure. Staphylococcus aureus was the most common pathogenic agent (38%), followed by mixed bacterial infection (10%). Several factors negatively influenced the final clinical outcome, including delayed treatment, advanced macroscopic staging made during debridement surgery, performing multiple debridement surgeries, and a larger Lysholm score difference pre- and posttreatment. More antibiotics administered, longer duration of antibiotic treatment, and more pathogenic agents present were also significantly correlated with poor outcome. These findings shed new light on the management of septic arthritis. Accurate diagnoses and effective treatments are important for the clinical outcome of knee joint bacterial infection in elderly patients.
Di Lorenzo, L; Zocchetti, C; Platania, A; De Francesco, G; De Metrio, R; Pirris, A; Gigante, M R
At present no official data are available for those occupational accidents which, according to current law, are not subject to notification to the Italian National Institute for Insurance of Occupational Accidents (INAIL) and which are conventionally called "minor" accidents. They can be divided into accidents with prognosis from 1 to 3 days (franchises) and accidents which do not cause absence from work (medications). The already mentioned lack of data, which is not confined to Italy, is reflected in the small number of articles published in Italian and international journals. Also information regarding the possible relationships between "minor" accidents and the life habits of injured workers, are rare. The aim of this study was to provide detailed data on the characteristics of the different kinds of occupational accidents occurring in a food factory in Apulia, southern Italy, from 1985 to 1994, as well as to verify whether any relationship existed between the different types of occupational accidents and the consumption of cigarettes and alcohol by injured workers. The company's accident register yielded data on injuries which caused absence from work; the nursing service register provided information about accidents which did not determine absence from work; personal health documents gave details of worker life habits; and the company pay roll showed the amount of "worked hours". "Minor" accidents represented 70% of all accidents occurring during the ten year period studied. "Blue collars" had more frequent and serious occupational injuries, in comparison with "technical employees". "Minor" accidents, and especially "medications", occurred more frequently during one-shift work than during three-shift work. As work seniority increased, the number of "major" accidents decreased and number of accidents without absence from work rose. Contusions were the most frequent lesions and were responsible for the majority of the 3 kinds of accidents. "Medications" together
Reichard, P; Pihl, M; Rosenqvist, U; Sule, J
Blood glucose values close to normal reduce the microvascular complications of insulin-dependent diabetes mellitus. The Stockholm study of this effect continued after the initial 7.5-year period in order to see what happened when intensively treated patients were left to control their own treatment while treatment was intensified in the control group. Forty-three patients with insulin-dependent diabetes randomised to intensified conventional treatment (ICT) and 48 patients randomised to standard treatment (ST) were followed-up for 10 years. Vascular complications, treatment side-effects and well-being were studied. Risk factors for complications were sought. HbA1c (normal range 3.9-5.7%) was reduced from 9.5 +/- 1.4% (mean +/- SD) in the ICT group and 9.4 +/- 1.2% in the ST group to a mean (during 10 years) of 7.2 +/- 0.6% and 8.3 +/- 1.0%, respectively (p < 0.001). Serious retinopathy (63 vs 33%, p = 0.003), nephropathy (26 vs 7%, p = 0.012) and symptoms of neuropathy (32 vs 14%, p = 0.041) were more common in the ST group after 10 years. HbA1c and age were the only risk factors for complications. Self-reported well-being increased to a greater degree and severe hypoglycaemia was more common in the ICT group. Cognitive function after 10 years was similar in both treatment groups, and was not related to the number of severe hypoglycaemic episodes. Intensified insulin treatment leads to reduced long-term complications and increased well-being without causing undue side-effects.
Stoeck, Katharina; Sanchez-Juan, Pascual; Gawinecka, Joanna; Green, Alison; Ladogana, Anna; Pocchiari, Maurizio; Sanchez-Valle, Raquel; Mitrova, Eva; Sklaviadis, Theodor; Kulczycki, Jerzy; Slivarichova, Dana; Saiz, Albert; Calero, Miguel; Knight, Richard; Aguzzi, Adriano; Laplanche, Jean-Louis; Peoc'h, Katell; Schelzke, Gabi; Karch, Andre; van Duijn, Cornelia M; Zerr, Inga
To date, cerebrospinal fluid analysis, particularly protein 14-3-3 testing, presents an important approach in the identification of Creutzfeldt-Jakob disease cases. However, one special point of criticism of 14-3-3 testing is the specificity in the differential diagnosis of rapid dementia. The constant observation of increased cerebrospinal fluid referrals in the national surveillance centres over the last years raises the concern of declining specificity due to higher number of cerebrospinal fluid tests performed in various neurological conditions. Within the framework of a European Community supported longitudinal multicentre study ('cerebrospinal fluid markers') we analysed the spectrum of rapid progressive dementia diagnoses, their potential influence on 14-3-3 specificity as well as results of other dementia markers (tau, phosphorylated tau and amyloid-β(1-42)) and evaluated the specificity of 14-3-3 in Creutzfeldt-Jakob disease diagnosis for the years 1998-2008. A total of 29 022 cerebrospinal fluid samples were analysed for 14-3-3 protein and other cerebrospinal fluid dementia markers in patients with rapid dementia and suspected Creutzfeldt-Jakob disease in the participating centres. In 10 731 patients a definite diagnosis could be obtained. Protein 14-3-3 specificity was analysed for Creutzfeldt-Jakob disease with respect to increasing cerebrospinal fluid tests per year and spectrum of differential diagnosis. Ring trials were performed to ensure the comparability between centres during the reported time period. Protein 14-3-3 test specificity remained high and stable in the diagnosis of Creutzfeldt-Jakob disease during the observed time period across centres (total specificity 92%; when compared with patients with definite diagnoses only: specificity 90%). However, test specificity varied with respect to differential diagnosis. A high 14-3-3 specificity was obtained in differentiation to other neurodegenerative diseases (95-97%) and non
Esmaeil, Samia; Alzeidan, Rasmieh; Elawad, Mamoun; Tabassum, Rabeena; Hansoti, Shehnaz; Magzoup, Mohie Edein; Al-Kadri, Hanan; Elsherif, Elham; Al-Mandil, Hazim; Al-Shaikh, Ghadeer; Zakaria, Nasria
Objectives To assess the effects of non-communicable diseases, such as diabetes, hypertension and obesity, on the mother and the infant. Methods A multicentre cohort study was conducted in three hospitals in the city of Riyadh in Saudi Arabia. All Saudi women and their babies who delivered in participating hospitals were eligible for recruitment. Data on socio-demographic characteristics in addition to the maternal and neonatal outcomes of pregnancy were collected. The cohort demographic profile was recorded and the prevalence of maternal conditions including gestational diabetes, pre-gestational diabetes, hypertensive disorders in pregnancy and obesity were estimated. Findings The total number of women who delivered in participating hospitals during the study period was 16,012 of which 14,568 women participated in the study. The mean age of the participants was 29 ± 5.9 years and over 40% were university graduates. Most of the participants were housewives, 70% were high or middle income and 22% were exposed to secondhand smoke. Of the total cohort, 24% were married to a first cousin. More than 68% of the participants were either overweight or obese. The preterm delivery rate was 9%, while 1.5% of the deliveries were postdate. The stillbirth rate was 13/1000 live birth. The prevalence of gestational diabetes was 24% and that of pre-gestational diabetes was 4.3%. The preeclampsia prevalence was 1.1%. The labour induction rate was 15.5% and the cesarean section rate was 25%. Conclusion Pregnant women in Saudi Arabia have a unique demographic profile. The prevalence of obesity and diabetes in pregnancy are among the highest in the world. PMID:26937965
Wu, Chia-Liang; Wen, Shu-Hui
Abstract Calcium channel blockers (CCBs) are widely used for reducing blood pressure of hypertensive patients. Recent reports document the beneficial effects of CCB for preventing dementia; however, the results are controversial. We aim to evaluate the risk of developing dementia among elderly hypertensive patients treated with CCB. We designed a retrospective population-based cohort study using the records of the National Health Insurance Research Database of Taiwan dated from 2000 to 2010. The study cohort comprised 82,107 hypertensive patients of more than 60 years of age, and 4004 propensity score (PS)-matched pairs were selected according to age, sex, year of hypertension diagnosis, and baseline comorbidities. We employed a robust Cox proportional hazard model to estimate the hazard ratio (HR) of developing dementia in the PS-matched cohort. The annual incidence of dementia in the CCB-exposure group was significantly lower than that in the comparator group (3.9 vs 6.9 per 1000 person-years, P < 0.01) during the follow-up period (4.4 ± 2.5 years). Based on the PS-matched cohort, the adjusted HR of dementia in the CCB-exposure group was significantly lower than that in comparator group (HR = 0.53, 95% confidence interval: 0.39–0.72, P < 0.01). Sensitivity and subgroup analyses also confirmed similar findings. Our results provided evidence for an association between CCB use and a lower risk of developing dementia among the elderly hypertensive patients. Further studies are required to explore the causal relationship between CCB use and dementia. PMID:27512890
Wu, Chia-Liang; Wen, Shu-Hui
Calcium channel blockers (CCBs) are widely used for reducing blood pressure of hypertensive patients. Recent reports document the beneficial effects of CCB for preventing dementia; however, the results are controversial. We aim to evaluate the risk of developing dementia among elderly hypertensive patients treated with CCB.We designed a retrospective population-based cohort study using the records of the National Health Insurance Research Database of Taiwan dated from 2000 to 2010. The study cohort comprised 82,107 hypertensive patients of more than 60 years of age, and 4004 propensity score (PS)-matched pairs were selected according to age, sex, year of hypertension diagnosis, and baseline comorbidities. We employed a robust Cox proportional hazard model to estimate the hazard ratio (HR) of developing dementia in the PS-matched cohort.The annual incidence of dementia in the CCB-exposure group was significantly lower than that in the comparator group (3.9 vs 6.9 per 1000 person-years, P < 0.01) during the follow-up period (4.4 ± 2.5 years). Based on the PS-matched cohort, the adjusted HR of dementia in the CCB-exposure group was significantly lower than that in comparator group (HR = 0.53, 95% confidence interval: 0.39-0.72, P < 0.01). Sensitivity and subgroup analyses also confirmed similar findings.Our results provided evidence for an association between CCB use and a lower risk of developing dementia among the elderly hypertensive patients. Further studies are required to explore the causal relationship between CCB use and dementia.
Amigo, Hugo; Bustos, Patricia; Zumelzú, Elinor; Rona, Roberto J
The Limache cohort was set up to assess the programming and life course events hypotheses in relation to cardiovascular risk factors and chronic respiratory conditions, especially asthma, in the context of an unprecedented economic growth in Chile. The cohort was a representative sample of 1232 participants born between 1974 and 1978 in the hospital of Limache. The study includes data collected at birth, during the 1st year of life, at 22 to 28 years (collected between 2000 and 2002) and at 32 to 38 years (collected between 2010 and 2012). The data collected include anthropometric measurements at birth, 1st year of life and in adulthood, socio-economic and demographic data, lifestyle information including smoking, alcohol consumption and food intake, respiratory symptoms, lung function, broncho-reactivity to methacholine and skin prick reaction to eight allergens, measurement of cardiovascular risk factors and information on common mental health, mainly in the most recent study. The principal researchers welcome collaborative projects, especially those that will compare similar data sets in other settings.
Amigo, Hugo; Bustos, Patricia; Zumelzú, Elinor; Rona, Roberto J
The Limache cohort was set up to assess the programming and life course events hypotheses in relation to cardiovascular risk factors and chronic respiratory conditions, especially asthma, in the context of an unprecedented economic growth in Chile. The cohort was a representative sample of 1232 participants born between 1974 and 1978 in the hospital of Limache. The study includes data collected at birth, during the 1st year of life, at 22 to 28 years (collected between 2000 and 2002) and at 32 to 38 years (collected between 2010 and 2012). The data collected include anthropometric measurements at birth, 1st year of life and in adulthood, socio-economic and demographic data, lifestyle information including smoking, alcohol consumption and food intake, respiratory symptoms, lung function, broncho-reactivity to methacholine and skin prick reaction to eight allergens, measurement of cardiovascular risk factors and information on common mental health, mainly in the most recent study. The principal researchers welcome collaborative projects, especially those that will compare similar data sets in other settings [E-mail: email@example.com]. PMID:24366489
Greenlee, Bobbie J.; Karanxha, Zorka
The purpose of this study was to examine group dynamics of educational leadership students in cohorts and make comparisons with the group dynamics characteristics of non-cohort students. Cohorts have emerged as dynamic and adaptive entities with attendant group dynamic processes that shape collective learning and action. Cohort (n=42) and…
Berbis, Julie; Michel, Gérard; Baruchel, André; Bertrand, Yves; Chastagner, Pascal; Demeocq, François; Kanold, Justyna; Leverger, Guy; Plantaz, Dominique; Poirée, Marilyne; Stephan, Jean-Louis; Auquier, Pascal; Contet, Audrey; Dalle, Jean-Hugues; Ducassou, Stéphane; Gandemer, Virginie; Lutz, Patrick; Sirvent, Nicolas; Tabone, Marie-Dominique; Thouvenin-Doulet, Sandrine
The main aim of the Leucémies de l’Enfant et l’Adolescent (LEA) project (Childhood and Adolescent Leukaemia) is to study the determinants (medical, socioeconomic, behavioural and environmental) of medium- and long-term outcomes of patients treated for childhood acute leukaemia (AL). The LEA study began in 2004 and is based on a French multicentric prospective cohort. Included are children treated for AL since January 1980 (incident and prevalent cases), surviving at month 24 for myeloblastic AL and lymphoblastic AL grafted in first complete remission or at month 48 for lymphoblastic AL not grafted in first complete remission. Information is collected during specific medical visits and notably includes the following data: socioeconomic data, AL history, physical late effects (such as fertility, cardiac function and metabolic syndrome) and quality of life. Data are collected every 2 years until the patient is 20 years old and has had a 10-year follow-up duration from diagnosis or last relapse. Thereafter, assessments are planned every 4 years. In active centres in 2013, eligible patients number more than 3000. The cohort has already included 2385 survivors, with rate of exhaustiveness of almost 80%. Data access can be requested from principal coordinators and must be approved by the steering committee. PMID:24639445
Sakon, Naomi; Yamazaki, Kenji; Nakata, Keiko; Kanbayashi, Daiki; Yoda, Tomoko; Mantani, Masanobu; Kase, Tetsuo; Takahashi, Kazuo; Komano, Jun
Human norovirus is a major cause of viral acute gastroenteritis worldwide. However, the transition of endemic norovirus genotypes remains poorly understood. The characteristics of natural immunity against norovirus are unclear because few studies have been performed in the natural infection setting. This prospective 10-year surveillance study of acute gastroenteritis in the province of Osaka, Japan, revealed that norovirus spread shows temporal, geographic, and age group-specific features in the humans. Genogroup II genotype 4 (GII.4) was detected in most sporadic pediatric cases, as well as in foodborne and nursing home outbreaks, respectively. The dominant genotypes in outbreaks at childcare facilities and schools shifted every season and involved GI, GII.2, GII.3, GII.4, and GII.6. Evidence at both the facility and individual levels indicated that genotype-specific herd immunity lasted long enough to influence the endemic norovirus genotype in the next season. Thus, norovirus circulates through human populations in a uniquely dynamic fashion.
Yasuda, Taketoshi; Hori, Takeshi; Suzuki, Kayo; Kawaguchi, Yoshiharu
Study Design Retrospective study. Purpose The aims of the current study are to evaluate the minimum 10-year follow-up clinical results of anterior lumbar interbody fusion (ALIF) for degenerative spondylolisthesis. Overview of Literature ALIF has been widely used as a treatment regimen in the management of lumbar spondylolisthesis. Still much controversy exists regarding the factors that affect the postoperative clinical outcomes. Methods The author performed a retrospective review of 20 patients with degenerative spondylolisthesis treated with ALIF (follow-up, 16.4 years). The clinical results were assessed by the Japanese Orthopaedic Association (JOA) score for low back pain, vertebral slip and disc height index on the radiographs. Results The mean preoperative JOA score was 7.1 ± 1.8 points (15-point-method). At 1 year, 5 years, and 10 years or more after surgery, the JOA scores were assessed as 12.4 ± 2.2 points, 12.7 ± 2.6 points, 12.0 ± 2.5 points, respectively (excluding the data of reoperated cases). The adjacent disc degeneration developed in all cases during the long-term follow-up. The progressive pattern of disc degeneration was divided into three types. Initially, disc degeneration occurred due to disc space narrowing. After that, the intervertebral discs showed segmental instability with translation at the upper level. But the lower discs showed osteophyte formation, and occasionally lead to the collapse or spontaneous union. Conclusions The clinical results of the long-term follow-up data after ALIF became worse due to the adjacent disc degeneration. The progressive pattern of disc degeneration was different according to the adjacent levels. PMID:22708014
Gest, Scott D.; Sesma, Arturo, Jr.; Masten, Ann S.; Tellegen, Auke
This study examined the differential developmental significance of multiple domains of peer reputation in childhood for current and future competence and symptoms. Participants were 205 children from a normative school cohort who completed assessments in grades 3-6 and then again 10 years later. Through re-analysis of original data from the…
van Beijsterveldt, C E M; Hudziak, James J; Boomsma, Dorret I
The aim of this study was to investigate the prevalence of cross-gender behavior during childhood, to estimate the influence of genotype and environment on variation in cross-gender behavior, and to explore the association of cross-gender behavior with maternal ratings of behavior problems as indexed by the Internalizing and Externalizing scales of the Child Behavior Checklist (CBCL). Cross-gender behavior was assessed by two items from the CBCL: "behaves like opposite sex" and "wishes to be of opposite sex." As part of an ongoing longitudinal study of the Netherlands Twin Registry, mothers were asked to complete the CBCL for their twins when they were 7 (n approximately 14,000 twins) and 10 years old (n approximately 8,500 twins). The prevalence of cross-gender behavior (as measured by maternal report of behaving like or wishing to be the opposite sex) was 3.2% and 5.2% for 7-year-old boys and girls, respectively, and decreased to 2.4% and 3.3% for 10-year-old boys and girls. Surprisingly, the prevalence rate of cross-gender behavior of girls with a male co-twin was lower than of girls with a female co-twin. At both ages, the similarity for cross-gender behavior was greater in monozygotic than in dizygotic twins pairs. Genetic structural equation modeling showed that 70% of the variance in the liability of cross-gender behavior could be explained by genetic factors, at both ages and for both sexes. Cross-gender behavior was associated with higher scores on Internalizing and Externalizing problems, both in boys and in girls.
Grotle, Margreth; Hagen, Kare B; Natvig, Bard; Dahl, Fredrik A; Kvien, Tore K
Background Obesity is one of the most important risk factors for osteoarthritis (OA) in knee(s). However, the relationship between obesity and OA in hand(s) and hip(s) remains controversial and needs further investigation. The purpose of this study was to investigate the impact of obesity on incident osteoarthritis (OA) in hip, knee, and hand in a general population followed in 10 years. Methods A total of 1854 people aged 24–76 years in 1994 participated in a Norwegian study on musculoskeletal pain in both 1994 and 2004. Participants with OA or rheumatoid arthritis in 1994 and those above 74 years in 1994 were excluded, leaving n = 1675 for the analyses. The main outcome measure was OA diagnosis at follow-up based on self-report. Obesity was defined by a body mass index (BMI) of 30 and above. Results At 10-years follow-up the incidence rates were 5.8% (CI 4.3–7.3) for hip OA, 7.3% (CI 5.7–9.0) for knee OA, and 5.6% (CI 4.2–7.1) for hand OA. When adjusting for age, gender, work status and leisure time activities, a high BMI (> 30) was significantly associated with knee OA (OR 2.81; 95%CI 1.32–5.96), and a dose-response relationship was found for this association. Obesity was also significantly associated with hand OA (OR 2.59; 1.08–6.19), but not with hip OA (OR 1.11; 0.41–2.97). There was no statistically significant interaction effect between BMI and gender, age or any of the other confounding variables. Conclusion A high BMI was significantly associated with knee OA and hand OA, but not with hip OA. PMID:18831740
Michelotti, A; Iodice, G; Piergentili, M; Farella, M; Martina, R
Among different malocclusions, posterior cross-bite is thought to have a strong impact on the correct functioning of the masticatory system. The association between unilateral posterior cross-bite (UPCB) and temporomandibular joint (TMJ) clicking, however, remains still controversial. The aim of this study was to investigate whether the presence of UCPB during early adolescence increases the risk of reporting TMJ clicking after a long-term follow-up. A longitudinal survey design was carried out in a group of 12-year-old young adolescents, who were examined at baseline for TMJ clicking sounds and unilateral posterior cross-bite. After 10 years, 519 subjects could be reached by a telephone survey. Standardised questions were used to collect self-reported TMJ sounds and to determine whether participants had received an orthodontic treatment. Logistic regression analysis revealed a significant association between unilateral posterior cross-bite and subjectively reported TMJ clicking (odds ratio = 6·0; 95% confidence limits = 3·4-10·8; P < 0·0001). The incidence of TMJ clicking was 12%. At a ten-year follow-up, self-reports of TMJ clicking were significantly associated with the presence of UPCB at baseline, but not with the report of having received an orthodontic treatment. Within the limitation of this study, the presence of unilateral posterior cross-bite in young adolescents may increase the risk of reporting TMJ sounds at a 10-year follow-up. The provision of an orthodontic treatment, however, does not appear to reduce the risk of reporting TMJ sounds.
Chen, Li-Wei; Chen, Fang-Ping; Hsieh, Chia-Wen; Kuo, Sheng-Fong; Chien, Rong-Nan
Helicobacter pylori (H. pylori) infection may induce inflammatory cytokines or adipokines that influence bone turnover and bone fracture risk. This study aimed to evaluate the association among H. pylori infection, adipokines, and 10-year fracture risk using the Fracture Risk Assessment Tool scale. From August 2013 to February 2016, a community-based cohort was surveyed by Keelung Chang-Gung Memorial Hospital. Subjects were included if they were older than 40 years and not pregnant. All participants underwent a standardized questionnaire survey, physical examination, urea breath test, and blood tests. A total of 2,689 participants (1,792 women) were included in this cross-sectional study. In both sexes, participants with a high fracture risk were older and had higher adiponectin values than participants without a high fracture risk (mean age, female: 72.9 ± 5.6 vs. 55.8 ± 7.3 years, P < 0.0001; male: 78.9 ± 4.7 vs. 58.1 ± 8.9 years, P < 0.001) (adiponectin, female: 10.8 ± 6.3 vs. 8.7 ± 5.2 ng/ml, P < 0.001; male: 9.7 ± 6.1 vs. 5.5 ± 3.8 ng/ml, P < 0.001). Adiponectin was correlated with high fracture risk in both sexes, but H. pylori infection and leptin was not. In logistic regression analysis, adiponectin could not predict high fracture risk when adjusting the factor of body mass index (BMI) in men group. In conclusion, H. pylori infection and leptin could not predict 10-year fracture risk in either sex. Adiponectin was correlated with bone fracture risk in both sexes and the correlation might be from the influence of BMI.
Coleman, Anne L.; Yu, Fei; Ensrud, Kristine E.; Stone, Katie L.; Cauley, Jane A; Pedula, Kathryn L.; Hochberg, Marc C.; Mangione, Carol M.
Purpose To assess vision-specific quality of life (QOL), based on abbreviated surveys derived from the National Eye Institute Visual Function Questionnaire (NEI-VFQ), in a cohort of US women who participated in the Study of Osteoporotic Fractures (SOF). Design Prospective, observational cohort study Methods Age-related macular degeneration (AMD) status, based on a three level classification (no AMD, early AMD, late AMD), and vision-specific QOL, based on abbreviated NEI-VFQ surveys were calculated for 1,674 women enrolled in the SOF at 4 centers within the US, who had gradable fundus photographs at both the 10-year and 15-year follow-up visits. The associations among 5-year changes in NEI-VFQ composite scores, change in AMD status, and distance visual acuity were examined. Results Compared to study participants without AMD at both visits, study participants with late AMD at both visits and those that progressed from early AMD to late AMD demonstrated the greatest declines in adjusted NEI-VFQ composite scores, up to a mean decrease of 16.2 out of a scale of 100. Visual acuity declines were also most prominent for patients with late AMD at both visits and for those that progressed from early AMD to late AMD. Change in visual acuity was found to correlate significantly with change in vision-specific QOL. Conclusions The abbreviated NEI-VFQ surveys provide reliable assessments of vision-specific QOL in AMD patients. The decline in vision-specific QOL associated with the progression of AMD is clinically meaningful. PMID:20691423
Morrison, John A; Glueck, Charles J; Wang, Ping
We evaluated the associations of teenage insulin and adolescent diet with 10-year weight gain in an analysis sample of black and white girls matched for pubertal stage, body mass index (BMI) (or fat mass), and insulin at ages 9 to 10 years. We hypothesized that preteen insulin and insulin resistance would interact with dietary factors to positively predict increases in BMI. Furthermore, we hypothesized that increased insulin and insulin resistance, interacting with higher caloric intake during adolescence, would lead to greater increments in BMI in black girls than in white girls. Prospective 10-year follow-up was performed on 215 pairs of black and white schoolgirls matched at baseline by BMI (or fat mass), insulin, and pubertal stage, with repeated measures of body habitus, insulin, and dietary intake. When matched for BMI, black girls had higher fat-free mass and white girls had higher fat mass at ages 9 to 10 years. Black-white differences in caloric intake were not significant at ages 9 to 10 years, but black girls consumed more calories at age 19 years. Black girls consumed a greater percentage of calories from fat throughout. At age 19 years, black girls had higher BMI, fat mass index, and insulin. When matched at ages 9 to 10 years for fat mass, black girls were heavier, had higher BMI, and had greater fat-free mass. By ages 18 to 19 years, black girls continued to have higher BMI, but had accrued higher fat mass and a higher percentage of body fat. By stepwise multiple regression, 10-year increases in BMI were predicted by ages 9 to 10 years BMI, 10-year change in insulin, and a 3-way interaction between ages 9 to 10 years insulin, adolescent caloric intake, and race (higher in black girls) (all Ps < .0001). Insulin at ages 9 to 10 years interacts with caloric intake to increase BMI by age 19 years. There appear to be intrinsic black-white metabolic differences that lead to greater gains in fat during adolescence in black girls. Evaluating BMI and insulin
Background The aim of this study was to determine the subsequent risk of acute urine retention and prostate surgery in patients receiving alpha-1 blockers treatment and having a maximum urinary flow rate of less than 15ml/sec. Methods We identified patients who were diagnosed with benign prostate hyperplasia (BPH) and had a maximum uroflow rate of less than 15ml/sec between 1 January, 2002 to 31 December, 2011 from Taiwan’s National Health Insurance Research Database into study group (n = 303). The control cohort included four BPH/LUTS patients without 5ARI used for each study group, randomly selected from the same dataset (n = 1,212). Each patient was monitored to identify those who subsequently developed prostate surgery and acute urine retention. Results Prostate surgery and acute urine retention are detected in 5.9% of control group and 8.3% of study group during 10-year follow up. Compared with the control group, there was increase in the risk of prostate surgery and acute urine retention in the study group (HR = 1.83, 95% CI: 1.16 to 2.91) after adjusting for age, comorbidities, geographic region and socioeconomic status. Conclusions Maximum urine flow rate of less than 15ml/sec is a risk factor of urinary retention and subsequent prostate surgery in BPH patients receiving alpha-1 blocker therapy. This result can provide a reference for clinicians. PMID:27513673
This article describes a number of human cohort studies based on the concept of brain-science and education. These studies assess the potential effects of new technologies on babies, children and adolescents, and test hypotheses drawn from animal and genetic case studies to see if they apply to people. A flood of information, virtual media,…
Goodfellow, Stephanie A; Rolfe, Edna M; Golding, Jean
The Isle of Man is a self-governing British Crown Dependency situated equidistantly from England, Scotland and Ireland. In 1991, its population of ∼75,000 comprised ∼50% indigenous Manx and 50% immigrants, mainly from the surrounding countries. It was invited to join the European Longitudinal Study of Pregnancy and Childhood. The aim of the study was to enrol all pregnant women resident on the Island with an expected date of delivery in the 18-month period of January 1991-June 1992. A total of 1314 livebirths formed the eligible cohort. Questionnaires were completed by mothers and their partners during pregnancy and subsequently at 6 weeks, 6 months, 18 months, 3, 5, 7 and 15/16 years. Hands-on examination of the children occurred at age 7 years, when biological samples were collected. Teachers completed questionnaires at 7 and 15 years; medical records were extracted for the obstetric and childhood periods. Response rates varied from >80% from teachers and children at 15 years to only 23% from partners when their children were aged 7 years. Selected data sets are available to collaborators, although many of the data need funds for further collaboration.
Grotmol, Kjersti S; Ekeberg, Øivind; Finset, Arnstein; Gude, Tore; Moum, Torbjørn; Vaglum, Per; Tyssen, Reidar
Elevated rates of suicide and depression among physicians have been reported. The associations between perceived parental bonding and depressive symptoms have yet to be studied longitudinally in this occupational group. In a nationwide cohort, we sought to study parental bonding as a predictor for severe depressive symptoms and to determine whether self-esteem mediates this relationship. After graduation (T1), medical students (N = 631) were followed-up after 1 (T2), 4 (T3), and 10 (T4) years. There were no gender differences in mean depressive scores. Female physicians reported higher levels of care from their mothers (p < 0.05) and less overprotection from their fathers (p < 0.05). Low-care from the mother predicted severe depressive symptoms (p = 0.01), an effect shown to be stronger for male than for female physicians. The relationship between perceived parental bonding and depressive symptoms was partially mediated by low self-esteem for both sexes.
Question: What are the key characteristics of the cohort study design and its varied applications, and how can this research design be utilized in health sciences librarianship? Data Sources: The health, social, behavioral, biological, library, earth, and management sciences literatures were used as sources. Study Selection: All fields except for health sciences librarianship were scanned topically for either well-known or diverse applications of the cohort design. The health sciences library literature available to the author principally for the years 1990 to 2000, supplemented by papers or posters presented at annual meetings of the Medical Library Association. Data Extraction: A narrative review for the health, social, behavioral, biological, earth, and management sciences literatures and a systematic review for health sciences librarianship literature for the years 1990 to 2000, with three exceptions, were conducted. The author conducted principally a manual search of the health sciences librarianship literature for the years 1990 to 2000 as part of this systematic review. Main Results: The cohort design has been applied to answer a wide array of theoretical or practical research questions in the health, social, behavioral, biological, and management sciences. Health sciences librarianship also offers several major applications of the cohort design. Conclusion: The cohort design has great potential for answering research questions in the field of health sciences librarianship, particularly evidence-based librarianship (EBL), although that potential has not been fully explored. PMID:12398244
Walijee, Hussein; Al-Hussaini, Ali; Harris, Andrew; Owens, David
There are a multitude of techniques to undertake tonsillectomy, with hot techniques such as diathermy and coblation being associated with a higher risk of secondary haemorrhage. The UK National Prospective Tonsillectomy Audit (2004) advocated cold steel dissection and ties to be the gold standard. This prospective observational study investigates the trends in tonsillectomy techniques across Wales in the last decade to establish if surgeons have adhered to this national guidance. Data relating to tonsillectomy were extracted over a 10-year period from 1 January 2003 to 31 December 2012 from the Wales Surgical Instrument Surveillance Programme database. A total of 19,195 patients were included. Time-series analysis using linear regression showed there was an increase in the number of bipolar diathermy tonsillectomies by 84% (Pearson's r = 0.762, p = 0.010) and coblation tonsillectomies by 120% (r = 0.825, p = 0.003). In contrast, there was a fall in the number of cold steel dissection tonsillectomies with ties by 60% (r = −0.939, p < 0.001). This observational study suggests that the use of bipolar and coblation techniques for tonsillectomy has increased. This deviation from national guidance may be due to these techniques being faster with less intraoperative bleeding. Further study for the underlying reasons for the increase in these techniques is warranted. PMID:26693228
Migdalis, Ilias; Rombopoulos, Grigorios; Hatzikou, Magdalini; Manes, Christos; Kypraios, Nikolaos; Tentolouris, Nikolaos
Objective. This study aimed to estimate the mean annual cost of treating type 2 diabetes mellitus patients (T2DM) including complications and comorbidities in Greece. Design. A noninterventional retrospective study was based on patient level data analysis (bottom-up approach) from medical records, with at least 10-year-follow-up data. Results. The total annual cost per patient for managing diabetes in Greece was estimated at € 7,111 and was, statistically significantly, higher for patients with inadequate glycemic control (Hba1c > 7%) versus patients with adequate control (Hba1c = 7%) (€ 7,783 versus € 6,366, resp.; P = 0.017). This was mainly attributed to difference in CV hospitalizations between groups 14/111 versus 4/100, respectively, OR = 3.46 (95% CI: 1.10-10.9) for inadequately controlled patients. The largest component of cost was management of comorbidities, accounting for 48% of costs, and pharmaceutical treatment at 35.9% while only 14.9% was attributed to diabetes treatment per se. Obese men and patients with poor education are the groups with higher treatment costs. Conclusions. This is the first study to capture all cost components and the real burden of diabetes in Greece. Comorbidities were found to account for almost half of total cost, significantly higher in nonoptimally controlled diabetes patients.
Murshid, Sakhr A.; Al-Labani, Mohammed A.; Aldhorae, Khalid A.; Rodis, Omar M. M.
Objectives: The premature loss of primary teeth is a potential risk factor for poor arch length development. Adequate arch length is important to the progression of the permanent teeth. Poor arch length can lead to crowding, ectopic eruption, or impaction of these teeth. This study is designed to assess the prevalence of premature loss of primary teeth in the 5-10-year-old age group. Materials and Methods: The study group included 185 children, that is, 91 boys and 94 girls. The dental examination was conducted by an experienced examiner under sufficient artificial light. Data including patient age and missing teeth were collected. Descriptive statistics were applied for data analysis, and from the results, Chi-square tests were used at a level of significance of 5% (P < 0.05). Results: We observed a 40.54% prevalence of premature loss of primary teeth with no statistically significant difference between genders. The lower left primary second molar was the most commonly absent tooth in the dental arch (13.5%). Conclusion: The status of premature loss of primary teeth was high in the study group. Implementation of efficient educational and preventive programs to promote oral health would help children maintain a healthy primary dentition and eventually prevent the disturbances in the future development of normal occlusion. Early detection and management of the space problems associated with the early loss of primary teeth would help in reducing malocclusion problems. PMID:27652244
Gonianakis, Michael I; Baritaki, Maria A; Neonakis, Ioannis K; Gonianakis, Ioannis M; Kypriotakis, Zacharias; Darivianaki, Eleftheria; Bouros, Dimosthenis; Kontou-Filli, Kalliopi
Pollen grains from the plant cover of a given area participate largely in the composition of aeroflora (pollen and molds) of this area. Association of allergic respiratory disorders with concentration of allergenic particles in the atmosphere is well documented, and aerobiologic studies are of great relevance. A 10-year volumetric aerobiologic study was conducted in the city of Heraklion, located in the center of the north-shore of the island of Crete, Greece. Main allergenic families and genera encountered were, in descending order of frequency Oleaceae, Quercus, Platanaceae, Cupressaceae, Pinaceae, Populus, Moraceae, and Corylaceae. Concentrations noted for most of these aeroallergens were much lower than those reported from other European regions. In parallel, an atopic population of 576 individuals, exhibiting allergic symptoms mainly of the respiratory tract were subjected to a battery of skin-prick tests. A fair degree of agreement between total pollen counts and positive skin-prick test frequencies for the families of Oleaceae, Platanaceae, and Cupressaceae was noted. On the contrary a poor degree of concordance was noted for the rest of the families and genera.
Bailey, Zinzi D; Slopen, Natalie; Albert, Michelle; Williams, David R
This study examined the relationship between multiple dimensions of religious involvement and transitions of tobacco smoking abstinence, persistence, cessation and relapse over 9-10 years of follow-up in a national sample of adults in the United States. Using data provided at baseline and follow-up, participants were categorized as non-smokers, persistent smokers, ex-smokers, and relapsed smokers. Religious involvement over the two time points were categorized into combinations of "high" and "low" involvement within the domains of (a) religious attendance, (b) religious importance, (c) spiritual importance, (d) religious/spiritual comfort seeking, and (e) religious/spiritual decision-making. High levels of religious involvement across five dimensions (religious attendance, religious importance, spiritual importance, religious/spiritual comfort-seeking, and religious/spiritual decision-making) were associated with lower odds of being a persistent smoker or ex-smoker. Religious involvement was not associated with smoking cessation among smokers at baseline. Interventions to increase smoking abstinence may be more effective if they draw on ties to religious and spiritual organizations and beliefs. Meanwhile, religious involvement is unlikely to affect smoking cessation effectiveness.
At the completion of the 1986-87 school year, the Albuquerque (New Mexico) Public Schools (APS) conducted a cohort survival and withdrawal study to follow-up 5,976 students who had begun the ninth grade within the district in 1983-84. Current records were matched with those from the 1983-84 school year to determine whether members of the…
Pierre, Samuel; Riviera, Vanessa; Jean, Circee Phara; Louis, Marie Jude Jean; Reif, Lindsey K; Severe, Patrice; Rouzier, Vanessa; Johnson, Warren D; Pape, Jean W; Fitzgerald, Daniel W; McNairy, Margaret L; Boutin-Foster, Carla
In 2003, the Haitian Study Group on Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), a nonprofit organization, began administering antiretroviral therapy (ART) to its patients. This practice transformed HIV from a fatal disease to a more manageable chronic condition. However, relatively few studies focus on the experiences of survivors. This study provided a unique opportunity to interview patients who survived at least 10 years after being treated with ART at GHESKIO. The goal of the study was to elicit from patients their perspectives on what enabled them to survive with AIDS. Grounded Theory, a qualitative research method was used to guide data collection, coding, and analysis. Individual interviews were conducted, audio-taped, transcribed and analyzed in Creole, and translated into English. Data saturation was reached at 25 participants. Of which, 64% were women, the mean age was 49, range of 43-55 years, 24% were married, 44% had not completed elementary school, and 72% had no income, the remaining participants had incomes ranging from $1000 to $5000 annually. Qualitative analysis resulted in 681 codes, which were grouped into six categories: being spiritually grounded, having supportive interactions with providers, caring for children, setting personal goals, persevering and living life as usual, and maintaining strict medication adherence practices. The overarching theory was that having a reason to live despite one's circumstances and living life as usual enabled one to survive. Having a strong spiritual foundation coupled with supportive family and providers motivated participants to live and adhere to their ART. As the number of patients who are living longer with HIV in Haiti increases, results from this study will be important in helping tailor interventions that enhance their overall quality of life.
The conference Swift: 10 years of discovery was held in Roma at La Sapienza University on Dec. 2-5 2014 to celebrate 10 years of Swift successes. Thanks to a large attendance and a lively program, it provided the opportunity to review recent advances of our knowledge of the high-energy transient Universe both from the observational and theoretical sides. When Swift was launched on November 20, 2004, its prime objective was to chase Gamma-Ray Bursts and deepen our knowledge of these cosmic explosions. And so it did, unveiling the secrets of long and short GRBs. However, its multi-wavelength instrumentation and fast scheduling capabilities made it the most versatile mission ever flown. Besides GRBs, Swift has observed, and contributed to our understanding of, an impressive variety of targets including AGNs, supernovae, pulsars, microquasars, novae, variable stars, comets, and much more. Swift is continuously discovering rare and surprising events distributed over a wide range of redshifts, out to the most distant transient objects in the Universe. Such a trove of discoveries has been addressed during the conference with sessions dedicated to each class of events. Indeed, the conference in Rome was a spectacular celebration of the Swift 10th anniversary. It included sessions on all types of transient and steady sources. Top scientists from around the world gave invited and contributed talks. There was a large poster session, sumptuous lunches, news interviews and a glorious banquet with officials attending from INAF and ASI. All the presentations, as well as several conference pictures, can be found in the conference website (http://www.brera.inaf.it/Swift10/Welcome.html). These proceedings have been collected owing to the efforts of Paolo D’Avanzo who has followed each paper from submission to final acceptance. Our warmest thanks to Paolo for all his work. The Conference has been made possible by the support from La Sapienza University as well as from the ARAP
Shin, H; Min, B; Park, J; Son, H
Female sexual dysfunction (FSD) is defined as disturbances in sexual desire and the psychophysiological changes that characterize the sexual response cycle, which cause marked distress and interpersonal difficulty. Female sexual dysfunction is strongly related to socio-cultural characteristics of a certain region and can change over time. Authors previously reported the features of FSD in Korea through an analysis of an internet-based survey conducted in 2004. This time, we designed a 10-year interval study to compare the prevalence of and risk factors of FSD through the Korean Internet Sexuality Survey (KISS) 2014. The internet-based survey was targeted towards 20-59-year-old women, who were asked to answer the questionnaire only if they were sexually active. In total, 516 responses were analyzed and the mean age of the subjects was 38.1±10.3 years. We defined FSD as having a total FSFI score of under 25.0, and resulted in a prevalence of FSD of 46.7%. The prevalence of FSD in each age group increased with age from 23.7, 45.4, 51.4 to 72%, for those in their 20, 30, 40 and 50s, respectively. Among the 50s age group, lubrication and pain domain dysfunctions were highly prevalent. The risk factors for FSD were identified as constipation, depression, incontinence, age of first intercourse, number of sexual partners and the use of oral contraceptive pills. Although the some demographic features of this study was different with those of the 2004 repot, the prevalence of FSD was similar with that reported previously in 2004 and a few risk factors of FSD was consistently significant in these interval studies.
Woodward, Mark; Huxley, Rachel; Ueshima, Hirotsugu; Fang, Xianghua; Kim, Hyeon Chang; Lam, Tai-Hing
The Asia Pacific Cohort Studies Collaboration (APCSC) was established in the late 1990s when there was a distinct shortfall in evidence of the importance of risk factors for cardiovascular disease in Asia. With few exceptions, most notably from Japan, most of the published reports on cardiovascular disease in the last century were from Western countries, and there was uncertainty how far etiological associations found in the West could be assumed to prevail in the East. Against this background, APCSC was set up as a pooling project, combining individual participant data (about 600,000 subjects) from all available leading cohort studies (36 from Asia and 8 from Australasia) in the region, to fill the knowledge gaps. In the past 10 years, APCSC has published 50 peer-reviewed publications of original epidemiological research, primarily concerned with coronary heart disease, stroke, and cancer. This work has established that Western risk factors generally act similarly in Asia and in Australasia, just as they do in other parts of the world. Consequently, strategies to reduce the prevalence of elevated blood pressure, obesity, and smoking are at least as important in Asia as elsewhere- and possibly more important when the vast size of Asia is considered. This article reviews the achievements of APCSC in the past decade, with an emphasis on coronary heart disease.
Mondal, Santosh Kumar; Mandal, Saikat
Background: Hereditary hemoglobin (Hb) disorders are the most commonly encountered single gene disorders in India. Proper timely identification of these disorders is of paramount importance to prevent thalassemia major and clinically severe hemoglobinopathy as well as for epidemiologic purposes. Aims: Our aim was to determine the prevalence of thalassemia and hemoglobinopathy in patients of a tertiary care hospital of West Bengal, India. Materials and Methods: This prospective study was conducted on 119,336 cases over a period of 10 years. After taking clinical history and familial history, complete hemogram report was obtained by an automated cell counter. High-performance liquid chromatography (HPLC) was performed on the samples with Bio-Rad Variant using beta thalassemia short program. Confirmatory tests were performed whenever required. Results: A normal Hb pattern was observed in 104,804 (87.83%) cases and abnormalities were detected in 14,532 (12.17%) patients. β (beta) thalassemia trait was the commonest abnormality found in 5,488 (4.60%) patients. HbE trait was found in 3,604 (3.02%) patients, β thalassemia major/intermedia in 1,981 (1.66%) cases, and Eβ thalassemia in 1,384 (1.16 %) cases. Other variants detected included HbE disease, sickle-cell disease, sickle β thalassemia, HbD-Punjab trait, HbQ-India trait, α-thal trait, double heterozygous state of HbS and HbE, double heterozygous state of HbS and HbD, HbJ-Meerut, hereditary persistence of fetal hemoglobin (HPFH), HbH, delta β-thal trait, and Hb Lepore. Conclusion: In view of the high prevalence of hemoglobinopathy in this region, a routine premarital screening program is needed for the identification and prevention of high-risk marriages and thus, prevention of the psychosocial trauma of bearing a transfusion-dependent child for life. PMID:27011683
Lowery, Amy E.; Starr, Tatiana; Dhingra, Lara K.; Rogak, Lauren; Hamrick-Price, Julie R.; Farberov, Maria; Kirsh, Kenneth L.; Saltz, Leonard B.; Breitbart, William S.; Passik, Steven D.
Objective The long-term effects of disease and treatment in colorectal cancer (CRC) survivors are poorly understood. This study examined the prevalence and characteristics of pain in a sample of CRC survivors up to 10 years post-treatment. Design One hundred cancer-free CRC survivors were randomly chosen from an institutional database and completed a telephone survey using the Brief Pain Inventory, Neuropathic Pain Questionnaire-Short Form, Quality of Life Cancer Survivor Summary, Brief Zung Self-Rating Depression Scale, Zung Self-Rating Anxiety Scale, and Fear of Recurrence Questionnaire. Results Participants were primarily Caucasian (90%) married (69%) males (53.5%) with a mean age of 64.7 years. Chronic pain was reported in 23% of CRC survivors, with a mean moderate intensity rating (mean = 6.05, standard deviation = 2.66) on a 0–10 rating scale. Over one-third (39%) of those with pain attributed it to their cancer or treatment. Chi-square and t-test analyses showed that survivors with pain were more likely to be female, have lower income, be more depressed and more anxious, and show a higher endorsement of suicidal ideation than CRC survivors without chronic pain. On average, pain moderately interfered with daily activity. Conclusions Chronic pain is likely a burdensome problem for a small but not inconsequential minority of CRC survivors requiring a biopsychosocial treatment approach to improve recognition and treatment. Open dialogue between clinicians and survivors about physical and emotional symptoms in long-term follow-up is highly recommended. PMID:24010414
Background Diabetes mellitus type 2 (DM2) is highly associated with increased risk for chronic kidney disease (CKD), end stage renal disease (ESRD) and cardiovascular morbidity. Epidemiological and genetic studies generate hypotheses for innovative strategies in DM2 management by unravelling novel mechanisms of diabetes complications, which is essential for future intervention trials. We have thus initiated the DIAbetes COhoRtE study (DIACORE). Methods DIACORE is a prospective cohort study aiming to recruit 6000 patients of self-reported Caucasian ethnicity with prevalent DM2 for at least 10 years of follow-up. Study visits are performed in University-based recruiting clinics in Germany using standard operating procedures. All prevalent DM2 patients in outpatient clinics surrounding the recruiting centers are invited to participate. At baseline and at each 2-year follow-up examination, patients are subjected to a core phenotyping protocol. This includes a standardized online questionnaire and physical examination to determine incident micro- and macrovascular DM2 complications, malignancy and hospitalization, with a primary focus on renal events. Confirmatory outcome information is requested from patient records. Blood samples are obtained for a centrally analyzed standard laboratory panel and for biobanking of aliquots of serum, plasma, urine, mRNA and DNA for future scientific use. A subset of the cohort is subjected to extended phenotyping, e.g. sleep apnea screening, skin autofluorescence measurement, non-mydriatic retinal photography and non-invasive determination of arterial stiffness. Discussion DIACORE will enable the prospective evaluation of factors involved in DM2 complication pathogenesis using high-throughput technologies in biosamples and genetic epidemiological studies. PMID:23409726
Hsu, Tai-Yi; Shih, Hong-Mo; Wang, Yu-Chiao; Lin, Leng-Chieh; He, Guan-Yi; Chen, Chih-Yu; Kao, Chia-Hung; Chen, Chao-Hsien
Purpose This study investigated whether alcoholic intoxication (AI) increases the risk of inflammatory bowel disease (IBD) by using a population-based database in Taiwan. Methods This retrospective matched-cohort study included 57 611 inpatients with new-onset AI (AI cohort) and 230 444 randomly selected controls (non-AI cohort). Each patient was monitored for 10 years to individually identify those who were subsequently diagnosed with Crohn disease (CD) and ulcerative colitis (UC) during the follow-up period. Cox proportional hazard regression analysis was conducted to determine the risk of IBD in patients with AI compared with controls without AI. Results The incidence rate of IBD during the 10-year follow-up period was 2.69 per 1 000 person-years and 0.49 per 1 000 person-years in the AI and non-AI cohorts, respectively. After adjustment for age, sex, and comorbidity, the AI cohort exhibited a 3.17-fold increased risk of IBD compared with the non-AI cohort (hazard ratio [HR] = 3.17, 95% confidence interval [CI] = 2.19–4.58). Compared with the non-AI cohort, the HRs of CD and UC were 4.40 and 2.33 for the AI cohort, respectively. After stratification for the severity of AI according to the duration of hospital stay, the adjusted HRs exhibited a significant correlation with the severity; the HRs of IBD were 1.76, 6.83, and 19.9 for patients with mild, moderate, and severe AI, respectively (p for the trend < .0001). Conclusion The risk of IBD was higher in patients with AI and increased with the length of hospital stay. PMID:27802288
Chanteau, S; Glaziou, P; Plichart, C; Luquiaud, P; Plichart, R; Faucher, J F; Cartel, J L
In 1983, a cohort study to follow up the family contacts of leprosy cases was implemented in French Polynesia to assess the usefulness and applicability of phenolic glycolipid-I (PGL-I) serology in a leprosy control program. A total of 1201 contacts (666 females, 535 males) have been included in the study. The IgM anti-PGL-I seroprevalence determined on the initial sera was 17%. It was significantly higher among females than males (20% vs 15%, p = 0.02). From 1983 to 1992, 4 out of 204 (2%) anti-PGL-I seropositive contacts developed the disease (1 indeterminate, 1 BT, 1 BL, 1 LL) compared with 10 out of 997 (1%) seronegative contacts (4 indeterminate, 3 BT, 1 BB, 2 TT). Of these 10 patients, only 3 (2 indeterminate, 1 BT) converted to seropositivity when leprosy was diagnosed. The risk of developing leprosy was not significantly higher among seropositive than among seronegative groups (2% vs 1%, p = 0.2). A PGL-I circulating antigen test performed on 216 selected sera at entry into the trial showed a higher antigen prevalence when the antibody level was higher. PGL-I antigen was detectable in 5 of 12 patients tested prior to diagnosis (1 LL, 1 BL, 3 indeterminate). The median time to externalize the disease was not significantly different among antibody-positive and -negative contacts (17 vs 25 months, p = 0.3). The relative risk of developing leprosy for contact individuals was 30.8 times that of noncontacts, and 15% of the total new cases detected between 1983 and 1992 emerged from the study population.(ABSTRACT TRUNCATED AT 250 WORDS)
Climate forecasts have been developed to assist decision making in sectors averse to, and affected by, climate risks, and agriculture is one of those. In agriculture and food security, climate information is now used on a range of timescales, from days (weather), months (seasonal outlooks) to decades (climate change scenarios). Former researchers have shown that when seasonal climate forecast information was provided to farmers prior to decision making, farmers adapted by changing their choice of planting seeds and timing or area planted. However, it is not always clear that the end-users' needs for climate information are met and there might be a large gap between information supplied and needed. It has been pointed out that even when forecasts were available, they were often not utilized by farmers and extension services because of lack of trust in the forecast or the forecasts did not reach the targeted farmers. Many studies have focused on the use of either seasonal forecasts or longer term climate change prediction, but little research has been done on the medium term, that is, 1 to 10 year future climate information. The agriculture and food system sector is one potential user of medium term information, as land use policy and cropping systems selection may fall into this time scale and may affect farmers' decision making process. Assuming that reliable information is provided and it is utilized by farmers for decision making, it might contribute to resilient farming and indeed to longer term food security. To this end, we try to determine the effect of medium term climate information on farmers' strategic decision making process. We explored the end-users' needs for climate information and especially the possible role of medium term information in agricultural system, by conducting interview surveys with farmers and agricultural experts. In this study, the cases of apple production in South Africa, maize production in Malawi and rice production in Tanzania
Bone metabolism and the 10-year probability of hip fracture and a major osteoporotic fracture using the country-specific FRAX algorithm in men over 50 years of age with type 2 diabetes mellitus: a case-control study.
Bhattoa, Harjit P; Onyeka, Ugo; Kalina, Edit; Balogh, Adam; Paragh, Gyorgy; Antal-Szalmas, Peter; Kaplar, Miklos
The aim of the study was to evaluate the 10-year probability of hip fracture and a major osteoporotic fracture using the FRAX algorithm, vitamin D status, bone mineral density (BMD), and biochemical markers of bone turnover in men over 50 years of age with type 2 diabetes mellitus (T2DM). We estimated FRAX-predicted 10-year fracture probability, levels of 25-hydroxyvitamin D (25-OH-D), markers of bone turnover, and bone mineral density at the L1-L4 (lumbar spine (LS)) and femur neck (FN) in 68 men with T2DM and compared these with an age-matched group (n = 68). The mean (range) age of the T2DM group was 61.4 (51-78) years. The prevalence of hypovitaminosis D (25-OH-D <75 nmol/L) was 59 %. The mean (range) FRAX hip fracture and FRAX major osteoporotic fracture was 0.7 (0-2.8) and 3.2 (0-8.5) %, respectively. BMD at the FN (0.974 vs. 0.915 g/cm(2), p = 0.008) and LS (1.221 vs. 1.068 g/cm(2), p < 0.001) was significantly higher in the T2DM cohort as compared to the healthy age-matched males. 25-OH-vitamin D (67.7 vs.79.8 nmol/L, p < 0.001), crosslaps (0.19 vs. 0.24 μg/L, p = 0.004), and osteocalcin (13.3 vs. 15.7 μg/L, p = 0.004) were significantly lower in the T2DM group. There was no difference in FRAX-related fracture probability between the two groups. Acknowledging the limitations of our study size, we suggest that the increased BMD in T2DM and the noninclusion of T2DM as a secondary risk factor in the FRAX algorithm may be probable explanations for the discordance between literature-observed and FRAX-related fracture probabilities.
Moore, J.; Meitin, J. G.
network required to support real-time mission planning and data collection. The capability to share real-time data and products has only been available in the last 5-10 years. The advent of Internet-based communications technology has proven invaluable. Unique communication solutions will be described. The impact of these capabilities on the success of the project will be discussed.Selected Field Projects Focused on Tropical SystemsTable includes project acronym, time frame, primary funding source and major mobile facilities
Desai, Chintan S; Bartz, Traci M; Gottdiener, John S; Lloyd-Jones, Donald M; Gardin, Julius M
Left ventricular (LV) mass and geometry are associated with risk of cardiovascular disease (CVD). We sought to determine whether LV mass and geometry contribute to risk prediction for CVD in adults aged ≥65 years of the Cardiovascular Health Study. We indexed LV mass to body size, denoted as LV mass index (echo-LVMI), and we defined LV geometry as normal, concentric remodeling, and eccentric or concentric LV hypertrophy. We added echo-LVMI and LV geometry to separate 10-year risk prediction models containing traditional risk factors and determined the net reclassification improvement (NRI) for incident coronary heart disease (CHD), CVD (CHD, heart failure [HF], and stroke), and HF alone. Over 10 years of follow-up in 2,577 participants (64% women, 15% black, mean age 72 years) for CHD and CVD, the adjusted hazards ratios for a 1-SD higher echo-LVMI were 1.25 (95% CI 1.14 to 1.37), 1.24 (1.15 to 1.33), and 1.51 (1.40 to 1.62), respectively. Addition of echo-LVMI to the standard model for CHD resulted in an event NRI of -0.011 (95% CI -0.037 to 0.028) and nonevent NRI of 0.034 (95% CI 0.008 to 0.076). Addition of echo-LVMI and LV geometry to the standard model for CVD resulted in an event NRI of 0.013 (95% CI -0.0335 to 0.0311) and a nonevent NRI of 0.043 (95% CI 0.011 to 0.09). The nonevent NRI was also significant with addition of echo-LVMI for HF risk prediction (0.10, 95% CI 0.057 to 0.16). In conclusion, in adults aged ≥65 years, echo-LVMI improved risk prediction for CHD, CVD, and HF, driven primarily by improved reclassification of nonevents.
Dai, Min; Bai, Yana; Pu, Hongquan; Cheng, Ning; Li, Haiyan; He, Jie
Cancer control is a long-term work. Cancer research and intervention really need the support of cohort study. In the recent years, more and more cohort studies on cancer control were conducted in China along with the increased ability of scientific research in China. Since 2010, Cancer Hospital, Chinese Academy of Medical Sciences, collaborated with Lanzhou University and the Worker' s Hospital of Jinchuan Group Company Limited, have carried out a large-scale cohort study on cancer, which covered a population of more than 50 000 called " Jinchang cohort". Since 2012, a National Key Public Health Project, "cancer screening in urban China" , has been conducted in Jinchang, which strengthened the Jinchang cohort study. Based on the Jinchang cohort study, historical cohort study, cross-sectional study and prospective cohort study have been conducted, which would provide a lot of evidence for the cancer control in China.
Austin, S.G.; Schnatter, A.R.
A historical prospective cohort mortality study was conducted for a cohort of 6,588 white male employees of a Texas petrochemical plant because of a suspected increased incidence of malignant brain tumors. Mortality experience from 1941 to 1977 was determined and compared with that of the general U.S. white male population adjusting for age and time period. Overall and cause-specific standardized mortality ratios were calculated for various subgroups of the population defined by length of employment, latency and payroll status. Significant deficits in total cohort mortality were found for all causes of death, all circulatory diseases, all respiratory diseases and all digestive diseases. Although not statistically significant, fewer deaths were observed (O) than expected (E) for all malignant neoplasms. No statistically significant excess of malignant brain tumors was found in the overall plant population (O/E = 12/7.42 = 1.62). A borderline significant excess of brain cancer deaths was found among hourly employees with more than six months' employment based on 10 observed and five expected deaths. This excess was observed to occur among elderly employees (over 55 years) and in later follow-up years (post-1970). Risk did not appear to be related to length of employment. Because of the nature of the problem that prompted this study, the small number of cases involved and the lack of a suspect agent in the plant that could have produced this excess, insufficient evidence was found to conclude that these tumors were occupationally related.
Whyte, D A; Lugton, J; Fawcett, T N
Continuing education is now recognized as essential if nursing is to develop as a profession. United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) consultations are currently seeking to establish appropriate preparation for a 'higher level of practice' in the United Kingdom. The relevance of Masters level education to developing professional roles merits examination. To this end the results of a 10-year follow-up study of graduates from the Masters programme at the University of Edinburgh are reported. The sample was the entire cohorts of nurses who graduated with a Masters degree in the academic sessions from 1986 to 1996. A postal questionnaire was designed consisting of mainly closed questions to facilitate coding and analysis but also including some open questions to allow for more qualitative data to be elicited. The findings indicated clearly that the possession of an MSc degree opened up job opportunities and where promotion was not identified, the process of study at a higher level was still perceived as relevant to the work environment. This applied as much to the context of clinical practice as to that of management, education or research. The perceived enhancement of clinical practice from a generic Masters programme was considered a significant finding. Also emerging from the data was an associated sense of personal satisfaction and achievement that related to the acquisition of academic skills and the ultimate reward of Masters status. The concept of personal growth, however, emerged as a distinct entity from that of satisfaction and achievement, relating specifically to the concept of intellectual sharing, the broadening of perspectives and the development of advanced powers of reasoning.
Hasselhorn, Hans Martin; Peter, Richard; Rauch, Angela; Schröder, Helmut; Swart, Enno; Bender, Stefan; du Prel, Jean-Baptist; Ebener, Melanie; March, Stefanie; Trappmann, Mark; Steinwede, Jacob; Müller, Bernd Hans
The lidA Cohort Study (German Cohort Study on Work, Age, Health and Work Participation) was set up to investigate and follow the effects of work and work context on the physical and psychological health of the ageing workforce in Germany and subsequently on work participation. Cohort participants are initially employed people subject to social security contributions and born in either 1959 (n = 2909) or 1965 (n = 3676). They were personally interviewed in their homes in 2011 and will be visited every 3 years. Data collection comprises socio-demographic data, work and private exposures, work ability, work and work participation attitudes, health, health-related behaviour, personality and attitudinal indicators. Employment biographies are assessed using register data. Subjective health reports and physical strength measures are complemented by health insurance claims data, where permission was given. A conceptual framework has been developed for the lidA Cohort Study within which three confirmatory sub-models assess the interdependencies of work and health considering age, gender and socioeconomic status. The first set of the data will be available to the scientific community by 2015. Access will be given by the Research Data Centre of the German Federal Employment Agency at the Institute for Employment Research (http://fdz.iab.de/en.aspx).
Hristova-Veleva, Svetla; Haddad, Ziad; Knosp, Brian; Lambrigtsen, Bjorn; Li, P. Peggy; Poulsen, William; Seo, Eun-Kyoung; Shen, Tsae-Pyng; Turk, Francis J.; Vu, Quoc
In spite of recent improvements in hurricane track forecast accuracy, currently there are still many unanswered questions about the physical processes that determine hurricane genesis, and evolution. Furthermore, a significant amount of work remains to be done in validating and improving hurricane forecast models. None of this can be accomplished without a comprehensive set of multi-parameter observations that are relevant to both the large-scale and the storm-scale processes in the atmosphere and in the ocean. Despite the significant amount of satellite observations today, they are still underutilized in hurricane research and operations, due to complexity and volume. To facilitate hurricane research, we developed the JPL Tropical Cyclone Information System (TCIS) of multi-instrument satellite observations pertaining to: i) the thermodynamic and microphysical structure of the storms; ii) the air-sea interaction processes; iii) the larger-scale environment as depicted by the SST and the Total Precipitable Water of the environment (Hristova-Veleva et al., 2008, 2011). Our goal was to create a one-stop place to provide the researchers with an extensive set of observed hurricane data, and their graphical representation, organized in an easy way to determine when coincident observations from multiple instruments are available. In this study we use the 10+ years of passive microwave observations of Atlantic hurricanes to create composite structures that are segregated by hurricane category and by intensification rate. The use of composite structures provides a statistically robust framework (e.g. Rogers et al., 2012). We analyze the storm asymmetry as depicted by several factors - brightness temperatures and their derivatives such as a newly-develop Rain Indicator and a new convective/stratiform separation that is based on the value and the spatial variability of this Rain Indicator. The goal is to determine whether the storm morphology (in particular, the storm
Becker, James T; Kingsley, Lawrence A; Molsberry, Samantha; Reynolds, Sandra; Aronow, Aaron; Levine, Andrew J; Martin, Eileen; Miller, Eric N; Munro, Cynthia A; Ragin, Ann; Sacktor, Ned; Selnes, Ola A
The Multicenter AIDS Cohort Study (MACS) is one of the largest and longest running studies of the natural and treated history of HIV disease. The Neuropsychological (NP) substudy was begun in 1988 following reports of significant adverse neurological consequences of HIV disease, including dementia. The goal was to characterize the neuropsychological deficits among individuals with HIV disease, and track the natural history of the neurological complications over time. There were three distinct MACS recruitment stages that focused on different groups of HIV-infected men, or men at risk for infection. Initially, a subcohort was evaluated semi-annually with NP tests but, beginning in 2005, the entire group of MACS participants have had NP examinations biannually, unless closer follow-up was warranted. The participants complete a battery of NP tests, and are classified as either normal, mildly or severely impaired using the Antinori criteria for HIV-Associated Neurocognitive Disorder (HAND). Additional behavioural data, including mood state and psychoactive substance use, are recorded as part of the main MACS data collection. The MACS public data set (PDS) has been available since 1994 and includes baseline and 6-monthly follow-up data. Beginning in October 1995, the PDS has been released annually with new releases superseding previous versions. PMID:24771276
Lubin, Amélie; Rossi, Sandrine; Simon, Grégory; Lanoë, Céline; Leroux, Gaëlle; Poirel, Nicolas; Pineau, Arlette; Houdé, Olivier
Are individual differences in numerical performance sustained by variations in gray matter volume in schoolchildren? To our knowledge, this challenging question for neuroeducation has not yet been investigated in typical development. We used the Voxel-Based Morphometry method to search for possible structural brain differences between two groups of 10-year-old schoolchildren (N = 22) whose performance differed only in numerical transcoding between analog and symbolic systems. The results indicated that children with low numerical proficiency have less gray matter volume in the parietal (particularly in the left intraparietal sulcus and the bilateral angular gyri) and occipito-temporal areas. All the identified regions have previously been shown to be functionally involved in transcoding between analog and symbolic numerical systems. Our data contribute to a better understanding of the intertwined relationships between mathematics learning and brain structure in healthy schoolchildren. PMID:23630510
Lubin, Amélie; Rossi, Sandrine; Simon, Grégory; Lanoë, Céline; Leroux, Gaëlle; Poirel, Nicolas; Pineau, Arlette; Houdé, Olivier
Are individual differences in numerical performance sustained by variations in gray matter volume in schoolchildren? To our knowledge, this challenging question for neuroeducation has not yet been investigated in typical development. We used the Voxel-Based Morphometry method to search for possible structural brain differences between two groups of 10-year-old schoolchildren (N = 22) whose performance differed only in numerical transcoding between analog and symbolic systems. The results indicated that children with low numerical proficiency have less gray matter volume in the parietal (particularly in the left intraparietal sulcus and the bilateral angular gyri) and occipito-temporal areas. All the identified regions have previously been shown to be functionally involved in transcoding between analog and symbolic numerical systems. Our data contribute to a better understanding of the intertwined relationships between mathematics learning and brain structure in healthy schoolchildren.
Aas, Eline; Odes, Selwyn; Småstuen, Milada; Stockbrugger, Reinhold; Hoff, Geir; Moum, Bjørn; Bernklev, Tomm
Background. The treatment of chronic inflammatory bowel disease (IBD) is costly, and limited resources call for analyses of the cost effectiveness of therapeutic interventions. The present study evaluated the equivalency of the Short Form 6D (SF-6D) and the Euro QoL (EQ-5D), two preference-based HRQoL instruments that are broadly used in cost-effectiveness analyses, in an unselected IBD patient population. Methods. IBD patients from seven European countries were invited to a follow-up visit ten years after their initial diagnosis. Clinical and demographic data were assessed, and the Short Form 36 (SF-36) was employed. Utility scores were obtained by calculating the SF-6D index values from the SF-36 data for comparison with the scores obtained with the EQ-5D questionnaire. Results. The SF-6D and EQ-5D provided good sensitivities for detecting disease activity-dependent utility differences. However, the single-measure intraclass correlation coefficient was 0.58, and the Bland-Altman plot indicated numerous values beyond the limits of agreement. Conclusions. There was poor agreement between the measures retrieved from the EQ-5D and the SF-6D utility instruments. Although both instruments may provide good sensitivity for the detection of disease activity-dependent utility differences, the instruments cannot be used interchangeably. Cost-utility analyses performed with only one utility instrument must be interpreted with caution. PMID:27630711
Slopen, Natalie; Kontos, Emily Zobel; Ryff, Carol D.; Ayanian, John Z.; Albert, Michelle A.; Williams, David R.
Purpose Year-to-year decreases in smoking in the US have been observed only sporadically in recent years, which suggest a need for intensified efforts to identify those at risk for persistent smoking. To address this need, we examined the association between a variety of psychosocial stressors and smoking persistence, cessation, and relapse over 9–10 years among adults in the United States (N=4938, ages 25–74). Methods Using information provided at baseline and follow-up, participants were categorized as non-smokers, persistent smokers, ex-smokers, and relapsed smokers. Stressors related to relationships, finances, work-family conflict, perceived inequality, neighborhood, discrimination, and past-year family problems were assessed at baseline and follow-up. Results High stress at both assessments was associated with greater odds of persistent smoking for stressors related to relationships, finances, work, perceived inequality, past-year family problems, and a summary score. Among respondents who were smokers at baseline, high stress at both time-points for relationship stress, perceived inequality, and past-year family problems was associated with nearly double the odds of failure to quit. Conclusions Interventions to address psychosocial stress may be important components within smoking cessation efforts. PMID:23860953
Owen, Christopher G.; Nightingale, Claire M.; Rudnicka, Alicja R.; van Sluijs, Esther M. F.; Ekelund, Ulf; Cook, Derek G.; Whincup, Peter H.
Background Travel to school may offer a convenient way to increase physical activity levels in childhood. We examined the association between method of travel to school and physical activity levels in urban multi-ethnic children. Methods and Findings 2035 children (aged 9–10 years in 2006–7) provided data on their usual method of travel to school and wore an Actigraph-GT1M activity monitor during waking hours. Associations between method of travel and mean level of physical activity (counts per minute [CPM], steps, time spent in light, moderate or vigorous activity per day) were examined in models adjusted for confounding variables. 1393 children (69%) walked or cycled to school; 161 (8%) used public transport and 481 (24%) travelled by car. White European children were more likely to walk/cycle, black African Caribbeans to travel by public transport and South Asian children to travel by car. Children travelling by car spent less time in moderate to vigorous physical activity (−7 mins, 95%CI-9,-5), and had lower CPM (−32 CPM, 95%CI-44,-19) and steps per day (−813 steps, 95%CI,-1043,-582) than walkers/cyclists. Pupils travelling by public transport had similar activity levels to walkers/cyclists. Lower physical activity levels amongst car travellers' were especially marked at travelling times (school days between 8–9 am, 3–5 pm), but were also evident on weekdays at other times and at weekends; they did not differ by gender or ethnic group. Conclusion Active travel to school is associated with higher levels of objectively measured physical activity, particularly during periods of travel but also at other times. If children travelling by car were to achieve physical activity levels (steps) similar to children using active travel, they would increase their physical activity levels by 9%. However, the population increase would be a modest 2%, because of the low proportion of car travellers in this urban population. PMID:22319596
López Gómez, María Andrée; Durán, Xavier; Zaballa, Elena; Sanchez-Niubo, Albert; Delclos, George L; Benavides, Fernando G
Purpose The global economy is changing the labour market and social protection systems in Europe. The effect of both changes on health needs to be monitored in view of an ageing population and the resulting increase in prevalence of chronic health conditions. The Spanish WORKing life Social Security (WORKss) cohort study provides unique longitudinal data to study the impact of labour trajectories and employment conditions on health, in terms of sickness absence, permanent disability and death. Participants The WORKss cohort originated from the Continuous Working Life Sample (CWLS) generated by the General Directorate for the Organization of the Social Security in Spain. The CWLS contains a 4% representative sample of all individuals in contact with the Social Security system. The WORKss cohort exclusively includes individuals with a labour trajectory from 1981 or later. In 2004, the cohort was initiated with 1 022 779 Social Security members: 840 770 (82.2%) contributors and 182 009 (17.8%) beneficiaries aged 16 and older. Findings to date The WORKss cohort includes demographic characteristics, chronological data about employment history, retirement, permanent disability and death. These data make possible the measurement of incidence of permanent disability, the number of potential years of working life lost, and the number of contracts and inactive periods with the Social Security system. The WORKss cohort was linked to temporary sickness absence registries to study medical diagnoses that lead to permanent disability and consequently to an earlier exit from the labour market in unhealthy conditions. Future plans Thanks to its administrative source, the WORKss cohort study will continue follow-up in the coming years, keeping the representativeness of the Spanish population affiliated to the Social Security system. The linkage between the WORKss cohort and temporary sickness absence registries is envisioned to continue. Future plans include the linkage of
Liu, Sze Yan; Buka, Stephen L; Kubzansky, Laura D; Kawachi, Ichiro; Gilman, Stephen E; Loucks, Eric B
While the association between education and adult health is well documented, it is unclear whether quantity (i.e. years of schooling) or credentials (i.e. degrees) drive this association. Individuals with degrees may have better health than their non-credentialed counterparts given similar years of schooling, the so-called "sheepskin" effect. This paper contributes to this line of inquiry by examining associations of educational degree and years of schooling with the Framingham Risk Score, a measure of 10-year risk of coronary heart disease (CHD), using data from a unique birth cohort (the New England Family Study; participants mean age 42 years) with prospective information on childhood health and intelligence quotient (IQ). According to our results, years of schooling were inversely associated with 10-year CHD risk in the unadjusted model but not in the fully adjusted models that included degree attainment. By contrast, associations between degree attainment and 10-year CHD risk remained significant in the fully adjusted models that included years of schooling. College degree holders had 10-year CHD risk 19% (95% CI: -33%, -2%) lower than individuals with HS degrees or less in the fully adjusted models. Subanalyses evaluating sheepskin effects on the individual components of the 10-year CHD risk algorithm showed the expected education gradient was generally noted for each of the individual components, with decreasing prevalence of "high risk" values associated with higher degree credentials. Our results suggest educational credentials provide an additional benefit to risk of coronary heart disease beyond schooling.
Cirillo, Massimo; Terradura-Vagnarelli, Oscar; Mancini, Mario; Menotti, Alessandro; Zanchetti, Alberto; Laurenzi, Martino
The Gubbio Study is a prospective epidemiological study on the population residing in the city of Gubbio, Italy. Original objectives of the study were the control of hypertension and the role of cellular electrolyte handling in hypertension. Other objectives were added during the 30-year activity of the study. The original target cohort consists of individuals aged ≥ 5 years residing within the medieval walls of the city. To complete family genealogies, individuals residing outside the city were also included. Three active screenings (exams) were conducted. A total of 5376 individuals (response rate 92%) participated in Exam 1 which was performed in 1983–86. Follow-up exams were completed between 1989–92 and 2001–2007. Data categories included demographics, personal and family medical history, lifestyle habits, education, type of work, anthropometry, blood pressure, pulse rate, blood biochemistry, urine biochemistry and special investigations on cellular electrolyte handling. Electrocardiogram, echocardiogram, 24-h ambulatory blood pressure and uroflowmetry were performed in selected subgroups defined by age and/or sex. Data about hospitalizations, mortality and causes of death were collected starting from completion of Exam 1. The study shared the data with other studies. PMID:23543599
Jones, Kay S.
Arthroscopic surgery of the hip is a well-established technique with numerous recognized indications. Despite the well-accepted nature of this procedure, there have been no outcomes studies with extended followup. We investigated the response to hip arthroscopy in a consecutive series of patients with 10 years followup. Since 1993, all patients undergoing hip arthroscopy have been assessed prospectively with a modified Harris hip score preoperatively and then postoperatively at 3, 12, 24, 60, and 120 months. A cohort of 50 patients (52 hips) was identified who had achieved 10-year followup and represent the substance of this study. There was 100% followup. The average age of the patients was 38 years (range, 14–84 years), with 27 males and 23 females. The median improvement was 25 points (preoperative, 56 points; postoperative, 81 points). Fourteen patients were converted to THA and two died. Four patients underwent repeat arthroscopy. There were two complications in one patient. The presence of arthritis at the time of the index procedure was an indicator of poor prognosis. This study substantiates the long-term effectiveness of arthroscopy in the hip as treatment for various disorders, including labral pathology, chondral damage, synovitis, and loose bodies. Arthritis is an indicator of poor long-term outcomes with these reported methods. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. PMID:19381742
Parkinson, Claire L.
NASA's Aqua spacecraft was launched at 2:55 a.m. on May 4, 2002, from Vandenberg Air Force Base in California, into a near-polar, sun-synchronous orbit at an altitude of 705 km. Aqua carries six Earth-observing instruments to collect data on water in all its forms (liquid, vapor, and solid) and on a wide variety of additional Earth system variables (Parkinson 2003). The design lifetime for Aqua's prime mission was 6 years, and Aqua is now well into its extended mission, approaching 10 years of successful operations. The Aqua data have been used for hundreds of scientific studies and continue to be used for scientific discovery and numerous practical applications.
Paulus, Jessica K; Santoyo-Vistrain, Rocío; Havelick, David; Cohen, Amy; Kalyesubula, Robert; Ajayi, Ikeoluwapo O; Mattsson, Jens G; Adami, Hans-Olov; Dalal, Shona
A striking disparity exists across the globe, with essentially no large-scale longitudinal studies ongoing in regions that will be significantly affected by the oncoming non-communicable disease epidemic. The successful implementation of cohort studies in most low-resource research environments presents unique challenges that may be aided by coordinated training programs. Leaders of emerging cohort studies attending the First World Cohort Integration Workshop were surveyed about training priorities, unmet needs and potential cross-cohort solutions to these barriers through an electronic pre-workshop questionnaire and focus groups. Cohort studies representing India, Mexico, Nigeria, South Africa, Sweden, Tanzania and Uganda described similar training needs, including on-the-job training, data analysis software instruction, and database and bio-bank management. A lack of funding and protected time for training activities were commonly identified constraints. Proposed solutions include a collaborative cross-cohort teaching platform with web-based content and interactive teaching methods for a range of research personnel. An international network for research mentorship and idea exchange, and modifying the graduate thesis structure were also identified as key initiatives. Cross-cohort integrated educational initiatives will efficiently meet shared needs, catalyze the development of emerging cohorts, speed closure of the global disparity in cohort research, and may fortify scientific capacity development in low-resource settings.
Hasselhorn, Hans Martin; Peter, Richard; Rauch, Angela; Schröder, Helmut; Swart, Enno; Bender, Stefan; du Prel, Jean-Baptist; Ebener, Melanie; March, Stefanie; Trappmann, Mark; Steinwede, Jacob; Müller, Bernd Hans
The lidA Cohort Study (German Cohort Study on Work, Age, Health and Work Participation) was set up to investigate and follow the effects of work and work context on the physical and psychological health of the ageing workforce in Germany and subsequently on work participation. Cohort participants are initially employed people subject to social security contributions and born in either 1959 (n = 2909) or 1965 (n = 3676). They were personally interviewed in their homes in 2011 and will be visited every 3 years. Data collection comprises socio-demographic data, work and private exposures, work ability, work and work participation attitudes, health, health-related behaviour, personality and attitudinal indicators. Employment biographies are assessed using register data. Subjective health reports and physical strength measures are complemented by health insurance claims data, where permission was given. A conceptual framework has been developed for the lidA Cohort Study within which three confirmatory sub-models assess the interdependencies of work and health considering age, gender and socioeconomic status. The first set of the data will be available to the scientific community by 2015. Access will be given by the Research Data Centre of the German Federal Employment Agency at the Institute for Employment Research (http://fdz.iab.de/en.aspx). PMID:24618186
Ostbye,Truls; Seim, Arnfinn; Krause, Katrina M.; Feightner, John; Hachinski, Vladimir; Sykes, Elizabeth; Hunskaar, Steinar
Urinary incontinence is common in the elderly. The epidemiology of fecal and double (urinary and fecal) incontinence is less known. The Canadian Study of Health and Aging (CSHA) is a national study of elderly living in the community at baseline (n = 8,949) and interviewed in 1991-1992, 1996, and 2001. Using data from the CSHA, we report the…
Connolly, John G; Bykov, Katsiaryna; Gagne, Joshua J
Thiazolidinediones, a class of medications indicated for the treatment of type 2 diabetes mellitus, reduce inflammation and have been shown to provide a therapeutic benefit in animal models of Parkinson disease. We examined the association between treatment with thiazolidinediones and the onset of Parkinson disease in older individuals. We performed a cohort study of 29,397 Medicare patients enrolled in state pharmaceutical benefits programs who initiated treatment with thiazolidinediones or sulfonylureas during the years 1997 through 2005 and had no prior diagnosis of Parkinson disease. New users of thiazolidinediones were propensity score matched to new users of sulfonylureas and followed to determine whether they were diagnosed with Parkinson disease. We used Cox proportional hazards models to compare time to diagnosis of Parkinson disease in the propensity score-matched populations. To assess the association with duration of use, we performed several analyses that required longer continuous use of medications. In the primary analysis, thiazolidinedione users had a hazard ratio for a diagnosis of Parkinson disease of 1.09 (95% confidence interval: 0.71, 1.66) when compared with sulfonylurea users. Increasing the duration-of-use requirements to 10 months did not substantially change the association; the hazard ratios ranged from 1.00 (95% confidence interval: 0.49, 2.05) to 1.17 (95% confidence interval: 0.60, 2.25). Thiazolidinedione use was not associated with a longer time to diagnosis of Parkinson disease than was sulfonylurea use, regardless of duration of exposure.
Blair, A.; Hines, C.J.; Thomas, K.W.; Alavanja, M.C.R.; Beane Freeman, L.E.; Hoppin, J.A.; Kamel, F.; Lynch, C.F.; Lubin, J.H.; Silverman, D.T.; Whelan, E.; Zahm, S. H.; Sandler, D. P.
Prospective cohorts have played a major role in understanding the contribution of diet, physical activity, medical conditions, and genes to the development of many diseases, but have not been widely used for occupational exposures. Studies in agriculture are an exception. We draw upon our experience using this design to study agricultural workers to identify conditions that might foster use of prospective cohorts to study other occupational settings. Prospective cohort studies are perceived by many as the strongest epidemiologic design. It allows updating of information on exposure and other factors, collection of biologic samples before disease diagnosis for biomarker studies, assessment of effect modification by genes, lifestyle, and other occupational exposures, and evaluation of a wide range of health outcomes. Increased use of prospective cohorts would be beneficial in identifying hazardous exposures in the workplace. Occupational epidemiologists should seek opportunities to initiate prospective cohorts to investigate high priority, occupational exposures. PMID:25603935
Yang, Jinghui; Liu, Jianwei; Liu, Jing; Li, Wenyuan; Li, Xiaoying; He, Yao; Ye, Ling
Background The metabolic syndrome (MetS) has been known as partly heritable, while the number of genetic studies on MetS and metabolic-related traits among Chinese elderly was limited. Methods A cross-sectional analysis was performed among 2 014 aged participants from September 2009 to June 2010 in Beijing, China. An additional longitudinal study was carried out among the same study population from 2001 to 2010. Biochemical profile and anthropometric parameters of all the participants were measured. The associations of 23 SNPs located within 17 candidate genes (MTHFR, PPARγ, LPL, INSIG, TCF7L2, FTO, KCNJ11, JAZF1, CDKN2A/B, ADIPOQ, WFS1, CDKAL1, IGF2BP2, KCNQ1, MTNR1B, IRS1, ACE) with overweight and obesity, diabetes, metabolic phenotypes, and MetS were examined in both studies. Results In this Chinese elderly population, prevalence of overweight, central obesity, diabetes, dyslipidemia, hypertension, and MetS were 48.3%, 71.0%, 32.4%, 75.7%, 68.3% and 54.5%, respectively. In the cross-sectional analyses, no SNP was found to be associated with MetS. Genotype TT of SNP rs4402960 within the gene IGF2BP2 was associated with overweight (odds ratio (OR) = 0.479, 95% confidence interval (CI): 0.316-0.724, p = 0.001) and genotype CA of SNP rs1801131 within the gene MTHFR was associated with hypertension (OR = 1.560, 95% CI: 1.194–2.240, p = 0.001). However, these associations were not observed in the longitudinal analyses. Conclusions The associations of SNP rs4402960 with overweight as well as the association of SNP rs1801131 with hypertension were found to be statistically significant. No SNP was identified to be associated with MetS in our study with statistical significance. PMID:24959828
Klein, R; Pointner, H; Zilly, W; Glässner-Bittner, B; Breuer, N; Garbe, W; Fintelmann, V; Kalk, J F; Müting, D; Fischer, R; Tittor, W; Pausch, J; Maier, K P; Berg, P A
In recent retrospective studies, it was shown that subtypes of antimitochondrial antibodies (AMA) can help to discriminate between a benign [only anti-M9 and/or anti-M2 positive by enzyme-linked immunosorbent assay (ELISA)] and a rather progressive course (anti-M2, -M4 and/or -M8 positive). According to different constellations of these AMA subspecificities in ELISA and complement fixation test (CFT), four AMA profiles (A-D) were defined. In 1984 we started a prospective study based on 200 PBC patients with known AMA profiles in order to correlate the antibody pattern with the clinical outcome. Progression was defined primarily as the necessity of liver transplantation and death due to hepatic failure or variceal bleeding. At entry, 18 (9%) of the 200 patients had AMA profile A (only anti-M9), 57 (29%) profile B (only anti-M2 with or without anti-M9), 74 (37%) profile C (anti-M2 in association with anti-M4/-M8 by ELISA), and 51 (26%) profile D (anti-M2/-M4/-M8 by ELISA and CFT). At the beginning of the study, 177 patients had PBC stage I/II. During the observation period of ten years, ten patients died and in 18 orthotopic liver transplantation (OLT) was performed; all these patients belonged to profile C/D. Furthermore, 44% of the patients with profile C and 31% of the patients with profile D progressed to late stages, as defined by histology and clinical manifestations such as portal hypertension and increase of bilirubin, while only one of the patients with profile B and none of the profile A-patients developed late stage PBC. A significant increase of bilirubin was observed only in C/D-patients. AMA profiles did not change during the follow-up. In conclusion, AMA profiles discriminate between a benign and a progressive course of PBC already at early stages.
Pinto, Giuliana; Tarchi, Christian; Bigozzi, Lucia
Joint narratives are a mean through which children develop and practice their Theory of Mind (ToM), thus they represent an ideal means to explore children’s use and development of mental state talk. However, creating a learning environment for storytelling based on peer interaction, does not necessarily mean that students will automatically exploit it by engaging in productive collaboration, thus it is important to explore under what conditions peer interaction promotes children’s ToM. This study extends our understanding of social aspects of ToM, focusing on the effect of joint narratives on school-age children’s mental state talk. Fifty-six Italian primary school children participated in the study (19 females and 37 males). Children created a story in two different experimental conditions (individually and with a partner randomly assigned). Each story told by the children, as well as their dialogs were recorded and transcribed. Transcriptions of narratives were coded in terms of text quality and mental state talk, whereas transcriptions of dialogs were coded in terms of quality of interaction. The results from this study confirmed that peer interaction does not always improve children’s mental state talk performances in oral narratives, but certain conditions need to be satisfied. Peer interaction was more effective on mental state talk with lower individual levels and productive interactions, particularly in terms of capacity to regulate the interactions. When children were able to focus on the interaction, as well as the product, they were also exposed to each other’s reasoning behind their viewpoint. This level of intersubjectivity, in turn, allowed them to take more in consideration the contribution of mental states to the narrative. PMID:27826283
Guglielmi, Dina; Bruni, Ilaria; Simbula, Silvia; Fraccaroli, Franco; Depolo, Marco
Despite the growing body of research on work engagement, little is known about what drives work engagement among different age cohorts. This study aims to investigate whether engagement varies across age cohorts and examines the job resources that foster teacher engagement. A questionnaire was distributed to 537 teachers who were employed in…
Lee, Chun-Te; Chiang, Yi-Cheng; Huang, Jing-Yang; Tantoh, Disline M; Nfor, Oswald N; Lee, Jia-Fu; Chang, Cheng-Chen; Liaw, Yung-Po
Major depressive disorder (MDD), the most prevalent mental disorder is a global public health issue. The aim of this study was to assess the association between low income and major depressive disorder (MDD) by age and sex. The National Health Insurance Research Database (NHIRD) of Taiwan was used to retrieve data. A total of 1,743,948 participants were eligible for the study. Low-income individuals were identified from 2001 and 2003 (specifically, Group Insurance Applicants, ie, category"51" or "52") and followed from 2004 to 2010. MDD was identified using the ICD-9-CM 296.2 and 296.3 codes. Among non-low-income individuals, the MDD incidence rates increased with age in both males and females, that is, 0.35, 0.93, 0.97, 1.40 per 10,000 person-months for males and 0.41, 1.60, 1.89, 1.95 per 10,000 person-months for females aged 0 to 17, 18 to 44, 45 to 64, and ≥65 years, respectively. Low-income females (18-44 years) and males (45-64 years) had the highest incidence of MDD, which was 3.90 and 3.04, respectively, per 10,000 person-months. Among low and non-low-income individuals, the MDD incidence rates were higher in the females than males in all age groups. Males aged 45 to 64 and 0 to 17 years had highest hazard ratios (HR) of 2.789 (95% confidence interval [CI], 1.937-4.014) and 2.446 (95% CI, 1.603-3.732), respectively. The highest HRs for females were 2.663 (95% CI, 1.878-3.775) and 2.219 (CI, 1.821-2.705) in the 0 to 17 and 18- to 44-year age groups. Low income was not found to serve as a risk factor for the development of MDD in males and females aged ≥65 years. Among the non-low-income males and females, the incidence rates of MDD were found to increase with age. Low income was found to serve as a significant risk factor for MDD only in individuals under age 65.
Neiderhiser, Jenae M; Marceau, Kristine; Reiss, David
This study examined genetic and environmental influences on associations among marital conflict about the child, parental monitoring, sibling relationship negativity, and peer delinquency during adolescence and initiation of illegal drug use by young adulthood. The sample comprised data collected longitudinally from same-sex sibling pairs and parents when the siblings were 10-18 years old (M = 14.5 and 12.9 years for Child 1 and Child 2, respectively) and 20-35 years old (M = 26.8 and 25.5 years for Child 1 and Child 2, respectively). Findings indicate four factors that explain the initiation of illegal drug use: two shaped by genetic influences and two shaped by environments shared by siblings. The two genetically shaped factors probably have distinct mechanisms: one a child-initiated coercive process in the family and the other parent and peer processes shaped by the child's disclosure. The environmentally influenced factors seem distinctively shaped by poor parental monitoring of both sibs and the effects of siblings on each other's deviancy.
NEIDERHISER, JENAE M.; MARCEAU, KRISTINE; REISS, DAVID
This study examined genetic and environmental influences on associations among marital conflict about the child, parental monitoring, sibling relationship negativity, and peer delinquency during adolescence and initiation of illegal drug use by young adulthood. The sample comprised data collected longitudinally from same-sex sibling pairs and parents when the siblings were 10–18 years old (M = 14.5 and 12.9 years for Child 1 and Child 2, respectively) and 20–35 years old (M = 26.8 and 25.5 years for Child 1 and Child 2, respectively). Findings indicate four factors that explain the initiation of illegal drug use: two shaped by genetic influences and two shaped by environments shared by siblings. The two genetically shaped factors probably have distinct mechanisms: one a child-initiated coercive process in the family and the other parent and peer processes shaped by the child’s disclosure. The environmentally influenced factors seem distinctively shaped by poor parental monitoring of both sibs and the effects of siblings on each other’s deviancy. PMID:23398758
Battise, Dawn M.; Neville, Michael W.
Objective. To examine whether pharmacy students characterized as low performers at the conclusion of their first semester remained low performers throughout their academic career. Methods. Bottom quartile performance on first semester grade point average (GPA) was compared to licensing examination success, cumulative grade point average at the end of the didactic education and whether the student graduated on time, using cross tabulation analysis. Relative risk ratios and confidence intervals were calculated. Results. Students in the bottom quartile for GPA at the end of their first semester in pharmacy school were approximately six times more likely not to graduate on time, not to pass the North American Pharmacist Licensure Exam on their first attempt and to remain in the bottom quartile for GPA at the end of their didactic education. Conclusion. This study suggests that pharmacy students who score in the bottom quartile for GPA at the end of their first semester are more likely to underperform academically unless they take corrective action. PMID:27756926
Verma, Rashmi; Utreja, Ashok Kumar; Singh, Satinder Pal; Jena, Ashok Kumar
Objective: The aim of the study was to evaluate the effect of post- treatment critical evaluation on the quality of orthodontic care in a postgraduate orthodontic clinic. Materials and Methods: Orthodontic treatment outcome of 109 consecutively treated cases was evaluated in Phase-I evaluation. Following Phase-I evaluation, PTCE of each case was made mandatory. After 6-years of implementation of compulsory PTCE for each case, orthodontic treatment outcome of all consecutively treated cases (n = 126) was evaluated (Phase-II). The treatment outcome was evaluated by American Board of Orthodontics Model Grading System (ABO MGS) and Subjective evaluation (Visual Analogue Scale, VAS). Results: Based on the ABO scores, the cases were divided into three grades, that is, Grade-I, Grade-II, and Grade-III. The mean total ABO score was improved significantly in Phase-II evaluation (P < 0.01). The total number of cases in ABO Grade-II were increased significantly (P < 0.01) whereas cases in ABO Grade-I remained comparable. The VAS score was improved from 5.66 ± 0.77 at Phase-I to 6.02 ± 0.99 at Phase-II evaluation (P < 0.01). Conclusion: The implementation of PTCE significantly improved the quality of orthodontic care in a postgraduate orthodontic clinic. Clinical Significance: Grading one's own treatment improves the quality of future treatment. PMID:26392728
Grinn-Gofroń, Agnieszka; Strzelczak, Agnieszka; Stępalska, Danuta; Myszkowska, Dorota
Alternaria and Cladosporium spores belong to the most frequent and allergenic particles in bioaerosol in the temperate climate. The investigation of Alternaria and Cladosporium spore concentrations was performed in two cities in Poland, Szczecin and Cracow, in 2004-2013. The meteorological parameters taken to assess their impact on fungal spores were average, maximum and minimum temperature, relative humidity and average wind velocity. In order to reveal whether changes in dynamics of spore seasons are driven by meteorological conditions, ordination methods were applied. Canonical correspondence analysis was used to explore redundancy among the predictors (meteorological parameters). Prior to ordination analyses, the data were log(x)-transformed. Concentrations of Alternaria and Cladosporium spores were significantly higher in Szczecin comparing to Cracow, but it was also observed the decreasing trend in the spore concentrations in Szczecin. As regards temperature, it was higher in Cracow and was still increasing in the studied years. Relative humidity and wind velocity were significantly lower in Cracow. In Szczecin meteorological conditions did not explain changes in spore season characteristics (insignificant redundancy analysis models), while in Cracow's redundancy analysis models indicated that spore season parameters were in over 40 % determined by meteorological conditions, mainly air temperature and wind velocity. If they increase, the peak value, total number of spores and their average concentrations in a season will also increase.
Meftah, Morteza; Potter, Hollis G; Gold, Stephanie; Ranawat, Anil S; Ranawat, Amar S; Ranawat, Chitranjan S
This is the first long-term (mean 11.6 years), prospective, matched-pair study (based on age, gender, BMI and UCLA scores) using MAVRIC (multi-acquisition variable-resonance image combination) magnetic resonance imaging to analyze reactive synovitis and osteolysis between rotating-platform posterior-stabilized (RP-PS), fixed-bearing metal-back (FB-MB), and all-polyethylene tibial (APT) in active patients (24 total, 8 in each group, mean age of 64 years, mean UCLA of 8.5) with identical femoral component and polyethylene. Reactive synovitis was observed in 6 RP-PS (75%), all 8 FB-MB (100%), and 6 APT (75%). There was a significant difference between the RP-PS and FB-MB knees in volumetric synovitis (P=0.023). Osteolysis with bone loss more than 4mm was seen in 3 FB-MB, 2 APT and none for RP-PS. These were not statistically significant.
Li, J.; Li, H. C.; Li, T.; Li, X.; Yuan, N.; Zhang, T.
The debate about how speleothem δ13C to reflect paleoclimate and paleovegetation changes calls for understanding of δ13C behavior in a cave system. We have conducted a monitoring study in Furong Cave, Chongqing, China since 2005 involving multiple sites in the overlying soil and inside the cave. The measured proxies include pCO2 of the atmosphere, soil and cave air; dripping rate, pH, electronic conductivity, Ca2+, HCO3-, d13CDIC of the dripwaters; and deposition rate, d13C of seasonally selected carbonate deposits. The many observations from this study are: (1) Soil pCO2 is close to the atmospheric pCO2 in winter and reaches >10000 ppm during the summer due to high productivity under warm and wet climates. (2) The pCO2 in cave air is slightly higher than Soil pCO2 and atmospheric pCO2 in winter (400~900 ppm), but elevates up to ~2000 ppm around October due to seepage of soil CO2 into the cave. The cave air pCO2 exhibits double peaks following the seasonal rainfall (1st peak in April-June controlled by Indian monsoon and 2nd peak in July-September influenced by the North Western Pacific monsoon). The cave air pCO2 has about 2-3 month lag to the soil pCO2. (3) Under the influence of soil CO2 and rainfall, the d13CDIC of drpiwaters are depleted in the summer and enriched during the winter. During 2009-2011, southwestern China experienced extremely drought due to summer monsoon failure. The d13CDIC of dripwater in Furong Cave was strongly enriched because of low soil CO2 productivity, less transportation of soil CO2 into the cave, and high CO2 ratio from bedrock input. Dripping rate does not affect the d13CDIC significantly. (4) The d13C of speleothems is controlled by the open/closed system of the seepage pathway on the first order. Monitoring site MP1 owns a relatively open system shown by fast dripping rates, low Ca and HCO3- contents, and low carbonate deposition rate. The d13C of modern deposits from this site not only shows the seasonal variation following
Geleijnse, Johanna M.; Giltay, Erik J.; Soedamah-Muthu, Sabita S.; de Goede, Janette; Oude Griep, Linda M.; Stijnen, Theo; Kromhout, Daan
Chronic kidney disease (CKD) is highly prevalent among older post-myocardial infarction (MI) patients. It is not known whether CKD is an independent risk factor for mortality in older post-MI patients with optimal cardiovascular drug-treatment. Therefore, we studied the relation between kidney function and all-cause and specific mortality among older post-MI patients, without severe heart failure, who are treated with state-of-the-art pharmacotherapy. From 2002–2006, 4,561 Dutch post-MI patients were enrolled and followed until death or January 2012. We estimated Glomerular Filtration Rate (eGFR) with cystatin C (cysC) and creatinine (cr) using the CKD-EPI equations and analyzed the relation with any and major causes of death using Cox models and restricted cubic splines. Mean (SD) for age was 69 years (5.6), 79% were men, 17% smoked, 21% had diabetes, 90% used antihypertensive drugs, 98% used antithrombotic drugs and 85% used statins. Patients were divided into four categories of baseline eGFRcysC: ≥90 (33%; reference), 60–89 (47%), 30–59 (18%), and <30 (2%) ml/min/1.73m2. Median follow-up was 6.4 years. During follow-up, 873 (19%) patients died: 370 (42%) from cardiovascular causes, 309 (35%) from cancer, and 194 (22%) from other causes. After adjustment for age, sex and classic cardiovascular risk factor, hazard ratios (95%-confidence intervals) for any death according to the four eGFRcysC categories were: 1 (reference), 1.4 (1.1–1.7), 2.9 (2.3–3.6) and 4.4 (3.0–6.4). The hazard ratios of all-cause and cause-specific mortality increased linearly below kidney functions of 80 ml/min/1.73 m2. Weaker results were obtained for eGFRcr. To conclude, we found in optimal cardiovascular drug-treated post-MI patients an inverse graded relation between kidney function and mortality for both cardiovascular as well as non-cardiovascular causes. Risk of mortality increased linearly below kidney function of about 80 ml/min/1.73 m2. PMID:28182761
Li, Jing; Fan, Jin hu; Zhang, Bin; Yang, Hong jian; Xie, Xiao ming; Tang, Zhong hua; Li, Hui; Li, Jia yuan; Wang, Shu lian; Qiao, You lin; Huang, Rong; Zhang, Pin
Endocrine therapy (ET) is one of the main systemic treatments for patients with breast cancer. To our knowledge, few studies have addressed the performance of ET or relevant influencing factors in cancer treatment in China. By retrospectively analyzing the clinicopathological data on breast cancer collected from representative hospitals of 7 traditional areas in China in one random month from each year between year 1999 and 2008, we found that: 1) The rate of the use of hormone receptor (HR) testing was 83.8% (3529/4211), with the estrogen receptor-positive (ER+) rate and/or the progesterone receptor-positive (PR+) rate being 67.9% (2395/3529), and the ER-PR rate being 32.1% (1134/3529). 2) Of the 1599 patients who had received ET, 999 patients (58.3%) were premenopausal while 600 (41.7%) were postmenopausal; 1598 patients received adjuvant hormonal therapy (AHT), whereas only 1 patient received palliative therapy. The medications mainly administered to patients were anti-estrogen agents (80.3% [1283/1598]), followed by AIs (15.5% [248/1598]). Of the 1598 patients receiving AHT, 1416 patients (88.6%) were positive for ER and/or PR, while 75 (4.7%) were negative for both and 108 patients (6.7%) had unknown HR status. The ratio of the use of endocrine therapy for breast cancer patients with ER+ and/or PR+ status was 60.0% (1416/2395). 3) Results from the logistic regression analysis revealed that geography, occupations, and history of chemotherapy and surgery were dependent factors affecting the application of ET in breast cancer treatment in China (P<0.001). In conclusion, the use of ET on Chinese women with breast cancer is increasingly and gradually accounted into the standardized process. Economic status, occupations, and history of chemotherapy and surgery were key factors affecting the application of ET. People residing in developed areas, engaging in mental labour, having history of chemotherapy and surgery are susceptible to accept ET. PMID:25036532
Choi, Dong Phil; Lee, Joo Young; Kim, Hyeon Chang
Major aetiologies of atherosclerotic cardiovascular diseases begin in childhood and atherosclerotic vascular abnormalities can be observed among children and adolescents. Adolescent cohort studies have important advantages because they can observe earlier changes in vascular structure and function. The purpose of the JS High School study (JSHS) is to identify biomarkers predicting or indicating early structural and functional vascular change in adolescents. The JSHS is a prospective cohort study of a Korean adolescent population. The target population of the JSHS was first-graders (aged 14 to17 years) at a high school of South Korea. Enrolment and baseline examinations were conducted in years 2007, 2010, 2011 and 2012. Among the total eligible population of 1115 students, 1071 (96.1%) participated in the study and completed all baseline examinations. Informed consent forms were obtained from each participant and his/her parent or guardian. Baseline examinations include: questionnaires on demographics, health behaviours, medical history, and depression symptoms; fasting blood analysis; anthropometric measurement; body impedance analysis; blood pressure measurement; radial artery tonometry; bone densitometry; pulmonary function tests; and carotid ultrasonography. Participants enrolled from 2007 through 2012 were re-examined after 30 months of follow-up, and those who enrolled in 2012 were re-examined after 24 months of follow-up. The corresponding author may be contacted for potential collaboration and data access.
Keuning, Jos; Hemker, Bas
The data collection of a cohort study requires making many decisions. Each decision may introduce error in the statistical analyses conducted later on. In the present study, a procedure was developed for estimation of the error made due to the composition of the sample, the item selection procedure, and the test equating process. The math results…
Weihe, Pál; Bjerregaard, Peter; Bonefeld-Jørgensen, Eva; Dudarev, Alexey; Halling, Jónrit; Hansen, Solrunn; Muckle, Gina; Nøst, Therese; Odland, Jon Øyvind; Petersen, Maria Skaalum; Rautio, Arja; Veyhe, Anna Sofía; Wennberg, Maria; Bergdahl, Ingvar
This article gives an overview of the ongoing cohort and dietary studies underlying the assessment of population health in the Arctic. The emphasis here is on a description of the material, methods and results or preliminary results for each study. Detailed exposure information is available in an article in this journal, whereas another paper describes the effects associated with contaminant exposure in the Arctic. The cohort descriptions have been arranged geographically, beginning in Norway and moving east to Finland, Sweden, Russia and the other Arctic countries and ultimately to the Faroe Islands. No cohort studies have been reported for Alaska or Iceland. PMID:27974135
Wolkewitz, Martin; Cooper, Ben S; Palomar-Martinez, Mercedes; Olaechea-Astigarraga, Pedro; Alvarez-Lerma, Francisco; Schumacher, Martin
In nested case-control studies, incidence density sampling is the time-dependent matching procedure to approximate hazard ratios. The cumulative incidence function can also be estimated if information from the full cohort is used. In the presence of competing events, however, the cumulative incidence function depends on the hazard of the disease of interest and on the competing events hazard. Using hospital-acquired infection as an example (full cohort), we propose a sampling method for nested case-control studies to estimate subdistribution hazard ratios. With further information on the full cohort, the cumulative incidence function for the event of interest can then be estimated as well.
Tekle, Fetene B; Tan, Frans E S; Berger, Martijn P F
Many large scale longitudinal cohort studies have been carried out or are ongoing in different fields of science. Such studies need a careful planning to obtain the desired quality of results with the available resources. In the past, a number of researches have been performed on optimal designs for longitudinal studies. However, there was no computer program yet available to help researchers to plan their longitudinal cohort design in an optimal way. A new interactive computer program for the optimization of designs of longitudinal cohort studies is therefore presented. The computer program helps users to identify the optimal cohort design with an optimal number of repeated measurements per subject and an optimal allocations of time points within a given study period. Further, users can compute the loss in relative efficiencies of any other alternative design compared to the optimal one. The computer program is described and illustrated using a practical example.
Chaman Ortiz, José Carlos; Padilla Machaca, P Martín; Rondon Leyva, Carlos; Carrasco Mascaró, Felix
The article reviews the experience in 10 years of hepatic transplants performed by The Transplant Department of the National Hospital Guillermo Almenara Irigoyen (HNGAI), describing the history, surgical outcomes in adults and children, retransplantation, combined liver-kidney transplants, complications in 72 transplants performed at the time of submission of the article.
Omland, Lars Haukali; Farkas, Dora Körmendiné; Jepsen, Peter; Obel, Niels; Pedersen, Lars
Background: Hepatitis C virus (HCV) infection is associated with an increased risk of primary liver cancer; however, 5- and 10-year risk estimates are needed. The association of HCV with non-Hodgkin lymphoma (NHL) is uncertain and the association with other cancers is unknown. Method: We conducted a nationwide, population-based cohort study of 4,349 HCV-infected patients in Denmark, computing standardized incidence ratios (SIR) of cancer incidence in HCV infected patients compared with cancer incidence of the general population. We calculated 5- and 10-year risks of developing cancer, stratifying our analyses based on the presence of HIV coinfection and cirrhosis. Results: We recorded an increased risk of primary liver cancer (SIR: 76.63 [95% CI: 51.69–109.40]), NHL (SIR: 1.89 [95% CI: 0.39–5.52]), and several smoking- and alcohol-related cancers in HCV infected patients without HIV coinfection. HCV-infected patients without HIV coinfection had a 6.3% (95% CI: 4.6%–8.7%) risk of developing cancer and 2.0% (95% CI: 1.1%–3.8%) risk of developing primary liver cancer within 10 years. Conclusion: We confirmed the association of HCV infection with primary liver cancer and NHL. We also observed an association between HCV infection and alcohol- and smoking-related cancers. PMID:20865115
Lawson, E. M.; Elliott, G.; Fallon, J.; Fink, D.; Hotchkis, M. A. C.; Hua, Q.; Jacobsen, G. E.; Lee, P.; Smith, A. M.; Tuniz, C.; Zoppi, U.
The status and capabilities of the ANTARES AMS facility after 10 years are reviewed. The common AMS radioisotopes, 10Be, 14C, 26Al, 36Cl and 129I, are routinely analysed. A capability for the detection of 236U and other actinide isotopes has been developed. The measurement program includes support to Quaternary science projects at Australian universities and to ANSTO projects in global climate change and nuclear safeguards.
Baron, Ralf; Ferriero, Donna M; Frisoni, Giovanni B; Bettegowda, Chetan; Gokaslan, Ziya L; Kessler, John A; Vezzani, Annamaria; Waxman, Stephen G; Jarius, Sven; Wildemann, Brigitte; Weller, Michael
Since the launch of our journal as Nature Clinical Practice Neurology in 2005, we have seen remarkable progress in many areas of neurology research, but what does the future hold? Will advances in basic research be translated into effective disease-modifying therapies, and will personalized medicine finally become a reality? For this special Viewpoint article, we invited a panel of Advisory Board members and other journal contributors to outline their research priorities and predictions in neurology for the next 10 years.
Habermann, Frank; Fritzsche, Juliane; Fuhlbrück, Frederike; Wacker, Evelin; Allignol, Arthur; Weber-Schoendorfer, Corinna; Meister, Reinhard; Schaefer, Christof
Women of childbearing age are often affected with psychotic disorders, requiring the use of antipsychotic medication during pregnancy. In the present study, we prospectively followed the pregnancies of 561 women exposed to second-generation antipsychotic agents (SGAs; study cohort) and compared these to 284 pregnant women exposed to first-generation antipsychotic agents (FGAs; comparison cohort I) and to 1122 pregnant women using drugs known as not harmful to the unborn (comparison cohort II). Subjects were enrolled through the Institute's consultation service. Major malformation rates of SGA exposed were higher compared to comparison cohort II (adjusted odds ratio, 2.17; 95% confidence interval, 1.20-3.91), possibly reflecting a detection bias concerning atrial and ventricular septal defects. Postnatal disorders occurred significantly more often in infants prenatally exposed to SGAs (15.6%) and FGAs (21.6%) compared to 4.2% of comparison cohort II. Cumulative incidences of elective terminations of pregnancy were significantly higher in both the study cohort (17%) and comparison cohort I (21%) compared to comparison cohort II (3%), whereas the rates of spontaneous abortions did not differ. The numbers of stillbirths and neonatal deaths were within the reference range. Preterm birth and low birth weight were more common in infants exposed to FGAs. To conclude, our findings did not reveal a major teratogenic risk for SGAs, making the better studied drugs of this group a treatment option during pregnancy. Because neonates exposed to SGAs or FGAs in the last gestational week are at higher risk of postnatal disorders, delivery should be planned in clinics with neonatal intensive care units.
Mukherjee, Devdeep; Sinha, Rajiv; Akhtar, Md Shakil; Saha, Agni Sekhar
AIM To ascertain the frequency of hyponatremic hypertensive syndrome (HHS) in a cohort of children with hypertensive emergency in a tertiary pediatric hospital. METHODS A retrospective review was undertaken among children with hypertensive emergency admitted in our tertiary children hospital between June 2014 and December 2015 with an aim to identify any children with HHS. Three children with HHS were identified during this period. RESULTS The 3 patients with HHS presented with hypertensive emergency. They were initially managed with Labetalol infusion and thereafter switched to oral anti-hypertensives (combination of Nifedipine sustained release, Hydralazine and Beta Blocker). All 3 were diagnosed to have unilateral renal artery stenosis. One child was lost to follow up, whereas the other 2 underwent renal angioplasty which was followed with normalization of blood pressure. CONCLUSION Despite activation of renin angiotensin axis secondary to renal artery stenosis, these groups of children have significant hyponatremia. Renal re-vascularisation produces excellent results in most of them. PMID:28101450
French, David; Nadji, Nabil; Shariati, Batoul; Hatzimanolakis, Penny; Larjava, Hannu
This retrospective study with a follow-up period of 4 months to 10 years evaluated survival, success, and complication rates of implants placed using osteotome sinus floor elevation (OSFE) without added bone grafting. A total of 926 implants were placed, including 530 short implants (6 mm to 8.5 mm) and 209 implants in low residual bone height (RBH) (< 5 mm). Bone levels were evaluated at approximately 3 months and at 1, 3, and 5 years, and in some cases up to 10 years after implants were placed. The implant survival rate was 98.3% at the 5-year follow-up. Twelve of the 926 implants failed (6 preprosthetic, 6 postprosthetic). The success rate was 95.4% at a threshold of less than 1 mm of bone loss for combined systems (Straumann; Nobel Biocare). Short implant survival and success rates were statistically comparable to conventional-length implants. Low-RBH implants had a lower but acceptable survival rate of 95.7%. Adverse events were rare, with one case of infection and zero cases of vertigo reported. The findings of this study indicate that implant placement with OSFE without added bone graft is highly successful, even when short implants are used in low RBH.
Brew, Bronwyn K.; Marks, Guy B.; Almqvist, Catarina; Cistulli, Peter A.; Webb, Karen; Marshall, Nathaniel S.
Objective To investigate the relationship between breastfeeding and snoring in childhood. Methods In a cohort of children with a family history of asthma who were recruited antenatally we prospectively recorded data on infant feeding practices throughout the first year of life. Snoring status and witnessed sleep apnea were measured at age 8 years by parent-completed questionnaire. Associations were estimated by logistic regression with, and without, adjustment for sets of confounders designed to exclude biasing effects. Results Habitual snoring was reported in 18.8% of the sample, and witnessed apnea in 2.7%. Any breastfeeding for longer than one month was associated with a reduced risk of habitual snoring at age 8 (adjusted OR 0.48, 95% CI 0.29 to 0.81) and duration of breastfeeding was inversely associated with the prevalence of habitual snoring (adjusted OR 0.79, 95% CI 0.62 to 1.00). Any breastfeeding for longer than 1 month was associated with a lower risk of witnessed sleep apnea (adjusted OR 0.17, 95% CI 0.04 to 0.71). The protective associations were not mediated by BMI, current asthma, atopy or rhinitis at age 8 years. Conclusions Breastfeeding for longer than one month decreases the risk of habitual snoring and witnessed apneas in this cohort of children with a family history of asthma. The underlying mechanism remains unclear but the finding would be consistent with a beneficial effect of the breast in the mouth on oropharyngeal development with consequent protection against upper airway dysfunction causing sleep-disordered breathing. PMID:24416321
Keogh, Ruth H; White, Ian R
In many large prospective cohorts, expensive exposure measurements cannot be obtained for all individuals. Exposure-disease association studies are therefore often based on nested case-control or case-cohort studies in which complete information is obtained only for sampled individuals. However, in the full cohort, there may be a large amount of information on cheaply available covariates and possibly a surrogate of the main exposure(s), which typically goes unused. We view the nested case-control or case-cohort study plus the remainder of the cohort as a full-cohort study with missing data. Hence, we propose using multiple imputation (MI) to utilise information in the full cohort when data from the sub-studies are analysed. We use the fully observed data to fit the imputation models. We consider using approximate imputation models and also using rejection sampling to draw imputed values from the true distribution of the missing values given the observed data. Simulation studies show that using MI to utilise full-cohort information in the analysis of nested case-control and case-cohort studies can result in important gains in efficiency, particularly when a surrogate of the main exposure is available in the full cohort. In simulations, this method outperforms counter-matching in nested case-control studies and a weighted analysis for case-cohort studies, both of which use some full-cohort information. Approximate imputation models perform well except when there are interactions or non-linear terms in the outcome model, where imputation using rejection sampling works well.
Victora, Cesar Gomes; Araújo, Cora Luiza Pavin; Menezes, Ana Maria Batista; Hallal, Pedro Curi; Vieira, Maria de Fátima; Neutzling, Marilda Borges; Gonçalves, Helen; Valle, Neiva Cristina; Lima, Rosangela Costa; Anselmi, Luciana; Behague, Dominique; Gigante, Denise Petrucci; Barros, Fernando Celso
This paper describes the main methodological aspects of a cohort study, with emphasis on its recent phases, which may be relevant to investigators planning to carry out similar studies. In 1993, a population based study was launched in Pelotas, Southern Brazil. All 5,249 newborns delivered in the city’s hospitals were enrolled, and sub-samples were visited at the ages of one, three and six months and of one and four years. In 2004-5 it was possible to trace 87.5% of the cohort at the age of 10-12 years. Sub-studies are addressing issues related to oral health, psychological development and mental health, body composition, and ethnography. Birth cohort studies are essential for investigating the early determinants of adult disease and nutritional status, yet few such studies are available from low and middle-income countries where these determinants may differ from those documented in more developed settings. PMID:16410981
Background and purpose There is an ongoing need to review large series of total ankle replacements (TARs) for monitoring of changes in practice and their outcome. 4 national registries, including the Swedish Ankle Register, have previously reported their 5-year results. We now present an extended series with a longer follow-up, and with a 10-year survival analysis. Patients and methods Records of uncemented 3-component TARs were retrospectively reviewed, determining risk factors such as age, sex, and diagnosis. Prosthetic survival rates were calculated with exchange or removal of components as endpoint—excluding incidental exchange of the polyethylene meniscus. Results Of the 780 prostheses implanted since 1993, 168 (22%) had been revised by June 15, 2010. The overall survival rate fell from 0.81 (95% CI: 0.79–0.83) at 5 years to 0.69 (95% CI: 0.67–0.71) at 10 years. The survival rate was higher, although not statistically significantly so, during the latter part of the period investigated. Excluding the STAR prosthesis, the survival rate for all the remaining designs was 0.78 at 10 years. Women below the age of 60 with osteoarthritis were at a higher risk of revision, but age did not influence the outcome in men or women with rheumatoid arthritis. Revisions due to technical mistakes at the index surgery and instability were undertaken earlier than revisions for other reasons. Interpretation The results have slowly improved during the 18-year period investigated. However, we do not believe that the survival rates of ankle replacements in the near future will approach those of hip and knee replacements—even though improved instrumentation and design of the prostheses, together with better patient selection, will presumably give better results. PMID:22066551
Kushnareva, Y. E.; Murphy, A. N.
The role of mitochondria in oxidative stress is well recognized, but many questions are still to be answered. This article is intended to update our comprehensive review in 2005 by highlighting the progress in understanding of mitochondrial reactive oxygen species (ROS) metabolism over the past 10 years. We review the recently identified or re-appraised sources of ROS generation in mitochondria, such as p66shc protein, succinate dehydrogenase, and recently discovered properties of the mitochondrial antioxidant system. We also reflect upon some controversies, disputes, and misconceptions that confound the field. PMID:26071769
Malan, Leoné; Hamer, Mark; Frasure-Smith, Nancy; Steyn, Hendrik S; Malan, Nicolaas T
Adapting to an over-demanding stressful urban environment may exhaust the psychophysiological resources to cope with these demands, and lead to sympathetic nervous system dysfunction. The evidence that an urban-dwelling lifestyle may be detrimental to the cardiometabolic health of Africans motivated the design of the Sympathetic activity and Ambulatory Blood Pressure in African Prospective cohort study. We aimed to determine neural mechanistic pathways involved in emotional distress and vascular remodelling. The baseline sample included 409 teachers representing a bi-ethnic sex cohort from South Africa. The study was conducted in 2008–09 and repeated after 3-year follow-up in 2011–12, with an 87.8% successful follow-up rate. Seasonal changes were avoided and extensive clinical assessments were performed in a well-controlled setting. Data collection included sociodemographics, lifestyle habits, psychosocial battery and genetic analysis, mental stress responses mimicking daily life stress (blood pressure and haemostatic, cardiometabolic, endothelial and stress hormones). Target organ damage was assessed in the brain, heart, kidney, blood vessels and retina. A unique highly phenotyped cohort is presented that can address the role of a hyperactive sympathetic nervous system and neural response pathways contributing to the burden of cardiometabolic diseases in Africans. PMID:25344943
Magnus, Per; Birke, Charlotte; Vejrup, Kristine; Haugan, Anita; Alsaker, Elin; Daltveit, Anne Kjersti; Handal, Marte; Haugen, Margaretha; Høiseth, Gudrun; Knudsen, Gun Peggy; Paltiel, Liv; Schreuder, Patricia; Tambs, Kristian; Vold, Line; Stoltenberg, Camilla
This is an update of the Norwegian Mother and Child Cohort Study (MoBa) cohort profile which was published in 2006. Pregnant women attending a routine ultrasound examination were initially invited. The first child was born in October 1999 and the last in July 2009. The participation rate was 41%. The cohort includes more than 114 000 children, 95 000 mothers and 75 000 fathers. About 1900 pairs of twins have been born. There are approximately 16 400 women who participate with more than one pregnancy. Blood samples were obtained from both parents during pregnancy and from mothers and children (umbilical cord) after birth. Samples of DNA, RNA, whole blood, plasma and urine are stored in a biobank. During pregnancy, the mother responded to three questionnaires and the father to one. After birth, questionnaires were sent out when the child was 6 months, 18 months and 3 years old. Several sub-projects have selected participants for in-depth clinical assessment and exposure measures. The purpose of this update is to explain and describe new additions to the data collection, including questionnaires at 5, 7, 8 and 13 years as well as linkages to health registries, and to point to some findings and new areas of research. Further information can be found at [www.fhi.no/moba-en]. Researchers interested in collaboration and access to the data can complete an electronic application available on the MoBa website above.
Genetic restriction of HIV-1 infection and progression to AIDS by a deletion allele of the CKR5 structural gene. Hemophilia Growth and Development Study, Multicenter AIDS Cohort Study, Multicenter Hemophilia Cohort Study, San Francisco City Cohort, ALIVE Study.
Dean, M; Carrington, M; Winkler, C; Huttley, G A; Smith, M W; Allikmets, R; Goedert, J J; Buchbinder, S P; Vittinghoff, E; Gomperts, E; Donfield, S; Vlahov, D; Kaslow, R; Saah, A; Rinaldo, C; Detels, R; O'Brien, S J
The chemokine receptor 5 (CKR5) protein serves as a secondary receptor on CD4(+) T lymphocytes for certain strains of human immunodeficiency virus-type 1 (HIV-1). The CKR5 structural gene was mapped to human chromosome 3p21, and a 32-base pair deletion allele (CKR5Delta32) was identified that is present at a frequency of approximately0.10 in the Caucasian population of the United States. An examination of 1955 patients included among six well-characterized acquired immunodeficiency syndrome (AIDS) cohort studies revealed that 17 deletion homozygotes occurred exclusively among 612 exposed HIV-1 antibody-negative individuals (2.8 percent) and not at all in 1343 HIV-1-infected individuals. The frequency of CKR5 deletion heterozygotes was significantly elevated in groups of individuals that had survived HIV-1 infection for more than 10 years, and, in some risk groups, twice as frequent as their occurrence in rapid progressors to AIDS. Survival analysis clearly shows that disease progression is slower in CKR5 deletion heterozygotes than in individuals homozygous for the normal CKR5 gene. The CKR5Delta32 deletion may act as a recessive restriction gene against HIV-1 infection and may exert a dominant phenotype of delaying progression to AIDS among infected individuals.
Kossenko, M M.; Preston, D L.; Krestinina, L Y.; Degteva, M O.; Startsev, N V.; Thomas, T; Vyushkova, O V.; Anspaugh, L R.; Napier, Bruce A. ); Kozheurov, V P.; Ron, E; Akleyev, A V.
Initial population-based studies of riverside residents were begun in the late 1950s and in 1967 a systematic effort was undertaken to develop a well-defined fixed cohort of Techa river residents, to carry out ongoing mortality and (limited) clinical follow-up of this cohort, and to provide individualized dose estimates for cohort members. Over the past decade, extensive efforts have been made to refine the cohort definition and improve both the follow-up and dosimetry data. Analyses of the Techa river cohort can provide useful quantitative estimates of the effects of low dose rate, chronic external and internal exposures on cancer mortality and incidence and non-cancer mortality rates. These risk estimates complement quantitative risk estimates for acute exposures based on the atomic bomb survivors and chronic exposure risk estimates from worker studies, including Mayak workers and other groups with occupational radiation exposures. As the dosimetry and follow-up are refined it may also be possible to gain useful insights into risks associated with 90Sr exposures.
Tamakoshi, Akiko; Ozasa, Kotaro; Fujino, Yoshihisa; Suzuki, Koji; Sakata, Kiyomi; Mori, Mitsuru; Kikuchi, Shogo; Iso, Hiroyasu; Sakauchi, Fumio; Motohashi, Yutaka; Tsuji, Ichiro; Nakamura, Yosikazu; Mikami, Haruo; Kurosawa, Michiko; Hoshiyama, Yoshiharu; Tanabe, Naohito; Tamakoshi, Koji; Wakai, Kenji; Tokudome, Shinkan; Hashimoto, Shuji; Wada, Yasuhiko; Kawamura, Takashi; Watanabe, Yoshiyuki; Miki, Tsuneharu; Date, Chigusa; Kurozawa, Yoichi; Yoshimura, Takesumi; Shibata, Akira; Okamoto, Naoyuki; Shio, Hideo
The Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study) was established in the late 1980s to evaluate the risk impact of lifestyle factors and levels of serum components on human health. During the 20-year follow-up period, the results of the study have been published in almost 200 original articles in peer-reviewed English-language journals. However, continued follow-up of the study subjects became difficult because of the retirements of principal researchers, city mergers throughout Japan in the year 2000, and reduced funding. Thus, we decided to terminate the JACC Study follow-up at the end of 2009. As a final point of interest, we reviewed the population registry information of survivors. A total of 207 (0.19%) subjects were ineligible, leaving 110 585 eligible participants (46 395 men and 64 190 women). Moreover, errors in coding date of birth and sex were found in 356 (0.32%) and 59 (0.05%) cases, respectively, during routine follow-up and final review. Although such errors were unexpected, their impact is believed to be negligible because of the small numbers relative to the large total study population. Here, we describe the final cohort profile at the end of the JACC Study along with selected characteristics of the participants and their status at the final follow-up. Although follow-up of the JACC Study participants is finished, we will continue to analyze and publish study results.
Yu, Yiqin; Zhu, Yu; Sun, Xingzhi; Tao, Ying; Zhang, Shuo; Xu, Linhao; Pan, Yue
This paper presents a clinical informatics toolkit that can assist physicians to conduct cohort studies effectively and efficiently. The toolkit has three key features: 1) support of procedures defined in epidemiology, 2) recommendation of statistical methods in data analysis, and 3) automatic generation of research reports. On one hand, our system can help physicians control research quality by leveraging the integrated knowledge of epidemiology and medical statistics; on the other hand, it can improve productivity by reducing the complexities for physicians during their cohort studies.
Ietri, E; Belli, S; Comba, P; Gerosa, A; Raffi, G B; Pirastu, R M
A retrospective cohort mortality study was carried out in 20 industrial factories in the Local Health Unit Bologna Sud (Emilia Romagna, Italy), where different rubber and plastics products were manufactured. The cohort consisted of 925 subjects (578 males and 347 females) employed for at least six months continuously; follow-up was between the beginning of operation of each factory, ranging between mid fifties and mid seventies, and 31 December 1989. For those exposed more than one year cause specific Standardized Mortality Ratios (SMRs) were computed using regional rates for comparison, 90% confidence intervals (CI) were calculated assuming the Poisson distribution. Among the 748 subjects employed for more than one year (457 males and 291 females) there were no lost to follow-up, 54 individuals were dead (41 males and 13 females) and for three subjects the cause of death was unknown. The results showed that all causes mortality was above expectancy in the total cohort (SMR = 123; 54 Obs; 90% CI = 97-154), among males (SMR = 117; 41 Obs; 90% CI = 89-152) and females (SMR = 143; 13 Obs; 90% CI = 85-228). Increased mortality for all malignant tumours was observed in the total cohort (SMR = 150; 25 Obs; 90% CI = 104-209) and for both genders. All nine lung cancer cases were observed among males, the SMR was equal to 218 and was statistically significant; seven cases occurred at duration of exposure less than 10 years and six at latency up to 20 years. The interpretation in terms of causality of the present investigation is limited by the small number of observations and by exposure definition solely in terms of employment in the study factories; nonetheless the results are indicating the existence, in this group of rubber and plastics product makers, of an adverse health effect which deserve further investigation.
Prospective cohorts have played a major role in understanding the role of diet, physical activity, medical conditions, and genes in the development of many diseases, but have not been widely used in the study of occupational exposures. Studies in agriculture are an exception. W...
Kim, Sung-Wan; Lee, Bong Ju; Kim, Jung Jin; Yu, Je-Chun; Lee, Kyu Young; Won, Seung-Hee; Lee, Seung-Hwan; Kim, Seung-Hyun; Kang, Shi Hyun
The present study details the rationale and methodology of the Korean Early Psychosis Cohort Study (KEPS), which is a clinical cohort investigation of first episode psychosis patients from a Korean population. The KEPS is a prospective naturalistic observational cohort study that follows the participants for at least 2 years. This study includes patients between 18 and 45 years of age who fulfill the criteria for one of schizophrenia spectrum and other psychotic disorders according to the diagnostic criteria of DSM-5. Early psychosis is defined as first episode patients who received antipsychotic treatment for fewer than 4 consecutive weeks after the onset of illness or stabilized patients in the early stages of the disorder whose duration of illness was less than 2 years from the initiation of antipsychotic treatment. The primary outcome measures are treatment response, remission, recovery, and relapse. Additionally, several laboratory tests are conducted and a variety of objective and subjective psychiatric measures assessing early life trauma, lifestyle pattern, and social and cognitive functioning are administered. This long-term prospective cohort study may contribute to the development of early intervention strategies and the improvement of long-term outcomes in patients with schizophrenia. PMID:28096881
This study was set to investigate how a cohort of ten Indonesian teachers experienced transformations in their teaching professionalism upon receiving an assignment of instructional leadership training to other school leaders. These ten teachers, who came from three different Indonesian Jesuit high schools and one archdiocese-based educational…
The association of drinking water arsenic and mortality outcome was investigated in a cohort of residents from Millard County, Utah. Median drinking water arsenic concentrations for selected study towns ranged from 14 to 166 ppb and were from public and private samples collected ...
Signorello, Lisa B.; Hargreaves, Margaret K.; Blot, William J.
Summary Over 73,700 adults age 40–79, nearly 70% African American, were recruited at community health centers across 12 southeastern states; individual characteristics were recorded and biologic specimens collected at baseline for later follow-up. The Southern Community Cohort Study is a unique national resource for assessing determinants of racial/ethnic differentials in diseases. PMID:20173283
Dubakiene, Ruta; Rudzeviciene, Odilija; Butiene, Indre; Sezaite, Indre; Petronyte, Malvina; Vaicekauskaite, Dalia; Zvirbliene, Aurelija
Cohort studies are of great importance in defining the mechanism responsible for the development of allergy-associated diseases, such as atopic dermatitis, allergic asthma, and allergic rhinoconjunctivitis. Although these disorders share genetic and environmental risk factors, it is still under debate whether they are linked or develop sequentially along an atopic pathway. The current study was aimed to determine the pattern of allergy sensitization in the Lithuanian birth cohort “Alergemol” (n = 1558) established as a part of the multicenter European birth cohort “EuroPrevall”. Early sensitization to food allergens in the “Alergemol” birth cohort was analysed. The analysis revealed 1.3% and 2.8% of symptomatic-sensitized subjects at 6 and 12 months of age, respectively. The sensitization pattern in response to different allergens in the group of infants with food allergy symptoms was studied using allergological methods in vivo and in vitro. The impact of maternal and environmental risk factors on the early development of food allergy in at 6 and 12 months of age was evaluated. Our data showed that maternal diet, diseases, the use of antibiotics, and tobacco smoke during pregnancy had no significant impact on the early sensitization to food allergens. However, infants of atopic mothers were significantly more often sensitized to egg as compared to the infants of nonatopic mothers. PMID:22606067
Yanagawa, Yasuaki; Nagata, Naoyoshi; Watanabe, Koji; Tsukada, Kunihisa; Teruya, Katsuji; Kikuchi, Yoshimi; Gatanaga, Hiroyuki; Akiyama, Junichi; Uemura, Naomi; Oka, Shinichi
Serological evidence of the epidemiological trends in Entamoeba histolytica infection is scarce, especially in nonendemic countries. We aimed to determine the antibody-positive rates over a 10-year period, and compare the trends between human immunodeficiency virus (HIV)–infected and –noninfected patients. We reviewed 3,514 patients who underwent antibody testing during the study periods, which were divided into five annual categories: 2004–2005, 2006–2007, 2008–2009, 2010–2011, and 2012–2013. Anti-E. histolytica antibody was assessed by indirect immunofluorescence assay. The antibody-positive rate increased yearly from 2004–2005 to 2012–2013 (P < 0.001), although there was no increase in the annual number of antibody tests. This trend was seen among males (18.6–28.3%; P < 0.01), females (5.4–28.2%; P < 0.01), HIV-infected patients (18.4–26.9%; P < 0.001), and non-HIV-infected patients (14.6–36.8%; P < 0.001), and HIV-infected men who have sex with men (19.4–29.1%; P < 0.001). Among antibody-positive patients, there was a significant increase in the proportion of patients with high (≥ 1,600) titers (0.7–12.9%; P < 0.001), whereas this trend was not seen in patients with low (100) or intermediate (200–800) titers (P = 0.282 and 0.409, respectively). This large hospital-based study demonstrated that positive anti-E. histolytica antibody rates increased over 10 years, even though the annual number of antibody tests remained constant. Moreover, this trend was identified in non-high-risk patients (females and non-HIV-infected patients) as well as in high-risk patients. The proportion of patients with high antibody titers significantly increased among the antibody-positive patients. PMID:27296390
Birk, T; Weiland, S K; Schumann, J; Person, M; Mundt, K; Keil, U
A historical cohort study is carried out to investigate occupational hazards in the German rubber industry since 1991. We present and discuss the study objectives and study design features such as cohort definition, assessment of occupational exposure and selection of the reference population. Cohort enumeration, assessment of vital status and cause of death ascertainment are described. With approximately 2,800 deaths throughout the observation period 1981 to 1991 it will be possible also to study the occupational etiology of rare diseases.
Lee, David M; Pye, Stephen R; Tajar, Abdelouahid; O'Neill, Terence W; Finn, Joseph D; Boonen, Steven; Bartfai, Gyorgy; Casanueva, Felipe F; Forti, Gianni; Giwercman, Aleksander; Han, Thang S; Huhtaniemi, Ilpo T; Kula, Krzysztof; Lean, Michael E J; Pendleton, Neil; Punab, Margus; Silman, Alan J; Vanderschueren, Dirk; Wu, Frederick C W
The European Male Ageing Study (EMAS) was designed to examine the hypothesis that inter-individual and regional variability in symptomatic dysfunctions, alterations in body composition and health outcomes in ageing men can be explained by different rates of decline in anabolic hormones, the most important of which being testosterone. Between 2003 and 2005, 3369 community-dwelling men, aged between 40 and 79 years, were recruited from population-based registers in eight European centres to participate in the baseline survey, with follow-up investigations performed a median of 4.3 years later. Largely, identical questionnaire instruments and clinical investigations were used in both phases to capture contemporaneous data on general health (including cardiovascular diseases and chronic conditions), physical and cognitive functioning, mental health, sexual function, quality of life, bone health, chronic pain, disease biomarkers, hormones (sex hormones and metabolic hormones) and genetic polymorphisms. EMAS actively encourages new collaborations, data sharing for validation studies and participation in genetic study consortia. Potential collaborators should contact the principal investigator (F.C.W.W.) in the first instance.
Casas, Lidia; Tiesler, Carla; Thiering, Elisabeth; Brüske, Irene; Koletzko, Sibylle; Bauer, Carl-Peter; Wichmann, H-Erich; von Berg, Andrea; Berdel, Dietrich; Krämer, Ursula; Schaaf, Beate; Lehmann, Irina; Herbarth, Olf; Sunyer, Jordi; Heinrich, Joachim
Indoor microbial agents exposure is associated to depressive symptoms in adults and persistent exposure to indoor mould is associated to poorer cognitive function in children. In our study, we aimed to assess the effects of the exposure to indoor factors associated with increased microbial exposure (mould, dampness and pets) on behavioural problems in children aged 10 years, participating in two German birth cohorts. A total of 4860 children were followed until the age of 10 years, and the strengths and difficulties questionnaire (SDQ) was administered to the parents. Indoor factors were assessed through parental reported questionnaires in periodical surveys. Logistic and multinomial regressions adjusting for potential confounders were performed. Prevalences of borderline/abnormal total scores in the SDQ at 10 years of age were higher in children exposed to mould (aOR=1.23, 95%CI=1.00-1.56), dampness (aOR=1.51, 95%CI=1.10-2.07), and pets (aOR=1.48, 95%CI=1.20-1.94). The dimension "emotional symptoms" showed statistically significant risk estimates for mould and pets, meanwhile "conduct problems" and "hyperactivity/inattention" dimensions only did for pets. No significant associations were found for the "peer relationship problems" dimension. We found a significant strong interaction between dampness and pet, the risk of borderline/abnormal scores in the "total difficulties" scale and the "emotional symptoms" dimension for pets' was at least twice the risk in children with reported dampness than in children without. Our findings point to a potential effect of microbial exposure on children's behavioural problems, especially on emotional disorders, probably mediated through neurotoxicity and immune system activation.
Chu, Yeh-Wen; Wu, Wen-Shiann; Hsu, Chen-Fang; Wang, Jhi-Joung; Weng, Shih-Feng; Chien, Chih-Chiang
Background Diabetes is associated with development of end-stage renal disease (ESRD) dialysis, but it is not clear whether ESRD dialysis is a risk factor for new-onset diabetes (NODM). Methods Using the Taiwan National Health Insurance Research Database, we designed two cohort studies to determine the association between dialysis and diabetes. Analysis 1 estimated the hazard ratios (HR) of ESRD dialysis in 20,585 patients with type 2 diabetes (T2DM) and 82,340 gender- and age- matched controls without diabetes. Analysis 2 estimated the HRs of NODM in 18,489 ESRD patients undergoing dialysis and 73,956 gender- and age- matched controls without ESRD dialysis. The follow-up period was from 2000 to date of endpoint, the date of death, or December 31, 2008. Cox proportional models were used to estimate the relative hazards. Results In analysis 1, the incidence of ESRD dialysis was higher in the T2DM cohort than in the non-diabetes cohort (6.78 vs. 0.61 per 1,000 person-years; HR: 7.97; 95%CI: 7.05–8.00). In analysis 2, the incidence of NODM was higher in the ESRD dialysis cohort than in the without-ESRD dialysis cohort (22.84 vs. 13.99 per 1,000 person-years; HR: 1.40; 95% CI: 1.34–1.47). Conclusions ESRD dialysis and diabetes were bidirectionally associated. The relationship between T2DM and incident ESRD dialysis was much stronger than between ESRD dialysis and NODM. Further studies are needed to determine the mechanism of ESRD dialysis-related NODM. PMID:28296932
Welham, Joy; Isohanni, Matti; Jones, Peter; McGrath, John
Background: Birth cohort (BC) studies demonstrate that individuals who develop schizophrenia differ from the general population on a range of developmental indices. The aims of this article were to summarize key findings from BC studies in order to identify areas of convergence and to outline areas requiring further research. Method: We define BC studies as studies based on general population BCs where data are collected prospectively from birth or childhood and which identify schizophrenia or related disorders as an outcome. To identify such studies, we searched various electronic databases using the search parameters (schizo* OR psych*) AND (birth cohort). We also checked the references of relevant articles and previous reviews. Results: We identified 11 BCs from 7 countries that have examined schizophrenia as an outcome in adulthood. There is relatively consistent evidence that, as a group, children who later develop schizophrenia have behavioral disturbances and psychopathology, intellectual and language deficits, and early motor delays. Evidence with respect to alterations in language, educational performance, and physical growth has also been identified in some studies. BC studies have also contributed evidence about a wide range of putative risk factors for schizophrenia. Conclusions: BC studies have provided important, convergent insights into how the developmental trajectory of individuals who develop schizophrenia differs from their peers. The combination of new paradigms and larger cohorts, with the tools of modern epidemiology and biomedical science, is advancing our understanding of the developmental pathways to schizophrenia. PMID:18658128
McCampbell, Beth; Wasif, Nabil; Rabbitts, Angela; Staiano-Coico, Lisa; Yurt, Roger W; Schwartz, Suzanne
Burn injuries are often associated with multisystemic complications, even in otherwise healthy individuals. It is therefore intuitive that for the diabetic patient, the underlying pathophysiologic alterations in vascular supply, peripheral neuropathy, and immune function could have a profoundly devastating impact on patient outcome. The effects of diabetes on morbidity and mortality of the burn-injured patient have not been examined in great detail. The purpose of this retrospective study was to compare clinical outcomes between diabetic and nondiabetic burn patients. We reviewed the charts of 181 diabetic (DM) and 190 nondiabetic (nDM) patients admitted with burns between January 1996 and May 2000, matched by sex and date of admission. Burn cause and size, time to presentation, clinical course, and outcomes were evaluated. Because age was a factor, the analysis was done by three age groups: younger than 18 years, 18 to 65 years, and older than 65 years. Of patients 18 to 65 years, 51% (98/191) were diabetic, whereas 84% (81/96) of those older than 65 and only 4% (3/85) of patients younger than 18 were diabetic. Because of the disproportion in numbers of diabetics compared with nondiabetics in the younger than 18 and older than 65 years-old groups, these patients will not be discussed. Diabetics were more likely to incur scald injury from tub or shower water rather than hot fluid spills (33% DM vs 15% nDM; P < or = 0.01), and have a delayed presentation (45 vs 23%; P = 0.00001). There was no difference in total burn size in all groups. Diabetics in the 18 to 65 years group had a higher rate of full-thickness burns (51 vs 31%; P = 0.025), skin grafts (50 vs 28%; P = 0.01) and burn-related procedures (57 vs 32%; P = 0.001), infections (65 vs 51%; P = 0.05), and longer lengths of stay (23 vs 12 days; P = 0.0001). Although there was no statistically significant difference in incidence of specific infections, the rates of cellulitis, wound infection, urinary tract
Shahbazi, Fatemeh; Ranjbaran, Mehdi; Karami-far, Simin; Soori, Hamid; Manesh, Hadi Jafari
Background: Kidney transplantation is a preferred treatment for many patients with end-stage renal disease (ESRD) and is far more profitable than hemodialysis. Analyzing renal transplantation data can help to evaluate the effectiveness of transplantation interventions. The aim of this study was to determine the organ survival rate after kidney transplantation during a period of 10 years (March 2001-March 2011) among transplanted patients in Arak, Markazi Province, Iran. Materials and Methods: In this historical cohort study, all recipients of kidney transplantation from Arak, Markazi Province, Iran who had medical records in Valiasr Hospital and “charity for kidney patients” of Arak, Markazi Province, Iran during a period of 10 years from March 2001 to March 2011 were included. Data collected by using checklists were completed from patients’ hospital records. Kaplan-Meier method was used to determine the graft cumulative survival rate, log-rank test to compare survival curves in subgroups, and Cox regression model to define the hazard ratio and for ruling out the intervening factors. Statistical analysis was conducted by Statistical Package for the Social Sciences (SPSS) 20 and Stata 11. Results: Mean duration of follow-up was 55.43 ± 42.02 months. By using the Kaplan-Meier method, the cumulative probability of graft survival at 1, 3, 5, 7, and 10 years was 99.1, 97.7, 94.3, 85.7, and 62.1%, respectively. The number of dialysis by controlling the effect of other variables had a significant association with the risk of graft failure [hazard ratios and 95% confidence interval (CI): 1.47 (1.02-2.13)]. Conclusion: This study showed that the graft survival rate was satisfactory in this community and was similar to the results of single-center studies in the world. Dialysis time after transplantation was a significant predictor of survival in the recipients of kidney transplantation that should be considered. PMID:26941807
Ahrens, W; Greiser, H; Linseisen, J; Kluttig, A; Schipf, S; Schmidt, B; Günther, K
The German National Cohort (GNC) is the largest population-based cohort study in Germany. Beginning in 2014, a total of 200,000 women and men aged 20-69 years will be examined in 18 study centers. The aim of the study is to investigate the etiology of chronic diseases in relation to lifestyle, genetic, socioeconomic, and environmental factors and to develop appropriate methods for early diagnosis and prevention of diseases such as cardiovascular and respiratory diseases, cancer, diabetes, neurodegenerative/psychiatric diseases, as well as musculoskeletal and infectious diseases. Pretest studies (phase 1 and 2) were conducted to select methods, instruments, and procedures for the main study, to develop standard operating procedures, and to design and test the examination program according to acceptance, expected duration, and feasibility. The pretest studies included testing of interviews, questionnaires, anthropometric measurements, several medical examinations, and the collection of biosamples. In addition, the logistic, technical, and personnel infrastructure for the main study could be established including the study centers, the central infrastructure for data management, processes to coordinate the study, and data protection and quality management concepts. The examination program for the main phase of the GNC was designed and optimized based on the results of the pretest studies. The GNC is a population-based, highly standardized and excellently phenotyped cohort that will be the basis for new strategies for risk assessment and identification, early diagnosis, and prevention of multifactorial diseases.
Tate, Robert B; Cuddy, T Edward; Mathewson, Francis A L
The Manitoba Follow-up Study (MFUS) is Canada's longest running study of cardiovascular disease and ageing. The MFUS cohort consists of 3983 men recruited from the Royal Canadian Air Force at the end of World War II. At entry to the study, 1 July 1948, their mean age was 31 years, with 90% between ages 20 and 39 years. All study members were free of clinical evidence of ischaemic heart disease. The protocol of MFUS was to obtain routine medical examinations from these men at regular intervals over time. The research goal of the study was to examine the role that any abnormalities detected on routine electrocardiograms from apparently healthy men might play in the prediction of subsequent diagnoses of cardiovascular disease. Over the course of 65 years, about 35% of the cohort has documented evidence of ischaemic heart disease. The research focus was expanded in 1996 to explore the roles of physical, mental and social functioning in support of healthy and successful ageing. On 1 July 2013, 429 original cohort members were alive with a mean age of 92 years. Collaborative research with others outside the in-house team is welcomed.
Chang, Ping-Ying; Huang, Wen-Yen; Lin, Cheng-Li; Huang, Tzu-Chuan; Wu, Yi-Ying; Chen, Jia-Hong; Kao, Chia-Hung
β-Blockers have been reported to exhibit potential anticancer effects in cancer cell lines and animal models. However, clinical studies have yielded inconsistent results regarding cancer outcomes and cancer risk when β-blockers were used. This study investigated the association between propranolol and cancer risk.Between January 1, 2000 and December 31, 2011, a patient cohort was extracted from the Longitudinal Health Insurance Database 2000, a subset of the Taiwan National Health Insurance Research Database. A propranolol cohort (propranolol usage >6 months) and nonpropranolol cohort were matched using a propensity score. Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of cancer associated with propranolol treatment.The study sample comprised 24,238 patients. After a 12-year follow-up period, the cumulative incidence for developing cancer was low in the propranolol cohort (HR: 0.75; 95% CI: 0.67-0.85; P < 0.001). Patients with propranolol treatment exhibited significantly lower risks of cancers in head and neck (HR: 0.58; 95% CI: 0.35-0.95), esophagus (HR: 0.35; 95% CI: 0.13-0.96), stomach (HR: 0.54; 95% CI: 0.30-0.98), colon (HR: 0.68; 95% CI: 0.49-0.93), and prostate cancers (HR: 0.52; 95% CI: 0.33-0.83). The protective effect of propranolol for head and neck, stomach, colon, and prostate cancers was most substantial when exposure duration exceeded 1000 days.This study supports the proposition that propranolol can reduce the risk of head and neck, esophagus, stomach, colon, and prostate cancers. Further prospective study is necessary to confirm these findings.
van Lonkhuijzen, Luc; Kirsh, Victoria A; Kreiger, Nancy; Rohan, Thomas E
Diet plays an important role in the etiology of certain cancers, but there is limited evidence with regard to the association between diet and risk of endometrial cancer. Few prospective studies have investigated meat intake as a potential determinant of endometrial cancer risk. The objective of this study was to examine the association between endometrial cancer risk and total meat, red meat, processed meat, fish, and poultry intake. We conducted a case-cohort analysis within the Canadian Study of Diet, Lifestyle, and Health, a prospective cohort of 73 909 adults (39 614 women). Participants were recruited from 1992 to 1999, predominantly from three Canadian universities. We conducted a linkage with the Ontario Cancer Registry for the years 1992-2007 for the female cohort members, who resided in Ontario at the time of enrollment (n=26 024), to yield data on cancer incidence. The analytic sample was comprised of 107 incident cases and 1830 subcohort members, the latter being an age-stratified sample of the full cohort. A nonsignificant increase in the risk of endometrial cancer was associated with increased consumption of red meat [hazard ratio (HR)=1.62, 95% confidence intervals (CI)=0.86-3.08, for high vs. low intake; P trend=0.13)], processed meat (HR=1.45, 95% CI=0.80-2.61, for high vs. low intake; P trend=0.058), and all meat combined (HR=1.50, 95% CI=0.78-2.89, for high vs. low intake; P trend=0.14). No clear patterns were noted for poultry or fish. The results of this study, although based on a limited number of cases, suggest that relatively high meat intake may be associated with increased risk of endometrial cancer.
Berge, Jerica M.; Wall, Melanie; Hsueh, Tsun-Fang; Fulkerson, Jayne A.; Larson, Nicole; Neumark-Sztainer, Dianne
Objective To examine whether having family meals as an adolescent protects against becoming overweight or obese 10 years later as a young adult. Study design Data from Project EAT-III, a longitudinal cohort study with emerging young adults, were used. At baseline (1998-1999) adolescents completed surveys in middle or high schools and at 10-year follow-up (2008-2009) surveys were completed online or via mailed surveys. Young adult participants (n=2117) were racially/ethnically and socioeconomically diverse (52% minority; 38% low income) between the ages of 19-31 (mean age=25.3; 55% female). Logistic regression was used to associate weight status at follow-up with family meal frequency 10-years earlier during adolescence, controlling and testing for interactions with demographic characteristics. Results All levels of baseline family meal frequency (i.e., 1-2, 3-4, ≥5 family meals/week) during adolescence were significantly associated with reduced odds of overweight or obesity ten years later in young adulthood as compared with never having family meals as an adolescent. Interactions by race indicated that family meals had a stronger protective effect for obesity in black versus white young adults. Conclusions Family meals during adolescence were protective against the development of overweight and obesity in young adulthood. Professionals who work with adolescents and parents may want to strategize with them how to successfully carry out at least one to two family meals per week in order to protect adolescents from overweight or obesity in young adulthood. PMID:25266343
Sibon, David; Morschhauser, Franck; Resche-Rigon, Matthieu; Ghez, David; Dupuis, Jehan; Marçais, Ambroise; Deau-Fischer, Bénédicte; Bouabdallah, Reda; Sebban, Catherine; Salles, Gilles; Brice, Pauline
We assessed the long-term results of autologous stem-cell transplantation for patients with first-relapsed or refractory Hodgkin lymphoma included in the prospective Lymphoma Study Association/Société Française de Greffe de Moelle H96 trial. This large multicenter phase II trial evaluated a risk-adapted strategy with single or tandem autologous stem-cell transplantation for 245 Hodgkin lymphoma patients. Poor-risk patients (n=150) had primary refractory Hodgkin lymphoma (n=77) or ≥2 risk factors at first relapse (n=73) and were eligible for tandem autologous stem-cell transplantation. Intermediate-risk patients (n=95) had one risk factor at first relapse and were eligible for single autologous stem-cell transplantation. With a median follow-up of 10.3 years, 10-year freedom from second failure and overall survival rates were, respectively: 64% (95% CI, 54% to 74%) and 70% (95% CI, 61% to 80%) for the intermediate-risk group, and 41% (95% CI, 33% to 49%) and 47% (95% CI, 39% to 55%) for the poor-risk group. Considering only patients who did not relapse after completing autologous stem-cell transplantation, the 15-year cumulative incidences of second primary malignancies were 24% for the 70 intermediate-risk patients and 2% for the 75 poor-risk ones. With long-term follow-up, the risk-adapted strategy remains appropriate. Tandem autologous stem-cell transplantation can still be considered an option for poor-risk patients, but integration of positron-emission tomography findings and new drugs may help to refine the need for a second autologous stem-cell transplant and possibly improve outcomes of patients with first-relapsed or refractory Hodgkin lymphoma. PMID:26721893
Miller, Ashley; Franzen-Castle, Lisa; Aguirre, Trina; Krehbiel, Michelle; Colby, Sarah; Kattelmann, Kendra; Olfert, Melissa D; Mathews, Douglas; White, Adrienne
It is important to understand adult outcomes in childhood obesity prevention programs as parents and caregivers have a significant influence on the eating and physical activity habits of youth. Grounded in the social cognitive theory, the iCook 4-H study was centered on a dyad model (9-10 year-olds and their primary meal preparers) to teach healthy cooking skills, shopping and meal habits, and being active as a family. The program took place in five states and dyads (n = 54) were recruited through flyers, e-mails, and in-person contact. The focus of this article is to provide findings from adult program participants. Demographics and self-reported food intake, procurement, preparation and safety practices, feeding relationships, mealtime routines, and height and weight were collected through surveys at baseline and program completion, which spanned 3 months. Descriptive statistics including two-related samples tests and paired samples t tests were used to assess pre- and post-program survey data responses at p < 0.05 significance level. Most had a bachelor's degree (31%) or some college (29%), about half were white, 66% were married, about 30% of households participated in assistance programs, and 82% were female. At program conclusion, participants significantly improved meal planning, prioritizing healthy meal choices, shopping with a grocery list, and reading Nutrition Facts Labels. There were also significant, positive differences noted in cooking skill confidence (p = 0.015), desire to cook more meals at home, and fewer fast food meals. Adult-youth feeding interactions also significantly improved. There were also significant increases in fruit juice (100%), vegetable soup, and whole grain consumption. Based on results, adults reported improvements in meal planning, cooking, and purchasing skills that were taught in classes.
Sibon, David; Morschhauser, Franck; Resche-Rigon, Matthieu; Ghez, David; Dupuis, Jehan; Marçais, Ambroise; Deau-Fischer, Bénédicte; Bouabdallah, Reda; Sebban, Catherine; Salles, Gilles; Brice, Pauline
We assessed the long-term results of autologous stem-cell transplantation for patients with first-relapsed or refractory Hodgkin lymphoma included in the prospective Lymphoma Study Association/Société Française de Greffe de Moelle H96 trial. This large multicenter phase II trial evaluated a risk-adapted strategy with single or tandem autologous stem-cell transplantation for 245 Hodgkin lymphoma patients. Poor-risk patients (n=150) had primary refractory Hodgkin lymphoma (n=77) or ≥2 risk factors at first relapse (n=73) and were eligible for tandem autologous stem-cell transplantation. Intermediate-risk patients (n=95) had one risk factor at first relapse and were eligible for single autologous stem-cell transplantation. With a median follow-up of 10.3 years, 10-year freedom from second failure and overall survival rates were, respectively: 64% (95% CI, 54% to 74%) and 70% (95% CI, 61% to 80%) for the intermediate-risk group, and 41% (95% CI, 33% to 49%) and 47% (95% CI, 39% to 55%) for the poor-risk group. Considering only patients who did not relapse after completing autologous stem-cell transplantation, the 15-year cumulative incidences of second primary malignancies were 24% for the 70 intermediate-risk patients and 2% for the 75 poor-risk ones. With long-term follow-up, the risk-adapted strategy remains appropriate. Tandem autologous stem-cell transplantation can still be considered an option for poor-risk patients, but integration of positron-emission tomography findings and new drugs may help to refine the need for a second autologous stem-cell transplant and possibly improve outcomes of patients with first-relapsed or refractory Hodgkin lymphoma.
Onoye, Jane M M; Hishinuma, Earl S; McArdle, John J; Zonderman, Alan B; Bumanglag, R Janine; Takeshita, Junji
Intergenerational longitudinal studies over the lifespan provide valuable information for understanding the contexts and dynamic relations among cognition, family and health in adults and the elderly. The Hawai'i Family Study of Cognition (HFSC), initiated in the early 1970s, included a cohort of over 6500 individuals representing over 1800 families of parents and their offspring. The HFSC gathered data on cognitive, personality, biological and other psychosocial variables, and provided novel information on the nature of cognitive abilities, especially on family issues. Some families were reassessed with short-term retesting in the 1970s. A select sample of offspring and their siblings and spouses were re-measured in the 1980s. Decades later, a 40-year follow-up of the original HFSC cohort was facilitated by the availability of contemporary tracking and tracing methods and internet-based testing. A subgroup of the original HFSC participants was re-contacted and retested on contemporary cognitive as well as socio-demographic and health measures. In this paper, we describe the original HFSC cohort and the design and methodology of the re-contact and retest studies of the HFSC, plans for expanding the re-contact and retesting, as well as directions for future research and collaborations. The Principal Investigator may be contacted for more information regarding the application, review and approval process for data access requests from qualified individuals outside the project.
Onoye, Jane MM; Hishinuma, Earl S; McArdle, John J; Zonderman, Alan B; Takeshita, Junji
Intergenerational longitudinal studies over the lifespan provide valuable information for understanding the contexts and dynamic relations among cognition, family and health in adults and the elderly. The Hawai‘i Family Study of Cognition (HFSC), initiated in the early 1970s, included a cohort of over 6500 individuals representing over 1800 families of parents and their offspring. The HFSC gathered data on cognitive, personality, biological and other psychosocial variables, and provided novel information on the nature of cognitive abilities, especially on family issues. Some families were reassessed with short-term retesting in the 1970s. A select sample of offspring and their siblings and spouses were re-measured in the 1980s. Decades later, a 40-year follow-up of the original HFSC cohort was facilitated by the availability of contemporary tracking and tracing methods and internet-based testing. A subgroup of the original HFSC participants was re-contacted and retested on contemporary cognitive as well as socio-demographic and health measures. In this paper, we describe the original HFSC cohort and the design and methodology of the re-contact and retest studies of the HFSC, plans for expanding the re-contact and retesting, as well as directions for future research and collaborations. The Principal Investigator may be contacted for more information regarding the application, review and approval process for data access requests from qualified individuals outside the project. PMID:24639439
Effects of anthropogenic stressors on animal populations are often evaluated by assembling vital rate responses from isolated cohort studies into a single demographic model. However, models constructed from cohort studies are difficult to translate into ecological predictions be...
Kume, T.; Tanaka, N.; Komatsu, H.; Yoshifuji, N.; Saitoh, T. M.; Suzuki, M.; Kumagai, T.
This study was undertaken to quantify 10-year evapotranspiration (ET) in a tropical rainforest, Sarawak, Malaysia. To this aim, a simplified big-leaf model was formulated, which can consider transpiration (Et) and rainfall interception (Ei). The model was independently validated using eddy covariance fluxes, rainfall interception based on throughfall and stemflow measurements, and sap flow measurements conducted for more than two years. Consequently, our big-leaf model could successfully reproduce Et and Ei. By using the model and a 10-year meteorological data set, Et, Ei, and ET was estimated in the period between 2000 and 2009. The annual Et , Ei, and ET averaged over 10 years were estimated as 1114, 209, and 1323 mm, respectively, with the small seasonal fluctuations. The derived estimations for 10 years showed conservative year-to-year variations in Et, Ei, and ET (CV = 5-7%) against considerable year-to-year variations in annual rainfall (CV = 11%). Specific rainfall characteristics in this site could be a reason for conservative year-to-year variations in Ei. Small interannual variations in meteorological conditions and no occurrence of unusually severe drought in this study period could be a reason for the small year-to-year variations in Et. As well, we compared ET, Ei at this site with those of other tropical forests. Our forest ET was smaller than global maximum value of ET estimated in other tropical forests because of the smaller Ei, relative to annual rainfall at this site. Based on the derived characteristics of ET, we also discussed possible changes in ET, Et, and Ei in response to changes in rainfall regime at this site.
Twenge, Jean M; Carter, Nathan T; Campbell, W Keith
Orth, Trzesniewski, and Robins (2010) concluded that the nationally representative Americans' Changing Lives (ACL) cohort-sequential study demonstrated moderate to large age differences in self-esteem, and no birth cohort (generational) differences in the age trajectory. In a reanalysis of these data using 2 different statistical techniques, we find significant increases in self-esteem that could be attributed to birth cohort or time period. First, hierarchical linear modeling analyses with birth cohort as a continuous variable (vs. the multiple group formulation used by Orth et al.) find that birth cohort has a measurable influence on self-esteem through its interaction with age. Participants born in later years (e.g., 1960) were higher in self-esteem and were more likely to increase in self-esteem as they aged than participants born in earlier years (e.g., 1920). However, the estimated age trajectory up to age 60 is similar in Orth et al.'s results and in the results from our analyses including cohort. Second, comparing ACL respondents of the same age in 1986 versus 2002 (a time-lag design) yields significant birth cohort differences in self-esteem, with 2002 participants of the same age higher in self-esteem than those in 1986. Combined with some previous studies finding significant increases in self-esteem and positive self-views over time, these results suggest that cultural change in the form of cohort and time period cannot be ignored as influences in cross-sectional and longitudinal studies. (PsycINFO Database Record
Mikkelsen, Sigurd; Brauer, Charlotte; Pedersen, Ellen Bøtker; Alkjær, Tine; Koblauch, Henrik; Simonsen, Erik Bruun; Helweg-Larsen, Karin; Thygesen, Lau Caspar
Meniscal lesions are common and may contribute to the development of knee arthrosis. A few case-control and cross-sectional studies have identified knee-straining work as risk factors for meniscal lesions, but exposure-response relations and the role of specific exposures are uncertain, and previous results may be sensitive to reporting and selection bias. We examined the relation between meniscal lesions and cumulative exposure to heavy lifting in a prospective register-based study with complete follow-up and independent information on exposure and outcome. We established a cohort of unskilled men employed at Copenhagen Airport or in other companies in the metropolitan Copenhagen area from 1990 to 2012 (the Copenhagen Airport Cohort). The cohort at risk included 3,307 airport baggage handlers with heavy lifting and kneeling or squatting work tasks and 63,934 referents with a similar socioeconomic background and less knee-straining work. Baggage handlers lifted suitcases with an average weight of approximately 15 kg, in total approximately five tonnes during a 9-hour workday. The cohort was followed in the National Patient Register and Civil Registration System. The outcome was a first time hospital diagnosis or surgery of a meniscal lesion. Baggage handlers had a higher incidence of meniscal lesions than the referents. Within baggage handlers spline regression showed that the incidence rate ratio was 1.91 (95% confidence interval: 1.29–2.84) after five years as a baggage handler and then decreased slowly to reach unity after approximately 30 years, adjusted for effects of potential confounders. This relation between baggage handling and meniscal lesions was present for work on the apron which involves lifting in a kneeling or squatting position, but not in the baggage hall, which only involves lifting in standing positions. The results support that long-term heavy lifting in a kneeling or squatting position is a risk factor for the development of symptomatic
Henricson, Anders; Nilsson, Kjell G
Background and purpose - Total knee replacement (TKR) in younger patients using cemented components has shown inferior results, mainly due to aseptic loosening. Excellent clinical results have been reported with components made of trabecular metal (TM). In a previous report, we have shown stabilization of the TM tibial implants for up to 5 years. In this study, we compared the clinical and RSA results of these uncemented implants with those of cemented implants. Patients and methods - 41 patients (47 knees) aged ≤ 60 years underwent TKR. 22 patients (26 knees) received an uncemented monoblock cruciate-retaining (CR) tibial component (TM) and 19 patients (21 knees) received a cemented NexGen Option CR tibial component. Follow-up examination was done at 10 years, and 16 patients (19 knees) with TM tibial components and 17 patients (18 knees) with cemented tibial components remained for analysis. Results - 1 of 19 TM implants was revised for infection, 2 of 18 cemented components were revised for knee instability, and no revisions were done for loosening. Both types of tibial components migrated in the first 3 months, the TM group to a greater extent than the cemented group. After 3 months, both groups were stable during the next 10 years. Interpretation - The patterns of migration for uncemented TM implants and cemented tibial implants over the first 10 years indicate that they have a good long-term prognosis regarding fixation.
Henricson, Anders; Nilsson, Kjell G
Background and purpose Total knee replacement (TKR) in younger patients using cemented components has shown inferior results, mainly due to aseptic loosening. Excellent clinical results have been reported with components made of trabecular metal (TM). In a previous report, we have shown stabilization of the TM tibial implants for up to 5 years. In this study, we compared the clinical and RSA results of these uncemented implants with those of cemented implants. Patients and methods 41 patients (47 knees) aged ≤ 60 years underwent TKR. 22 patients (26 knees) received an uncemented monoblock cruciate-retaining (CR) tibial component (TM) and 19 patients (21 knees) received a cemented NexGen Option CR tibial component. Follow-up examination was done at 10 years, and 16 patients (19 knees) with TM tibial components and 17 patients (18 knees) with cemented tibial components remained for analysis. Results 1 of 19 TM implants was revised for infection, 2 of 18 cemented components were revised for knee instability, and no revisions were done for loosening. Both types of tibial components migrated in the first 3 months, the TM group to a greater extent than the cemented group. After 3 months, both groups were stable during the next 10 years. Interpretation The patterns of migration for uncemented TM implants and cemented tibial implants over the first 10 years indicate that they have a good long-term prognosis regarding fixation PMID:27357222
Eom, Bang Wool; Kim, Young-Woo; Nam, Byung-Ho; Ryu, Keun Won; Jeong, Hyun-Yong; Park, Young-Kyu; Lee, Young-Joon; Yang, Han-Kwang; Yu, Wansik; Yook, Jeong-Hwan; Song, Geun Am; Youn, Sei-Jin; Kim, Heung Up; Noh, Sung-Hoon; Park, Sung Bae; Yang, Doo-Hyun; Kim, Sung
Purpose This study aimed to establish a large-scale database of patients with gastric cancer to facilitate the development of a national-cancer management system and a comprehensive cancer control policy. Materials and Methods An observational prospective cohort study on gastric cancer was initiated in 2010. A total of 14 cancer centers throughout the country and 152 researchers were involved in this study. Patient enrollment began in January 2011, and data regarding clinicopathological characteristics, life style-related factors, quality of life, as well as diet diaries were collected. Results In total, 4,963 patients were enrolled until December 2014, and approximately 5% of all Korean patients with gastric cancer annually were included. The mean age was 58.2±11.5 years, and 68.2% were men. The number of patients in each stage was as follows: 3,394 patients (68.4%) were in stage IA/B; 514 patients (10.4%), in stage IIA/B; 469 patients (9.5%), in stage IIIA/B/C; and 127 patients (2.6%), in stage IV. Surgical treatment was performed in 3,958 patients (79.8%), endoscopic resection was performed in 700 patients (14.1%), and 167 patients (3.4%) received palliative chemotherapy. The response rate for the questionnaire on the quality of life was 95%; however, diet diaries were only collected for 27% of patients. Conclusions To provide comprehensive information on gastric cancer for patients, physicians, and government officials, a large-scale database of Korean patients with gastric cancer was established. Based on the findings of this cohort study, an effective cancer management system and national cancer control policy could be developed. PMID:27752396
Lewis, D R; Southwick, J W; Ouellet-Hellstrom, R; Rench, J; Calderon, R L
The association of drinking water arsenic and mortality outcome was investigated in a cohort of residents from Millard County, Utah. Median drinking water arsenic concentrations for selected study towns ranged from 14 to 166 ppb and were from public and private samples collected and analyzed under the auspices of the State of Utah Department of Environmental Quality, Division of Drinking Water. Cohort members were assembled using historical documents of the Church of Jesus Christ of Latter-day Saints. Standard mortality ratios (SMRs) were calculated. Using residence history and median drinking water arsenic concentration, a matrix for cumulative arsenic exposure was created. Without regard to specific exposure levels, statistically significant findings include increased mortality from hypertensive heart disease [SMR = 2.20; 95% confidence interval (CI), 1.36-3.36], nephritis and nephrosis (SMR = 1.72; CI, 1.13-2.50), and prostate cancer (SMR = 1.45; CI, 1.07-1. 91) among cohort males. Among cohort females, statistically significant increased mortality was found for hypertensive heart disease (SMR = 1.73; CI, 1.11-2.58) and for the category of all other heart disease, which includes pulmonary heart disease, pericarditis, and other diseases of the pericardium (SMR = 1.43; CI, 1.11-1.80). SMR analysis by low, medium, and high arsenic exposure groups hinted at a dose relationship for prostate cancer. Although the SMRs by exposure category were elevated for hypertensive heart disease for both males and females, the increases were not sequential from low to high groups. Because the relationship between health effects and exposure to drinking water arsenic is not well established in U.S. populations, further evaluation of effects in low-exposure populations is warranted.
Lewis, D R; Southwick, J W; Ouellet-Hellstrom, R; Rench, J; Calderon, R L
The association of drinking water arsenic and mortality outcome was investigated in a cohort of residents from Millard County, Utah. Median drinking water arsenic concentrations for selected study towns ranged from 14 to 166 ppb and were from public and private samples collected and analyzed under the auspices of the State of Utah Department of Environmental Quality, Division of Drinking Water. Cohort members were assembled using historical documents of the Church of Jesus Christ of Latter-day Saints. Standard mortality ratios (SMRs) were calculated. Using residence history and median drinking water arsenic concentration, a matrix for cumulative arsenic exposure was created. Without regard to specific exposure levels, statistically significant findings include increased mortality from hypertensive heart disease [SMR = 2.20; 95% confidence interval (CI), 1.36-3.36], nephritis and nephrosis (SMR = 1.72; CI, 1.13-2.50), and prostate cancer (SMR = 1.45; CI, 1.07-1. 91) among cohort males. Among cohort females, statistically significant increased mortality was found for hypertensive heart disease (SMR = 1.73; CI, 1.11-2.58) and for the category of all other heart disease, which includes pulmonary heart disease, pericarditis, and other diseases of the pericardium (SMR = 1.43; CI, 1.11-1.80). SMR analysis by low, medium, and high arsenic exposure groups hinted at a dose relationship for prostate cancer. Although the SMRs by exposure category were elevated for hypertensive heart disease for both males and females, the increases were not sequential from low to high groups. Because the relationship between health effects and exposure to drinking water arsenic is not well established in U.S. populations, further evaluation of effects in low-exposure populations is warranted. PMID:10210691
Margolin, Edward A.
Background Temporal artery biopsy is the gold standard for the diagnosis of giant cell arteritis, but the numbers and types of surgical specialists performing temporal artery biopsies are unknown. The goal of this study was to determine which surgical specialists performed temporal artery biopsies and how geographic location influenced this trend over a period of 10 years. Methods This retrospective cohort study included all physicians practising in Ontario from 2002 to 2013. Using comprehensive physician services data from the IntelliHEALTH Medical Services database, physicians performing temporal artery biopsies were identified by the Ontario Health Insurance Plan billing code submitted for remuneration. Physicians were categorized by specialty and geographic Local Health Integration Unit. Results A total of 9958 patients underwent a temporal artery biopsy during the study period: the biopsies were performed by 11 different subspecialties. The number of patients undergoing a temporal artery biopsy declined over the 10-year study period. Most procedures were performed by general surgeons (38.1%), followed by ophthalmologists (31.0%) and plastic surgeons (23.6%). Ophthalmologists performed more temporal artery biopsies per person compared with general surgeons, but significantly more general surgeons performed at least 1 biopsy. There was significant variation based on geographic location: plastic surgeons performed the most biopsies in regions with a population of more than 1 million people, and general surgeons performed most of the biopsies in rural areas. Interpretation Geographic location heavily influenced which specialty was most likely to perform temporal artery biopsies. General surgery, ophthalmology and plastic surgery emerged as leaders in this area, and their residency programs should include formal training in this procedure in their curricula. PMID:26442226
Physical activity and dietary behaviour in a population-based sample of British 10-year old children: the SPEEDY study (Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people)
van Sluijs, Esther MF; Skidmore, Paula ML; Mwanza, Kim; Jones, Andrew P; Callaghan, Alison M; Ekelund, Ulf; Harrison, Flo; Harvey, Ian; Panter, Jenna; Wareham, Nicolas J; Cassidy, Aedin; Griffin, Simon J
Background The SPEEDY study was set up to quantify levels of physical activity (PA) and dietary habits and the association with potential correlates in 9–10 year old British school children. We present here the analyses of the PA, dietary and anthropometry data. Methods In a cross-sectional study of 2064 children (926 boys, 1138 girls) in Norfolk, England, we collected anthropometry data at school using standardised procedures. Body mass index (BMI) was used to define obesity status. PA was assessed with the Actigraph accelerometer over 7 days. A cut-off of ≥ 2000 activity counts was used to define minutes of moderate-to-vigorous PA (MVPA). Dietary habits were assessed using the Health Behaviour in School Children food questionnaire. Weight status was defined using published international cut-offs (Cole, 2000). Differences between groups were assessed using independent t-tests for continuous data and chi-squared tests for categorical data. Results Valid PA data (>500 minutes per day on ≥ 3 days) was available for 1888 children. Mean (± SD) activity counts per minute among boys and girls were 716.5 ± 220.2 and 635.6 ± 210.6, respectively (p < 0.001). Boys spent an average of 84.1 ± 25.9 minutes in MVPA per day compared to 66.1 ± 20.8 among girls (p < 0.001), with an average of 69.1% of children accumulating 60 minutes each day. The proportion of children classified as overweight and obese was 15.0% and 4.1% for boys and 19.3% and 6.6% for girls, respectively (p = 0.001). Daily consumption of at least one portion of fruit and of vegetables was 56.8% and 49.9% respectively, with higher daily consumption in girls than boys and in children from higher socioeconomic backgrounds. Conclusion Results indicate that almost 70% of children meet national PA guidelines, indicating that a prevention of decline, rather than increasing physical activity levels, might be an appropriate intervention target. Promotion of daily fruit and vegetable intake in this age group is
... page: https://medlineplus.gov/news/fullstory_162676.html Mumps Cases Hit 10-Year High in U.S. Contagious ... 21, 2016 WEDNESDAY, Dec. 21, 2016 (HealthDay News) -- Mumps cases have hit a 10-year high in ...
Iki, Masayuki; Tamaki, Junko; Sato, Yuho; Morita, Akemi; Ikeda, Yukihiro; Kajita, Etsuko; Nishino, Harumi; Akiba, Takashi; Matsumoto, Toshio; Kagamimori, Sadanobu; Kagawa, Yoshiko; Yoneshima, Hideo; Matsukura, Tomoharu; Yamagami, Takashi; Kitagawa, Jun
The Japanese Population-based Osteoporosis (JPOS) Cohort Study was launched in 1996 to produce a reference database of areal bone mineral density (aBMD) by dual energy X-ray absorptiometry (DXA) and bone turnover markers in the Japanese female population and to determine risk factors for osteoporotic fractures. At baseline, 3984 women aged 15 to 79 years were randomly selected to provide representative bone status data and aBMD values for the diagnosis of osteoporosis. Follow-up surveys were conducted in 1999, 2002, 2006 and 2011/12 to determine changes in aBMD and identify incident morphometry-confirmed vertebral fractures and clinical fractures. These outcomes were obtained from 2174 women who participated in at least one follow-up survey. JPOS is a unique resource of individual-level bone health information with radiological and biological archives that include DXA images, and serum, plasma and DNA for future analyses with emerging radiological and biological techniques. The JPOS dataset is not freely available, but new collaborations are encouraged. Potential collaborators are invited to contact the Secretary General (M.I.) at the administrative office of the JPOS Study Group.
In 2006, Takahashi and Yamanaka reported the breakthrough discovery of induction of pluripotent stem cells from fibroblasts by a combination of defined factors. Ten years later, Cell editor João Monteiro brings together Shinya Yamanaka and Hans Schöler, one the original reviewers of the landmark study, to revisit the history behind the paper and its long-lasting legacy.
Background Growing levels of both obesity and chronic disease in the general population pose a major public health problem. In the UK, an innovative 'health and weight' cohort trials facility, the 'South Yorkshire Cohort', is being built in order to provide robust evidence to inform policy, commissioning and clinical decisions in this field. This protocol reports the design of the facility and outlines the recruitment phase methods. Method/Design The South Yorkshire Cohort health and weight study uses the cohort multiple randomised controlled trial design. This design recruits a large observational cohort of patients with the condition(s) of interest which then provides a facility for multiple randomised controlled trials (with large representative samples of participants, long term outcomes as standard, increased comparability between each trial conducted within the cohort and increased efficiency particularly for trials of expensive interventions) as well as ongoing information as to the natural history of the condition and treatment as usual. This study aims to recruit 20,000 participants to the population based South Yorkshire Cohort health and weight research trials facility. Participants are recruited by invitation letters from their General Practitioners. Data is collected using postal and/or online patient self completed Health Questionnaires. NHS numbers will be used to facilitate record linkage and access to routine data. Participants are eligible if they are: aged 16 - 85 years, registered with one of 40 practices in South Yorkshire, provide consent for further contact from the researchers and to have their information used to look at the benefit of health treatments. The first wave of data is being collected during 2010/12 and further waves are planned at 2 - 5 year intervals for the planned 20 year duration of the facility. Discussion The South Yorkshire Cohort combines the strengths of the standard observational, longitudinal cohort study design with
Forsythe, Peter; Paterson, Sue
Ciclosporin is a lipophilic cyclic polypeptide with powerful immunosuppressive and immunomodulatory properties that has been used in veterinary medicine for two decades. It is a calcineurin inhibitor whose principal mode of action is to inhibit T cell activation. The drug is principally absorbed from the small intestine and is metabolised in the intestine and liver by the cytochrome P450 enzyme system. Ciclosporin is known to interact with a wide range of pharmacological agents. Numerous studies have demonstrated good efficacy for the management of canine atopic dermatitis and this has been a licensed indication since 2003. In addition to the treatment of atopic dermatitis, it has been used as an aid in the management of numerous other dermatological conditions in animals including perianal fistulation, sebaceous adenitis, pododermatitis, chronic otitis externa and pemphigus foliaceus. This article reviews the mode of action, pharmacokinetics, indications for use and efficacy of ciclosporin in veterinary dermatology. PMID:24682697
Stephan, Blossom C M; Tzourio, Christophe; Auriacombe, Sophie; Amieva, Hélène; Dufouil, Carole; Alpérovitch, Annick
Objective To determine whether the addition of data derived from magnetic resonance imaging (MRI) of the brain to a model incorporating conventional risk variables improves prediction of dementia over 10 years of follow-up. Design Population based cohort study of individuals aged ≥65. Setting The Dijon magnetic resonance imaging study cohort from the Three-City Study, France. Participants 1721 people without dementia who underwent an MRI scan at baseline and with known dementia status over 10 years’ follow-up. Main outcome measure Incident dementia (all cause and Alzheimer’s disease). Results During 10 years of follow-up, there were 119 confirmed cases of dementia, 84 of which were Alzheimer’s disease. The conventional risk model incorporated age, sex, education, cognition, physical function, lifestyle (smoking, alcohol use), health (cardiovascular disease, diabetes, systolic blood pressure), and the apolipoprotein genotype (C statistic for discrimination performance was 0.77, 95% confidence interval 0.71 to 0.82). No significant differences were observed in the discrimination performance of the conventional risk model compared with models incorporating data from MRI including white matter lesion volume (C statistic 0.77, 95% confidence interval 0.72 to 0.82; P=0.48 for difference of C statistics), brain volume (0.77, 0.72 to 0.82; P=0.60), hippocampal volume (0.79, 0.74 to 0.84; P=0.07), or all three variables combined (0.79, 0.75 to 0.84; P=0.05). Inclusion of hippocampal volume or all three MRI variables combined in the conventional model did, however, lead to significant improvement in reclassification measured by using the integrated discrimination improvement index (P=0.03 and P=0.04) and showed increased net benefit in decision curve analysis. Similar results were observed when the outcome was restricted to Alzheimer’s disease. Conclusions Data from MRI do not significantly improve discrimination performance in prediction of all cause dementia
The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study
Notara, Venetia; Kogias, Yannis; Stravopodis, Petros; Antonoulas, Antonis; Zombolos, Spyros; Mantas, Yannis; Pitsavos, Christos
Objectives: The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated. Methods: From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient’s educational status was classified as low (<9 years of school), intermediate (9 to 14 years), or high (>14 years). Results: Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001). Additionally, 10-year recurrent ACS events (fatal and non-fatal) were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001), and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001); however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed. Conclusions: A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity. PMID:27499164
Morrison, John A.; Glueck, Charles J.; Wang, Ping
Objective: We evaluated the associations of teenage insulin and adolescent diet with 10-year weight gain in an analysis sample of black and white girls matched for pubertal stage, BMI (or fat mass), and insulin at ages 9-10. We hypothesized that pre-teen insulin and insulin resistance (IR) would interact with dietary factors to positively predict increases in BMI. Further, we hypothesized that increased insulin and IR, interacting with higher caloric intake during adolescence, would lead to greater increments in BMI in black girls than in white girls. Patients and Methods: Prospective 10-yr follow-up of 215 pairs of black and white schoolgirls matched at baseline by BMI (or fat mass), insulin, and pubertal stage, with repeated measures of body habitus, insulin, and dietary intake. Results: When matched for BMI, black girls had higher fat free mass and white girls had higher fat mass at ages 9-10 years. Black-white differences in caloric intake were not significant at ages 9-10, but black girls consumed more calories at age 19. Black girls consumed a greater percent of calories from fat throughout. At age 19, black girls had higher BMI, fat mass index, and insulin. When matched at ages 9-10 for fat mass, black girls were heavier, had higher BMI, and greater fat free mass. By ages 18-19, black girls continued to have higher BMI, but had accrued higher fat mass and a higher percentage of body fat. By stepwise multiple regression, 10-year increases in BMI were predicted by age 9-10 BMI, 10 year change in insulin, and a 3-way interaction between age 9-10 insulin, adolescent caloric intake, and race (higher in black girls), all p <.0001. Conclusions: Insulin at ages 9-10 interacts with caloric intake to increase BMI by age 19. There appear to be intrinsic black-white metabolic differences that lead to greater gains in fat during adolescence in black girls. Evaluating BMI and insulin at ages 9-10 could identify girls (particularly black) who would optimally benefit from
Stenbacka, M; Romelsjö, A; Jokinen, J
Objectives This study aimed to investigate whether violent and non-violent offending were related to elevated risk of suicide. We also investigated whether the risk was higher among those with repeated offences and how experiences of substance misuse and suicide attempt modified the relationship. Design A nationwide prospective cohort study. Setting A register study of 48 834 conscripted men in 1969/1970 in Sweden followed up during a 35-year period in official registers. Participants A birth cohort of 48 834 men who were mandatory conscripted for military service in 1969/70 at the age of 18–20 years. Possible confounders were retrieved from psychological assessments at conscription and the cohort was linked to mortality and hospitalisation and crime records from 1970 onwards. Estimates of suicide risks were calculated as HR with 95% CIs using Cox proportional regression analyses with adjustment for potential confounding by family, psychological and behavioural factors including substance use and psychiatric disorders. Results Of the total cohort, 2671 (5.5%) persons died during the follow-up period. Of these, 615 (23%) persons died due to suicide. Non-violent criminality was evident for 29% and violent criminality for 4.7% of all the participants. In the crude model, the violent offenders had nearly five times higher risk (HR=4.69, 3.56 to 6.19) to die from suicide and non-violent criminals had about two times higher risk (HR=2.08, 1.72 to 2.52). In the fully adjusted model, the HRs were still significant for suicide in the non-violent group. Conclusions Experiences of violent or non-violent criminality were associated with increased risk of suicide. Comorbidity with alcohol and substance use and psychiatric disorders modified the risk, but the suicide risk remained significantly elevated for non-violent criminals. It is crucial to identify offenders and especially repeated offenders who also suffer from alcohol or substance misuse and psychiatric illness in
Omland, Lars Haukali; Christensen, Peer Brehm; Krarup, Henrik; Jepsen, Peter; Weis, Nina; Sørensen, Henrik Toft; Obel, Niels
Background The increased mortality in HCV-infected individuals partly stems from viral damage to the liver and partly from risk-taking behaviours. We examined mortality in patients who cleared their HCV-infection, comparing it to that of the general population. We also addressed the question whether prognosis differed according to age, substance abuse (alcohol abuse and injection drug use) and comorbidity. Methodology/Principal Findings Patients with cleared HCV-infection were categorized into one of 8 groups according to age (20–39 years or 40–69 years) and patient characteristics (no substance abuse/no comorbidity; substance abuse/no comorbidity; no substance abuse/comorbidity; and substance abuse/comorbidity). For each patient, 4 age- and gender-matched individuals without substance abuse or comorbidity were selected from the general population, comprising a total of 8 comparison cohorts. We analyzed 10-year survival and used stratified Cox Regression analysis to compute mortality rate ratios (MRRs), comparing mortality between the 8 patient groups and the comparison cohorts, adjusting for personal income. Among patients without substance abuse or comorbidity, those aged 40–69 years had the same mortality as the comparison cohort (10-year survival: 95% (95% confidence interval [CI]: 93%–97%), MRR: 1.3 (95% CI: 0.8–2.3)), whereas those aged 20–39 years had higher mortality than the comparison cohort (10-year survival: 93% versus 99%, MRR: 5.7 (95% CI: 2.3–14.0). For both age categories, substance abuse and comorbidity decreased survival and increased MRRs. Patients aged 40–69 years with substance abuse and comorbidity suffered from substantial mortality (MRR: 12.5 (95% CI: 5.1–30.6)). Conclusions Mortality in patients aged 40–69 years with cleared HCV-infection is comparable to individuals without HCV, provided they have no substance abuse or comorbidity. Any substance abuse and/or comorbidity not captured in the registries used for our study
Brennan, Penny L.; Schutte, Kathleen K.; Moos, Rudolf H.
Objective: Little research has examined the role of retirement in shaping late-life drinking careers, and it has generally been limited to cross-sectional designs or short-term follow-ups that emphasize group-level comparisons of retirees and nonretirees. The purpose of this study was to determine the following: (a) the effect of retired status on older adults’ 10-year within-person drinking trajectories and (b) whether age, gender, income, health, and problem-drinker status account for or moderate this effect. Method: We first estimated older adults’ (baseline M= 62 years; n = 595) 10-year within-person drinking trajectories using three successively predictive multilevel regression models: unconditional growth, retired status alone, and retired status controlling for covariates. Next, we determined whether inclusion of Retired Status × Covariate interactions would improve prediction of the trajectories. Results: Participants’ drinking frequency declined moderately over the 10-year interval, and retired status hastened the decline. However, this effect disappeared once covariates were added to the model: Baseline poorer health, lower income, and current problem-drinker status predicted steeper decline in drinking frequency, whereas former problem-drinker status predicted slower decline. Lower income and current drinking problems also predicted steeper declines in amount of alcohol consumed. There were no statistically significant or uniquely contributive interactions between retired status and age, gender, health, income, or drinking problems for predicting late-life drinking trajectories. Conclusions: Baseline health, income, and problem-drinking history are more important than retired status for predicting older adults’ long-term within-person drinking trajectories. These factors—and recency of drinking problems—should be considered in future studies of retirement and late-life drinking patterns. PMID:20230712
Olsen, Catherine M; Green, Adèle C; Neale, Rachel E; Webb, Penelope M; Cicero, Rebekah A; Jackman, Lea M; O'Brien, Suzanne M; Perry, Susan L; Ranieri, Barbara A; Whiteman, David C
The QSkin Sun and Health Study comprises a cohort of 43 794 men and women aged 40-69 years randomly sampled from the population of Queensland, Australia in 2011. The cohort was established to study the development of skin cancer and melanoma in the population with the highest reported incidence of these diseases in the world. At baseline, besides demographic items and general medical history, information about standard pigmentary characteristics (including hair and eye colour, freckling tendency, tanning ability and propensity to sunburn), past and recent history of sun exposure and sunburns, sun protection behaviours, use of tanning beds and history of skin cancer was collected by self-completed questionnaire. Participants have given their consent for data linkage to the universal national health insurance scheme and for linkage to cancer registries and pathology databases, thus ensuring complete ascertainment of all future skin cancer and melanoma occurrences and medical treatments and other cancer events. Linkage to these registers will occur at predetermined intervals. Approval to access QSkin data can be obtained on application to the study investigators and submission of a formal research plan that has previous approval from the human research ethics committee of the applicant's institution.
Hsieh, S F; Yen, Y Y; Lan, S J; Hsieh, C C; Lee, C H; Ko, Y C
In 1979, an outbreak of food poisoning ("Yu-Cheng") occurred in Central Taiwan, ROC, involving more than 2000 people. The event was caused by ingestion of rice oil contaminated with polychlorinated derivatives of biphenyls, dibenzofurans, and quaterphenyls. A retrospective cohort study on mortality was undertaken, and possible long-term health effects in the affected individuals were studied. The mortality experience of 1940 victims (929 males, 1011 females) between 1980 and 1991 was compared with the expected numbers, which were calculated from national and local mortality rates. By the end of 1991, 102 deaths were identified, thus producing a standardized mortality ratio (SMR) of overall mortality of 0.99 for males and 1.34 for females. Total cancer mortality was lower than in each comparison group. Mortality from liver diseases was elevated significantly (SMR = 3.22), especially during the first 3 y after the food-poisoning event (SMR = 10.76). Increased clinical severity of polychlorinated biphenyl intoxication was associated with increased mortality from all causes and from liver diseases. In summary, there was a positive association between mortality and intoxication dose, and severe polychlorinated biphenyl poisoning acutely affected mainly the liver. A continued follow-up of this cohort would be valuable in the study of long-term health effects of polychlorinated biphenyl poisoning.
Gude, Tore; Tyssen, Reidar; Aasland, Olaf G
Objective To investigate levels and predictors of change in dimensions of burnout after an intervention for stressed doctors. Design Cohort study followed by self reported assessment at one year. Setting Norwegian resource centre. Participants 227 doctors participating in counselling intervention, 2003-5. Interventions Counselling (lasting one day (individual) or one week (group based)) aimed at motivating reflection on and acknowledgement of the doctors’ situation and personal needs. Main outcome measures Levels of burnout (Maslach burnout inventory) and predictors of reduction in emotional exhaustion investigated by linear regression. Results 185 doctors (81%, 88 men, 97 women) completed one year follow-up. The mean level of emotional exhaustion (scale 1-5) was significantly reduced from 3.00 (SD 0.94) to 2.53 (SD 0.76) (t=6.76, P<0.001), similar to the level found in a representative sample of 390 Norwegian doctors. Participants had reduced their working hours by 1.6 hours/week (SD 11.4). There was a considerable reduction in the proportion of doctors on full time sick leave, from 35% (63/182) at baseline to 6% (10/182) at follow-up and a parallel increase in the proportion who had undergone psychotherapy, from 20% (36/182) to 53% (97/182). In the whole cohort, reduction in emotional exhaustion was independently associated with reduced number of work hours/week (β=0.17, P=0.03), adjusted for sex, age, and personality dimensions. Among men “satisfaction with the intervention” (β=0.25, P=0.04) independently predicted reduction in emotional exhaustion. Conclusions A short term counselling intervention could contribute to reduction in emotional exhaustion in doctors. This was associated with reduced working hours for the whole cohort and, in men, was predicted by satisfaction with the intervention. PMID:19001492
NestedCohort is an R software package for fitting Kaplan-Meier and Cox Models to estimate standardized survival and attributable risks for studies where covariates of interest are observed on only a sample of the cohort.
Chiu, Chang-Ta; Huang, Shu-Min; Lin, Yu-Wen; Ko, Ming-Chung; Li, Chung-Yi
We conducted a cohort study of 7,760 dentists in Taiwan between 2003 and 2007 to assess the risk of outpatient visit among dentists. Control groups included physicians and other health personnel. Over the 5-yr study period, the dentist cohort made a total of 270,712 outpatient visits, representing an incidence rate of 7,038 visits /10(3) person-years. Compared to physicians, dentists experienced a significantly reduced covariate adjusted rate ratio (ARR) for all-cause visits (ARR=0.59, 95%CI=0.58-0.59), as well as for nearly all other causes, except neoplasm (ARR=1.06, 95%CI=1.02-1.09). Compared to other health personnel, the dentists still experienced a significantly reduced ARR for all causes (ARR=0.70), but had a slightly but significantly increased risk for endocrine/metabolic/immunity (ARR=1.04, 95%CI=1.02-1.05) and mental (ARR=1.04, 95%CI=1.01-1.07) disorders. Although the dentists in Taiwan utilized lesser outpatient visits than did their medical colleagues, they tended to have slightly higher rates of outpatient visits for neoplasm, endocrine/metabolic/immunity disorders, and mental illnesses. Policy makers and hospital administrators must not overlook dentists' potentially unseen health problems. A mandatory periodical physical examination for dentists can seriously be considered.
Nakaya, N; Tsubono, Y; Nishino, Y; Hosokawa, T; Fukudo, S; Shibuya, D; Akizuki, N; Yoshikawa, E; Kobayakawa, M; Fujimori, M; Saito-Nakaya, K; Uchitomi, Y; Tsuji, I
We tested the hypothesis that personality plays a role in cancer outcome in a population-based prospective cohort study in Japan. In July 1990, 41 442 residents of Japan completed a short form of the Eysenck Personality Questionnaire-Revised and a questionnaire on various health habits, and between January 1993 and December 1997, 890 incident cases of cancer were identified among them. These 890 cases were followed up until March 2001, and a total of 356 deaths from all causes was identified among them. Cox proportional-hazards regression was used to estimate the hazard ratio (HR) of death according to four score levels on each of four personality subscales (extraversion, neuroticism, psychoticism, and lie), with adjustment for potential confounding factors. Multivariable HRs of deaths from all causes for individuals in the highest score level on each personality subscale compared with those at the lowest level were 1.0 for extraversion (95% CI=0.8–1.4; Trend P=0.73), 1.1 for neuroticism (0.8–1.6; Trend P=0.24), 1.2 for psychoticism (0.9–1.6; Trend P=0.29), and 1.0 for lie (0.7–1.5; Trend P=0.90). The data obtained in this population-based prospective cohort study in Japan do not support the hypothesis that personality is associated with cancer survival. PMID:15900301
Perucci, C A; Davoli, M; Rapiti, E; Abeni, D D; Forastiere, F
A historical cohort study was carried out in Rome to examine overall and cause-specific mortality among intravenous drug users (IVDUs). A total of 4200 IVDUs (3411 men and 789 women) enrolled in methadone treatment centers between 1980 and 1988 were studied. There were 239 deaths during the follow-up period. The overall SMR was 10.10 in the entire cohort (95% confidence interval, 8.86-11.47), 9.30 in males and 18.07 in females. A large excess of mortality in both sexes was found for infectious, circulatory, respiratory, and digestive diseases as well as for violence, overdose, AIDS, and unknown or ill-defined causes. Tumors and suicide were excessive only in males. Deaths due to drug overdose, violence or trauma, and cirrhosis accounted for 63.6%, AIDS for 7.1%, endocarditis and other bacterial infections for 7.1%, and neoplasms for 3.8% of total mortality. These findings document serious health consequences of drug abuse in Italy. PMID:1656799
Ahrens, Wolfgang; Jöckel, K-H
The prospective nature of large-scale epidemiological multi-purpose cohort studies with long observation periods facilitates the search for complex causes of diseases, the analysis of the natural history of diseases and the identification of novel pre-clinical markers of disease. The German National Cohort (GNC) is a population-based, highly standardised and in-depth phenotyped cohort. It shall create the basis for new strategies for risk assessment and identification, early diagnosis and prevention of multifactorial diseases. The GNC is the largest population-based cohort study in Germany to date. In the year 2014 the examination of 200,000 women and men aged 20-69 years started in 18 study centers. The study facilitates the investigation of the etiology of chronic diseases in relation to lifestyle, genetic, socioeconomic, psychosocial and environmental factors. By this the GNC creates the basis for the development of methods for early diagnosis and prevention of these diseases. Cardiovascular and respiratory diseases, cancer, diabetes, neurodegenerative/-psychiatric diseases, musculoskeletal and infectious diseases are in focus of this study. Due to its mere size, the study could be characterized as a Big Data project. We deduce that this is not the case.
Oskarsson, Viktor; Orsini, Nicola; Sadr-Azodi, Omid; Wolk, Alicja
Background: Several case reports have suggested that women’s use of exogenous sex hormones is associated with acute pancreatitis; however, relevant epidemiologic data are sparse. We examined the association between postmenopausal hormone replacement therapy and risk of acute pancreatitis. Methods: We conducted a prospective study involving 31 494 postmenopausal women (aged 48–83 yr) from the population-based Swedish Mammography Cohort. Participants completed a baseline questionnaire in 1997 assessing their use of hormone replacement therapy. We linked the cohort to the hospital-based Swedish National Patient Register to determine hospital admissions for acute pancreatitis through 2010. Relative risks (RRs) were calculated using Cox proportional hazard models. Results: Over a total follow-up of 389 456 person-years, we identified 237 cases of incident acute pancreatitis. The age-standardized incidence rates per 100 000 person-years were 71 cases among women who had ever used hormone replacement therapy and 52 cases among women who had never used such hormones. Among ever users of hormone replacement therapy, the multivariable-adjusted RR of acute pancreatitis was 1.57 (95% confidence interval [CI] 1.20–2.05) compared with never users. The risk did not differ by current or past use, but it seemed to be higher among women who used systemic therapy (RR 1.92, 95% CI 1.38–2.66) and among those with duration of therapy of more than 10 years (RR 1.87, 95% CI 1.11–3.17). Interpretation: Use of postmenopausal hormone replacement therapy was associated with increased risk of acute pancreatitis. Physicians should consider this potential increase in risk when prescribing such therapy. PMID:24468693
Barclay, Kieron; Kolk, Martin
This study uses Swedish population register data to investigate the relationship between birth order and mortality at ages 30 to 69 for Swedish cohorts born between 1938 and 1960, using a within-family comparison. The main analyses are conducted with discrete-time survival analysis using a within-family comparison, and the estimates are adjusted for age, mother's age at the time of birth, and cohort. Focusing on sibships ranging in size from two to six, we find that mortality risk in adulthood increases with later birth order. The results show that the relative effect of birth order is greater among women than among men. This pattern is consistent for all the major causes of death but is particularly pronounced for mortality attributable to cancers of the respiratory system and to external causes. Further analyses in which we adjust for adult socioeconomic status and adult educational attainment suggest that social pathways only mediate the relationship between birth order and mortality risk in adulthood to a limited degree.
Horwitz, Henrik; Ahlgren, Birgitte; Nærum, Elisabeth
Objective The aim of this study was to estimate the occupational risks in relation to multiple sclerosis (MS). The immediate background for this research was our finding that there had been a high number of critical illness insurance claims by patients diagnosed with MS within the agricultural segment of a Danish pension fund. Design An open insurance cohort. All payouts for the critical illness insurance from 2002 to 2011 were continuously registered. Settings PensionDanmark; one of Denmark's largest pension funds. Participants PensionDanmark insures more than 300 000 members of the Danish Confederation of Trade Unions against critical illness. All members are insured, and all policies are identical. The total exposure is 3.3 million person-years. Primary outcome measures The incidence of MS. Results During the 10-year period, 389 persons were diagnosed with MS. The crude incidence rate for men was 10.2/100 000; the corresponding figure for women was 16.1/100 000. We found signs of an overall effect of occupation on the risk of developing MS, and the high frequency found within the agricultural segment was attributed to dairy operators, who had an incidence of MS 2.0 times higher than the rest of the study's population (95% CI=1.2 to 3.0). Conclusions Our results indicate some occupational risk factors in MS, and this should be investigated further. PMID:23794592
Kishi, Reiko; Kobayashi, Sachiko; Ikeno, Tamiko; Araki, Atsuko; Miyashita, Chihiro; Itoh, Sachiko; Sasaki, Seiko; Okada, Emiko; Kobayashi, Sumitaka; Kashino, Ikuko; Itoh, Kumiko; Nakajima, Sonomi
The Hokkaido Study on Environment and Children's Health is an ongoing cohort study that began in 2002. The study consists of two prospective birth cohorts, the Sapporo cohort (n = 514) and the Hokkaido large-scale cohort (n = 20,940). The primary goals of this study are to first examine the potential negative effects of perinatal environmental chemical exposures on birth outcomes, including congenital malformations and growth retardation; second, to evaluate the development of allergies, infectious diseases and neurodevelopmental disorders and perform longitudinal observations of the children's physical development to clarify the causal relationship between these outcomes and environmental chemicals; third, to identify individuals genetically susceptible to environmental chemicals; finally, to identify the additive effects of various environmental factors in our daily life, such as secondhand smoke exposure or low folate intake during early pregnancy. In this paper, we introduce our recent progress in the Hokkaido study with a cohort profile updated in 2013. For the last ten years, we followed pregnant women and their offspring, measuring various environmental chemicals, i.e., PCB, OH-PCB and dioxins, PFCs (Perfluorinated Compounds), Organochlorine pesticides, Phthalates, bisphenol A and mercury. We discovered that the concentration of toxic equivalents (TEQ) of dioxin and other specific congeners of PCDF or PCDD have effects on birth weight, infants' neurodevelopment and immune function. There were significant gender differences in these effects; our results suggest that male infants have more susceptibility to those chemical exposures than female infants. Interestingly, we found maternal genetic polymorphisms in AHR, CYP1A1 or GSTs that significantly modified the dioxin concentrations in maternal blood, suggesting different dioxin accumulations in the bodies of individuals with these genotypes, which would lead to different dioxin exposure levels. These genetic
Korkeila, Jyrki; Lietzen, Raija; Sillanmäki, Lauri H; Rautava, Päivi; Korkeila, Katariina; Kivimäki, Mika; Koskenvuo, Markku; Vahtera, Jussi
Objectives Childhood adversities may be important determinants of later illnesses and poor health behaviour. However, large-scale prospective studies on the associations between childhood adversities and the onset of asthma in adulthood are lacking. Design Prospective cohort study with 7-year follow-up. Setting Nationally representative study. Data were collected from the Health and Social Support (HeSSup) survey and national registers. Participants The participants represent the Finnish population from the following age groups: 20–24, 30–34, 40–44, and 50–54 years at baseline in 1998 (24 057 survey participants formed the final cohort of this study). The occurrence of childhood adversities was assessed at baseline with a six-item survey scale. The analyses were adjusted for sociodemographic characteristics, behavioural health risks and common mental disorders. Primary and secondary outcomes The survey data were linked to data from national health registers on incident asthma during a 7-year follow-up to define new-onset asthma cases with verified diagnoses. Results A total of 12 126 (59%) participants reported that they encountered a childhood adversity. Of them 3677 (18% of all) endured three to six adversities. During a follow-up of 7 years, 593 (2.9%) participants were diagnosed with incident asthma. Those who reported three or more childhood adversities had a 1.6-fold (95% CI 1.31 to 2.01) greater risk of asthma compared to those without childhood adversities. This hazard attenuated but remained statistically significant after adjustment for conventional risk factors (HR 1.33; 95% CI 1.06 to 1.67). Conclusions Adults who report having encountered adversities in childhood may have an increased risk of developing asthma. PMID:23069774
Kassaian, Seyed Ebrahim; Sadeghian, Saeed; Karimi, Abbasali; Saadat, Soheil; Peyvandi, Flora; Jalali, Arash; Davarpasand, Tahereh; Shahmansouri, Nazila; Lotfi-Tokaldany, Masoumeh; Abchouyeh, Maryam Amiri; Isfahani, Farah Ayatollahzade; Rosendaal, Frits
Abstract Background: Data on premature coronary artery disease (CAD) are scarce. The Tehran Heart Center's Premature Coronary Atherosclerosis Cohort Study (THC-PAC) is the first study of its kind in the Middle East to assess major adverse cardiac events (MACE) in young CAD patients. Methods: The cohort consists of CAD patients, males ≤ 45 years old and females ≤ 55 years old. The participants are residents of Tehran or its suburbs and underwent coronary angiography between June 2004 and July 2011. A 10-year follow-up, via either clinical visits or telephone calls at least once a year, was commenced in August 2012. The end point is considered MACE, encompassing death, myocardial infarction, stroke, new coronary involvement, percutaneous coronary intervention, and coronary artery bypass grafting. Results: The cohort comprises 1232 eligible patients (613 [49.8%] males) at a mean age of 45.1 years (SD = 5.8). High frequencies of conventional risk factors, including hyperlipidemia (884 [71.8%]), hypertension (575 [46.7%]), positive family history (539 [43.8%]), cigarette smoking (479 [38.8%]), and diabetes mellitus (390 [31.7%]), were seen in the participants. The mean body mass index (BMI) of the enrolled patients was high (29.2 ± 4.8 kg/m2), and 532 (43.3%) and 440 (35.8%) of them were overweight and obese, respectively. The females’ BMI was higher (30.4 ± 5.3 vs. 28.0 ± 3.9 kg/m2; P < 0.001) and they had a greater mean abdominal circumference (99.9 ± 13.5 vs. 98.1 ± 9.3 cm; P = 0.035). Between August 2012 and August 2013, follow-up was successful in 1173 (95.2%) patients (median follow-up duration = 55.3 months, 95%CI: 53.5–57.0 months). Conclusion: Our younger patients with CAD had a high frequency of risk factors compared to the same-age general population and all-age CAD patients, which may predispose them to higher incidence of recurrent MACE. PMID:26157461
Dantoft, Thomas Meinertz; Ebstrup, Jeanette Frost; Linneberg, Allan; Skovbjerg, Sine; Madsen, Anja Lykke; Mehlsen, Jesper; Brinth, Louise; Eplov, Lene Falgaard; Carstensen, Tina Wisbech; Schroder, Andreas; Fink, Per Klausen; Mortensen, Erik Lykke; Hansen, Torben; Pedersen, Oluf; Jørgensen, Torben
The Danish study of Functional Disorders (DanFunD) cohort was initiated to outline the epidemiology of functional somatic syndromes (FSS) and is the first larger coordinated epidemiological study focusing exclusively on FSS. FSS are prevalent in all medical settings and can be defined as syndromes that, after appropriate medical assessment, cannot be explained in terms of a conventional medical or surgical disease. FSS are frequent and the clinical importance varies from vague symptoms to extreme disability. No well-described medical explanations exist for FSS, and how to delimit FSS remains a controversial topic. The specific aims with the cohort were to test delimitations of FSS, estimate prevalence and incidence rates, identify risk factors, delimitate the pathogenic pathways, and explore the consequences of FSS. The study population comprises a random sample of 9,656 men and women aged 18–76 years from the general population examined from 2011 to 2015. The survey comprises screening questionnaires for five types of FSS, ie, fibromyalgia, whiplash-associated disorder, multiple chemical sensitivity, irritable bowel syndrome, and chronic fatigue syndrome, and for the unifying diagnostic category of bodily distress syndrome. Additional data included a telephone-based diagnostic interview assessment for FSS, questionnaires on physical and mental health, personality traits, lifestyle, use of health care services and social factors, and a physical examination with measures of cardiorespiratory and morphological fitness, metabolic fitness, neck mobility, heart rate variability, and pain sensitivity. A biobank including serum, plasma, urine, DNA, and microbiome has been established, and central registry data from both responders and nonresponders are similarly available on morbidity, mortality, reimbursement of medicine, heath care use, and social factors. A complete 5-year follow-up is scheduled to take place from year 2017 to 2020, and further reexaminations will be
Smolina, Kate; Morgan, Steven G.; Hanley, Gillian E.; Oberlander, Tim F.; Mintzes, Barbara
Background: Domperidone is commonly used off-label to stimulate milk production in mothers who have low milk supply. The aim of this study was to describe trends, patterns and determinants of postpartum domperidone use. Methods: This is a retrospective, population-based study involving all women with a live birth between Jan. 1, 2002, and Dec. 31, 2011, in the province of British Columbia. We examined administrative data sets containing person-specific information on filled prescriptions and use of medical services, and we used logistic regression to examine associations between domperidone use and maternal characteristics. Results: The study population consisted of 225 532 women with 320 351 live births. The prevalence of postpartum domperidone use more than doubled between 2002 and 2011. In 2011, 1 in 3 women with a preterm birth and 1 in 5 women with a full-term birth were prescribed domperidone in the first 6 months postpartum. Women who were older, had a higher body mass index, had a chronic disease, were first-time mothers, delivered more than 1 baby (multiple pregnancy), had a preterm birth or had a cesarian delivery were more likely to fill a postpartum domperidone prescription. Interpretation: We found an increase in postpartum domperidone use over a 10-year period. More research is needed on maternal and infant health outcomes. PMID:27280111
Clark, Emma M; Taylor, Hilary J; Harding, Ian; Hutchinson, John; Nelson, Ian; Deanfield, John E; Ness, Andy R; Tobias, Jon H
There is an increasing body of research suggesting that low body weight is associated with scoliosis, but this is based on case-control studies, which are prone to bias. No studies have investigated the components of body weight: fat and lean mass. We have therefore carried out the first population-based prospective study of the association between fat and lean mass at age 10 years assessed by dual-energy X-ray absorptiometry (DXA), with presence of scoliosis at age 15 years using the Avon Longitudinal Study of Parents and Children (ALSPAC). All children with scoliosis at age 10 years were excluded. Of 5299 children at age 15 years, 312 (5.9%) had scoliosis. Our results show a negative association between body mass index (BMI)/body weight at age 10 years and scoliosis at age 15 years, with a 20% reduced risk of scoliosis per SD increase in BMI (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.70-0.92; p = 0.001). This association with BMI/body weight reflects associations with both fat mass and lean mass. After adjustment for age, gender, leg length, and fat mass per SD increase in lean mass, there was a 20% reduced risk of scoliosis (OR, 0.80; 95% CI, 0.65-0.97) and per SD increase in fat mass there was a 13% reduced risk of scoliosis (OR, 0.87; 95% CI, 0.74-1.03). In terms of adipocyte function, an inverse association was seen between leptin at age 10 years and scoliosis (OR for scoliosis per SD increase in leptin of 0.78; 95% CI, 0.63-0.99), and a positive association between adiponectin at age 10 years and scoliosis (OR for scoliosis per SD increase in adiponectin of 1.44; 95% CI, 0.99-2.10). This is the first study to address the association between the individual components of body weight and scoliosis in a prospective cohort study, and shows altered body composition that is present before the onset of clinically detected scoliosis.
Wolpin, Brian M; Kabrhel, Christopher; Varraso, Raphaëlle; Kraft, Peter; Rimm, Eric B; Goldhaber, Samuel Z; Camargo, Carlos A; Fuchs, Charles S
Prior studies have suggested an association of ABO blood type and the risk of venous thromboembolism; however, most studies were retrospective and lacked important covariates or validated endpoints. Moreover, risk estimates varied widely across studies. Therefore, we prospectively examined the association of blood type and the risk of incident pulmonary embolism (PE) in two large cohort studies, the Nurses' Health Study and Health Professionals Follow-up Study. During 1,010,378 person-years of follow-up among 77,025 women and 30,105 men, 499 participants developed PE. Compared to those with O-blood type, participants with non-O blood type had multivariable-adjusted hazard ratios (HR) of 1.86 (95% CI, 1.35-2.57) for idiopathic PE, 1.29 (95% CI, 1.03-1.62) for non-idiopathic PE, and 1.46 (95% CI, 1.22-1.76) for any PE. Hazard ratios were similar for participants with blood types A, B, and AB. Age-adjusted absolute rates of idiopathic PE over 10 years of follow-up differed by blood type: 0.11% for O, 0.20% for A, 0.19% for AB, and 0.21% for B. For idiopathic PE, the population attributable fraction was 33% for inheritance of non-O blood type. Among past and current smokers, participants with non-O vs. O-blood type had a HR for idiopathic PE of 2.56 (95% CI, 1.61-4.08). Among never smokers, the HR for idiopathic PE was 1.30 (95% CI, 0.82-2.05; P interaction=0.04). In two large, prospective cohorts, ABO blood type was significantly associated with the risk of idiopathic and non-idiopathic PE, with even greater risk for idiopathic PE among current and past smokers with non-O blood type.
Maher, K.V.; Defonso, L.R.
This historical cohort study examined mortality among 1,510 white male researchers employed from 1950-1959 who handled chemicals. During 1950-1979, 95 deaths were observed, significantly less than the 173.2 predicted by general population rates (SMR = 55). This was due to deficits in overall cancer deaths (SMR = 66), particularly respiratory cancer (SMR = 28), and reduced mortality from circulatory diseases and accidents. Those who had worked directly with chemicals for more than 5 yr and those who had the most hazardous exposures experienced similar low mortality for all causes, all cancers, and respiratory cancer. Although deaths due to digestive cancer were elevated among those with 1-5 yr of work experience, there was no excess among those working more than 5 yr as would be expected from occupational exposure.
Streit, Marcus R; Weiss, Stefan; Andreas, Franziska; Bruckner, Thomas; Walker, Tilman; Kretzer, J Philippe; Ewerbeck, Volker; Merle, Christian
Background and purpose Uncemented acetabular components in primary total hip arthroplasty (THA) are commonly used today, but few studies have evaluated their survival into the second decade in young and active patients. We report on a minimum 10-year follow-up of an uncemented press-fit acetabular component that is still in clinical use. Methods We examined the clinical and radiographic results of our first 121 consecutive cementless THAs using a cementless, grit-blasted, non-porous, titanium alloy press-fit cup (Allofit; Zimmer Inc., Warsaw, IN) without additional screw fixation in 116 patients. Mean age at surgery was 51 (21–60) years. Mean time of follow-up evaluation was 11 (10–12) years. Results At final follow-up, 8 patients had died (8 hips), and 1 patient (1 hip) was lost to follow-up. 3 hips in 3 patients had undergone acetabular revision, 2 for deep infection and 1 for aseptic acetabular loosening. There were no impending revisions at the most recent follow-up. We did not detect periacetabular osteolysis or loosening on plain radiographs in those hips that were evaluated radiographically (n = 90; 83% of the hips available at a minimum of 10 years). Kaplan-Meier survival analysis using revision of the acetabular component for any reason (including isolated inlay revisions) as endpoint estimated the 11-year survival rate at 98% (95% CI: 92–99). Interpretation Uncemented acetabular fixation using the Allofit press-fit cup without additional screws was excellent into early in the second decade in this young and active patient cohort. The rate of complications related to the liner and to osteolysis was low. PMID:24875058
Thiering, Elisabeth; Brüske, Irene; Kratzsch, Jürgen; Thiery, Joachim; Sausenthaler, Stefanie; Meisinger, Christa; Koletzko, Sibylle; Bauer, Carl-Peter; Schaaf, Beate; von Berg, Andrea; Berdel, Dietrich; Lehmann, Irina; Herbarth, Olf; Krämer, Ursula; Wichmann, H Erich; Heinrich, Joachim
In this study, we evaluated the association between prenatal and postnatal exposure to environmental tobacco smoke and the development of insulin resistance in 10 year old children. Fasting blood samples were collected from 470 children participating in two prospective birth cohorts. Of those 276 were selected population based and enriched with 194 children exceeding the 85th percentile of body mass index in this age group. Children already having diabetes type 1 or 2 at the age of 10 years were excluded. Fasting blood insulin and glucose levels and calculated HOMA index for insulin resistance assessment were analysed using generalised additive models. Potential confounders were adjusted for. Insulin resistance was increased by 24% in children frequently exposed to environmental tobacco smoke during childhood (MR(adj) = 1.24, p = 0.001), while glucose levels were not. Exclusion of prenatally exposed children did not attenuate the association (MR(adj) = 1.25, p = 0.006). After stratification, the effect sizes were identical within overweight children and the population based sample of children. Insulin resistance and fasting insulin levels were increasing with increasing numbers of cigarettes smoked in children's home. Maternal smoking during the third trimester of pregnancy increased children's insulin levels (MR(adj) = 1.19, p = 0.037), and even more so, if children were exclusively breastfed after birth (MR(adj) = 1.31, p = 0.016). Increased mean ratios were found for smoking of a third person in addition to maternal smoking. Positive dose-dependent associations and independent effects of postnatal exposure suggest involvement of environmental tobacco smoke in the risk for development of insulin resistance in children.
Newton, R.; Vincent, S.; Gribbin, S.; Peteet, D. M.; Sambrotto, R.; Bostick, B. C.; Corbett, E.; Nguyen, K.; Bjornton, J.; Lee, D.; Dubossi, D.; Reyes, N.
This fall marks the 10th year in which we have run a research-project-based educational program for high school students and science teachers at the Lamont-Doherty Earth Observatory. This summer's cohort included 31 teenagers, 7 science teachers, and 16 college students, most of whom are returning to the program to help run the research projects. Nearly all of our students attend non-competitive-entry public schools in NYC or the neighborhoods around the Observatory. Over 80% are from under-served minority populations. Most receive Title I/III assistance. About 60% are young women. During the past 10 years, nearly all of our participants have gone on to 4-year colleges. About half are declaring science and engineering majors. Our students receive scholarship support at rates several times higher than their graduating peers, including 5 Gates Millennium scholars over the past 5 years. Our science is centered on studies of a nearby tidal wetland, where we have expanded from fish collections in year one to include everything from sediment core analysis to soil chemistry to nutrient cycles to the local food web. In this presentation we will look back over 10 years of experience and focus on what lessons can be learned about (1) how to engage teams of young investigators in authentic scientific research; (2) what cultural/organizational structures encourage them to make use of place- and project-based learning and (3) what the participants themselves report as the most useful aspects of our programming. The presentation will include video clips from the students' field experiences and from reflective interviews with "graduates".
Gerstorf, Denis; Ram, Nilam; Hoppmann, Christiane; Willis, Sherry L.; Schaie, K. Warner
Life span researchers have long been interested in how and why fundamental aspects of human ontogeny differ between cohorts of people who have lived through different historical epochs. When examined at the same age, later born cohorts are often cognitively and physically fitter than earlier born cohorts. Less is known, however, about cohort differences in the rate of cognitive aging and if, at the very end of life, pervasive mortality-related processes overshadow and minimize cohort differences. We used data on 5 primary mental abilities from the Seattle Longitudinal Study (Schaie, 2005) to compare both age-related and mortality-related changes between earlier born cohorts (1886–1913) and later born cohorts (1914–1948). Our models covary for several individual and cohort differences in central indicators of life expectancy, education, health, and gender. Age-related growth models corroborate and extend earlier findings by documenting level differences at age 70 of up to 0.50 SD and less steep rates of cognitive aging on all abilities between 50 and 80 years of age favoring the later born cohort. In contrast, mortality-related models provide limited support for positive cohort differences. The later born cohort showed steeper mortality-related declines. We discuss possible reasons why often reported positive secular trends in age-related processes may not generalize to the vulnerable segment of the population that is close to death and suggest routes for further inquiry. PMID:21517155
Pugh, C A; Bronsvoort, B M de C; Handel, I G; Summers, K M; Clements, D N
Studies of animals that visit primary and secondary veterinary centres dominate companion animal epidemiology. Dogslife is a research initiative that collects data directly from owners about the health and lifestyle of Kennel Club (KC) registered Labrador Retrievers (LR) in the UK. The ultimate aim is to seek associations between canine lifestyle and health. A selection of data from Dogslife regarding the height, weight and lifestyle of 4307 LR up to four years of age is reported here. The majority of the dogs were household pets, living with at least one other pet, in families or households with more than one adult. The dogs typically ate diets of dried food and daily meal frequency decreased as the dogs aged. Working dogs spent more time exercising than pets, and dogs in Wales and Scotland were exercised more than their counterparts in England. Dogs in households with children spent less time exercising than dogs in other types of households. There was considerable variation in height and weight measurements indicative of a highly heterogeneous population. The average male height at the shoulders was 2-3cm taller than the UK breed standard. Dog weights continued to increase between one and four years of age. Those with chocolate coloured coats were heavier than their yellow and black counterparts. Greater dog weight was also associated with dogs whose owners reported restricting their dog's exercise due to where they lived. These findings highlight the utility of wide public engagement in the collation of phenotypic measures, providing a unique insight into the physical development and lifestyle of a cohort of LRs. In combination with concurrently collected data on the health of the cohort, phenotypic data from the Dogslife Project will contribute to understanding the relationship between dog lifestyle and health.
Ovsyannikova, Inna G; Pankratz, V Shane; Vierkant, Robert A; Jacobson, Robert M; Poland, Gregory A
Associations between HLA genotypes and measles vaccine humoral and cellular immune responses were examined to better understand immunogenetic drivers of vaccine response. Two independent study cohorts of healthy schoolchildren were examined: cohort one, 346 children between 12 and 18 years of age; and cohort two, 388 children between 11 and 19 years of age. All received two age-appropriate doses of measles-containing vaccine. The purpose of this study was to identify and replicate associations between HLA genes and immune responses following measles vaccination found in our first cohort. Associations of comparable magnitudes and with similar p-values were observed between B*3503 (1st cohort p=0.01; 2nd cohort p=0.07), DQA1*0201 (1st cohort p=0.03; 2nd cohort p=0.03), DQB1*0303 (1st cohort p=0.10; 2 cohort p=0.02), DQB1*0602 (1st cohort p=0.07; 2nd cohort p=0.10), and DRB1*0701 (1st cohort p=0.03; 2nd cohort p=0.07) alleles and measles-specific antibody levels. Suggestive, yet consistent, associations were observed between the B7 (1st cohort p=0.01; 2nd cohort p=0.08) supertype and higher measles antibody levels in both cohorts. Also, in both cohorts, the B*0801 and DRB1*0301 alleles, C*0802 and DPA1*0202 alleles, and DRB1*1303 alleles displayed consistent associations with variations in IFN-γ, IL-2 and IL-10 secretion, respectively. This study emphasizes the importance of replicating HLA associations with measles vaccine-induced humoral and cellular immune responses and increases confidence in the results. These data will inform strategies for functional studies and novel vaccine development, including epitope-based measles vaccines. This is the first HLA association replication study with measles vaccine-specific immune responses to date.
Ribeiro, Ligia G. dos Santos Chaves; Portal, Maria de Nazare Dias; da Silva, Joao Bittencourt; Saraiva, Alan; da Cruz Monte, Gerson, Jr.; Dantas, Estelio H. M.
Study aim: To compare two exercise training modes on the physical fitness of 10 year-old children. Material and methods: A sample of 60 schoolboys aged 10 years were randomly divided into 3 groups: Traditional (TG), trained according to the Brazilian national curricular parameters, Maturational (MG), in which the degree of difficulty of the…
Ramos, Adilson Luiz
Early Class III malocclusion treatment may not have long-term stability due to mandibular growth. Although some features of this malocclusion point to a better prognosis, it is practically impossible for the orthodontist to foresee cases that require new intervention. Many patients need retreatment, whether compensatory or orthodontic-surgical. The present study reports the case of a Class III patient treated at the end of the mixed dentition with the use of a face mask followed by conventional fixed appliances. The case remains stable 10 years after treatment completion. It was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as a requirement for the title of certified by the BBO. PMID:25715726
Kooijman, Marjolein N; Kruithof, Claudia J; van Duijn, Cornelia M; Duijts, Liesbeth; Franco, Oscar H; van IJzendoorn, Marinus H; de Jongste, Johan C; Klaver, Caroline C W; van der Lugt, Aad; Mackenbach, Johan P; Moll, Henriëtte A; Peeters, Robin P; Raat, Hein; Rings, Edmond H H M; Rivadeneira, Fernando; van der Schroeff, Marc P; Steegers, Eric A P; Tiemeier, Henning; Uitterlinden, André G; Verhulst, Frank C; Wolvius, Eppo; Felix, Janine F; Jaddoe, Vincent W V
The Generation R Study is a population-based prospective cohort study from fetal life until adulthood. The study is designed to identify early environmental and genetic causes and causal pathways leading to normal and abnormal growth, development and health from fetal life, childhood and young adulthood. This multidisciplinary study focuses on several health outcomes including behaviour and cognition, body composition, eye development, growth, hearing, heart and vascular development, infectious disease and immunity, oral health and facial growth, respiratory health, allergy and skin disorders of children and their parents. Main exposures of interest include environmental, endocrine, genomic (genetic, epigenetic, microbiome), lifestyle related, nutritional and socio-demographic determinants. In total, 9778 mothers with a delivery date from April 2002 until January 2006 were enrolled in the study. Response at baseline was 61%, and general follow-up rates until the age of 10 years were around 80%. Data collection in children and their parents includes questionnaires, interviews, detailed physical and ultrasound examinations, behavioural observations, lung function, Magnetic Resonance Imaging and biological sampling. Genome and epigenome wide association screens are available. Eventually, results from the Generation R Study contribute to the development of strategies for optimizing health and healthcare for pregnant women and children.
Steptoe, Andrew; Breeze, Elizabeth; Banks, James; Nazroo, James
The English Longitudinal Study of Ageing (ELSA) is a panel study of a representative cohort of men and women living in England aged ≥50 years. It was designed as a sister study to the Health and Retirement Study in the USA and is multidisciplinary in orientation, involving the collection of economic, social, psychological, cognitive, health, biological and genetic data. The study commenced in 2002, and the sample has been followed up every 2 years. Data are collected using computer-assisted personal interviews and self-completion questionnaires, with additional nurse visits for the assessment of biomarkers every 4 years. The original sample consisted of 11 391 members ranging in age from 50 to 100 years. ELSA is harmonized with ageing studies in other countries to facilitate international comparisons, and is linked to financial and health registry data. The data set is openly available to researchers and analysts soon after collection (http://www.esds.ac.uk/longitudinal/access/elsa/l5050.asp). PMID:23143611
Jaddoe, Vincent W V; van Duijn, Cornelia M; Franco, Oscar H; van der Heijden, Albert J; van Iizendoorn, Marinus H; de Jongste, Johan C; van der Lugt, Aad; Mackenbach, Johan P; Moll, Henriëtte A; Raat, Hein; Rivadeneira, Fernando; Steegers, Eric A P; Tiemeier, Henning; Uitterlinden, Andre G; Verhulst, Frank C; Hofman, Albert
The Generation R Study is a population-based prospective cohort study from fetal life until adulthood. The study is designed to identify early environmental and genetic causes and causal pathways leading to normal and abnormal growth, development and health during fetal life, childhood and adulthood. The study focuses on six areas of research: (1) maternal health; (2) growth and physical development; (3) behavioural and cognitive development; (4) respiratory health and allergies; (5) diseases in childhood; and (6) health and healthcare for children and their parents. Main exposures of interest include environmental, endocrine, genetic and epigenetic, lifestyle related, nutritional and socio-demographic determinants. In total, n = 9,778 mothers with a delivery date from April 2002 until January 2006 were enrolled in the study. Response at baseline was 61 %, and general follow-up rates until the age of 6 years exceed 80 %. Data collection in mothers, fathers and children include questionnaires, detailed physical and ultrasound examinations, behavioural observations, and biological samples. A genome and epigenome wide association screen is available in the participating children. From the age of 5 years, regular detailed hands-on assessments are performed in a dedicated research center including advanced imaging facilities such as Magnetic Resonance Imaging. Eventually, results forthcoming from the Generation R Study contribute to the development of strategies for optimizing health and healthcare for pregnant women and children.
Kaplan, Gary J.; And Others
Histories of ear disease, otoscopic examinations, and audiologic, intelligence, and achievement tests were obtained from a cohort of 489 Alaskan Eskimo children, followed through the first 10 years of life, to determine whether otitis media (middle ear inflammation) deleteriously affected intellectual functioning and achievement in school.…
Khademi, Hooman; Pourshams, Akram; Jafari, Elham; Salahi, Rasool; Semnani, Shahryar; Abaie, Behrooz; Islami, Farhad; Nasseri-Moghaddam, Siavosh; Etemadi, Arash; Byrnes, Graham; Abnet, Christian C; Dawsey, Sanford M; Day, Nicholas E; Pharoah, Paul D; Boffetta, Paolo; Kamangar, Farin
Objectives To investigate the association between opium use and subsequent risk of death. Design Prospective cohort study. Setting The Golestan Cohort Study in north-eastern Iran collected detailed validated data on opium use and other exposures at baseline. Participants were enrolled between January 2004 and June 2008 and were followed to May 2011, with a follow-up success rate of over 99%. Participants 50 045 participants aged 40-75 at baseline. Main outcomes Mortality, all cause and major subcategories. Results 17% (n=8487) of the participants reported opium use, with a mean duration of 12.7 years. During the follow-up period 2145 deaths were reported. The adjusted hazard ratio for all cause mortality associated with ever use of opium was 1.86 (95% confidence interval 1.68 to 2.06). Opium consumption was significantly associated with increased risks of deaths from several causes including circulatory diseases (hazard ratio 1.81) and cancer (1.61). The strongest associations were seen with deaths from asthma, tuberculosis, and chronic obstructive pulmonary disease (11.0, 6.22, and 5.44, respectively). After exclusion of people who self prescribed opium after the onset of major chronic illnesses, the associations remained strong with a dose-response relation. Conclusion Opium users have an increased risk of death from multiple causes compared with non-users. Increased risks were also seen in people who used low amounts of opium for a long period and those who had no major illness before use. PMID:22511302
Kikuchi, Nobutaka; Ohmori-Matsuda, Kaori; Shimazu, Taichi; Sone, Toshimasa; Kakizaki, Masako; Nakaya, Naoki; Kuriyama, Shinichi; Tsuji, Ichiro
Unrelieved pain is a major factor that influences suicide risk among terminally ill patients, but little is known about the relationship between pain and the risk of completed suicide in the general population. We prospectively examined the association between self-reports of pain and subsequent risk of completed suicide in 26,481 men aged 40 to 79 years from the Ohsaki National Health Insurance Cohort study, a population-based, prospective cohort study initiated in 1994. On the basis of a five-item questionnaire on pain, individuals were classified as having no pain, very mild pain, mild pain, or moderate or severe pain. Completed suicide cases were documented from 1995 to 2001. During 131,027 person-years, 64 completed suicides were documented. After adjustment for covariates, the risk for completed suicide was significantly higher in the subjects with more pain. Multivariate hazard ratios (95% confidence intervals) relative to the subjects who had no pain were 1.36 (0.67-2.75), 2.11 (1.02-4.33), and 2.93 (1.34-6.42) in the subjects who had very mild pain, mild pain, and moderate or severe pain, respectively (P for trend=0.004). Stratified analysis showed that the positive association between pain and suicide risk was robust in the subjects with good health, low stress, adequate sleep, good physical activity, and no history of chronic diseases. Our results suggest that pain is associated with an increased risk of completed suicide among Japanese men. The association was consistently observed among apparently healthy subjects.
Cheng, Xin; Lu, Wenbin; Liu, Mengling
Summary Pooled analyses integrate data from multiple studies and achieve a larger sample size for enhanced statistical power. When heterogeneity exists in variables’ effects on the outcome across studies, the simple pooling strategy fails to present a fair and complete picture of the effects of heterogeneous variables. Thus, it is important to investigate the homogeneous and heterogeneous structure of variables in pooled studies. In this paper, we consider the pooled cohort studies with time-to-event outcomes and propose a penalized Cox partial likelihood approach with adaptively weighted composite penalties on variables’ homogeneous and heterogeneous effects. We show that our method can characterize the variables as having heterogeneous, homogeneous, or null effects, and estimate non-zero effects. The results are readily extended to high-dimensional applications where the number of parameters is larger than the sample size. The proposed selection and estimation procedure can be implemented using the iterative shooting algorithm. We conduct extensive numerical studies to evaluate the performance of our proposed method and demonstrate it using a pooled analysis of gene expression in patients with ovarian cancer. PMID:25732747
Kummeling, Ischa; Thijs, Carel; Penders, John; Snijders, Bianca E P; Stelma, Foekje; Reimerink, Johan; Koopmans, Marion; Dagnelie, Pieter C; Huber, Machteld; Jansen, Margje C J F; de Bie, Rob; van den Brandt, Piet A
The aim of the KOALA Birth Cohort Study in the Netherlands is to identify factors that influence the clinical expression of atopic disease with a main focus on lifestyle (e.g., anthroposophy, vaccinations, antibiotics, dietary habits, breastfeeding and breast milk composition, intestinal microflora composition, infections during the first year of life, and gene-environment interaction). The recruitment of pregnant women started in October 2000. First, participants with 'conventional lifestyles' (n = 2343) were retrieved from an ongoing prospective cohort study (n = 7020) on pregnancy-related pelvic girdle pain. In addition, pregnant women (n = 491) with 'alternative lifestyles' with regard to child rearing practices, dietary habits (organic, vegetarian), vaccination schemes and/or use of antibiotics, were recruited through organic food shops, anthroposophic doctors and midwives, Steiner schools, and dedicated magazines. All participants were enrolled between 14 and 18 wk of gestation and completed an intake questionnaire on family history of atopy and infant care intentions. Documentation of other relevant variables started in the pregnant mother and covered the first and third trimester as well as early childhood by repeated questionnaires at 14-18, 30, and 34 wk of gestation and 3, 7, 12, and 24 months post-partum. A subgroup of participants, including both conventional and alternative lifestyles, was asked to consent to maternal blood sampling, breast milk and a faecal sample of the infant at 1 month post-partum, capillary blood at age 1 yr, venous blood and observation of manifestation of atopic dermatitis during home visits at the age of 2 yr (using the UK working party criteria and the severity scoring of atopic dermatitis index), and buccal swabs for DNA isolation from child-parent trios. From the start, ethical approval and informed consent procedures included gene-environment interaction studies. Follow-up at 3 and 7 months post-partum was completed with
Veierød, Marit B; Parr, Christine L; Lund, Eiliv; Hjartåker, Anette
We studied the test-retest reproducibility of melanoma risk factors, including the use of sunscreen and sun protection factor (SPF), in a self-administered exposure follow-up questionnaire from the Norwegian Women and Cancer Study, a large national population-based cohort. In 2002, a random sample of 2000 women (46-75 years) received the questionnaire twice, about 3 months a part (response 75%). Kappa (kappa) was 0.77 for freckling when sunbathing [95% confidence interval (CI), 0.74-0.81]. Weighted kappa, kappaw, for sunbathing vacations to southern latitudes and solarium use last 5 years was 0.71 (95% CI, 0.68-0.74) and 0.70 (95% CI, 0.67-0.73), respectively. Reproducibility was also good for sunscreen use (yes/no) on specific occasions (0.64< or =kappa< or =0.74) and the corresponding SPF. Spearman's correlation coefficient (r(s)) for SPF on sunbathing vacations to southern latitudes was 0.73 (95% CI, 0.69-0.77) for today and 0.71 (95% CI, 0.66-0.76) for 10 years ago. For the eight most common sunscreen brands, reproducibility was lower for use (yes/no) (0.31< or =kappa< or =0.60) than for SPF (0.38< or =r(s)< or =0.87). The frequency of sunburn and sunbathing vacations in Norway or outside southern latitudes had fair reproducibility (kappaw was 0.49 and 0.47, respectively). Other studies have also found it challenging to measure sunburn. This study was larger than previous studies, permitting subgroup analyses. In conclusion, the overall reproducibility of the questionnaire was acceptable and not affected by age, education or skin color. In particular, our study has added new knowledge about the reproducibility of sunscreen use and SPF.
Nielsen, Nete Munk; Harpsøe, Maria; Simonsen, Jacob; Stenager, Egon; Magyari, Melinda; Koch-Henriksen, Nils; Baker, Jennifer L; Hjalgrim, Henrik; Frisch, Morten; Bager, Peter
Few studies have addressed the possible association between age at menarche and multiple sclerosis (MS), and results are conflicting. We studied this issue in a large prospective cohort study. The study cohort comprised 77,330 women included in the Danish National Birth Cohort (1996-2002). Information on menarcheal age was ascertained at the first interview, which took place in the 16th week of pregnancy. Women were followed for MS from the first interview to December 31, 2011. Associations between age at menarche and risk of MS were evaluated with hazard ratios and 95% confidence intervals using Cox proportional hazards regression models. Overall, 226 women developed MS during an average follow-up period of 11.7 years. Age at menarche among women with MS was generally lower than that among women without MS (Wilcoxon rank-sum test; P = 0.002). We observed an inverse association between age at menarche and MS risk. For each 1-year increase in age at menarche, risk of MS was reduced by 13% (hazard ratio = 0.87, 95% confidence interval: 0.79, 0.96). Early age at menarche appears to be associated with an increased risk of MS. The mechanisms behind this association remain to be established.
As a precursor to the National Children's Study (NCS), the North Carolina Cohort Study (NC Cohort Study) will provide the opportunity to field test procedures to better inform the implementation of the NCS. In order to test some of the study hypotheses, it will be important to ob...
Gencer, Baris; Collet, Tinh-Hai; Virgini, Vanessa; Auer, Reto; Rodondi, Nicolas
The association between subclinical thyroid dysfunction and cardiovascular outcomes has been recently clarified with the publication of three individual participant data (IPD) analyses from the Thyroid Studies Collaboration. We identified original cohort studies with a systematic review and pooled individual data from over 70'000 participants to obtain a more precise estimate of the risks of cardiovascular outcomes associated with subclinical thyroid dysfunction. Subclinical hypothyroidism and subclinical hyperthyroidism, defined as normal thyroxine (FT4) levels with increased or decreased Thyroid-Stimulating Hormones (TSH or thyrotropin) respectively, are associated with increased risk of cardiovascular outcomes compared to euthyroid state, particularly in those with a more pronounced thyroid dysfunction. Specifically, subclinical hypothyroidism is associated with an increased risk of coronary heart disease (CHD) events, CHD mortality and heart failure (HF) events in individuals with higher TSH levels, particularly in those with TSH levels ≥10.0 mIU/L. Conversely, subclinical hyperthyroidism is associated with an increased risk of total mortality, CHD mortality, HF and atrial fibrillation, particularly in those with suppressed TSH levels <0.10 mIU/L. Pending ongoing randomized controlled trials, these observational findings allow identifying potential TSH thresholds for thyroid medication initiation based on risk of clinical outcomes, although clinical decision based solely on observational data need caution. The impact of thyroid replacement among the elderly with subclinical hypothyroidism is currently studied in a multicenter international randomized controlled trial (Thyroid Hormone Replacement for Subclinical Hypothyroidism Trial, TRUST trial).
O'Loughlin, Jennifer; Dugas, Erika N; Brunet, Jennifer; DiFranza, Joseph; Engert, James C; Gervais, Andre; Gray-Donald, Katherine; Karp, Igor; Low, Nancy C; Sabiston, Catherine; Sylvestre, Marie-Pierre; Tyndale, Rachel F; Auger, Nathalie; Auger, Nathalie; Mathieu, Belanger; Tracie, Barnett; Chaiton, Michael; Chenoweth, Meghan J; Constantin, Evelyn; Contreras, Gisèle; Kakinami, Lisa; Labbe, Aurelie; Maximova, Katerina; McMillan, Elizabeth; O'Loughlin, Erin K; Pabayo, Roman; Roy-Gagnon, Marie-Hélène; Tremblay, Michèle; Wellman, Robert J; Hulst, Andraeavan; Paradis, Gilles
The Nicotine Dependence in Teens (NDIT) study is a prospective cohort investigation of 1294 students recruited in 1999-2000 from all grade 7 classes in a convenience sample of 10 high schools in Montreal, Canada. Its primary objectives were to study the natural course and determinants of cigarette smoking and nicotine dependence in novice smokers. The main source of data was self-report questionnaires administered in class at school every 3 months from grade 7 to grade 11 (1999-2005), for a total of 20 survey cycles during high school education. Questionnaires were also completed after graduation from high school in 2007-08 and 2011-12 (survey cycles 21 and 22, respectively) when participants were aged 20 and 24 years on average, respectively. In addition to its primary objectives, NDIT has embedded studies on obesity, blood pressure, physical activity, team sports, sedentary behaviour, diet, genetics, alcohol use, use of illicit drugs, second-hand smoke, gambling, sleep and mental health. Results to date are described in 58 publications, 20 manuscripts in preparation, 13 MSc and PhD theses and 111 conference presentations. Access to NDIT data is open to university-appointed or affiliated investigators and to masters, doctoral and postdoctoral students, through their primary supervisor (www.nditstudy.ca).
O’Loughlin, Jennifer; Dugas, Erika N; Brunet, Jennifer; DiFranza, Joseph; Engert, James C; Gervais, Andre; Gray-Donald, Katherine; Karp, Igor; Low, Nancy C; Sabiston, Catherine; Sylvestre, Marie-Pierre; Tyndale, Rachel F; Auger, Nathalie; Barnett, Tracie; Mathieu, Bélanger; Chaiton, Michael; Chenoweth, Meghan J; Constantin, Evelyn; Contreras, Gisèle; Kakinami, Lisa; Labbe, Aurélie; Maximova, Katerina; McMillan, Elizabeth; O’Loughlin, Erin K; Pabayo, Roman; Roy-Gagnon, Marie-Hélène; Tremblay, Michèle; Wellman, Robert J; van Hulst, Andraea; Paradis, Gilles
The Nicotine Dependence in Teens (NDIT) study is a prospective cohort investigation of 1294 students recruited in 1999–2000 from all grade 7 classes in a convenience sample of 10 high schools in Montreal, Canada. Its primary objectives were to study the natural course and determinants of cigarette smoking and nicotine dependence in novice smokers. The main source of data was self-report questionnaires administered in class at school every 3 months from grade 7 to grade 11 (1999–2005), for a total of 20 survey cycles during high school education. Questionnaires were also completed after graduation from high school in 2007–08 and 2011–12 (survey cycles 21 and 22, respectively) when participants were aged 20 and 24 years on average, respectively. In addition to its primary objectives, NDIT has embedded studies on obesity, blood pressure, physical activity, team sports, sedentary behaviour, diet, genetics, alcohol use, use of illicit drugs, second-hand smoke, gambling, sleep and mental health. Results to date are described in 58 publications, 20 manuscripts in preparation, 13 MSc and PhD theses and 111 conference presentations. Access to NDIT data is open to university-appointed or affiliated investigators and to masters, doctoral and postdoctoral students, through their primary supervisor (www.nditstudy.ca). PMID:25022274
Feral-Pierssens, Anne-Laure; Aubry, Adeline; Truchot, Jennifer; Raynal, Pierre-Alexis; Boiffier, Mathieu; Hutin, Alice; Leleu, Agathe; Debruyne, Geraud; Joly, Luc-Marie; Juvin, Philippe; Riou, Bruno
Objectives. To determine whether homeless patients experience suboptimal care in the emergency department (ED) by the provision of fewer health care resources. Methods. We conducted a prospective multicenter cohort study in 30 EDs in France. During 72 hours in March 2015, all homeless patients that visited the participating EDs were included in the study. The primary health care service measure was the order by the physician of a diagnostic investigation or provision of a treatment in the ED. Secondary measures of health care services included ED waiting time, number and type of investigations per patient, treatment in the ED, and discharge disposition. Results. A total of 254 homeless patients and 254 nonhomeless patients were included. After excluding homeless patients that attended the ED for the sole purpose of housing, we analyzed 214 homeless and 214 nonhomeless. We found no significant difference between the 2 groups in terms of health care resource consumption, and for our secondary endpoints. Conclusions. We did not find significant differences in the level of medical care delivered in French EDs to homeless patients compared with matched nonhomeless patients. PMID:26985613
Kiernan, Kathleen; Smith, Kate
This study uses information from the Millennium Cohort Study to examine the characteristics of families where children are born within a marriage, within a cohabiting union or outside of a co-residential partnership. For this latter group, for the first time in a national data set, an assessment can be made of the 'strength' of the parent's relationship at the time of the birth. We show that the context of childbearing varies with respect to geography, ethnicity, age, parity and educational status of the mother, and that the socioeconomic wellbeing of families varies according to the partnership status of their parents. A closer look at the non-partnered parents shows that the extent to which the fathers were involved with the mother of the child around the time the baby was born was related to the presence of the father at the birth of the child and whether his name was recorded on the child's birth certificate; as well as to subsequent behaviour, such as, whether they moved in with the mother, saw their children on a regular basis or contributed money to the child's maintenance.
Rasekhjahromi, Athar; Alipour, Farzaneh; Maalhagh, Mehrnoosh; Sobhanian, Saeed
Background. The aim of this study was to assess the association between herbal medication and OHSS. Methods. This retrospective cohort study was conducted with 101 polycystic ovary syndrome patients. 66 patients took conventional pharmacological medications and 35 took herbal medications. Data were analyzed by statistical test including Fisher's Exact and binominal logistic regression. P < 0.05 was considered significant. Results. Of the 101 females, 53 were married and 48 were single. There was no significant association between the groups in marriage. No significant association was found in mean age between the two groups (23.9 ± 5.8 years in the control group versus 26.3 ± 6.7 years in the case group). There was a significant difference between the two groups .After adding the dependent (OHSS prevalence) and independent (marriage and group) variables into the model, the Hosmer-Lemeshow test showed suitability. Variances analyzed with this model ranged between 29.4% and 40.7%. Conclusion. The indiscriminate use of herbs is correlated with OHSS. Because patients increasingly consume herbs, they should be aware of potential side effects. However, appropriate dosages of herbs could be obtained for use instead of conventional treatments, which often have side effects. PMID:27688772
Harville, Emily W.; Boynton-Jarrett, Renée
Purpose To examine the effect of lifetime social hardships on fertility. Methods Using the British National Child Development Study, a longitudinal cohort study, the impact of exposure to childhood hardships on becoming pregnant, reported infertility, and time to pregnancy was investigated. 6477 women reported on whether they had become pregnant by age 41, and 5198 women had data on at least one pregnancy. Factor analysis was used to identify six types of childhood hardships (as reported by parent, child, social worker, or teacher); retrospective report of child abuse was also examined. Logistic regression and discrete failure-time analysis was used to adjust for potential confounders. Results Never-married women were more likely to have become pregnant at some point if they had experienced more childhood hardships. Retrospectively reported child abuse was associated with an increased likelihood of having been told one was unable to have children. Among ever-married women, childhood hardships were associated with reduced fecundability, but the association was weakened by adjustment for adult social class. Conclusions The relationship between childhood adversity and adult fertility is complex. Future research should investigate pathways between characteristics of adversities and fertility. PMID:24404568
Frohlich, Katherine L; Shareck, Martine; Vallée, Julie; Abel, Thomas; Agouri, Rowena; Cantinotti, Michael; Daniel, Mark; Dassa, Clément; Datta, Geetanjali; Gagné, Thierry; Leclerc, Bernard-Simon; Kestens, Yan; O'Loughlin, Jennifer; Potvin, Louise
The Interdisciplinary Study of Inequalities in Smoking (ISIS) is a cohort study investigating the joint effects of residents' socio-demographic characteristics and neighbourhood attributes on the social distribution of smoking in a young adult population. Smoking is a behaviour with an increasingly steep social class gradient; smoking prevalence among young adults is no longer declining at the same rate as among the rest of the population, and there is evidence of growing place-based disparities in smoking. ISIS was established to examine these pressing concerns. The ISIS sample comprises non-institutionalized individuals aged 18-25 years, who are proficient in English and/or French and who had been living at their current address in Montréal, Canada, for at least 1 year at time of first contact. Two waves of data have been collected: baseline data were collected November 2011-September 2012 (n = 2093), and a second wave of data was collected January-June 2014 (n = 1457). Data were collected from respondents using a self-administered questionnaire, developed by the research team based on sociological theory, which includes questions concerning social, economic, cultural and biological capital, and activity space as well as smoking behaviour. Data are available upon request from [firstname.lastname@example.org].
Background No longitudinal data from population-based studies of eye disease in sub-Saharan-Africa are available. A population-based survey was undertaken in 2007/08 to estimate the prevalence and determinants of blindness and low vision in Nakuru district, Kenya. This survey formed the baseline to a six-year prospective cohort study to estimate the incidence and progression of eye disease in this population. Methods/Design A nationally representative sample of persons aged 50 years and above were selected between January 2007 and November 2008 through probability proportionate to size sampling of clusters, with sampling of individuals within clusters through compact segment sampling. Selected participants underwent detailed ophthalmic examinations which included: visual acuity, autorefraction, visual fields, slit lamp assessment of the anterior and posterior segments, lens grading and fundus photography. In addition, anthropometric measures were taken and risk factors were assessed through structured interviews. Six years later (2013/2014) all subjects were invited for follow-up assessment, repeating the baseline examination methodology. Discussion The methodology will provide estimates of the progression of eye diseases and incidence of blindness, visual impairment, and eye diseases in an adult Kenyan population. PMID:24886366
Schoenenberger, Andreas W; Muggli, Franco; Parati, Gianfranco; Gallino, Augusto; Ehret, Georg; Suter, Paolo M; Schoenenberger-Berzins, Renate; Resink, Therese J; Erne, Paul
Introduction Increased longevity and consequent major changes in demographics and population lifestyles necessitate new approaches to reduce the burden of ageing-related diseases (including cardiovascular disease) and maintain an optimal quality of life. This study aims to examine and longitudinally follow health status and disease risk factors in a Swiss rural cohort, evaluating all health-related research and practice disciplines to assure development of new implementable and successful preventive strategies for healthy ageing. Methods and objectives Small Swiss villages with low migration rates will be selected for this study. 2 villages (Cama/Lostallo) have already been selected as initial study sites. All residents (age ≥6 years, no upper age limit) are eligible. The target enrolment number per village is 300. Examinations and measurements encompass medical history, anthropometry, cardiac and vascular health, pulmonary function, physical performance, nutritional, mental and emotional status, biochemical and molecular analyses. Follow-up examinations (identical to baseline) will be performed after 5 and 10 years, and in 10-year intervals thereafter. The major objective is to assess, and observe change in, health status over time in a prospective manner. Secondary objectives are to: (1) identify ‘hidden’ (asymptomatic and/or unrecognised) health problems which enhance risk for chronic diseases; (2) identify barriers to accessing healthcare and adapting health behaviours; (3) evaluate efficacy of present preventive strategies and recommendations; (4) evaluate knowledge and attitude towards ongoing health programmes and public health recommendations; (5) monitor change and progress towards the national health objectives; (6) formulate new preventive strategies and recommendations based on the findings and knowledge base of the past 10 years; (7) formulate models for successful prevention of chronic diseases and for healthy ageing. Ethics and
One of the important programmatic outcomes from the U.N. Conference on Sustainable Development (Rio+20) was the adoption of the 10-Year Framework of Programmes (10YFP) on Sustainable Consumption and Production (SCP).
Beaino, Ghada; Khoshnood, Babak; Kaminski, Monique; Pierrat, Veronique; Marret, Stephane; Matis, Jacqueline; Ledesert, Bernard; Thiriez, Gerard; Fresson, Jeanne; Roze, Jean-Christophe; Zupan-Simunek, Veronique; Arnaud, Catherine; Burguet, Antoine; Larroque, Beatrice; Breart, Gerard; Ancel, Pierre-Yves
Aim: The aim of this study was to assess the independent role of cerebral lesions on ultrasound scan, and several other neonatal and obstetric factors, as potential predictors of cerebral palsy (CP) in a large population-based cohort of very preterm infants. Method: As part of EPIPAGE, a population-based prospective cohort study, perinatal data…
Sánchez-Villegas, Almudena; Ruíz-Canela, Miguel; de la Fuente-Arrillaga, Carmen; Gea, Alfredo; Shivappa, Nitin; Hébert, James R; Martínez-González, Miguel A
Only one prospective study has analysed the relationship between the inflammatory properties of diet and risk of depression thus far. The aim of this study was to assess the association between the dietary inflammatory index (DII) and the incidence of depression. In a cohort study of 15 093 university graduates, participants completed a validated FFQ at baseline and after 10 years of follow-up. The DII was calculated based on the FFQ. Each of the twenty-eight nutrients or foods received a score based on findings from the peer-reviewed literature reporting on the relationships between diet and inflammatory biomarkers (IL-1β, IL-4, IL-6, IL-10, TNF-α and C-reactive protein). Participants were classified as having depression if they reported a new clinical diagnosis of depression by a physician, antidepressant drugs, or both. Multivariable Cox regression models were used to estimate hazard ratios (HR) of depression according to quintiles of the DII. After a median 8·5 years of follow-up, we observed 1051 incident cases of depression. The HR for participants in the highest quintile of DII (strongly pro-inflammatory) was 1·47 (95% CI 1·17, 1·85) compared with those in the bottom quintile, with a significant dose-response relationship (P trend=0·01). In the subgroup analyses, the association between DII and depression was stronger among participants >55 years and among those with cardiometabolic comorbidities (HR 2·70; 95% CI 1·22, 5·97 and HR 1·80; 95% CI 1·27, 2·57, respectively). A pro-inflammatory diet was associated with a significantly higher risk of depression in a Mediterranean population. This association was stronger among older subjects and subjects with cardiometabolic diseases.
Thomson, WM; Zeng, J; Broadbent, JM; Foster Page, LA; Shalev, I; Moffitt, TE; Caspi, A; Williams, SM; Braithwaite, AW; Robertson, SP; Poulton, R
Aim To examine the association between telomere erosion and periodontitis in a longstanding prospective cohort study of New Zealand adults. Specific hypotheses tested were: (1) that exposure to periodontitis at ages 26 and 38 was associated with accelerated leucocyte telomere erosion; and (2) that accelerated leucocyte telomere erosion was associated with higher rates of periodontitis by ages 26 and 38. Materials and Methods Periodontal attachment loss data were collected at ages 26 and 38. Blood samples taken at the same ages were analysed to obtain estimates of leucocyte telomere length and erosion over a 12-year period. Results Overall, mean telomere length reduced by 0.15 T/S ratio (adjusted) from age 26 to 38 among the 661 participants reported on here. During the same period, the mean attachment loss increased by 10%, after adjusting for sex, socio-economic status and smoking. Regression models showed that attachment loss did not predict telomere length, and that telomere erosion did not predict attachment loss. Conclusions Although both periodontitis and telomere length are age-dependent, they do not appear to be linked, suggesting that determination of leucocyte telomere length may not be a promising clinical approach at this age for identifying people who are at risk for periodontitis. PMID:26713854
Rockx, Barry; De Wit, Matty; Vennema, Harry; Vinjé, Jan; De Bruin, Erwin; Van Duynhoven, Yvonne; Koopmans, Marion
We investigated the natural history of human Calicivirus infection in the community. Clinical information was obtained from 99 subjects infected with Norwalk-like viruses (NLV) and 40 subjects infected with Sapporo-like viruses (SLV) in a prospective, community-based cohort study. NLV infection was common in all age groups, whereas SLV infection was mainly restricted to children aged <5 years. Symptoms lasted for a median of 5 and 6 days for NLV and SLV infections, respectively. Disease was characterized by diarrhea during the first 5 days (87% of patients with NLV infection and 95% of patients with SLV infection) and vomiting on the first day (74% for NLV and 60% for SLV). Vomiting was less common in children aged <1 year (59% for NLV and 44% for SLV) than it was among children aged >/=1 year (>75% for NLV and >67% for SLV). Overall, NLV was detected in 26% of patients up to 3 weeks after the onset of illness. This proportion was highest (38%) for children aged <1 year. SLV shedding subsided after 14 days. These data show that the durations of disease and viral shedding of caliciviruses are longer than has been described elsewhere. Therefore, the impact of these infections may have been underestimated.
Ojard, Connor; Donnelly, John P.; Safford, Monika M.; Griffin, Russell
OBJECTIVE To characterize the relationship between stress and future risk of sepsis. We also evaluated the role of depression in this relationship. METHODS We used population-based data on 30,183 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, characterizing stress using the Perceived Stress Scale (PSS) and depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D). We identified incident sepsis events as hospitalizations for a serious infection with the presence of ≥2 SIRS criteria. We assessed associations between PSS and incidence of sepsis over one- and ten-years of follow-up, adjusting for demographics and chronic medical conditions and assessing the role of health behaviors and CES-D in these relationships. RESULTS During 2003–2012, 1,500 participants experienced an episode of sepsis. Mean PSS and CES-D scores were 3.2±2.9 and 1.2±2.1. PSS was associated with increased one-year adjusted incidence of sepsis (HR 1.21 per PSS standard deviation; 95% CI: 1.06–1.38); multivariable adjustment for health behaviors and CES-D did not change this association (1.20; 1.20; 1.03–1.39). PSS was also associated with increased 10-year adjusted incidence of sepsis (HR 1.07 per PSS standard deviation; 95% CI: 1.02–1.13). Multivariable adjustment showed that health behaviors did not affect this long-term association whereas addition of CES-D reduced the association between PSS and sepsis during 10-year follow-up (HR 1.04; 0.98–1.11). CONCLUSIONS Increased stress was associated higher one-year adjusted incidence of sepsis, even after accounting for depressive symptoms. The association between stress and ten-year adjusted incidence of sepsis was also significant, but this association was reduced when adjusting for depressive symptoms. Reduction of stress may limit short-term sepsis risk. PMID:25469683
Halder, Ajay; Agarwal, Rachana
Objective Parenteral opioids can be administered with ease at a very low cost with high efficacy as labour analgesia. However, there are insufficient data available to accept the benefits of parenteral opioids over other proven methods of labour analgesia. Butorphanol, a new synthetic opioid, has emerged as a promising agent in terms of efficacy and a better safety profile. This study investigates the effect of butorphanol as a labour analgesia to gather further evidence of its safety and efficacy to pave the way for its widespread use in low resource settings. Material and Methods One hundred low risk term consenting pregnant women were recruited to take part in a prospective cohort study. Intramuscular injections of butorphanol tartrate 1 mg (Butrum 1/2mg, Aristo, Mumbai, India) were given in the active phase of labour and repeated two hourly. Pain relief was noted on a 10-point visual pain analogue scale (VPAS). Obstetric and neonatal outcome measures were mode of delivery, duration of labour, Apgar scores at 1 and 5 minutes and Neonatal Intensive Care Unit admissions. Collected data were analysed for statistically significant pain relief between pre- and post-administration VPAS scores and also for the incidence of adverse outcomes. Results Pain started to decrease significantly within 15 minutes of administration and reached the nadir (3.08 SD0.51) at the end of two hours. The pain remained below four on the VPAS until the end of six hours and was still significantly low after eight hours. The incidence of adverse outcomes was low in the present study. Conclusion Butorphanol is an effective parenteral opioid analgesic which can be administered with reasonable safety for the mother and the neonate. The study has the drawback of lack of control and small sample size. PMID:24592110
ceremony, along with ambassadors in Chile of ESO members States, and representatives of the Chilean government and the scientific community. To review the impact of the numerous projects financed over the last decade, ESO presented the book "10 Years Exploring the Universe", based on the reports of the beneficiaries of the ESO-Chile fund. Since the beginning, the ESO-Chile fund has granted over 2.5 million euros to finance post-doc and astronomy professors for main Chilean universities, development of research infrastructure, organisation of scientific congresses, workshops for science teachers, and astronomy outreach programmes for the public. In addition to the 400,000 euros given annually by ESO to the ESO-Chile Joint Committee, around 550,000 euros are granted every year to finance regional collaboration programmes, fellowships for students in Chilean universities, and the development of radio astronomy through the ALMA-Chile Committee. In total, apart form the 10 percent of the observing time at all ESO telescopes, ESO contributes annually with 950,000 euros for the promotion of astronomy and scientific culture in Chile. The growth of astronomy and related sciences in Chile in the last years has been outstanding. According to a study by the Chilean Academy of Science in 2005, the number of astronomers has doubled over the last 20 years and there has been an 8-fold increase in the number of scientific publications. It is gratifying to see that 100 percent of the observing time granted by international observatories in Chile is actually used by the national community. The same study stated that astronomy could be the first scientific discipline in Chile with the standards of a developed country, with additional benefits in terms of technological improvement and growth of human resources. The English edition of the book "10 Years Exploring the Universe" is available here. The Spanish edition can be downloaded here.
Sakata, R; McGale, P; Grant, E J; Ozasa, K; Peto, R
Objective To investigate the impact of smoking on overall mortality and life expectancy in a large Japanese population, including some who smoked throughout adult life. Design The Life Span Study, a population-based prospective study, initiated in 1950. Setting Hiroshima and Nagasaki, Japan. Participants Smoking status for 27 311 men and 40 662 women was obtained during 1963-92. Mortality from one year after first ascertainment of smoking status until 1 January 2008 has been analysed. Main outcome measures Mortality from all causes in current, former, and never smokers. Results Smokers born in later decades tended to smoke more cigarettes per day than those born earlier, and to have started smoking at a younger age. Among those born during 1920-45 (median 1933) and who started smoking before age 20 years, men smoked on average 23 cigarettes/day, while women smoked 17 cigarettes/day, and, for those who continued smoking, overall mortality was more than doubled in both sexes (rate ratios versus never smokers: men 2.21 (95% confidence interval 1.97 to 2.48), women 2.61 (1.98 to 3.44)) and life expectancy was reduced by almost a decade (8 years for men, 10 years for women). Those who stopped smoking before age 35 avoided almost all of the excess risk among continuing smokers, while those who stopped smoking before age 45 avoided most of it. Conclusions The lower smoking related hazards reported previously in Japan may have been due to earlier birth cohorts starting to smoke when older and smoking fewer cigarettes per day. In Japan, as elsewhere, those who start smoking in early adult life and continue smoking lose on average about a decade of life. Much of the risk can, however, be avoided by giving up smoking before age 35, and preferably well before age 35. PMID:23100333
Thinkhamrop, W; Laohasiriwong, W
Background Health, safety, and well being have been known to be influenced by occupational characteristics. Nurses constantly encounter musculoskeletal disorders (MSDs) from work demands worldwide. Nevertheless, there is insufficient of knowledge regarding causes of musculoskeletal disorders among nurses in Thailand. Objective To investigate factors associated with musculoskeletal disorder among registered nurses in Thailand. Method This study is part of the 2009 Thai Nurse Cohort Study which consisted of 18,756 nationally representative sample of registered nurses. Data collection was performed via postal self-administered questionnaires. Manifesting musculoskeletal disorders was self-reported by registered nurses, 1,070 nurses were excluded since they were unemployed during previous 12 months. Multiple logistic regression was used for data analysis. Result Of 17,686 registered nurses, the overall 12 months prevalence of musculoskeletal disorders was 47.8%. It was found that workplace violence was the strongest factor which statistically significant associated with musculoskeletal disorders (adjusted odds ratio, OR, 2.01; 95% confidence interval, 95% CI, 1.42 to 2.83; P < 0.001), anxiety/depression (OR = 1.96: 95% CI: 1.78 to 2.15; P < 0.001), perceiving job required a lot of physical effort (OR = 1.69; 95% CI: 1.52 to 1.87; P < 0.001), every 10 years increased of age (OR = 1.40; 95% CI: 1.22 to 1.62; P < 0.001), overweight (OR = 1.39; 95% CI: 1.01 to 1.52; P = 0.015). Conclusion Registered nurses were most vulnerable of musculoskeletal disorders especially those who experienced workplace violence, anxiety/depression, strenuous work, older age, and overweight. Consequently, recommending safety practices to nurses should be considered for musculoskeletal disorders (MSDs) prevention by ergonomics and workplace design.
Sørensen, Mette; Ketzel, Matthias; Overvad, Kim; Tjønneland, Anne; Raaschou-Nielsen, Ole
Exposure to traffic noise may result in stress and sleep disturbances. Studies on self-reported sleep duration and breast cancer risk have found inconsistent results. In a population-based Danish cohort of 29,875 women aged 50-64 years at enrolment in 1993-1997, we identified 1219 incident, postmenopausal breast cancer cases during follow-up through 2010. Mean follow-up time was 12.3 years. Road traffic and railway noise was calculated for all present and historical residential addresses from 1987 to 2010. We used Cox proportional hazard model for analyses and adjusted for hormone replacement therapy use, parity, alcohol consumption and other potential confounders. We found no overall association between residential road traffic or railway noise and breast cancer risk. Among women with estrogen receptor negative breast cancer, a 10-dB higher level of road traffic noise (continuous scale) during the previous 1, 5 and 10 years were associated with 28% (95% CI: 1.04-1.56), 23% (95% CI: 1.00-1.51) and 20% (95% CI: 0.97-1.48) higher risks of estrogen receptor negative breast cancer, respectively, in fully adjusted models. Similarly, a 10-dB increase in railway noise (1-year mean at diagnosis address) increased risk for estrogen receptor negative breast cancer by 38% (95% CI: 1.01-1.89). There was no association between road traffic or railway noise and estrogen receptor positive breast cancer. In conclusion, these results suggest that residential road traffic and railway noise may increase risk of estrogen receptor negative breast cancer. As the first study on traffic noise and breast cancer results should be treated with caution.
van Koeverden, Ian; Blanc, Paul D.; Bowler, Russell P.; Arjomandi, Mehrdad
Background Exposure to secondhand tobacco smoke (SHS) can be a risk factor for chronic obstructive pulmonary disease (COPD), but its role among relatively heavy smokers with potential co-exposure to workplace vapors, gas, dust, and fumes (VGDF) has not been studied. Methods To estimate the contribution of SHS exposure to COPD risk, taking into account smoking effects and work-related exposures to VGDF, we quantified SHS based on survey responses for 1400 ever-employed subjects enrolled in the COPDGene study, all current or former smokers with or without COPD. Occupational exposures to VGDF were quantified based on a job exposure matrix. The associations between SHS and COPD were tested in multivariate logistic regression analyses adjusted for age, sex, VGDF exposure, and cumulative smoking. Results and Discussion Exposures to SHS at work and at home during adulthood were associated with increased COPD risk: odds ratio (OR) = 1.12 (95% confidence interval [CI]: 1.02–1.23; p = 0.01) and OR = 1.09 (95% CI: 1.00–1.18; p = 0.04) per 10 years of exposure adjusted for smoking and other covariates, respectively. In addition, subjects with employment histories likely to entail exposure to VGDF were more likely to have COPD: OR = 1.52 (95%CI: 1.16–1.98; p < 0.01) (adjusted for other covariates). While adult home SHS COPD risk was attenuated among the heaviest smokers within the cohort, workplace SHS and job VGDF risks persisted in that stratum. Conclusion Among smokers all with at least 10 pack-years, adult home and work SHS exposures and occupational VGDF exposure are all associated with COPD. PMID:24983136
The German National Cohort (GNC) is a joint interdisciplinary endeavour of scientists from the Helmholtz and the Leibniz Association, universities, and other research institutes. Its aim is to investigate the causes for the development of major chronic diseases, i.e. cardiovascular diseases, cancer, diabetes, neurodegenerative/-psychiatric diseases, musculoskeletal diseases, respiratory and infectious diseases, and their pre-clinical stages or functional health impairments. Across Germany, a random sample of the general population will be drawn by 18 regional study centres, including a total of 100,000 women and 100,000 men aged 20-69 years. The baseline assessments include an extensive interview and self-completion questionnaires, a wide range of medical examinations and the collection of various biomaterials. In a random subgroup of 20 % of the participants (n = 40,000) an intensified examination ("Level 2") programme will be performed. In addition, in five of the 18 study centres a total of 30,000 study participants will take part in a magnetic resonance imaging examination programme, and all of these participants will also be offered the intensified Level 2 examinations. After 4-5 years, all participants will be invited for a re-assessment. Information about chronic disease endpoints will be collected through a combination of active follow-up (including questionnaires every 2-3 years) and record linkages. The GNC is planned for an overall duration of 25-30 years. It will provide a major, central resource for population-based epidemiology in Germany, and will help to identify new and tailored strategies for early detection, prediction, and primary prevention of major diseases.
Vaz, Paula; Faria-Almeida, Ricardo; Braga, Ana-Cristina; Felino, António
Background Proximity of the dental roots to the sinus floor makes dental disease a probable cause of maxillary sinusitis. The aim of this study was to find out if maxillary sinus pathologic changes were more prevalent in patients with dental disease and to evaluate the performance of computed tomography (CT) in analyzing and detecting apical periodontitis and other odontogenic causes on the maxillary sinusitis etiology in a Portuguese Caucasian population. Material and Methods Retrospective cohort study. The total sample of 504 patients and their CT was included in this study. The patients were from a private dental clinic, specializing in oral surgery, where the first complaint was not directly related to sinus disease, but with dental pathology. For each patient, the etiological factors of maxillary sinusitis and the imaging CT findings were analyzed. All the axial, coronal and sagittal CT slices were evaluated and general data were registered. The latter was selected based on the maxillary sinus CT published literature. Results 32.40% of patients presented normal sinus (without any etiological factor associated), 29.00% showed presence of etiological and imaging findings in the maxillary sinus, 20.60% had only imaging changes in the maxillary sinus and 18.00% of patients presented only etiological factors and no change in the maxillary sinus. Conclusions Radiological imaging is an important tool for establishing the diagnosis of maxillary sinus pathology. These results indicate that the CT scan should be an excellent tool for complement the odontogenic sinusitis diagnosis. Key words: Maxillary sinusitis/etiology, odontogenic, computed tomography, maxillary sinus. PMID:25858084
Hülür, Gizem; Infurna, Frank J.; Ram, Nilam; Gerstorf, Denis
Studies of birth-year cohorts examined over the same age range often report secular trends favoring later-born cohorts, who are cognitively fitter and show less steep cognitive declines than earlier-born cohorts. However, there is initial evidence that those advantages of later-born cohorts do not carry into the last years of life, suggesting that pervasive mortality-related processes minimize differences that were apparent earlier in life. Elaborating this work from an alternative perspective on cohort differences, we compared rates of cognitive aging and terminal decline in episodic memory between cohorts based on the year participants had died, earlier (between 1993 and 1999) or later in historical time (between 2000 and 2010). Specifically, we compared trajectories of cognitive decline in two death-year cohorts of participants in the Asset and Health Dynamics among the Oldest Old (AHEAD) Study that were matched on age at death and education and controlled for a variety of additional covariates. Results revealed little evidence of secular trends favoring later cohorts. To the contrary, the cohort that died in the 2000s showed a less favorable trajectory of age-related memory decline than the cohort who died in the 1990s. In examinations of change in relation to time-to-death, the cohort dying in the 2000s experienced even steeper terminal declines than the cohort dying in the 1990s. We suggest that secular increases in “manufacturing” survival may exacerbate age- and mortality-related cognitive declines among the oldest old. PMID:23046001
Ko, Byuk Sung; Kim, Ji Yeon; Seo, Dong-Woo; Kim, Won Young; Lee, Jae Ho; Sheikh, Aziz; Bates, David W
Although adrenaline (epinephrine) is a cornerstone of initial anaphylaxis treatment, it is not often used. We sought to assess whether use of adrenaline in hemodynamically stable patients with anaphylaxis could prevent the development of hypotension. We conducted a retrospective cohort study of 761 adult patients with anaphylaxis presenting to the emergency department (ED) of a tertiary care hospital over a 10-year period. We divided the patients into two groups according to the occurrence of hypotension and compared demographic characteristics, clinical features, treatments and outcomes. Of the 340 patients with anaphylaxis who were normotensive at first presentation, 40 patients experienced hypotension during their ED stay. The ED stay of the hypotension group was significantly longer than that of patients who did not experience hypotension (496 min vs 253 min, P = 0.000). Adrenaline use in hemodynamically stable anaphylaxis patient was independently associated with a lower risk of developing in-hospital occurrence of hypotension: OR, 0.254 [95% CI, 0.091-0.706]. Adrenaline use in hemodynamically stable anaphylaxis patients was associated with a reduced risk of developing in-hospital occurrence of hypotension. Adverse events induced by adrenaline were rare when the intramuscular route was used.
Tran, Thuy B.; Postlewait, Lauren M.; Maithel, Shishir K.; Prescott, Jason D.; Wang, Tracy S.; Glenn, Jason; Phay, John E.; Keplinger, Kara; Fields, Ryan C.; Jin, Linda X.; Weber, Sharon M.; Salem, Ahmed; Sicklick, Jason K.; Gad, Shady; Yopp, Adam C.; Mansour, John C.; Duh, Quan-Yang; Seiser, Natalie; Solorzano, Carmen C.; Kiernan, Colleen M.; Votanopoulos, Konstantinos I.; Levine, Edward A.; Hatzaras, Ioannis; Shenoy, Rivfka; Pawlik, Timothy M.; Norton, Jeffrey A.; Poultsides, George A.
Background Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with limited therapeutic options beyond surgical resection. The characteristics of actual long-term survivors following surgical resection for ACC have not been previously reported. Method Patients who underwent resection for ACC at one of 13 academic institutions participating in the US Adrenocortical Carcinoma Group from 1993 to 2014 were analyzed. Patients were stratified into four groups: early mortality (died within 2 years), late mortality (died within 2–5 years), actual 5-year survivor (survived at least 5 years), and actual 10-year survivor (survived at least 10 years). Patients with less than 5 years of follow-up were excluded. Results Among the 180 patients available for analysis, there were 49 actual 5-year survivors (27%) and 12 actual 10-year survivors (7%). Patients who experienced early mortality had higher rates of cortisol-secreting tumors, nodal metastasis, synchronous distant metastasis, and R1 or R2 resections (all P < 0.05). The need for multi-visceral resection, perioperative blood transfusion, and adjuvant therapy correlated with early mortality. However, nodal involvement, distant metastasis, and R1 resection did not preclude patients from becoming actual 10-year survivors. Ten of twelve actual 10-year survivors were women, and of the seven 10-year survivors who experienced disease recurrence, five had undergone repeat surgery to resect the recurrence. Conclusion Surgery for ACC can offer a 1 in 4 chance of actual 5-year survival and a 1 in 15 chance of actual 10-year survival. Long-term survival was often achieved with repeat resection for local or distant recurrence, further underscoring the important role of surgery in managing patients with ACC. PMID:27633419
Chen, Hsin-Yi; Lin, Cheng-Li; Kao, Chia-Hung
This study investigated whether migraine influences the risk of primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) in Taiwan.We retrieved the data analyzed in this study from the National Health Insurance Research Database in Taiwan. We included 17,606 newly diagnosed migraine patients without preexisting glaucoma and randomly selected and matched 70,423 subjects without migraine as the comparison cohort. The same exclusion criteria were also applied to comparison subjects. Multivariate Cox proportion-hazards regression model was used to assess the effects of migraines on the risk of glaucoma after adjusting for demographic characteristics and comorbidities.The cumulative incidence of POAG was higher in the migraine cohort than that in the comparison cohort (log-rank P = 0.04). The overall incidence of POAG (per 10,000 person-years) was 9.62 and 7.69, respectively, for migraine cohort and nonmigraine cohort (crude hazard ratio [HR] = 1.24, 95% confidence interval [CI] = 1.01-1.54). After adjusting the covariates, the risk of POAG was not significantly higher in the migraine cohort than in the comparison cohort (adjusted HR [aHR] = 1.15, 95% CI = 0.93-1.42). The cumulative incidence of PACG did not differ between the migraine cohort and the comparison cohort (log-rank test P = 0.53). The overall incidence of PACG was not significantly higher in the migraine cohort than that in the comparison cohort (7.42 vs 6.84 per 10,000 person-years), with an aHR of 1.04 (95% CI = 0.82-1.32).This study shows that migraines are not associated with a higher risk either in POAG or in PACG.
Yuen, K.; Riebeek, H.; Chambers, L. H.
1 Author Yuen, Karen JPL (818) 393-7716 2 Author Riebeek, Holli Sigma Space Corporation (department) at NASA Goddard Space Flight Center (Institution), Greenbelt, Maryland 3 Author Chambers, Lin NASA Abstract: Since launch, Terra has returned about 195 gigabytes (level 0) of data per day or 1 terabyte every 5 days. Few outlets were able to accommodate and quickly share that amount of information as well as the Internet. To honor the 10-year anniversary of the launch of Terra, we would like to highlight the education and outreach efforts of the Terra mission on the Internet and its reach to the science attentive public. The Internet or web has been the primary way of delivering Terra content to different groups- from formal and informal education to general public outreach. Through the years, many different web-based projects have been developed, and they were of service to a growing population of the science attentive public. One of Terra’s original EPO activities was the Earth Observatory. It was initially dedicated to telling the remote sensing story of Terra, but quickly grew to include science and imagery from other sensors. The web site allowed for collaboration across NASA centers, universities and other organizations by exchanging and sharing of story ideas, news and images. The award winning Earth Observatory helped pave the way for the more recently funded development of the Climate Change website. With its specific focus on climate change studies, once again, Terra stories and images are shared with an even more specific audience base. During the last 10 years, Terra as a mission has captured the imagination of the public through its visually stunning and artistically arresting images. With its five instruments of complementary but unique capabilities, the mission gave the world not just pretty pictures, but scientific data-based images. The world was able to see from space everything from calving icebergs to volcanic eruption plumes and the eye of a
Sadatmahalleh, Shahideh Jahanian; Ziaei, Saeideh; Kazemnejad, Anoshirvan; Mohamadi, Eesa
Background Tubal ligation (TL) is recommended for women who have completed their family planning. The existence of the menstrual disorders following this procedure has been the subject of debate for decades. This study was conducted to identify the relationship between tubal ligation and menstrual disorders. Materials and Methods A historical cohort study was carried out on 140 women undergoing tubal ligation (TL group) and on 140 women using condom as the main contraceptive method (Non-TL group). They aged between 20 and 40 years and were selected from a health care center in Rudsar, Guilan Province, Iran, during 2013-2014. The two groups were comparable in demographic characteristics, obstetrical features and menstrual bleeding pattern using a routine questionnaire. A validated pictorial blood loss assessment chart (PBLAC) was also used to measure the menstrual blood loss. Results Women with TL had more menstrual irregularity than those without TL (24.3 vs. 10%, P=0.002). Women with TL had more polymenorrhea (9.3 vs. 1.4%, P=0.006), hypermenorrhea (12.1 vs. 2.1%, P=0.002), menorrhagia (62.9 vs. 22.1%, P<0.0001) and menometrorrhagia (15.7 vs. 3.6%, P=0.001) than those without TL. There is a significant difference in the PBLAC score between women with and without TL (P<0.0001). According to logistic regression, age odds ratio [(OR=1.08, con- fidence interval (CI):1.07-1.17, P=0.03)], TL (OR=5.95, CI:3.45-10.26, P<0.0001) and cesarean section (OR=2.72, CI:1.49-4.97, P=0.001) were significantly associated with menorrhagia. Conclusion We found significant differences in menstrual disorders between women with and without TL. Therefore, women should be informed by the health providers regarding the advantages and disadvantages of TL before the procedures. PMID:26985334
Skjærven, Rolv; Grjibovski, Andrej M; Gunnes, Nina; Vangen, Siri; Magnus, Per
Objective To estimate the risk of hyperemesis gravidarum (hyperemesis) according to whether the daughters and sons under study were born after pregnancies complicated by hyperemesis. Design Population based cohort study. Setting Registry data from Norway. Participants Linked generational data from the medical birth registry of Norway (1967-2006): 544 087 units of mother and childbearing daughter and 399 777 units of mother and child producing son. Main outcome measure Hyperemesis in daughters in mother and childbearing daughter units and hyperemesis in female partners of sons in mother and child producing son units. Results Daughters who were born after a pregnancy complicated by hyperemesis had a 3% risk of having hyperemesis in their own pregnancy, while women who were born after an unaffected pregnancy had a risk of 1.1% (unadjusted odds ratio 2.9, 95% confidence interval 2.4 to 3.6). Female partners of sons who were born after pregnancies complicated by hyperemesis had a risk of 1.2% (1.0, 0.7 to 1.6). Daughters born after a pregnancy not complicated by hyperemesis had an increased risk of the condition if the mother had hyperemesis in a previous or subsequent pregnancy (3.2 (1.6 to 6.4) if hyperemesis had occurred in one of the mother’s previous pregnancies and 3.7 (1.5 to 9.1) if it had occurred in a later pregnancy). Adjustment for maternal age at childbirth, period of birth, and parity did not change the estimates. Restrictions to firstborns did not influence the results. Conclusions Hyperemesis gravidarum is more strongly influenced by the maternal genotype than the fetal genotype, though environmental influences along the maternal line cannot be excluded as contributing factors. PMID:21030362
Jansen, N; van Amelsvoort, L G P M; Kristensen, T; van den Brandt, P A; Kant, I.
Aims: (1) To describe the prevalence of fatigue among employees in different work schedules (day work, three-shift, five-shift, and irregular shift work); (2) to investigate whether different work schedules are related to increasing fatigue over time, while taking into account job title and job characteristics; and (3) to study fatigue among shift workers changing to day work. Methods: Data from nine consecutive four-monthly self administered questionnaires from the Maastricht Cohort Study on Fatigue at work (n = 12 095) were used with 32 months of follow up. Day and shift workers were matched on job title. Results: The prevalence of fatigue was 18.1% in day workers, 28.6% in three-shift, 23.7% in five-shift, and 19.1% in irregular shift workers. For three-shift and five-shift workers substantial higher fatigue levels were observed compared to day workers at baseline measurement. In the course of fatigue over the 32 months of follow up there were only small and insignificant differences between employees in different work schedules. However, among employees fatigued at baseline, fatigue levels decreased faster over time among five-shift workers compared to fatigued day workers. Shift workers changing to day work reported substantially higher fatigue levels prior to change, compared to those remaining in shift work. Conclusions: Substantial differences in fatigue existed between day and shift workers. However, as no considerable differences in the course of fatigue were found, these differences have probably developed within a limited time span after starting in a shift work job. Further, evidence was found that fatigue could be an important reason for quitting shift work and moving to day work. Finally, in the relation between work schedules and fatigue, perceived job characteristics might play an important role. PMID:12782747
Lung, For-Wey; Chiang, Tung-Liang; Lin, Shio-Jean; Shu, Bih-Ching; Lee, Meng-Chih
The Taiwan Birth Cohort Study (TBCS) is the first nationwide birth cohort database in Asia designed to establish national norms of children's development. Several challenges during database development and data analysis were identified. Challenges include sampling methods, instrument development and statistical approach to missing data. The…
Spatz, Erica S; Jiang, Xianyan; Lu, Jiapeng; Masoudi, Frederick A; Spertus, John A; Wang, Yongfei; Li, Xi; Downing, Nicholas S; Nasir, Khurram; Du, Xue; Li, Jing; Krumholz, Harlan M; Liu, Xiancheng; Jiang, Lixin
Purpose In China, efforts are underway to respond to rapidly increasing rates of heart disease and stroke. Yet the epidemiology of cardiovascular disease in China may be different from that of other populations. Thus, there is a critical need for population-based studies that provide insight into the risk factors, incidence and outcomes of cardiovascular disease in China. The Qingdao Port Cardiovascular Health Study is designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. Participants For this study, from 2000 through 2013, 32 404 employees aged 18 years or older were recruited from the Qingdao Port Group in China, contributing 221 923 annual health assessments. The mean age at recruitment was 43.4 (SD=12.9); 79% were male. In this ongoing study, annual health assessments, governed by extensive quality control mechanisms, include a questionnaire (capturing demographic and employment information, medical history, medication use, health behaviours and health outcomes), physical examination, ECG, and blood and urine analysis. Additional non-annual assessments include an X-ray, echocardiogram and carotid ultrasound; bio-samples will be collected for future genetic and proteomic analyses. Cardiovascular outcomes are accessed via self-report and are actively being verified with medical insurance claims; efforts are underway to adjudicate outcomes with hospital medical records. Findings to date Early findings reveal a significant increase in cardiovascular risk factors from 2000 to 2010 (hypertension: 26.4–39.4%; diabetes: 3.3–8.9%; hyperlipidaemia: 5.0–33.6%; body mass index >28 m/kg2: 14.1–18.6%). Future Plans We aim to generate novel insights about the epidemiology and outcomes of cardiovascular disease in China, with specific emphasis on the potentially unique risk factor profiles of this Chinese population. Knowledge
Saeedi, Pouya; Skeaff, Sheila A.; Wong, Jyh Eiin; Skidmore, Paula M. L.
The aim of this study was to assess the reproducibility and validity of a non-quantitative 28-item food frequency questionnaire (FFQ). Children aged 9–10 years (n = 50) from three schools in Dunedin, New Zealand, completed the FFQ twice and a four-day estimated food diary (4DEFD) over a two-week period. Intraclass correlation coefficients (ICC) and Spearman’s correlation coefficients (SCC) were used to determine reproducibility and validity of the FFQ, respectively. Weekly intakes were estimated for each food item and aggregated into 23 food items/groups. More than half of the food items/groups (52.2%) had an ICC ≥0.5. The median SCC between FFQ administrations was 0.66 (ranging from 0.40 for processed meat to 0.82 for sweets and non-dairy drinks). Cross-classification analysis between the first FFQ and 4DEFD for ranking participants into thirds showed that breakfast cereals had the highest agreement (54.0%) and pasta the lowest (34.0%). In validity analyses, 70% of food items/groups had a SCC ≥0.3. Results indicate that the FFQ is a useful tool for ranking children according to food items/groups intake. The low respondent burden and relative simplicity of the FFQ makes it suitable for use in large cohort studies of 9–10 year-old children in New Zealand. PMID:27164137
United States. Bonneville Power Administration.
In 1988 Bonneville Power Administration (BPA) began work on this Operations, Maintenance, and Replacement 10-Year Plan to develop a levelized program that would assure high system reliability. During the Programs in Perspective (PIP) meetings in the late summer and fall of 1988, many of the concerns to be addressed in an Operations, Maintenance, and Replacement Plan were identified. Following these PIP meetings BPA established internal work groups. During the winter and spring of 1989, these work groups developed technical background and issue papers on topics that ranged from substation maintenance to environmental protection. In addition, a customer forum group was established and met on several occasions to review work on the plan, to offer ideas and points of view, and to assure that BPA understood customer concerns. Based on recommendations from the work group reports and customer input, BPA's O M Management Team developed the draft Operations, Maintenance, and Replacement 10-Year Plan that was released for public comment during the spring of 1990. During the public review period, BPA received a number of written comments from customers and the interested public. In addition, special meetings were held with interested customers. This final Operations, Maintenance, and Replacement 10-Year Plan reflects BPA's response to customers and interested public on each topic discussed in the 10-Year Plan. The plan is a distillation of BPA's strategies to achieve a levelized program over 10 years.
In 1988 Bonneville Power Administration (BPA) began work on this Operations, Maintenance, and Replacement 10-Year Plan to develop a levelized program that would assure high system reliability. During the Programs in Perspective (PIP) meetings in the later summer and fall of 1988, many of the concerns to be addressed in an Operations, Maintenance, and Replacement Plan were identified. Following these PIP meetings BPA established internal work groups. During the winter and spring of 1989, these work groups developed technical background and issue papers on topics that ranged from substation maintenance to environmental protection. In addition, a customer forum group was established and met on several occasions to review work on the plan, to offer ideas and points of view, and to assure that BPA understood customer concerns. Based on recommendations from the work group reports and customer input, BPA's O M Management Team developed the draft Operations, Maintenance, and Replacement 10-Year Plan that was released for public comment during the spring of 1990. During the public review period, BPA received a number of written comments from customers and the interested public. In addition, special meetings were held with interested customers. This final Operations, Maintenance, and Replacement 10-year Plan reflects BPA's response to customers and interested public on each topic discussed in the 10-Year Plan. The plan is a distillation of BPA's strategies to achieve a levelized program over 10 years.
Shi, Di; Li, Jiangbo; Wang, Yong; Wang, Si; Liu, Kai; Shi, Rufeng; Zhang, Qiang; Chen, Xiaoping
Low health literacy is associated with poor clinical outcomes. The relationship between literacy and blood pressure (BP) has been inconsistent. We investigated the determinants of health literacy and the potential relationship between health literacy and hypertension management. We conducted a retrospective cohort trial of 360 hypertensive patients. Scale measurements, physical examination, and laboratory tests were performed based on a standard protocol. To determine factors associated with health literacy, multiple logistic regression analysis was performed and the discriminatory power of the scale score for hypertension control was assessed by the area under the receiver operating curve. After adjusting for potential confounders, our findings show that the level of education, home blood pressure measurement, regular medication, and systolic blood pressure are significantly associated with health literacy. Moreover, patients with high health literacy have better hypertension control, a lower risk of ischemic cardiovascular disease (ICVD), lower brachial ankle pulse wave velocity values, and better health-related quality of life. In addition, our study also demonstrates that we can identify the health literacy level of hypertensive patients using the Chinese Health Literacy Scale for Hypertension. At a cut-off value of 13.5, we predict that patients will achieve long-term hypertension control. Adequate health literacy is a contributing factor to better blood pressure (BP) control and better perceived quality of life in hypertensive patients. Low health literacy increases the 10-year risk of ICVD and incidence of artery stiffness in hypertensive patients. Improving health literacy should be considered an important part of the management of hypertension.
Stohr, Amber D.
Commencing in 2011, the Mathematics Academies Initiative is a series of professional development academies (lasting 1 to 2 years, depending on cohort) with the primary objectives of (a) providing educators with a high quality professional development experience that enhances their mathematical content knowledge and pedagogical skills, and (b)…
Background International collaborative cohorts the NINFEA and the ELF studies are mother-child cohorts that use the internet for recruitment and follow-up of their members. The cohorts investigated the association of early life exposures and a wide range of non-communicable diseases. Objective The objective is to report the research methodology, with emphasis on the advantages and limitations offered by an Internet-based design. These studies were conducted in Turin, Italy and Wellington, New Zealand. Methods The cohorts utilized various online/offline methods to recruit participants. Pregnant women who became aware volunteered, completed an online questionnaire, thus obtaining baseline information. Results The NINFEA study has recruited 7003 pregnant women, while the ELF study has recruited 2197 women. The cohorts targeted the whole country, utilizing a range of support processes to reduce the attrition rate of the participants. For the NINFEA and ELF cohorts, online participants were predominantly older (35% and 28.9%, respectively), highly educated (55.6% and 84.9%, respectively), and were in their final trimester of pregnancy (48.5% and 53.6%, respectively). Conclusions Internet-based cohort epidemiological studies are feasible, however, it is clear that participants are self-selective samples, as is the case for many birth cohorts. Internet-based cohort studies are potentially cost-effective and novel methodology for conducting long-term epidemiology research. However, from our experience, participants tend to be self-selective. In marked time, if the cohorts are to form part of a larger research program they require further use and exploration to address biases and overcome limitations. PMID:26071071
Carroll, Ian R.; Hah, Jennifer M.; Barelka, Peter L.; Wang, Charlie KM.; Wang, Bing M.; Gillespie, Matthew J.; McCue, Rebecca; Younger, Jarred W.; Trafton, Jodie; Humphreys, Keith; Goodman, Stuart B.; Dirbas, Fredrick M.; Mackey, Sean C.
Objective Preoperative determinants of pain duration following surgery are poorly understood. We identified preoperative predictors of prolonged pain after surgery in a mixed surgical cohort. Methods We conducted a prospective longitudinal study of patients undergoing mastectomy, lumpectomy, thoracotomy, total knee replacement, or total hip replacement. We measured preoperative psychological distress and substance use, and then measured pain and opioid use after surgery until patients reported the cessation of both opioid consumption and pain. The primary endpoint was time to opioid cessation, and those results have been previously reported. Here we report preoperative determinants of time to pain resolution following surgery in Cox proportional hazards regression. Results Between January 2007 and April 2009 we enrolled 107 of 134 consecutively approached patients undergoing the aforementioned surgical procedures. In the final multivariate model, preoperative self-perceived risk of addiction predicted more prolonged pain. Unexpectedly, anxiety sensitivity predicted more rapid pain resolution after surgery. Each one-point increase (on a four point scale) of self-perceived risk of addiction was associated with a 38% (95% CI 3 - 61) reduction in the rate of pain resolution (p= 0.04). Furthermore, higher anxiety sensitivity was associated with an 89% (95% CI 23–190) increased rate of pain resolution (p=0.004). Conclusions Greater preoperative self-perceived risk of addiction, and lower anxiety sensitivity predicted a slower rate of pain resolution following surgery. Each of these factors was a better predictor of pain duration than preoperative depressive symptoms, PTSD symptoms, past substance use, fear of pain, gender, age, preoperative pain, or preoperative opioid use. PMID:26179223
Mair, Frances S.; Roger, Véronique L.; Weston, Susan A.; Jiang, Ruoxiang; Chamberlain, Alanna M.
Objective To examine the association between depression and clinical outcomes in heart failure (HF) in a community cohort. Patients and Methods HF patients in Minnesota, United States completed depression screening using the 9-item Patient Health Questionnaire (PHQ-9) between 1st Oct 2007 and 1st Dec 2011; patients with PHQ-9≥5 were labelled “depressed”. We calculated the risk of death and first hospitalization within 2 years using Cox regression. Results were adjusted for 10 commonly used prognostic factors (age, sex, systolic blood pressure, estimated glomerular filtration rate, serum sodium, ejection fraction, blood urea nitrogen, brain natriuretic peptide, presence of diabetes and ischaemic aetiology). Area under the curve (AUC), integrated discrimination improvement (IDI) and net reclassification improvement (NRI) compared depression as a predictor against the aforementioned factors. Results 425 patients (mean age 74, 57.6% males) were included in the study; 179 (42.1%) had PHQ-9≥5. The adjusted hazard ratio of death was 2.02 (95% CI 1.34–3.04) and of hospitalization was 1.42 (95% CI 1.13–1.80) for those with compared to those without depression. Adding depression to the models did not appreciably change the AUC but led to statistically significant improvements in both the IDI (p = 0.001 and p = 0.005 for death and hospitalization, respectively) and NRI (for death and hospitalization, 35% (p = 0.002) and 27% (p = 0.007) were reclassified correctly, respectively). Conclusion Depression is frequent among community patients with HF and associated with increased risk of hospitalizations and death. Risk prediction for death and hospitalizations in HF patients can be improved by considering depression. PMID:27362359
Berger, John T.; Carcillo, Joseph A.; Shanley, Thomas P.; Wessel, David L.; Clark, Amy; Holubkov, Richard; Meert, Kathleen L.; Newth, Christopher J.L.; Berg, Robert A.; Heidemann, Sabrina; Harrison, Rick; Pollack, Murray; Dalton, Heidi; Harvill, Eric; Karanikas, Alexia; Liu, Teresa; Burr, Jeri S.; Doctor, Allan; Dean, J. Michael; Jenkins, Tammara L.; Nicholson, Carol E.
Objective Pertussis persists in the United States despite high immunization rates. The present report characterizes the presentation and acute course of critical pertussis by quantifying demographic data, laboratory findings, clinical complications, and critical care therapies required among children requiring admission to the pediatric intensive care unit (PICU). Design Prospective cohort study. Setting Eight PICUs comprising the Eunice Kennedy Shriver National Institute for Child Health and Human Development Collaborative Pediatric Critical Care Research Network and 17 additional PICUs across the United States. Patients Eligible patients had laboratory confirmation of pertussis infection, were < 18 years of age, and died in the PICU or were admitted to the PICU for at least 24 hours between June 2008 and August 2011. Interventions None. Measurements and Main Results 127 patients were identified. Median age was 49 days, and 105 (83%) patients were < 3 months of age. Fifty-five (43%) required mechanical ventilation. Twelve (9.4%) died during initial hospitalization. Pulmonary hypertension was found in 16 patients (12.5%), and was present in 75% of patients who died, compared with 6% of survivors (p< 0.001). Median white blood cell count (WBC) was significantly higher in those requiring mechanical ventilation (p<0.001), those with pulmonary hypertension (p<0.001) and non-survivors (p<0.001). Age, sex and immunization status did not differ between survivors and non-survivors. Fourteen patients received leukoreduction therapy (exchange transfusion (12), leukopheresis (1) or both (1)). Survival benefit was not apparent. Conclusions Pulmonary hypertension may be associated with mortality in pertussis critical illness. Elevated WBC is associated with the need for mechanical ventilation, pulmonary hypertension, and mortality risk. Research is indicated to elucidate how pulmonary hypertension, immune responsiveness, and elevated WBC contribute to morbidity and mortality
Background The course of depression from pregnancy to 1 year post partum and risk factors among mothers and fathers are not known. Aims (1) To report the longitudinal patterns of depression from the third trimester of pregnancy to 1 year after childbirth; (2) to determine the gender differences between women and their partners in the effect of psychosocial and personal factors on postpartum depression. Methods A longitudinal cohort study was carried out over a consecutive sample of 769 women in their third trimester of pregnancy and their partners attending the prenatal programme in the Valencian Community (Spain) and follow-up at 3 and 12 months post partum. The outcome variable was the presence of depression at 3 or 12 months post partum measured by the Edinburgh Postnatal Depression Scale. Predictor variables were: psychosocial (marital dissatisfaction, confidant and affective social support) and personal (history of depression, partner's depression and negative life events, depression during the third trimester of pregnancy) variables. Logistic regression models were fitted via generalised estimating equations. Results At 3 and 12 months post partum, 9.3% and 4.4% of mothers and 3.4% and 4.0% of fathers, respectively, were newly diagnosed as having depression. Low marital satisfaction, partner's depression and depression during pregnancy increased the probability of depression during the first 12 months after birth in mothers and fathers. Negative life events increased the risk of depression only among mothers. Conclusions Psychosocial and personal factors were strong predictors of depression during the first 12 months post partum for both mothers and fathers. PMID:20515899
Ancel, Pierre-Yves; Goffinet, François; Hascoët, Jean-Michel; Truffert, Patrick; Tran, Diep; Lebeaux, Cécile; Jarreau, Pierre-Henri
OBJECTIVE: To investigate the relationship between placenta-mediated pregnancy complications and bronchopulmonary dysplasia (BPD) in very preterm infants. METHODS: National prospective population-based cohort study including 2697 singletons born before 32 weeks’ gestation. The main outcome measure was moderate to severe BPD. Three groups of placenta-mediated pregnancy complications were compared with no placenta-mediated complications: maternal disorders only (gestational hypertension or preeclampsia), fetal disorders only (antenatal growth restriction), and both maternal and fetal disorders. RESULTS: Moderate to severe BPD rates were 8% in infants from pregnancies with maternal disorders, 15% from both maternal and fetal disorders, 23% from fetal disorders only, and 9% in the control group (P < .001). When we adjusted for gestational age, the risk of moderate to severe BPD was greater in the groups with fetal disorders only (odds ratio [OR] = 6.6; 95% confidence interval [CI], 4.1–10.7), with maternal and fetal disorders (OR = 3.7; 95% CI, 2.5–5.5), and with maternal disorders only (OR = 1.7; 95% CI, 1.0–2.7) than in the control group. When we also controlled for birth weight, the relationship remained in groups with fetal disorders only (OR = 4.2; 95% CI, 2.1–8.6) and with maternal and fetal disorders (OR = 2.1; 95% CI, 1.1–3.9). CONCLUSIONS: Placenta-mediated pregnancy complications with fetal consequences are associated with moderate to severe BPD in very preterm infants independently of gestational age and birth weight, but isolated maternal hypertensive disorders are not. Fetal growth restriction, more than birth weight, could predispose to impaired lung development. PMID:26908662
Senturk Cankorur, Vesile; Duman, Berker; Taylor, Clare; Stewart, Robert
Background Child gender preference is important in some cultures and has been found to modify risk for antenatal and postnatal depression. We investigated discrepancies in the child gender preference between participating women and other key family members and the extent to which these predicted perinatal depression. Methods In a large cohort study of perinatal depression in urban and rural Turkey, participants had been asked about child gender preferences: their own, and those of their husband, parents, and parents in-law. Of 730 participants recruited in their third trimester (94.6% participation), 578 (79.2%) were reassessed at a mean (SD) 4.1 (3.3) months after childbirth, and 488 (66.8%) were reassessed at 13.7 (2.9) months. Results No associations were found between any gender preference reported in the antenatal period and depression at any examination. On the other hand, we found associations of antenatal depression with differences in participant-reported gender preference and that reported for their mother-in-law (OR 1.81, 1.08–3.04). This non-agreement also predicted depression at the 4 month (OR 2.24, 1.24–4.03) and 14 month (OR 2.07, 1.05–4.04) post-natal examinations. These associations with postnatal depression persisted after adjustment for a range of covariates (ORs 3.19 (1.54–6.59) and 3.30 (1.49–7.33) respectively). Conclusions Reported disagreement in child gender preferences between a woman and her mother-in-law was a predictor of post-natal depression and may reflect wider family disharmony as an underlying factor. PMID:28355286
Stern, J. M.; Simes, R. J.
OBJECTIVES: To determine the extent to which publication is influenced by study outcome. DESIGN: A cohort of studies submitted to a hospital ethics committee over 10 years were examined retrospectively by reviewing the protocols and by questionnaire. The primary method of analysis was Cox's proportional hazards model. SETTING: University hospital, Sydney, Australia. STUDIES: 748 eligible studies submitted to Royal Prince Alfred Hospital Ethics Committee between 1979 and 1988. MAIN OUTCOME MEASURES: Time to publication. RESULTS: Response to the questionnaire was received for 520 (70%) of the eligible studies. Of the 218 studies analysed with tests of significance, those with positive results (P < 0.05) were much more likely to be published than those with negative results (P > or = 0.10) (hazard ratio 2.32 (95% confidence interval 1.47 to 3.66), P = 0.0003), with a significantly shorter time to publication (median 4.8 v 8.0 years). This finding was even stronger for the group of 130 clinical trials (hazard ratio 3.13 (1.76 to 5.58). P = 0.0001), with median times to publication of 4.7 and 8.0 years respectively. These results were not materially changed after adjusting for other significant predictors of publication. Studies with indefinite conclusions (0.05 < or = P < 0.10) tended to have an even lower publication rate and longer time to publication than studies with negative results (hazard ratio 0.39 (0.13 to 1.12), P = 0.08). For the 103 studies in which outcome was rated qualitatively, there was no clear cut evidence of publication bias, although the number of studies in this group was not large. CONCLUSIONS: This study confirms the evidence of publication bias found in other studies and identifies delay in publication as an additional important factor. The study results support the need for prospective registration of trials to avoid publication bias and also support restricting the selection of trials to those started before a common date in undertaking
Wu, L Q; Wang, Z S; Cao, J Y; Hu, W Y; Han, B; Sun, C D; Zhang, B Y; Qiu, F B; Zhang, S; Yang, J Y; Cui, Z J
Objective: To clarify the clinicopathologic features of hepatocellular carcinoma (HCC) patients survived more than 10 years after radical hepatectomy. Methods: Two hundreds and fifty-two patients who underwent curative resection for HCC between January 1999 and March 2006 at Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qingdao University were included.There were 217 male cases and 35 female cases aging from 17 to 82 years with median age of (53.8±10.5)years. Followed by March 31 2016, clinicopathologic factors in 10-year survivors and patients who died within 10 years were compared by χ(2) test, Kaplan-Meier survival analysis and Cox proportional hazards model and the prognostic factors affecting survival were identified. Results: All patients were followed-up for 4.0 to 205.7 months with median time of 53.4 months. The 10-year overall survival rate was 26%, there were 62 cases(26.2%) who survived for more than 10 years after initial hepatectomy. In survival >10-year group, the paitents with ALT<40 U/L, gamma-glutamyl transpeptidase<64 U/L, albumin≥35 g/L, without liver cirrhosis and portal hypertension, Child-Pugh grade A, no blood transfusion, AFP≤20 μg/L, tumor size ≤5.0 cm, single tumor, high differentiation, TNM stage Ⅰ and TACE negative after resection were more than the patients in survival <10-year group (P<0.05). In multivariate analysis, Child-Pugh grade A, the tumor size ≤5.0 cm and TACE negative after resection were favorable independent factors associated with 10-year survival (P<0.05). Conclusion: Based on the results of the study, Child-Pugh grade A, tumor size ≤5.0 cm and TACE negative after resection at initial hepatectomy might be biologically favorable conditions for patients surviving more than 10 years.
Egeberg, Alexander; Khalid, Usman; Gislason, Gunnar Hilmar; Mallbris, Lotus; Skov, Lone; Hansen, Peter Riis
Study Objectives: Psoriasis and sleep apnea are associated with significant morbidity and mortality. Although both diseases have been linked with systemic inflammation, studies on their potential bidirectional association are lacking. We investigate the potential association between psoriasis and sleep apnea. Methods: All Danish citizens age 18 y or older between January 1, 1997 and December 31, 2011 (n = 5,522,190) were linked at individual level in nationwide registries. Incidence rates (IRs) per 10,000 person-years were calculated and incidence rate ratios (IRRs) adjusted for age, sex, socioeconomic status, smoking history, alcohol abuse, medication, and comorbidity were estimated by Poisson regression. Results: There were 53,290, 6,885, 6,348, and 39,908 incident cases of mild psoriasis, severe psoriasis, psoriatic arthritis, and sleep apnea, respectively. IRRs (95% confidence interval) for sleep apnea were 1.30 (1.17–1.44), 1.65 (1.23–2.22), and 1.75 (1.35–2.26) in subjects with mild and severe psoriasis, and psoriatic arthritis, and IRRs for mild and severe psoriasis, and psoriatic arthritis in sleep apnea without continuous positive airway pressure (CPAP) therapy were 1.62 (1.41–1.86), 2.04 (1.47–2.82), and 1.94 (1.34–2.79), respectively. In patients with sleep apnea and CPAP therapy (i.e., severe sleep apnea) the IRRs were 1.82 (1.43–2.33), 3.27 (2.03–5.27), and 5.59 (3.74–8.37), respectively. Conclusions: Psoriasis was associated with increased risk of sleep apnea, and sleep apnea was associated with increased risk of psoriasis. The clinical significance of this bidirectional relationship warrants further study. Citation: Egeberg A, Khalid U, Gislason GH, Mallbris L, Skov L, Hansen PR. Psoriasis and sleep apnea: a Danish nationwide cohort study. J Clin Sleep Med 2016;12(5):663–671. PMID:26715401
Owa, Soichi; Hirayanagi, Noriyuki
In the past 10 years, immersion lithography has been the most effective high volume manufacturing method for the critical layers of semiconductor devices. Thinking of the next 10 years, we can expect continuous improvement on existing 300 mm wafer scanners with better accuracy and throughput to enhance the total output value per input cost. This value productivity, however, can be upgraded also by larger innovations which might happen in optical lithography. In this paper, we will discuss the possibilities and the impossibilities of potential innovation ideas of optical lithography, which are 450 mm wafer, optical maskless, multicolor lithography, and metamaterial.
Baltacioglu, Esra; Guzeldemir, Esra; Sukuroglu, Erkan; Yildiz, Kadriye; Yuva, Pinar; Aydin, Güven; Karacal, Naci
Juvenile hyaline fibromatosis (JHF) is a rare hereditary disease with an autosomal recessive transmission. JHF is characterized by papulonodular skin lesions, osteolytic bone lesions, flexural joint contractures, and gingival hyperplasia and usually diagnosed in infancy or early childhood. JHF is thought to be a disorder of collagen metabolism and characterized by homogenous amorphous eosinophilic material and fibrous tissue. We report the case of a 14-year-old male child with multiple papulonodular skin lesions, progressive flexion contractures of joints, and severe gingival hyperplasia, with a 10-year follow-up. Although the lesions were totally removed thrice during the last 10 years, they recurred rigorously.
Wacholder, Sholom; Rotunno, Melissa
Investigators planning studies within cohorts have many options for choosing an efficient sampling design for genome-wide association and other molecular epidemiology studies. Consideration of person-year and proportional hazards analyses of full cohorts may add further insight into ramifications of different designs. Empirical evidence from genome-wide association studies can supplement intuition and simulations in comparing properties of various case-control designs within cohorts. Additional theoretical and empirical work, justification of sampling choice in publications, and consideration of context and scientific aims can improve designs and, thereby, increase the scientific value and cost effectiveness of future studies.
JORDAN, BETH C.; LOVING, ROSA H.
THE PURPOSES OF THIS STUDY WERE TO DETERMINE THE NEEDS FOR STRENGTHENING THE HOMEMAKING PROGRAM AND FOR PLANNING PROGRAMS TO PREPARE YOUNG WOMEN FOR OCCUPATIONS USING HOME ECONOMICS SKILLS AND KNOWLEDGE. HOME ECONOMICS TEACHERS COMPLETED DATA SHEETS FOR 2,679 OF THE 20,000 10TH GRADE GIRLS IN VIRGINIA SCHOOLS IN 1954-55. QUESTIONNAIRES WERE SENT…
Palmer, Joy A.; Suggate, Jennifer
The research reported here forms part of a major international study entitled "Emergent Environmentalism". The overall purpose of the Emergent Environmentalism research is to investigate the acquisition and development of environmental knowledge, awareness and concern in both adults and young children. This report is of the results of one aspect…
Cameron, Cate M; Spinks, Anneliese B; Osborne, Jodie M; Davey, Tamzyn M; Sipe, Neil; McClure, Roderick J
Objective The aim of the present study was to compare sociodemographic characteristics of children with single versus recurrent episodes of injury and provide contemporary evidence for Australian injury prevention policy development.Methods Participants were identified from the Environments for Healthy Living: Griffith Birth Cohort Study 2006-11 (n=2692). Demographic data were linked to the child's hospital emergency and admissions data from birth to December 2013. Data were dichotomised in two ways: (1) injured or non-injured; and (2) single or recurrent episodes of injury. Multivariate logistic regression was used for analysis.Results The adjusted model identified two factors significantly associated with recurrent episodes of injury in children aged <3 years. Children born to mothers <25 years were almost fourfold more likely to have recurrent episodes of injury compared with children of mothers aged ≥35 years (adjusted odds ratio (aOR)=3.68; 95% confidence interval (CI) 1.44-9.39) and, as a child's age at first injury increased, odds of experiencing recurrent episodes of injury decreased (aOR=0.97; 95% CI 0.94-0.99). No differences were found in sociodemographic characteristics of children aged 3-7 years with single versus recurrent episodes of injury (P>0.1).Conclusion National priorities should include targeted programs addressing the higher odds of recurrent episodes of injury experienced by children aged <3 years with younger mothers or those injured in the first 18 months of life.What is known about the topic? Children who experience recurrent episodes of injury are at greater risk of serious or irrecoverable harm, particularly when repeat trauma occurs in the early years of life.What does the paper add? The present study identifies key factors associated with recurrent episodes of injury in young Australian children. This is imperative to inform evidence-based national injury prevention policy development in line with the recent expiry of the National
Nagendran, Sonali T; Lee, N Grace; Fay, Aaron; Lefebvre, Daniel R; Sutula, Francis C; Freitag, Suzanne K
The authors report their experience with orbital exenteration surgery at one academic institution over a 10-year period and review the literature. This retrospective cohort study monitored outcomes of all patients who underwent orbital exenteration surgery at Massachusetts Eye and Ear Infirmary between January 2003 and January 2013. Patients with no follow-up data or survival data were excluded from the study. The main outcome measures were surgical complications, disease status of surgical margins, need for adjuvant treatment, local recurrence, metastases and survival. 23 patients with malignancy and 2 with mucormycosis met inclusion criteria for the study. Surgical procedures included non-lid sparing total exenteration (44%), lid-sparing total exenteration (32%), non-lid sparing partial exenteration (8%) and lid-sparing partial exenteration (16%). 44% underwent additional extra-orbital procedures. Survival rates were 72% at 1 year, 48% at 3 years, and 37% at 5 years. Of patients with malignancies, 48% had clear margins after exenteration. There was no statistically significant difference in survival between patients with negative surgical margins compared to positive margins (p = 0.12). Mortality was highest in patients with melanoma (85.7%) and lowest in patients with non-squamous cell lid malignancies (0%). Our study suggests that the type of disease has a much greater impact on the survival of patients undergoing exenteration surgery than the type of exenteration surgery or the disease status of surgical margins. Patients with non-squamous cell lid malignancies and localized orbital disease have the best prognosis for tumor eradication from this radical and highly disfiguring surgery.
Chiriac, S; Dissaux, C; Bruant-Rodier, C; Djerada, Z; Bodin, F; François, C
The position of the skin paddle on the breast area is a fundamental element for the breast reconstructions by latissimus dorsi flap and prosthesis implantation. Should, as Millard advocated, to recreate the initial defect and include it in the mastectomy scar or is it better in an additional incision as have others authors. This study compares the long-term morphological results of these two attitudes, with or without additional incision.
Soh, Shu E; Lee, Samuel Shang Ming; Hoon, Sarah Wenli; Tan, Mae Yun; Goh, Anne; Lee, Bee Wah; Shek, Lynette Pei-Chi; Teoh, Oon Hoe; Kwek, Kenneth; Saw, Seang Mei; Godfrey, Keith; Chong, Yap Seng; Gluckman, Peter; van Bever, Hugo Ps
Growing Up in Singapore Towards healthy Outcomes (GUSTO) is Singapore's largest birth cohort study to date. The main aim of GUSTO is to evaluate the role of developmental factors in the early pathways to metabolic compromise. Detailed data is collected for a range of environmental exposures in the parents and offspring, and allergic disorders are among a number of outcomes assessed in infancy and childhood. Under the Allergy domain of GUSTO, this integrated study will describe the epidemiology of allergic manifestations and different phenotypes in the Asian context and help shed light on the association of metabolic disease to allergy. Epigenetic mechanisms and associations with other childhood disorders will also be explored. The aim of this report is to focus on methodology of GUSTO, and to suggest similar approaches (i.e., integrated cohort studies on pediatric allergy) worldwide. Recruitment commenced in 2009 with a cohort of 1,163 pregnant mothers in their first trimester. The mothers and children were followed throughout pregnancy and follow-up will continue until the child reaches 3 years of age. Preliminary results showed that 39.8% of the mothers had a personal history of having at least one allergic disease, which included asthma, eczema and allergic rhinitis. Further data collection and analyses are still ongoing. Allergy is a complex spectrum of disorders with numerous poorly-understood aspects. The ongoing GUSTO cohort study, with its longitudinal design and multi-disciplinary nature, may provide new insights into developmental influences on allergy. As a Singapore-based study, it will be the first integrated allergy cohort in Southeast Asia, of which recruitment started during pregnancy.
Solberg, Øivind; Holmstrøm, Henrik; Landolt, Markus A.; Eskedal, Leif T.; Vollrath, Margarete E.
Objective To assess the level of partner relationship satisfaction among mothers of children with different severity of congenital heart defects (CHD) compared with mothers in the cohort. Methods Mothers of children with mild, moderate, or severe CHD (n = 182) and a cohort of mothers of children without CHD (n = 46,782) from the Norwegian Mother and Child Cohort Study were assessed at 5 time points from pregnancy to 36 months postpartum. A 5-item version of the Relationship Satisfaction scale was used, and relevant covariates were explored. Results The trajectories of relationship satisfaction among mothers of children with varying CHD severity did not differ from the trajectories in the cohort. All women in the cohort experienced decreasing relationship satisfaction from 18 months after delivery up to 36 months after delivery. Conclusions Having a child with CHD, regardless of severity, does not appear to exacerbate the decline in relationship satisfaction. PMID:23792348
Moncada, G; Fernández, E; Mena, K; Martin, J; Vildósola, P; De Oliveira Junior, O B; Estay, J; Mjör, I A; Gordan, V V
The aim of this prospective and blind clinical trial was to assess the effectiveness of sealing localized marginal defects of amalgam restoration that were initially scheduled to be replaced. A cohort of twenty six patients with 60 amalgam restorations (n=44Class I and n=16Class II), that presented marginal defects deviating from ideal (Bravo) according to USPHS criteria, were assigned to either sealing or replacement groups: A: sealing n=20, Replacement n=20, and no treatment (n=20). Two blind examiners evaluated the restorations at baseline (K=0.74) and after ten years (K=0.84) according with USPHS criteria, in four parameters: marginal adaptation (MA), secondary caries (SC), marginal staining (MS) and teeth sensitivity (TS). Multiple comparison of restorations degradation/upgrade was analyzed by Friedman test and the comparisons within groups were performed by Wilcoxon test. After 10 years, 44 restorations were assessed (73.3%), Group A: n=14 and Group B: n=16; and Group C: n=14 sealing and replacement amalgam restorations presented similar level of quality in MA (p=0.76), SC (p=0.25) and TS (p=0.52), while in MS (p=0.007) presented better performance in replacement group after 10-years. Most of the occlusal amalgam restorations with marginal gaps showed similar long term outcomes than the restorations were sealed, replaced, or not treated over a 10-year period. Most of the restorations of the three groups were clinically acceptable, under the studied parameters. All restorations had the tendency to present downgrade/deterioration over time.
Shirmohammadi, Farimah; Wang, Dongbin; Hasheminassab, Sina; Verma, Vishal; Schauer, James J.; Shafer, Martin M.; Sioutas, Constantinos
This study describes on-road measurements of fine particulate matter (PM2.5) using a mobile instrumentation platform to assess the chemical composition and oxidative potential of PM2.5, using the dithiothreitol (DTT) assay, over three representative roadways in the Los Angeles Basin: the I-110 and I-710 freeways, the Wilshire/Sunset boulevards as well as the main campus of the University of Southern California (USC), used as a reference urban background site. Samples were chemically analyzed for elemental carbon (EC), organic carbon (OC), polycyclic aromatic hydrocarbons (PAHs) and 50 elements. The cumulative mass fraction of the measured PAHs was highest on the freeways (0.16 ± 0.01 and 0.15 ± 0.01 ng/μg PM, on I-110 and I-710, respectively); which on average was 3 and 3.3-fold higher than at Wilshire/Sunset and USC site, respectively. Mass fractions of Ba, Cr, Cu, Mn, Ni, Pb, Sb and Zn, tracers of vehicular abrasion, were 3.8 ± 0.8 times higher on both freeways in comparison to Wilshire/Sunset. The observed intrinsic (normalized per PM mass) DTT activity was greatest on freeways, averaging 30.13 ± 3.15 nmol/min mg PM and being roughly 1.9 and 2.1 times higher than the values obtained at Wilshire/Sunset and USC, respectively. Furthermore, comparison of our results with previous on-road and roadside studies conducted in the last decade in Los Angeles indicated an overall reduction in the contribution of carbonaceous species and PAHs (important tracers of exhaust emissions) to PM mass, especially on I-710 freeway with the higher heavy-duty diesel vehicle fraction, indicating the effectiveness of diesel vehicle emissions control policies implemented in recent years in California. In contrast, greater contributions of certain groups of metals and trace elements that are indicators of non-tailpipe emissions compared to previous studies provide evidence on the increasing importance of non-tailpipe emissions to the oxidative potential of on-road PM2.5 as vehicular
Pranjic, Nurka; Bajraktarevic, Amila; Ramic, Enisa
Introduction: embarrassed emotional experience may affect the ability to oncology patient effectively cope with cancer, symptoms and treatment. Distress extends a long period, from common, normal feelings of vulnerability, sadness and fears to problems of PTSD, depression, anxiety, panic, social isolation and the perception of spiritual crisis. The aim of the research is to determine the level of distress and PTSD in cancer patients. Patients and Methods: In a prospective, cohort study cases from 2011- 2014 were included patients with cancer who are treated under the supervision of his chosen family medicine doctor. Including a factor for the participation of patients in the study is that from the moment of diagnosis of malignant disease passed <12 months. The total sample was 174 of the planned 200 (response rate=87%). The subjects were divided into three groups. A key factor in the creation of the group was the time elapsed from the moment of acknowledgment and confirmation of the diagnosis: T1 <14 days, n=56 patients; T2>14 days-<6 months, n=79 patients; T3>6 months n=39 patients. To achieve the set goals of the research was used instruments of 3 questionnaires: Questionnaire on the clinical characteristics of patients with malignant disease, demographic and individual characteristics; questionnaire distress oncology patient–hospital scales of depression and anxiety, HADS scale (Hospital Anxiety and Depression Scale - HADS) and a rapid test for self-assessment of the symptoms of PTSD. Results: Age of patients was 54.63 ± 11:46 years, and the age of the respondents when they were diagnosed with cancer 54.34 ± 11.26 years. The prevalence of distress was a high 76% 82x higher than expected), and PTSD 55%. Predictors of burnout syndrome in cancer patients are all important determinants of malignant disease: the time elapsed since the diagnosis of the disease which determines the clinical status of malignant disease (β=0.280; P=0.001; 95% CI, 0742
Fournial, G; Fourcade, J; Roux, D; Garcia, O; Sauer, M; Glock, Y
Although the predictive factors of postoperative mortality after coronary artery surgery are well known, those predictive of long-term survival have received less attention. This study reviews the outcome of a group of 480 patients between 50 and 65 years of age, operated between 1984 and 1986. The patients were classified in two groups according to the presence or absence of internal mammary artery bypass grafts: Group I (304 patients with saphenous vein bypass grafts alone) and group II (176 patients with an internal mammary artery +/- saphenous vein bypass grafts). The long-term results were assessed according to 3 criteria: isolated cardiac mortality: cardiac mortality associated with a repeat revascularisation procedure and cardiac mortality associated with reoperation or recurrence of angina. Cardiac survival at 10 years was significantly better after internal mammary-LAD bypass: 91.4% (CI 87.1-95.1) than after saphenous vein bypass grafting alone: 79.6% (CI 74.8-84.4) (p = 0.012). Univariate analysis identified the following poor predictive factors: three vessel disease (p = 0.03), preoperative left ventricular dysfunction with an ejection fraction inferior to 45% (p = 0.0001), incomplete revascularisation (p = 0.0003), use of venous bypass graft alone (p < 0.014) and perioperative infarction (p = 0.0254). For each criterion of survival (cardiac isolated or associated with a new revascularisation and/or recurrence of angina), multivariate analysis identified three independent predictive factors of long-term extramortality: not using internal mammary artery-LAD bypass graft, incomplete revascularisation and preoperative hypertension. This study confirms the beneficial effects of internal mammary-LAD artery grafting on long-term survival after coronary artery surgery, and also demonstrates the prejudicial effects of hypertension.
Chou, Yin-Yi; Lai, Kuo-Lung; Chen, Der-Yuan; Lin, Ching-Heng; Chen, Hsin-Hua
Background The risk of periodontitis (PD) is increased in the patient group of rheumatoid arthritis (RA). RA and PD also shared some pathological mechanism. The aim of this study is to investigate the risk of RA associated with PD exposure. Methods and Findings This study identified 3 mutually exclusive cohorts using the 1999–2010 Taiwanese National Health Insurance Research Database (NHIRD) to investigate the association between PD and the risk of incident RA. All patients with PD in 2000 were identified from the database of all enrollees as the PD cohort. From the representative database of 1,000,000 enrollees randomly selected in 2010 (LHID2010), individuals without any periodontal disease (PO) during 1999–2010 were selected as the non-PO cohort. Individuals who were not included in the non-PO cohort and received dental scaling (DS) no more than two times per year during 1999–2010 were selected as the DS cohort from LHID2010. Using cox proportional regression analysis, hazard ratios (HRs) with 95% confidence intervals (Cis) were calculated to quantify the association between PD exposure and RA development. In the three-group comparison using the non-PO cohort as reference, we found that the risk of RA was higher in the PD and DS cohorts (HRs, 1.89 and 1.43; 95% CIs, 1.56–2.29 and 1.09–1.87, respectively). For comparisons between two cohorts, the PD cohort had a higher risk of RA than the non-PO and DS cohorts (HRs, 1.91 and 1.35; 95% CIs, 1.57–2.30 and 1.09–1.67, respectively). Conclusion PD was associated with an increased risk of RA development. PMID:26426533
Lewis, Catherine; Kingdom, Blanche
This article provides a 10-year review by the test developers of the Canadian English Language Benchmark Assessment for Nurses (CELBAN™). From 2004 to 2014, the development, implementation, national administration, and operations of CELBAN and CELBAN-related products and services were the responsibility of the test developers and team at the…
Prideaux, Lee-Ann; Creed, Peter
A review of the first 10 years of the Australian Journal of Career Development identified 26 articles meeting methodological criteria. These topics predominated: cross-sectional analyses, Holland's theory of vocational choice, self-efficacy/self-concept theory, gender issues, and career counseling/career education. A need for an…
Abstract A 10-year-old Thoroughbred mare was presented with a 2.5-week history of headshaking. Based on a thorough physical examination, blood analysis, and a fine needle aspirate of an enlarged thyroid gland, a tentative diagnosis of seasonal idiopathic headshaking was made. Treatment with cyproheptadine was attempted. PMID:15025153
When the author started working with teachers and students on classroom multimedia productions a little over 10 years ago, he had not yet encountered the term "media literacy", nor did he realize he had joined a long standing international movement of media literacy educators. Serendipitous exposure to "old-media" texts by Neil Postman and Noam…
Sears, James T.
This paper provides an overview of the contributions to this special issue in the context of a wider argument about the notion of queering elementary education. When "Queering Elementary Education" was published 10 years ago there was very little writing or research on matters related to primary education, and just finding experienced educators to…
Bates, A. W.
This paper provides an overview of new technologies likely to be widely available within the next 10 years for teaching in Europe. It begins by presenting a framework which draws distinctions between different technologies based on their educational applications, i.e., for teaching or operational purposes, for communicating within or between…
Introduction: Neglected cases of osteomyelitis are not uncommon. We present a case of humerus osteomyelitis neglected for 10 years and presented with a sequestrum protruding out of the arm in the shape of a flowerpot. Such a long duration of neglect and a startling presentation are rare and have implications not only on healthcare but also reflect the socio-economic and cultural fabric of the society. Case Report: 22 year old lady presented with history of bone jutting out of right arm since last 10 years. She had a trivial injury to the arm 10 years back followed by pain and fever. She was treated by local osteopath and ‘registered’ doctors but developed wound over the arm with purulent discharge. On and off treatment with dressing was continued with symptomatic relief but in few weeks bone fragment started protruding out of the wound. The size of bone protruding from the wound increased gradually with on and off history of discharge since 10 years. Clinically a flowerpot shaped sequestrum was seen protruding from the arm. Radiographs showed a defined diaphyseal sequestrum of the humerus with continuity of the bone maintained by new bone formation. Sequestrectomy was done and at one year follow up patient was fine with no recurrence of infection Conclusions: Lack of health infrastructure, ignorance, and other social and cultural factors lead to such bad wounds. Even with such long history a single surgery for debridement and sequestrectomy was all that was needed for healing the patient.
Physical activity, obesity and cardiometabolic risk factors in 9- to 10-year-old UK children of white European, South Asian and black African-Caribbean origin: the Child Heart And health Study in England (CHASE)
Nightingale, C. M.; Rudnicka, A. R.; Sattar, N.; Cook, D. G.; Ekelund, U.; Whincup, P. H.
Aims/hypothesis Physical inactivity is implicated in unfavourable patterns of obesity and cardiometabolic risk in childhood. However, few studies have quantified these associations using objective physical activity measurements in children from different ethnic groups. We examined these associations in UK children of South Asian, black African-Caribbean and white European origin. Methods This was a cross-sectional study of 2,049 primary school children in three UK cities, who had standardised anthropometric measurements, provided fasting blood samples and wore activity monitors for up to 7 days. Data were analysed using multilevel linear regression and allowing for measurement error. Results Overall physical activity levels showed strong inverse graded associations with adiposity markers (particularly sum of skinfold thicknesses), fasting insulin, HOMA insulin resistance, triacylglycerol and C-reactive protein; for an increase of 100 counts of physical activity per min of registered time, levels of these factors were 12.2% (95% CI 10.2–14.1%), 10.2% (95% CI 7.5–12.8%), 10.2% (95% CI 7.5–12.8%), 5.8% (95% CI 4.0–7.5%) and 19.2% (95% CI 13.9–24.2%) lower, respectively. Similar increments in physical activity levels were associated with lower diastolic blood pressure (1.0 mmHg, 95% CI 0.6–1.5 mmHg) and LDL-cholesterol (0.04 mmol/l, 95% CI 0.01–0.07 mmol/l), and higher HDL-cholesterol (0.02 mmol/l, 95% CI 0.01–0.04 mmol/l). Moreover, associations were broadly similar in strength in all ethnic groups. All associations between physical activity and cardiometabolic risk factors were reduced (albeit variably) after adjustment for adiposity. Conclusions/interpretation Objectively measured physical activity correlates at least as well with obesity and cardiometabolic risk factors in South Asian and African-Caribbean children as in white European children, suggesting that efforts to increase activity levels in such groups would have equally beneficial
A Nationwide Study of Campylobacter jejuni and Campylobacter coli Bacteremia in Finland Over a 10-Year Period, 1998–2007, With Special Reference to Clinical Characteristics and Antimicrobial Susceptibility
Lauhio, Anneli; Ellström, Patrik; Rautelin, Hilpi
Background. Campylobacter bacteremia is an uncommon condition, usually diagnosed in elderly and immunocompromised patients. Methods. Blood culture isolates and clinical information were collected for patients with diagnoses of Campylobacter jejuni or Campylobacter coli bacteremia in Finland from 1998 through 2007. Bacterial species were identified by means of polymerase chain reaction analysis, and minimal inhibitory concentrations for ciprofloxacin, clindamycin, doxycycline, erythromycin, gentamicin, meropenem, and metronidazole were determined with an agar dilution method. Medical records and mortality data within 1 year after the bacteremic episode were reviewed. Results. The study included 76 patients (median age, 46 years), for whom bacterial isolates (C. jejuni in 73, C. coli in 3) and clinical information were available. Most patients (70%) had no significant underlying diseases. The majority (82%) of the isolates were susceptible for all antimicrobial agents tested. However, antimicrobial therapy seemed to have only a limited effect, because no differences could be detected between patients with appropriate empirical antimicrobial treatment and those with delayed appropriate, inappropriate, or no antimicrobial therapy, either in the duration of hospitalization (median, 4 days for both groups) or in attributable mortality. The outcome of the infection was severe in 4 patients infected with C. jejuni; 2 died within 30 days, spondylodiscitis developed in 1, and Guillain-Barré syndrome developed in 1. Conclusions. C. jejuni and C. coli bacteremia occurred mainly in moderately young individuals without severe underlying diseases. The bacterial isolates were predominantly susceptible to antimicrobial agents, and the outcome of the disease was typically good, regardless of appropriate or inappropriate antimicrobial treatment given in the hospital. PMID:21921217
Reduction in fluoroquinolone use following introduction of ertapenem into a hospital formulary is associated with improvement in susceptibility of Pseudomonas aeruginosa to group 2 carbapenems: a 10-year study.
Cook, Paul P; Gooch, Michael; Rizzo, Shemra
We examined the effect of the addition of ertapenem to our hospital formulary on the resistance of nosocomial Pseudomonas aeruginosa to group 2 carbapenems (imipenem, meropenem, and doripenem). This was a retrospective, observational study conducted between 1 January 2000 and 31 January 2009 at a large, tertiary-care hospital. Autoregressive integrated moving average (ARIMA) regression models were used to evaluate the effect of ertapenem use on the susceptibility of Pseudomonas aeruginosa to group 2 carbapenems as well as on the use of the group 2 carbapenems, ciprofloxacin, and other antipseudomonal drugs (i.e., tobramycin, cefepime, and piperacillin-tazobactam). Resistance was expressed as a percentage of total isolates as well as the number of carbapenem-resistant bacterial isolates per 10,000 patient days. Pearson correlation was used to assess the relationship between antibiotic use and carbapenem resistance. Following the addition of ertapenem to the formulary, there was a statistically significant decrease in the percentage of Pseudomonas aeruginosa isolates resistant to the group 2 carbapenems (P = 0.003). Group 2 carbapenem use and the number of carbapenem-resistant Pseudomonas aeruginosa isolates per 10,000 patient days did not change significantly over the time period. There was a large decrease in the use of ciprofloxacin (P = 0.0033), and there was a correlation of ciprofloxacin use with the percentage of isolates resistant to the group 2 carbapenems (ρ = 0.47, P = 0.002). We suspect that the improvement in susceptibility of Pseudomonas aeruginosa to group 2 carbapenems was related to a decrease in ciprofloxacin use.
Riis, Anders H; Wise, Lauren A; Hatch, Elizabeth E; Rothman, Kenneth J; Cueto, Heidi T; Sørensen, Henrik Toft
Objective To investigate to what extent alcohol consumption affects female fecundability. Design Prospective cohort study. Setting Denmark, 1 June 2007 to 5 January 2016. Participants 6120 female Danish residents, aged 21-45 years, in a stable relationship with a male partner, who were trying to conceive and not receiving fertility treatment. Main outcome measures Alcohol consumption was self reported as beer (330 mL bottles), red or white wine (120 mL glasses), dessert wine (50 mL glasses), and spirits (20 mL) and categorized in standard servings per week (none, 1-3, 4-7, 8-13, and ≥14). Participants contributed menstrual cycles at risk until the report of pregnancy, start of fertility treatment, loss to follow-up, or end of observation (maximum 12 menstrual cycles). A proportional probability regression model was used to estimate fecundability ratios (cycle specific probability of conception among exposed women divided by that among unexposed women). Results 4210 (69%) participants achieved a pregnancy during follow-up. Median alcohol intake was 2.0 (interquartile range 0-3.5) servings per week. Compared with no alcohol consumption, the adjusted fecundability ratios for alcohol consumption of 1-3, 4-7, 8-13, and 14 or more servings per week were 0.97 (95% confidence interval 0.91 to 1.03), 1.01 (0.93 to 1.10), 1.01 (0.87 to 1.16) and 0.82 (0.60 to 1.12), respectively. Compared with no alcohol intake, the adjusted fecundability ratios for women who consumed only wine (≥3 servings), beer (≥3 servings), or spirits (≥2 servings) were 1.05 (0.91 to1.21), 0.92 (0.65 to 1.29), and 0.85 (0.61 to 1.17), respectively. The data did not distinguish between regular and binge drinking, which may be important if large amounts of alcohol are consumed during the fertile window. Conclusion Consumption of less than 14 servings of alcohol per week seemed to have no discernible effect on fertility. No appreciable difference in fecundability was observed by level of
Little, Mark P; Zablotska, Lydia B; Brenner, Alina V; Lipshultz, Steven E
High-dose ionizing radiation is associated with circulatory disease. Risks from lower-dose fractionated exposures, such as from diagnostic radiation procedures, remain unclear. In this study we aimed to ascertain the relationship between fractionated low-to-medium dose radiation exposure and circulatory disease mortality in a cohort of 13,568 tuberculosis patients in Massachusetts, some with fluoroscopy screenings, between 1916 and 1961 and follow-up until the end of 2002. Analysis of mortality was in relation to cumulative thyroid (cerebrovascular) or lung (all other circulatory disease) radiation dose via Poisson regression. Over the full dose range, there was no overall radiation-related excess risk of death from circulatory disease (n = 3221; excess relative risk/Gy -0.023; 95% CI -0.067, 0.028; p = 0.3574). Risk was somewhat elevated in hypertensive heart disease (n = 89; excess relative risk/Gy 0.357; 95% CI -0.043, 1.030, p = 0.0907) and slightly decreased in ischemic heart disease (n = 1950; excess relative risk/Gy -0.077; 95% CI -0.130, -0.012; p = 0.0211). However, under 0.5 Gy, there was a borderline significant increasing trend for all circulatory disease (excess relative risk/Gy 0.345; 95% CI -0.032, 0.764; p = 0.0743) and for ischemic heart disease (excess relative risk/Gy 0.465; 95% CI, -0.032, 1.034, p = 0.0682). Pneumolobectomy increased radiation-associated risk (excess relative risk/Gy 0.252; 95% CI 0.024, 0.579). Fractionation of dose did not modify excess risk. In summary, we found no evidence of radiation-associated excess circulatory death risk overall, but there are indications of excess circulatory death risk at lower doses (<0.5 Gy). Although consistent with other radiation-exposed groups, the indications of higher risk at lower doses are unusual and should be confirmed against other data.
Hohl, Michael K.
This study directly compares total intrafascial laparoscopic (TAIL™) hysterectomy with vaginal (VH) and abdominal (AH) hysterectomy with regard to safety, operating time and time of convalescence. The study is a prospective cohort study (Canadian Task Force classification II-2), including data from patients of a single university-affiliated teaching institution, admitted between 1997 and 2008 for hysterectomy due to benign uterus pathology. Patient data were collected pre-, intra- and postoperatively and complications documented using a standardised data sheet of a Swiss obstetric and gynaecological study group (Arbeitsgemeinschaft Schweizerische Frauenkliniken, Amlikon/Switzerland). Classification of complications (major complications and minor complications) for all three operation techniques, evaluation of surgeons and comparison of operation times and days of hospitalisation were analysed. 3066 patients were included in this study. 993 patients underwent AH, 642 VH and 1,431 total intrafascial hysterectomy. No statistically significant difference for the operation times comparing the three groups can be demonstrated. The mean hospital stay in the TAIL™ hysterectomy, VH and AH groups is 5.8 ± 2.4, 8.8 ± 4.0 and 10.4 ± 3.9 days, respectively. The postoperative minor complications including infection rates are low in the TAIL™ hysterectomy group (3.8%) when compared with either the AH group (15.3%) or the VH group (11.2%), respectively. The total of minor complications is statistically significant lower for TAIL™ hysterectomy as for AH (O.R. 4.52, CI 3.25–6.31) or VH (O.R. 3.16, CI 2.16–4.62). Major haemorrhage with consecutive reoperation is observed statistically significantly more frequent in the AH group when compared to the TAIL™ hysterectomy group, with an O.R. of 6.13 (CI 3.05–12.62). Overall, major intra- and postoperative complications occur significant more frequently in the AH group (8.6%) when compared to the VH group (3
Made, C; Elmqvist, L-G
Snowboard injuries in a Swedish ski area were evaluated from 1989 to 1999. All injured skiers (alpine, telemark, snowboarders) who sought medical attention at the local Medical Center within 48 h of the accident, were asked to answer an injury form. Physicians assessed and treated the injured skiers. There were a total of 1775 injured skiers; 568 injured snowboarders mean age 19 years. The female/male ratio was 34/66%, the injury rate 3/1000 skier days, three times higher than that of alpine skiers. The skill level of the injured snowboard riders improved during the period. The fall/run ratio of the beginners was higher (1.0) and their risk behavior lower (3.9 on visual analogue scale 1-10) in comparison to the advanced riders (0.4 and 6.6, respectively). Injuries were in 54% located to the upper extremity, 35% were wrist/lower arm injuries. Beginners had significantly higher frequency of lower arm/wrist injuries (46%), than average (32%) and advanced riders (20%). The most frequent single diagnosis was wrist/lower arm fracture (20%). Advanced riders tend to have more head/neck injuries than beginners, 17% vs. 13% (NS). Thus, with elevated skill level the injury pattern changed. For injury prevention, wrist guards and helmets are recommended for snowboard riders.
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A large longitudinal cohort study designed to evaluate the association between children's exposures to environmental agents and health outcomes presents many challenges for exposure monitoring. Exposure of the child must be measured for multiple chemicals through multiple path...
Sutherland, D E; Dunn, D L; Goetz, F C; Kennedy, W; Ramsay, R C; Steffes, M W; Mauer, S M; Gruessner, R; Moudry-Munns, K C; Morel, P
Since our report at the 1984 American Surgical Association meeting of 100 pancreas transplants from 1966 through 1983, another 190 have been performed. The current series, begun in 1978, now numbers 276 cases, and includes 133 nonuremic recipients of pancreas transplants alone (PTA), 46 simultaneous pancreas/kidney transplants (SPK), and 97 pancreas tranplants after a kidney transplant (PAK). Duct management techniques used were free intraperitoneal drainage in 44 cases, duct occlusion in 44, enteric drainage in 89, and bladder drainage in 128. The 1-year patient and graft survival rates in the entire cohort of 276 were 91% and 42%. One-year patient survival rates were 88% in the first 100, 91% in the second 100, and 92% in the last 76 cases; corresponding 1-year graft survival rates were 28%, 47%, and 56% (p less than 0.05). A prospective comparison of bladder drainage (n = 82) versus enteric drainage (n = 46) in PAK/PTA cases since November 1, 1984 favored bladder drainage (1-year graft survival rates of 52% vs. 41%) because of urinary amylase monitoring. The best results were in recipients of primary SPK bladder-drained transplants (n = 39), with a 1-year pancreas graft survival rate of 75%, kidney graft survival rate of 80%, and patient survival rate of 95%. Logistic regression analysis, with 1-year graft function as the independent variable, showed significant (p less than 0.05) predictors of success (odds ratio) to be technique: bladder drainage (5.8) versus enteric drainage (2.5) versus duct injection (1.0); category: SPK (6.0) versus PAK from same donor (3.2) versus PAK from different donor (1.2) versus PTA (1.0); and donor HLA DR mismatch: 0 (5.0) versus 1 (2.5) versus 2 (1.0) antigens. On April 1, 1989, 90 patients had functioning grafts (60 euglycemic and insulin-free for more than 1 year, 10 for 5 to 10 years); these, along with 24 others whose grafts functioned for 1 to 6 years before failing, are part of an expanding cohort in whom the influence of
Karam, Vincent; Sebagh, Mylène; Rifai, Kinan; Yilmaz, Funda; Bhangui, Prashant; Danet, Colette; Saliba, Faouzi; Samuel, Didier; Castaing, Denis; Adam, René; Feray, Cyrille
AIM To evaluate the relationship between the state of transplanted liver graft and the recipient quality of life (QOL) of histologically proven lesions in a 10-year post liver transplantation (LT) cohort of patients. METHODS Seventy-two recipients with a functional first graft at 10 years post-LT underwent liver biopsy and completed a QOL questionnaire. Logistic regression analysis was used to explore associations between histological, clinical and QOL criteria. RESULTS Ten years after LT, fibrosis was detected in 53% of patients, and affected the general health perception, while ductopenia, present in 36%, affected the well-being (P = 0.05). Hepatic steatosis (HS) was present in 33% of patients and was associated with the worst QOL score on multiple domains. When compared to patients without HS, patients with HS had significantly higher incidence of fibrosis (P = 0.03), hepatitis C virus (HCV) infection (P = 0.007), and more patients had retired from their job (P = 0.03). Recurrent or de novo HCV-associated fibrosis and patient retirement as objective variables, and abdominal pain or discomfort and joint aches or pains as subjective variables, emerged as independent determinants of HS. CONCLUSION Long-term liver graft lesions, mainly HS presumably as a surrogate marker of HCV infection, may have a substantial impact on QOL 10 years after LT. PMID:28058221
Moroni, Samanta; Moscatelli, Guillermo; Bournissen, Facundo García; González, Nicolás; Ballering, Griselda; Freilij, Héctor; Salgueiro, Fabián; Altcheh, Jaime
Introduction Cystic echinococcosis is endemic in Argentina. The standard pharmacological treatment for the disease is albendazole, but surgery is a common alternative. Even though primary infection occurs mainly in the pediatric population, the optimal therapeutic option in pediatrics is not clearly defined and few pediatric cohorts with cystic echinococcosis treated with albendazole have been described to date. Objective To describe therapeutic response to albendazole in a cohort of pediatric patients with abdominal cystic echinococcosis. Population and Methods Patients (0–18 years old) with abdominal cystic echinococcosis who were treated with albendazole between January 1998 and August 2013. Diagnosis of abdominal cystic echinococcosis was made by ultrasound. All patients received albendazole, 10–15 mg/kg/day. Epidemiological data, symptoms, number, location and outcome of the cysts, serology and treatment received were analyzed. The parameter used to assess treatment response was cyst changes evaluated by ultrasound follow up using the WHO-IWGE classification. Results A total of 28 patients (with 46 abdominal cysts) were included in the cohort. Mean age at enrolment was 9.4 years and mean duration of follow-up, 23.8 months. All patients resided in rural areas and had had contact with dogs. The asymptomatic form of the disease was the most common presentation. All patients received albendazole (mean duration: 142.5 days), with low incidence of adverse events. Albendazole had a positive effect on most of the cysts. Surgery was performed in 13 patients. Conclusion Treatment with albendazole for uncomplicated cystic echinococcosis cysts is safe and effective, and can potentially reduce the need for surgical intervention. PMID:27589236
Zhu, Wei; Wu, Yan; Meng, Yi-Fang; Xing, Qian; Tao, Jian-Jun; Lu, Jiong
The association between fish consumption and risk of age-related macular degeneration (AMD) is still unclear. The aim of the current meta-analysis and systematic review was to quantitatively evaluate findings from observational studies on fish consumption and the risk of AMD. Relevant studies were identified by searching electronic databases (Medline and EMBASE) and reviewing the reference lists of relevant articles up to August, 2016. Prospective cohort studies that reported relative risks (RRs) and 95% confidence intervals (CIs) for the link between fish consumption and risk of AMD were included. A total of 4202 cases with 128,988 individuals from eight cohort studies were identified in the current meta-analysis. The meta-analyzed RR was 0.76 (95% CI, 0.65–0.90) when any AMD was considered. Subgroup analyses by AMD stages showed that fish consumption would reduce the risk of both early (RR, 0.83; 95% CI, 0.72–0.96) and late (RR; 0.76; 95% CI, 0.60–0.97) AMD. When stratified by the follow-up duration, fish consumption was a protective factor of AMD in both over 10 years (n = 5; RR, 0.81; 95% CI, 0.67–0.97) and less than 10 years (n = 3; RR, 0.70; 95% CI, 0.51 to 0.97) follow-up duration. Stratified analyses by fish type demonstrated that dark meat fish (RR, 0.68, 95% CI, 0.46–0.99), especially tuna fish (RR, 0.58; 95% CI, 95% CI, 0.47–0.71) intake was associated with reduced AMD risk. Evidence of a linear association between dose of fish consumption and risk of AMD was demonstrated. The results of this meta-analysis demonstrated that fish consumption can reduce AMD risk. Advanced, well-designed, randomized clinical trials are required in order to validate the conclusions in this study. PMID:27879656
Poulain, Tanja; Baber, Ronny; Vogel, Mandy; Pietzner, Diana; Kirsten, Toralf; Jurkutat, Anne; Hiemisch, Andreas; Hilbert, Anja; Kratzsch, Jürgen; Thiery, Joachim; Fuchs, Michael; Hirsch, Christian; Rauscher, Franziska G; Loeffler, Markus; Körner, Antje; Nüchter, Matthias; Kiess, Wieland
The LIFE Child study is a large population-based longitudinal childhood cohort study conducted in the city of Leipzig, Germany. As a part of LIFE, a research project conducted at the Leipzig Research Center for Civilization Diseases, it aims to monitor healthy child development from birth to adulthood and to understand the development of lifestyle diseases such as obesity. The study consists of three interrelated cohorts; the birth cohort, the health cohort, and the obesity cohort. Depending on age and cohort, the comprehensive study program comprises different medical, psychological, and sociodemographic assessments as well as the collection of biological samples. Optimal data acquisition, process management, and data analysis are guaranteed by a professional team of physicians, certified study assistants, quality managers, scientists and statisticians. Due to the high popularity of the study, more than 3000 children have already participated until the end of 2015, and two-thirds of them participate continuously. The large quantity of acquired data allows LIFE Child to gain profound knowledge on the development of children growing up in the twenty-first century. This article reports the number of available and analyzable data and demonstrates the high relevance and potential of the study.
Bhama, Prabhat K; Weinberg, Julie S; Lindsay, Robin W; Hohman, Marc H; Cheney, Mack L; Hadlock, Tessa A
IMPORTANCE Objective assessment of smile outcome after microvascular free gracilis transfer is challenging, and quantification of smile outcomes in the literature is inconsistent. OBJECTIVE To report objective excursion and symmetry outcomes from a series of free gracilis cases and investigate the predictive value of intraoperative measurements on final outcomes. DESIGN, SETTING, AND PARTICIPANTS A retrospective medical chart review was undertaken of all patients who underwent microvascular free gracilis transfer for smile at our institution over the past 10 years. MAIN OUTCOMES AND MEASURES Outcome measures included the following: smile excursion, angle of smile with respect to the vertical midline, and facial symmetry during repose and with smile. Measurements were obtained using an automated tool for assessment of facial landmarks (FACE-Gram). An exhaustive set of intraoperative parameters including degree of recoil of the gracilis muscle following harvest, the degree to which the muscle foreshortened during stimulation of the obturator nerve, final stretched length of the inset muscle, surgeon assessment of neurorrhaphy and pulse pressure, ischemia time, number of sutures used during neurorrhaphy, nerve used to innervate the flap, and surgeon assessment of oral commissure overcorrection were recorded and placed into a linear regression model to investigate correlations with smile. RESULTS From March 2003 to March 2013, 154 microvascular free gracilis transfers were performed for facial reanimation at our institution, 14 (9%) of which were deemed failures. Of the remaining 140 flaps, 127 fulfilled inclusion criteria and constituted the study cohort. Smile excursion, angle excursion, and symmetry of the oral commissure at repose and with smile all improved following gracilis free flap (P < .05). Associations between selected outcomes measures and intraoperative gracilis measurements were identified. CONCLUSIONS AND RELEVANCE Facial reanimation using free
Sugiura, Minoru; Nakamura, Mieko; Ogawa, Kazunori; Ikoma, Yoshinori; Yano, Masamichi
Recent epidemiological studies show the association of carotenoids with the metabolic syndrome (MetS), but thorough longitudinal cohort studies regarding this association have not been well conducted. The objective of this study was to investigate longitudinally whether serum carotenoids are associated with the risk of developing the MetS and its components in Japanese subjects. We conducted a follow-up study on 1073 men and women aged 30-79 years at the baseline from the Mikkabi prospective cohort study. Those who participated in the baseline and completed follow-up surveys were examined longitudinally. Over the 10-year period, 910 subjects (295 men and 615 women) took part in the follow-up survey at least once. Over a mean follow-up period of 7·8 (sd 2·9) years, thirty-six men and thirty-one women developed new MetS. After adjustments for confounders, the hazard ratio (HR) for the MetS in the highest tertile of serum β-carotene against the lowest tertile was 0·47 (95 % CI 0·23, 0·95). On the other hand, significantly lower risks for dyslipidaemia were observed in the highest tertiles of serum α- and β-carotene and β-cryptoxanthin (HR 0·66; 95 % CI 0·46, 0·96; HR, 0·54; 95 % CI 0·37, 0·79; and HR 0·66; 95 % CI 0·44, 0·99, respectively). Other significant associations between the risks for obesity, high blood pressure and hyperglycaemia with serum carotenoids were not observed. Our results further support the hypothesis that eating a diet rich in carotenoids might help prevent the development of the MetS and its complications in Japanese subjects.
Rahu, Kaja; Bromet, Evelyn J; Hakulinen, Timo; Auvinen, Anssi; Uusküla, Anneli; Rahu, Mati
Objective To examine non-cancer morbidity in the Estonian Chernobyl cleanup workers cohort compared with the population sample with special attention to radiation-related diseases and mental health disorders. Design Register-based cohort study. Setting Estonia. Participants An exposed cohort of 3680 men (cleanup workers) and an unexposed cohort of 7631 men (population sample) were followed from 2004 to 2012 through the Population Registry and Health Insurance Fund database. Methods Morbidity in the exposed cohort compared with the unexposed controls was estimated in terms of rate ratio (RR) with 95% CIs using Poisson regression models. Results Elevated morbidity in the exposed cohort was found for diseases of the nervous system, digestive system, musculoskeletal system, ischaemic heart disease and for external causes. The most salient excess risk was observed for thyroid diseases (RR=1.69; 95% CI 1.38 to 2.07), intentional self-harm (RR=1.47; 95% CI 1.04 to 2.09) and selected alcohol-related diagnoses (RR=1.25; 95% CI 1.12 to 1.39). No increase in morbidity for stress reactions, depression, headaches or sleep disorders was detected. Conclusions No obvious excess morbidity consistent with biological effects of radiation was seen in the exposed cohort, with the possible exception of benign thyroid diseases. Increased alcohol-induced morbidity may reflect alcohol abuse, and could underlie some of the higher morbidity rates. Mental disorders in the exposed cohort were probably under-reported. The future challenge will be to study mental and physical comorbidities in the Chernobyl cleanup workers cohort. PMID:24833681
Bhardwaj, Bindu; Sharma, Sunil; Agarwal, Prateek; Bhamboo, Amit; Rastogi, Komal
Dentigerous cyst is the most common odontogenic cyst. It is characterized by a unilocular radiolucent lesion that encloses permanent tooth buds or, under certain circumstances, displaced tooth buds. Buccal bony expansion and a missing tooth is the most common clinical feature. Various treatment modalities have been mentioned in the literature for management of dentigerous cysts. This article presents a left mandibular dentigerous cyst in a 10-year-old boy. Marsupialization was the treatment of choice and a denturelike space maintainer was provided. Long-term follow-up revealed good healing of the bony lesion. How to cite this article Bhardwaj B, Sharma S, Chitlangia P, Agarwal P, Bhamboo A, Rastogi K. Mandibular Dentigerous Cyst in a 10-Year-Old Child. Int J Clin Pediatr Dent 2016;9(3): 281-284. PMID:27843264
Over the past 10 years, the development and convergence of microbial opsin engineering, modular genetic methods for cell-type targeting and optical strategies for guiding light through tissue have enabled versatile optical control of defined cells in living systems, defining modern optogenetics. Despite widespread recognition of the importance of spatiotemporally precise causal control over cellular signaling, for nearly the first half (2005–2009) of this 10-year period, as optogenetics was being created, there were difficulties in implementation, few publications and limited biological findings. In contrast, the ensuing years have witnessed a substantial acceleration in the application domain, with the publication of thousands of discoveries and insights into the function of nervous systems and beyond. This Historical Commentary reflects on the scientific landscape of this decade-long transition. PMID:26308982
Ryan, Aisling M; Bermingham, Niamh; Harrington, Hugh J; Keohane, Catherine
Macrophagic myofasciitis (MMF) is an uncommon inflammatory disorder of muscle believed to be due to persistence of vaccine-derived aluminium hydroxide at the site of injection. The condition is characterised by diffuse myalgias, arthralgia and fatigue. We describe a patient with histologically confirmed MMF whose presentation was atypical with left chest and upper limb pain beginning more than 10 years post vaccination. Treatment with steroids led to symptomatic improvement. Although rare, clinicians should consider MMF in cases of atypical myalgia.
Estevan Solano, J M; García-Cosío, J; Rodríguez, E; Barreiro, A; Maynar, M
Authors present their experiences during 10 years (1980-89) with the treatment of peripheral arteriopathies with the ATP. Between a total of 455 procedures, an accumulative permeability of 82% in the iliac sector and 71% in the femoro-popliteal sector in elective indications was reached. The total availability of this therapeutic method, the accurate selection of indications and the valious cooperation between Angioradiology and Vascular Surgery Departments should be noted.
Edgington, S. G.; Spilker, L. J.; Altobelli, N.
After 10 years in orbit, the Cassini-Huygens Mission to Saturn, a collaboration of NASA, ESA, and ASI, continues to wow the imagination. Every year Cassini produces answers to questions raised by the Voyager flybys, while at the same time posing new questions that can only be answered with a long duration mission using a flagship-class spacecraft. In this talk, we sample a few of Cassini's discoveries from the past decade and give an overview of what comes next.
Park, Tai Sun; Lee, Jae Seung; Seo, Joon Beom; Hong, Yoonki; Yoo, Jung-Wan; Kang, Byung Ju; Lee, Sei Won; Oh, Yeon-Mok
Background The Korean Obstructive Lung Disease (KOLD) Cohort Study is a prospective longitudinal study of patients with chronic obstructive pulmonary disease (COPD), asthma, or other unclassified obstructive lung diseases. It was designed to develop new classification models and biomarkers that predict clinically relevant outcomes for patients with obstructive lung diseases. Methods Patients over 18 years old who have chronic respiratory symptoms and airflow limitations or bronchial hyper-responsiveness were enrolled at 17 centers in South Korea. After a baseline visit, the subjects were followed up every 3 months for various assessments. Results From June 2005 to October 2013, a total of 477 subjects (433 [91%] males; 381 [80%] diagnosed with COPD) were enrolled. Analyses of the KOLD Cohort Study identified distinct phenotypes in patients with COPD, and predictors of therapeutic responses and exacerbations as well as the factors related to pulmonary hypertension in COPD. In addition, several genotypes were associated with radiological phenotypes and therapeutic responses among Korean COPD patients. Conclusion The KOLD Cohort Study is one of the leading long-term prospective longitudinal studies investigating heterogeneity of the COPD and is expected to provide new insights for pathogenesis and the long-term progression of COPD. PMID:24851130
LaVange, Lisa M.; Kalsbeek, William; Sorlie, Paul D.; Avilés-Santa, Larissa M.; Kaplan, Robert C.; Barnhart, Janice; Liu, Kiang; Giachello, Aida; Lee, David J.; Ryan, John; Criqui, Michael H.; Elder, John P.
PURPOSE The Hispanic Community Health Study (HCHS)/Study of Latinos (SOL) is a multi-center, community based cohort study of Hispanic/Latino adults in the United States. A diverse participant sample is required that is both representative of the target population and likely to remain engaged throughout follow-up. The choice of sample design, its rationale, and benefits and challenges of design decisions are described in this paper. METHODS The study design calls for recruitment and follow-up of a cohort of 16,000 Hispanics/Latinos aged 18-74 years, with 62.5% (10,000) over 44 years of age and adequate subgroup sample sizes to support inference by Hispanic/Latino background. Participants are recruited in community areas surrounding four field centers in the Bronx, Chicago, Miami, and San Diego. A two-stage area probability sample of households is selected with stratification and over-sampling incorporated at each stage to provide a broadly diverse sample, offer efficiencies in field operations, and ensure that the target age distribution is obtained. CONCLUSIONS Embedding probability sampling within this traditional, multi-site cohort study design enables competing research objectives to be met. However, the use of probability sampling requires developing solutions to some unique challenges in both sample selection and recruitment, as described here. PMID:20609344
Graybeal, J.; Gayanilo, F.; Rueda-Velasquez, C. A.
The Marine Metadata Interoperability project (http://marinemetadata.org) held its public opening at AGU's 2004 Fall Meeting. For 10 years since that debut, the MMI guidance and vocabulary sites have served over 100,000 visitors, with 525 community members and continuous Steering Committee leadership. Originally funded by the National Science Foundation, over the years multiple organizations have supported the MMI mission: "Our goal is to support collaborative research in the marine science domain, by simplifying the incredibly complex world of metadata into specific, straightforward guidance. MMI encourages scientists and data managers at all levels to apply good metadata practices from the start of a project, by providing the best guidance and resources for data management, and developing advanced metadata tools and services needed by the community." Now hosted by the Harte Research Institute at Texas A&M University at Corpus Christi, MMI continues to provide guidance and services to the community, and is planning for marine science and technology needs for the next 10 years. In this presentation we will highlight our major accomplishments, describe our recent achievements and imminent goals, and propose a vision for improving marine data interoperability for the next 10 years, including Ontology Registry and Repository (http://mmisw.org/orr) advancements and applications (http://mmisw.org/cfsn).
Twedt, D.J.; Wilson, R.R.; Henne-Kerr, J.L.; Grosshuesch, D.A.
Bttomland hardwood forests were planted on agricultural fields in Mississippi and Louisiana using either predominantly Quercus species (oaks) or Populus deltoides (eastern cottonwood). We assessed avian colonization of these reforested sites between 2 and 10 years after planting. Rapid vertical growth of cottonwoods (circa 2 - 3 m / yr) resulted in sites with forest structure that supported greater species richness of breeding birds, increased Shannon diversity indices, and supported greater territory densities than on sites planted with slower-growing oak species. Grassland birds (Spiza americana [Dickcissel], and Sturnella magna [Eastern Meadowlark]) were indicative of species breeding on oak-dominated reforestation # 10 years old. Agelaius phoeniceus (Red-winged Blackbird) and Colinus virginianus (Northern Bobwhite) characterized cottonwood reforestation # 4 years old, whereas 14 species of shrub-scrub birds (e.g., Passerina cyanea [Indigo Bunting]) and early-successional forest birds (e.g., Vireo gilvus [Warbling Vireo]) typified cottonwood reforestation 5 to 9 years after planting. Rates of daily nest survival did not differ between reforestation strategies. Nest parasitism increased markedly in older cottonwood stands, but was overwhelmed by predation as a cause of nest failure. Based on Partners in Flight prioritization scores and territory densities, the value of cottonwood reforestation for avian conservation was significantly greater than that of oak reforestation during their first 10 years. Because of benefits conferred on breeding birds, we recommend reforestation of bottomland hardwoods include a high proportion of fast-growing, early successional species such as cottonwood.
). This session will examine what was accomplished during GLOBE's first 10 years as a Federal program, what challenges the Program faces, and what plans are afoot for GLOBE's next ten years under UCAR's leadership.
Kalinjuma, Aneth Vedastus; Furrer, Hansjakob; Hatz, Christoph; Tanner, Marcel; Battegay, Manuel; Letang, Emilio
Introduction Scarce data are available on the epidemiology of hypertension among HIV patients in rural sub-Saharan Africa. We explored the prevalence, incidence and risk factors for incident hypertension among patients who were enrolled in a rural HIV cohort in Tanzania. Methods Prospective longitudinal study including HIV patients enrolled in the Kilombero and Ulanga Antiretroviral Cohort between 2013 and 2015. Non-ART naïve subjects at baseline and pregnant women during follow-up were excluded from the analysis. Incident hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg on two consecutive visits. Cox proportional hazards models were used to assess the association of baseline characteristics and incident hypertension. Results Among 955 ART-naïve, eligible subjects, 111 (11.6%) were hypertensive at recruitment. Ten women were excluded due to pregnancy. The remaining 834 individuals contributed 7967 person-months to follow-up (median 231 days, IQR 119–421) and 80 (9.6%) of them developed hypertension during a median follow-up of 144 days from time of enrolment into the cohort [incidence rate 120.0 cases/1000 person-years, 95% confidence interval (CI) 97.2–150.0]. ART was started in 630 (75.5%) patients, with a median follow-up on ART of 7 months (IQR 4–14). Cox regression models identified age [adjusted hazard ratio (aHR) 1.34 per 10 years increase, 95% CI 1.07–1.68, p = 0.010], body mass index (aHR per 5 kg/m2 1.45, 95% CI 1.07–1.99, p = 0.018) and estimated glomerular filtration rate (aHR < 60 versus ≥ 60 ml/min/1.73 m2 3.79, 95% CI 1.60–8.99, p = 0.003) as independent risk factors for hypertension development. Conclusions The prevalence and incidence of hypertension were high in our cohort. Traditional cardiovascular risk factors predicted incident hypertension, but no association was observed with immunological or ART status. These data support the implementation of routine hypertension
Al-Rubeaan, Khalid; Al Derwish, Mohammad; Ouizi, Samir; Youssef, Amira M.; Subhani, Shazia N.; Ibrahim, Heba M.; Alamri, Bader N.
Background Foot complications are considered to be a serious consequence of diabetes mellitus, posing a major medical and economical threat. Identifying the extent of this problem and its risk factors will enable health providers to set up better prevention programs. Saudi National Diabetes Registry (SNDR), being a large database source, would be the best tool to evaluate this problem. Methods This is a cross-sectional study of a cohort of 62,681 patients aged ≥25 years from SNDR database, selected for studying foot complications associated with diabetes and related risk factors. Results The overall prevalence of diabetic foot complications was 3.3% with 95% confidence interval (95% CI) of (3.16%–3.44%), whilst the prevalences of foot ulcer, gangrene, and amputations were 2.05% (1.94%–2.16%), 0.19% (0.16%–0.22%), and 1.06% (0.98%–1.14%), respectively. The prevalence of foot complications increased with age and diabetes duration predominantly amongst the male patients. Diabetic foot is more commonly seen among type 2 patients, although it is more prevalent among type 1 diabetic patients. The Univariate analysis showed Charcot joints, peripheral vascular disease (PVD), neuropathy, diabetes duration ≥10 years, insulin use, retinopathy, nephropathy, age ≥45 years, cerebral vascular disease (CVD), poor glycemic control, coronary artery disease (CAD), male gender, smoking, and hypertension to be significant risk factors with odds ratio and 95% CI at 42.53 (18.16–99.62), 14.47 (8.99–23.31), 12.06 (10.54–13.80), 7.22 (6.10–8.55), 4.69 (4.28–5.14), 4.45 (4.05–4.89), 2.88 (2.43–3.40), 2.81 (2.31–3.43), 2.24 (1.98–2.45), 2.02 (1.84–2.22), 1.54 (1.29–1.83), and 1.51 (1.38–1.65), respectively. Conclusions Risk factors for diabetic foot complications are highly prevalent; they have put these complications at a higher rate and warrant primary and secondary prevention programs to minimize morbidity and mortality in addition to economic impact
Given the growing recognition of the importance of the life course approach for the determination of chronic diseases, birth cohort studies are becoming increasingly important. This paper describes the methods used in the 1982 Pelotas (Brazil) birth cohort study, one of the largest and longest studies of this type in developing countries. All 5,914 hospital births occurring in Pelotas in 1982 (over 99% of all deliveries) were studied prospectively. The main stages of the study took place in 1983, 1984, 1986, 1995, 1997, 2000, and 2001. More than two thousand variables are available for each subject who participated in all stages of the study. Recent phases of the study included the examination of 2,250 males when presenting for the army recruitment exam in 2000, the study of a 27% sample of men and women in 2001 through household visits, and the study of over 400 children born to the cohort women. Follow-up rates in the recent stages of the cohort were 78.9% for the army examination and 69.0% for the household visits. Ethnographic and oral health studies were conducted in sub-samples. Some recent results on blood pressure, adolescent pregnancy, and asthma are presented as examples of utilization of the data. Suggestions on lessons learned for other cohort studies are proposed. PMID:14666206
Charvat, Jacqueline M.; Lee, Stuart M. C.; Davenport, Eddie; Barlow, Carolyn E.; Radford, Nina B.; De Fina, Laura F.; Stenger, Michael B.; Van Baalen, Mary
Acute effects of spaceflight on the cardiovascular system have been studied extensively, but the combined chronic effects of spaceflight and aging are not well understood. Preparation for and participation in space flight activities are potentially associated with cardiovascular disease risk factors (e.g., altered dietary and exercise habits, physical and emotional stress, circadian shifts, radiation). Further, astronauts who travel into space multiple times may be at an increased risk across their lifespan. However, comparing the risk of cardiovascular disease in astronauts to other large cohorts is difficult. For example, comparisons between astronauts and large national cohorts, such as the National Health and Nutrition Examination Survey and the National Health Information Survey, are hampered by significant differences in health status between astronauts and the general population, and most of these national studies fail to provide longitudinal data on population health. To address those limitations, NASA's Longitudinal Study of Astronaut Health previously sought to compare the astronauts to a cohort of civil servants employed at the Johnson Space Center. However, differences between the astronauts and civil servants at the beginning of the study, as well as differential follow up, limited the ability to interpret the results. To resolve some of these limitations, two unique cohorts of healthy workers, U.S. Air Force aviators and Cooper Center Longitudinal Study participants, have been identified as potential comparison populations for the astronaut corps. The Air Force cohort was chosen due to similarities in health at selection, screening, and some occupational exposures that Air Force aviators endure, many of which mirror that of the astronaut corps. The Cooper Clinic cohort, a generally healthy prevention cohort, was chosen for the vast array of clinical cardiovascular measures collected in a longitudinal manner complementary to those collected on
ATTARD, Samantha M; HERRING, Amy H; ZHANG, Bing; DU, Shufa; POPKIN, Barry M; GORDON-LARSEN, Penny
Objective Little is known about whether large-scale environmental changes, such as those seen with urbanization, are differentially associated with systolic versus diastolic blood pressure, and whether those changes vary by birth cohort. Methods We used data from the China Health and Nutrition Survey, a population-based cohort study of Chinese adults (n=18,976; ages 18–70y) seen a maximum of 7 times over 1991–2009. We used hierarchical multivariable linear models to simultaneously estimate systolic and diastolic blood pressure as correlated outcomes over time, accounting for their physiologic, time-varying correlation. Main exposure variables were urbanicity, age, and birth cohort. Over 18 years of modernization, median systolic and diastolic blood pressure increased by 10 and 7 mm Hg, respectively. Results Our hierarchical model results suggest greater temporal increases in systolic and particularly diastolic blood pressure at lower versus higher urbanicity. At the same chronological age, for a 10-year difference in birth cohort (i.e., born in 1980s versus 1970s) the adjusted mean diastolic blood pressure was ~3mm Hg higher for the later birth cohort (p<0.001). Pulse pressure (calculated as model-predicted systolic minus diastolic blood pressure) was also higher at low versus high urbanicity. Conclusions These results suggest increased susceptibility of diastolic blood pressure (and thus peripheral vascular resistance) to environmental change, particularly in younger Chinese adults. Because diastolic blood pressure more strongly predicts cardiovascular disease risk in younger adulthood, hypertension-related health burden in China may increase over time. PMID:25668349
Lockwood, M.; Hill, G.W.
The intent of expanding the exploration already begun on the outer continental shelf to the frontier of the EEZ (Exclusive Economic Zone) is to determine the "characteristics' and resource potential of this region. To coordinate this exploration, a Joint Office for Mapping and Research (JOMAR) has been established by the US Geological Survey (in the Department of the Interior) and the National Oceanic and Atmospheric Administration (in the Department of Commerce). JOMAR's main purpose is to help direct and coordinate ongoing and planned seafloor related activities in the EEZ and prepare a 10-year plan for mapping and research. -from Authors
Duffy, Joseph R
Research and practice in the area of motor speech disorders (MSDs) will change in the next 10 years, most likely in evolutionary rather revolutionary ways. We are likely to see an increase in the understanding of the underpinnings of MSDs and refinements in assessment and diagnosis. Management approaches probably will be refined, as will how outcomes are measured. The evidence base for treatment efficacy will grow. Technology and changes in the health care system will have strong and overarching, but not easily predicted, influences. This article provides a broad overview of these and related issues, with some cautious predictions.
Yamada, Kayo; Sakurai, Yoshihiko; Shibata, Mari; Miyagawa, Sachiko; Yoshioka, Akira
We describe a 10-year-old girl who presented with bizarre purpura. Both congenital and autoimmune hemorrhagic disorders were excluded based on her past medical history and physical and laboratory findings. Child abuse was also ruled out as purpura continued to develop after child-family separation. Histologic examination of the skin lesions revealed disruption of collagen fiber bundles. This finding indicated application of external force, leading to a definitive diagnosis of factitious purpura. Although it is very rare in school-age children, the diagnosis of factitious purpura should be included in the differential diagnosis of purpura in children. Histologic analysis of skin biopsies may aid in establishing the diagnosis.
Hong, Kai; Xu, Qing-Quan; Zhao, Yong-Ping; Gu, Yi-Qun; Jiang, Hui; Wang, Xiao-Feng; Zhu, Ji-Chuan
Andrology has a long history in traditional Chinese medicine. There are records of male sexual health, male sexual dysfunction and male infertility from over thousands of years ago. Modern andrology in China had a late start, with the Chinese Andrology Association founded in 1995. Within last decade, andrology in China has grown rapidly. In this review article, we summarized the progress of andrology in last 10 years and outlined the current status of Chinese andrology with a special focus on progress in male erectile dysfunction, prostate diseases, male infertility and male hormonal contraception. PMID:21642997
NASA Administrator Dan Goldin (left) watches as 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA, shakes hands with astronaut Dog Wheelock. Behind Jonathan is his mother, Penny. Jonathan suffers from erythropoietic protoporphyria, a rare condition that makes his body unable to withstand ultraviolet rays. The suit allows him to be outside during the day, which would otherwise be impossible. Jonathan's trip was funded by the Make-A-Wish Foundation and included a visit to Disney World. He and his family were among a dozen VIPs at KSC to view the launch of STS-99.
NASA Administrator Dan Goldin (left) shares a laugh with VIP 10- year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. Behind Goldin is astronaut Doug Wheelock; behind Jonathan is his mother, Penny. Jonathan suffers from erythropoietic protoporphyria, a rare condition that makes his body unable to withstand ultraviolet rays. The suit allows him to be outside during the day, which would otherwise be impossible. Jonathan's trip was funded by the Make-A-Wish Foundation and included a visit to Disney World. He and his family were among a dozen VIPs at KSC to view the launch of STS- 99.
NASA Administrator Dan Goldin (left) shares a light moment during his meeting with 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. Behind Goldin is astronaut Doug Wheelock; behind Jonathan is his mother, Penny. Jonathan suffers from erythropoietic protoporphyria, a rare condition that makes his body unable to withstand ultraviolet rays. The suit allows him to be outside during the day, which would otherwise be impossible. Jonathan's trip was funded by the Make-A-Wish Foundation and included a visit to Disney World. He and his family were among a dozen VIPs at KSC to view the launch of STS-99.
NASA Administrator Dan Goldin (left) listens intently to 10-year- old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. Behind Goldin is astronaut Doug Wheelock; behind Jonathan is his mother, Penny. Jonathan suffers from erythropoietic protoporphyria, a rare condition that makes his body unable to withstand ultraviolet rays. The suit allows him to be outside during the day, which would otherwise be impossible. Jonathan's trip was funded by the Make-A-Wish Foundation and included a visit to Disney World. He and his family were among a dozen VIPs at KSC to view the launch of STS- 99.
Chong, Elaine W; Wang, Yuanyuan; Robman, Liubov D; Aung, Khin Zaw; Makeyeva, Galina A; Giles, Graham G; Graves, Stephen; Cicuttini, Flavia M; Guymer, Robyn H
Osteoarthritis is the leading cause of total hip replacement, accounting for more than 80% of all total hip replacements. Emerging evidence suggests that osteoarthritis has a chronic inflammatory component to its pathogenesis similar to age-related macular degeneration. We evaluated the association between age-related macular degeneration and total hip replacement as proxy for severe osteoarthritis or fractured neck of femur in the Melbourne Collaborative Cohort Study. 20,744 participants had complete data on both age-related macular degeneration assessed from colour fundus photographs taken during 2003-2007 and total hip replacement. Total hip replacements due to hip osteoarthritis and fractured neck of femur during 2001-2011 were identified by linking the cohort records to the Australian Orthopedic Association National Joint Replacement Registry. Logistic regression was used to examine the association between age-related macular degeneration and risk of total hip replacement due to osteoarthritis and fracture separately, adjusted for confounders. There were 791 cases of total hip replacement for osteoarthritis and 102 cases of total hip replacement due to fractured neck of femur. After adjustment for age, sex, body mass index, smoking, and grouped country of birth, intermediate age-related macular degeneration was directly associated with total hip replacement for osteoarthritis (odds ratio 1.22, 95% CI 1.00-1.49). Late age-related macular degeneration was directly associated with total hip replacement due to fractured neck of femur (odds ratio 5.21, 95% CI2.25-12.02). The association between intermediate age-related macular degeneration and an increased 10-year incidence of total hip replacement due to osteoarthritis suggests the possibility of similar inflammatory processes underlying both chronic diseases. The association of late age-related macular degeneration with an increased 10-year incidence of total hip replacement due to fractured neck of femur may be
de Frias, Cindy M; Nilsson, Lars-Göran; Herlitz, Agneta
Sex differences in declarative memory and visuospatial ability are robust in cross-sectional studies. The present longitudinal study examined whether sex differences in cognition were present over a 10-year period, and whether age modified the magnitude of sex differences. Tests assessing episodic and semantic memory, and visuospatial ability were administered to 625 nondemented adults (initially aged 35-80 years), participating in the population-based Betula study at two follow-up occasions. There was stability of sex differences across five age groups and over a 10-year period. Women performed at a higher level than men on episodic recall, face and verbal recognition, and semantic fluency, whereas men performed better than women on a task-assessing, visuospatial ability. Sex differences in cognitive functions are stable over a 10-year period and from 35 to 90 years of age.
Perälä, Mia-Maria; von Bonsdorff, Mikaela; Männistö, Satu; Salonen, Minna K; Simonen, Mika; Kanerva, Noora; Pohjolainen, Pertti; Kajantie, Eero; Rantanen, Taina; Eriksson, Johan G
Epidemiological studies have shown that a number of nutrients are associated with better physical performance. However, little is still known about the role of the whole diet, particularly a healthy Nordic diet, in relation to physical performance. Therefore, we examined whether a healthy Nordic diet was associated with measures of physical performance 10 years later. We studied 1072 participants from the Helsinki Birth Cohort Study. Participants' diet was assessed using a validated 128-item FFQ at the mean age of 61 years, and a priori-defined Nordic diet score (NDS) was calculated. The score included Nordic fruits and berries, vegetables, cereals, PUFA:SFA and trans-fatty acids ratio, low-fat milk, fish, red and processed meat, total fat and alcohol. At the mean age of 71 years, participants' physical performance was measured using the Senior Fitness Test (SFT), and an overall SFT score was calculated. Women in the highest fourth of the NDS had on average 5 points higher SFT score compared with those in the lowest fourth (P for trend 0·005). No such association was observed in men. Women with the highest score had 17% better result in the 6-min walk test, 16% better arm curl and 20% better chair stand results compared with those with the lowest score (all P values<0·01). In conclusion, a healthy Nordic diet was associated with better overall physical performance among women and might help decrease the risk of disability in old age.
A 10-year follow-up of treatment outcomes in patients with early stage breast cancer and clinically negative axillary nodes treated with tangential breast irradiation following sentinel lymph node dissection or axillary clearance.
Wernicke, A Gabriella; Goodman, Robert L; Turner, Bruce C; Komarnicky, Lydia T; Curran, Walter J; Christos, Paul J; Khan, Imraan; Vandris, Katherine; Parashar, Bhupesh; Nori, Dattatreyudu; Chao, K S Clifford
We compare long-term outcomes in patients with node negative early stage breast cancer treated with breast radiotherapy (RT) without the axillary RT field after sentinel lymph node dissection (SLND) or axillary lymph node dissection (ALND). We hypothesize that though tangential RT was delivered to the breast tissue, it at least partially sterilized occult axillary nodal metastases thus providing low nodal failure rates. Between 1995 and 2001, 265 patients with AJCC stages I-II breast cancer were treated with lumpectomy and either SLND (cohort SLND) or SLND and ALND (cohort ALND). Median follow-up was 9.9 years (range 8.3-15.3 years). RT was administered to the whole breast to the median dose of 48.2 Gy (range 46.0-50.4 Gy) plus boost without axillary RT. Chi-square tests were employed in comparing outcomes of two groups for axillary and supraclavicular failure rates, ipsilateral in-breast tumor recurrence (IBTR), distant metastases (DM), and chronic complications. Progression-free survival (PFS) was compared using log-rank test. There were 136/265 (51%) and 129/265 (49%) patients in the SLND and ALND cohorts, respectively. The median number of axillary lymph nodes assessed was 2 (range 1-5) in cohort SLND and 18 (range 7-36) in cohort ALND (P < 0.0001). Incidence of AFR and SFR in both cohorts was 0%. The rates of IBTR and DM in both cohorts were not significantly different. Median PFS in the SLND cohort is 14.6 years and 10-year PFS is 88.2%. Median PFS in the ALND group is 15.0 years and 10-year PFS is 85.7%. At a 10-year follow-up chronic lymphedema occurred in 5/108 (4.6%) and 40/115 (34.8%) in cohorts SLND and ALND, respectively (P = 0.0001). This study provides mature evidence that patients with negative nodes, treated with tangential breast RT and SLND alone, experience low AFR or SFR. Our findings, while awaiting mature long-term data from NSABP B-32, support that in patients with negative axillary nodal status such treatment provides excellent
Fondell, Elinor; O'Reilly, Eilis J; Fitzgerald, Kathryn C; Falcone, Guido J; McCullough, Marjorie L; Park, Yikyung; Kolonel, Laurence N; Ascherio, Alberto
A low magnesium intake has been suggested to be associated with amyotrophic lateral sclerosis (ALS) in pathological and case-control studies, but prospective studies in humans are lacking. The relation between dietary intake of magnesium and ALS risk was explored in five large prospective cohort studies (the Nurses' Health Study, the Health Professionals Follow-up Study, the Cancer Prevention Study II Nutrition Cohort, the Multiethnic Cohort Study, and the National Institutes of Health - AARP Diet and Health Study), comprising over 1,050,000 males and females contributing 1093 cases of ALS during a mean of 15 years of follow-up. Cox proportional hazards models were used within each cohort, and cohort-specific estimates were subsequently pooled using a random-effects model. Results demonstrated that dietary magnesium intake was not associated with ALS risk, relative risk 1.07, 95% confidence interval 0.88 - 1.31 comparing the highest quintile of intake with the lowest. This finding does not support a protective effect of magnesium intake on ALS risk. Further analyses should explore magnesium intake in combination with heavy metal exposure and genetic variants affecting magnesium absorption.
Primo, Neudí Antonio; Gazzola, Vivian Bertoglio; Primo, Bruno Tochetto; Tovo, Maximiano Ferreira; Faraco Junior, Italo Medeiros
Objective This study aimed at describing the profiles of Brazilian and international studies published in orthodontic journals. Methods The sample comprised 635 articles selected from two scientific journals, i.e., Dental Press Journal of Orthodontics and American Journal of Orthodontics and Dentofacial Orthopedics, which were analyzed at three different intervals over a 10-year period (1999 - 2004 - 2009). Articles were described in terms of knowledge domain, study design, and country of origin (or state of origin for Brazilian papers). Results The most frequent study designs adopted in international studies were cohort (23.9%) and cross-sectional (21.7%) designs. Among Brazilian papers, cross-sectional studies (28.9%) and literature reviews (24.6%) showed greater frequency. The topics most often investigated were dental materials (17%) and treatment devices (12.4%) in international articles, with the latter topic being addressed by 16% of the Brazilian publications, followed by malocclusion, with 12.6%. In all cases, the most frequent countries of origin coincided with the countries of origin of each journal. Conclusions The majority of the studies analyzed featured a low level of scientific evidence. Moreover, the findings showed that journals tend to publish studies produced in their own country of origin, and that there are marked discrepancies in the number of papers published by different Brazilian states. PMID:24945515
Kelsen, Judith; Bittinger, Kyle; Pauly-Hubbard, Helen; Posivak, Leah; Grunberg, Stephanie; Baldassano, Robert; Lewis, James D; Wu, Gary D; Bushman, Frederic D
Background Oral manifestations are common in Crohn's disease (CD). Here we characterized the subgingival microbiota in pediatric CD patients initiating therapy and after 8 weeks to identify microbial community features associated with CD and therapy. Methods Pediatric CD patients were recruited from The Children's Hospital of Pennsylvania. Healthy control subjects were recruited from primary care or orthopedics clinic. Subgingival plaque samples were collected at initiation of therapy and after 8 weeks. Treatment exposures included 5-ASAs, immunomodualtors, steroids, and infliximab. The microbiota was characterized by 16S rRNA gene sequencing. The study was repeated in separate discovery (35 CD, 43 healthy) and validation cohorts (43 CD, 31 healthy). Results A majority of subjects in both cohorts demonstrated clinical response after 8 weeks of therapy (discovery cohort 88%, validation cohort 79%). At week 0, both antibiotic exposure and disease state were associated with differences in bacterial community composition. Seventeen genera were identified in the discovery cohort as candidate biomarkers, of which 11 were confirmed in the validation cohort. Capnocytophaga, Rothia, and TM7 were more abundant in CD relative to healthy controls. Other bacteria were reduced in abundance with antibiotic exposure among CD subjects. CD-associated genera were not enriched compared to healthy controls after 8 weeks of therapy. Conclusions Subgingival microbial community structure differed with CD and antibiotic use. Results in the discovery cohort were replicated in a separate validation cohort. Several potentially pathogenic bacterial lineages were associated with CD but were not diminished in abundance by antibiotic treatment, suggesting targets for additional surveillance. PMID:26288001
Yeh, Jun-Jun; Wang, Yu-Chiao; Chen, Jiunn-Horng; Hsu, Wu-Huei
Purpose We conducted a nationwide cohort study to investigate the relationship between systemic lupus erythematosus (SLE) and the risk of incident respiratory failure. Methods From the National Health Insurance Research Database, we identified 11 533 patients newly diagnosed with SLE and 46 132 controls without SLE who were randomly selected through frequency-matching according to age, sex, and index year. Both cohorts were followed until the end of 2011 to measure the incidence of incident respiratory failure, which was compared between the 2 cohorts through a Cox proportional hazards regression analysis. Results The adjusted hazard ratio (aHR) of incident respiratory failure was 5.80 (95% confidence interval [CI] = 5.15–6.52) for the SLE cohort after we adjusted for sex, age, and comorbidities. Both men (aHR = 3.44, 95% CI = 2.67–4.43) and women (aHR = 6.79, 95% CI = 5.93–7.77) had a significantly higher rate of incident respiratory failure in the SLE cohort than in the non-SLE cohort. Both men and women aged <35 years (aHR = 31.2, 95% CI = 21.6–45.2), 35–65 years; (aHR = 6.19, 95% CI = 5.09–7.54) and ≥65 years (aHR = 2.35, 95% CI = 1.92–2.87) had a higher risk of incident respiratory failure in the SLE cohort. Moreover, the risk of incident respiratory failure was higher in the SLE cohort than the non-SLE cohort, for subjects with (aHR = 2.65, 95% CI = 2.22–3.15) or without (aHR = 9.08, 95% CI = 7.72–10.7) pre-existing comorbidities. In the SLE cohort, subjects with >24 outpatient visits and hospitalizations per year had a higher incident respiratory failure risk (aHR = 21.7, 95% CI = 18.0–26.1) compared with the non-SLE cohort. Conclusion Patients with SLE are associated with an increased risk of incident respiratory failure, regardless of their age, sex, and pre-existing comorbidities; especially medical services with higher frequency. PMID:27654828
Real, Jordi; Galindo, Gisela; Galván, Leonardo; Lafarga, María Antonia; Rodrigo, María Dolors; Ortega, Marta
Oral bisphosphonates are first-line drugs in the treatment of osteoporosis under most guidelines, and have been shown to decrease risk of first fracture only in asymptomatic vertebral fractures and in clinical trial populations that are generally very different from the general population. Objective To compare incidence of first osteoporotic fracture in two cohorts of postmenopausal women, one treated with bisphosphonates and the other only with calcium and vitamin D. Design Retrospective population cohort study with paired matching based on data from electronic health records. Setting Women aged 60 years and older in 2005, from 21 primary care centers in a healthcare region of Spain. Participants Two groups of women aged 60 years and older (n = 1208), prescribed either calcium and vitamin D (CalVitD) or bisphosphonates (BIPHOS) with or without calcium and vitamin D, were compared for the end point of first recorded osteoporotic-related fracture, with 5-years follow-up. Main Outcome Measure Incidence of first fracture: Vertebral fracture, osteoporosis with pathological fracture, fracture of the upper humeral epiphysis, fracture of the lower radial epiphysis, or femur fracture. Results Estimated 10-year risk of fracture was 11.4% (95% confidence interval: 9.6 to 13.2), 11.8% (9.2 to 14.3) in the BIPHOS group and 11.1% (8.6 to 13.6) in the CalVitD group. No significant differences were found between groups in total fractures (Hazard ratio = 0.934 (0.67 to 1.31)) or location (vertebral, femoral, radial or humeral). Conclusions In postmenopausal women, bisphosphonates have not been shown to better decrease risk of first fracture compared with calcium and vitamin D therapy alone. PMID:25861000
United States. Bonneville Power Administration.
Two years ago, BPA released its first-ever Operations, Maintenance, and Replacement (OM&R) 10-Year Plan. That effort broke new ground and was an extensive look at the condition of Operations, Maintenance, and Replacement on BPA`s power system. This document -- the 1992 OM&R 10-Year Plan -- uses that original plan as its foundation. It takes a look at how well BPA has accomplished the challenging task set out in the 1990 Plan. The 1992 Plan also introduces the Construction Program. Construction`s critical role in these programs is explored, and the pressures of construction workload -- such as the seasonal nature of the work and the broad swings in workload between projects and years -- are discussed. The document then looks at how situations may have changed with issues explored initially in the 1990 Plan. Importantly, this Plan also surfaces and explains some new issues that threaten to impact BPA`s ability to accomplish its OM&R workload. Finally, the document focuses on the revised strategies for Operations, Maintenance, Replacement, Construction, and Environment for the 1992 to 2001 time period, including the financial and human resources needed to accomplish those strategies.
United States. Bonneville Power Administration.
Two years ago, BPA released its first-ever Operations, Maintenance, and Replacement (OM R) 10-Year Plan. That effort broke new ground and was an extensive look at the condition of Operations, Maintenance, and Replacement on BPA's power system. This document -- the 1992 OM R 10-Year Plan -- uses that original plan as its foundation. It takes a look at how well BPA has accomplished the challenging task set out in the 1990 Plan. The 1992 Plan also introduces the Construction Program. Construction's critical role in these programs is explored, and the pressures of construction workload -- such as the seasonal nature of the work and the broad swings in workload between projects and years -- are discussed. The document then looks at how situations may have changed with issues explored initially in the 1990 Plan. Importantly, this Plan also surfaces and explains some new issues that threaten to impact BPA's ability to accomplish its OM R workload. Finally, the document focuses on the revised strategies for Operations, Maintenance, Replacement, Construction, and Environment for the 1992 to 2001 time period, including the financial and human resources needed to accomplish those strategies.
Kenyon, Katherine H.; Paramasivam, Arjun; Tu, Jiachin; Zhang, Albert; Graham, Alister W.
Expanding upon Pimbblet's 2011 analysis of career h-indices for members of the Astronomical Society of Australia, we provide additional citation metrics which are geared to quantifying the current performance of all professional astronomers in Australia. We have trawled the staff web-pages of Australian Universities, Observatories and Research Organisations hosting professional astronomers, and identified 384 PhD-qualified, research-active, astronomers in the nation. 132 of these are not members of the Astronomical Society of Australia. Using the SAO/NASA Astrophysics Data System, we provide the three following common metrics based on publications in the first decade of the 21st century (2001-2010): h-index, author-normalised citation count and lead-author citation count. We additionally present a somewhat more inclusive analysis, applicable for many early-career researchers, that is based on publications from 2006-2010. Histograms and percentiles, plus top-performer lists, are presented for each category. Finally, building on Hirsch's empirical equation, we find that the (10-year) h-index and (10-year) total citation count T can be approximated by the relation AS12011_IE1.gif for h>~5.
Background Ensuring successful follow-up is essential when conducting a prospective cohort study. Most existing literature reviewing methods to ensure a high response rate is based on experience in developed nations. Findings We report our 4-year follow-up success for a national cohort study examining the health transition underway in Thailand. We began the cohort study in 2005 with a baseline postal questionnaire sent to all 200,000 Thais enrolled as distance learning students at Sukhothai Thammathirat Open University and residing all over Thailand; 87,134 or 44% of the students responded. Subsequently we used University and national media to inform cohort members of study progress. Also, we prepared a health book with study results and health advice which was distributed to all cohort members. After 4 years we repeated the survey and achieved a 71% response rate. In this paper we report the methods used to achieve this response The initial follow-up mail-out generated a response rate of about 48% reflecting the extensive preparatory work between baseline and follow-up. After 4 rounds of telephone contact (more than 100,000 phone calls) and 4 related mail-out rounds progressively over 16 months an overall response rate was achieved of just over 71% (n = 60,774). The total cost was US$4.06/respondent - 19% for printing, 21% for postage, 14% for tape measures (included in mail-out), 18% for data processing 22% for prizes and 6% for telephone. Conclusions Many of the methods reported as effective for mail questionnaire and cohort response rates held true for Thailand. These included being associated with a university, incentivating cooperation, follow-up contact, providing a second copy of questionnaire where necessary, and assurance of confidentiality. Telephone contact with the cohort and the small prizes given to responders were particularly important in the Thai context as was Thai leadership of the research team. PMID:21615963
Morgan, Steven G.; Gladstone, Emilie J.; Weymann, Deirdre; Khan, Nadia
Background: In recent years, some provinces have implemented income-based catastrophic drug coverage in an effort to provide universal drug coverage while limiting government liability for the escalating costs of medicines needed for an aging population. We sought to examine the effects of income-based deductibles under British Columbia's Fair PharmaCare system on older patients' use of cardiovascular medicines in 2013, 10 years after the province's policy change. Methods: Using linked administrative databases, we studied rates of hypertension and cholesterol medication used by 2 cohorts of older, married women who had different levels of public drug subsidy based solely on their spouses' ages. We compare measures of 2013 medication use by study cohorts using statistical models that controlled for age, general health status, indicators of need for specific drug classes, ethnicity, rural residence and household income. Results: Among members of our study cohorts, the odds of filling cardiovascular prescriptions in 2013 were influenced by patient age, general health status, drug-specific diagnoses, ethnicity, place of residence and household income. For women with household incomes less than $50 000 (42% of our study population), having preferential public drug coverage by way of spousal age was associated with a 15% increase in the adjusted odds of filling 1 or more prescription for hypertension treatment (adjusted odds ratio [OR] 1.15, 95% confidence interval [CI] 1.06 to 1.24) and a 13% increase in the adjusted odds of filling 1 or more prescription for cholesterol treatments (adjusted OR 1.13, 95% CI 1.06 to 1.21). There were no statistically significant effects on the number of days of therapy purchased per user of these cardiovascular medicines. Interpretation: We have found that the level of income-based deductibles under catastrophic drug benefi t plans can affect the use of cardiovascular drug treatments, even long after deductibles are put in place. These
Background Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for analyzing jobs. Disorders to analyze included carpal tunnel syndrome, lateral epicondylalgia, medial epicondylalgia, trigger digit, deQuervain’s stenosing tenosynovitis and other tendinoses. Workers have thus far been enrolled from 17 different employment settings in 3 diverse US states and performed widely varying work. At baseline, workers undergo laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of musculoskeletal disorders. Repeat nerve conduction studies are performed for those with symptoms of tingling and numbness in the prior six months. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. Case definitions have been established. Point prevalence of carpal tunnel syndrome is a combination of paraesthesias in at least two median nerve-served digits plus an abnormal nerve conduction study at baseline. The lifetime cumulative incidence of carpal tunnel syndrome will also include those with a past history of carpal tunnel syndrome. Incident cases will exclude those with either a past history or prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion A prospective cohort study of
Johansen, C; Olsen, J H
We report the incidence of cancer in a large cohort of employees identified from all 99 Danish utility companies. Personal data, and information on employment and exposure to magnetic fields and asbestos were obtained from manual files at the companies, the Danish Supplementary Pension Fund and the public payroll administration. A total of 32,006 individuals with more than three months of employment were linked with the files of the Danish Cancer Registry. Overall, 3008 cancers were observed, with 2825 expected, yielding a small but significantly increased risk of 1.06 (95% CI, 1.03-1.10). No excess was observed for all leukemias or for cancers of the brain or breast among men or women. There was no association of electromagnetic field exposure with risk of these cancers even when the level and length of exposure to magnetic fields were taken into account. Increased risks for cancers of the lung and pleural cavity were seen mainly for workers whose jobs involve exposure to asbestos. Our results do not support the hypothesis of an association between occupational exposures to magnetic fields in the electric utility industry and the risk for cancer.
Layton, Deborah; Shakir, Saad A W
The evolving regulatory landscape has heightened the need for innovative, proactive, efficient and more meaningful solutions for 'real-world' post-authorization safety studies (PASS) that not only align with risk management objectives to gather additional safety monitoring information or assess a pattern of drug utilization, but also satisfy key regulatory requirements for marketing authorization holder risk management planning and execution needs. There is a need for data capture across the primary care and secondary care interface, or for exploring use of new medicines in secondary care to support conducting PASS. To fulfil this need, event monitoring has evolved. The Specialist Cohort Event Monitoring (SCEM) study is a new application that enables a cohort of patients prescribed a medicine in the hospital and secondary care settings to be monitored. The method also permits the inclusion of a comparator cohort of patients receiving standard care, or another counterfactual comparator group, to be monitored concurrently, depending on the study question. The approach has been developed in parallel with the new legislative requirement for pharmaceutical companies to undertake a risk management plan as part of post-authorization safety monitoring. SCEM studies recognize that the study population comprises those patients who may have treatment initiated under the care of specialist health care professionals and who are more complex in terms of underlying disease, co-morbidities and concomitant medications than the general disease population treated in primary care. The aims of this paper are to discuss the SCEM new-user study design, rationale and features that aim to address possible bias (such as selection bias) and current applications.
Cardiovascular disease (CVD) is the most common cause of death in patients with chronic kidney disease (CKD). We report the baseline cardiovascular characteristics of 2,238 participants by using the data of the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) study. The cohort comprises 5 subcohorts according to the cause of CKD: glomerulonephritis (GN), diabetic nephropathy (DN), hypertensive nephropathy (HTN), polycystic kidney disease (PKD), and unclassified. The average estimated glomerular filtration rate (eGFR) was 50.5 ± 30.3 mL/min−1/1.73 m−2 and lowest in the DN subcohort. The overall prevalence of previous CVD was 14.4% in all patients, and was highest in the DN followed by that in the HTN subcohort. The DN subcohort had more adverse cardiovascular risk profiles (higher systolic blood pressure [SBP], and higher levels of cardiac troponin T, left ventricular mass index [LVMI], coronary calcium score, and brachial-ankle pulse wave velocity [baPWV]) than the other subcohorts. The HTN subcohort exhibited less severe cardiovascular risk profiles than the DN subcohort, but had more severe cardiovascular risk features than the GN and PKD subcohorts. All these cardiovascular risk profiles were inversely correlated with eGFR. In conclusion, this study shows that the KNOW-CKD cohort exhibits high cardiovascular burden, as other CKD cohorts in previous studies. Among the subcohorts, the DN subcohort had the highest risk for CVD. The ongoing long-term follow-up study up to 10 years will further delineate cardiovascular characteristics and outcomes of each subcohort exposed to different risk profiles. PMID:28049233
Kim, Hyoungnae; Yoo, Tae Hyun; Choi, Kyu Hun; Oh, Kook Hwan; Lee, Joongyub; Kim, Soo Wan; Kim, Tae Hee; Sung, Suah; Han, Seung Hyeok
Cardiovascular disease (CVD) is the most common cause of death in patients with chronic kidney disease (CKD). We report the baseline cardiovascular characteristics of 2,238 participants by using the data of the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) study. The cohort comprises 5 subcohorts according to the cause of CKD: glomerulonephritis (GN), diabetic nephropathy (DN), hypertensive nephropathy (HTN), polycystic kidney disease (PKD), and unclassified. The average estimated glomerular filtration rate (eGFR) was 50.5 ± 30.3 mL/min⁻¹/1.73 m⁻² and lowest in the DN subcohort. The overall prevalence of previous CVD was 14.4% in all patients, and was highest in the DN followed by that in the HTN subcohort. The DN subcohort had more adverse cardiovascular risk profiles (higher systolic blood pressure [SBP], and higher levels of cardiac troponin T, left ventricular mass index [LVMI], coronary calcium score, and brachial-ankle pulse wave velocity [baPWV]) than the other subcohorts. The HTN subcohort exhibited less severe cardiovascular risk profiles than the DN subcohort, but had more severe cardiovascular risk features than the GN and PKD subcohorts. All these cardiovascular risk profiles were inversely correlated with eGFR. In conclusion, this study shows that the KNOW-CKD cohort exhibits high cardiovascular burden, as other CKD cohorts in previous studies. Among the subcohorts, the DN subcohort had the highest risk for CVD. The ongoing long-term follow-up study up to 10 years will further delineate cardiovascular characteristics and outcomes of each subcohort exposed to different risk profiles.
Monrad, Maria; Sajadieh, Ahmad; Christensen, Jeppe Schultz; Ketzel, Matthias; Raaschou-Nielsen, Ole; Tjønneland, Anne; Overvad, Kim; Loft, Steffen; Sørensen, Mette
Background: Atrial fibrillation is the most common sustained arrhythmia and is associated with cardiovascular morbidity and mortality. The few studies conducted on short-term effects of air pollution on episodes of atrial fibrillation indicate a positive association, though not consistently. Objectives: The aim of this study was to evaluate the long-term impact of traffic-related air pollution on incidence of atrial fibrillation in the general population. Methods: In the Danish Diet, Cancer, and Health cohort of 57,053 people 50–64 years old at enrollment in 1993–1997, we identified 2,700 cases of first-ever hospital admission for atrial fibrillation from enrollment to end of follow-up in 2011. For all cohort members, exposure to traffic-related air pollution assessed as nitrogen dioxide (NO2) and nitrogen oxides (NOx) was estimated at all present and past residential addresses from 1984 to 2011 using a validated dispersion model. We used Cox proportional hazard model to estimate associations between long-term residential exposure to NO2 and NOx and risk of atrial fibrillation, after adjusting for lifestyle and socioeconomic position. Results: A 10 μg/m3 higher 10-year time-weighted mean exposure to NO2 preceding diagnosis was associated with an 8% higher risk of atrial fibrillation