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Sample records for 10-year framingham risk

  1. Sheepskin effects of education in the 10-year Framingham risk of coronary heart disease.

    PubMed

    Liu, Sze Yan; Buka, Stephen L; Kubzansky, Laura D; Kawachi, Ichiro; Gilman, Stephen E; Loucks, Eric B

    2013-03-01

    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.

  2. HIGH PREVALENCE OF SUBCLINICAL ATHEROSCLEROSIS BY CAROTID ULTRASOUND AMONG MEXICAN AMERICANS: DISCORDANCE WITH 10-YEAR RISK ASSESSMENT USING THE FRAMINGHAM RISK SCORE

    PubMed Central

    Laing, Susan T.; Smulevitz, Beverly; Vatcheva, Kristina P.; Rentfro, Anne R.; McPherson, David D.; Fisher-Hoch, Susan P.; McCormick, Joseph B.

    2012-01-01

    Background Framingham Risk Scores (FRS) were validated in a mostly Caucasian population. Evaluation of subclinical atherosclerosis by carotid ultrasound may improve ascertainment of risk in non-White populations. This study aimed to evaluate carotid intima-media thickness (cIMT) and carotid plaquing among Mexican Americans, and to correlate these markers with coronary risk factors and the FRS. Methods/Results Participants (n=141) were drawn from the Cameron County Hispanic Cohort. Carotid artery ultrasound was performed and cIMT measured. Carotid plaque was defined as areas of thickening >50% of the thickness of the surrounding walls. Mean age was 53.1±11.7 years (73.8% female). Most were overweight or obese (88.7%) and more than half (53.2%) had the metabolic syndrome. One third (34.8%) had abnormal carotid ultrasound findings (either cIMT ≥75th percentile for gender and age or presence of plaque). Among those with abnormal carotid ultrasound, the majority were classified as being at low 10-year risk for cardiovascular events. Carotid ultrasound reclassified nearly a third of the cohort as being at high risk. This discordance between 10-year FRS and carotid ultrasound was noted whether risk was assessed for hard coronary events or global risk. Concordance between FRS and carotid ultrasound findings was best when long-term (30-year) risk was assessed and no subject with an abnormal carotid ultrasound was categorized as low risk by the 30-year FRS algorithm. Conclusions Integration of carotid ultrasound findings to coronary risk assessments and use of longer term prediction models may provide better risk assessment in this minority population, with earlier initiation of appropriate therapies. PMID:22747630

  3. Physical activity assessed with three different methods and the Framingham Risk Score on 10-year coronary heart disease risk

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Physical activity (PA) protects against coronary heart disease (CHD) by favorably altering several CHD risk factors. In order to best understand the true nature of the relationship between PA and CHD, the impact different PA assessment methods have on the relationships must first be clarified. The p...

  4. Yield of Screening for Coronary Artery Calcium in Early Middle-Age Adults Based on the 10-Year Framingham Risk Score

    PubMed Central

    Okwuosa, Tochi M.; Greenland, Philip; Ning, Hongyan; Liu, Kiang; Lloyd-Jones, Donald M.

    2013-01-01

    OBJECTIVES The purpose of this study was to assess the prevalence and distribution of coronary artery calcium (CAC) across Framingham Risk Score (FRS) strata and therefore determine FRS levels at which asymptomatic, young to early middle-age individuals could potentially benefit from CAC screening. BACKGROUND High CAC burden is associated with increased risk of coronary events beyond the FRS. Expert panel recommendations for CAC screening are based on data obtained in middle-age and older individuals. METHODS We included 2,831 CARDIA (Coronary Artery Risk Development in Young Adults) study participants with an age range of 33 to 45 years. The number needed to screen ([NNS] number of people in each FRS stratum who need to be screened to detect 1 person with a CAC score above the specified cut point) was used to assess the yield of screening for CAC. CAC prevalence was compared across FRS strata using a chi-square test. RESULTS CAC scores >0 and ≥100 were present in 9.9% and 1.8% of participants, respectively. CAC prevalence and amount increased across higher FRS strata. A CAC score >0 was observed in 7.3%, 20.2%, 19.1%, and 44.8% of individuals with FRSs of 0 to 2.5%, 2.6% to 5%, 5.1% to 10%, and >10%, respectively (NNS = 14, 5, 5, and 2, respectively). A CAC score of ≥100 was observed in 1.3%, 2.4%, and 3.5% of those with FRSs of 0 to 2.5%, 2.6% to 5%, and 5.1% to 10%, respectively (NNS = 79, 41, and 29, respectively), but in 17.2% of those with an FRS >10% (NNS = 6). Similar trends were observed when findings were stratified by sex and race. CONCLUSIONS In this young to early middle-age cohort, we observed concordance between CAC prevalence/amount and FRS strata. Within this group, the yield of screening and possibility of identifying those with a high CAC burden (CAC score of ≥100) is low in those with an FRS of ≤10%, but considerable in those with an FRS >10%. PMID:22974805

  5. Risk stratification and selection for statin therapy: going beyond Framingham.

    PubMed

    Fitchett, David H; Mancini, G B John; Gregoire, Jean; Anderson, Todd; McPherson, Ruth

    2014-06-01

    Decisions for statin therapy in the primary prevention of atherosclerotic cardiovascular disease are generally made using the 10-year Framingham Risk Score (FRS). Even when a family history of premature cardiovascular disease is taken into account, there is often ambiguity about the need for statin therapy for patients with a 10-year FRS of 5%-19% and low-density lipoprotein cholesterol <3.5 mmol/L. Current Canadian dyslipidemia guidelines recommend consideration of a diversity of other factors, including biochemical measurements and imaging studies to help determine whether the calculated FRS might be misleadingly low and whether statin therapy might, therefore, be prudent. However, efficient use of the plethora of secondary factors makes this decision process itself potentially ambiguous. This brief summary provides a practical approach for using clinical information, basic biochemical tests, and more specialized tests, such as carotid ultrasound and coronary artery calcium scoring, to identify groups of patients at greater risk for atherosclerotic cardiovascular disease than suggested by the FRS.

  6. Risk of Cardiovascular Disease Using Framingham Risk Score in Korean Cancer Survivors

    PubMed Central

    So, Ji-Hyun; Shin, Jin-Young; Park, Wan

    2016-01-01

    Background Cardiovascular disease is an important cause of morbidity and mortality in cancer survivors. The aim of this study was to investigate the modifiable cardiovascular disease risk factors and 10-year probability of the disease based on the Framingham risk score in cancer survivors, compared with the general population. Methods A total of 1,225 cancer survivors and 5,196 non-cancer controls who participated in the 2007–2013 Korea National Health and Nutrition Examination Surveys were enrolled. We assessed modifiable cardiovascular disease risk factors including smoking, body mass index, physical inactivity, high blood pressure, high cholesterol, and elevated blood glucose level. The 10-year probability of cardiovascular disease was determined by applying the Framingham cardiovascular disease risk equation among cancer survivors and non-cancer controls, ranging from 30 to 74 years old who had no overt cardiovascular diseases. Results The proportion of subjects who had higher fasting glucose levels, hemoglobin A1c levels, systolic blood pressure, and low density lipoprotein cholesterol levels, and those who had lower high density lipoprotein cholesterol levels was significantly higher in the cancer survivors than in the non-cancer controls. The average 10-year probability of cardiovascular disease among the cancer survivors was higher than that in the non-cancer controls in both men and women. The average 10-year probability of cardiovascular disease in relation to the cancer type was significantly higher in patients with hepatic, colon, lung, breast, and gastric cancer. Conclusion Cancer survivors have a higher cardiovascular disease risk and 10-year probability of cardiovascular disease than non-cancer controls. Control of cardiovascular disease risk factors and implementation of a well-defined cardiovascular disease prevention program are needed for treating cancer survivors. PMID:27468342

  7. Framingham cardiovascular risk in patients with obesity and periodontitis

    PubMed Central

    Pires, Juliana Rico; dos Santos, Isac Pinheiro; de Camargo, Lilian Flosi; Zuza, Elizangela Partata; de Toledo, Benedicto Egbert Corrêa; Monteiro, Sally Cristina Moutinho

    2014-01-01

    Background: Obesity is a chronic inflammatory condition that has been associated to a risk factor for the development of periodontitis and cardiovascular disease; however, the relationship still needs to be clarified. The objective of this study was to evaluate the cardiovascular risk in obese patients with chronic periodontitis. Materials and Methods: A total of 87 obese patients were evaluated for anthropometric data (body mass index [BMI], waist circumference, body fat), systolic blood pressure (SBP) and diastolic blood pressure (DBP), cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL), triglycerides, glycemia and periodontal parameters (visible plaque index (VPI), gingival bleeding index (GBI), bleeding on probing (BOP), periodontal probing depth (PPD) and clinical attachment level (CAL)). Results: Patients were divided into two groups according to the periodontal characteristics found: Group O-PD: Obese patients with chronic periodontitis (n = 45), 22 men and 23 women; and Group O-sPD: Obese patients without chronic periodontitis (n = 42), 17 men and 25 women. Patients had a BMI mean of 35.2 (±5.1) kg/m2 . Group O-PD showed a similarity between the genders regarding age, SBP, DBP, cholesterol, HDL, GBI, VPI, PPD ≥4 mm and CAL ≥4 mm. O-PD women showed greater glycemia level and smoking occurrence, but O-PD men presented a 13% - risk over of developing coronary artery disease in 10 years than O-PD women, 9% - risk over than O-sPD men and 15% - risk over than O-sPD women, by the Framingham Score. Conclusions: It was concluded that obesity and periodontal disease are cardiovascular risk factors and that the two associated inflammatory conditions potentially increases the risk for heart diseases. PMID:24744538

  8. Increased 10-year cardiovascular disease and mortality risk scores in asymptomatic patients with calcium oxalate urolithiasis.

    PubMed

    Aydin, Hasan; Yencilek, Faruk; Erihan, Ismet Bilger; Okan, Binnur; Sarica, Kemal

    2011-12-01

    Both the prevalence of cardiovascular risk factors and event rate are increased in patients with urolithiasis. Screening is recommended to all patients who have high cardiovascular risk. The aim of this study was to document 10-year risk of cardiovascular disease and mortality in asymptomatic patients with urolithiasis. Consecutive 200 patients with calcium oxalate urolithiasis were compared with 200 age- and sex-matched healthy controls. Ten-year cardiovascular disease risk was calculated with the Framingham Risk Score and mortality risk with SCORE risk score. Calcium, oxalate, and citrate excretion were studied as urinary stone risk factors. The results indicate that patients with urolithiasis had higher total cholesterol (p < 0.0001), lower HDL-cholesterol (p < 0.0001), and higher systolic blood pressure (p < 0.0001) and hsCRP (p < 0.0001) compared with controls. Patients with urolithiasis had a higher Framingham Risk Scores [OR 8.36 (95% CI 3.81-18.65), p = 0.0001] and SCORE risk score [OR 3.02 (95% CI 1.30-7.02), p = 0.0006] compared with controls. The Framingham and SCORE risk score were significantly correlated with urinary calcium (p = 0.0001, r = 0.460, and p = 0.005, r = 0.223, respectively) and oxalate excretion (p = 0.0001, r = 0.516, p = 0.001, r = 0.290, respectively). In multiple linear regression analysis, urinary calcium and oxalate excretion, age, sex, total cholesterol, HDL-cholesterol, hsCRP and smoking were the independent predictors of 10-year cardiovascular disease risk and urinary calcium and oxalate excretion, age, sex, total cholesterol, fasting blood glucose for 10-year cardiovascular mortality. In conclusion, patients with calcium oxalate urolithiasis carry high risk of cardiovascular disease and mortality. All patients should be screened at the initial diagnosis of urolithiasis for the risk factors.

  9. Performance of the Framingham and SCORE cardiovascular risk prediction functions in a non-diabetic population of a Spanish health care centre: a validation study

    PubMed Central

    Barroso, Lourdes Cañón; Muro, Eloísa Cruces; Herrera, Natalio Díaz; Ochoa, Gerardo Fernández; Hueros, Juan Ignacio Calvo; Buitrago, Francisco

    2010-01-01

    Objective To analyse the 10-year performance of the original Framingham coronary risk function and of the SCORE cardiovascular death risk function in a non-diabetic population of 40–65 years of age served by a Spanish healthcare centre. Also, to estimate the percentage of patients who are candidates for antihypertensive and lipid-lowering therapy. Design Longitudinal, observational study of a retrospective cohort followed up for 10 years. Setting Primary care health centre. Patients A total of 608 non-diabetic patients of 40–65 years of age (mean 52.8 years, 56.7% women), without evidence of cardiovascular disease were studied. Main outcome measures Coronary risk at 10 years from the time of their recruitment, using the tables based on the original Framingham function, and of their 10-year risk of fatal cardiovascular disease using the SCORE tables. Results The actual incidence rates of coronary and fatal cardiovascular events were 7.9% and 1.5%, respectively. The original Framingham equation over-predicted risk by 64%, while SCORE function over-predicted risk by 40%, but the SCORE model performed better than the Framingham one for discrimination and calibration statistics. The original Framingham function classified 18.3% of the population as high risk and SCORE 9.2%. The proportions of patients who would be candidates for lipid-lowering therapy were 31.0% and 23.8% according to the original Framingham and SCORE functions, respectively, and 36.8% and 31.2% for antihypertensive therapy. Conclusion The SCORE function showed better values than the original Framingham function for each of the discrimination and calibration statistics. The original Framingham function selected a greater percentage of candidates for antihypertensive and lipid-lowering therapy. PMID:20873973

  10. Assessment of cardiovascular risk in Tunisia: applying the Framingham risk score to national survey data

    PubMed Central

    Saidi, O; Malouche, D; O'Flaherty, M; Ben Mansour, N; A Skhiri, H; Ben Romdhane, H; Bezdah, L

    2016-01-01

    Objective This paper aims to assess the socioeconomic determinants of a high 10 year cardiovascular risk in Tunisia. Setting We used a national population based cross sectional survey conducted in 2005 in Tunisia comprising 7780 subjects. We applied the non-laboratory version of the Framingham equation to estimate the 10 year cardiovascular risk. Participants 8007 participants, aged 35–74 years, were included in the sample but effective exclusion of individuals with cardiovascular diseases and cancer resulted in 7780 subjects (3326 men and 4454 women) included in the analysis. Results Mean age was 48.7 years. Women accounted for 50.5% of participants. According to the Framingham equation, 18.1% (17.25–18.9%) of the study population had a high risk (≥20% within 10 years). The gender difference was striking and statistically significant: 27.2% (25.7–28.7%) of men had a high risk, threefold higher than women (9.7%; 8.8–10.5%). A higher 10 year global cardiovascular risk was associated with social disadvantage in men and women; thus illiterate and divorced individuals, and adults without a professional activity had a significantly higher risk of developing a cardiovascular event in 10 years. Illiterate men were at higher risk than those with secondary and higher education (OR=7.01; 5.49 to 9.14). The risk in illiterate women was more elevated (OR=13.57; 7.58 to 24.31). Those living in an urban area had a higher risk (OR=1.45 (1.19 to 1.76) in men and OR=1.71 (1.35 to 2.18) in women). Conclusions The 10 year global cardiovascular risk in the Tunisian population is already substantially high, affecting almost a third of men and 1 in 10 women, and concentrated in those more socially disadvantaged. PMID:27903556

  11. Cardiovascular Risk Assessment: A Comparison of the Framingham, PROCAM, and DAD Equations in HIV-Infected Persons

    PubMed Central

    Nery, Max Weyler; Martelli, Celina Maria Turchi; Aparecida Silveira, Erika; de Sousa, Clarissa Alencar; Falco, Marianne de Oliveira; de Castro, Aline de Cássia Oliveira; Esper, Jorge Tannus; Souza, Luis Carlos Silva e; Turchi, Marília Dalva

    2013-01-01

    This study aims to estimate the risk of cardiovascular disease (CVD) and to assess the agreement between the Framingham, Framingham with aggravating factors, PROCAM, and DAD equations in HIV-infected patients. A cross-sectional study was conducted in an outpatient centre in Brazil. 294 patients older than 19 years were enrolled. Estimates of 10-year cardiovascular risk were calculated. The agreement between the CVD risk equations was assessed using Cohen's kappa coefficient. The participants' mean age was 36.8 years (SD = 10.3), 76.9% were men, and 66.3% were on antiretroviral therapy. 47.8% of the participants had abdominal obesity, 23.1% were current smokers, 20.0% had hypertension, and 2.0% had diabetes. At least one lipid abnormality was detected in 72.8%, and a low HDL-C level was the most common. The majority were classified as having low risk for CV events. The percentage of patients at high risk ranged from 0.4 to 5.7. The PROCAM score placed the lowest proportion of the patients into a high-risk group, and the Framingham equation with aggravating factors placed the highest proportion of patients into the high-risk group. Data concerning the comparability of different tools are informative for estimating the risk of CVD, but accuracy of the outcome predictions should also be considered. PMID:24228022

  12. Framingham risk score in impaired glucose tolerant population: A sub analysis of Diabetes Prevention and Awareness Program of Pakistan

    PubMed Central

    Fawwad, Asher; Moin, Hassan; Siddiqui, Iftikhar Ahmed; Hydrie, Muhammad Zafar Iqbal; Basit, Abdul

    2016-01-01

    Objective: To assess the 10-year risk of coronary artery disease (CAD) in subjects with impaired glucose tolerance (IGT) using Framingham risk score. Methods: Data for this study was collected from Diabetes Prevention and Awareness Program. Primary prevention team visited different primary health care centers, factories, service organizations and offices within Karachi, Pakistan. IGT was diagnosed according to World Health Organization criteria after taking informed consent. Information regarding social-demography, dietary habits and physical activities were obtained by a designed questionnaire on one-to-one based interview. Framingham risk score (FRS) was used to assess risk of developing CAD. Results: A total of 315 subjects with IGT were recruited for the study. Mean age of subjects was 44.1 ± 9.8 years and mean BMI was 27.3 ± 5.0 kg/m2. Overall, 31.4% of the participants were at risk of having CAD. Males were 6.4 times and hypertensive subjects were 2.44 times more likely to have CAD in next 10 years. Conclusion: According to the findings of the study, male and hypertensive IGT subjects were more likely to develop CAD in next 10 years. Community based awareness programs are needed to educate people regarding healthy lifestyle in order to reduce the risk of IGT and CAD. PMID:27882006

  13. Effect of eprosartan-based antihypertensive therapy on coronary heart disease risk assessed by Framingham methodology in Canadian patients: results of the POWER survey

    PubMed Central

    Petrella, Robert J; Tremblay, Guy; De Backer, Guy; Gill, Dawn P

    2014-01-01

    Purpose/introduction The Canadian Hypertension Education Program (CHEP) has identified blood pressure (BP) control as a key target for an overall reduction in cardiovascular disease risk. The POWER survey (Physicians’ Observational Work on Patient Education According to their Vascular Risk) used Framingham methodology to investigate the impact of an angiotensin-receptor-blocker-based regimen on arterial BP and total coronary heart disease (CHD) risk in a subset of patients recruited in Canada. Methods 309 Canadian practices screened for patients with either newly diagnosed or uncontrolled mild/moderate hypertension (sitting systolic blood pressure [SBP] >140 mmHg with diastolic blood pressure [DBP] <110 mmHg). Treatment comprised eprosartan 600 mg/day with add-on antihypertensive therapy after 1 month if required. The primary efficacy variable was change in SBP at 6 months; the secondary variable was the absolute change in the Framingham 10-year CHD risk score. Results 1,385 patients were identified, of whom 1,114 were included in the intention-to-treat (ITT) cohort. Thirty-eight point four percent of ITT patients were managed with monotherapy at 6 months, versus 35.2% and 13.7% with two-drug or multiple-drug therapy, respectively. SBP in the ITT cohort declined 22.4 (standard deviation [SD] 14.8) mmHg and DBP declined 10.5 (SD 10.3) mmHg during that time. The absolute mean Framingham score declined 2.1 (SD 3.1) points with significant age and sex variation (P<0.001) and differences between the various Framingham methods used. Discussion/conclusion Primary care physicians were able to use a strategy of BP lowering and CHD risk assessment to achieve significant reductions in BP and Framingham-assessed CHD risk. The effect size estimate of the different Framingham methods varied noticeably; reasons for those differences warrant further investigation. PMID:24493928

  14. Framingham Risk Score for Prediction of Cardiovascular Diseases: A Population-Based Study from Southern Europe

    PubMed Central

    Artigao-Rodenas, Luis M.; Carbayo-Herencia, Julio A.; Divisón-Garrote, Juan A.; Gil-Guillén, Vicente F.; Massó-Orozco, Javier; Simarro-Rueda, Marta; Molina-Escribano, Francisca; Sanchis, Carlos; Carrión-Valero, Lucinio; López de Coca, Enrique; Caldevilla, David; López-Abril, Juan; Carratalá-Munuera, Concepción; Lopez-Pineda, Adriana

    2013-01-01

    Background The question about what risk function should be used in primary prevention remains unanswered. The Framingham Study proposed a new algorithm based on three key ideas: use of the four risk factors with the most weight (cholesterol, blood pressure, diabetes and smoking), prediction of overall cardiovascular diseases and incorporating the concept of vascular age. The objective of this study was to apply this new function in a cohort of the general non Anglo-Saxon population, with a 10-year follow-up to determine its validity. Methods The cohort was studied in 1992-94 and again in 2004-06. The sample comprised 959 randomly-selected persons, aged 30-74 years, who were representative of the population of Albacete, Spain. At the first examination cycle, needed data for the new function were collected and at the second examination, data on all events were recorded during the follow-up period. Discrimination was studied with ROC curves. Comparisons of prediction models and reality in tertiles (Hosmer-Lemeshow) were performed, and the individual survival functions were calculated. Results The mean risks for women and men, respectively, were 11.3% and 19.7% and the areas under the ROC curve were 0.789 (95%CI, 0.716-0.863) and 0.780 (95%CI, 0.713-0.847) (P<0.001, both). Cardiovascular disease events occurred in the top risk tertiles. Of note were the negative predictive values in both sexes, and a good specificity in women (85.6%) and sensitivity in men (79.1%) when their risk for cardiovascular disease was high. This model overestimates the risk in older women and in middle-aged men. The cumulative probability of individual survival by tertiles was significant in both sexes (P<0.001). Conclusions The results support the proposal for “reclassification” of Framingham. This study, with a few exceptions, passed the test of discrimination and calibration in a random sample of the general population from southern Europe. PMID:24039972

  15. Validity of an adaptation of the Framingham cardiovascular risk function: the VERIFICA study

    PubMed Central

    Marrugat, Jaume; Subirana, Isaac; Comín, Eva; Cabezas, Carmen; Vila, Joan; Elosua, Roberto; Nam, Byung‐Ho; Ramos, Rafel; Sala, Joan; Solanas, Pascual; Cordón, Ferran; Gené‐Badia, Joan; D'Agostino, Ralph B

    2007-01-01

    Background To assess the reliability and accuracy of the Framingham coronary heart disease (CHD) risk function adapted by the Registre Gironí del Cor (REGICOR) investigators in Spain. Methods A 5‐year follow‐up study was completed in 5732 participants aged 35–74 years. The adaptation consisted of using in the function the average population risk factor prevalence and the cumulative incidence observed in Spain instead of those from Framingham in a Cox proportional hazards model. Reliability and accuracy in estimating the observed cumulative incidence were tested with the area under the curve comparison and goodness‐of‐fit test, respectively. Results The Kaplan–Meier CHD cumulative incidence during the follow‐up was 4.0% in men and 1.7% in women. The original Framingham function and the REGICOR adapted estimates were 10.4% and 4.8%, and 3.6% and 2.0%, respectively. The REGICOR‐adapted function's estimate did not differ from the observed cumulated incidence (goodness of fit in men, p = 0.078, in women, p = 0.256), whereas all the original Framingham function estimates differed significantly (p<0.001). Reliabilities of the original Framingham function and of the best Cox model fit with the study data were similar in men (area under the receiver operator characteristic curve 0.68 and 0.69, respectively, p = 0.273), whereas the best Cox model fitted better in women (0.73 and 0.81, respectively, p<0.001). Conclusion The Framingham function adapted to local population characteristics accurately and reliably predicted the 5‐year CHD risk for patients aged 35–74 years, in contrast with the original function, which consistently overestimated the actual risk. PMID:17183014

  16. Utility of Framingham Risk Score in Urban Emergency Department Patients with Asymptomatic Hypertension

    PubMed Central

    Brody, Aaron M.; Flack, John M.; Ference, Brian A.; Levy, Phillip D.

    2014-01-01

    Hypertension (HTN) is the primary population-attributable risk for the development of heart failure (HF); a disease with devastating consequences particularly in urban centers where morbidity and mortality are more pronounced. The Framingham Risk Profile (FRP) is widely used to quantify risk for cardiovascular disease (CVD), but its applicability in an urban population who utilize the emergency department (ED) for primary care is unknown. Our objective for this study is to evaluate FRP scores in ED patients with asymptomatic HTN and subclinical hypertensive heart disease (SHHD). This is a sub study of a prospective randomized clinical trial designed to evaluate optimal blood pressure (BP) targets. Eligible patients were screened with echocardiography for the presence of SHHD and FRP scores were calculated. 149 patients enrolled in the study, 133 (89.2%) of whom had detectable SHHD. Mean [SD] calculated FRP scores were statistically similar for patients with SHHD vs. those without (general CVD: 20.2 [8.5] vs. 15.6 [8.7]; p=0.13 and HF calibrated: 2.4 [1.0] vs. 1.8 [1.0]; p=0.12) corresponding to a calculated risk of 15%–30% for subsequent development of CVD. The HF specific risk score for patients with SHHD was 2.4, which equates to a 2.5% risk of HF development in 10 years. The FRP correctly identified those with SHHD as high-risk for general CVD but appeared to underestimate the likelihood of HF. Recalibration of the HF adjustment factor and inclusion of additional data elements such as echocardiography is needed to enhance applicability of the FRP in this setting. PMID:25062396

  17. Plasma phosphatidylcholine docosahexaenoic acid content and risk of dementia and Alzheimer disease: the Framingham Heart Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our aim in carrying out this analysis, was to assess the predictive value of plasma phosphatidylcholine (PC) DHA content, DHA intake, and fish intake for the risk of developing dementia in the Framingham Heart Study. A cohort of 899 subjects free of dementia was followed to assess the onset of incid...

  18. Adiponectin: an independent risk factor for coronary heart disease in men in the Framingham Offspring Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our aim was to determine whether plasma adiponectin levels were an independent predictor of coronary heart disease (CHD) risk. Plasma adiponectin levels were measured in 3,188 male and female participants from cycle 6 of the Framingham Offspring Study (mean age: 57 years in both men and women; BMI:...

  19. Relationship Between Forced Vital Capacity and Framingham Cardiovascular Risk Score Beyond the Presence of Metabolic Syndrome

    PubMed Central

    Kang, Hyung Koo; Park, Hye Yun; Jeong, Byeong-Ho; Koh, Won-Jung; Lim, Seong Yong

    2015-01-01

    Abstract Impaired lung function is a risk factor for cardiovascular (CV) events. However, it has not been well established whether FVC reduction even within normal range is associated with cardiovascular disease (CVD) risk and whether reduced FVC is an independent relationship of CVD irrespective of metabolic syndrome. Thus, we aimed to explore the relationship between FVC and CV-event risk using the FRS beyond the presence of metabolic syndrome or abdominal obesity in a representative Korean population based on data from the nationwide Korea National Health and Nutrition Examination Survey (KNHANES IV). The study population included 9688 subjects ≥ 30 years of age with no previous diagnosis of CVD and obstructive lung disease. Using a logistic regression model and area under the curve (AUC) analysis, we evaluated the relationship between FVC quintiles and CV-event risk using the Framingham Risk Score (FRS; ≥ 10% or ≥ 20%). In addition, we examined the effect of FVC on CV-event risk based on the presence of metabolic syndrome (MetS) and abdominal obesity. After adjusting for covariates, comparison of subjects in the lowest FVC (% pred) quintile (Q1) with those in the highest quintile (Q5) yielded an odds ratio (OR) of 2.27 (95% CI, 1.91–2.71) for intermediate and high risk, and 2.89 (95% CI, 2.31–3.61) for high risk. The ORs for cardiovascular risk using FRS also increased irrespective of the presence of abdominal obesity and MetS without significant interaction. Furthermore, the addition of FVC status to MetS status and abdominal obesity status significantly increased the AUC of the model predicting CV-event risk (P < 0.001 and P < 0.001). Our study demonstrates that FVC is inversely associated with 10-year CV-event risk, irrespective of MetS and abdominal obesity in the general population without obstructive lung disease. Furthermore, the addition of FVC to MetS or abdominal obesity increased prediction of CVD event risks, implying a potential

  20. Cardiovascular Disease Risk Factors, Type 2 Diabetes Mellitus, and the Framingham Heart Study

    PubMed Central

    Fox, Caroline S.

    2010-01-01

    Type 2 diabetes is a common disorder and an important risk factor for cardiovascular disease (CVD). The Framingham Heart Study (FHS) is a population-based epidemiologic study that has contributed to our knowledge of CVD and its risk factors. This review will focus on the contemporary contributions of the FHS to the field of diabetes epidemiology, including data on diabetes trends, genetics, and future advances in population-based studies. PMID:21130952

  1. Coronary artery calcium scoring is a better predictor of cardiac risk in subclinical hypothyroidism patients with low-risk Framingham score

    PubMed Central

    Verma, Rajesh; Verma, Ashish; Gupta, Piyush; Agrawal, N. K.

    2016-01-01

    Context: Overt hypothyroidism accelerates the cardiovascular disease. Subclinical hypothyroidism (SCH), being considered as a preclinical state, impacts on cardiovascular status is not clear. Aims: This study was aimed at assessing cardiac risk stratification by Framingham risk scoring (FRS) and coronary coronary artery calcium score (CACS) by noncontrast cardiac computed tomography in SCH. Study Design: Observational study. Subjects and Methods: We enrolled thirty treatment-naive SCH patients (aged 30–60 years with no serious concurrent medical conditions), thirty euthyroid (age, sex, and body mass index-matched) controls, and ten healthy controls. All cases were evaluated for coronary artery calcium scoring and Framingham risk score. Statistical Analysis: Qualitative data were analyzed using the Chi-square test. In addition, demographics and CACS are summarized graphically or in a table. Results: SCH cases had higher thyroglobulin, while there was a trend toward an increase in total cholesterol, low-density lipoprotein (LDL), very LDL, and decrease in HDL levels. All participants had low-risk FRS (10-year FRS < 10%). The mean CACS in SCH was significantly higher than simple obese and healthy controls (47.17 vs. 2.67 vs. 0.00). Conclusion: This study suggests that SCH is an independent risk factor for coronary artery disease in apparently healthy controls. The risk of occult coronary artery disease is increased in SCH cases. PMID:27867875

  2. Cardiovascular risk prediction: a comparative study of Framingham and quantum neural network based approach

    PubMed Central

    Narain, Renu; Saxena, Sanjai; Goyal, Achal Kumar

    2016-01-01

    Purpose Currently cardiovascular diseases (CVDs) are the main cause of death worldwide. Disease risk estimates can be used as prognostic information and support for treating CVDs. The commonly used Framingham risk score (FRS) for CVD prediction is outdated for the modern population, so FRS may not be accurate enough. In this paper, a novel CVD prediction system based on machine learning is proposed. Methods This study has been conducted with the data of 689 patients showing symptoms of CVD. Furthermore, the dataset of 5,209 CVD patients of the famous Framingham study has been used for validation purposes. Each patient’s parameters have been analyzed by physicians in order to make a diagnosis. The proposed system uses the quantum neural network for machine learning. This system learns and recognizes the pattern of CVD. The proposed system has been experimentally evaluated and compared with FRS. Results During testing, patients’ data in combination with the doctors’ diagnosis (predictions) are used for evaluation and validation. The proposed system achieved 98.57% accuracy in predicting the CVD risk. The CVD risk predictions by the proposed system, using the dataset of the Framingham study, confirmed the potential risk of death, deaths which actually occurred and had been recorded as due to myocardial infarction and coronary heart disease in the dataset of the Framingham study. The accuracy of the proposed system is significantly higher than FRS and other existing approaches. Conclusion The proposed system will serve as an excellent tool for a medical practitioner in predicting the risk of CVD. This system will be serving as an aid to medical practitioners for planning better medication and treatment strategies. An early diagnosis may be effectively made by using this system. An overall accuracy of 98.57% has been achieved in predicting the risk level. The accuracy is considerably higher compared to the other existing approaches. Thus, this system must be used

  3. Does job strain increase the risk for coronary heart disease or death in men and women? The Framingham Offspring Study.

    PubMed

    Eaker, Elaine D; Sullivan, Lisa M; Kelly-Hayes, Margaret; D'Agostino, Ralph B; Benjamin, Emelia J

    2004-05-15

    Conflicting findings in the literature have made the relation between job strain and coronary heart disease (CHD) controversial. The effect of high job strain on the 10-year incidence of CHD and total mortality was examined in men and women participating in the Framingham Offspring Study; 3,039 participants, 1,711 men and 1,328 women, aged 18-77 years, were examined between 1984 and 1987 and followed for 10 years. Measures of job strain, occupational characteristics, and risk factors for CHD were collected at the baseline examination. Before and after controlling for systolic blood pressure, body mass index, cigarette smoking, diabetes, and the total/high density lipoprotein cholesterol ratio in Cox proportional hazards models, the authors found that high job strain was not associated with mortality or incident CHD in either men or women over the follow-up period. Contrary to expectation, women with active job strain (high demands-high control) had a 2.8-fold increased risk of CHD (95% confidence interval: 1.1, 7.2) compared with women with high job strain (high demands-low control). For men, higher education, personal income, and occupational prestige were related to decreased risk of total mortality and CHD. These findings do not support high job strain as a significant risk factor for CHD or death in men or women.

  4. Validation of the Framingham Heart Study and CHARGE-AF Risk Scores for Atrial Fibrillation in Hispanics, African-Americans, and Non-Hispanic Whites.

    PubMed

    Shulman, Eric; Kargoli, Faraj; Aagaard, Philip; Hoch, Ethan; Di Biase, Luigi; Fisher, John; Gross, Jay; Kim, Soo; Krumerman, Andrew; Ferrick, Kevin J

    2016-01-01

    A risk score for atrial fibrillation (AF) has been developed by the Framingham Heart Study and Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE)-AF consortium. However, validation of these risk scores in an inner-city population is uncertain. Thus, a validation model was built using the Framingham Risk Score for AF and CHARGE-AF covariates. An in and outpatient electrocardiographic database was interrogated from 2000 to 2013 for the development of AF. Patients were included if their age was >45 and <95 years, had <10-year follow-up, if their initial electrocardiogram was without AF, had ≥ 2 electrocardiograms, and declared a race and/or ethnicity as non-Hispanic white, African-American, or Hispanic. For the Framingham Heart Study, 49,599 patients met inclusion criteria, of which 4,860 developed AF. Discrimination analysis using area under the curve (AUC) for original risk equations: non-Hispanic white AUC = 0.712 (95% confidence interval [CI] 0.694 to 0.731), African-American AUC = 0.733 (95% CI 0.716 to 0.751), and Hispanic AUC = 0.740 (95% CI 0.723 to 0.757). For the CHARGE-AF, 45,571 patients met inclusion criteria, of which 4,512 developed AF. Non-Hispanic white AUC = 0.673 (95% CI 0.652 to 0.694), African-American AUC = 0.706 (95% CI 0.685 to 0.727), and Hispanic AUC = 0.711 (95% CI 0.691 to 0.732). Calibration analysis showed qualitative similarities between cohorts. In conclusion, this is the first study to validate both the Framingham Heart Study and CHARGE-AF risk scores in both a Hispanic and African-American cohort. All models predicted AF well across all race and ethnic cohorts.

  5. Metabolic factors and genetic risk mediate familial type 2 diabetes risk in the Framingham Heart Study

    PubMed Central

    Raghavan, Sridharan; Porneala, Bianca; McKeown, Nicola; Fox, Caroline S.; Dupuis, Josée; Meigs, James B.

    2015-01-01

    Aims/hypothesis Type 2 diabetes mellitus in parents is a strong determinant of diabetes risk in their offspring. We hypothesise that offspring diabetes risk associated with parental diabetes is mediated by metabolic risk factors. Methods We studied initially non-diabetic participants of the Framingham Offspring Study. Metabolic risk was estimated using beta cell corrected insulin response (CIR), HOMA-IR or a count of metabolic syndrome components (metabolic syndrome score [MSS]). Dietary risk and physical activity were estimated using questionnaire responses. Genetic risk score (GRS) was estimated as the count of 62 type 2 diabetes risk alleles. The outcome of incident diabetes in offspring was examined across levels of parental diabetes exposure, accounting for sibling correlation and adjusting for age, sex and putative mediators. The proportion mediated was estimated by comparing regression coefficients for parental diabetes with (βadj) and without (βunadj) adjustments for CIR, HOMA-IR, MSS and GRS (percentage mediated = 1 – βadj / βunadj). Results Metabolic factors mediated 11% of offspring diabetes risk associated with parental diabetes, corresponding to a reduction in OR per diabetic parent from 2.13 to 1.96. GRS mediated 9% of risk, corresponding to a reduction in OR per diabetic parent from 2.13 to 1.99. Conclusions/interpretation Metabolic risk factors partially mediated offspring type 2 diabetes risk conferred by parental diabetes to a similar magnitude as genetic risk. However, a substantial proportion of offspring diabetes risk associated with parental diabetes remains unexplained by metabolic factors, genetic risk, diet and physical activity, suggesting that important familial influences on diabetes risk remain undiscovered. PMID:25619168

  6. Original and REGICOR Framingham Functions in a Nondiabetic Population of a Spanish Health Care Center: A Validation Study

    PubMed Central

    Buitrago, Francisco; Calvo-Hueros, Juan Ignacio; Cañón-Barroso, Lourdes; Pozuelos-Estrada, Gerónimo; Molina-Martínez, Luis; Espigares-Arroyo, Manuel; Galán-González, Juan Antonio; Lillo-Bravo, Francisco J.

    2011-01-01

    PURPOSE Risk functions can help general practitioners identify patients at high cardiovascular risk, but overprediction inevitably leads to a disproportionate number of patients being targeted for treatment. To assess predicted cardiovascular risk, we analyzed the 10-year performance of the original and REGICOR Framingham coronary risk functions in nondiabetic patients. METHODS Ours was a longitudinal, observational study of a retrospective cohort of patients observed for 10 years in primary care practices in Badajoz, Spain. Our cohort comprised 447 nondiabetic patients aged 35 to 74 years who had no evidence of cardiovascular disease and were not on lipid-lowering or antihypertensive therapy. We assessed the patients’ 10-year coronary risk measurement from the time of their recruitment. We also estimated the percentage of patients who were candidates for antihypertensive and lipid-lowering therapy. RESULTS The actual incidence rate of coronary events was 6.7%. The original Framingham equation overpredicted risk by 73%, whereas the REGICOR Framingham function underpredicted risk by 64%. The Brier scores were 0.06364 and 0.06093 (P = .365) for the original Framingham and REGICOR Framingham functions, respectively, and the remaining discrimination and calibration parameters were also highly similar for both functions. The original Framingham function classified 14.8% of the population as high risk and the REGICOR Framingham function classified 6.9%. The proportions of patients who, according to the original Framingham and REGICOR functions, would be candidates for lipid-lowering therapy were 14.3% and 6.7%, and for antihypertensive therapy they were 12.5% and 7.8%, respectively. CONCLUSION The original Framingham equation overestimated coronary risk whereas the REGICOR Framingham function underestimated it. The original Framingham function selected a greater percentage of candidates for antihypertensive and lipid-lowering therapy. PMID:21911762

  7. Clinical usefulness of the Framingham cardiovascular risk profile beyond its statistical performance: the Tehran Lipid and Glucose Study.

    PubMed

    Khalili, Davood; Hadaegh, Farzad; Soori, Hamid; Steyerberg, Ewout W; Bozorgmanesh, Mohammadreza; Azizi, Fereidoun

    2012-08-01

    The utility of a risk function in clinical practice is an important concept that has received insufficient attention. The authors evaluated the clinical usefulness of the Framingham risk function (FRF) for cardiovascular disease in a Middle Eastern population (2,640 men and 3,584 women aged 30-74 years) free of cardiovascular disease at baseline in 1999. They calculated the net benefit fraction for treatment of subjects with an estimated 10-year risk of ≥10% and also ≥20%, where the net benefit fraction is a weighted sum of true-positive and false-positive rates divided by incidence, as estimated by Kaplan-Meier analysis. The authors drew a decision curve by plotting the net benefit fraction against a wide range of risk thresholds for treatment. The cumulative incidence of cardiovascular disease was 7.6% and 12.3% in women and men, respectively. The FRF had a C index of 0.832 in women and 0.785 in men with a reasonable calibration. On the basis of the net benefit fraction, about 50% of the incidence in men and women could be appropriately treated by using the 10% threshold; however, the FRF was not useful at the 20% threshold, especially in women. In both genders, usefulness of the FRF was as good as the function derived directly from Tehrani data with the same variables; however, it could be useful in low thresholds for treatment.

  8. Correlation between the intima-media thickness and Framingham risk score in patients with sleep apnea syndrome

    PubMed Central

    Conkbayır, Işık; Kuru, Aslıhan; Fırat, Hikmet; Sökücü, Sinem Nedime; Dalar, Levent; Ergün, Recai; Uzunmehmetoğlu, Çağla Pınar; Ergün, Dilek; Ardıc, Sadık

    2013-01-01

    Background In the present study, we want to demonstrate the correlation between obstructive sleep apnea syndrome (OSAS) whose independent effect on carotid artery intima-media thickness (IMT) was demonstrated, with Framingham risk score (FRS) showing the overall cardiovascular risk. Methods IMT of the carotid artery was measured with ultrasonography and 10-year risk of coronary heart disease (CHD) was defined with FRS in 90 consecutive patients referred to our sleep clinic and who underwent polysomnography (PSG), with vascular risk factors and without a clinical atherosclerotic disease. Results IMT and FRS were found to be statistically significantly increased in the severe OSAS group compared to the other two groups. Carotid IMT was found to be significantly positively correlated with, apnea-hypopnea index (AHI), oxygen desaturation index (ODI) and time duration with oxygen saturation (SpO2) <90%, and negatively correlated with minimum oxygen saturation at sleep (minimum SpO2) and mean SpO2. In control and mild OSAS group IMT and FRS have significantly positive correlation (r: 0.501, P: 0.027; r: 0.625, P<0.001), while in severe OSAS group no significant correlation was detected between IMT and FRS (r: 0.321, P: 0.06). In the regression analysis AHI and ODI were found to be an independent predictor of carotid IMT. ODI was found to have an independent effect on the progression of atherosclerosis. Conclusions Increased carotid IMT in severe OSAS group could not be explained with the classical risk factors. In this respect, FRS might be insufficient to determine correctly the cardiovascular risk and protection strategies against the disease in OSAS patients. PMID:24409351

  9. Cardiovascular Outcomes in the Outpatient Kidney Transplant Clinic: The Framingham Risk Score Revisited

    PubMed Central

    Kiberd, Bryce; Panek, Romuald

    2008-01-01

    Background and objectives: Cardiovascular disease is an important cause of morbidity and death in kidney transplant recipients. This study examines the Framingham risk score's ability to predict cardiac and stroke events. Because cyclosporine and tacrolimus have different cardiovascular risk profiles, these agents were also examined. Design, setting, participants, & measurements: A prospective cohort evaluation of 540 patients were followed for a median of 4.7 yr in an outpatient kidney transplant clinic. Baseline Framingham risk scores were calculated and all cardiovascular outcomes were collected. Results: Rates per 100 patient-years were 1.79 for cardiac and 0.78 for stroke events. The ratio of observed-to-predicted cardiac events was 1.64-fold higher [95% confidence interval (CI) 1.19 to 2.94] for the cohort, 2.74-fold higher (95% CI 1.70 to 4.24) in patients age 45 to 60 with prior cardiac disease or diabetes mellitus, but not higher in other age subgroups. Stroke was not increased above predicted. Risk scores for cardiac (c = 0.65, P = 0.003) and stroke (c = 0.71, P = 0.004) events were modest predictors. 10-yr event scores for cardiac (9.3 versus 13.5%, P < 0.001) and stroke (7.1 versus 10.0%, P = 0.002) were lower for tacrolimus compared with cyclosporine-treated patients. However observed cardiac events were higher in tacrolimus recipients (2.50, 95% CI 1.09 to 5.90) in an adjusted Cox model. Conclusions: Although risk scores are only modest predictors, patients with the highest event rates are easily identified. Treating high-risk patients with cardioprotective medications should remain a priority. PMID:18322053

  10. Comparison of self-perceived cardiovascular disease risk among smokers with Framingham and PROCAM scores: a cross-sectional analysis of baseline data from a randomised controlled trial

    PubMed Central

    Desgraz, Benoît; Collet, Tinh-Hai; Rodondi, Nicolas; Cornuz, Jacques; Clair, Carole

    2017-01-01

    Objectives Previous studies suggest that smokers have a misperception of their 10-year cardiovascular risk. We aimed to compare 10-year cardiovascular risk self-perception and calculated risk among smokers willing to quit and assess the determinants of a possible misperception. Design Cross-sectional secondary analysis of baseline data from a randomised controlled trial of smoking cessation. Participants 514 participants, mean age 51.1 years, 46% women, 98% Caucasian. Eligible participants were regular smokers, aged between 40 and 70 years, with a consumption of at least 10 cigarettes per day for at least a year. None of them had experienced cardiovascular disease before. Exclusion criteria comprised a history of myocardial infarction, coronary heart disease, stroke, heart failure, peripheral vascular disease, carotid atherosclerosis or cardiac arrhythmia. Participants with renal or liver failure, psychiatric disorders, substance and alcohol abuse and with smoking cessation therapies were excluded. Interventions Participants were asked to estimate their 10-year cardiovascular risk using a 3-item scale corresponding to high-risk, moderate-risk and low-risk categories. We compared their risk perception with Framingham and Prospective Cardiovascular Munster Study (PROCAM) scores. We used multivariable-adjusted logistic regression models to determine characteristics of participants who underestimate their risk versus those who correctly estimate or overestimate it. Results Between 38% and 42% of smokers correctly perceived their 10-year cardiovascular risk, and 39–50% overestimated their 10-year cardiovascular risk while 12–19% underestimated it compared with their calculated 10-year cardiovascular risk depending on the score used. Underestimation of 10-year cardiovascular risk was associated with male gender (OR 8.16; CI 3.83 to 17.36), older age (OR 1.06; CI 1.02 to 1.09), and the presence of hyperlipidaemia (OR 2.71; CI 1.47 to 5.01) and diabetes mellitus

  11. Effects of switching from olanzapine, quetiapine, and risperidone to aripiprazole on 10-year coronary heart disease risk and metabolic syndrome status: Results from a randomized controlled trial

    PubMed Central

    Stroup, T. Scott; Byerly, Matthew J.; Nasrallah, Henry A.; Ray, Neepa; Khan, Ahsan Y.; Lamberti, J. Steven; Glick, Ira D.; Steinbook, Richard M.; McEvoy, Joseph P.; Hamer, Robert M.

    2013-01-01

    Purpose This study examined the clinical significance of switching from olanzapine, quetiapine, or risperidone to aripiprazole by examining changes in predicted risk of cardiovascular disease (CVD) according to the Framingham Risk Score (FRS) and metabolic syndrome status. FRS estimates 10-year risk of “hard” coronary heart disease (CHD) outcomes (myocardial infarction and coronary death) while metabolic syndrome is associated with increased risk of CVD, stroke, and diabetes mellitus. Method Changes in FRS and metabolic syndrome status were compared between patients with BMI ≥ 27 and non-HDL-C ≥ 130 mg/dL randomly assigned to stay on stable current treatment (olanzapine, quetiapine, or risperidone) or switch to treatment with aripiprazole with 24 weeks of follow-up. All study participants were enrolled in a behavioral program that promoted healthy diet and exercise. Results The pre-specified analyses included 89 switchers and 98 stayers who had post-baseline measurements needed to assess changes. Least squares mean estimates of 10-year CHD risk decreased more for the switch (from 7.0% to 5.2%) than the stay group (from 7.4% to 6.4%) (p=0.0429). The odds ratio for having metabolic syndrome (stay vs. switch) at the last observation was 1.748 (95% CI 0.919, 3.324, p=0.0885). Conclusion Switching from olanzapine, quetiapine, or risperidone to aripiprazole was associated with larger reductions in predicted 10-year risk of CHD than the behavioral program alone. The advantage of switching on metabolic syndrome was not statistically significant. The benefits of switching must be balanced against its risks, which in this study included more discontinuations of the study treatment but no significant increase in symptoms or hospitalizations. PMID:23434503

  12. Alimentary Habits, Physical Activity, and Framingham Global Risk Score in Metabolic Syndrome

    PubMed Central

    Soares, Thays Soliman; Piovesan, Carla Haas; Gustavo, Andréia da Silva; Macagnan, Fabrício Edler; Bodanese, Luiz Carlos; Feoli, Ana Maria Pandolfo

    2014-01-01

    Background Metabolic syndrome is a complex disorder represented by a set of cardiovascular risk factors. A healthy lifestyle is strongly related to improve Quality of Life and interfere positively in the control of risk factors presented in this condition. Objective To evaluate the effect of a program of lifestyle modification on the Framingham General Cardiovascular Risk Profile in subjects diagnosed with metabolic syndrome. Methods A sub-analysis study of a randomized clinical trial controlled blind that lasted three months. Participants were randomized into four groups: dietary intervention + placebo (DIP), dietary intervention + supplementation of omega 3 (fish oil 3 g/day) (DIS3), dietary intervention + placebo + physical activity (DIPE) and dietary intervention + physical activity + supplementation of omega 3 (DIS3PE). The general cardiovascular risk profile of each individual was calculated before and after the intervention. Results The study included 70 subjects. Evaluating the score between the pre and post intervention yielded a significant value (p < 0.001). We obtained a reduction for intermediate risk in 25.7% of subjects. After intervention, there was a significant reduction (p < 0.01) on cardiovascular age, this being more significant in groups DIP (5.2%) and DIPE (5.3%). Conclusion Proposed interventions produced beneficial effects for reducing cardiovascular risk score. This study emphasizes the importance of lifestyle modification in the prevention and treatment of cardiovascular diseases. PMID:24652053

  13. Risk for Subsequent Injuries After Spinal Cord Injury: A 10-Year Longitudinal Analysis

    PubMed Central

    Krause, James S.

    2011-01-01

    Objectives To identify: (a) the annual incidence of subsequent injury and injury related hospitalizations among individuals with pre-existing spinal cord injury (SCI) and (b) risk and protective behaviors associated with differential risk of injury. Design Longitudinal, mailed survey. Participants were enrolled in 1997-1998, with a follow-up conducted 10 years later. Setting Data were collected from participants identified from a specialty hospital and analyzed at a medical university in the Southeastern United States. Participants There were 1386 participants during the baseline enrollment, 821 of whom also participated in the 10-year follow-up. Inclusion criteria were: (1) traumatic SCI with residual impairment A-D, (2) non-surgical onset, (3) age 18 years or older, and (4) a minimum of 12 months post-SCI. Interventions Main Outcome Measures Number of injuries severe enough to require treatment in a clinic, emergency department, or hospital in the 12 months prior to the survey, and number of injury related hospitalizations. Predictor variables included selected items from the Behavioral Risk Factor Surveillance System, the Zuckerman-Kuhlman Personality Questionnaire, and prescription medication usage. Results Over 23% of participants reported at least 1 injury within the past year, an increase from that reported 10 years earlier by the same participants (19%), and 7% reported at least 1 injury related hospitalization. Those who reported a subsequent injury during the preliminary baseline data collection were about twice as likely to report at least 1 injury 10 years later. Binge drinking, psychotropic prescription medication use, and several personality characteristics were also related to injuries and/or injury hospitalization. Conclusions Risk of injury continues to be a significant concern in the years and decades after SCI onset. Behavioral and personality factors hold the key to prevention. PMID:21044720

  14. Combination of High Ankle–Brachial Index and Hard Coronary Heart Disease Framingham Risk Score in Predicting the Risk of Ischemic Stroke in General Population

    PubMed Central

    Wang, Tong; Kong, Minyi; Chen, Renhua; Liu, Yu; Chen, Jianping; Wang, Zhiyu; Wang, Jingfeng; Huang, Hui

    2014-01-01

    Our previous study showed that the patients with more metabolic risk factors had higher risk of high ankle–brachial index (ABI), but the relationship between high ABI and the risk of severe cardiovascular and cerebrovascular diseases is still under debate. This study aims to evaluate this association in the general population. 1486 subjects of South China were recruited in the study. 61 subjects were defined as high ABI group (ABI≥1.3) and 65 subjects were randomly selected as normal ABI group (0.910-year hard coronary heart disease (HCHD) Framingham Risk Score (FRS) were compared between two groups. The results showed that the 10-year HCHD FRS of high ABI group was significantly higher than normal ABI group (7.87±6.11 vs. 3.98±2.90%, P<0.001). There was a positive correlation between ABI value and HCHD FRS in overweight participants (R = 0.576, P<0.01). The prevalence of ischemic stroke was higher in high ABI group than normal ABI group (21.3% vs. 6.2%, P<0.05), and it was higher in participants with HCHD FRS≥6% than those with HCHD FRS<6% (19.1% vs. 6.9%, P<0.05). Moreover, the prevalence of ischemic stroke was higher in participants with high ABI and HCHD FRS≥6% than those with normal ABI and HCHD FRS<6% (26.7% vs. 4.1%, P<0.05). BMI, hypertension, hsCRP and smoking were proved to be the independent factors and effective predictors for high ABI (P<0.05). In conclusion, high ABI combined with high HCHD FRS should be a potential predictor of ischemic stroke in the general population of South China. PMID:25198106

  15. Cluster Individuals Based on Phenotype and Determine the Risk for Atrial Fibrillation in the PREVEND and Framingham Heart Study Populations

    PubMed Central

    Rienstra, Michiel; Geelhoed, Bastiaan; Yin, Xiaoyan; Siland, Joylene E.; Vermond, Rob A.; Mulder, Bart A.; Van Der Harst, Pim; Hillege, Hans L.; Van Gelder, Isabelle C.

    2016-01-01

    Background Risk prediction of atrial fibrillation (AF) is of importance to improve the early diagnosis and treatment of AF. Latent class analysis takes into account the possible existence of classes of individuals each with shared risk factors, and maybe a better method of incorporating the phenotypic heterogeneity underlying AF. Methods and findings Two prospective community-based cohort studies from Netherlands and United States were used. Prevention of Renal and Vascular End-stage Disease (PREVEND) study, started in 1997, and the Framingham Heart Study (FHS) Offspring cohort started in 1971, both with 10-years follow-up. The main objective was to determine the risk of AF using a latent class analysis, and compare the discrimination and reclassification performance with traditional regression analysis. Mean age in PREVEND was 49±13 years, 49.8% were men. During follow-up, 250(3%) individuals developed AF. We built a latent class model based on 18 risk factors. A model with 7 distinct classes (ranging from 341 to 1517 individuals) gave the optimum tradeoff between a high statistical model-likelihood and a low number of model parameters. All classes had a specific profile. The incidence of AF varied; class 1 0.0%, class 2 0.3%, class 3 7.5%, class 4 0.2%, class 5 1.3%, class 6 4.2%, class 7 21.7% (p<0.001). The discrimination (C-statistic 0.830 vs. 0.842, delta-C -0.013, p = 0.22) and reclassification (IDI -0.028, p<0.001, NRI -0.090, p = 0.049, and category-less-NRI -0.049, p = 0.495) performance of both models was comparable. The results were successfully replicated in a sample of the FHS study (n = 3162; mean age 58±9 years, 46.3% men). Conclusions Latent class analysis to build an AF risk model is feasible. Despite the heterogeneity in number and severity of risk factors between individuals at risk for AF, latent class analysis produces distinguishable groups. PMID:27832125

  16. Personality Disorder Risk Factors for Suicide Attempts over 10 Years of Follow-up

    PubMed Central

    Ansell, Emily B.; Wright, Aidan G.C.; Markowitz, John C.; Sanislow, Charles A.; Hopwood, Christopher J.; Zanarini, Mary C.; Yen, Shirley; Pinto, Anthony; McGlashan, Thomas H.; Grilo, Carlos M.

    2015-01-01

    Objective Identifying personality disorder (PD) risk factors for suicide attempts is an important consideration for research and clinical care alike. However, most prior research has focused on single PDs or categorical PD diagnoses without considering unique influences of different PDs, or severity (sum) of PD criteria on the risk for suicide related outcomes. This has usually been done in cross-sectional or retrospective assessment methods. Rarely are dimensional models of PDs examined in longitudinal, naturalistic prospective designs. In addition, it is important to consider divergent risk factors in predicting the risk of ever making a suicide attempt versus making an increasing number of attempts within the same model. Method This study examined 431 participants who were followed for 10 years in the Collaborative Longitudinal Personality Disorders Study (CLPS). Baseline assessments of personality disorder criteria were summed as dimensional counts of personality pathology and examined as predictors of suicide attempts reported at annual interviews throughout the ten-year follow-up. We employed univariate and multivariate zero-inflated Poisson regression models to simultaneously evaluate PD risk factors for ‘ever attempt’ and for increasing numbers of attempts among attempters. Results Consistent with prior research, borderline PD was uniquely associated with ever attempting. However, only narcissistic PD was uniquely associated with an increasing number of attempts. Conclusion These findings highlight the relevance of both borderline and narcissistic personality pathology as unique contributors to suicide related outcomes. PMID:25705977

  17. Midlife Hypertension Risk and Cognition in the Non-Demented Oldest Old: Framingham Heart Study.

    PubMed

    Nishtala, Arvind; Himali, Jayandra J; Beiser, Alexa; Murabito, Joanne M; Seshadri, Sudha; Wolf, Philip A; Au, Rhoda

    2015-01-01

    Midlife cardiovascular risk, hypertension (HTN) in particular, has been related cross-sectionally to poorer neuropsychological (NP) performance in middle age and older adults. This study investigated whether a similar relationship persists between midlife HTN or systolic blood pressure (SBP) and NP performance approximately 30 years later. 378 Framingham stroke and dementia-free Original cohort participants, with HTN and SBP ascertained between 50-60 years of age (mean age 55 ± 1, 65% women), were administered a NP assessment at age ≥80 years. Tests included Logical Memory, Visual Reproduction, Paired Associate, Hooper Visual Organization Test, Trail Making A & B, Digit Span Forward and Backward, Controlled Word Association Test (COWAT), and Similarities. Multivariable linear regression, adjusted for age, time interval between risk factor and NP testing, gender, and premorbid intelligence, assessed association between midlife HTN/SBP and NP outcomes. Midlife HTN was not significantly associated with NP outcome measures. Midlife SBP was associated with poorer Digit Span Forward and COWAT performance (p <  0.05). No significant interaction of age on HTN/SBP to NP associations was found. There was a significant interaction between ApoE4 status and SBP in their effects on COWAT (pinteraction = 0.074); SBP was negatively associated with COWAT only in those with the ApoE4 allele (p = 0.025). While midlife HTN is not associated with late life cognitive impairment, midlife SBP is related to late life attention and verbal fluency impairments, particularly among ApoE4+ individuals. These results offer insight into processes that are operative in the absence of overt cognitive impairment and dementia.

  18. Interaction analysis of the new pooled cohort equations for 10-year atherosclerotic cardiovascular disease risk estimation: a simulation analysis

    PubMed Central

    Schiros, Chun G; Denney, Thomas S; Gupta, Himanshu

    2015-01-01

    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

  19. Cardiovascular risk assessment in diabetes mellitus: comparison of the general Framingham risk profile versus the World Health Organization/International Society of Hypertension risk prediction charts in Arabs--clinical implications.

    PubMed

    Al-Lawati, Jawad A; Barakat, Mohammed N; Al-Lawati, Najla A; Al-Maskari, Masoud Y; Elsayed, Medhat K; Mikhailidis, Dimitri P; Al-Zakwani, Ibrahim S

    2013-07-01

    We estimated the prevalence of cardiovascular disease (CVD) risk and its clinical implications among 1 110 Omani patients with type 2 diabetes mellitus (DM) using 2 different CVD risk tools: the general Framingham risk profile (GFRP) and the joint World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts. The GFRP tool identified higher proportion of patients compared with joint WHO/ISH tool at 10-year CVD risk 10% to <20% and at 20% to <30%. At CVD risk ≥30%, both assessment tools identified similar proportions of patients (22% vs 24%; P=.120). Compared with WHO/ISH charts, the GFRP identified almost double the number of men eligible for aspirin treatment at CVD risk thresholds of ≥10% (86% vs 43%). In women, the proportions were, 66% and 45%, respectively. For statins, the figures were, 60% and 37%, for men and 28% and 36%, for women. In conclusion, the GFRP overestimates the number of patients eligible for primary prevention of CVD compared with the joint WHO/ISH method.

  20. The impact of ankle brachial index and pulse wave velocity on cardiovascular risk according to SCORE and Framingham scales and sex differences.

    PubMed

    Woźnicka-Leśkiewicz, L; Posadzy-Małaczyńska, A; Juszkat, R

    2015-08-01

    The aim of the study was to evaluate the usefulness of ankle brachial index (ABI) and pulse wave velocity (PWV) in patients with or without coronary artery disease (CAD) and hypertension (HT) in cardiovascular risk prediction. We studied 200 patients randomized to one of four groups: CAD+HT+; CAD+HT-; CAD-HT+; CAD-HT- (Department of Hypertensiology, Angiology and Internal Diseases, Poznan, Poland: 2009-2012). We evaluated: patient age, lipids profile, ABI and PWV. The cardiovascular risks according to SCORE and Framingham scales were assessed. Statistical calculations were performed in StatSoft Statistica 10. The most interesting aspects of this study were: logistic regression model evaluated the simultaneously influence of ABI and PWV on cardiovascular risk by the SCORE scale and logistic regression model evaluated the influence of ABI and PWV on cardiovascular risk according to the Framingham scale. They showed the possibility (SCORE) of more accurate estimation of cardiovascular risk in an individual patient and graduation of this risk in the exemplary patients. Analysis of the assessment of both: ABI and PWV in predicting of cardiovascular risk according to SCORE and Framingham scales using a logistic regression model indicates that the Framingham scale is less precise than the SCORE scale because it underestimates the real high cardiovascular risk.

  1. Association between Knee Osteoarthritis, Cardiovascular Risk Factors, and the Framingham Risk Score in South Koreans: A Cross-Sectional Study

    PubMed Central

    Kim, Ho Sun; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-riong; Bae, Young-Hyeon; Park, Ki Byung; Lee, Eun-Jung; Kim, Joo-Hee

    2016-01-01

    Background Osteoarthritis is a significant burden on personal health and for social cost, and its prevalence is rising. Recent research has revealed an association between osteoarthritis and cardiovascular disease, and this study uses the Framingham risk score (FRS), which is widely used as a composite index of cardiovascular risk factors, to investigate the association between osteoarthritis and various cardiovascular risk factors. Methods A total 9,514 participants aged 50 years or older who received knee X-ray diagnosis of the 5th Korean National Health and Nutrition Examination Survey (total surveyees = 24,173) released by the Korean Centers for Disease Control and Prevention was included for analysis. Knee osteoarthritis patients were defined as participants with K-L grade ≥2 on knee X-ray regardless of knee pain. The association between major cardiovascular risk factors (blood pressure, diabetes, cholesterol, and smoking habits), FRS, and knee osteoarthritis was analyzed, adjusting for various covariates. Results Prevalence of knee osteoarthritis in Koreans aged ≥50 years was 36.6%, and higher in women (men: 24.9%, women: 45.4%). Prevalence of knee osteoarthritis in participants with hypertension was significantly higher than those without hypertension (fully adjusted odds ratio (OR) 1.26; 95% confidence interval (CI) 1.08–1.48). Knee osteoarthritis prevalence was also higher in participants with impaired fasting glucose or diabetes than those without (age, sex adjusted OR 1.19; 95% CI 1.00–1.41). Also, OR values increased statistically significantly with FRS as a continuous variable (fully adjusted OR 1.007; 95% CI 1.00–1.01). Conclusions Prevalence of knee osteoarthritis was associated with hypertension and diabetes, which are major cardiovascular risk factors, and the FRS. Further studies on FRS pertaining to its relationship with osteoarthritis are warranted. PMID:27764239

  2. Evaluating the Framingham hypertension risk prediction model in young adults: the Coronary Artery Risk Development in Young Adults (CARDIA) study.

    PubMed

    Carson, April P; Lewis, Cora E; Jacobs, David R; Peralta, Carmen A; Steffen, Lyn M; Bower, Julie K; Person, Sharina D; Muntner, Paul

    2013-12-01

    A prediction model was developed in the Framingham Heart Study (FHS) to evaluate the short-term risk of hypertension. Our goal was to determine the predictive ability of the FHS hypertension model in a cohort of young adults advancing into middle age and compare it with the predictive ability of prehypertension and individual components of the FHS model. We studied 4388 participants, aged 18 to 30 years without hypertension at baseline, enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study, who participated in 2 consecutive examinations occurring 5 years apart between the baseline (1985-1986) and year 25 examination (2010-2011). Weibull regression was used to assess the association of the FHS model overall, individual components of the FHS model, and prehypertension with incident hypertension. During the 25-year follow-up period, 1179 participants developed incident hypertension. The FHS hypertension model (c-index=0.84; 95% confidence interval, 0.83-0.85) performed well in discriminating those who did and did not develop hypertension and was better than prehypertension alone (c-index=0.71; 95% confidence interval, 0.70-0.73). The predicted risk from the FHS hypertension model was systematically lower than the observed hypertension incidence initially (χ(2)=249.4; P<0.001) but demonstrated a good fit after recalibration (χ(2)=14.6; P=0.067). In summary, the FHS model performed better than prehypertension and may be a useful tool for identifying young adults with a high risk for developing hypertension.

  3. Young Adult Exposure to Cardiovascular Risk Factors and Risk of Events Later in Life: The Framingham Offspring Study

    PubMed Central

    Pletcher, Mark J.; Vittinghoff, Eric; Thanataveerat, Anusorn; Bibbins-Domingo, Kirsten

    2016-01-01

    Background It is unclear whether coronary heart disease (CHD) risk factor exposure during early adulthood contributes to CHD risk later in life. Our objective was to analyze whether extent of early adult exposures to systolic and diastolic blood pressure (SBP, DBP) and low-and high-density lipoprotein cholesterol (LDL, HDL) are independent predictors of CHD events later in life. Methods and Findings We used all available measurements of SBP, DBP, LDL, and HDL collected over 40 years in the Framingham Offspring Study to estimate risk factor trajectories, starting at age 20 years, for all participants. Average early adult (age 20–39) exposure to each risk factor was then estimated, and used to predict CHD events (myocardial infarction or CHD death) after age 40, with adjustment for risk factor exposures later in life (age 40+). 4860 participants contributed an average of 6.3 risk factor measurements from in-person examinations and 24.5 years of follow-up after age 40, and 510 had a first CHD event. Early adult exposures to high SBP, DBP, LDL or low HDL were associated with 8- to 30-fold increases in later life CHD event rates, but were also strongly correlated with risk factor levels later in life. After adjustment for later life levels and other risk factors, early adult DBP and LDL remained strongly associated with later life risk. Compared with DBP≤70 mmHg, adjusted hazard ratios (HRs) were 2.1 (95% confidence interval: 0.8–5.7) for DBP = 71–80, 2.6 (0.9–7.2) for DBP = 81–90, and 3.6 (1.2–11) for DBP>90 (p-trend = 0.019). Compared with LDL≤100 mg/dl, adjusted HRs were 1.5 (0.9–2.6) for LDL = 101–130, 2.2 (1.2–4.0) for LDL = 131–160, and 2.4 (1.2–4.7) for LDL>160 (p-trend = 0.009). While current levels of SBP and HDL were also associated with CHD events, we did not detect an independent association with early adult exposure to either of these risk factors. Conclusions Using a mixed modeling approach to estimation of young adult exposures

  4. Longitudinal association of dairy consumption with the changes in blood pressure and the risk of incident hypertension: the Framingham Heart Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We aimed to examine the longitudinal association of dairy consumption with the changes in blood pressure (BP) and the risk of incident hypertension (HTN) among adults. This study included 2636 Framingham Heart Study Offspring Cohort members who participated in the 5th through 8th examinations (1991-...

  5. Relationship Between Forced Vital Capacity and Framingham Cardiovascular Risk Score Beyond the Presence of Metabolic Syndrome: The Fourth Korea National Health and Nutrition Examination Survey.

    PubMed

    Kang, Hyung Koo; Park, Hye Yun; Jeong, Byeong-Ho; Koh, Won-Jung; Lim, Seong Yong

    2015-11-01

    Impaired lung function is a risk factor for cardiovascular (CV) events. However, it has not been well established whether FVC reduction even within normal range is associated with cardiovascular disease (CVD) risk and whether reduced FVC is an independent relationship of CVD irrespective of metabolic syndrome. Thus, we aimed to explore the relationship between FVC and CV-event risk using the FRS beyond the presence of metabolic syndrome or abdominal obesity in a representative Korean population based on data from the nationwide Korea National Health and Nutrition Examination Survey (KNHANES IV).The study population included 9688 subjects ≥ 30 years of age with no previous diagnosis of CVD and obstructive lung disease. Using a logistic regression model and area under the curve (AUC) analysis, we evaluated the relationship between FVC quintiles and CV-event risk using the Framingham Risk Score (FRS; ≥ 10% or ≥ 20%). In addition, we examined the effect of FVC on CV-event risk based on the presence of metabolic syndrome (MetS) and abdominal obesity.After adjusting for covariates, comparison of subjects in the lowest FVC (% pred) quintile (Q1) with those in the highest quintile (Q5) yielded an odds ratio (OR) of 2.27 (95% CI, 1.91-2.71) for intermediate and high risk, and 2.89 (95% CI, 2.31-3.61) for high risk. The ORs for cardiovascular risk using FRS also increased irrespective of the presence of abdominal obesity and MetS without significant interaction. Furthermore, the addition of FVC status to MetS status and abdominal obesity status significantly increased the AUC of the model predicting CV-event risk (P < 0.001 and P < 0.001).Our study demonstrates that FVC is inversely associated with 10-year CV-event risk, irrespective of MetS and abdominal obesity in the general population without obstructive lung disease. Furthermore, the addition of FVC to MetS or abdominal obesity increased prediction of CVD event risks, implying a potential role of FVC to predict CV

  6. Framingham Risk Score underestimates cardiovascular disease risk in severe psoriatic patients: implications in cardiovascular risk factors management and primary prevention of cardiovascular disease.

    PubMed

    Torres, Tiago; Sales, Rita; Vasconcelos, Carlos; Martins da Silva, Berta; Selores, Manuela

    2013-11-01

    Severe psoriasis has been associated with increase cardiovascular mortality, due to a higher prevalence of traditional cardiovascular risk factors and premature atherosclerosis, as a consequence of its systemic inflammation. Recently, it has been estimated that severe psoriasis may confer an increased 6.2% on long-term risk of cardiovascular disease based on Framingham Risk Score, which can have practical implications in the treatment of cardiovascular risk factors and primary prevention of cardiovascular disease, as treatment guidelines account for the risk of cardiovascular disease in treatment goals. The aim of this study was to analyze the influence of the attributable risk of severe psoriasis on long-term risk of cardiovascular disease and its implication on the correct treatment of cardiovascular risk factors and primary prevention of cardiovascular disease on a real-world cohort of patients. One hundred severe psoriasis patients without psoriatic arthritis or previous cardiovascular disease were evaluated and it was found that more than half of the patients were reclassified to a higher cardiovascular risk category with important clinical implications on the correct management of their cardiovascular risk factors and primary prevention of cardiovascular disease, as a considerable proportion of patients with hypertension, hypercholesterolemia and coronary heart disease equivalent risk were not being correctly managed.

  7. Lipoprotein(a) levels, apo(a) isoform size, and coronary heart disease risk in the Framingham Offspring Study

    PubMed Central

    Lamon-Fava, Stefania; Marcovina, Santica M.; Albers, John J.; Kennedy, Hal; DeLuca, Carl; White, Charles C.; Cupples, L. Adrienne; McNamara, Judith R.; Seman, Leo J.; Bongard, Vanina; Schaefer, Ernst J.

    2011-01-01

    The aim of this study was to assess the independent contributions of plasma levels of lipoprotein(a) (Lp(a)), Lp(a) cholesterol, and of apo(a) isoform size to prospective coronary heart disease (CHD) risk. Plasma Lp(a) and Lp(a) cholesterol levels, and apo(a) isoform size were measured at examination cycle 5 in subjects participating in the Framingham Offspring Study who were free of CHD. After a mean follow-up of 12.3 years, 98 men and 47 women developed new CHD events. In multivariate analysis, the hazard ratio of CHD was approximately two-fold greater in men in the upper tertile of plasma Lp(a) levels, relative to those in the bottom tertile (P < 0.002). The apo(a) isoform size contributed only modestly to the association between Lp(a) and CHD and was not an independent predictor of CHD. In multivariate analysis, Lp(a) cholesterol was not significantly associated with CHD risk in men. In women, no association between Lp(a) and CHD risk was observed. Elevated plasma Lp(a) levels are a significant and independent predictor of CHD risk in men. The assessment of apo(a) isoform size in this cohort does not add significant information about CHD risk. In addition, the cholesterol content in Lp(a) is not a significant predictor of CHD risk. PMID:21478162

  8. Arsenic Exposure and Predicted 10-Year Atherosclerotic Cardiovascular Risk Using the Pooled Cohort Equations in U.S. Hypertensive Adults

    PubMed Central

    Nong, Qingjiao; Zhang, Yiyi; Guallar, Eliseo; Zhong, Qiuan

    2016-01-01

    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

  9. Assessment of the 10-year risk of fracture in Italian postmenopausal women using FRAX®: a north Italian multicenter study.

    PubMed

    Pedrazzoni, M; Girasole, G; Giusti, A; Barone, A; Pioli, G; Passeri, G; Palummeri, E; Bianchi, G

    2011-12-01

    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.

  10. A 10-year retrospective study of suicide in Sikkim, India: Sociodemographic profile and risk assessment

    PubMed Central

    Chettri, Reshma; Gurung, Jiwan; Singh, Bisu

    2016-01-01

    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

  11. Developmental vitamin D deficiency and risk of schizophrenia: a 10-year update.

    PubMed

    McGrath, John J; Burne, Thomas H; Féron, François; Mackay-Sim, Allan; Eyles, Darryl W

    2010-11-01

    There is an urgent need to generate and test candidate risk factors that may explain gradients in the incidence of schizophrenia. Based on clues from epidemiology, we proposed that developmental vitamin D deficiency may contribute to the risk of developing schizophrenia. This hypothesis may explain diverse epidemiological findings including season of birth, the latitude gradients in incidence and prevalence, the increased risk in dark-skinned migrants to certain countries, and the urban-rural gradient. Animal experiments demonstrate that transient prenatal hypovitaminosis D is associated with persisting changes in brain structure and function, including convergent evidence of altered dopaminergic function. A recent case-control study based on neonatal blood samples identified a significant association between neonatal vitamin D status and risk of schizophrenia. This article provides a concise summary of the epidemiological and animal experimental research that has explored this hypothesis.

  12. The Association between Non-Invasive Hepatic Fibrosis Markers and Cardiometabolic Risk Factors in the Framingham Heart Study

    PubMed Central

    Pedley, Alison; Massaro, Joseph M.; Hoffmann, Udo; Fox, Caroline S.

    2016-01-01

    Background & Aims Non-alcoholic fatty liver disease (NAFLD) is associated with an increased risk of cardiovascular related death, particularly in those with hepatic fibrosis. We determined the prevalence of predicted fibrosis based on non-invasive fibrosis markers and the association of hepatic fibrosis with cardiovascular risk factors. Methods Cross-sectional study of 575 Framingham Heart Study participants with NAFLD based on computed tomography. We determined the prevalence of predicted fibrosis based on the aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, AST to platelet ratio index (APRI), the Fibrosis-4 score (FIB4), and the NAFLD Fibrosis Score (NFS). Using multivariable logistic regression models, we examined the association between low, indeterminate, or high risk for fibrosis according to the NFS and various cardiometabolic risk factors. Results The predicted risk of fibrosis was 12%, 4%, 5%, and 32% for the NFS, FIB4, APRI, and AST/ALT ratio, respectively. In multivariable models, participants with a high risk for advanced fibrosis by the NFS had a wider pulse pressure (adjusted mean difference = 6.87 mm Hg; p = 0.0002) and an increased odds of hypertension (OR 2.92; p = 0.007) compared to those with low risk of fibrosis. There were no statistically significant differences between other cardiovascular risk factors for those with a high versus low risk of fibrosis. Conclusions The AST/ALT ratio, APRI, and NFS give widely disparate predictions of liver fibrosis. Participants with a high risk for fibrosis based on NFS had wider pulse pressure and increased odds of hypertension. Whether modifying these risk factors impacts cardiovascular endpoints in NAFLD patients remains unknown. PMID:27341207

  13. Dietary calcium intake and risk of obesity in school girls aged 8-10 years

    PubMed Central

    Samadi, Mehnoosh; Sadrzadeh-Yeganeh, Haleh; Azadbakht, Leila; Feizi, Avat; Jafarian, Korosh; Sotoudeh, Gity

    2012-01-01

    Background: Some studies have demonstrated the role of calcium in reducing body mass index (BMI) or fat mass. Though, BMI does not provide very valid information about changes in body fat mass, Fat Mass Index (FMI) relates body fat mass to height and allows comparing body fat mass of individuals at different heights. This study investigated the possible association between dietary calcium intake (CI) and other nutritional factors and weight status of girls aged 8-10 years. Materials and Methods: In this case-control study, 110 girls aged 8-10 with FMI at or above 7.2 kg/m2 as cases and 307 girls with FMI less than 7.2 kg/m2 as controls were recruited through multistage cluster random sampling. FMI at or above 7.2 kg/m2 was considered as the cutoff point for obesity. Body fat mass was assessed by a stand on bio impedance analyzer. In order to assess CI, participants were asked to complete a validated food frequency questionnaire. Results: Mean and standard deviation of CI in the case group was significantly lower than the control group 649 ± 103 and 951 ± 152 mg/d, respectively (P < 0.01). After Adjustment for total energy intake, the percentage of energy from fat, carbohydrate and protein in quartiles of physical activity, inverse association between CI and obesity was significant and in the highest quartile of physical activity the association was weaker. By further adjustment for the effect of fruits and vegetable intake inverse association between CI and obesity became weaker but yet was significant. Conclusion: The inverse relationship between CI and FMI remained significant even after controlling for confounding factors. FMI may be more accurate, compared to BMI, in showing the association between CI and obesity. PMID:23853625

  14. Overeating and Binge Eating in Emerging Adulthood: 10-Year Stability and Risk Factors

    ERIC Educational Resources Information Center

    Goldschmidt, Andrea B.; Wall, Melanie M.; Zhang, Jun; Loth, Katie A.; Neumark-Sztainer, Dianne

    2016-01-01

    Overeating (eating an unusually large amount of food) and binge eating (overeating with loss of control [LOC]) predict adverse health consequences in adolescence. We aimed to characterize the stability of and risk factors for these distinct but interrelated constructs during critical developmental transitions. We used a population-based sample (n…

  15. Overeating and binge eating in emerging adulthood: 10-year stability and risk factors.

    PubMed

    Goldschmidt, Andrea B; Wall, Melanie M; Zhang, Jun; Loth, Katie A; Neumark-Sztainer, Dianne

    2016-03-01

    Overeating (eating an unusually large amount of food) and binge eating (overeating with loss of control [LOC]) predict adverse health consequences in adolescence. We aimed to characterize the stability of and risk factors for these distinct but interrelated constructs during critical developmental transitions. We used a population-based sample (n = 1,902) that completed surveys at 5-year intervals spanning adolescence and young adulthood. The trajectories of no overeating, overeating, binge eating, and binge eating disorder (BED; recurrent binge eating with associated distress) were characterized using cross-tabulations. Body mass index, depressive symptoms, self-esteem, and body satisfaction were examined as risk factors for no overeating, overeating, and binge eating (including BED) 5-years later using multinomial logistic regression. We found that all overeating categories tended to remit to no overeating at 5-year follow-up. Although overeating had the lowest remittance rates at each time-point, binge eating and BED showed higher rates of persistence or worsening of symptoms during the transition from late adolescence/early young adulthood to early/middle young adulthood. Overeating and binge eating had similar risk factors, although for females, depressive symptoms, body satisfaction, and self-esteem in late adolescence/early young adulthood differentially predicted binge eating versus overeating in early/middle young adulthood (ps < .05). While overeating with or without LOC tends to remit over time, problematic eating persists for a subset of individuals. Greater psychosocial problems in late adolescence/early young adulthood predicted greater odds of binge eating relative to overeating in early/middle young adulthood among females, indicating that poorer psychosocial functioning in this developmental stage portends more severe eating-related psychopathology later in life.

  16. Does low diastolic blood pressure contribute to the risk of recurrent hypertensive cardiovascular disease events? The Framingham Heart Study.

    PubMed

    Franklin, Stanley S; Gokhale, Sohum S; Chow, Vincent H; Larson, Martin G; Levy, Daniel; Vasan, Ramachandran S; Mitchell, Gary F; Wong, Nathan D

    2015-02-01

    Whether low diastolic blood pressure (DBP) is a risk factor for recurrent cardiovascular disease (CVD) events in persons with isolated systolic hypertension is controversial. We studied 791 individuals (mean age 75 years, 47% female, mean follow-up time: 8±6 years) with DBP <70 (n=225) versus 70 to 89 mm Hg (n=566) after initial CVD events in the original and offspring cohorts of the Framingham Heart Study. Recurrent CVD events occurred in 153 (68%) participants with lower DBP and 271 (48%) with higher DBP (P<0.0001). Risk of recurrent CVD events in risk factor-adjusted Cox regression was higher in those with DBP <70 mm Hg versus DBP 70 to 89 mm Hg in both treated (hazard ratio, 5.1 [95% confidence interval: 3.8-6.9] P<0.0001) and untreated individuals (hazard ratio, 11.7 [95% confidence interval: 6.5-21.1] P<0.0001; treatment interaction: P=0.71). Individually, coronary heart disease, heart failure, and stroke recurrent events were more likely with DBP <70 mm Hg versus 70 to 89 mm Hg (P<0.0001). To examine for an effect of wide pulse pressure on excess risk associated with low DBP, we defined 4 binary groupings of pulse pressure (≥68 versus <68 mm Hg) and DBP (<70 versus 70-89 mm Hg). CVD incidence rates were higher only in the group with pulse pressure ≥68 and DBP <70 mm Hg (76% versus 46%-54%; P<0.001). Persons with isolated systolic hypertension and prior CVD events have increased risk for recurrent CVD events in the presence of DBP <70 mm Hg versus DBP 70 to 89 mm Hg, whether treated or untreated, supporting wide pulse pressure as an important risk modifier for the adverse effect of low DBP.

  17. LDL Particle Number and Risk of Future Cardiovascular Disease in the Framingham Offspring Study – Implications for LDL Management

    PubMed Central

    Cromwell, William C.; Otvos, James D.; Keyes, Michelle J.; Pencina, Michael J.; Sullivan, Lisa; Vasan, Ramachandran S.; Wilson, Peter W.F.; D’Agostino, Ralph B.

    2009-01-01

    Background The cholesterol content of LDL particles is variable, causing frequent discrepancies between concentrations of LDL cholesterol and LDL particle number. In managing patients at risk for cardiovascular disease (CVD) to LDL target levels, it is unclear whether LDL cholesterol provides the optimum measure of residual risk and adequacy of LDL lowering treatment. Objective To compare the ability of alternative measures of LDL to provide CVD risk discrimination at relatively low levels consistent with current therapeutic targets. Methods Concentrations of LDL cholesterol (LDL-C) and non-HDL cholesterol (non-HDL-C) were measured chemically and LDL particle number (LDL-P) and VLDL particle number (VLDL-P) were measured by nuclear magnetic resonance (NMR) in 3066 middle-aged white participants (53% women) without CVD in the Framingham Offspring cohort. The main outcome measure was incidence of first CVD event. Results At baseline, the cholesterol content per LDL particle was negatively associated with triglycerides and positively associated with LDL-C. On follow-up (median 14.8 yrs), 265 men and 266 women experienced a CVD event. In multivariable models adjusting for non-lipid CVD risk factors, LDL-P was related more strongly to future CVD in both sexes than LDL-C or non-HDL-C. Subjects with a low level of LDL-P (<25th percentile) had a lower CVD event rate (59 events per 1000 person-years) than those with an equivalently low level of LDL-C or non-HDL-C (81 and 74 events per 1000 person-years, respectively). Conclusions In a large community-based sample, LDL-P was a more sensitive indicator of low CVD risk than either LDL-C or non-HDL-C, suggesting a potential clinical role for LDL-P as a goal of LDL management. PMID:19657464

  18. Low-density-lipoprotein cholesterol concentrations and risk of incident diabetes: epidemiological and genetic insights from the Framingham Heart Study

    PubMed Central

    Andersson, Charlotte; Lyass, Asya; Larson, Martin G.; Robins, Sander J.; Vasan, Ramachandran S.

    2015-01-01

    Aims/hypothesis Statins and niacin (nicotinic acid) reduce circulating LDL-cholesterol (LDLC) levels by different mechanisms. Yet, both increase the risk of diabetes mellitus. Our objective was to relate blood LDL-C concentrations and a genetic risk score (GRS) for LDLC to the risk of incident diabetes in individuals not treated with lipid-modifying therapy. Methods We evaluated participants of the Framingham Heart Study who attended any of Offspring cohort examination cycles 3–8 and Third Generation cohort examination cycle 1 (N =14,120 person-observations, 6,011 unique individuals; mean age 50 ± 11 years, 56% women), who were not treated with lipid-modifying or antihypertensive medications and who were free from cardiovascular disease at baseline. Incident diabetes was assessed at the next examination. Results The GRS was significantly associated with LDL-C concentrations (sex- and age-adjusted estimated influence 0.24, p < 0.0001). On follow-up (mean 4.5 ± 1.5 years), 312 individuals (2.2%) developed new-onset diabetes. In multivariable models, a higher LDL-C concentration was associated with lower risk of diabetes (OR per SD increment 0.81, 95% CI 0.70, 0.93, p = 0.004). The GRS was associated with incident diabetes in similar direction and of comparable magnitude (OR per SD increment 0.85, 95% CI 0.76, 0.96, p = 0.009). Conclusions/interpretation Among individuals not treated with lipid-modifying therapy low LDL-C concentrations were associated with increased diabetes risk. These observations may contribute to our understanding of why lipid-lowering treatment may cause diabetes in some individuals. Additional studies are warranted to elucidate the molecular mechanisms underlying our observations. PMID:26409460

  19. Association between the Family Nutrition and Physical Activity screening tool and cardiovascular disease risk factors in 10-year old children

    NASA Astrophysics Data System (ADS)

    Yee, Kimbo Edward

    Purpose. To examine the association of the Family Nutrition and Physical Activity (FNPA) screening tool, a behaviorally based screening tool designed to assess the obesogenic family environment and behaviors, with cardiovascular disease (CVD) risk factors in 10-year old children. Methods. One hundred nineteen children were assessed for body mass index (BMI), percent body fat (%BF), waist circumference (WC), total cholesterol, HDL-cholesterol, and resting blood pressure. A continuous CVD risk score was created using total cholesterol to HDL-cholesterol ratio (TC:HDL), mean arterial pressure (MAP), and WC. The FNPA survey was completed by parents. The associations between the FNPA score and individual CVD risk factors and the continuous CVD risk score were examined using correlation analyses. Results. Approximately 35% of the sample were overweight (19%) or obese (16%). The mean FNPA score was 24.6 +/- 2.5 (range 18 to 29). Significant correlations were found between the FNPA score and WC (r = -.35, p<.01), BMI percentile (r = -.38, p<.01), %BF (r = -.43, p<.01), and the continuous CVD risk score (r = -.22, p = .02). No significant association was found between the FNPA score and TC:HDL (r=0.10, p=0.88) or MAP (r=-0.12, p=0.20). Conclusion. Children from a high-risk, obesogenic family environment as indicated with a lower FNPA score have a higher CVD risk factor profile than children from a low-risk family environment.

  20. Dietary carbohydrates and cardiovascular disease risk factors in the Framingham Offspring Cohort

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Evidence from observational studies has suggested that carbohydrate quality rather than absolute intake is associated with greater risk of chronic diseases. The aim of this study was to examine the relationship between carbohydrate intake and glycemic index and several cardiovascular disease risk f...

  1. Predicting coronary heart disease: from Framingham Risk Score to ultrasound bioimaging.

    PubMed

    Sillesen, Henrik; Fuster, Valentin

    2012-01-01

    Atherosclerosis is the leading cause of death and disabling disease. Whereas risk factors are well known and constitute therapeutic targets, they are not useful for prediction of risk of future myocardial infarction, stroke, or death. Therefore, methods to identify atherosclerosis itself have been tested and found useful (ie, coronary calcium detection by computed tomography scanning, reduction in ankle-brachial index, and ultrasound scanning of the carotid arteries). This review will focus on the latter technique. Detection of thickened carotid intima-media by ultrasound has been used in many large epidemiological studies, but although it has been found to be associated with increased risk of cardiovascular death, its clinical utility is limited. Detection of carotid plaque has, on the other hand, been found to be associated with a substantial risk of future events. Similarly, detection of plaque in the femoral arteries is associated with increased risk, and plaque in the femoral as well as carotid arteries predicts even higher risk. Furthermore, quantification of plaque size (plaque area), such as quantification of amount of coronary calcium on computed tomography scanning, improves predictability-the larger the plaques, the higher the risk. So far, studies using ultrasound all have been performed with 2-dimensional ultrasound imaging. Recently, 3-dimensional ultrasound imaging has been introduced, which allows for more accurate quantification of atherosclerosis. Small studies pioneering its use have indicated the utility of measuring changes in vessel-wall volume and plaque volume with respect to treatment effect. The High-Risk Plaque Initiative BioImage Study is currently investigating the predictive value of total carotid plaque volume with respect to prediction of future cardiovascular events.

  2. A Novel Risk Score to the Prediction of 10-year Risk for Coronary Artery Disease Among the Elderly in Beijing Based on Competing Risk Model

    PubMed Central

    Liu, Long; Tang, Zhe; Li, Xia; Luo, Yanxia; Guo, Jin; Li, Haibin; Liu, Xiangtong; Tao, Lixin; Yan, Aoshuang; Guo, Xiuhua

    2016-01-01

    Abstract The study aimed to construct a risk prediction model for coronary artery disease (CAD) based on competing risk model among the elderly in Beijing and develop a user-friendly CAD risk score tool. We used competing risk model to evaluate the risk of developing a first CAD event. On the basis of the risk factors that were included in the competing risk model, we constructed the CAD risk prediction model with Cox proportional hazard model. Time-dependent receiver operating characteristic (ROC) curve and time-dependent area under the ROC curve (AUC) were used to evaluate the discrimination ability of the both methods. Calibration plots were applied to assess the calibration ability and adjusted for the competing risk of non-CAD death. Net reclassification index (NRI) and integrated discrimination improvement (IDI) were applied to quantify the improvement contributed by the new risk factors. Internal validation of predictive accuracy was performed using 1000 times of bootstrap re-sampling. Of the 1775 participants without CAD at baseline, 473 incident cases of CAD were documented for a 20-year follow-up. Time-dependent AUCs for men and women at t = 10 years were 0.841 [95% confidence interval (95% CI): 0.806–0.877], 0.804 (95% CI: 0.768–0.839) in Fine and Gray model, 0.784 (95% CI: 0.738–0.830), 0.733 (95% CI: 0.692–0.775) in Cox proportional hazard model. The competing risk model was significantly superior to Cox proportional hazard model on discrimination and calibration. The cut-off values of the risk score that marked the difference between low-risk and high-risk patients were 34 points for men and 30 points for women, which have good sensitivity and specificity. A sex-specific multivariable risk factor algorithm-based competing risk model has been developed on the basis of an elderly Chinese cohort, which could be applied to predict an individual's risk and provide a useful guide to identify the groups at a high risk for CAD among the Chinese

  3. A Novel Risk Score to the Prediction of 10-year Risk for Coronary Artery Disease Among the Elderly in Beijing Based on Competing Risk Model.

    PubMed

    Liu, Long; Tang, Zhe; Li, Xia; Luo, Yanxia; Guo, Jin; Li, Haibin; Liu, Xiangtong; Tao, Lixin; Yan, Aoshuang; Guo, Xiuhua

    2016-03-01

    The study aimed to construct a risk prediction model for coronary artery disease (CAD) based on competing risk model among the elderly in Beijing and develop a user-friendly CAD risk score tool. We used competing risk model to evaluate the risk of developing a first CAD event. On the basis of the risk factors that were included in the competing risk model, we constructed the CAD risk prediction model with Cox proportional hazard model. Time-dependent receiver operating characteristic (ROC) curve and time-dependent area under the ROC curve (AUC) were used to evaluate the discrimination ability of the both methods. Calibration plots were applied to assess the calibration ability and adjusted for the competing risk of non-CAD death. Net reclassification index (NRI) and integrated discrimination improvement (IDI) were applied to quantify the improvement contributed by the new risk factors. Internal validation of predictive accuracy was performed using 1000 times of bootstrap re-sampling. Of the 1775 participants without CAD at baseline, 473 incident cases of CAD were documented for a 20-year follow-up. Time-dependent AUCs for men and women at t = 10 years were 0.841 [95% confidence interval (95% CI): 0.806-0.877], 0.804 (95% CI: 0.768-0.839) in Fine and Gray model, 0.784 (95% CI: 0.738-0.830), 0.733 (95% CI: 0.692-0.775) in Cox proportional hazard model. The competing risk model was significantly superior to Cox proportional hazard model on discrimination and calibration. The cut-off values of the risk score that marked the difference between low-risk and high-risk patients were 34 points for men and 30 points for women, which have good sensitivity and specificity. A sex-specific multivariable risk factor algorithm-based competing risk model has been developed on the basis of an elderly Chinese cohort, which could be applied to predict an individual's risk and provide a useful guide to identify the groups at a high risk for CAD among the Chinese adults over 55

  4. Dietary carbohydrates and cardiovascular disease risk factors in the Framingham Offspring Cohort

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Evidence from observational studies has suggested that carbohydrate quality rather than absolute intake is associated with greater risk of chronic diseases. The aim of this study was to examine the relationship between carbohydrate intake and dietary glycemic index and several cardiovascular disease...

  5. A genetic risk score based on direct associations with coronary heart disease improves coronary heart disease risk prediction in the Atherosclerosis Risk in Communities (ARIC), but not in the Rotterdam and Framingham Offspring, Studies

    PubMed Central

    Brautbar, Ariel; Pompeii, Lisa A.; Dehghan, Abbas; Ngwa, Julius S.; Nambi, Vijay; Virani, Salim S.; Rivadeneira, Fernando; Uitterlinden, André G.; Hofman, Albert; Witteman, Jacqueline C.M.; Pencina, Michael J.; Folsom, Aaron R.; Cupples, L. Adrienne; Ballantyne, Christie M.; Boerwinkle, Eric

    2013-01-01

    Objective Multiple studies have identified single-nucleotide polymorphisms (SNPs) that are associated with coronary heart disease (CHD). We examined whether SNPs selected based on predefined criteria will improve CHD risk prediction when added to traditional risk factors (TRFs). Methods SNPs were selected from the literature based on association with CHD, lack of association with a known CHD risk factor, and successful replication. A genetic risk score (GRS) was constructed based on these SNPs. Cox proportional hazards model was used to calculate CHD risk based on the Atherosclerosis Risk in Communities (ARIC) and Framingham CHD risk scores with and without the GRS. Results The GRS was associated with risk for CHD (hazard ratio [HR] = 1.10; 95% confidence interval [CI]: 1.07–1.13). Addition of the GRS to the ARIC risk score significantly improved discrimination, reclassification, and calibration beyond that afforded by TRFs alone in non-Hispanic whites in the ARIC study. The area under the receiver operating characteristic curve (AUC) increased from 0.742 to 0.749 (Δ= 0.007; 95% CI, 0.004–0.013), and the net reclassification index (NRI) was 6.3%. Although the risk estimates for CHD in the Framingham Offspring (HR = 1.12; 95% CI: 1.10–1.14) and Rotterdam (HR = 1.08; 95% CI: 1.02–1.14) Studies were significantly improved by adding the GRS to TRFs, improvements in AUC and NRI were modest. Conclusion Addition of a GRS based on direct associations with CHD to TRFs significantly improved discrimination and reclassification in white participants of the ARIC Study, with no significant improvement in the Rotterdam and Framingham Offspring Studies. PMID:22789513

  6. Role of Coronary Artery Calcium Scoring in Detection of Coronary Artery Disease according to Framingham Risk Score in Populations with Low to Intermediate Risks.

    PubMed

    Kim, Won-Jang; Kwon, Chang Hee; Han, Seungbong; Lee, Woo Seok; Kang, Joon Won; Ahn, Jung-Min; Lee, Jong-Young; Park, Duk-Woo; Kang, Soo-Jin; Lee, Seung-Whan; Kim, Young-Hak; Lee, Cheol Whan; Park, Seong-Wook; Park, Seung-Jung

    2016-06-01

    Current guidelines recommend that coronary artery calcium (CAC) screening should only be used for intermediate risk groups (Framingham risk score [FRS] of 10%-20%). The CAC distributions and coronary artery disease (CAD) prevalence in various FRS strata were determined. The benefit to lower risk populations of CAC score-based screening was also assessed. In total, 1,854 participants (aged 40-79 years) without history of CAD, stroke, or diabetes were enrolled. CAC scores of > 0, ≥ 100, and ≥ 300 were present in 33.8%, 8.2%, and 2.9% of the participants, respectively. The CAC scores rose significantly as the FRS grew more severe (P < 0.01). The total CAD prevalence was 6.1%. The occult CAD prevalence in the FRS ≤ 5%, 6%-10%, 11%-20%, and > 20% strata were 3.4%, 6.7%, 9.0%, and 11.6% (P < 0.001). In multivariate logistic regression analysis adjusting, not only the intermediate and high risk groups but also the low risk (FRS 6%-10%) group had significantly increased odds ratio for occult CAD compared to the very low-risk (FRS ≤ 5%) group (1.89 [95% confidence interval, CI, 1.09-3.29] in FRS 6%-10%; 2.48 [95% CI, 1.47-4.20] in FRS 11%-20%; and 3.10 [95% CI, 1.75-5.47] in FRS > 20%; P < 0.05). In conclusion, the yield of screening for significant CAC and occult CAD is low in the very low risk population but it rises in low and intermediate risk populations.

  7. Evolution of Framingham cardiovascular risk score in HIV-infected patients initiating EFV- and LPV/r-based HAART in a Latin American cohort

    PubMed Central

    Cecchini, Diego; Ines Mattioli, Maria; Cassetti, Julia; Chan, Debora; Cassetti, Isabel

    2014-01-01

    Introduction Epidemiological studies suggest that some antiretroviral drugs may contribute to increase cardiovascular risk in HIV-infected patients. However, data from Latin American countries are limited, as impact of HAART on cardiovascular risk remains understudied. In this context, we aimed to evaluate if 10-year Framingham Cardiovascular Risk Score (FCRS) increases in patients following exposure to EFV- and LPV/r-based HAART in a Latin American cohort. Materials and Methods Retrospective 48-week cohort study. We reviewed clinical charts of randomly selected samples of patients initiating (according to national guidelines) EFV first-line HAART and LPV/r first- or second-line (but first PI-based) HAART assisted at a reference HIV centre in Buenos Aires, Argentina (period 2004–2012). Each patient could only be included in one arm. FCRS was calculated according to National Institutes of Health risk assessment tool (http://cvdrisk.nhlbi.nih.gov/). Results A total of 357 patients were included: 249 in EFV arm and 108 in LPV/r arm (80 as first line and 28 as second line, but first PI-based HAART). Baseline characteristics (median, interquartile range): age, 38 (33–45) years; male, 247 (69%); viral load, 98200 (20550–306000) copies/mL; CD4 T-cell count, 115 (60–175) cel/µL; total cholesterol, 159 (135–194) mg/dL; HDL: 39 (31–41) mg/dL; LDL: 94 (72–123) mg/dL; current smoker, 29%; on antihypertensive drugs: 14 (4%), diabetic: 4 (1%). Most frequent accompanying nucleoside reverse transcriptase inhibitors (NRTIs) were 3TC (92%) and zidovudine (AZT; 76%). Baseline FCRS was low, moderate and high for 93%, 7% and 0% of patients on EFV arm and 96.7%, 1.7% and 1.7% on LPV/r arm. On EFV arm, an increase in FCRS category (low to moderate or moderate to high) was observed in 1 patient (0.9%) at 24 weeks and 6 (5,6%) at 48 weeks; 5 (4.7%) decreased category. On LPV/r arm no one varied FCRS category at 24 weeks and 2 (3.4%) increased from low to moderate at 48 weeks

  8. Correlates of sedentary behaviour in 8- to 10-year-old children at elevated risk for obesity.

    PubMed

    Herman, Katya M; Sabiston, Catherine M; Mathieu, Marie-Eve; Tremblay, Angelo; Paradis, Gilles

    2015-01-01

    The purpose of this study was to describe correlates of sedentary behaviour (SED) in children at elevated risk of obesity because of parental obesity. Participants were 534 children aged 8-10 years with ≥ 1 obese parent. SED and physical activity (PA) were measured by accelerometer, screen time by self-report, and height, weight, waist circumference, and cardiovascular fitness objectively measured. Data describing the child, parents, friends, and home and neighbourhood environments were from child self-report. Higher total SED time was significantly positively associated with child's age, mother's age, Tanner stage, weight status or waist circumference, less self-reported PA, choosing screen time over PA/sport, mother saying PA/sport good for them, and fewer weekly physical education (PE) classes. Exceeding 2 h/day screen time was significantly associated with child's age, male sex, weight status or waist circumference, choosing screen time over PA/sport, and dinnertime TV viewing. Children regularly watching TV with dinner had 2.3 times greater odds (95% confidence interval (CI) 1.52, 3.58) of exceeding screen time guidelines compared with children rarely watching TV with dinner; children reporting ≤ 2 PE classes/week had 2.4 times greater odds (95% CI 1.41, 4.10) of being in the highest SED tertile compared with children reporting >2 PE classes/week. Hence, the most sedentary children are older, more biologically mature, less active, more overweight/obese, have fewer PE classes, and are more likely to choose screen time over PA and watch TV with dinner compared with less sedentary children. PE opportunities and mealtime TV viewing are potentially modifiable targets for reducing total SED and screen time in children.

  9. P Wave Duration and Risk of Longitudinal Atrial Fibrillation Risk in Persons ≥60 Years Old (from the Framingham Heart Study)

    PubMed Central

    Magnani, Jared W.; Johnson, Victor M.; Sullivan, Lisa M.; Gorodeski, Eiran Z.; Schnabel, Renate B.; Lubitz, Steven A.; Levy, Daniel; Ellinor, Patrick T.; Benjamin, Emelia J.

    2011-01-01

    Long-term risk prediction is a priority for the prevention of atrial fibrillation (AF). P wave indices are electrocardiographic measurements describing atrial conduction. The role of P wave indices in the prospective determination of AF and mortality risk has had limited assessment. We quantified by digital caliper the P wave indices of maximum duration and dispersion in 1,550 Framingham Heart Study participants ≥60 years old (58% women) from single-channel electrocardiograms recorded from 1968 through 1971. We examined the association of selected P wave indices and long-term outcomes using Cox proportional hazards regression incorporating age, gender, body mass index, systolic blood pressure, treatment for hypertension, significant murmur, heart failure, and PR interval. Over a median follow-up of 15.8 years (range 0 to 38.7), 359 participants developed AF and 1,525 died. Multivariable-adjusted hazard ratios (HRs) per SD increase in maximum P wave duration were 1.15 (95% confidence interval [CI] 0.90 to 1.47, p = 0.27) for AF and 1.02 (95% CI 0.96 to 1.08, p = 0.18) for mortality. The upper 5% of P wave maximum duration had a multivariable-adjusted HR of 2.51 (95% CI 1.13 to 5.57, p = 0.024) for AF and an HR of 1.11 (95% CI 0.87 to 1.40, p = 0.20) for mortality. We found no significant associations between P wave dispersion with incidence of AF or mortality. In conclusion, maximum P wave duration at the upper fifth percentile was associated with long-term AF risk in an elderly community-based cohort. P wave duration is an electrocardiographic endophenotype for AF. PMID:21255761

  10. Relation of nonalcoholic fatty liver disease and Framingham Risk Score to flow-mediated dilation in patients with cardiometabolic risk factors.

    PubMed

    Pastori, Daniele; Loffredo, Lorenzo; Perri, Ludovica; Baratta, Francesco; Scardella, Laura; Polimeni, Licia; Pani, Arianna; Brancorsini, Monica; Albanese, Fabiana; Catasca, Elisa; Del Ben, Maria; Violi, Francesco; Angelico, Francesco

    2015-05-15

    Nonalcoholic fatty liver disease (NAFLD) has a high prevalence in the general population. Brachial artery flow-mediated dilation (FMD) is a surrogated marker of early atherosclerosis. Few data investigating the relation between FMD, NAFLD, and cardiovascular (CV) risk are available. We recruited 367 consecutive outpatients with cardiometabolic risk factors who underwent ultrasound scanning for liver steatosis and FMD. Mean age was 54.2 ± 12.2 years, and 37% were women. NAFLD was present in 281 patients (77%). Median FMD was 5.1%. FMD was significantly reduced in patients with NAFLD (p <0.001), diabetes (p = 0.001), history of coronary heart disease (p = 0.034), and metabolic syndrome (p = 0.050) and in those taking antihypertensive drugs (p = 0.022). Women disclosed greater FMD than males (p = 0.033). Moreover, FMD inversely correlated with age (Spearman rank correlation test [Rs], -0.171; p = 0.001), waist circumference (Rs, -0.127; p = 0.016), fasting blood glucose (Rs, -0.204; p <0.001), and gamma-glutamyl transpeptidase (Rs, -0.064; p = 0.234). At multivariate regression analysis, fasting blood glucose (β, -0.148; p = 0.008), age (β, -0.158; p = 0.005), and the presence of NAFLD (β, -0.132; p = 0.016) inversely correlated with FMD, whereas female gender predicted a better FMD (β, 0.125; p = 0.022). FMD and Framingham Risk Score (FRS) were inversely correlated (Rs, -0.183; p <0.001). After dividing patients into low (FRS <10; FMD, 5.5% [3.1% to 8.9%]), intermediate (FRS 10 to 20; FMD, 4.9% [2.7% to 7.5%]), and high (FRS >20; FMD, 3.3% [1.7% to 4.5%]) risk, FMD significantly decreased across risk classes of FRS (p = 0.003). At multivariate regression analysis, both FRS (β, -0.129; p = 0.016) and NAFLD (β, -0.218; p <0.001) were variables independently associated with FMD. In conclusion, the presence of NAFLD and FRS inversely correlated with FMD.

  11. Serum BDNF and VEGF levels are associated with Risk of Stroke and Vascular Brain Injury: Framingham Study

    PubMed Central

    Pikula, Aleksandra; Beiser, Alexa S.; Chen, Tai C.; Preis, Sarah R.; Vorgias, Demetrios; DeCarli, Charles; Au, Rhoda; Kelly-Hayes, Margaret; Kase, Carlos S.; Wolf, Philip A.; Vasan, Ramachandran S.; Seshadri, Sudha

    2013-01-01

    Background and Purpose BDNF, a major neurotrophin and VEGF, an endothelial growth factor have a documented role in neurogenesis, angiogenesis and neuronal survival. In animal experiments they impact infarct size and functional motor recovery after an ischemic brain lesion. We sought to examine the association of serum BDNF and VEGF with the risk of clinical stroke or subclinical vascular brain injury in a community-based sample. Methods In 3440 stroke/TIA-free FHS participants (mean age 65±11yrs, 56%W), we related baseline BDNF and logVEGF to risk of incident stroke/TIA. In a subsample with brain MRI and with neuropsychological (NP) tests available (N=1863 and 2104, respectively; mean age 61±9yrs, 55%W, in each) we related baseline BDNF and logVEGF to log-white matter hyperintensity volume (lWMHV) on brain MRI, and to visuospatial memory and executive function tests. Results During a median follow-up of 10 years, 193 participants experienced incident stroke/TIA. In multivariable analyses adjusted for age-, sex- and traditional stroke risk factors, lower BDNF and higher logVEGF levels were associated with an increased risk of incident stroke/TIA (HR comparing BDNF Q1 versus Q2–4:1.47, 95%CI:1.09–2.00, p=0.012; and HR/SD increase in logVEGF:1.21, 95%CI:1.04–1.40, p=0.012). Persons with higher BDNF levels had less lWMHV (β±SE=−0.05±0.02; p=0.025), and better visual memory (β±SE=0.18±0.07; p=0.005). Conclusions Lower serum BDNF and higher VEGF concentrations were associated with increased risk of incident stroke/TIA. Higher levels of BDNF were also associated with less white matter hyperintensity and better visual memory. Our findings suggest that circulating BDNF and VEGF levels modify risk of clinical and subclinical vascular brain injury. PMID:23929745

  12. Intra-uterine growth restriction as a risk factor for hypertension in children six to 10 years old

    PubMed Central

    Zamecznik, Agata; Niewiadomska-Jarosik, Katarzyna; Zamojska, Justyna; Stańczyk, Jerzy; Wosiak, Agnieszka; Moll, Jadwiga

    2014-01-01

    Summary Introduction Intra-uterine growth restriction (IUGR) is present in about 3–10% of live-born newborns and it is as high as 20–30% in developing countries. Since the 1990s, it has been known that abnormalities during foetal growth may result in cardiovascular disease, including hypertension in adulthood. Methods This study evaluated blood pressure parameters (using ambulatory blood pressure monitoring) in children aged six to 10 years old, born as small for gestational age (SGA), and compared them to their healthy peers born as appropriate for gestational age (AGA). Results In the SGA group, an abnormal blood pressure level (prehypertension or hypertension) was present significantly more often than in the AGA group (50 vs 16%, p < 0.01). This relationship also occurred in association with the type of IUGR (asymmetric p < 0.01, symmetric p < 0.05). Conclusion In SGA children, abnormal blood pressure values occurred more frequently than in AGA children. PMID:24844552

  13. Joint association of physical activity/screen time and diet on CVD risk factors in 10-year-old children.

    PubMed

    Drenowatz, Clemens; Carlson, Joseph J; Pfeiffer, Karin A; Eisenmann, Joey C

    2012-12-01

    The increasing prevalence of childhood overweight and obesity has been associated with an increased risk for cardiovascular disease (CVD). While several studies examined the effect of single behaviors such as physical activity (PA), sedentary behavior or diet on CVD risk, there is a lack of research on combined associations, specifically in children. Therefore, the purpose of this study was to examine the joint association of PA or screen time (ST) and diet on CVD risk factors in children. PA, STand diet were assessed via questionnaire in 210 fifth grade students (age: 10.6 ± 0.4 years). The healthy eating index (HEI) was subsequently calculated as indicator for diet quality. Height, weight, % body fat, and resting blood pressure were measured according to standard procedures and blood samples obtained via fingerprick were assayed for blood lipids. Total cholesterol HDL ratio (TC:HDL), mean arterial pressure (MAP), and % body fat were used as indicators of CVD risk. 55% of children did not meet current PA recommendations on at least 5 days/week and 70% exceeded current recommendations for ST. Further, only 2.5% possessed a "good" diet (HEI> 80). There was no significant association of PA or STand diet on CVD risk score. Neither TC:HDL, MAP, and % body fat nor the total CVD risk score was significantly correlated with diet, PA, or ST. Children in the high PA group, however, had significantly better diet scores. Despite the fact that self-reported PA, ST, or dietary intake were not directly related to CVD risk in this sample, higher activity levels were associated with a healthier diet and lower ST indicating an overall healthier lifestyle of this subgroup.

  14. Living in danger: previous violence, socioeconomic position, and mortality risk among women over a 10-year period.

    PubMed

    Trygged, Sven; Hedlund, Ebba; Kåreholt, Ingemar

    2014-01-01

    Violence against women has many negative consequences. In this short report the authors investigate patterns of mortality among women experiencing violence leading to inpatient care from 1992 to 2006. Do women who are victims of severe violence have an increased mortality risk (a) in general? (b) by violence? (c) by suicide? Does socioeconomic position have any bearing on the mortality risk? The study was based on Swedish national registers, where 6,085 women exposed to violence resulting in inpatient care were compared with a nonexposed population sample of 55,016 women. Women of all social strata previously exposed to severe violence and treated in hospital had a highly increased risk of premature death from all-cause mortality, violence, or suicide. Women previously exposed to severe violence continue to live a life in danger. There is need for a societal response to support and protect these women against further violence after discharge from hospital.

  15. Head injury as a risk factor for Alzheimer's disease: the evidence 10 years on; a partial replication

    PubMed Central

    Fleminger, S; Oliver, D; Lovestone, S; Rabe-Hesketh, S; Giora, A

    2003-01-01

    Objective: To determine, using a systematic review of case-control studies, whether head injury is a significant risk factor for Alzheimer's disease. We sought to replicate the findings of the meta-analysis of Mortimer et al (1991). Methods: A predefined inclusion criterion specified case-control studies eligible for inclusion. A comprehensive and systematic search of various electronic databases, up to August 2001, was undertaken. Two independent reviewers screened studies for eligibility. Fifteen case-control studies were identified that met the inclusion criteria, of which seven postdated the study of Mortimer et al. Results: We partially replicated the results of Mortimer et al. The meta-analysis of the seven studies conducted since 1991 did not reach significance. However, analysis of all 15 case-control studies was significant (OR 1.58, 95% CI 1.21 to 2.06), indicating an excess history of head injury in those with Alzheimer's disease. The finding of Mortimer et al that head injury is a risk factor for Alzheimer's disease only in males was replicated. The excess risk of head injury in those with Alzheimer's disease is only found in males (males: OR 2.29, 95% CI 1.47 to 2.06; females: OR 0.91, 95% CI 0.56 to 1.47). Conclusions: This study provides support for an association between a history of previous head injury and the risk of developing Alzheimer's disease. PMID:12810767

  16. Risk of heart failure after community acquired pneumonia: prospective controlled study with 10 years of follow-up.

    PubMed

    Eurich, Dean T; Marrie, Thomas J; Minhas-Sandhu, Jasjeet K; Majumdar, Sumit R

    2017-02-13

    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

  17. Dairy Intakes at Age 10 Years Do Not Adversely Affect Risk of Excess Adiposity at 13 Years123

    PubMed Central

    Bigornia, Sherman J.; LaValley, Michael P.; Moore, Lynn L.; Northstone, Kate; Emmett, Pauline; Ness, Andy R.; Newby, P. K.

    2014-01-01

    Evidence of an association between milk intake and childhood adiposity remains inconsistent, with few data available regarding the effects of the amount of dairy fat consumed. This study examined the relation between dairy consumption (total, full, and reduced fat) at age 10 y on risk of excess adiposity at age 13 y in participants of the Avon Longitudinal Study of Parents and Children (ALSPAC; n = 2455). Intakes were assessed by 3-d dietary records. Total body fat mass (TBFM) using dual-energy X-ray absorptiometry was examined at 13 y. Outcomes included excess TBFM (top quintile of TBFM), overweight, and change in body mass index (BMI). The highest vs. lowest quartile of total dairy consumers (g/d) at age 10 y did not have an increased risk of excess TBFM (OR: 0.73; 95% CI: 0.46, 1.16; P-trend = 0.28) or overweight (OR: 0.69; 95% CI: 0.41, 1.15; P = 0.24) at age 13 y. Children in the highest quartile of full-fat dairy intakes vs. those in the lowest quartile had a reduced risk of excess TBFM (OR: 0.64; 95% CI: 0.41, 1.00; P = 0.04) and a suggestion of a reduction in overweight (OR: 0.65; 95% CI: 0.40, 1.06; P = 0.19) at age 13 y. Furthermore, the highest vs. lowest consumers of full-fat products had smaller gains in BMI during follow-up [2.5 kg/m2 (95% CI: 2.2, 2.7) vs. 2.8 kg/m2 (95% CI: 2.5, 3.0); P < 0.01]. Associations with reduced-fat dairy consumption did not attain statistical significance. In this study, dairy consumption was not related to excess fat accumulation during late childhood. Estimates had wide confidence limits but generally showed inverse relations between dairy intakes and risk of excess adiposity. Additional prospective research is warranted to confirm the effects of dairy intake on obesity in children. PMID:24744312

  18. From process to pattern: how fluctuating predation risk impacts the stress axis of snowshoe hares during the 10-year cycle.

    PubMed

    Sheriff, Michael J; Krebs, Charles J; Boonstra, Rudy

    2011-07-01

    Predation is a central organizing process affecting populations and communities. Traditionally, ecologists have focused on the direct effects of predation--the killing of prey. However, predators also have significant sublethal effects on prey populations. We investigated how fluctuating predation risk affected the stress physiology of a cyclic population of snowshoe hares (Lepus americanus) in the Yukon, finding that they are extremely sensitive to the fluctuating risk of predation. In years of high predator numbers, hares had greater plasma cortisol levels at capture, greater fecal cortisol metabolite levels, a greater plasma cortisol response to a hormone challenge, a greater ability to mobilize energy and poorer body condition. These indices of stress had the same pattern within years, during the winter and over the breeding season when the hare:lynx ratio was lowest and the food availability the worst. Previously we have shown that predator-induced maternal stress lowers reproduction and compromises offspring's stress axis. We propose that predator-induced changes in hare stress physiology affect their demography through negative impacts on reproduction and that the low phase of cyclic populations may be the result of predator-induced maternal stress reducing the fitness of progeny. The hare population cycle has far reaching ramifications on predators, alternate prey, and vegetation. Thus, predation is the predominant organizing process for much of the North American boreal forest community, with its indirect signature--stress in hares--producing a pattern of hormonal changes that provides a sensitive reflection of fluctuating predator pressure that may have long-term demographic consequences.

  19. 10-Year Survival and Quality of Life in Patients With High-Risk {sub P}N{sub 0} Prostate Cancer Following Definitive Radiotherapy

    SciTech Connect

    Berg, Arne Lilleby, Wolfgang; Bruland, Oyvind Sverre; Fossa, Sophie Dorothea

    2007-11-15

    Purpose: To evaluate long-term overall survival (OS), cancer-specific survival (CSS), clinical progression-free survival (cPFS), and health-related quality of life (HRQoL) following definitive radiotherapy (RT) given to T{sub 1-4p}N{sub 0}M{sub 0} prostate cancer patients provided by a single institution between 1989 and 1996. Methods and Materials: We assessed outcome among 203 patients who had completed three-dimensional conformal RT (66 Gy) without hormone treatment and in whom staging by lymphadenectomy had been performed. OS was compared with an age-matched control group from the general population. A cross-sectional, self-report survey of HRQoL was performed among surviving patients. Results: Median observation time was 10 years (range, 1-16 years). Eighty-one percent had high-risk tumors defined as T{sub 3-4} or Gleason score (GS) {>=}7B (4+3). Among these, 10-year OS, CSS, and cPFS rates were 52%, 66%, and 39%, respectively. The corresponding fractions in low-risk patients (T{sub 1-2} and GS {<=}7A [3+4]) were 79%, 95%, and 73%, respectively. Both CSS and cPFS were predicted by GS and T-classification; OS was associated with GS only. High-risk, but not low-risk, patients had reduced OS compared with the general population (p < 0.0005). When pelvis-related side effects were included in multivariate analyzes together with physical function and pain, sexual, urinary, and bowel function were not independently associated with self-reported global quality of life. Conclusions: Despite surgically proven {sub p}N{sub 0}, RT with dosage <70 Gy as monotherapy does not give satisfactory CSS rates after 10 years in patients with T{sub 3-4} or GS {>=}7B.

  20. First incident hospitalisation for Australian women aged 70 and beyond: A 10 year examination using competing risks.

    PubMed

    Harris, Melissa L; Dolja-Gore, Xenia; Kendig, Hal; Byles, Julie E

    2016-01-01

    There are increasing concerns regarding high hospital use among older adults and the capacity to manage the economic impact of the ageing population trend on healthcare systems. First hospitalisation in old age may act as a catalyst for ongoing intensification of health problems and acute care use. This study examined factors associated with first incident hospitalisation in women aged over 70, accounting for the health inequalities associated with geographic location. Survey data from 3780 women from the 1921 to 1926 cohort of the Australian Longitudinal Study on Women's Health were matched with the Admitted Patients Data Collection and National Death Index. Days to first event (hospitalisation or death) were modelled using competing risks methods. A total of 3065 (80.3%) women had at least one hospital admission. More than half of the top 15 reasons for first hospitalisation were related to cardiovascular disease, with atrial fibrillation the most common. Proportional subdistribution hazards models showed that first hospital admission was driven by enabling and need factors including asthma/bronchitis diagnosis (HR=1.16; p=0.047), private health insurance (HR=1.16; p=0.004) more than two prescribed medications in previous month (HR=1.31; p=0.001), more than four general practitioner visits in previous year (HR=1.50; p=0.034), lower physical functioning (HR=0.99; p<0.001) and living in an inner regional area (HR=1.17; p=0.003). First overnight hospitalisation was primarily related with potentially preventable and treatable chronic diseases. Primary and secondary strategies aimed at chronic disease generally, and better chronic disease management particularly for cardiovascular and respiratory diseases, may play a vital role in disease prevention or delay in readmissions among this population.

  1. A high energy intake from dietary fat among middle-aged and older adults is associated with increased risk of malnutrition 10 years later.

    PubMed

    Söderström, Lisa; Rosenblad, Andreas; Adolfsson, Eva T; Wolk, Alicja; Håkansson, Niclas; Bergkvist, Leif

    2015-09-28

    A higher fat content in the diet could be an advantage for preventing malnutrition among older adults. However, there is sparse scientific evidence to determine the optimal fat intake among older adults. This prospective cohort study examined whether a high energy intake of dietary fat among middle-aged and older adults is associated with the risk of malnutrition 10 years later. The study population comprised 725 Swedish men and women aged 53-80 years who had completed a questionnaire about dietary intake and lifestyle factors in 1997 (baseline) and whose nutritional status was assessed when admitted to the hospital in 2008-2009 (follow-up). At the follow-up, 383 (52.8%) participants were identified as being at risk of malnutrition and fifty-two (7.2%) were identified as malnourished. Multinomial logistic regression models were used to analyse the association between previous dietary fat intake and nutritional status later in life. Contrary to what was expected, a high energy intake from total fat, saturated fat and monounsaturated fat among middle-aged and older adults increased the risk of exhibiting malnutrition 10 years later. However, this applied only to individuals with a BMI<25 kg/m² at the baseline. In conclusion, these findings suggest that preventive actions to counteract malnutrition in older adults should focus on limiting the intake of total fat in the diet by reducing consumption of food with a high content of saturated and monounsaturated fat.

  2. Prediction of absolute risk of fragility fracture at 10 years in a Spanish population: validation of the WHO FRAX ™ tool in Spain

    PubMed Central

    2011-01-01

    Background Age-related bone loss is asymptomatic, and the morbidity of osteoporosis is secondary to the fractures that occur. Common sites of fracture include the spine, hip, forearm and proximal humerus. Fractures at the hip incur the greatest morbidity and mortality and give rise to the highest direct costs for health services. Their incidence increases exponentially with age. Independently changes in population demography, the age - and sex- specific incidence of osteoporotic fractures appears to be increasing in developing and developed countries. This could mean more than double the expected burden of osteoporotic fractures in the next 50 years. Methods/Design To assess the predictive power of the WHO FRAX™ tool to identify the subjects with the highest absolute risk of fragility fracture at 10 years in a Spanish population, a predictive validation study of the tool will be carried out. For this purpose, the participants recruited by 1999 will be assessed. These were referred to scan-DXA Department from primary healthcare centres, non hospital and hospital consultations. Study population: Patients attended in the national health services integrated into a FRIDEX cohort with at least one Dual-energy X-ray absorptiometry (DXA) measurement and one extensive questionnaire related to fracture risk factors. Measurements: At baseline bone mineral density measurement using DXA, clinical fracture risk factors questionnaire, dietary calcium intake assessment, history of previous fractures, and related drugs. Follow up by telephone interview to know fragility fractures in the 10 years with verification in electronic medical records and also to know the number of falls in the last year. The absolute risk of fracture will be estimated using the FRAX™ tool from the official web site. Discussion Since more than 10 years ago numerous publications have recognised the importance of other risk factors for new osteoporotic fractures in addition to low BMD. The extension of a

  3. Protective effect of total and supplemental vitamin C intake on the risk of hip fracture - A 17-year follow-up from the Framingham Osteoporosis Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Dietary antioxidants such as vitamin C may play a role in bone health. We evaluated associations of vitamin C intake (total, dietary and supplemental) with incident hip fracture and non-vertebral osteoporotic fracture, over a 15 to 17-y follow-up, in the Framingham Osteoporosis Study. 366 men and 59...

  4. Systemic Inflammation during the First Postnatal Month and the Risk of Attention Deficit Hyperactivity Disorder Characteristics among 10 year-old Children Born Extremely Preterm.

    PubMed

    Allred, Elizabeth N; Dammann, Olaf; Fichorova, Raina N; Hooper, Stephen R; Hunter, Scott J; Joseph, Robert M; Kuban, Karl; Leviton, Alan; O'Shea, Thomas Michael; Scott, Megan N

    2017-04-12

    Although multiple sources link inflammation with attention difficulties, the only human study that evaluated the relationship between systemic inflammation and attention problems assessed attention at age 2 years. Parent and/or teacher completion of the Childhood Symptom Inventory-4 (CSI-4) provided information about characteristics that screen for attention deficit hyperactive disorder (ADHD) among 793 10-year-old children born before the 28th week of gestation who had an IQ ≥ 70. The concentrations of 27 proteins in blood spots obtained during the first postnatal month were measured. 151 children with ADHD behaviors were identified by parent report, while 128 children were identified by teacher report. Top-quartile concentrations of IL-6R, TNF-α, IL-8, VEGF, VEFG-R1, and VEGF-R2 on multiple days were associated with increased risk of ADHD symptoms as assessed by a teacher. Some of this increased risk was modulated by top-quartile concentrations of IL-6R, RANTES, EPO, NT-4, BDNF, bFGF, IGF-1, PIGF, Ang-1, and Ang-2. Systemic inflammation during the first postnatal month among children born extremely preterm appears to increase the risk of teacher-identified ADHD characteristics, and high concentrations of proteins with neurotrophic properties appear capable of modulating this increased risk.

  5. Fatigue as a long-term risk factor for limitations in instrumental activities of daily living and/or mobility performance in older adults after 10 years

    PubMed Central

    Mueller-Schotte, Sigrid; Bleijenberg, Nienke; van der Schouw, Yvonne T; Schuurmans, Marieke J

    2016-01-01

    Objectives Decline in the performance of instrumental activities of daily living (IADL) and mobility may be preceded by symptoms the patient experiences, such as fatigue. The aim of this study is to investigate whether self-reported non-task-specific fatigue is a long-term risk factor for IADL-limitations and/or mobility performance in older adults after 10 years. Methods A prospective study from two previously conducted cross-sectional studies with 10-year follow-up was conducted among 285 males and 249 females aged 40–79 years at baseline. Fatigue was measured by asking “Did you feel tired within the past 4 weeks?” (males) and “Do you feel tired?” (females). Self-reported IADLs were assessed at baseline and follow-up. Mobility was assessed by the 6-minute walk test. Gender-specific associations between fatigue and IADL-limitations and mobility were estimated by multivariable logistic and linear regression models. Results A total of 18.6% of males and 28.1% of females were fatigued. After adjustment, the odds ratio for fatigued versus non-fatigued males affected by IADL-limitations was 3.3 (P=0.023). In females, the association was weaker and not statistically significant, with odds ratio being 1.7 (P=0.154). Fatigued males walked 39.1 m shorter distance than those non-fatigued (P=0.048). For fatigued females, the distance was 17.5 m shorter compared to those non-fatigued (P=0.479). Conclusion Our data suggest that self-reported fatigue may be a long-term risk factor for IADL-limitations and mobility performance in middle-aged and elderly males but possibly not in females. PMID:27877027

  6. Lipoprotein(a) levels, apo(a) isoform size, and coronary heart disease risk in the Framingham Offspring Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The aim of this study was to assess the independent contributions of plasma levels of lipoprotein(a) [Lp(a)], Lp(a) cholesterol, and of apo(a) isoform size to prospective coronary heart disease (CHD) risk. Plasma Lp(a) and Lp(a) cholesterol levels, and apo(a) isoform size were measured at examinati...

  7. Adiposity, insulin resistance and cardiovascular risk factors in 9–10-year-old Indian children: relationships with birth size and postnatal growth

    PubMed Central

    Krishnaveni, G. V.; Veena, S. R.; Wills, A. K.; Hill, J. C.; Karat, S. C.; Fall, C. H. D.

    2011-01-01

    Lower birthweight, and rapid childhood weight gain predict elevated cardiovascular risk factors in children. We examined associations between serial, detailed, anthropometric measurements from birth to 9.5 years of age and cardiovascular risk markers in Indian children. Children (n = 663) born at the Holdsworth Memorial Hospital, Mysore, India were measured at birth and 6–12 monthly thereafter. At 9.5 years, 539 (255 boys) underwent a 2-h oral glucose tolerance test, and blood pressure (BP) and fasting lipid concentrations were measured. Insulin resistance was calculated using the HOMA equation. These outcomes were examined in relation to birth measurements and changes in measurements (growth) during infancy (0–2 years), 2–5 years and 5–9.5 years using conditional s.d. scores. Larger current weight, height and skinfold thickness were associated with higher risk markers at 9.5 years (P<0.05). Lower weight, smaller length and mid-arm circumference at birth were associated with higher fasting glucose concentrations at 9.5 years (P≤0.01). After adjusting for current weight/height, there were inverse associations between birthweight and/or length and insulin concentrations, HOMA, systolic and diastolic BP and plasma triglycerides (P<0.05). Increases in conditional weight and height between 0–2, 2–5 and 5–9.5 years were associated with higher insulin concentrations, HOMA and systolic BP. In conclusion, in 9–10-year-old Indian children, as in other studies, cardiovascular risk factors were highest in children who were light or short at birth but heavy or tall at 9 years. Greater infant and childhood weight and height gain were associated with higher risk markers. PMID:22318657

  8. Disturbed sleep as risk factor for the subsequent onset of bipolar disorder--Data from a 10-year prospective-longitudinal study among adolescents and young adults.

    PubMed

    Ritter, Philipp S; Höfler, Michael; Wittchen, Hans-Ulrich; Lieb, Roselind; Bauer, Michael; Pfennig, Andrea; Beesdo-Baum, Katja

    2015-09-01

    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.

  9. A 10-year observation of PM2.5-bound nickel in Xi’an, China: Effects of source control on its trend and associated health risks

    PubMed Central

    Xu, Hongmei; Ho, Steven Sai Hang; Cao, Junji; Guinot, Benjamin; Kan, Haidong; Shen, Zhenxing; Ho, Kin Fai; Liu, Suixin; Zhao, Zhuzi; Li, Jianjun; Zhang, Ningning; Zhu, Chongshu; Zhang, Qian; Huang, Rujin

    2017-01-01

    This study presents the first long term (10-year period, 2004–2013) datasets of PM2.5-bound nickel (Ni) concentration obtained from the daily sample in urban of Xi’an, Northwestern China. The Ni concentration trend, pollution sources, and the potential health risks associated to Ni were investigated. The Ni concentrations increased from 2004 to 2008, but then decreased due to coal consumption reduction, energy structure reconstruction, tighter emission rules and the improvement of the industrial and motor vehicle waste control techniques. With the comparison of distributions between workday and non-workday periods, the effectiveness of local and regional air pollution control policies and contributions of hypothetical Ni sources (industrial and automobile exhausts) were evaluated, demonstrating the health benefits to the populations during the ten years. Mean Ni cancer risk was higher than the threshold value of 10−6, suggesting that carcinogenic Ni still was a concern to the residents. Our findings conclude that there are still needs to establish more strict strategies and guidelines for atmospheric Ni in our living area, assisting to balance the relationship between economic growth and environmental conservation in China. PMID:28117355

  10. A 10-year observation of PM2.5-bound nickel in Xi’an, China: Effects of source control on its trend and associated health risks

    NASA Astrophysics Data System (ADS)

    Xu, Hongmei; Ho, Steven Sai Hang; Cao, Junji; Guinot, Benjamin; Kan, Haidong; Shen, Zhenxing; Ho, Kin Fai; Liu, Suixin; Zhao, Zhuzi; Li, Jianjun; Zhang, Ningning; Zhu, Chongshu; Zhang, Qian; Huang, Rujin

    2017-01-01

    This study presents the first long term (10-year period, 2004–2013) datasets of PM2.5-bound nickel (Ni) concentration obtained from the daily sample in urban of Xi’an, Northwestern China. The Ni concentration trend, pollution sources, and the potential health risks associated to Ni were investigated. The Ni concentrations increased from 2004 to 2008, but then decreased due to coal consumption reduction, energy structure reconstruction, tighter emission rules and the improvement of the industrial and motor vehicle waste control techniques. With the comparison of distributions between workday and non-workday periods, the effectiveness of local and regional air pollution control policies and contributions of hypothetical Ni sources (industrial and automobile exhausts) were evaluated, demonstrating the health benefits to the populations during the ten years. Mean Ni cancer risk was higher than the threshold value of 10‑6, suggesting that carcinogenic Ni still was a concern to the residents. Our findings conclude that there are still needs to establish more strict strategies and guidelines for atmospheric Ni in our living area, assisting to balance the relationship between economic growth and environmental conservation in China.

  11. A 10-year interval study to compare the prevalence and risk factors of female sexual dysfunction in Korea: the Korean internet sexuality survey (KISS) 2014.

    PubMed

    Shin, H; Min, B; Park, J; Son, H

    2017-03-01

    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.

  12. Healthy Homes/Healthy Kids: A Randomized Trial of a Pediatric Primary Care Based Obesity Prevention Intervention for At-Risk 5-10 Year Olds

    PubMed Central

    Sherwood, Nancy E.; Levy, Rona L.; Langer, Shelby L.; Senso, Meghan M.; Crain, A. Lauren; Hayes, Marcia G.; Anderson, Julie D.; Seburg, Elisabeth M.; Jeffery, Robert W.

    2014-01-01

    Pediatric primary care is an important setting in which to address obesity prevention, yet relatively few interventions have been evaluated and even fewer have been shown to be effective. The development and evaluation of cost-effective approaches to obesity prevention that leverage opportunities of direct access to families in the pediatric primary care setting, overcome barriers to implementation in busy practice settings, and facilitate sustained involvement of parents is an important public health priority. The goal of the Healthy Homes/Healthy Kids (HHHK 5-10) randomized controlled trial is to evaluate the efficacy of a relatively low-cost primary care-based obesity prevention intervention aimed at 5 to 10 year old children who are at risk for obesity. Four hundred twenty one parent/child dyads were recruited and randomized to either the obesity prevention arm or a contact control condition that focuses on safety and injury prevention. The HHHK 5-10 obesity prevention intervention combines brief counseling with a pediatric primary care provider during routine well-child visits and follow-up telephone coaching that supports parents in making home environmental changes to support healthful eating, activity patterns, and body weight. The contact control condition combines the same provider counseling with telephone coaching focused on safety and injury prevention messages. This manuscript describes the study design and baseline characteristics of participants enrolled in the HHHK 5-10 trial. PMID:23816490

  13. Celebrating 40 Years of the Framingham Heart Study.

    ERIC Educational Resources Information Center

    Lenfant, Claude; And Others

    1987-01-01

    The Framingham Heart Study pioneered the concept of risk factors. This article recaps the history of the study, describes poster and essay contests used to commemorate the 40th anniversary of the study, and outlines the involvement of the National Heart, Lung, and Blood Institute in school health research. (Author/MT)

  14. Genetics of the Framingham Heart Study Population

    PubMed Central

    Govindaraju, Diddahally R.; Cupples, L. Adrienne; Kannel, William B.; O’Donnell, Christopher J.; Atwood, Larry D.; D’Agostino, Ralph B.; Fox, Caroline S.; Larson, Marty; Levy, Daniel; Morabito, Joanne; Vasan, Ramachandran S.; Splansky, Greta Lee; Wolf, Philip A.; Benjamin, Emelia J.

    2010-01-01

    This article provides an introduction to the Framingham Heart Study (FHS) and the genetic research related to cardiovascular diseases conducted in this unique population1. It briefly describes the origins of the study, the risk factors that contribute to heart disease and the approaches taken to discover the genetic basis of some of these risk factors. The genetic architecture of several biological risk factors has been explained using family studies, segregation analysis, heritability, phenotypic and genetic correlations. Many quantitative trait loci underlying cardiovascular diseases have been discovered using different molecular markers. Additionally, results from genome-wide association studies using 100,000 markers, and the prospects of using 550,000 markers for association studies are presented. Finally, the use of this unique sample in genotype and environment interaction is described. PMID:19010253

  15. Analysis of the associations among Helicobacter pylori infection, adiponectin, leptin, and 10-year fracture risk using the fracture risk assessment tool: A cross-sectional community-based study.

    PubMed

    Chen, Li-Wei; Chen, Fang-Ping; Hsieh, Chia-Wen; Kuo, Sheng-Fong; Chien, Rong-Nan

    2017-01-01

    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.

  16. Baseline factors predicting the risk of conversion from ocular hypertension to primary open-angle glaucoma during a 10-year follow-up.

    PubMed

    Salvetat, M L; Zeppieri, M; Tosoni, C; Brusini, P

    2016-06-01

    PurposeTo evaluate the ability of baseline clinical, morphological, and functional factors to predict the conversion to primary open-angle glaucoma (POAG) in ocular hypertensive (OHT) patients.MethodsThis single-center prospective longitudinal observational study included 116 eyes of 116 OHT patients followed for a 10-year period. All patients had intraocular pressure (IOP) ≥24 mm Hg in one eye and >21 mm Hg in the other eye, normal visual fields (VFs) and normal optic disc (OD) appearance in both eyes at baseline. All OHT patients were untreated at baseline with subsequent treatment upon need according to clinical judgement. Only one eye per subject was randomly selected. Patient age, gender, IOP, central corneal thickness (CCT), and ibopamine test results were collected at baseline. All patients underwent standard automated perimetry, short-wavelength automated perimetry (SWAP), frequency-doubling technology, confocal scanning laser ophthalmoscopy (CSLO), and scanning laser polarimetry (SLP) at baseline and every 6 months thereafter. Main outcome measure was the conversion to POAG, defined as the development of reproducible VF and/or OD abnormalities attributable to glaucoma. Cox proportional hazards models were used to identify the baseline factors predictive of POAG conversion.ResultsDuring the 10-year follow-up, 25% of eyes converted to POAG. In multivariate Cox models, baseline factors that were significant predictors of POAG development included: older age (hazard ratio (HR) 1.0, 99% confidence intervals (CIs) 1.0-1.2, per 1 year older); SWAP Glaucoma Hemifield test 'outside normal limits' (HR 4.3, 99% CIs 1.2-17.9); greater SLP 'Inter-eye Symmetry' (HR 1.1, 99% CIs 0.4-3.0, per 1 unit lower); lower CSLO Rim Volume (HR 1.1, 99% CIs 0.3-3.2, per 0.1 mm(3) lower); and greater CSLO cup-to-disc ratio (HR 6.0, 99% CIs 3.6-16.8, per 0.1 unit greater).ConclusionsThe baseline parameters that proved to be useful in assessing the likelihood of an OHT

  17. Concordance with World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines for cancer prevention and obesity-related cancer risk in the Framingham Offspring cohort (1991–2008)

    PubMed Central

    Makarem, Nour; Lin, Yong; Bandera, Elisa V.; Jacques, Paul F.

    2016-01-01

    Purpose This prospective cohort study evaluates associations between healthful behaviors consistent with WCRF/AICR cancer prevention guidelines and obesity-related cancer risk, as a third of cancers are estimated to be preventable. Methods The study sample consisted of adults from the Framingham Offspring cohort (n = 2,983). From 1991 to 2008, 480 incident doctor-diagnosed obesity-related cancers were identified. Data on diet, measured by a food frequency questionnaire, anthropometric measures, and self-reported physical activity, collected in 1991 was used to construct a 7-component score based on recommendations for body fatness, physical activity, foods that promote weight gain, plant foods, animal foods, alcohol, and food preservation, processing, and preparation. Multivariable Cox regression models were used to estimate associations between the computed score, its components, and subcomponents in relation to obesity-related cancer risk. Results The overall score was not associated with obesity-related cancer risk after adjusting for age, sex, smoking, energy, and preexisting conditions (HR 0.94, 95 % CI 0.86–1.02). When score components were evaluated separately, for every unit increment in the alcohol score, there was 29 % lower risk of obesity-related cancers (HR 0.71, 95 % CI 0.51–0.99) and 49–71 % reduced risk of breast, prostate, and colorectal cancers. Every unit increment in the subcomponent score for non-starchy plant foods (fruits, vegetables, and legumes) among participants who consume starchy vegetables was associated with 66 % reduced risk of colorectal cancer (HR 0.44, 95 % CI 0.22–0.88). Conclusions Lower alcohol consumption and a plant-based diet consistent with the cancer prevention guidelines were associated with reduced risk of obesity-related cancers in this population. PMID:25559553

  18. Association of high normal HbA1c and TSH levels with the risk of CHD: a 10-year cohort study and SVM analysis

    PubMed Central

    Li, Hui; Cui, Ying; Zhu, Yanan; Yan, Haiying; Xu, Wenge

    2017-01-01

    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

  19. Association of high normal HbA1c and TSH levels with the risk of CHD: a 10-year cohort study and SVM analysis.

    PubMed

    Li, Hui; Cui, Ying; Zhu, Yanan; Yan, Haiying; Xu, Wenge

    2017-03-27

    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.

  20. Birth weight and risk factors for cardiovascular disease and type 2 diabetes in US children and adolescents: 10 year results from NHANES.

    PubMed

    Zhang, Zhiying; Kris-Etherton, Penny M; Hartman, Terryl J

    2014-08-01

    Previous studies have shown that birth weight and other birth characteristics may be associated with risk for type 2 diabetes and cardiovascular disease (CVD) later in life; however, results using large US national survey data are limited. Our goal was to determine the aforementioned associations using nationally representative data. We studied children and adolescents 6-15 years using data from the National Health and Nutrition Examination Survey cycles 2001-2010. Survey and examination data included demographic and early childhood characteristics, current health status, physical activity information, anthropometric measurements, dietary data (total energy, saturated fat, sodium, and sugar intakes), biomarkers related to selected risk factors of CVD [systolic blood pressure (SBP), plasma C-reactive protein (CRP) and lipid profiles], and type 2 diabetes [fasting glucose, insulin, and homeostasis model assessment (HOMA)]. Birth weight (proxy-reported) was inversely associated with SBP among girls; SBP levels increased 1.4 mmHg for each 1,000 g decrease in birth weight (p = 0.003) after controlling for potential confounders. Birth weight was not associated with levels of CRP or lipid profiles across the three racial groups. In addition, birth weight was inversely related to levels of fasting insulin and HOMA among non-Hispanic Whites; for each 1,000 g decrease in birth weight, fasting insulin levels increased 9.1% (p = 0.007) and HOMA scores increased 9.8% (p = 0.007). Birth weight was inversely associated with the levels of SBP, fasting insulin, and HOMA. These results support a role for birth weight, independent of the strong effects of current body weight status, in increasing risk for CVD and type 2 diabetes.

  1. Assessment of the 10-year probability of osteoporotic hip fracture combining clinical risk factors and heel bone ultrasound: the EPISEM prospective cohort of 12,958 elderly women.

    PubMed

    Hans, Didier; Durosier, Claire; Kanis, John A; Johansson, Helena; Schott-Pethelaz, Anne-Marie; Krieg, Marc-Antoine

    2008-07-01

    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.

  2. Comorbidities and cardiovascular risk factors in patients with psoriasis*

    PubMed Central

    Baeta, Isabela Guimarães Ribeiro; Bittencourt, Flávia Vasques; Gontijo, Bernardo; Goulart, Eugênio Marcos Andrade

    2014-01-01

    BACKGROUND Psoriasis is a chronic inflammatory disease and its pathogenesis involves an interaction between genetic, environmental, and immunological factors. Recent studies have suggested that the chronic inflammatory nature of psoriasis may predispose to an association with other inflammatory diseases, especially cardiovascular diseases and metabolic disorders. OBJECTIVES To describe the demographic, clinical, epidemiological, and laboratory characteristics of a sample of psoriasis patients; to assess the prevalence of cardiovascular comorbidities in this group of patients; and to identify the cardiovascular risk profile using the Framingham risk score. METHODS We conducted a cross-sectional study involving the assessment of 190 patients. Participants underwent history and physical examination. They also completed a specific questionnaire about epidemiological data, past medical history, and comorbidities. The cardiovascular risk profile was calculated using the Framingham risk score. RESULTS Patients' mean age was 51.5 ± 14 years, and the predominant clinical presentation was plaque psoriasis (78.4%). We found an increased prevalence of systemic hypertension, type 2 diabetes, metabolic syndrome, and obesity. Increased waist circumference was also found in addition to a considerable prevalence of depression, smoking, and regular alcohol intake. Patients' cardiovascular risk was high according to the Framingham risk score, and 47.2% of patients had moderate or high risk of fatal and non-fatal coronary events in 10 years. CONCLUSIONS Patients had high prevalence of cardiovascular comorbidities, and high cardiovascular risk according to the Framingham risk score. Further epidemiological studies are needed in Brazil for validation of our results. PMID:25184912

  3. A 10-year follow-up study of the association between calcium channel blocker use and the risk of dementia in elderly hypertensive patients

    PubMed Central

    Wu, Chia-Liang; Wen, Shu-Hui

    2016-01-01

    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

  4. A 10-year follow-up study of the association between calcium channel blocker use and the risk of dementia in elderly hypertensive patients.

    PubMed

    Wu, Chia-Liang; Wen, Shu-Hui

    2016-08-01

    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.

  5. Risk factors for development of multiple-class resistance to Streptococcus pneumoniae Strains in Belgium over a 10-year period: antimicrobial consumption, population density, and geographic location.

    PubMed

    Van Eldere, Johan; Mera, Robertino M; Miller, Linda A; Poupard, James A; Amrine-Madsen, Heather

    2007-10-01

    We investigated the impact of the usage of antibiotics in ambulatory patients in Belgium in 147 defined geographical circumscriptions and at the individual isolate level. The study included 14,448 Streptococcus pneumoniae strains collected by the Belgium national reference lab from 1994 to 2004. Additional risk factors for resistance, such as population density/structure and day care attendance, were investigated for the same time-space window. A statistical model that included resistance to two or more antimicrobial classes offered the best fit for measuring the changes in nonsusceptibility to penicillin, macrolides, and tetracycline over time and place in Belgium. Analysis at the geographic level identified antimicrobial consumption with a 1-year lag (0.5% increase per additional defined daily dose) and population density as independent predictors of multiple resistance. Independent risk factors at the isolate level were age (odds ratio [OR], 1.55 for children aged <5 years), population density (7% increase in multiple resistance per 100 inhabitants/km(2)), conjugate 7-valent vaccine serotype (OR, 14.3), location (OR, 1.55 for regions bordering high-resistance France), and isolate source (OR, 1.54 for ear isolates). The expansion of multiple-resistant strains explains most of the overall twofold increase and subsequent decrease in single antimicrobial resistance between 1994 and 2004. We conclude that factors in addition to antibiotic use, such as high population density and proximity to high-resistance regions, favor multiple resistance. Regional resistance rates are not linearly related to actual antibiotic use but are linked to past antibiotic use plus a combination of demographic and geographic factors.

  6. The Impact of Diabetes on the Risk of Prostate Cancer Development according to Body Mass Index: A 10-year Nationwide Cohort Study

    PubMed Central

    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

    2016-01-01

    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

  7. Swift: 10 Years of Discovery

    NASA Astrophysics Data System (ADS)

    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

  8. Prevalence and Distribution of Abdominal Aortic Calcium by Sex and Age-Group in a Community-based Cohort (From The Framingham Heart Study)

    PubMed Central

    Chuang, Michael L.; Massaro, Joseph M.; Levitzky, Yamini S.; Fox, Caroline S.; Manders, Emily S.; Hoffmann, Udo; O'Donnell, Christopher J.

    2012-01-01

    Abdominal aortic calcium (AAC) is associated with incident cardiovascular disease but the age and sex-related distribution of AAC in a community-dwelling population free of standard cardiovascular disease risk factors has not been described. A total of 3285 participants (aged 50.2±9.9 years) in the Framingham Heart Study Offspring and Third Generation cohorts underwent abdominal multidetector computed tomography (MDCT) scanning during 1998-2005. The presence and amount of AAC was quantified (Agatston score) by an experienced reader using standardized criteria. A healthy referent subsample (N=1656, 803 men) free of hypertension, hyperlipidemia, diabetes, obesity and smoking was identified, and participants were stratified by sex and age group (<45, 45-54, 55-64, 65-74, ≥75 years). The prevalence and burden of AAC increased monotonically and supralinearly with age in both sexes but was greater in men than women in each age group. Below age 45 <16% of referent-subsample participants had any quantifiable AAC, while above age 65 nearly 90% of referent participants had >0 AAC. Across the entire study sample, AAC prevalence and burden similarly increased with greater age. Defining the 90th percentile of referent group AAC as “high,” the prevalence of high AAC was 19% for each sex in the overall study sample. AAC also increased across categories of 10-year coronary heart disease risk, as calculated using the Framingham Risk Score, in the entire study sample. We found AAC to be widely prevalent, with the burden of AAC associated with 10-year coronary risk, in a white, free-living adult cohort. PMID:22727181

  9. Prevalence and distribution of abdominal aortic calcium by gender and age group in a community-based cohort (from the Framingham Heart Study).

    PubMed

    Chuang, Michael L; Massaro, Joseph M; Levitzky, Yamini S; Fox, Caroline S; Manders, Emily S; Hoffmann, Udo; O'Donnell, Christopher J

    2012-09-15

    Abdominal aortic calcium (AAC) is associated with incident cardiovascular disease. However, the age- and gender-related distribution of AAC in a community-dwelling population free of standard cardiovascular disease risk factors has not been described. A total of 3,285 participants (aged 50.2 ± 9.9 years) in the Framingham Heart Study Offspring and Third Generation cohorts underwent abdominal multidetector computed tomography from 1998 to 2005. The presence and amount of AAC was quantified (Agatston score) by an experienced reader using standardized criteria. A healthy referent subsample (n = 1,656, 803 men) free of hypertension, hyperlipidemia, diabetes, obesity, and smoking was identified, and participants were stratified by gender and age (<45, 45 to 54, 55 to 64, 65 to 74, and ≥75 years). The prevalence and burden of AAC increased monotonically and supra-linearly with age in both genders but was greater in men than in women in each age group. For those <45 years old, <16% of the referent subsample participants had any quantifiable AAC. However, for those >65 years old, nearly 90% of the referent participants had >0 AAC. Across the entire study sample, AAC prevalence and burden similarly increased with greater age. Defining the 90th percentile of the referent group AAC as "high," the prevalence of high AAC was 19% for each gender in the overall study sample. The AAC also increased across categories of 10-year coronary heart disease risk, as calculated using the Framingham Risk Score, in the entire study sample. We found AAC to be widely prevalent, with the burden of AAC associated with 10-year coronary risk, in a white, free-living adult cohort.

  10. 10-year survival of total ankle arthroplasties

    PubMed Central

    2011-01-01

    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

  11. The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective

    PubMed Central

    Mahmood, Syed S.; Levy, Daniel; Vasan, Ramachandran S.; Wang, Thomas J.

    2014-01-01

    Summary On October 11, 2013, the Framingham Heart Study will celebrate 65 years since the examination of its first participant in 1948. During this period, the study has provided substantial insight into the epidemiology of cardiovascular disease and its risk factors. The origin of the study is closely linked to the cardiovascular health of President Franklin D. Roosevelt and his premature death from hypertensive heart disease and stroke in 1945. The present article describes the events leading to the founding of the Framingham Heart Study, and provides a brief historical overview of selected contributions from the study. PMID:24084292

  12. Association of serum vitamin D with the risk of incident dementia and subclinical indices of brain aging the framingham heart study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Identifying nutrition- and lifestyle-based risk factors for cognitive impairment and dementia may aid future primary prevention efforts. Objective: We aimed to examine the association of serum vitamin D levels with incident all-cause dementia, clinically characterized Alzheimer's disease...

  13. Protective effect of total carotenoid and lycopene intake on the risk of hip fracture: A 17-year follow-up from the Framingham Osteoporosis Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In vitro and in vivo studies suggest that carotenoids may inhibit bone resorption; yet no previous study has examined individual carotenoid intake (other than beta-carotene) and the risk of fracture. We evaluated associations of total and individual carotenoid intake (alpha-carotene, beta-carotene,...

  14. Cardiovascular outcomes in framingham participants with diabetes: the importance of blood pressure.

    PubMed

    Chen, Guanmin; McAlister, Finlay A; Walker, Robin L; Hemmelgarn, Brenda R; Campbell, Norm R C

    2011-05-01

    We designed this study to explore to what extent the excess risk of cardiovascular events in diabetic individuals is attributable to hypertension. We retrospectively analyzed prospectively collected data from the Framingham original and offspring cohorts. Of the 1145 Framingham subjects newly diagnosed with diabetes mellitus who did not have a previous history of cardiovascular events, 663 (58%) had hypertension at the time that diabetes mellitus was diagnosed. During 4154 person-years of follow-up, 125 died, and 204 experienced a cardiovascular event. Framingham participants with hypertension at the time of diabetes mellitus diagnosis exhibited higher rates of all-cause mortality (32 versus 20 per 1000 person-years; P<0.001) and cardiovascular events (52 versus 31 per 1000 person-years; P<0.001) compared with normotensive subjects with diabetes mellitus. After adjustment for demographic and clinical covariates, hypertension was associated with a 72% increase in the risk of all-cause death and a 57% increase in the risk of any cardiovascular event in individuals with diabetes mellitus. The population-attributable risk from hypertension in individuals with diabetes mellitus was 30% for all-cause death and 25% for any cardiovascular event (increasing to 44% and 41%, respectively, if the 110 normotensive subjects who developed hypertension during follow-up were excluded from the analysis). In comparison, after adjustment for concurrent hypertension, the population-attributable risk from diabetes mellitus in Framingham subjects was 7% for all-cause mortality and 9% for any cardiovascular disease event. Although diabetes mellitus is associated with increased risks of death and cardiovascular events in Framingham subjects, much of this excess risk is attributable to coexistent hypertension.

  15. Coronary artery disease risk assessment from unstructured electronic health records using text mining.

    PubMed

    Jonnagaddala, Jitendra; Liaw, Siaw-Teng; Ray, Pradeep; Kumar, Manish; Chang, Nai-Wen; Dai, Hong-Jie

    2015-12-01

    Coronary artery disease (CAD) often leads to myocardial infarction, which may be fatal. Risk factors can be used to predict CAD, which may subsequently lead to prevention or early intervention. Patient data such as co-morbidities, medication history, social history and family history are required to determine the risk factors for a disease. However, risk factor data are usually embedded in unstructured clinical narratives if the data is not collected specifically for risk assessment purposes. Clinical text mining can be used to extract data related to risk factors from unstructured clinical notes. This study presents methods to extract Framingham risk factors from unstructured electronic health records using clinical text mining and to calculate 10-year coronary artery disease risk scores in a cohort of diabetic patients. We developed a rule-based system to extract risk factors: age, gender, total cholesterol, HDL-C, blood pressure, diabetes history and smoking history. The results showed that the output from the text mining system was reliable, but there was a significant amount of missing data to calculate the Framingham risk score. A systematic approach for understanding missing data was followed by implementation of imputation strategies. An analysis of the 10-year Framingham risk scores for coronary artery disease in this cohort has shown that the majority of the diabetic patients are at moderate risk of CAD.

  16. Maximum Urine Flow Rate of Less than 15ml/Sec Increasing Risk of Urine Retention and Prostate Surgery among Patients with Alpha-1 Blockers: A 10-Year Follow Up Study

    PubMed Central

    Kuo, Yu-Hung

    2016-01-01

    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

  17. Framingham State University: Faculty and Program Development

    ERIC Educational Resources Information Center

    Huibregtse, Jon; Holloway, Lorretta M.; Greenberg, Scott

    2012-01-01

    In spring 2010, institution-wide budget cuts resulted in several layoffs at Framingham State University (FSU), including the position of Associate Dean of the Division of Graduate and Continuing Education (DGCE). In his position as the Associate Vice President for Academic Affairs and Dean of DGCE, Scott Greenberg asked their Vice President for…

  18. Use of Chronic Kidney Disease to Enhance Prediction of Cardiovascular Risk in Those at Medium Risk.

    PubMed

    Chia, Yook Chin; Lim, Hooi Min; Ching, Siew Mooi

    2015-01-01

    Based on global cardiovascular (CV) risk assessment for example using the Framingham risk score, it is recommended that those with high risk should be treated and those with low risk should not be treated. The recommendation for those of medium risk is less clear and uncertain. We aimed to determine whether factoring in chronic kidney disease (CKD) will improve CV risk prediction in those with medium risk. This is a 10-year retrospective cohort study of 905 subjects in a primary care clinic setting. Baseline CV risk profile and serum creatinine in 1998 were captured from patients record. Framingham general cardiovascular disease risk score (FRS) for each patient was computed. All cardiovascular disease (CVD) events from 1998-2007 were captured. Overall, patients with CKD had higher FRS risk score (25.9% vs 20%, p = 0.001) and more CVD events (22.3% vs 11.9%, p = 0.002) over a 10-year period compared to patients without CKD. In patients with medium CV risk, there was no significant difference in the FRS score among those with and without CKD (14.4% vs 14.6%, p = 0.84) However, in this same medium risk group, patients with CKD had more CV events compared to those without CKD (26.7% vs 6.6%, p = 0.005). This is in contrast to patients in the low and high risk group where there was no difference in CVD events whether these patients had or did not have CKD. There were more CV events in the Framingham medium risk group when they also had CKD compared those in the same risk group without CKD. Hence factoring in CKD for those with medium risk helps to further stratify and identify those who are actually at greater risk, when treatment may be more likely to be indicated.

  19. P Wave Indices: Derivation of Reference Values from the Framingham Heart Study

    PubMed Central

    Magnani, Jared W.; Johnson, Victor M.; Sullivan, Lisa M.; Lubitz, Steven A.; Schnabel, Renate B.; Ellinor, Patrick T.; Benjamin, Emelia J.

    2012-01-01

    Background P wave indices, an electrocardiographic phenotype reflecting atrial electrophysiology and morphology, may be altered in multiple disease states or by cardiovascular risk factors. Reference values for P wave indices, providing cut points for their classification and interpretation, have not yet been established and are essential towards facilitating clinical application and comparison between studies. Methods We randomly selected 20 men and 20 women from 10-year age intervals between <25 years to 76–85 years from the Framingham Heart Study Original and Offspring Cohorts, excluding subjects with prevalent cardiovascular disease, hypertension, diabetes or obesity. The total included 295 subjects; eligibility in women >75 years was limited by exclusion criteria. We used a digital measurement technique with demonstrated intrarater reproducibility to determine P wave indices. P wave indices examined included the maximum, mean, lead II and PR durations, dispersion, and the standard deviation of duration. Results All P wave indices were significantly (P<0.0001) correlated with advancing age. Means of all P wave indices were lower in women as compared to men. PR interval duration was strongly correlated with maximum, mean, and lead II mean P wave durations. In multivariable models adjusting for significant anthropometric and clinical associations risk factors, significant differences persisted by age and sex in P wave indices. Conclusions In our healthy sample without cardiovascular disease, hypertension, diabetes or obesity, men and older subjects had longer mean P wave indices. Our description of P wave indices establishes reference values for future comparative studies and facilitates the classification of P wave indices. PMID:20946557

  20. Dietary Approaches for Bone Health: Lessons from the Framingham Osteoporosis Study.

    PubMed

    Sahni, Shivani; Mangano, Kelsey M; McLean, Robert R; Hannan, Marian T; Kiel, Douglas P

    2015-08-01

    Osteoporosis is characterized by systemic impairment of bone mass, strength, and microarchitecture, resulting in increased risk for fragility fracture, disability, loss of independence, and even death. Adequate nutrition is important in achieving and maintaining optimal bone mass, as well as preventing this debilitating disease. It is widely accepted that adequate calcium and vitamin D intake are necessary for good bone health; however, nutritional benefits to bone go beyond these two nutrients. This review article will provide updated information on all nutrients and foods now understood to alter bone health. Specifically, this paper will focus on related research from the Framingham Osteoporosis Study, an ancillary study of the Framingham Heart Study, with data on more than 5000 adult men and women.

  1. Dietary approaches for bone health: lessons from the Framingham Osteoporosis Study

    PubMed Central

    Sahni, Shivani; Mangano, Kelsey M; McLean, Robert R; Hannan, Marian T; Kiel, Douglas P

    2016-01-01

    Osteoporosis is characterized by systemic impairment of bone mass, strength, and microarchitecture, resulting in increased risk for fragility fracture, disability, loss of independence and even death. Adequate nutrition is important in achieving and maintaining optimal bone mass, as well as preventing this debilitating disease. It is widely accepted that adequate calcium and vitamin D intake are necessary for good bone health; however, nutritional benefits to bone go beyond these two nutrients. This review article will provide updated information on all nutrients and foods now understood to alter bone health. Specifically, this paper will focus on related research from the Framingham Osteoporosis Study, an ancillary study of the Framingham Heart Study, with data on more than five thousand adult men and women. PMID:26045228

  2. Comparative assessment of absolute cardiovascular disease risk characterization from non-laboratory-based risk assessment in South African populations

    PubMed Central

    2013-01-01

    Background All rigorous primary cardiovascular disease (CVD) prevention guidelines recommend absolute CVD risk scores to identify high- and low-risk patients, but laboratory testing can be impractical in low- and middle-income countries. The purpose of this study was to compare the ranking performance of a simple, non-laboratory-based risk score to laboratory-based scores in various South African populations. Methods We calculated and compared 10-year CVD (or coronary heart disease (CHD)) risk for 14,772 adults from thirteen cross-sectional South African populations (data collected from 1987 to 2009). Risk characterization performance for the non-laboratory-based score was assessed by comparing rankings of risk with six laboratory-based scores (three versions of Framingham risk, SCORE for high- and low-risk countries, and CUORE) using Spearman rank correlation and percent of population equivalently characterized as ‘high’ or ‘low’ risk. Total 10-year non-laboratory-based risk of CVD death was also calculated for a representative cross-section from the 1998 South African Demographic Health Survey (DHS, n = 9,379) to estimate the national burden of CVD mortality risk. Results Spearman correlation coefficients for the non-laboratory-based score with the laboratory-based scores ranged from 0.88 to 0.986. Using conventional thresholds for CVD risk (10% to 20% 10-year CVD risk), 90% to 92% of men and 94% to 97% of women were equivalently characterized as ‘high’ or ‘low’ risk using the non-laboratory-based and Framingham (2008) CVD risk score. These results were robust across the six risk scores evaluated and the thirteen cross-sectional datasets, with few exceptions (lower agreement between the non-laboratory-based and Framingham (1991) CHD risk scores). Approximately 18% of adults in the DHS population were characterized as ‘high CVD risk’ (10-year CVD death risk >20%) using the non-laboratory-based score. Conclusions We found a high level of

  3. [10 years of liver transplantation in Peru].

    PubMed

    Chaman Ortiz, José Carlos; Padilla Machaca, P Martín; Rondon Leyva, Carlos; Carrasco Mascaró, Felix

    2010-01-01

    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.

  4. Cardiac risk factors and metabolic syndrome in patients with schizophrenia admitted to a general hospital psychiatric unit

    PubMed Central

    Grover, Sandeep; Nebhinani, Naresh; Chakrabarti, Subho; Avasthi, Ajit; Basu, Debasish; Kulhara, Parmanand; Mattoo, Surendra Kumar; Malhotra, Savita

    2014-01-01

    Objective: The study aimed to evaluate the prevalence of cardiovascular risk (CVR) factors and metabolic syndrome (MS) in patients with schizophrenia. Materials and Methods: By consecutive sampling, 143 patients (of age ≥ 20 years), out of total 159 patients with schizophrenia admitted to the inpatient unit were evaluated for the coronary heart disease (CHD) risk as per Framingham (10-year all CHD events) function/risk equation and systematic coronary risk evaluation (SCORE) - 10-year cardiovascular mortality risk (CMR). Prevalence of MS was estimated by using the consensus definition. Results: Fifty-two (36.4%) patients fulfilled the criteria for MS. 10-year CHD risk was 1.65%, and 10-year CMR was 1.39%. Compared to females, males had higher Framingham score (1.96 ± 2.74 vs. 1.09 ± 0.41, U value 1987.5*, P < 0.05). Conclusion: Patients of schizophrenia have a high prevalence of MS and CVR factors. Hence, there is a need to screen the patient of schizophrenia for the same and manage the same as early as possible during the course of illness. PMID:25568478

  5. AMS at ANTARES - The first 10 years

    NASA Astrophysics Data System (ADS)

    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.

    2000-10-01

    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.

  6. Neurology--the next 10 years.

    PubMed

    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

    2015-11-01

    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.

  7. Bivariate Heritability of Total and Regional Brain Volumes: the Framingham Study

    PubMed Central

    DeStefano, Anita L.; Seshadri, Sudha; Beiser, Alexa; Atwood, Larry D.; Massaro, Joe M.; Au, Rhoda; Wolf, Philip A.; DeCarli, Charles

    2009-01-01

    Heritability and genetic and environmental correlations of total and regional brain volumes were estimated from a large, generally healthy, community-based sample, to determine if there are common elements to the genetic influence of brain volumes and white matter hyperintensity volume. There were 1538 Framingham Heart Study participants with brain volume measures from quantitative magnetic resonance imaging (MRI) who were free of stroke and other neurological disorders that might influence brain volumes and who were members of families with at least two Framingham Heart Study participants. Heritability was estimated using variance component methodology and adjusting for the components of the Framingham stroke risk profile. Genetic and environmental correlations between traits were obtained from bivariate analysis. Heritability estimates ranging from 0.46 to 0.60, were observed for total brain, white matter hyperintensity, hippocampal, temporal lobe, and lateral ventricular volumes. Moderate, yet significant, heritability was observed for the other measures. Bivariate analyses demonstrated that relationships between brain volume measures, except for white matter hyperintensity, reflected both moderate to strong shared genetic and shared environmental influences. This study confirms strong genetic effects on brain and white matter hyperintensity volumes. These data extend current knowledge by showing that these two different types of MRI measures do not share underlying genetic or environmental influences. PMID:19812462

  8. Mitochondrial ROS Metabolism: 10 Years Later

    PubMed Central

    Kushnareva, Y. E.; Murphy, A. N.

    2015-01-01

    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

  9. Aqua's First 10 Years: An Overview

    NASA Technical Reports Server (NTRS)

    Parkinson, Claire L.

    2012-01-01

    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.

  10. Prognostic Value of Stress Echocardiography in Patients With Low-Intermediate or High Short-Term (10 Years) Versus Low (<39%) or High (≥39%) Lifetime Predicted Risk of Cardiovascular Disease According to the American College of Cardiology/American Heart Association 2013 Cardiovascular Risk Calculator.

    PubMed

    Yao, Siu-Sun; Supariwala, Azhar; Yao, Amanda; Dukkipati, Sai Sreenija; Wyne, Jamshad; Chaudhry, Farooq A

    2015-09-01

    This study evaluates the prognostic value of stress echocardiography (Secho) in short-term (10 years) and lifetime atherosclerotic cardiovascular disease risk-defined groups according to the American College of Cardiology/American Heart Association 2013 cardiovascular risk calculator. The ideal risk assessment and management of patients with low-to-intermediate or high short-term versus low (<39%) or high (≥39%) lifetime CV risk is unclear. The purpose of this study was to evaluate the prognostic value of Secho in short-term and lifetime CV risk-defined groups. We evaluated 4,566 patients (60 ± 13 years; 46% men) who underwent Secho (41% treadmill and 59% dobutamine) with low-intermediate short-term (<20%) risk divided into low (<39%, n = 368) or high (≥39%, n = 661) lifetime CV risk and third group with high short-term risk (≥20%, n = 3,537). Follow-up (3.2 ± 1.5 years) for nonfatal myocardial infarction (n = 102) and cardiac death (n = 140) were obtained. By univariate analysis, age (p <0.001) and ≥3 new ischemic wall motion abnormalities (WMAs, p <0.001) were significant predictors of cardiac events. Cumulative survival in patients was significantly worse in patients with ≥3 WMA versus <3 WMA in low-intermediate short-term and low (3.3% vs 0.3% per year, p <0.001) or high (2.0% vs 0% per year, p <0.001) lifetime risk and also in those with high short-term CV risk group (3.5% vs 1.0% per year, p <0.001). Multivariate Cox proportional hazards analysis identified ≥3 new ischemic WMAs as the strongest predictor of cardiac events (hazard ratio 3.0, 95% confidence interval 2.3 to 3.9, p <0.001). In conclusion, Secho results (absence or presence of ≥3 new ischemic segments) can further refine risk assessment in patients with low-intermediate or high short-term versus low or high lifetime cardiovascular risk. Event rate with normal Secho is low (≤1% per year) but higher in patients with high short-term CV risk by the American College of

  11. Regression From Prediabetes to Normal Glucose Regulation Is Associated With Reduction in Cardiovascular Risk: Results From the Diabetes Prevention Program Outcomes Study

    PubMed Central

    Temprosa, Marinella; Mather, Kieren J.; Horton, Ed; Kitabchi, Abbas; Larkin, Mary; Montez, Maria G.; Thayer, Debra; Orchard, Trevor J.; Hamman, Richard F.; Goldberg, Ronald B.

    2014-01-01

    OBJECTIVE Restoration of normal glucose regulation (NGR) in people with prediabetes significantly decreases the risk of future diabetes. We sought to examine whether regression to NGR is also associated with a long-term decrease in cardiovascular disease (CVD) risk. RESEARCH DESIGN AND METHODS The Framingham (2008) score (as an estimate of the global 10-year CVD risk) and individual CVD risk factors were calculated annually for the Diabetes Prevention Program Outcomes Study years 1–10 among those patients who returned to NGR at least once during the Diabetes Prevention Program (DPP) compared with those who remained with prediabetes or those in whom diabetes developed during DPP (N = 2,775). RESULTS The Framingham scores by glycemic exposure did not differ among the treatment groups; therefore, pooled estimates were stratified by glycemic status and were adjusted for differences in risk factors at DPP baseline and in the treatment arm. During 10 years of follow-up, the mean Framingham 10-year CVD risk scores were highest in the prediabetes group (16.2%), intermediate in the NGR group (15.5%), and 14.4% in people with diabetes (all pairwise comparisons P < 0.05), but scores decreased over time for those people with prediabetes (18.6% in year 1 vs. 15.9% in year 10, P < 0.01). The lower score in the diabetes group versus other groups, a declining score in the prediabetes group, and favorable changes in each individual risk factor in all groups were explained, in part, by higher or increasing medication use for lipids and blood pressure. CONCLUSIONS Prediabetes represents a high-risk state for CVD. Restoration of NGR and/or medical treatment of CVD risk factors can significantly reduce the estimated CVD risk in people with prediabetes. PMID:24969574

  12. Spatial comparison of areas at risk for schistosomiasis in the hilly and mountainous regions in the People's Republic of China: evaluation of the long-term effect of the 10-year World Bank Loan Project.

    PubMed

    Zhang, Zhi-Jie; Zhu, Rong; Bergquist, Robert; Chen, Dong-Mei; Chen, Yue; Zhang, Li-Juan; Guo, Jia-Gang; Zhao, Fei; Jiang, Qing-Wu

    2012-05-01

    The long-term effectiveness of the mainly chemotherapy-based control strategy of the World Bank Loan Project (WBLP) for schistosomiasis control in Chinese hilly and mountainous regions was evaluated with a view to determine the best road forward. Based on the national database of schistosomiasis prevalence for the periods of 1999-2001 and 2007-2008 in the People's Republic of China, a Bayesian regression model was used for spatial comparison of schistosomiasis risk distribution between two periods taking account of all the potential risk factors simultaneously through two latent components of random effects: spatially correlated heterogeneities (CH) and spatially uncorrelated heterogeneities (UH). Four different types of endemic areas were investigated: those that remained endemic despite control efforts (17 or 37.8%), those that became non-endemic (9 or 20.0%), those that reverted back to endemicity (7 or 15.6%), and those with fluctuating endemicity (12 or 26.7%). The overall prevalence of schistosomiasis was lower in 2007-2008 compared with that in 1999-2001, but the spatial distribution of risk remained similar. Compared to 1999-2001, the magnitude and range of risk even tended to be greater in 2007-2008. UH showed a fluctuating pattern, while CH increased gradually doubling over the two periods. There was no evidence for long-term effectiveness of the WBLP chemotherapy-based control strategy in this region. Controlling the effect of UH is still the main aspect of current schistosomiasis control strategy for the hilly and mountainous regions, but innovative methods are urgently needed for effectively controlling UH.

  13. Cardiovascular correlates of platelet count and volume in the Framingham Heart Study

    PubMed Central

    Sloan, Arielle; Gona, Philimon; Johnson, Andrew

    2015-01-01

    Purpose Platelet count and volume are inexpensive, routinely-assayed biomarkers associated with cardiovascular health, but specific relationships among platelet indices, cardiovascular risk factors, and disease warrant further investigation. The purpose of this study was to understand associations among platelet count, volume, and 20 cardiovascular health-related variables in the Framingham Heart Study. Methods Cross-sectional analyses were performed on platelet count and volume associations with cardiovascular health indicators in three Framingham Heart Study cohorts (Original n=964, Offspring n=2,699, and Third Generation n=2,419) using multivariable linear regression analysis. Time-to-event analysis was employed for cardiovascular disease-related event incidences using Kaplan-Meier plots and Cox proportional hazards regression adjusted for age and gender. Results Results were concordant with the hypothesis that higher platelet counts are associated with less favorable cardiovascular risk profiles, although mean platelet volume associations were weaker. In our analysis, increased platelet count across FHS cohorts was consistently associated with smoking, triglycerides, LDL and total cholesterol levels. Some associations with platelet count appeared gender-dependent. Conclusions Significant associations of common blood platelet measurements are observed with gender and cardiovascular risk factors, namely smoking and lipids. Research is warranted to confirm these relationships in other cohorts, evaluate differences by ethnicity and examine longitudinal effects on disease risk. PMID:25771288

  14. Association of dietary fat and carbohydrate consumption and predicted ten-year risk for developing coronary heart disease in a general Japanese population.

    PubMed

    Minoura, Akira; Wang, Da-Hong; Sato, Yoshie; Zou, Yu; Sakano, Noriko; Kubo, Masayuki; Takemoto, Kei; Masatomi, Chie; Ogino, Keiki

    2014-01-01

    We examined the relationships between dietary carbohydrate, protein, fat, and the ratio of n6/n3 fatty acid intakes with the predicted 10-year coronary heart disease (CHD) risk in a general Japanese population. We used the Framingham risk score to determine the 10-year CHD risk of the subjects, who were employees of 6 companies in a single prefecture in Japan. After excluding the subjects who reported any history of angina pectoris, myocardial infarction, diabetes, or cancer, and those with missing data resulting in the inability of estimation of 10-year CHD risk and food intakes, the final data analysis was carried out for 809 subjects. The logistic regression models revealed a significantly increased odds ratio of 10-year CHD risk in the subjects with the highest tertile of carbohydrate intake (% energy) (odds ratio 3.64, 95% CI, 2.07-6.40); after adjustment for other variables, the odds ratio for the 10-year CHD risk was also higher in the subjects with the highest tertile of carbohydrate intake (odds ratio 1.72, 95% CI, 0.70-4.25). We also found that fat intake and the ratio of n6/n3 fatty acids were inversely associated with the predicted 10-year CHD risk (p for trend<0.01). The present findings added evidence of a positive association of dietary carbohydrate and inverse associations of total fat and n6/n3 fatty acid ratio with the predicted 10-year CHD risk in a general Japanese population.

  15. 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)

    PubMed Central

    Nightingale, C. M.; Rudnicka, A. R.; Sattar, N.; Cook, D. G.; Ekelund, U.; Whincup, P. H.

    2010-01-01

    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

  16. Growth mixture modelling in families of the Framingham Heart Study

    PubMed Central

    2009-01-01

    Growth mixture modelling, a less explored method in genetic research, addresses unobserved heterogeneity in population samples. We applied this technique to longitudinal data of the Framingham Heart Study. We examined systolic blood pressure (BP) measures in 1060 males from 692 families and detected three subclasses, which varied significantly in their developmental trajectories over time. The first class consisted of 60 high-risk individuals with elevated BP early in life and a steep increase over time. The second group of 131 individuals displayed first normal BP, but showed a significant increase over time and reached high BP values late in their life time. The largest group of 869 individuals could be considered a normative group with normal BP on all exams. To identify genetic modulators for this phenotype, we tested 2,340 single-nucleotide polymorphisms on chromosome 8 for association with the class membership probabilities of our model. The probability of being in Class 1 was significantly associated with a very rare variant (rs1445404) present in only four individuals from four different families located in the coding region of the gene EYA (eyes absent homolog 1 in Drosophila) (p = 1.39 × 10-13). Mutations in EYA are known to cause brachio-oto-renal syndrome, as well as isolated renal malformations. Renal malformations could cause high BP early in life. This result awaits replication; however, it suggests that analyzing genetic data stratified for high-risk subgroups defined by a unique development over time could be useful for the detection of rare mutations in common multi-factorial diseases. PMID:20017979

  17. Administrative Reinstatement Interlock Programs: Florida, a 10-Year Study

    PubMed Central

    Voas, Robert B.; Tippetts, A. Scott; Grosz, Milton

    2013-01-01

    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

  18. Mumps Cases Hit 10-Year High in U.S.

    MedlinePlus

    ... 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 ...

  19. Incidence of Dementia over Three Decades in the Framingham Heart Study

    PubMed Central

    Satizabal, Claudia L.; Beiser, Alexa S.; Chouraki, Vincent; Chêne, Geneviève; Dufouil, Carole; Seshadri, Sudha

    2016-01-01

    BACKGROUND The prevalence of dementia is expected to soar as the average life expectancy increases, but recent estimates suggest that the age-specific incidence of dementia is declining in high-income countries. Temporal trends are best derived through continuous monitoring of a population over a long period with the use of consistent diagnostic criteria. We describe temporal trends in the incidence of dementia over three decades among participants in the Framingham Heart Study. METHODS Participants in the Framingham Heart Study have been under surveillance for incident dementia since 1975. In this analysis, which included 5205 persons 60 years of age or older, we used Cox proportional-hazards models adjusted for age and sex to determine the 5-year incidence of dementia during each of four epochs. We also explored the interactions between epoch and age, sex, apolipoprotein E ε4 status, and educational level, and we examined the effects of these interactions, as well as the effects of vascular risk factors and cardiovascular disease, on temporal trends. RESULTS The 5-year age- and sex-adjusted cumulative hazard rates for dementia were 3.6 per 100 persons during the first epoch (late 1970s and early 1980s), 2.8 per 100 persons during the second epoch (late 1980s and early 1990s), 2.2 per 100 persons during the third epoch (late 1990s and early 2000s), and 2.0 per 100 persons during the fourth epoch (late 2000s and early 2010s). Relative to the incidence during the first epoch, the incidence declined by 22%, 38%, and 44% during the second, third, and fourth epochs, respectively. This risk reduction was observed only among persons who had at least a high school diploma (hazard ratio, 0.77; 95% confidence interval, 0.67 to 0.88). The prevalence of most vascular risk factors (except obesity and diabetes) and the risk of dementia associated with stroke, atrial fibrillation, or heart failure have decreased over time, but none of these trends completely explain the

  20. Burden of rare sarcomere gene variants in the Framingham and Jackson Heart Study cohorts.

    PubMed

    Bick, Alexander G; Flannick, Jason; Ito, Kaoru; Cheng, Susan; Vasan, Ramachandran S; Parfenov, Michael G; Herman, Daniel S; DePalma, Steven R; Gupta, Namrata; Gabriel, Stacey B; Funke, Birgit H; Rehm, Heidi L; Benjamin, Emelia J; Aragam, Jayashri; Taylor, Herman A; Fox, Ervin R; Newton-Cheh, Christopher; Kathiresan, Sekar; O'Donnell, Christopher J; Wilson, James G; Altshuler, David M; Hirschhorn, Joel N; Seidman, J G; Seidman, Christine

    2012-09-07

    Rare sarcomere protein variants cause dominant hypertrophic and dilated cardiomyopathies. To evaluate whether allelic variants in eight sarcomere genes are associated with cardiac morphology and function in the community, we sequenced 3,600 individuals from the Framingham Heart Study (FHS) and Jackson Heart Study (JHS) cohorts. Out of the total, 11.2% of individuals had one or more rare nonsynonymous sarcomere variants. The prevalence of likely pathogenic sarcomere variants was 0.6%, twice the previous estimates; however, only four of the 22 individuals had clinical manifestations of hypertrophic cardiomyopathy. Rare sarcomere variants were associated with an increased risk for adverse cardiovascular events (hazard ratio: 2.3) in the FHS cohort, suggesting that cardiovascular risk assessment in the general population can benefit from rare variant analysis.

  1. Assessment of 2013 AHA/ACC ASCVD risk scores with behavioral characteristics of an urban cohort in India

    PubMed Central

    Menon, Vidya P.; Edathadathil, Fabia; Sathyapalan, Dipu; Moni, Merlin; Don, Ann; Balachandran, Sabarish; Pushpa, Binny; Prasanna, Preetha; Sivaram, Nithu; Nair, Anupama; Vinod, Nithu; Jayaprasad, Rekha; Menon, Veena

    2016-01-01

    Abstract Cardiovascular diseases (CVDs) are the leading cause of death and disability in India. Early and sustained exposure to behavioral risk factors leads to development of CVDs. The aim of this study was to determine the baseline risk of a “hard CVD event” in subjects attending comprehensive health clinic and assess behavioral characteristics in “at risk” population. Using WHO STEPwise approach to Surveillance modified questionnaire, prevalence of noncommunicable diseases (NCDs) and risk factors was estimated in this cross-sectional study of 4507 subjects. Baseline cardiovascular risk was determined using Framingham risk score (FRS) and American College of Cardiology (ACC)/American Heart Association (AHA) atherosclerotic cardiovascular disease (ASCVD) algorithms. Modifiable behavior associated with high CVD risk was assessed. Among 40 to 59-year olds, ASCVD risk tool derived both a 10-year and lifetime risk score, which were used to stratify the cohort into 3 risk groups, namely, a high 10-year and high lifetime, a low 10-year and high lifetime, and a low 10-year and low lifetime risks. Dyslipidemia (30.6%), hypertension (25.5%), diabetes mellitus (20%), and obstructive airway disorders (17.6%) were most prevalent NCDs in our cohort. The ASCVD score stratified 26.1% subjects into high 10-yr and 59.5% into high lifetime risk while FRS classified 17.2% into high 10-year risk. Compared with FRS, the ASCVD risk estimator identified a larger proportion of subjects “at risk” of developing CVD. A high prevalence of alcohol use (38.4%), decreased intake of fruits and vegetables (96.2%) and low physical activity (58%) were observed in “at risk” population. Logistic regression analysis showed that in 40 to 59-year group, regular and occasional drinkers were 8.5- and 3.1-fold more likely to be in high 10-year and high lifetime ASCVD risk category than in low 10-year and low lifetime risk group. Similarly, regular drinkers and occasional drinkers were 2

  2. The academic occupational physician as consultant. A 10-year perspective.

    PubMed

    McCunney, R J

    1994-04-01

    The academic community has long served the private sector in a consultant capacity in engineering and in the sciences. With respect to occupational medicine, physicians, when working for industry, have generally practiced in a health care setting. Within the past 10 years, however, the business sector has placed more attention on the health implications of its operations as a result of regulations, liability, and rising health care costs. These issues, which go beyond traditional clinical responsibilities, have furthered the need for businesses to receive strategic medical advice to effectively operate and to maintain a competitive edge. One particular business sector, the chemical industry, has been challenged seriously because of legitimate as well as perceived health risks associated with the production and use of its products. This paper describes the professional experiences over a 10-year period (1983 to 1993) of an occupational physician working as a consultant to an international chemical company. Services have related to epidemiology, health policy, toxicology, plant oversight as well as serving as a health advisor on matters involving the relation between business and health. An academic affiliation with an occupational medicine residency program has facilitated access to related occupational health professionals to assist in problem solving and research. Opportunities for consulting in occupational medicine will depend upon the nature of the organization as well as the personal and professional characteristics of the physician. Requests for these types of services, however, are likely to expand in the near future, primarily as a result of wider awareness of the implications of work on health, increased litigation, and government regulations.

  3. Language Disorders: A 10-Year Research Update Review

    PubMed Central

    TOPPELBERG, CLAUDIO O.; SHAPIRO, THEODORE

    2012-01-01

    Objective To review the past 10 years of research in child language or communication disorders, which are highly prevalent in the general population and comorbid with childhood psychiatric disorders. Method A literature search of 3 major databases was conducted. The child language literature, describing the domains of language development—phonology, grammar, semantics, and pragmatics—is reviewed. Results Disorders of grammar, semantics, and pragmatics, but not phonology, overlap significantly with childhood psychiatric disorders. Receptive language disorders have emerged as high-risk indicators, often undiagnosed. Language disorders and delays are psychiatric risk factors and have implications for evaluation, therapy, and research. However, they are often undiagnosed in child mental health and community settings. The research has focused mostly on monolingual English-speaking children. Conclusion Awareness of basic child language development, delay, and deviance is crucial for the practicing child and adolescent psychiatrist, who must diagnose and refer relevant cases for treatment and remediation. Future research needs to address the growing language diversity of our clinical populations. PMID:10673823

  4. Development of Health Parameter Model for Risk Prediction of CVD Using SVM

    PubMed Central

    Unnikrishnan, P.; Kumar, H.; Mitchell, P.; Kawasaki, R.

    2016-01-01

    Current methods of cardiovascular risk assessment are performed using health factors which are often based on the Framingham study. However, these methods have significant limitations due to their poor sensitivity and specificity. We have compared the parameters from the Framingham equation with linear regression analysis to establish the effect of training of the model for the local database. Support vector machine was used to determine the effectiveness of machine learning approach with the Framingham health parameters for risk assessment of cardiovascular disease (CVD). The result shows that while linear model trained using local database was an improvement on Framingham model, SVM based risk assessment model had high sensitivity and specificity of prediction of CVD. This indicates that using the health parameters identified using Framingham study, machine learning approach overcomes the low sensitivity and specificity of Framingham model. PMID:27594895

  5. The Envy of Scholars: Applying the Lessons of the Framingham Heart Study to the Prevention of Chronic Kidney Disease

    PubMed Central

    Wasser, Walter G.; Gil, Amnon; Skorecki, Karl L.

    2015-01-01

    During the past 50 years, a dramatic reduction in the mortality rate associated with cardiovascular disease has occurred in the US and other countries. Statistical modeling has revealed that approximately half of this reduction is the result of risk factor mitigation. The successful identification of such risk factors was pioneered and has continued with the Framingham Heart Study, which began in 1949 as a project of the US National Heart Institute (now part of the National Heart, Lung, and Blood Institute). Decreases in total cholesterol, blood pressure, smoking, and physical inactivity account for 24%, 20%, 12%, and 5% reductions in the mortality rate, respectively. Nephrology was designated as a recognized medical professional specialty a few years later. Hemodialysis was first performed in 1943. The US Medicare End-Stage Renal Disease (ESRD) Program was established in 1972. The number of patients in the program increased from 5,000 in the first year to more than 500,000 in recent years. Only recently have efforts for risk factor identification, early diagnosis, and prevention of chronic kidney disease (CKD) been undertaken. By applying the approach of the Framingham Heart Study to address CKD risk factors, we hope to mirror the success of cardiology; we aim to prevent progression to ESRD and to avoid the cardiovascular complications associated with CKD. In this paper, we present conceptual examples of risk factor modification for CKD, in the setting of this historical framework. PMID:26241225

  6. The Envy of Scholars: Applying the Lessons of the Framingham Heart Study to the Prevention of Chronic Kidney Disease.

    PubMed

    Wasser, Walter G; Gil, Amnon; Skorecki, Karl L

    2015-07-30

    During the past 50 years, a dramatic reduction in the mortality rate associated with cardiovascular disease has occurred in the US and other countries. Statistical modeling has revealed that approximately half of this reduction is the result of risk factor mitigation. The successful identification of such risk factors was pioneered and has continued with the Framingham Heart Study, which began in 1949 as a project of the US National Heart Institute (now part of the National Heart, Lung, and Blood Institute). Decreases in total cholesterol, blood pressure, smoking, and physical inactivity account for 24%, 20%, 12%, and 5% reductions in the mortality rate, respectively. Nephrology was designated as a recognized medical professional specialty a few years later. Hemodialysis was first performed in 1943. The US Medicare End-Stage Renal Disease (ESRD) Program was established in 1972. The number of patients in the program increased from 5,000 in the first year to more than 500,000 in recent years. Only recently have efforts for risk factor identification, early diagnosis, and prevention of chronic kidney disease (CKD) been undertaken. By applying the approach of the Framingham Heart Study to address CKD risk factors, we hope to mirror the success of cardiology; we aim to prevent progression to ESRD and to avoid the cardiovascular complications associated with CKD. In this paper, we present conceptual examples of risk factor modification for CKD, in the setting of this historical framework.

  7. Sex specific differences in the predictive value of cholesterol homeostasis markers and 10-Year CVD event rate in Framingham Offspring Study participants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Available data are inconsistent on factors influencing plasma cholesterol homeostasis marker concentrations and their value in predicting subsequent cardiovascular disease (CVD) events. To address this issue the relationship between markers of cholesterol absorption (campesterol, sitosterol, cholest...

  8. Sugar-sweetened beverage, diet soda, and fatty liver disease in the Framingham Heart Study cohorts

    PubMed Central

    Ma, Jiantao; Fox, Caroline S.; Jacques, Paul F.; Speliotes, Elizabeth K.; Hoffmann, Udo; Smith, Caren E.; Saltzman, Edward; McKeown, Nicola M.

    2016-01-01

    Background & Aims Non-alcoholic fatty liver disease affects ~30% of US adults, yet the role of sugar-sweetened beverages and diet soda on these diseases remains unknown. We examined the cross-sectional association between intake of sugar-sweetened beverages or diet soda and fatty liver disease in participants of the Framingham Offspring and Third Generation cohorts. Methods Fatty liver disease was defined using liver attenuation measurements generated from computed tomography in 2634 participants. Alanine transaminase concentration, a crude marker of fatty liver disease, was measured in 5908 participants. Sugar-sweetened beverage and diet soda intake were estimated using a food frequency questionnaire. Participants were categorized as either non-consumers or consumers (3 categories: 1 serving/month to <1 serving/week, 1 serving/week to <1 serving/-day, and ⩾1 serving/day) of sugar-sweetened beverages or diet soda. Results After adjustment for age, sex, smoking status, Framingham cohort, energy intake, alcohol, dietary fiber, fat (% energy), protein (% energy), diet soda intake, and body mass index, the odds ratios of fatty liver disease were 1, 1.16 (0.88, 1.54), 1.32 (0.93, 1.86), and 1.61 (1.04, 2.49) across sugar-sweetened beverage consumption categories (p trend = 0.04). Sugar-sweetened beverage consumption was also positively associated with alanine transaminase levels (p trend = 0.007). We observed no significant association between diet soda intake and measures of fatty liver disease. Conclusion In conclusion, we observed that regular sugar-sweetened beverage consumption was associated with greater risk of fatty liver disease, particularly in overweight and obese individuals, whereas diet soda intake was not associated with measures of fatty liver disease. PMID:26055949

  9. 10-Year Framework of Programmes on Sustainable Consumption and Production

    EPA Pesticide Factsheets

    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).

  10. Agreement Between Cardiovascular Disease Risk Scores in Resource-Limited Settings: Evidence from 5 Peruvian Sites

    PubMed Central

    Bazo-Alvarez, Juan Carlos; Quispe, Renato; Peralta, Frank; Poterico, Julio A.; Valle, Giancarlo A.; Burroughs, Melissa; Pillay, Timesh; Gilman, Robert H.; Checkley, William; Malaga, Germán; Smeeth, Liam; Bernabé-Ortiz, Antonio

    2015-01-01

    It is unclear how well currently available risk scores predict cardiovascular disease (CVD) risk in low-income and middle-income countries. We aim to compare the American College of Cardiology/American Heart Association (ACC/AHA) Pooled Cohort risk equations (ACC/AHA model) with 6 other CVD risk tools to assess the concordance of predicted CVD risk in a random sample from 5 geographically diverse Peruvian populations. We used data from 2 Peruvian, age and sex-matched, population-based studies across 5 geographical sites. The ACC/AHA model were compared with 6 other CVD risk prediction tools: laboratory Framingham risk score for CVD, non-laboratory Framingham risk score for CVD, Reynolds risk score, systematic coronary risk evaluation, World Health Organization risk charts, and the Lancet chronic diseases risk charts. Main outcome was in agreement with predicted CVD risk using Lin’s concordance correlation coefficient. Two thousand one hundred and eighty-three subjects, mean age 54.3 (SD ± 5.6) years, were included in the analysis. Overall, we found poor agreement between different scores when compared with ACC/AHA model. When each of the risk scores was used with cut-offs specified in guidelines, ACC/AHA model depicted the highest proportion of people at high CVD risk predicted at 10 years, with a prevalence of 29.0% (95% confidence interval, 26.9–31.0%), whereas prevalence with World Health Organization risk charts was 0.6% (95% confidence interval, 0.2–8.6%). In conclusion, poor concordance between current CVD risk scores demonstrates the uncertainty of choosing any of them for public health and clinical interventions in Latin American populations. There is a need to improve the evidence base of risk scores for CVD in low-income and middle-income countries. PMID:26102017

  11. Agreement Between Cardiovascular Disease Risk Scores in Resource-Limited Settings: Evidence from 5 Peruvian Sites.

    PubMed

    Bazo-Alvarez, Juan Carlos; Quispe, Renato; Peralta, Frank; Poterico, Julio A; Valle, Giancarlo A; Burroughs, Melissa; Pillay, Timesh; Gilman, Robert H; Checkley, William; Malaga, Germán; Smeeth, Liam; Bernabé-Ortiz, Antonio; Miranda, J Jaime

    2015-06-01

    It is unclear how well currently available risk scores predict cardiovascular disease (CVD) risk in low-income and middle-income countries. We aim to compare the American College of Cardiology/American Heart Association (ACC/AHA) Pooled Cohort risk equations (ACC/AHA model) with 6 other CVD risk tools to assess the concordance of predicted CVD risk in a random sample from 5 geographically diverse Peruvian populations. We used data from 2 Peruvian, age and sex-matched, population-based studies across 5 geographical sites. The ACC/AHA model were compared with 6 other CVD risk prediction tools: laboratory Framingham risk score for CVD, non-laboratory Framingham risk score for CVD, Reynolds risk score, systematic coronary risk evaluation, World Health Organization risk charts, and the Lancet chronic diseases risk charts. Main outcome was in agreement with predicted CVD risk using Lin's concordance correlation coefficient. Two thousand one hundred and eighty-three subjects, mean age 54.3 (SD ± 5.6) years, were included in the analysis. Overall, we found poor agreement between different scores when compared with ACC/AHA model. When each of the risk scores was used with cut-offs specified in guidelines, ACC/AHA model depicted the highest proportion of people at high CVD risk predicted at 10 years, with a prevalence of 29.0% (95% confidence interval, 26.9-31.0%), whereas prevalence with World Health Organization risk charts was 0.6% (95% confidence interval, 0.2-8.6%). In conclusion, poor concordance between current CVD risk scores demonstrates the uncertainty of choosing any of them for public health and clinical interventions in Latin American populations. There is a need to improve the evidence base of risk scores for CVD in low-income and middle-income countries.

  12. Actual 10-Year Survivors Following Resection of Adrenocortical Carcinoma

    PubMed Central

    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.

    2017-01-01

    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

  13. Impact of Adolescent Alcohol and Drug Use on Neuropsychological Functioning in Young Adulthood: 10-Year Outcomes

    ERIC Educational Resources Information Center

    Hanson, Karen L.; Medina, Krista Lisdahl; Padula, Claudia B.; Tapert, Susan F.; Brown, Sandra A.

    2011-01-01

    Because of ongoing neuromaturation, youth with chronic alcohol/substance use disorders (AUD/SUD) are at risk for cognitive decrements during young adulthood. We prospectively examined cognition over 10 years based on AUD/SUD history. Youth (N = 51) with no AUD/SUD history (n = 14), persisting AUD/SUD (n = 18), or remitted AUD/SUD (n = 19) were…

  14. Eating With Your Heart In Mind: 7 to 10 Year Olds.

    ERIC Educational Resources Information Center

    National Heart, Lung, and Blood Inst. (DHHS/NIH), Bethesda, MD.

    The purpose of this brightly illustrated guide is to teach 7-10 year old children that all healthy Americans, 2 years of age or older, should eat in a way that is low in saturated fat and cholesterol so as to help reduce the risk of heart disease. The theme reflected throughout the manual is that changes in eating patterns help lower blood…

  15. Operations, Maintenance, and Replacement 10-Year Plan, 1990 -1999.

    SciTech Connect

    United States. Bonneville Power Administration.

    1990-08-01

    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.

  16. Operations, Maintenance, and Replacement 10-Year Plan, 1990--1999

    SciTech Connect

    Not Available

    1990-08-01

    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.

  17. Expected innovations of optical lithography in the next 10 years

    NASA Astrophysics Data System (ADS)

    Owa, Soichi; Hirayanagi, Noriyuki

    2016-03-01

    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.

  18. Juvenile Hyaline Fibromatosis: A 10-year Follow-up

    PubMed Central

    Baltacioglu, Esra; Guzeldemir, Esra; Sukuroglu, Erkan; Yildiz, Kadriye; Yuva, Pinar; Aydin, Güven; Karacal, Naci

    2017-01-01

    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.

  19. Rheumatoid arthritis: workload and outcome over 10 years.

    PubMed

    Capell, H A; Murphy, E A; Hunter, J A

    1991-06-01

    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

  20. Nonspecific electrocardiographic abnormality as a predictor of coronary heart disease: the Framingham Study.

    PubMed

    Kannel, W B; Anderson, K; McGee, D L; Degatano, L S; Stampfer, M J

    1987-02-01

    The risk of developing overt coronary heart disease is examined in relation to occurrence of non-specific electrocardiographic S-T and T-wave abnormalities (NSA-ECG) in the Framingham Study. In the course of follow-up, 14% of the 5127 men and women had or developed NSA-ECG without clinically apparent intervening coronary heart disease. During 30 years of surveillance, 760 men and 578 women developed a first overt clinical manifestation of coronary heart disease. NSA-ECG appears to be a hallmark of a compromised coronary circulation which predicted the occurrence of every clinical manifestation of coronary heart disease independently of known risk factors including hypertension, its chief determinant. Coronary morbidity and mortality was increased twofold in each sex. The more common T-wave abnormality alone carried a significant increased risk, although the combination of S-T and T-wave seemed most hazardous. Persons who develop NSA-ECG without other explanation warrant vigorous preventive management against coronary heart disease.

  1. CELBAN™: A 10-Year Retrospective Catherine Lewis & Blanche Kingdon

    ERIC Educational Resources Information Center

    Lewis, Catherine; Kingdom, Blanche

    2016-01-01

    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…

  2. Career Theory Building in AJCD during Its Inaugural 10 Years.

    ERIC Educational Resources Information Center

    Prideaux, Lee-Ann; Creed, Peter

    2002-01-01

    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…

  3. Headshaking in a 10-year-old Thoroughbred mare

    PubMed Central

    2004-01-01

    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

  4. 10 Years of Media Literacy Education in K-12 Schools

    ERIC Educational Resources Information Center

    Daunic, Rhys

    2011-01-01

    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…

  5. Interrogating the Subject: Queering Elementary Education, 10 Years On

    ERIC Educational Resources Information Center

    Sears, James T.

    2009-01-01

    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…

  6. Technology for Distance Education: A 10 Year Prospective.

    ERIC Educational Resources Information Center

    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…

  7. Flowerpot sequestrum of the Humerus Neglect for 10 years!!

    PubMed Central

    Sharma, Rakesh

    2012-01-01

    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.

  8. A Comparative Assessment of Non-Laboratory-Based versus Commonly Used Laboratory-Based Cardiovascular Disease Risk Scores in the NHANES III Population

    PubMed Central

    Pandya, Ankur; Weinstein, Milton C.; Gaziano, Thomas A.

    2011-01-01

    Background National and international primary CVD risk screening guidelines focus on using total CVD risk scores. Recently, we developed a non-laboratory-based CVD risk score (inputs: age, sex, smoking, diabetes, systolic blood pressure, treatment of hypertension, body-mass index), which can assess risk faster and at lower costs compared to laboratory-based scores (inputs include cholesterol values). We aimed to assess the exchangeability of the non-laboratory-based risk score to four commonly used laboratory-based scores (Framingham CVD [2008, 1991 versions], and Systematic COronary Risk Evaluation [SCORE] for low and high risk settings) in an external validation population. Methods and Findings Analyses were based on individual-level, score-specific rankings of risk for adults in the Third National Health and Nutrition Examination Survey (NHANES III) aged 25–74 years, without history of CVD or cancer (n = 5,999). Risk characterization agreement was based on overlap in dichotomous risk characterization (thresholds of 10-year risk >10–20%) and Spearman rank correlation. Risk discrimination was assessed using receiver operator characteristic curve analysis (10-year CVD death outcome). Risk characterization agreement ranged from 91.9–95.7% and 94.2–95.1% with Spearman correlation ranges of 0.957–0.980 and 0.946–0.970 for men and women, respectively. In men, c-statistics for the non-laboratory-based, Framingham (2008, 1991), and SCORE (high, low) functions were 0.782, 0.776, 0.781, 0.785, and 0.785, with p-values for differences relative to the non-laboratory-based score of 0.44, 0.89, 0.68 and 0.65, respectively. In women, the corresponding c-statistics were 0.809, 0.834, 0.821, 0.792, and 0.792, with corresponding p-values of 0.04, 0.34, 0.11 and 0.09, respectively. Conclusions Every score discriminated risk of CVD death well, and there was high agreement in risk characterization between non-laboratory-based and laboratory-based risk scores, which

  9. Low Cardiac Index is Associated with Incident Dementia and Alzheimer’s Disease: The Framingham Heart Study

    PubMed Central

    Jefferson, Angela L.; Beiser, Alexa S.; Himali, Jayandra J.; Seshadri, Sudha; O’Donnell, Christopher J.; Manning, Warren J.; Wolf, Philip A.; Au, Rhoda; Benjamin, Emelia J.

    2015-01-01

    Background Cross-sectional epidemiological and clinical research suggest lower cardiac index is associated with abnormal brain aging, including smaller brain volumes, increased white matter hyperintensities, and worse cognitive performances. Lower systemic blood flow may have implications for dementia among older adults. Methods & Results 1039 Framingham Offspring Cohort participants free from clinical stroke, transient ischemic attack, or dementia formed our sample (69±6 years; 53% women). Multivariable-adjusted proportional hazard models adjusting for Framingham Stroke Risk Profile score (age, sex, systolic blood pressure, anti-hypertensive medication, diabetes, cigarette smoking, cardiovascular disease [CVD] history, atrial fibrillation), education, and apolipoprotein E4 status related cardiac MRI-assessed cardiac index (cardiac output/body surface area) to incident all-cause dementia and Alzheimer’s disease (AD). Over the median 7.7 year follow-up period, 32 participants developed dementia, including 26 cases of AD. Each one standard deviation unit decrease in cardiac index increased the relative risk of both dementia (HR=1.66; 95% confidence intervals [CI], 1.11–2.47; p=0.013) and AD (HR=1.65; 95% CI, 1.07–2.54; p=0.022). Compared to normal cardiac index, individuals with clinically low cardiac index had a higher relative risk of dementia (HR=2.07; 95% CI, 1.02–4.19; p=0.044). If participants with clinically prevalent CVD and atrial fibrillation were excluded (n=184), individuals with clinically low cardiac index had a higher relative risk of both dementia (HR=2.92; 95% CI, 1.34–6.36; p=0.007) and AD (HR=2.87; 95% CI, 1.21–6.80; p=0.016) compared to individuals with normal cardiac index. Conclusions Lower cardiac index is associated with an increased risk for the development of dementia and AD. PMID:25700178

  10. Predicting all-cause mortality from basic physiology in the Framingham Heart Study.

    PubMed

    Zhang, William B; Pincus, Zachary

    2016-02-01

    Using longitudinal data from a cohort of 1349 participants in the Framingham Heart Study, we show that as early as 28-38 years of age, almost 10% of variation in future lifespan can be predicted from simple clinical parameters. Specifically, we found diastolic and systolic blood pressure, blood glucose, weight, and body mass index (BMI) to be relevant to lifespan. These and similar parameters have been well-characterized as risk factors in the relatively narrow context of cardiovascular disease and mortality in middle to old age. In contrast, we demonstrate here that such measures can be used to predict all-cause mortality from mid-adulthood onward. Further, we find that different clinical measurements are predictive of lifespan in different age regimes. Specifically, blood pressure and BMI are predictive of all-cause mortality from ages 35 to 60, while blood glucose is predictive from ages 57 to 73. Moreover, we find that several of these parameters are best considered as measures of a rate of 'damage accrual', such that total historical exposure, rather than current measurement values, is the most relevant risk factor (as with pack-years of cigarette smoking). In short, we show that simple physiological measurements have broader lifespan-predictive value than indicated by previous work and that incorporating information from multiple time points can significantly increase that predictive capacity. In general, our results apply equally to both men and women, although some differences exist.

  11. Profiles by Sex of Brain MRI and Cognitive Function in The Framingham Offspring Study

    PubMed Central

    Albert, Mark; Massaro, Joseph; DeCarli, Charles; Beiser, Alexa; Seshadri, Sudha; Wolf, Philip A.; Au, Rhoda

    2009-01-01

    Objective To examine whether there are sex-specific associations between brain MRI measures and neuropsychological test performance. Background Differences in cardiovascular risk factors (CVRF) have been linked to decreased total cerebral brain volume (TCBV) and white matter hyperintensities (WMH). Although brain morphology has been related to cognitive performance, few studies have addressed sex-specific effects in this relationship. Methods Framingham Offspring who were stroke and dementia-free underwent a brain MRI scan and neuropsychological (NP) testing (n=2,085; 978 men). Factor analysis identified four domain-specific neuropsychological factors. MRI participants were divided into four MRI subgroups based on measures of TCBV and combinations of the presence of WMH and silent cerebral infarcts (≥3mm; SCI). Results Overall, the relationship between MRI and NP measures was similar between the sexes. The exception was that only men showed a positive relationship between executive function (EF) and cerebrovascular disease defined as large white matter hyperintensity volume plus SCI. This finding was attributed only among men with FSRP scores > 90th percentile range (p=0.0019). Conclusions Measures of brain atrophy and subclinical markers of vascular disease showed that sex does not significantly alter the relationship between MRI and NP, except among men and women who are at high risk for stroke; these men show poorer performance on EF, whereas the women do not. PMID:20505436

  12. Mandibular Dentigerous Cyst in a 10-Year-Old Child

    PubMed Central

    Bhardwaj, Bindu; Sharma, Sunil; Agarwal, Prateek; Bhamboo, Amit; Rastogi, Komal

    2016-01-01

    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

  13. Optogenetics: 10 years of microbial opsins in neuroscience

    PubMed Central

    Deisseroth, Karl

    2016-01-01

    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

  14. Atypical presentation of macrophagic myofasciitis 10 years post vaccination.

    PubMed

    Ryan, Aisling M; Bermingham, Niamh; Harrington, Hugh J; Keohane, Catherine

    2006-12-01

    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.

  15. [Percutaneous transluminal angioplasty (PTA), 10 years of experience].

    PubMed

    Estevan Solano, J M; García-Cosío, J; Rodríguez, E; Barreiro, A; Maynar, M

    1991-01-01

    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.

  16. 10 Years at Saturn, and More Excitement to Come!

    NASA Astrophysics Data System (ADS)

    Edgington, S. G.; Spilker, L. J.; Altobelli, N.

    2014-04-01

    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.

  17. 10-year evapotranspiration estimates in a Bornean tropical rainforest

    NASA Astrophysics Data System (ADS)

    Kume, T.; Tanaka, N.; Komatsu, H.; Yoshifuji, N.; Saitoh, T. M.; Suzuki, M.; Kumagai, T.

    2010-12-01

    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.

  18. Clinical correlates of change in inflammatory biomarkers: The Framingham Heart Study

    PubMed Central

    Fontes, Joao D.; Yamamoto, Jennifer F.; Larson, Martin G.; Wang, Na; Dallmeier, Dhayana; Rienstra, Michiel; Schnabel, Renate B.; Vasan, Ramachandran S.; Keaney, John F.; Benjamin, Emelia J.

    2013-01-01

    Objectives Traditional clinical risk factors are associated with inflammation cross-sectionally, but associations of longitudinal variation in inflammatory biomarkers with corresponding changes in clinical risk factors are incompletely described. We sought to analyze clinical factors associated with change in inflammation in the community. Methods We studied 3013 Framingham Offspring (n = 2735) and Omni Cohort (n = 278) participants (mean age 59 years, 55% women, 9% ethnic/racial minority) who attended two consecutive examination cycles (mean 6.7 years apart). We selected ten inflammatory biomarkers representing distinctive biological functions: C-reactive protein (CRP), intercellular adhesion molecule-1, interleukin-6, isoprostanes, lipoprotein-associated phospholipase-2 (Lp-PLA2) activity, Lp-PLA2-mass, monocyte chemoattractant protein-1, osteoprotegerin, P-selectin, and tumor necrosis factor receptor II (TNFRII). We constructed multivariable-adjusted regression models to assess the relations of baseline, follow-up and change in clinical risk factors with change in biomarker concentrations over time. Results Baseline, follow-up and change in clinical risk factors explain a moderate amount of the variation in biomarker concentrations across 2 consecutive examinations (ranging from r2 = 0.28 [TNFRII] up to 0.52 [Lp-PLA2-mass]). In multivariable models, increasing body-mass index, smoking initiation, worsening lipid profile, and increasing waist size were associated with increasing concentrations of several biomarkers. Conversely, hypercholesterolemia therapy and hormone replacement cessation were associated with decreasing concentrations of biomarkers such as CRP, Lp-PLA2-mass and activity. Conclusion Cardiovascular risk factors have different patterns of association with longitudinal change in inflammatory biomarkers and explain modest amounts of variability in biomarker concentrations. Nevertheless, a substantial proportion of longitudinal change in inflammatory

  19. MMI's Metadata and Vocabulary Solutions: 10 Years and Growing

    NASA Astrophysics Data System (ADS)

    Graybeal, J.; Gayanilo, F.; Rueda-Velasquez, C. A.

    2014-12-01

    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).

  20. Avian response to bottomland hardwood reforestation: the first 10 years

    USGS Publications Warehouse

    Twedt, D.J.; Wilson, R.R.; Henne-Kerr, J.L.; Grosshuesch, D.A.

    2002-01-01

    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.

  1. Trabecular metal tibial knee component still stable at 10 years.

    PubMed

    Henricson, Anders; Nilsson, Kjell G

    2016-10-01

    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.

  2. Trabecular metal tibial knee component still stable at 10 years

    PubMed Central

    Henricson, Anders; Nilsson, Kjell G

    2016-01-01

    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

  3. Serum Gamma-glutamyl Transferase Concentration Within the Reference Range is Related to the Coronary Heart Disease Risk Prediction in Korean Men: Analysis of the Korea National Health and Nutrition Examination Survey (V-1, 2010 and V-2, 2011)

    PubMed Central

    Han, Kyung-Sun; Cho, Doo-Yeoun; Kim, Young-Sang; Kim, Kyu-Nam

    2015-01-01

    Background: Limited data exist on the association of serum gamma-glutamyl transferase (GGT) level within the reference range with the increased risk of coronary heart disease (CHD) prediction in men. The study examined the association between serum GGT concentration within the reference range and the CHD risk prediction in Korean men. Methods: The study employed data from Korean National Health and Nutrition Examination Survey (V-1, 2010 and V-2, 2011) where a total of 1301 individuals were analyzed. A 10-year CHD risk prediction was computed using the Framingham Risk Score (FRS) modified by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III). Results: Positive correlations were established between log-transformed GGT concentration and FRS (r = 0.237, P < 0.001). After adjustment of body mass index, the amount of alcohol intake and low-density lipoprotein-cholesterol, the odds ratio (95% confidence interval) for intermediate risk and beyond of 10-year CHD prediction (10-year risk ≥10%) with lowest quartile of participants was 1.21 (0.78–1.87) for second quartiles, 1.39 (0.88–2.21) for third quartiles and 2.03 (1.23–3.34) for highest quartiles. Conclusions: Higher serum GGT within its reference range was significantly correlated with a 10-year CHD risk prediction estimation using NCEP ATP III in Korean men. PMID:26228210

  4. Association of Plasma ADMA Levels with MRI Markers of Vascular Brain Injury: The Framingham Offspring Study

    PubMed Central

    Pikula, Aleksandra; Böger, Rainer H.; Beiser, Alexa S.; Maas, Renke; DeCarli, Charles; Schwedhelm, Edzard; Himali, Jayandra J.; Schulze, Friedrich; Au, Rhoda; Kelly-Hayes, Margaret; Kase, Carlos S.; Vasan, Ramachandran S.; Wolf, Philip A.; Seshadri, Sudha

    2009-01-01

    Background and Purpose Asymmetric dimethylarginine (ADMA), an inhibitor of endothelial nitric oxide synthase, is a marker of endothelial dysfunction. Elevated circulating ADMA concentrations have been associated with systemic and carotid atherosclerosis, an elevated risk of developing stroke and with MRI white matter hyperintensities (WMH). The relation of plasma ADMA to subclinical vascular brain injury has not been previously studied in a middle-aged, community-based sample. Methods In 2013 stroke-free Framingham Offspring (mean age 58±9.5yrs, 53% women) we related baseline plasma ADMA levels (1995–98) to subsequent brain MRI (1999–2004) measures of subclinical vascular injury: presence of silent brain infarcts (SBI) and large white matter hyperintensity volume (LWMH; defined as >1SD above age-specific mean). Results Prevalence of SBI and LWMH were 10.7% and 12.6%, respectively. In multivariable analyses adjusting for age-, sex- and traditional stroke risk factors, higher ADMA levels were associated with an increased risk of prevalent SBI (OR per SD increase in ADMA: 1.16, 95%CI: 1.01–1.33, p= 0.04).We observed that participants in the upper three age-specific quartiles of plasma ADMA had an increased prevalence of SBI (OR for Q2–4 versus Q1:1.43, 95%CI: 1.00–2.04, p<0.05). Prevalence of SBI in Q1and Q2–4 was 8.3% and 11.6%, respectively. Prevalence of LWMH did not differ according to ADMA concentrations. Conclusion Higher plasma ADMA was associated with increased prevalence of SBI after adjustment for traditional stroke risk factors. Thus, ADMA may be a potentially useful new biomarker of subclinical vascular brain injury, which is an important correlate of vascular cognitive impairment and risk of stroke. PMID:19644064

  5. High Vitamin D Consumption Is Inversely Associated with Cardiovascular Disease Risk in an Urban Mexican Population

    PubMed Central

    Flores, Mario; Salazar-Martínez, Eduardo

    2016-01-01

    Background Vitamin D deficiency is a major global public health problem. Recent epidemiological studies have assessed the relationship between vitamin D and multiple outcomes, including cardiovascular disease. However, this evidence is limited and inconclusive. Our purpose in this study was to evaluate the association between dietary vitamin D intake and cardiovascular disease risk in adult Mexican population. Methods We conducted a cross-sectional analysis with the baseline data from 6294 men and women aged 20–80 years participating in the Health Workers Cohort Study. Data on sociodemographic, lifestyle, and medical history factors were collected with a self-administered questionnaire. Dietary intake was evaluated by using a semi-quantitative food-frequency questionnaire. Cardiovascular disease risk was calculated using a recalibration of the Framingham heart disease prediction score. To evaluate the association between vitamin D intake and 10-year cardiovascular disease risk, odds ratios (OR) and 95% confidence intervals (95% CI) were calculated using multiple logistic regression analysis. Results A total of 6294 subjects (1820 men and 4474 women) with a mean age of 42 years, were included. Of these, subjects in the highest quintile of vitamin D intake presented lower levels of triglycerides 14.6 mg/dL (P for trend = 0.001); 2.0 cm less in waist circumference (P for trend = 0.001) and 0.8 points less in the Framingham cardiovascular disease risk score (P for trend = 0.002) compared with the subjects in the lower quintile of vitamin D intake. Additionally, participants in the highest quintile of vitamin D consumption were less likely to develop elevated 10-year cardiovascular disease risk, compared with those in the lowest quintile (OR = 0.51; 95%CI: 0.33, 0.77; P for trend = 0.007). Conclusion Our data suggest that higher consumption of vitamin D is associated with a reduced risk of cardiovascular disease in Mexican population. PMID:27893863

  6. Comprehensive coronary risk determination in primary prevention: an imaging and clinical based definition combining computed tomographic coronary artery calcium score and national cholesterol education program risk score.

    PubMed

    Nasir, Khurram; Vasamreddy, Chandra; Blumenthal, Roger S; Rumberger, John A

    2006-06-16

    Cardiovascular disease (CVD) is the leading cause of mortality and a major cause of morbidity. Coronary heart disease (CHD) accounts for nearly half of all CVD deaths. Currently estimation of risk in primary prevention is based on the Framingham risk equations, which inputs traditional risk factors and is helpful in predicting the development of CHD in asymptomatic individuals. However many individuals suffer events in the absence of established risk factors for atherosclerosis and broad based population risk estimations may have little precision when applied to a given individual. To meet the challenge of CHD risk assessment, several tools have been developed to identify atherosclerotic disease in its preclinical stages. This paper aims to incorporate information from coronary artery calcification (CAC) scoring from a computed tomographic "heartscan" (using Electron Beam Tomography (EBT) as the validated prototype) along with current Framingham risk profiling in order to refine risk on an absolute scale by combining imaging and clinical data to affect a more comprehensive calculation of absolute risk in a given individual. For CAC scores above the 75th percentile but <90th percentile, 10 years is added to chronological age, and for CAC scores above the 90th percentile, 20 years is added to current chronological age. Among those in whom a positive CAC score is the norm such as older individuals (men> or =55 years, women> or =65 years) a CAC = 0 will result in an age point score corresponding to the age-group whose median CAC score is zero i.e., 40-44 years for men and 55-59 years for women. The utilization of CAC scores allows the inclusion of sub-clinical disease definition into the context of modifiable risk factors as well as identifies high-risk individuals requiring aggressive treatment.

  7. Cohort Profile: The Framingham Heart Study (FHS): overview of milestones in cardiovascular epidemiology

    PubMed Central

    Tsao, Connie W; Vasan, Ramachandran S

    2015-01-01

    The Framingham Heart Study (FHS) has conducted seminal research defining cardiovascular disease (CVD) risk factors and fundamentally shaping public health guidelines for CVD prevention over the past five decades. The success of the Original Cohort, initiated in 1948, paved the way for further epidemiological research in preventive cardiology. Due to the keen observations suggesting the role of shared familial factors in the development of CVD, in 1971 the FHS began enroling the second generation cohort, comprising the children of the Original Cohort and the spouses of the children. In 2002, the third generation cohort, comprising the grandchildren of the Original Cohort, was initiated to additionally explore genetic contributions to CVD in greater depth. Additionally, because of the predominance of White individuals of European descent in the three generations of FHS participants noted above, the Heart Study enrolled the OMNI1 and OMNI2 cohorts in 1994 and 2003, respectively, aimed to reflect the current greater racial and ethnic diversity of the town of Framingham. All FHS cohorts have been examined approximately every 2–4 years since the initiation of the study. At these periodic Heart Study examinations, we obtain a medical history and perform a cardiovascular-focused physical examination, 12-lead electrocardiography, blood and urine samples testing and other cardiovascular imaging studies reflecting subclinical disease burden. The FHS has continually evolved along the cutting edge of cardiovascular science and epidemiological research since its inception. Participant studies now additionally include study of cardiovascular imaging, serum and urine biomarkers, genetics/genomics, proteomics, metabolomics and social networks. Numerous ancillary studies have been established, expanding the phenotypes to encompass multiple organ systems including the lungs, brain, bone and fat depots, among others. Whereas the FHS was originally conceived and designed to study the

  8. Cohort Profile: The Framingham Heart Study (FHS): overview of milestones in cardiovascular epidemiology.

    PubMed

    Tsao, Connie W; Vasan, Ramachandran S

    2015-12-01

    The Framingham Heart Study (FHS) has conducted seminal research defining cardiovascular disease (CVD) risk factors and fundamentally shaping public health guidelines for CVD prevention over the past five decades. The success of the Original Cohort, initiated in 1948, paved the way for further epidemiological research in preventive cardiology. Due to the keen observations suggesting the role of shared familial factors in the development of CVD, in 1971 the FHS began enroling the second generation cohort, comprising the children of the Original Cohort and the spouses of the children. In 2002, the third generation cohort, comprising the grandchildren of the Original Cohort, was initiated to additionally explore genetic contributions to CVD in greater depth. Additionally, because of the predominance of White individuals of European descent in the three generations of FHS participants noted above, the Heart Study enrolled the OMNI1 and OMNI2 cohorts in 1994 and 2003, respectively, aimed to reflect the current greater racial and ethnic diversity of the town of Framingham. All FHS cohorts have been examined approximately every 2-4 years since the initiation of the study. At these periodic Heart Study examinations, we obtain a medical history and perform a cardiovascular-focused physical examination, 12-lead electrocardiography, blood and urine samples testing and other cardiovascular imaging studies reflecting subclinical disease burden.The FHS has continually evolved along the cutting edge of cardiovascular science and epidemiological research since its inception. Participant studies now additionally include study of cardiovascular imaging, serum and urine biomarkers, genetics/genomics, proteomics, metabolomics and social networks. Numerous ancillary studies have been established, expanding the phenotypes to encompass multiple organ systems including the lungs, brain, bone and fat depots, among others. Whereas the FHS was originally conceived and designed to study the

  9. Retired Status and Older Adults’ 10-Year Drinking Trajectories*

    PubMed Central

    Brennan, Penny L.; Schutte, Kathleen K.; Moos, Rudolf H.

    2010-01-01

    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

  10. Developing of 10-year EEZ seafloor mapping and research program

    USGS Publications Warehouse

    Lockwood, M.; Hill, G.W.

    1988-01-01

    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

  11. Motor Speech Disorders: Where Will We Be in 10 Years?

    PubMed

    Duffy, Joseph R

    2016-08-01

    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.

  12. Factitious purpura in a 10-year-old girl.

    PubMed

    Yamada, Kayo; Sakurai, Yoshihiko; Shibata, Mari; Miyagawa, Sachiko; Yoshioka, Akira

    2009-01-01

    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.

  13. Andrology in China: current status and 10 years' progress

    PubMed Central

    Hong, Kai; Xu, Qing-Quan; Zhao, Yong-Ping; Gu, Yi-Qun; Jiang, Hui; Wang, Xiao-Feng; Zhu, Ji-Chuan

    2011-01-01

    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

  14. NASA Administrator Dan Goldin greets 10-year-old VIP.

    NASA Technical Reports Server (NTRS)

    2000-01-01

    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.

  15. NASA Administrator Dan Goldin greets 10-year-old VIP.

    NASA Technical Reports Server (NTRS)

    2000-01-01

    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.

  16. NASA Administrator Dan Goldin greets 10-year-old VIP.

    NASA Technical Reports Server (NTRS)

    2000-01-01

    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.

  17. NASA Administrator Dan Goldin greets 10-year-old VIP.

    NASA Technical Reports Server (NTRS)

    2000-01-01

    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.

  18. Atherosclerotic Biomarkers and Aortic Atherosclerosis by Cardiovascular Magnetic Resonance Imaging in the Framingham Heart Study

    PubMed Central

    Hong, Susie N.; Gona, Philimon; Fontes, Joao D.; Oyama, Noriko; Chan, Raymond H.; Kenchaiah, Satish; Tsao, Connie W.; Yeon, Susan B.; Schnabel, Renate B.; Keaney, John F.; O'Donnell, Christopher J.; Benjamin, Emelia J.; Manning, Warren J.

    2013-01-01

    Background The relations between subclinical atherosclerosis and inflammatory biomarkers have generated intense interest but their significance remains unclear. We sought to determine the association between a panel of biomarkers and subclinical aortic atherosclerosis in a community‐based cohort. Methods and Results We evaluated 1547 participants of the Framingham Heart Study Offspring cohort who attended the 7th examination cycle and underwent both cardiovascular magnetic resonance imaging (CMR) and assays for 10 biomarkers associated with atherosclerosis: high‐sensitivity C‐reactive protein, fibrinogen, intercellular adhesion molecule‐1, interleukin‐6, interleukin‐18, lipoprotein‐associated phospholipase‐A2 activity and mass, monocyte chemoattractant protein‐1, P‐selectin, and tumor necrosis factor receptor‐2. In logistic regression analysis, we found no significant association between the biomarker panel and the presence of aortic plaque (global P=0.53). Using Tobit regression with aortic plaque as a continuous variable, we noted a modest association between biomarker panel and aortic plaque volume in age‐ and sex‐adjusted analyses (P=0.003). However, this association was attenuated after further adjustment for clinical covariates (P=0.09). Conclusions In our community‐based cohort, we found no significant association between our multibiomarker panel and aortic plaque. Our results underscore the strengths and limitations of the use of biomarkers for the identification of subclinical atherosclerosis and the importance of traditional risk factors. PMID:24242683

  19. Sugar-Sweetened Beverages and Prevalence of the Metabolically Abnormal Phenotype in the Framingham Heart Study

    PubMed Central

    Green, Angela K.; Jacques, Paul F.; Rogers, Gail; Fox, Caroline S.; Meigs, James B.; McKeown, Nicola M.

    2014-01-01

    Objective The purpose of this study was to examine the relationship between usual sugar-sweetened beverage (SSB) consumption and prevalence of abnormal metabolic health across body mass index (BMI) categories. Design and Methods The metabolic health of 6,842 non-diabetic adults was classified using cross-sectional data from the Framingham Heart Study Offspring (1998–2001) and Third Generation (2002–2005) cohorts. Adults were classified as normal weight, overweight or obese and, within these categories, metabolic health was defined based on five criteria – hypertension, elevated fasting glucose, elevated triglycerides, low HDL cholesterol, and insulin resistance. Individuals without metabolic abnormalities were considered metabolically healthy. Logistic regression was used to examine the associations between categories of SSB consumption and risk of metabolic health after stratification by BMI. Results Comparing the highest category of SSB consumers (median of 7 SSB per week) to the lowest category (non-consumers), odds ratios (95% confidence intervals) for metabolically abnormal phenotypes, compared to the metabolically normal, were 1.9 (1.1–3.4) among the obese, 2.0 (1.4–2.9) among the overweight, and 1.9 (1.4–2.6) among the normal weight individuals. Conclusions In this cross-sectional analysis, it is observed that, irrespective of weight status, consumers of SSB were more likely to display metabolic abnormalities compared to non-consumers in a dose-dependent manner. PMID:24550031

  20. Dietary flavonoid intakes and CVD incidence in the Framingham Offspring Cohort.

    PubMed

    Jacques, Paul F; Cassidy, Aedin; Rogers, Gail; Peterson, Julia J; Dwyer, Johanna T

    2015-11-14

    This study examines the relationship between long-term intake of six flavonoid classes and incidence of CVD and CHD, using a comprehensive flavonoid database and repeated measures of intake, while accounting for possible confounding by components of a healthy dietary pattern. Flavonoid intakes were assessed using a FFQ among the Framingham Offspring Cohort at baseline and three times during follow-up. Cox proportional hazards regression was used to characterise prospective associations between the natural logarithms of flavonoid intakes and CVD incidence using a time-dependent approach, in which intake data were updated at each examination to represent average intakes from previous examinations. Mean baseline age was 54 years, and 45 % of the population was male. Over an average 14·9 years of follow-up among 2880 participants, there were 518 CVD events and 261 CHD events. After multivariable adjustment, only flavonol intake was significantly associated with lower risk of CVD incidence (hazard ratios (HR) per 2·5-fold flavonol increase=0·86, P trend=0·05). Additional adjustment for total fruit and vegetable intake and overall diet quality attenuated this observation (HR=0·89, P trend=0·20 and HR=0·92, P trend=0·33, respectively). There were no significant associations between flavonoids and CHD incidence after multivariable adjustment. Our findings suggest that the observed association between flavonol intake and CVD risk may be a consequence of better overall diet. However, the strength of this non-significant association was also consistent with relative risks observed in previous meta-analyses, and therefore a modest benefit of flavonol intake on CVD risk cannot be ruled out.

  1. Draft 1992 : Operations, Maintenance, and Replacement 10-Year Plan.

    SciTech Connect

    United States. Bonneville Power Administration.

    1992-05-01

    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.

  2. Draft 1992 : Operations, Maintenance, and Replacement 10-Year Plan.

    SciTech Connect

    United States. Bonneville Power Administration.

    1992-05-01

    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.

  3. Citations to Australian Astronomy: 5- and 10-Year Benchmarks

    NASA Astrophysics Data System (ADS)

    Kenyon, Katherine H.; Paramasivam, Arjun; Tu, Jiachin; Zhang, Albert; Graham, Alister W.

    2012-03-01

    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.

  4. Personalized nutrition and cardiovascular disease prevention: From Framingham to PREDIMED.

    PubMed

    Konstantinidou, Valentini; Daimiel, Lidia; Ruiz, Lidia Angeles Daimiel; Ordovás, Jose M

    2014-05-01

    Diet is considered the cornerstone for the prevention of age-related diseases, and a low-fat diet has been considered for decades as the most suitable alternative to achieve this goal. However, mounting evidence supports the efficacy of other alternatives, such as the Mediterranean diet. Nevertheless, it is well known that people present a dramatic range of responses to similar environmental challenges, and it has been shown that some of this variability is rooted in the genome. In fact, this knowledge is driving the field of nutrigenetics. The finding of interactions between diet and genetic variants has led to intense research and debate about the effectiveness of personalized nutrition as a more suitable tool for the prevention of chronic diseases than the traditional 1-size-fits-all recommendations. Here, we provide some of our own examples that illustrate the progression of nutrigenetics through the years, from the initial studies within the Framingham Heart Study, to the most recent use of large consortia, such as the Cohorts for Heart and Aging Research in Genomic Epidemiology, and ending up with large dietary intervention studies, such as the PREDIMED (Prevención con Dieta Mediterránea) study. These recent approaches are providing more robust and clinically relevant gene-diet interactions. Therefore, although the current evidence level of applying genomic information to tailoring is at its early stages, the prospect of widespread incorporation of nutrigenetics to the clinical practice is encouraging.

  5. Genetic Contribution to Biological Aging: The Framingham Study

    PubMed Central

    Karasik, David; Hannan, Marian T.; Cupples, L. Adrienne; Felson, David T.; Kiel, Douglas P.

    2005-01-01

    This study assessed the contribution of genetic and nongenetic factors to biological aging in American Caucasians. The studied sample included 1402 members of 288 pedigrees from the Framingham Heart Study. The original cohort participants received hand radiography in 1967–1969 (mean age, 58.7 years) and their offspring in 1992–1993 (mean age, 51.6 years). An osseographic score was applied to hand radiographs. Standardized residuals between Osseographic Scoring System-predicted age and actual age were used as a measure of biological age (BA). In variance component genetic analysis, sex, cohort, height, body mass index, and, in women, menopausal status and estrogen use, jointly explained approximately 6% of the total variance of BA. Genetic factors explained an additional 57%. Linkage analysis of covariate-adjusted BA suggested the presence of quantitative trait loci on chromosomes 3p, 7q, 11p, 16q, and 21q. In conclusion, the variation in BA measured by radiography was strongly governed by genetic factors in a sample of American adults. PMID:15031305

  6. Kennedy Space Center Coronary Heart Disease Risk Screening Program

    NASA Technical Reports Server (NTRS)

    Tipton, David A.; Scarpa, Philip J.

    1999-01-01

    The number one cause of death in the U.S. is coronary heart disease (CHD). It is probably a major cause of death and disability in the lives of employees at Kennedy Space Center (KSC) as well. The KSC Biomedical Office used a multifactorial mathematical formula from the Framingham Heart Study to calculate CHD risk probabilities for individuals in a segment of the KSC population that required medical evaluation for job certification. Those assessed to be high-risk probabilities will be targeted for intervention. Every year, several thousand KSC employees require medical evaluations for job related certifications. Most medical information for these evaluations is gathered on-site at one of the KSC or Cape Canaveral Air Station (CCAS) medical clinics. The formula used in the Framingham Heart Study allows calculation of a person's probability of acquiring CHD within 10 years. The formula contains the following variables: Age, Diabetes, Smoking, Left Ventricular Hypertrophy, Blood Pressure (Systolic or Diastolic), Cholesterol, and HDL cholesterol. The formula is also gender specific. It was used to calculate the 10-year probabilities of CHD in KSC employees who required medical evaluations for job certifications during a one-year time frame. This KSC population was profiled and CHD risk reduction interventions could be targeted to those at high risk. Population risk could also be periodically reevaluated to determine the effectiveness of intervention. A 10-year CHD risk probability can be calculated for an individual quite easily while gathering routine medical information. An employee population's CHD risk probability can be profiled graphically revealing high risk segments of the population which can be targeted for risk reduction intervention. The small audience of NASA/contractor physicians, nurses and exercise/fitness professionals at the breakout session received the lecture very well. Approximately one third indicated by a show of hands that they would be

  7. The metabolic syndrome and risk of coronary artery disease in patients with chronic schizophrenia or schizoaffective disorder in a chronic mental institute.

    PubMed

    Tseng, Ping-Tao; Wang, Hung-Yu; Cheng, Yu-Shian; Shen, Feng-Chih; Lin, Pao-Yen; Wu, Ching-Kuan

    2014-11-01

    The prevalence rate of metabolic syndrome (MS) and coronary artery disease (CAD) has been found to be high in patients with chronic schizophrenia. Current evidence shows that CAD is underdiagnosed in this group. Our study evaluated the prevalence of MS and the risk of CAD in patients with chronic schizophrenia in a chronic care mental hospital in southern Taiwan. We included all patients with the diagnosis of schizophrenia or schizoaffective disorder. We collected all laboratory, physical examination, psychiatric interview, and chart review data. We also evaluated the risk of CAD in these patients using the Framingham point system. There was no significant age difference in the MS prevalence rate in these patients. The young patients with schizophrenia in our study tended to have a higher prevalence of MS than the general population. In addition, female patients had a higher prevalence rate of MS than males. Based on the Framingham point system, we found the 10-year risk of CAD to be higher among the patients with schizophrenia than in the general population. Our study highlights the importance of the high risk of MS in both younger and older patients with schizophrenia, without a significant relationship to the use of antipsychotics. More complete cohort studies are needed to confirm these findings. Psychiatrists may want to establish more specific and detailed clinical guidelines for patients with chronic schizophrenia with comorbid physical diseases, especially MS and CAD.

  8. Reduction in cardiovascular risk using a proactive multifactorial intervention is consistent among patients residing in Pacific Asian and non-Pacific Asian regions: a CRUCIAL trial subanalysis

    PubMed Central

    Cho, Eun Joo; Kim, Jae Hyung; Sutradhar, Santosh; Yunis, Carla; Westergaard, Mogens

    2014-01-01

    Background Few trials have compared different approaches to cardiovascular disease prevention among Pacific Asian (PA) populations. The Cluster Randomized Usual Care versus Caduet Investigation Assessing Long-term-risk (CRUCIAL) trial demonstrated that a proactive multifactorial intervention (PMI) approach (based on single-pill amlodipine/atorvastatin) resulted in a greater reduction in calculated Framingham 10-year coronary heart disease (CHD) risk compared with usual care (UC) among hypertensive patients with additional risk factors. One-third of CRUCIAL patients resided in the PA region. The aim of this subanalysis was to compare two approaches to cardiovascular risk factor management (PMI versus UC) among patients residing in PA and non-PA regions. Methods This subanalysis of the CRUCIAL trial compared treatment-related changes in calculated CHD risk among patients residing in PA and non-PA regions. Sensitivity analyses were conducted among men and women and those with and without diabetes. Results Overall, 448 patients (31.6%) resided in the PA region and 969 patients (68.4%) resided in non-PA regions. The PMI approach was more effective in reducing calculated CHD risk versus UC in both PA (−37.1% versus −3.5%; P<0.001) and non-PA regions (−31.1% versus −4.2%; P<0.001); region interaction P=0.131. PA patients had slightly greater reductions in total cholesterol compared with non-PA patients. PA patients without diabetes had slightly greater reductions in CHD risk compared with non-PA patients. Treatment effects were similar in men and women and those with diabetes. Conclusion The PMI approach was more effective in reducing calculated Framingham 10-year CHD risk compared with UC among men and women with and without diabetes residing in the PA and non-PA region. PMID:24707184

  9. 1992 Resource Program, 10 Year Plan : Draft II.

    SciTech Connect

    United States. Bonneville Power Administration.

    1992-05-01

    The Resource Program is the Bonneville Power Administration's primary process for deciding how to meet future electricity resource needs, how much new resources to develop, which types of resources to acquire or option and how to go about acquiring them, and how much BPA will have to spend for these resources. Recognizing that BPA must make a long-term commitment to acquiring conservation effectively, the 1992 Resource Program outlines a 10-year plan. Draft 2 of the 1992 Resource Program provides a framework for discussing the funding levels proposed in the Programs in Perspective (PIP) process. Previous final resource programs have been released prior to the PIP process. This version of the Resource Program recognizes that the PIP discussions are an integral part of the resource decision-making process and, therefore, it will be finalized after PIP.

  10. 1992 Resource Program, 10 Year Plan : Draft II.

    SciTech Connect

    United States. Bonneville Power Administration.

    1992-05-01

    The Resource Program is the Bonneville Power Administration`s primary process for deciding how to meet future electricity resource needs, how much new resources to develop, which types of resources to acquire or option and how to go about acquiring them, and how much BPA will have to spend for these resources. Recognizing that BPA must make a long-term commitment to acquiring conservation effectively, the 1992 Resource Program outlines a 10-year plan. Draft 2 of the 1992 Resource Program provides a framework for discussing the funding levels proposed in the Programs in Perspective (PIP) process. Previous final resource programs have been released prior to the PIP process. This version of the Resource Program recognizes that the PIP discussions are an integral part of the resource decision-making process and, therefore, it will be finalized after PIP.

  11. Scurvy in a 10-year-old boy.

    PubMed

    Cole, John A; Warthan, Molly M; Hirano, Stefanie A; Gowen, Clarence W; Williams, Judith V

    2011-01-01

    Scurvy, or hypovitaminosis C, is an uncommon condition that exists today primarily within certain unique populations-particularly the elderly subjects, patients with neurodevelopmental disabilities or psychiatric illnesses, or others with unusual dietary habits. Vitamin C is an essential nutrient in the human body, and is important in synthesizing collagen factor whose faulty production is responsible for most of the clinical manifestations of scurvy. These clinical manifestations can include dystrophic or corkscrew hairs, gingival hyperplasia, and weakened blood vessel walls, causing bleeding in the skin, joints, and other organs. Although rare in the Unites States, the presence of scurvy should not be forgotten because of its presence among susceptible populations. Moreover, with its diagnosis, treatment and cure is one of the simplest in modern medicine. We report a case of scurvy in a 10-year-old autistic child.

  12. Dynamics of income packaging: a 10-year longitudinal study.

    PubMed

    Zippay, Allison

    2002-07-01

    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.

  13. [One-stop outpatient cardiology clinics: 10 years' experience].

    PubMed

    Falces, Carlos; Sadurní, Josep; Monell, Joan; Andrea, Rut; Ylla, Miquel; Moleiro, Angels; Cantillo, Jordi

    2008-05-01

    A one-stop outpatient cardiology clinic was set up at the Vic General Hospital in Spain in 1996. The aims were to provide patients with a rapid response, and to ensure that, on the same day, they saw a specialist and were referred for any relevant investigations required, primarily echocardiography, exercise testing, and Holter monitoring. We report experience from 10 years of follow-up, involving 19,515 consultations. The mean waiting time for a consultation was 3 days. We analyzed the reasons for the consultations, the investigations carried out, and the reductions in follow-up visits and hospital admissions. Primary care physicians' level of satisfaction was increased by this approach. The one-stop clinic proved feasible in clinical practice and proved robust during the follow-up period. This clinical model was beneficial for patients, was highly acceptable to primary care physicians, reduced the need for patients to contact the hospital, and, possibly, reduced hospital admissions.

  14. NASA Administrator Dan Goldin greets 10-year-old VIP.

    NASA Technical Reports Server (NTRS)

    2000-01-01

    NASA Administrator Dan Goldin (center) greets 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. In the background, between them, are Jonathan's mother, Penny; his grandfather, John Janocka; and his sister, Jaimie.. At left is Mrs. Goldin. 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.

  15. NASA Administrator Dan Goldin greets 10-year-old VIP.

    NASA Technical Reports Server (NTRS)

    2000-01-01

    NASA Administrator Dan Goldin (center) presents a bag of special gifts to 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. In the background, between them, are Jonathan's mother, Penny; his grandfather, John Janocka; and his sister, Jaimie.. At left is Mrs. Goldin. 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.

  16. NASA Administrator Dan Goldin greets 10-year-old VIP.

    NASA Technical Reports Server (NTRS)

    2000-01-01

    NASA Administrator Dan Goldin (center) talks to 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. In the background, between them, are Jonathan's mother, Penny; his grandfather, John Janocka; and his sister, Jaimie. At left is Mrs. Goldin. 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.

  17. Class III treatment using facial mask: Stability after 10 years

    PubMed Central

    Ramos, Adilson Luiz

    2014-01-01

    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

  18. ESO and Chile: 10 Years of Productive Scientific Collaboration

    NASA Astrophysics Data System (ADS)

    2006-06-01

    ESO and the Government of Chile launched today the book "10 Years Exploring the Universe", written by the beneficiaries of the ESO-Chile Joint Committee. This annual fund provides grants for individual Chilean scientists, research infrastructures, scientific congresses, workshops for science teachers and astronomy outreach programmes for the public. In a ceremony held in Santiago on 19 June 2006, the European Organisation for Astronomical Research in the Southern Hemisphere (ESO) and the Chilean Ministry of Foreign Affairs marked the 10th Anniversary of the Supplementary Agreement, which granted to Chilean astronomers up to 10 percent of the total observing time on ESO telescopes. This agreement also established an annual fund for the development of astronomy, managed by the so-called "ESO-Chile Joint Committee". ESO PR Photo 21/06 ESO PR Photo 21/06 Ten Years ESO-Chile Agreement Ceremony The celebration event was hosted by ESO Director General, Dr. Catherine Cesarsky, and the Director of Special Policy for the Chilean Ministry of Foreign Affairs, Ambassador Luis Winter. "ESO's commitment is, and always will be, to promote astronomy and scientific knowledge in the country hosting our observatories", said ESO Director General, Dr. Catherine Cesarsky. "We hope Chile and Europe will continue with great achievements in this fascinating joint adventure, the exploration of the universe." On behalf of the Government of Chile, Ambassador Luis Winter outlined the historical importance of the Supplementary Agreement, ratified by the Chilean Congress in 1996. "Such is the magnitude of ESO-Chile Joint Committee that, only in 2005, this annual fund represented 8 percent of all financing sources for Chilean astronomy, including those from Government and universities", Ambassador Winter said. The ESO Representative and Head of Science in Chile, Dr. Felix Mirabel, and the appointed Chilean astronomer for the ESO-Chile Joint Committee, Dr. Leonardo Bronfman, also took part in the

  19. 10 years of Terra Outreach over the Internet

    NASA Astrophysics Data System (ADS)

    Yuen, K.; Riebeek, H.; Chambers, L. H.

    2009-12-01

    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

  20. Association of Uric Acid With Vascular Stiffness in the Framingham Heart Study

    PubMed Central

    Nuccio, Eugene; McFann, Kim; Madero, Magdalena; Sarnak, Mark J.; Jalal, Diana

    2015-01-01

    BACKGROUND Uric acid is associated with increased risk of cardiovascular disease and arterial stiffness in patients with hypertension or stroke. It remains unknown if uric acid is associated with arterial stiffness in the general population. METHODS We analyzed the association between serum uric acid levels and measures of arterial stiffness such as carotid-femoral pulse wave velocity (CF PWV), carotid-radial pulse wave velocity (CR PWV) and augmentation index (AI) in 4,140 participants from the Generation 3 Framingham cohort using linear regression. RESULTS Mean (SD) age was 40.0 (8.8) years and mean (SD) serum uric acid levels were 5.3 (1.5) mg/dl. Mean (SD) CF PWV was 7.0 (1.4) m/s. Individuals in the highest quartile of uric acid were more likely to be male, have a higher prevalence of hypertension, higher BMI, fasting glucose and insulin, and lower estimated glomerular filtration rate (eGFR). Multivariate adjusted means of CF PWV were 6.90, 6.94, 7.06, and 7.15 m/s for uric acid quartile 1, 2, 3, and 4 respectively. In unadjusted analysis each 1mg/dl increase in uric acid was associated with higher CF-PWV (β = 0.27; 95% CI = 0.25, 0.29; P < 0.0001). This was attenuated but remained significant after adjusting for age, sex, smoking, hypertension, BMI, fasting glucose, insulin, animal protein intake, and eGFR (β= 0.06; 95% CI = 0.02, 0.09; P < 0.0007). There was no association between serum uric acid levels and AI upon adjustment for cardiovascular risk factors. CONCLUSIONS Serum uric acid levels are significantly associated with CF PWV and CR PWV in a younger Caucasian population. PMID:25552515

  1. Oral squamous cell carcinoma in a 10 year old boy.

    PubMed

    Khan, M H; Naushad, Q N

    2011-01-01

    Squamous cell carcinoma of the oral cavity a type of Oral Cancer in young patients is a very rare occurrence particularly during the first decade of life. Oral cancer is predominantly an aggressive neoplasm of middle-aged people where 96% of the patients are more than 40 years of age and it occurs mainly due to the excessive consumption of tobacco and alcohol. In South-East Asia it has a higher rate of occurrence than the rest of the world, partly due to increased consumption of chewing tobacco and various harmful spices, areca nuts and betel quids. These rare varieties of aggressive neoplasm commonly affect tongue and lip. This report describes a case of squamous cell carcinoma in a 10 year old boy who had an exophytic type of granulomatous lesion with some indurated borders which diffusely involved the left side of the hard palate, alveolar mucosa, left maxillary antrum and aggressively emerged within the left orbit by engulfing the left inferior rectus muscle. The purpose of this case report is to provide information that younger group can suffer from oral squamous cell carcinoma though it is very rare and this younger group would appear to have a biologically more aggressive tumor and they require more complex treatment. The role of more aggressive initial therapy must be considered.

  2. The Cryptophlebia Leucotreta Granulovirus—10 Years of Commercial Field Use

    PubMed Central

    Moore, Sean D.; Kirkman, Wayne; Richards, Garth I.; Stephen, Peter R.

    2015-01-01

    In the last 15 years, extensive work on the Cryptophlebia leucotreta granulovirus (CrleGV) has been conducted in South Africa, initially in the laboratory, but subsequently also in the field. This culminated in the registration of the first CrleGV-based biopesticide in 2004 (hence, the 10 years of commercial use in the field) and the second one three years later. Since 2000, more than 50 field trials have been conducted with CrleGV against the false codling moth, Thaumatotibia leucotreta, on citrus in South Africa. In a representative sample of 13 field trials reported over this period, efficacy (measured by reduction in larval infestation of fruit) ranged between 30% and 92%. Efficacy was shown to persist at a level of 70% for up to 17 weeks after application of CrleGV. This only occurred where the virus was applied in blocks rather than to single trees. The addition of molasses substantially and sometimes significantly enhanced efficacy. It was also established that CrleGV should not be applied at less than ~2 × 1013 OBs per ha in order to avoid compromised efficacy. As CrleGV-based products were shown to be at least as effective as chemical alternatives, persistent and compatible with natural enemies, their use is recommended within an integrated program for control of T. leucotreta on citrus and other crops. PMID:25809025

  3. Amiodarone for refractory cardiac arrhythmias: 10-year study.

    PubMed Central

    Leak, D; Eydt, J N

    1986-01-01

    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

  4. Alopecia Areata in the Elderly: A 10-Year Retrospective Study

    PubMed Central

    Jang, Yong Hyun; Park, Kyung Hea; Kim, Sang Lim; Lim, Hyun Jung; Lee, Weon Ju; Lee, Seok-Jong

    2015-01-01

    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

  5. Dissociative recombination of H3+: 10 years in retrospect

    PubMed Central

    Larsson, Mats

    2012-01-01

    The dissociative recombination of has been an intriguing problem for more than half a century. The early experiments on during the first 20 years were carried out without mass analysis in decaying plasma afterglows, and thus the measured rates pertained to an uncontrolled mixture of and impurity ions. When mass analysis was used, the rate coefficient was determined to be an uneventful value of about 10−7 cm3 s−1, a very common rate coefficient for many molecular ions. But this was not the end of the story, not even the beginning of the end; it marked only the end of the beginning. The story I will tell in this article started about 10 years ago, when the dissociative recombination of was approaching its deepest crisis. Today, owing to an extensive experimental and theoretical effort, the state of affairs has reached a historically unique level of harmony, although there still remains many things to sort out. PMID:23028159

  6. Prospective Analysis of Hip Arthroscopy with 10-year Followup

    PubMed Central

    Jones, Kay S.

    2009-01-01

    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

  7. A 10-year review of false aneurysms in Nottingham.

    PubMed Central

    Berridge, D. C.; Earnshaw, J. J.; Makin, G. S.; Hopkinson, B. R.

    1988-01-01

    Over a 10-year period, twenty-nine patients who developed false aneurysms were reviewed retrospectively. The diagnosis was delayed for as long as 7 months in the eight patients who developed aneurysms following trauma. However, all these patients had an excellent outcome after surgery. The results were also good in patients with non-infected false aneurysms after vascular reconstruction, with 17 of the 19 patients having the affected limb saved by remedial surgery. The main principle of remedial surgery was to perform the simplest surgical procedure possible. The results in infected false aneurysms were poor and management should be considered along the lines laid down for graft infection. The incidence of false aneurysms may be reduced by the use of suitable non-absorbable sutures, prevention of tension at an anastomosis and prevention of infection. However, degeneration of the arterial wall is thought to be a major cause of false aneurysms and is, of course, beyond control. Recent technical advances such as digital subtraction angiography, labelled leucocyte scanning and computed tomography have all contributed to improvements in the management of false aneurysms. Images fig. 1 fig. 3 PMID:3415176

  8. Penetrating keratoplasty: indications over a 10 year period

    PubMed Central

    Al-Yousuf, N; Mavrikakis, I; Mavrikakis, E; Daya, S M

    2004-01-01

    Aims: To determine the indications for penetrating keratoplasty (PK) at the Corneoplastic Unit and Eye Bank, UK, a tertiary referral centre, over a 10 year period. Methods: Records of all patients who underwent PK at our institution between 1990 and 1999 were reviewed retrospectively. Of the 1096 procedures performed in this period, 784 records were available for evaluation (72%). Results: Regrafting was the most common indication, accounting for 40.9% of all cases. Keratoconus was the second most common indication (15%), followed by Fuchs’ endothelial dystrophy (9.3%), pseudophakic bullous keratopathy (7.6%), and viral keratitis (5.9%), which included both herpes simplex and herpes zoster and showed a statistically significant decreasing trend using regression analysis (p<0.005). Among the regraft subgroup, viral keratitis accounted for 21.2% as the underlying primary diagnosis. The most common cause for graft failure in the regraft subgroup was endothelial failure (41.8%). Conclusion: Regrafting is the leading indication for PK; viral disease—although declining—is the leading primary diagnosis. PMID:15258012

  9. Neighborhood socioeconomic status and coronary heart disease risk prediction in a nationally representative sample

    PubMed Central

    Pollack, Craig E.; Slaughter, Mary E.; Griffin, Beth A.; Dubowitz, Tamara; Bird, Chloe E.

    2012-01-01

    Objectives Test the association between coronary heart disease (CHD) risk scores and neighborhood socioeconomic status (NSES) in a US nationally-representative sample and describe whether any association varies by gender and race/ethnicity. Study Design Cross-sectional study Methods We use Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004 linked with Census tract data. Multivariable regression models and propensity score adjusted models are employed to test the association between NSES and 10-year risk of CHD based on the Framingham Risk Score (FRS), adjusting for individual-level characteristics. Results An individual living in a neighborhood at the 75th percentile of NSES (high NSES) has, on average, a 10-year CHD risk that is 0.16 percentage points lower (95% Confidence Interval 0.16, 0.17) than a similar person residing in a neighborhood at the 25th percentile of NSES (low NSES). Race/ethnicity and gender were found to significantly modify the association between NSES on CHD risk: the association is larger in men than women and in whites than minorities. Propensity score models showed findings on the main effects of NSES were robust to self-selection into neighborhoods. Similar results were observed between NSES and risk of cardiovascular disease events. Conclusions NSES is significantly associated with CHD risk, and the relationship varies by gender and race/ethnicity. PMID:23083844

  10. Genome-Wide Association Study of Lp-PLA2 Activity and Mass in the Framingham Heart Study

    PubMed Central

    Suchindran, Sunil; Rivedal, David; Guyton, John R.; Milledge, Tom; Gao, Xiaoyi; Benjamin, Ashlee; Rowell, Jennifer; Ginsburg, Geoffrey S.; McCarthy, Jeanette J.

    2010-01-01

    Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an emerging risk factor and therapeutic target for cardiovascular disease. The activity and mass of this enzyme are heritable traits, but major genetic determinants have not been explored in a systematic, genome-wide fashion. We carried out a genome-wide association study of Lp-PLA2 activity and mass in 6,668 Caucasian subjects from the population-based Framingham Heart Study. Clinical data and genotypes from the Affymetrix 550K SNP array were obtained from the open-access Framingham SHARe project. Each polymorphism that passed quality control was tested for associations with Lp-PLA2 activity and mass using linear mixed models implemented in the R statistical package, accounting for familial correlations, and controlling for age, sex, smoking, lipid-lowering-medication use, and cohort. For Lp-PLA2 activity, polymorphisms at four independent loci reached genome-wide significance, including the APOE/APOC1 region on chromosome 19 (p = 6×10−24); CELSR2/PSRC1 on chromosome 1 (p = 3×10−15); SCARB1 on chromosome 12 (p = 1×10−8) and ZNF259/BUD13 in the APOA5/APOA1 gene region on chromosome 11 (p = 4×10−8). All of these remained significant after accounting for associations with LDL cholesterol, HDL cholesterol, or triglycerides. For Lp-PLA2 mass, 12 SNPs achieved genome-wide significance, all clustering in a region on chromosome 6p12.3 near the PLA2G7 gene. Our analyses demonstrate that genetic polymorphisms may contribute to inter-individual variation in Lp-PLA2 activity and mass. PMID:20442857

  11. Racial Discrimination & Cardiovascular Disease Risk: My Body My Story Study of 1005 US-Born Black and White Community Health Center Participants (US)

    PubMed Central

    Krieger, Nancy; Waterman, Pamela D.; Kosheleva, Anna; Chen, Jarvis T.; Smith, Kevin W.; Carney, Dana R.; Bennett, Gary G.; Williams, David R.; Thornhill, Gisele; Freeman, Elmer R.

    2013-01-01

    Objectives To date, limited and inconsistent evidence exists regarding racial discrimination and risk of cardiovascular disease (CVD). Methods Cross-sectional observational study of 1005 US-born non-Hispanic black (n = 504) and white (n = 501) participants age 35–64 randomly selected from community health centers in Boston, MA (2008–2010; 82.4% response rate), using 3 racial discrimination measures: explicit self-report; implicit association test (IAT, a time reaction test for self and group as target vs. perpetrator of discrimination); and structural (Jim Crow status of state of birth, i.e. legal racial discrimination prior 1964). Results Black and white participants both had adverse cardiovascular and socioeconomic profiles, with black participants most highly exposed to racial discrimination. Positive crude associations among black participants occurred for Jim Crow birthplace and hypertension (odds ratio (OR) 1.92, 95% confidence interval (CI) 1.28, 2.89) and for explicit self-report and the Framingham 10 year CVD risk score (beta  = 0.04; 95% CI 0.01, 0.07); among white participants, only negative crude associations existed (for IAT for self, for lower systolic blood pressure (SBP; beta  = −4.86; 95% CI −9.08, −0.64) and lower Framingham CVD score (beta  = −0.36, 95% CI −0.63, −0.08)). All of these associations were attenuated and all but the white IAT-Framingham risk score association were rendered null in analyses that controlled for lifetime socioeconomic position and additional covariates. Controlling for racial discrimination, socioeconomic position, and other covariates did not attenuate the crude black excess risk for SBP and hypertension and left unaffected the null excess risk for the Framingham CVD score. Conclusion Despite worse exposures among the black participants, racial discrimination and socioeconomic position were not associated, in multivariable analyses, with risk of CVD. We interpret results in relation

  12. Evaluation of fire-safety programs that use 10-year smoke alarms.

    PubMed

    Jackson, Mark; Wilson, Jonathan; Akoto, Judith; Dixon, Sherry; Jacobs, David E; Ballesteros, Michael F

    2010-10-01

    The Centers for Disease Control and Prevention began funding a Smoke Alarm Installation and Fire Safety Education (SAIFE) program in 1998. This program involves the installation of lithium-powered "10-year" smoke alarms in homes at high risk for fires and injuries. This study aimed to (1) determine among original SAIFE homes if the lithium-powered alarms were still present and functional 8-10 years after installation and (2) understand factors related to smoke alarm presence and functionality. Data on a total of 384 homes and 601 smoke alarms in five states were collected and analyzed. Only one-third of alarms were still functional; 37% of installed alarms were missing; and 30% of alarms were present, but not functioning. Alarms were less likely to be functioning if they were installed in the kitchen and if homes had a different resident at follow-up. Of the 351 alarms that were present and had a battery at the time of the evaluation, only 21% contained lithium-powered batteries. Of these, 78% were still functioning. Programs that install lithium-powered alarms should use units that have sealed-in batteries and "hush" buttons. Additionally, education should be given on smoke alarm maintenance that includes a message that batteries in these alarms should not be replaced. Lithium-powered smoke alarms should last up to 10 years if maintained properly.

  13. A 10-year analysis of rearrests among a cohort of domestic violence offenders.

    PubMed

    Richards, Tara N; Jennings, Wesley G; Tomsich, Elizabeth; Gover, Angela

    2014-01-01

    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.

  14. Click Chemistry and Radiochemistry: The First 10 Years.

    PubMed

    Meyer, Jan-Philip; Adumeau, Pierre; Lewis, Jason S; Zeglis, Brian M

    2016-12-21

    The advent of click chemistry has had a profound influence on almost all branches of chemical science. This is particularly true of radiochemistry and the synthesis of agents for positron emission tomography (PET), single photon emission computed tomography (SPECT), and targeted radiotherapy. The selectivity, ease, rapidity, and modularity of click ligations make them nearly ideally suited for the construction of radiotracers, a process that often involves working with biomolecules in aqueous conditions with inexorably decaying radioisotopes. In the following pages, our goal is to provide a broad overview of the first 10 years of research at the intersection of click chemistry and radiochemistry. The discussion will focus on four areas that we believe underscore the critical advantages provided by click chemistry: (i) the use of prosthetic groups for radiolabeling reactions, (ii) the creation of coordination scaffolds for radiometals, (iii) the site-specific radiolabeling of proteins and peptides, and (iv) the development of strategies for in vivo pretargeting. Particular emphasis will be placed on the four most prevalent click reactions-the Cu-catalyzed azide-alkyne cycloaddition (CuAAC), the strain-promoted azide-alkyne cycloaddition (SPAAC), the inverse electron demand Diels-Alder reaction (IEDDA), and the Staudinger ligation-although less well-known click ligations will be discussed as well. Ultimately, it is our hope that this review will not only serve to educate readers but will also act as a springboard, inspiring synthetic chemists and radiochemists alike to harness click chemistry in even more innovative and ambitious ways as we embark upon the second decade of this fruitful collaboration.

  15. [Cardiac factors predictive of 10-year survival after coronary surgery].

    PubMed

    Fournial, G; Fourcade, J; Roux, D; Garcia, O; Sauer, M; Glock, Y

    1999-07-01

    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.

  16. Justification for Rhinoseptoplasty in Children – Our 10 Years Overview

    PubMed Central

    Kopacheva-Barsova, Gabriela; Nikolovski, Nikola

    2016-01-01

    BACKGROUND: Nasal septal surgery and rhinoplasty are controversial in children. Traditionally, an attitude of restraint has been employed by most surgeons till an empirical age of 16 to 18 years. This is to avoid the possible adverse effects that the growth spurts may have on the nose and midface region. AIM: The aim of this paper was to present the results of rhinoplasty in children in order to restore the anatomy and function or to promote normal development and outgrowth of the nose. MATERIAL AND METHODS: Ninety seven children aged 6-14, with severe nose deformities and breathing problems through the nose, were admitted for septo/rhinoplasty at the University Clinic for Ear, Nose and Throat, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Republic of Macedonia. At our Clinic, they have been observed and photographed (with parent permission) in the period of 10 years (2006-2016). The most frequent cause of these deformities was the nasal trauma in early childhood which was ignored or untreated. All of them rhino/septoplasty were indicated in accordance with the above-mentioned recommendations for rhino/septoplasty in early childhood and in adolescents. RESULTS: In 51 children and adolescents septoplasty were prepared. Mostly there was a group of younger children age from 6-10 (68%) and adolescents (32%). In the other 31 children and adolescents, septorhinoplasty was prepared. Mostly there were children older than 12 years old and adolescents (70%). Only 30% were younger than 12 years, of course with severe nasal breathing problems, nasal septal deformities and deformities of the nasal pyramid. CONCLUSION: The growth centres of the nose have to be avoided if possible; long-term nasal issues will theoretically be minimised. If the surgeon replaces it, the cartilage of the nose becomes straighter but still intact. PMID:27703562

  17. Association of soda consumption with subclinical cardiac remodeling in the Framingham Heart Study

    PubMed Central

    Andersson, Charlotte; Sullivan, Lisa; Benjamin, Emelia J.; Aragam, Jayashri; Jacques, Paul; Cheng, Susan; Vasan, Ramachandran S.

    2014-01-01

    Objective Diet soda consumption increases cardiometabolic risk. The aim of this investigation was to assess the relations between self-reported soda consumption and subclinical cardiac remodeling. Methods We assessed the relations between self-reported soda consumption and left ventricular mass (LVM) and left atrial dimension (LAD) (both standardized within sex) in a sample of middle-aged attendees from the Framingham Heart Offspring cohort examination 5 and 6. Results The overall mean age was 55 years and 59% of the participants were women. Compared to non-consumers (n=1010), soda consumers (n=3192) had greater body weight (mean 86 vs. 82 kg among men, and 70 vs. 67 kg among women). Compared with non-consumers, age- and height-adjusted LAD was increased (standard deviation units) among soda consumers by 0.15 standard error 0.042, p<0.001) for those drinking >0–7 diet soda (n=1023), −0.010 (0.043, p=0.82) for people drinking >0–7 regular soda (n=907), 0.22 (0.057, p<0.0001) for individuals consuming >7 diet soda (n=372), and 0.20 (0.092, p=0.034) for participants drinking >7 regular soda (n=116) per week. LVM was increased among participants consuming diet soda (p<0.05), but not in regular soda consumers (p>0.05). Upon adjustment for weight, however, all aforementioned associations were attenuated. Conclusion The observed associations between soda consumption and LAD or LVM were likely related to the greater body weight of soda drinkers relative to non-drinkers. PMID:25456096

  18. Depression Amplifies the Influence of Central Obesity on 10-Year Incidence of Diabetes: Findings from MIDUS

    PubMed Central

    Karlamangla, Arun

    2016-01-01

    Background Central obesity is a major risk factor for diabetes but many obese individuals never develop diabetes, suggesting the presence of important effect modifiers. Depression has emerged as a key risk factor for poor glycemic control, but to our knowledge, no previous work has investigated whether depression amplifies the effect of central obesity on glucoregulation. Methods and Findings We used a national sample of adults without prevalent diabetes (MIDUS; N = 919) to test for synergy between central obesity and depression in the development of diabetes 10 years later. We found that depression amplified the association of waist-to-hip ratio (WHR) with incident diabetes adjusted for age, race, gender, education, physical activity, and sleep problems (p = 0.01 for test of interaction). The relative risk for incident diabetes per every 0.1 increment in WHR was 1.75 (95% CI: 1.31; 2.33) in those without depression and 3.78 in those with depression (95% CI: 2.14; 6.66). Conclusions These results confirm the role of depression as a robust risk factor for the development of diabetes and for the first time, demonstrate a synergy between depression and central obesity. Identifying and addressing depression could prove to be an effective approach to preventing diabetes in at risk individuals. Ultimately, elucidating the interplay among risk factors from different domains will be key to understanding multifactorial diseases such as diabetes and informing theory-based, patient-centered interventions aimed at reducing diabetes risk. PMID:27755576

  19. The GLOBE Program 10 Years On: Challenges and Opportunities

    NASA Astrophysics Data System (ADS)

    Blurton, C.

    2004-12-01

    ). 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.

  20. Coronary artery disease risk reduction in HIV-infected persons: a comparative analysis.

    PubMed

    Okeke, Nwora Lance; Chin, Tammy; Clement, Meredith; Chow, Shein-Chung; Hicks, Charles B

    2016-01-01

    Despite an increased risk of coronary artery disease (CAD) in persons infected with human immunodeficiency virus (HIV), few data are available on primary prevention of CAD in this population. In this retrospective cohort study, HIV-infected patients treated in an academic medical center HIV Specialty Clinic between 1996 and 2010 were matched by age, gender, and ethnicity to a cohort of presumed uninfected persons followed in an academic medical center Internal Medicine primary care clinic. We compared CAD primary prevention care practices between the two clinics, including use of aspirin, HMG-CoA reductase inhibitors ("statins"), and anti-hypertensive drugs. CAD risk between the two groups was assessed with 10-year Framingham CAD risk scores. In the comparative analysis, 890 HIV-infected persons were compared to 807 controls. Ten-year Framingham CAD Risk Scores were similar in the two groups (median, 3; interquartile range [IQR], 0-5). After adjusting for relevant risk factors, HIV-infected persons were less likely to be prescribed aspirin (odds ratio [OR] 0.53; 95% confidence interval [CI], 0.40-0.71), statins (OR, 0.70; 95% CI, 0.53-0.92), and anti-hypertensive drugs (OR, 0.63; 95% CI, 0.50-0.79) than persons in the control group. In summary, when compared to demographically similar uninfected persons, HIV-infected persons treated in an HIV specialty clinic were less likely to be prescribed medications appropriate for CAD risk reduction. Improving primary preventative CAD care in HIV specialty clinic populations is an important step toward diminishing risk of heart disease in HIV-infected persons.

  1. Trends in dietary carbohydrate consumption from 1991 to 2008 in the Framingham Heart Study Offspring Cohort

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The intake of carbohydrates has been evaluated cross-sectionally, but not longitudinally in an ageing American adult population. The aim of the present study was to examine trends in the intake of dietary carbohydrates and their major food sources among the Framingham Heart Study Offspring (FOS) coh...

  2. Predicted 25-hydroxyvitamin D score and incident type 2 diabetes in the Framingham Offspring Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Accumulating evidence suggests that vitamin D is involved in the development of type 2 diabetes (T2D). Our objective was to examine the relation between vitamin D status and incidence of T2D. We used a subsample of 1972 Framingham Offspring Study participants to develop a regression model to predict...

  3. Predicted 25-hydroxyvitamin D Score and incident type 2 diabetes in the Framingham Offspring Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Accumulating evidence suggests that vitamin D is involved in the development of type 2 diabetes (T2D). Our objective was to examine the relation between vitamin D status and incidence of T2D. We used a subsample of 1972 Framingham Offspring Study participants to develop a regression model to predict...

  4. Prospective Predictors of Body Dissatisfaction in Young Adults: 10-year Longitudinal Findings

    PubMed Central

    Quick, Virginia; Eisenberg, Marla E.; Bucchianeri, Michaela M.; Neumark-Sztainer, Dianne

    2014-01-01

    This study identified longitudinal risk factors for body dissatisfaction (BD) over a 10-year period from adolescence to young adulthood. Participants (N = 2134; age at baseline: M =15.0, SD =1.6 years) provided two waves of survey data. A 6-step hierarchical linear regression analysis examined the predictive contribution of Time 1 BD, weight status, demographics, family and peer environmental factors, and psychological factors. Among females, Asian race/ethnicity, low self-esteem, greater BD, and higher body mass index during adolescence contributed significantly to predicting greater BD at 10-year follow up (R2 = 0.27). Among males, demographics (i.e., Asian, other-mixed ethnicity, education attainment), depressive symptoms, greater BD, higher body mass index, more parent communication, and less peer weight teasing during adolescence contributed to BD at follow-up (R2 = 0.27). Findings indicate who may be at greatest risk for BD in young adulthood and the types of factors that should be addressed during adolescence. PMID:25045599

  5. Non-Communicable Disease Risk Factors among Employees and Their Families of a Saudi University: An Epidemiological Study

    PubMed Central

    Rabiee, Fatemeh; Mandil, Ahmed; Hersi, Ahmad; Fayed, Amel

    2016-01-01

    Objectives To assess the prevalence of noncommunicable disease (NCD) risk factors among Saudi university employees and their families; to estimate the cardiovascular risk (CVR) amongst the study population in the following 10years. Methods The NCD risk factors prevalence was estimated using a cross-sectional approach for a sample of employees and their families aged ≥ 18 years old, in a Saudi university (Riyadh in Kingdom of Saudi Arabia; KSA). WHO STEPwise standardized tools were used to estimate NCD risk factors and the Framingham Coronary Heart Risk Score calculator was used to calculate the CVR. Results Five thousand and two hundred subjects were invited, of whom 4,500 participated in the study, providing a response rate of 87%. The mean age of participants was 39.3±13.4 years. The majority of participants reported low fruit/vegetables consumption (88%), and physically inactive (77%). More than two thirds of the cohort was found to be either overweight or obese (72%), where 36% were obese, and 59% had abdominal obesity. Of the total cohort, 22–37% were found to suffer from dyslipidaemia, 22% either diabetes or hypertension, with rather low reported current tobacco use (12%). One quarter of participants was estimated to have >10% risk to develop cardiovascular disease within the following 10-years. Conclusion The prevalence of NCD risk factors was found to be substantially high among the university employees and their families in this study. PMID:27814369

  6. Mining injuries in Serbian underground coal mines -- a 10-year study.

    PubMed

    Stojadinović, Saša; Svrkota, Igor; Petrović, Dejan; Denić, Miodrag; Pantović, Radoje; Milić, Vitomir

    2012-12-01

    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.

  7. Genetic analysis in neurology: the next 10 years.

    PubMed

    Pittman, Alan; Hardy, John

    2013-06-01

    In recent years, neurogenetics research had made some remarkable advances owing to the advent of genotyping arrays and next-generation sequencing. These improvements to the technology have allowed us to determine the whole-genome structure and its variation and to examine its effect on phenotype in an unprecedented manner. The identification of rare disease-causing mutations has led to the identification of new biochemical pathways and has facilitated a greater understanding of the etiology of many neurological diseases. Furthermore, genome-wide association studies have provided information on how common genetic variability impacts on the risk for the development of various complex neurological diseases. Herein, we review how these technological advances have changed the approaches being used to study the genetic basis of neurological disease and how the research findings will be translated into clinical utility.

  8. Social functioning and survival: A 10-year follow-up study.

    PubMed

    Arve, Seija; Lavonius, Sirkku; Savikko, Niina; Lehtonen, Aapo; Isoaho, Hannu

    2009-01-01

    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.

  9. Graft survival rate of renal transplantation during a period of 10 years in Iran

    PubMed Central

    Shahbazi, Fatemeh; Ranjbaran, Mehdi; Karami-far, Simin; Soori, Hamid; Manesh, Hadi Jafari

    2015-01-01

    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

  10. A 10-year study of snowboard injuries in Lapland Sweden.

    PubMed

    Made, C; Elmqvist, L-G

    2004-04-01

    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.

  11. The Effectiveness of Moxibustion: An Overview During 10 Years

    PubMed Central

    Kim, Song-Yi; Chae, Younbyoung; Lee, Seung Min; Lee, Hyejung; Park, Hi-Joon

    2011-01-01

    Moxibustion has been used to treat various types of disease. However, there is still insufficient evidence regarding its effectiveness. This study was performed to summarize and evaluate the effectiveness of moxibustion. A search was performed for all randomized controlled trials in PubMed between January 1998 and July 2008 with no language restriction. The results yielded 47 trials in which six moxibustion types were applied to 36 diseases ranging from breech presentation to digestive disorders. Moxibustion was compared to three types of control group: general care, Oriental medical therapies or waiting list. Moxibustion was superior to the control in 14 out of 54 control groups in 46 studies. There were no significant differences among groups in 7 studies, and the outcome direction was not determined in 33 studies. Seven studies were included in a meta-analysis. Moxibustion was more effective than medication in two ulcerative colitis studies (relative risk (95% CI), 2.20 (1.37, 3.52), P = .001, I2 = 0%). Overall, our results did not support the effectiveness of moxibustion in specific diseases due to the limited number and low quality of the studies and inadequate use of controls. In order to provide appropriate evidence regarding the effectiveness of moxibustion, more rigorous clinical trials using appropriate controls are warranted. PMID:19825873

  12. Capsule endoscopy in pediatrics: a 10-years journey.

    PubMed

    Oliva, Salvatore; Cohen, Stanley A; Di Nardo, Giovanni; Gualdi, Gianfranco; Cucchiara, Salvatore; Casciani, Emanuele

    2014-11-28

    Video capsule endoscopy (CE) for evaluation the esophagus (ECE), small bowel (SBCE) and the colon (CCE) is particularly useful in pediatrics, because this imaging modality does not require ionizing radiation, deep sedation or general anesthesia. The risk of capsule retention appears to be dependent on indication rather than age and parallels the adult experience by indication, making SBCE a relatively safe procedure with a significant diagnostic yield. The newest indication, assessment of mucosal change, greatly enhances and expands its potential benefit. The diagnostic role of CE extends beyond the SB. The use of ECE also may enhance our knowledge of esophageal disease and assist patient care. Colon CCE is a novel minimally invasive and painless endoscopic technique allowing exploration of the colon without need for sedation, rectal intubation and gas insufflation. The limited data on ECE and CCE in pediatrics does not yet allow the same conclusions regarding efficacy; however, both appear to provide safe methods to assess and monitor mucosal change in their respective areas with little discomfort. Moreover, although experience has been limited, the patency capsule may help lessen the potential of capsule retention; and newly researched protocols for bowel cleaning may further enhance CE's diagnostic yield. However, further research is needed to optimize the use of the various CE procedures in pediatric populations.

  13. Epidemiology of Left Ventricular False Tendons: Clinical Correlates in the Framingham Heart Study

    PubMed Central

    Kenchaiah, Satish; Benjamin, Emelia J.; Evans, Jane C.; Aragam, Jayashri; Vasan, Ramachandran S.

    2009-01-01

    Objectives To describe the echocardiographic characteristics and investigate the clinical correlates and prognostic significance of left ventricular false tendons (LVFTs). Background Although LVFTs are generally considered as anatomic variants, they have been associated with innocent precordial murmurs and electrocardiographic abnormalities in small case series. The correlates of LVFTs in the community are unknown. Methods We compared 101 Framingham Study participants with LVFTs (mean age 56 years, 45% women) on routine two-dimensional echocardiograms with 151 referents without LVFTs (mean age 57 years, 44% women). We examined the cross-sectional clinical, electrocardiographic (rest and ambulatory), and echocardiographic correlates of LVFTs using logistic regression models, and evaluated the prospective association between LVFTs and all-cause mortality using Cox proportional hazards regression models. Results A total of 107 LVFTs (94 simple with two points of attachment, and 13 complex/branching type with three or more points of attachment) were identified in 101 participants. LVFTs were most commonly visualized in the apical four chamber view (81%) and were predominantly localized to apical-third of the LV cavity (78%). LVFTs were associated with the presence of innocent precordial murmurs (multivariable adjusted odds ratio [OR] 5.55, 95% confidence interval [CI] 1.40-21.94), and electrocardiographic LV hypertrophy (OR 4.43, 95% CI 1.08-18.25). Body mass index (BMI) was inversely related to the presence of LVFTs (per kg/m2 increment, OR 0.94, 95% CI 0.88-0.99). LVFTs were not associated with QRS axis deviation, ventricular premature beats or repolarization abnormalities (all p-values >0.20). During a mean (±SD) follow-up of 7.7 (±1.6) years, 15 participants with and 19 without LVFTs died. In multivariable analyses, presence of LVFTs was not associated with the risk of death (p=0.92). Conclusions In our community-based sample of middle-aged to elderly white women

  14. Trends and predictors of asthma costs: results from a 10-year longitudinal study.

    PubMed

    Tan, Ngiap Chuan; Nguyen, Hai V; Lye, Weng Kit; Sankari, Usha; Nadkarni, Nivedita V

    2016-03-01

    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.

  15. Fishes and fisheries in tropical estuaries: The last 10 years

    NASA Astrophysics Data System (ADS)

    Blaber, S. J. M.

    2013-12-01

    Since 2002 there has been an increase in knowledge of many aspects of the biology and ecology of tropical estuarine fishes, as well as significant changes to many estuarine fisheries. Analyses of literature databases (2002-2012) show that: of the c. 600 relevant papers, 52% are primarily related to ecology, 11% to conservation, 11% to anthropogenic and pollution effects on fishes, 9% to fisheries, 7% to aquaculture, 4% to study techniques, and 1% each to fish larvae, effects of fishing, taxonomy, climate change, evolution and genetics. In terms of geographic spread 17% are from North America, 15% from south Asia, 14% from the Caribbean, 13% from Australasia, 12% from Africa and 9% each from South America and SE Asia. Research papers came from 50 countries of which the dominant were USA (15%), India (12%), Australia (11%) and Brazil (7%). Increasing numbers of studies in West Africa, SE and South Asia and South America have increased basic knowledge of the ecology of estuarine fish faunas. Increases in understanding relate to: roles of salinity, turbidity and habitat diversity; connectivity between habitats; water flow; ecological drivers of spatial variability; scale dependent variation; thermal tolerances; movement patterns; food webs; larval adaptations; and the viability of areas heavily impacted by human activities. New reviews both challenge and support different aspects of the estuarine dependence paradigm - still perhaps one of the main research issues - and the protective function of estuaries and mangroves for juvenile fishes has received attention in relation to e.g. predation risks and fisheries. There have also been significant advances in the use of guilds and biodiversity models. Fishing pressures have continued unabated in most tropical estuaries and are summarised and management issues discussed. Understanding of the relationships between fisheries production and mangroves has advanced and significant differences have emerged between Indo

  16. Relationship Status Predicts Lower Restrictive Eating Pathology for Bisexual and Gay Men across 10-year Follow-up

    PubMed Central

    Brown, Tiffany A.; Keel, Pamela K.

    2015-01-01

    Objective Cross-sectional studies support that bisexual and gay (BG) men are at increased risk for eating pathology, and romantic relationships may buffer against risk; however, no studies have examined this association longitudinally. The current study examined how romantic relationships impact the trajectory of eating pathology in BG versus heterosexual men. Method BG (n=51) and heterosexual (n=522) men completed surveys of health and eating behaviors at baseline and 10-year follow-up. Results For BG men, being single at baseline prospectively predicted an increase in Drive for Thinness scores over 10-year follow-up. Additionally, for BG men in relationships at baseline, lower relationship satisfaction predicted an increase in Drive for Thinness scores over time. Conversely, these relationship variables did not predict trajectory of eating pathology for heterosexual men. Discussion Implications for theoretical models of risk, including objectification theory and sexual minority stress theory, and prevention, including peer-led cognitive dissonance based interventions, are discussed. PMID:26172055

  17. Surgical treatment in Osteogenesis Imperfecta – 10 years experience

    PubMed Central

    Georgescu, I; Vlad, C; Gavriliu, TȘ; Dan, S; Pârvan, AA

    2013-01-01

    Introduction. Osteogenesis imperfecta (OI) is a very rare disease compared to other afflictions, running the risk of social isolation for children and their parents, due to the problems specific to the disease. All the social, psychological and physical disadvantages must be removed or at least mitigated, all within the society’s limited resources. In Romania, this situation has led in the last couple of years to the selection of a number of extremely severe cases, which could not be solved by orthopedic and classic surgical treatment methods. These patients exhibit gracile long bones, which are distorted, often with cystic degeneration at the level of the extremities, pseudarthroses, limb length discrepancies, most of them being unable to walk, being condemned to sitting in a wheelchair. Aim. This paper deals with the experience of the Orthopedics Department of "Maria Sklodowska Curie" Clinical Emergency Hospital for Children, in Bucharest, in the field of surgical treatment for moderate and severe forms of OI, within the time frame of May 2002-May 2012. For the first time in Romania, on May 20, 2002, the team led by Professor Gh. Burnei, MD, has implanted telescopic rods in the femur and tibia of a patient with OI. One of the most important themes, of great interest in the orthopedic surgery, is the osteoarticular regularization and reconstruction in severe forms of OI, which should allow the patients to stand and walk. These cases are a challenge for the surgeon, who is in the position of applying new, complex procedures, or perfecting, modifying and adapting techniques that have already been established. The aim of the surgical treatment is the increase of the quality of life of these children and adolescents and of their social integration. Methods and results. In the above-mentioned period, from the OI patients who are in the evidence of our clinic, 32 were operated on, totaling 81 surgeries. Out of these, 28 patients, aged 2-27 years, have benefited from

  18. Prospects for emerging infections in East and southeast Asia 10 years after severe acute respiratory syndrome.

    PubMed

    Horby, Peter W; Pfeiffer, Dirk; Oshitani, Hitoshi

    2013-06-01

    It is 10 years since severe acute respiratory syndrome (SARS) emerged, and East and Southeast Asia retain a reputation as a hot spot of emerging infectious diseases. The region is certainly a hot spot of socioeconomic and environmental change, and although some changes (e.g., urbanization and agricultural intensification) may reduce the probability of emerging infectious diseases, the effect of any individual emergence event may be increased by the greater concentration and connectivity of livestock, persons, and products. The region is now better able to detect and respond to emerging infectious diseases than it was a decade ago, but the tools and methods to produce sufficiently refined assessments of the risks of disease emergence are still lacking. Given the continued scale and pace of change in East and Southeast Asia, it is vital that capabilities for predicting, identifying, and controlling biologic threats do not stagnate as the memory of SARS fades.

  19. Prospects for Emerging Infections in East and Southeast Asia 10 Years after Severe Acute Respiratory Syndrome

    PubMed Central

    Pfeiffer, Dirk; Oshitani, Hitoshi

    2013-01-01

    It is 10 years since severe acute respiratory syndrome (SARS) emerged, and East and Southeast Asia retain a reputation as a hot spot of emerging infectious diseases. The region is certainly a hot spot of socioeconomic and environmental change, and although some changes (e.g., urbanization and agricultural intensification) may reduce the probability of emerging infectious diseases, the effect of any individual emergence event may be increased by the greater concentration and connectivity of livestock, persons, and products. The region is now better able to detect and respond to emerging infectious diseases than it was a decade ago, but the tools and methods to produce sufficiently refined assessments of the risks of disease emergence are still lacking. Given the continued scale and pace of change in East and Southeast Asia, it is vital that capabilities for predicting, identifying, and controlling biologic threats do not stagnate as the memory of SARS fades. PMID:23738977

  20. Visceral Adipose Tissue Is Associated With Bone Microarchitecture in the Framingham Osteoporosis Study

    PubMed Central

    Liu, Ching-Ti; Broe, Kerry E; Zhou, Yanhua; Boyd, Steven K; Cupples, L Adrienne; Hannan, Marian T; Lim, Elise; McLean, Robert R; Samelson, Elizabeth J; Bouxsein, Mary L; Kiel, Douglas P

    2017-01-01

    Obesity has been traditionally considered to protect the skeleton against osteoporosis and fracture. Recently, body fat, specifically visceral adipose tissue (VAT), has been associated with lower bone mineral density (BMD) and increased risk for some types of fractures. We studied VAT and bone microarchitecture in 710 participants (58% women, age 61.3 ± 7.7 years) from the Framingham Offspring cohort to determine whether cortical and trabecular BMD and microarchitecture differ according to the amount of VAT. VAT was measured from CT imaging of the abdomen. Cortical and trabecular BMD and microarchitecture were measured at the distal tibia and radius using high-resolution peripheral quantitative computed tomography (HR-pQCT). We focused on 10 bone parameters: cortical BMD (Ct.BMD), cortical tissue mineral density (Ct.TMD), cortical porosity (Ct.Po), cortical thickness (Ct.Th), cortical bone area fraction (Ct.A/Tt.A), trabecular density (Tb.BMD), trabecular number (Tb.N), trabecular thickness (Tb.Th), total area (Tt.Ar), and failure load (FL) from micro–finite element analysis. We assessed the association between sex-specific quartiles of VAT and BMD, microarchitecture, and strength in all participants and stratified by sex. All analyses were adjusted for age, sex, and in women, menopausal status, then repeated adjusting for body mass index (BMI) or weight. At the radius and tibia, Ct.Th, Ct.A/Tt.A, Tb.BMD, Tb.N, and FL were positively associated with VAT (all p-trend <0.05), but no other associations were statistically significant except for higher levels of cortical porosity with higher VAT in the radius. Most of these associations were only observed in women, and were no longer significant when adjusting for BMI or weight. Higher amounts of VAT are associated with greater BMD and better microstructure of the peripheral skeleton despite some suggestions of significant deleterious changes in cortical measures in the non–weight bearing radius. Associations were

  1. Lifestyle Factors and Indices of Kidney Function in the Framingham Heart Study

    PubMed Central

    Foster, Meredith C.; Hwang, Shih-Jen; Massaro, Joseph M.; Jacques, Paul F.; Fox, Caroline S.; Chu, Audrey Y.

    2015-01-01

    Background and objectives Lifestyle characteristics are modifiable factors that could be targeted as part of chronic kidney disease (CKD) prevention. We sought to determine the association of lifestyle characteristics with incident estimated glomerular filtration rate (eGFR)<60mL/min/1.73m2 and rapid eGFR decline in older adults in the United States. Methods Prospective cohort study of Framingham Offspring participants with baseline eGFR<60mL/min/1.73m2 (n=1802) who attended the seventh (1998–2001; baseline) and eighth (2005–2008; follow-up) examinations (mean age=59years, 54.8% women). Predictors included measures of diet quality, physical activity, alcohol intake, and current smoking status assessed during baseline. Outcomes were based on creatinine-based eGFR at baseline and follow-up and included incident eGFR<60mL/min/1.73m2 (at follow-up) and rapid eGFR decline (annual eGFR decrease≥3mL/min/1.73m2). Results Over 6.6 years average follow-up 9.5% (n=171) of participants developed incident eGFR<60. A trend was observed across quartiles of diet quality, with higher levels of diet quality associated with a decreased odds ratio [OR] of incident eGFR<60 (p-trend=0.045). Higher diet quality was associated with decreased odds of rapid eGFR decline (p-trend=0.03) and was attenuated with additional adjustment (p-trend=0.07). In sensitivity analysis for rapid eGFR decline using a secondary definition (annual eGFR decrease≥3 and incident eGFR<60), diet associations remained significant with additional adjustment (p-trend=0.04). No associations were observed with physical activity, smoking status, or alcohol intake with incident eGFR<60 or rapid eGFR decline (all p>0.19). Conclusions Higher diet quality may be associated with a decreased risk of incident eGFR<60mL/min/1.73m2, and rapid eGFR decline. Whether adherence to a healthy diet can prevent reduction in kidney function warrants further study. PMID:25998023

  2. The relationship between maternal education and mental retardation in 10-year-old children.

    PubMed

    Decouflé, P; Boyle, C A

    1995-09-01

    We conducted a case-control study of mental retardation (MR) in which case children (aged 10 years) were identified from existing records at multiple sources, primarily the public school systems. Control children were drawn from a roster of public school students not receiving special education services. We found that maternal educational level at the time of delivery was strongly and inversely related to a form of MR not accompanied by other serious neurologic conditions. For this isolated form of MR, maternal educational level was by far the most important predictor from among seven sociodemographic variables examined. There was a significant race-education interaction that indicated a steeper gradient in risk among white mothers than among black mothers. Relative to children of white mothers with 12 years of education, all children of black mothers, except those whose mothers had 16 or more years of education, were at increased risk. The results may be useful as a guide for selecting high-risk groups as candidates for early childhood intervention programs.

  3. PROSPECTIVE EVALUATION OF ASSOCIATIONS BETWEEN PRENATAL CORTISOL AND ADULTHOOD CORONARY HEART DISEASE RISK: THE NEW ENGLAND FAMILY STUDY

    PubMed Central

    Stinson, Lynda J.; Stroud, Laura R.; Buka, Stephen L.; Eaton, Charles B.; Lu, Bing; Niaura, Raymond; Loucks, Eric B.

    2016-01-01

    OBJECTIVE Increasing evidence suggests that early life factors may influence coronary heart disease (CHD) risk, however little is known about contributions of prenatal cortisol. Objectives were to prospectively assess associations of maternal cortisol levels during pregnancy with offspring’s 10-year CHD risk during middle-age. METHODS Participants were 262 mother-offspring dyads from the New England Family Study. Maternal free cortisol was assessed in third trimester maternal serum samples. Ten-year CHD risk was calculated in offspring at mean age 42 years, using the validated Framingham risk algorithm incorporating diabetes, systolic and diastolic blood pressure, total and HDL cholesterol, smoking, age and sex. RESULTS In multivariable-adjusted linear regression analyses adjusted for age and race/ethnicity, high vs. low maternal cortisol tertile was associated with 36.7% (95% CI: 8.4%, 72.5%) greater mean 10-year CHD risk score in females. There was no association in males (−2.8%, 95% CI: −23.8%, 24.0%). Further adjustment for in utero socioeconomic position showed 25.9% (95% CI: −1.0%, 60.0%) greater CHD risk in females. Adjustment for maternal age and size for gestational age had little effect on findings. CONCLUSIONS Maternal prenatal cortisol levels were positively associated with 10-year CHD risk among female, and not male, offspring. Adjusting for socioeconomic position during pregnancy reduced effect size in females, suggesting it may be a common prior factor in both maternal cortisol and CHD risk. These findings provide evidence that targeting mothers who have elevated prenatal cortisol levels, including elevated cortisol in the setting of low socioeconomic position, may potentially reduce long-term CHD risk in their offspring. PMID:25768844

  4. Healthcare-associated Pneumonia: Clinical Features and Retrospective Analysis Over 10 Years

    PubMed Central

    Qi, Fei; Zhang, Guo-Xin; She, Dan-Yang; Liang, Zhi-Xin; Wang, Ren-Tao; Yang, Zhen; Chen, Liang-An; Cui, Jun-Chang

    2015-01-01

    Background: Healthcare-associated pneumonia (HCAP) is associated with drug-resistant pathogens and high mortality, and there is no clear evidence that this is due to inappropriate antibiotic therapy. This study was to elucidate the clinical features, pathogens, therapy, and outcomes of HCAP, and to clarify the risk factors for drug-resistant pathogens and prognosis. Methods: Retrospective observational study among hospitalized patients with HCAP over 10 years. The primary outcome was 30-day all-cause hospital mortality after admission. Demographics (age, gender, clinical features, and comorbidities), dates of admission, discharge and/or death, hospitalization costs, microbiological results, chest imaging studies, and CURB-65 were analyzed. Antibiotics, admission to Intensive Care Unit (ICU), mechanical ventilation, and pneumonia prognosis were recorded. Patients were dichotomized based on CURB-65 (low- vs. high-risk). Results: Among 612 patients (mean age of 70.7 years), 88.4% had at least one comorbidity. Commonly detected pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, and coagulase-negative staphylococci. Initial monotherapy with β-lactam antibiotics was the most common initial therapy (50%). Mean age, length of stay, hospitalization expenses, ICU admission, mechanical ventilation use, malignancies, and detection rate for P. aeruginosa, and Staphylococcus aureus were higher in the high-risk group compared with the low-risk group. CURB-65 ≥3, malignancies, and mechanical ventilation were associated with an increased mortality. Logistic regression analysis showed that cerebrovascular diseases and being bedridden were independent risk factors for HCAP. Conclusion: Initial treatment of HCAP with broad-spectrum antibiotics could be an appropriate approach. CURB-65 ≥3, malignancies, and mechanical ventilation may result in an increased mortality. PMID:26481734

  5. Assessment of six cardiovascular risk calculators in Mexican mestizo patients with rheumatoid arthritis according to the EULAR 2015/2016 recommendations for cardiovascular risk management.

    PubMed

    Galarza-Delgado, Dionicio A; Azpiri-Lopez, Jose R; Colunga-Pedraza, Iris J; Cardenas-de la Garza, Jesus A; Vera-Pineda, Raymundo; Serna-Peña, Griselda; Arvizu-Rivera, Rosa I; Martinez-Moreno, Adrian; Wah-Suarez, Martin; Garza Elizondo, Mario A

    2017-02-01

    Variability of the 10-year cardiovascular (CV) risk predicted by the Framingham Risk Score (FRS) using lipids, FRS using body mass index (BMI), Reynolds Risk Score (RRS), QRISK2, Extended Risk Score-Rheumatoid Arthritis (ERS-RA), and algorithm developed by the American College of Cardiology and the American Heart Association in 2013 (ACC/AHA 2013) according to the European League Against Rheumatism (EULAR) 2015/2016 update of its evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis (RA) has not been evaluated in Mexican mestizo patients. CV risk was predicted using six different risk calculators in 116 patients, aged 40-75, who fulfilled the ACR/EULAR 2010 classification criteria. Results were multiplied by 1.5 according to the EULAR 2015/2016 update. Global comparison of the risk predicted by all scales was done using the Friedman test, considering a P value of ≤0.05 as statistically significant. Individual comparison between the algorithms was made using the Wilcoxon signed-rank test, and a P value of ≤0.003 was considered statistically significant. All calculators showed to be different in the Friedman test (p ≤ 0.001). Median values of predicted 10-year CV risk were 11.02% (6.18-17.55) for FRS BMI; 8.47% (4.6-13.16) for FRS lipids; 5.55% (2.5-11.85) for QRISK2; 5% (3.1-8.65) for ERS-RA; 3.6% (1.5-9.3) for ACC/AHA 2013; and 1.5% (1.5-4.5) for RRS. ERS-RA showed no difference when compared against QRISK2 (p = 0.269). CV risk calculators showed variability among them and cannot be used indistinctly in RA-patients.

  6. Prenatal and postnatal tobacco smoke exposure and development of insulin resistance in 10 year old children.

    PubMed

    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

    2011-09-01

    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.

  7. Lengths, girths, and diameters of children's fingers from 3 to 10 years of age.

    PubMed

    Hohendorff, B; Weidermann, C; Burkhart, K J; Rommens, P M; Prommersberger, K J; Konerding, M A

    2010-05-20

    We obtained data on the lengths, girths, and diameters of the fingers of children from 3 to 10 years of age. A total of 160 children (78 girls, 82 boys) were examined in a cross-sectional investigation. The length of each finger of the right hand of every child was measured, as were the girths of the proximal, middle, and distal phalanges, and of the proximal and distal interphalangeal joint. The average length of the thumb was 49 (35-65) mm. The index and ring fingers both averaged 69 (index, 50-88; ring, 42-96) mm in length, while the middle and little fingers averaged 72 (57-100) and 56 (40-74) mm, respectively. Average diameter, calculated from the girth measurement, was 16 (11-22) mm for the thumb, 15 mm for both the index (9-22) and middle (10-21) fingers, 14 (10-20) and 13 (8-19) mm for the ring and little fingers, respectively. The average length of each finger increased by 37% from 3 to 10 years of age, average girth by 24%, and diameter increased by 20%. We observed no differences in length, girth, and diameter between the sexes. The dimensions of children's fingers are relevant to injuries from automatic, power-operated window lifters of motor vehicles because risk of injury to a finger jammed between an ascending window and the seal entry depends upon the diameter of the finger. Additionally, short fingers of young children can be jammed over almost their entire length in the oblique design of a car window seal entry.

  8. Injuries in a Professional Ballet Dance Company: A 10-year Retrospective Study.

    PubMed

    Ramkumar, Prem N; Farber, Joseph; Arnouk, Johnny; Varner, Kevin E; Mcculloch, Patrick C

    2016-03-01

    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.

  9. Common carotid intima-media thickness measurements do not improve cardiovascular risk prediction in individuals with elevated blood pressure: the USE-IMT collaboration.

    PubMed

    Bots, Michiel L; Groenewegen, Karlijn A; Anderson, Todd J; Britton, Annie R; Dekker, Jacqueline M; Engström, Gunnar; Evans, Greg W; de Graaf, Jacqueline; Grobbee, Diederick E; Hedblad, Bo; Hofman, Albert; Holewijn, Suzanne; Ikeda, Ai; Kavousi, Maryam; Kitagawa, Kazuo; Kitamura, Akihiko; Ikram, M Arfan; Lonn, Eva M; Lorenz, Matthias W; Mathiesen, Ellisiv B; Nijpels, Giel; Okazaki, Shuhei; O'Leary, Daniel H; Polak, Joseph F; Price, Jacqueline F; Robertson, Christine; Rembold, Christopher M; Rosvall, Maria; Rundek, Tatjana; Salonen, Jukka T; Sitzer, Matthias; Stehouwer, Coen D A; Franco, Oscar H; Peters, Sanne A E; den Ruijter, Hester M

    2014-06-01

    Carotid intima-media thickness (CIMT) is a marker of cardiovascular risk. It is unclear whether measurement of mean common CIMT improves 10-year risk prediction of first-time myocardial infarction or stroke in individuals with elevated blood pressure. We performed an analysis among individuals with elevated blood pressure (i.e., a systolic blood pressure ≥140 mm Hg and a diastolic blood pressure ≥ 90 mm Hg) in USE-IMT, a large ongoing individual participant data meta-analysis. We refitted the risk factors of the Framingham Risk Score on asymptomatic individuals (baseline model) and expanded this model with mean common CIMT (CIMT model) measurements. From both models, 10-year risks to develop a myocardial infarction or stroke were estimated. In individuals with elevated blood pressure, we compared discrimination and calibration of the 2 models and calculated the net reclassification improvement (NRI). We included 17 254 individuals with elevated blood pressure from 16 studies. During a median follow-up of 9.9 years, 2014 first-time myocardial infarctions or strokes occurred. The C-statistics of the baseline and CIMT models were similar (0.73). NRI with the addition of mean common CIMT was small and not significant (1.4%; 95% confidence intervals, -1.1 to 3.7). In those at intermediate risk (n=5008, 10-year absolute risk of 10% to 20%), the NRI was 5.6% (95% confidence intervals, 1.6-10.4). There is no added value of measurement of mean common CIMT in individuals with elevated blood pressure for improving cardiovascular risk prediction. For those at intermediate risk, the addition of mean common CIMT to an existing cardiovascular risk score is small but statistically significant.

  10. Low rate of large polyps (>9 mm) within 10 years after an adequate baseline colonoscopy with no polyps

    PubMed Central

    Lieberman, David; Holub, Jennifer L.; Morris, Cynthia D.; Logan, Judith; Williams, J. Lucas; Carney, Patricia

    2014-01-01

    Background & Aims Guidelines recommend a 10 year interval between screening colonoscopies with negative results for average-risk individuals. However, many patients are examined at shorter intervals. We investigated outcomes of individuals with no polyps who had repeat colonoscopy in less than 10 years. Methods Data were collected using the National Endoscopic Database, from 69 gastroenterology centers, on 264,184 asymptomatic subjects who underwent screening colonoscopies from 2000 through 2006, were found to have no polyps, and received another colonoscopy examination within less than 10 years. Results No polyps were found in 147,375 patients during a baseline colonoscopy; 17,525 patients (11.9%) had a follow-up colonoscopy within less than 10 years, including 1806 (10.3%) who received the follow-up colonoscopy within less than 1 year. The most common reason for repeating the examination within 1 year was that the first was compromised by inadequate bowel preparation or incomplete examination. Of these patients, 6.5% (95% confidence interval [CI], 5.3–7.6) had large polyp(s) >9 mm—a proportion similar to the prevalence in the average-risk screening population. Reasons that examinations were repeated within 1–5 years included average-risk screening (15.7%), family history of colon polyps or cancer (30.1%), bleeding (31.2%), gastrointestinal symptoms (11.8%), or a positive result from a fecal blood test (5.5%). If the baseline exam was adequate, the incidence of large polyps within 1–5 years after baseline colonoscopy was 3.1% (95% CI, 2.7–3.5) and within years 5–10 years was 3.7% (95% CI, 3.3–4.1). Conclusions Repeat colonoscopies within 10 years are of no benefit to patients who had adequate examinations and were found to have no polyps. Repeat colonoscopies are beneficial to patients when the baseline examination was compromised. PMID:24768680

  11. Patterns and Predictors of Language and Literacy Abilities 4-10 Years in the Longitudinal Study of Australian Children

    PubMed Central

    Zubrick, Stephen R.; Taylor, Catherine L.; Christensen, Daniel

    2015-01-01

    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

  12. Screening for Future Cardiovascular Disease Using Age Alone Compared with Multiple Risk Factors and Age

    PubMed Central

    Wald, Nicholas J.; Simmonds, Mark; Morris, Joan K.

    2011-01-01

    Background Risk factors such as blood pressure and serum cholesterol are used, with age, in screening for future cardiovascular disease (CVD) events. The value of using these risk factors with age compared with using age alone is not known. We compared screening for future CVD events using age alone with screening using age and multiple risk factors based on regular Framingham risk assessments. Methods Ten-year CVD risk was estimated using Framingham risk equations in a hypothetical sample population of 500,000 people aged 0–89 years. Risk estimates were used to identify individuals who did and did not have a CVD event over a ten-year period. For screening using age alone (age screening) and screening using multiple risk factors and age (Framingham screening) we estimated the (i) detection rate (sensitivity); (ii) false–positive rate; (iii) proportion of CVD-free years of life lost in affected individuals with positive results (person-years detection rate); and (iv) cost per CVD-free life year gained from preventive treatment. Results Age screening using a cut-off of 55 years detected 86% of all first CVD events arising in the population every year and 72% of CVD-free years of life lost for a 24% false-positive rate; for five yearly Framingham screening the false-positive rate was 21% for the same 86% detection rate. The estimated cost per CVD-free year of life gained was £2,000 for age screening and £2,200 for Framingham screening if a Framingham screen costs £150 and the annual cost of preventive treatment is £200. Conclusion Age screening for future CVD events is simpler than Framingham screening with a similar screening performance and cost-effectiveness. It avoids blood tests and medical examinations. The advantages of age screening in the prevention of heart attack and stroke warrant considering its use in preference to multiple risk factor screening. PMID:21573224

  13. Recommendations for Serogroup B Meningococcal Vaccine for Persons 10 Years and Older.

    PubMed

    2016-09-01

    This policy statement provides recommendations for the prevention of serogroup B meningococcal disease through the use of 2 newly licensed serogroup B meningococcal vaccines: MenB-FHbp (Trumenba; Wyeth Pharmaceuticals, a subsidiary of Pfizer, Philadelphia, PA) and MenB-4C (Bexsero; Novartis Vaccines, Siena, Italy). Both vaccines are approved for use in persons 10 through 25 years of age. MenB-FHbp is licensed as a 2- or 3-dose series, and MenB-4C is licensed as a 2-dose series for all groups. Either vaccine is recommended for routine use in persons 10 years and older who are at increased risk of serogroup B meningococcal disease (category A recommendation). Persons at increased risk of meningococcal serogroup B disease include the following: (1) persons with persistent complement component diseases, including inherited or chronic deficiencies in C3, C5-C9, properdin, factor D, or factor H or persons receiving eculizumab (Soliris; Alexion Pharmaceuticals, Cheshire, CT), a monoclonal antibody that acts as a terminal complement inhibitor by binding C5 and inhibiting cleavage of C5 to C5A; (2) persons with anatomic or functional asplenia, including sickle cell disease; and (3) healthy persons at increased risk because of a serogroup B meningococcal disease outbreak. Both serogroup B meningococcal vaccines have been shown to be safe and immunogenic and are licensed by the US Food and Drug Administration for individuals between the ages of 10 and 25 years. On the basis of epidemiologic and antibody persistence data, the American Academy of Pediatrics agrees with the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention that either vaccine may be administered to healthy adolescents and young adults 16 through 23 years of age (preferred ages are 16 through 18 years) to provide short-term protection against most strains of serogroup B meningococcal disease (category B recommendation).

  14. Employment and social benefits up to 10 years after breast cancer diagnosis: a population-based study

    PubMed Central

    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

    2016-01-01

    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

  15. The Career Trap. Breaking through the 10-Year Barrier To Get the Job You Really Want.

    ERIC Educational Resources Information Center

    Allen, Jeffrey G.

    This book, which is intended for individuals who have been in a job for a decade and feel that their career development has stalled, explains how to break through the 10-year career barrier and get a desired job. The following topics are discussed in the book's 15 chapters: career stalls and their causes; the 10-year career barrier; the legality…

  16. Effects of Two Modes of Exercise Training on Physical Fitness of 10 Year-Old Children

    ERIC Educational Resources Information Center

    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.

    2010-01-01

    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…

  17. Natural History of Thyroid Function in Adults with Down Syndrome--10-Year Follow-Up Study

    ERIC Educational Resources Information Center

    Prasher, V.; Gomez, G.

    2007-01-01

    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…

  18. Identifying Individuals at Risk for Cardiovascular Events Across the Spectrum of Blood Pressure Levels

    PubMed Central

    Karmali, Kunal N; Ning, Hongyan; Goff, David C; Lloyd-Jones, Donald M

    2015-01-01

    Background We determined the proportion of atherosclerotic cardiovascular disease (ASCVD) events that occur across the spectrum of systolic blood pressure (SBP) and assessed whether multivariable risk assessment can identify persons who experience ASCVD events at all levels of SBP, including those with goal levels. Methods and Results Participants aged 45 to 64 years from the Framingham Offspring and Atherosclerosis Risk in Communities studies were stratified based on treated and untreated SBP levels (<120, 120 to 129, 130 to 139, 140 to 149, 150 to 159, ≥160 mm Hg). We determined the number of excess ASCVD events in each SBP stratum by calculating the difference between observed and expected events (ASCVD event rate in untreated SBP <120 mm Hg was used as the reference). We categorized participants into 10-year ASCVD risk groups using the Pooled Cohort risk equations. There were 18 898 participants (78% white; 22% black) who were followed for 10 years. We estimated 427 excess ASCVD events, of which 56% (109 of 197) and 50% (115 of 230), respectively, occurred among untreated and treated participants with elevated SBP who were not recommended for antihypertensive therapy. Among untreated participants, 10-year ASCVD risk ≥7.5% identified 64% of those who experienced an ASCVD at 10 years and 30% of those who did not. Multivariable risk assessment was less useful in baseline-treated participants. Conclusions Half of excess ASCVD events occurred in persons with elevated SBP who were not currently recommended for antihypertensive therapy. Multivariable risk assessment may help identify those likely to benefit from further risk-reducing therapies. These findings support consideration of multivariable risk in guiding prevention across the spectrum of SBP. PMID:26391134

  19. Prediction of cardiovascular disease risk among low-income urban dwellers in metropolitan Kuala Lumpur, Malaysia.

    PubMed

    Su, Tin Tin; Amiri, Mohammadreza; Mohd Hairi, Farizah; Thangiah, Nithiah; Bulgiba, Awang; Majid, Hazreen Abdul

    2015-01-01

    We aimed to predict the ten-year cardiovascular disease (CVD) risk among low-income urban dwellers of metropolitan Malaysia. Participants were selected from a cross-sectional survey conducted in Kuala Lumpur. To assess the 10-year CVD risk, we employed the Framingham risk scoring (FRS) models. Significant determinants of the ten-year CVD risk were identified using General Linear Model (GLM). Altogether 882 adults (≥30 years old with no CVD history) were randomly selected. The classic FRS model (figures in parentheses are from the modified model) revealed that 20.5% (21.8%) and 38.46% (38.9%) of respondents were at high and moderate risk of CVD. The GLM models identified the importance of education, occupation, and marital status in predicting the future CVD risk. Our study indicated that one out of five low-income urban dwellers has high chance of having CVD within ten years. Health care expenditure, other illness related costs and loss of productivity due to CVD would worsen the current situation of low-income urban population. As such, the public health professionals and policy makers should establish substantial effort to formulate the public health policy and community-based intervention to minimize the upcoming possible high mortality and morbidity due to CVD among the low-income urban dwellers.

  20. Children of treated substance-abusing mothers: a 10-year prospective study.

    PubMed

    Hser, Y-I; Evans, E; Li, L; Metchik-Gaddis, A; Messina, N

    2014-04-01

    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.

  1. Investigating kidney donation as a risk factor for hypertension and microalbuminuria: findings from the Swiss prospective follow-up of living kidney donors

    PubMed Central

    Thiel, Gilbert T; Nolte, Christa; Tsinalis, Dimitrios; Steiger, Jürg; Bachmann, Lucas M

    2016-01-01

    Objectives To assess the role of nephrectomy as a risk factor for the development of hypertension and microalbuminuria. Design Prospective, long-term follow-up study. Setting Swiss Organ Living-Donor Health Registry. Participants All living kidney donors in Switzerland between 1993 and 2009. Interventions Data on health status and renal function before 1 year and biennially after donation were collected. Primary and secondary outcome measures Comparison of 1-year and 5-year occurrences of hypertension among normotensive donors with 1-year and 5-year estimates from the Framingham hypertension risk score. Multivariate random intercept models were used to investigate changes of albumin excretion after donation, correcting for repeated measurements and cofactors such as age, male gender and body mass index. Results A total of 1214 donors contributed 3918 data entries with a completed biennial follow-up rate of 74% during a 10-year period. Mean (SD) follow-up of donors was 31.6 months (34.4). Median age at donation was 50.5 years (IQR 42.2–58.8); 806 donors (66.4%) were women. Donation increased the risk of hypertension after 1 year by 3.64 (95% CI 3.52 to 3.76; p<0.001). Those participants remaining normotensive 1 year after donation return to a risk similar to that of the healthy Framingham population. Microalbuminuria before donation was dependent on donor age but not on the presence of hypertension. After nephrectomy, hypertension became the main driver for changes in albumin excretion (OR 1.19; 95% CI 0.13 to 2.25; p=0.03) and donor age had no effect. Conclusions Nephrectomy propagates hypertension and increases susceptibility for the development of hypertension-induced microalbuminuria. PMID:27006347

  2. [Clinicopathologic features of hepatocellular carcinoma patients surviving more than 10 years after radical hepatectomy].

    PubMed

    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

    2017-02-01

    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.

  3. Gene by Sex Interaction for Measures of Obesity in the Framingham Heart Study

    PubMed Central

    Benjamin, Ashlee M.; Suchindran, Sunil; Pearce, Kaela; Rowell, Jennifer; Lien, Lillian F.; Guyton, John R.; McCarthy, Jeanette J.

    2011-01-01

    Obesity is an increasingly prevalent and severe health concern with a substantial heritable component and marked sex differences. We sought to determine if the effect of genetic variants also differed by sex by performing a genome-wide association study modeling the effect of genotype-by-sex interaction on obesity phenotypes. Genotype data from individuals in the Framingham Heart Study Offspring cohort were analyzed across five exams. Although no variants showed genome-wide significant gene-by-sex interaction in any individual exam, four polymorphisms displayed a consistent BMI association (P-values .00186 to .00010) across all five exams. These variants were clustered downstream of LYPLAL1, which encodes a lipase/esterase expressed in adipose tissue, a locus previously identified as having sex-specific effects on central obesity. Primary effects in males were in the opposite direction from females and were replicated in Framingham Generation 3. Our data support a sex-influenced association between genetic variation at the LYPLAL1 locus and obesity-related traits. PMID:21253498

  4. Identification by ultrasound evaluation of the carotid and femoral arteries of high-risk subjects missed by three validated cardiovascular disease risk algorithms.

    PubMed

    Postley, John E; Luo, Yanting; Wong, Nathan D; Gardin, Julius M

    2015-11-15

    Atherosclerotic cardiovascular disease (ASCVD) events are the leading cause of death in the United States and globally. Traditional global risk algorithms may miss 50% of patients who experience ASCVD events. Noninvasive ultrasound evaluation of the carotid and femoral arteries can identify subjects at high risk for ASCVD events. We examined the ability of different global risk algorithms to identify subjects with femoral and/or carotid plaques found by ultrasound. The study population consisted of 1,464 asymptomatic adults (39.8% women) aged 23 to 87 years without previous evidence of ASCVD who had ultrasound evaluation of the carotid and femoral arteries. Three ASCVD risk algorithms (10-year Framingham Risk Score [FRS], 30-year FRS, and lifetime risk) were compared for the 939 subjects who met the algorithm age criteria. The frequency of femoral plaque as the only plaque was 18.3% in the total group and 14.8% in the risk algorithm groups (n = 939) without a significant difference between genders in frequency of femoral plaque as the only plaque. Those identified as high risk by the lifetime risk algorithm included the most men and women who had plaques either femoral or carotid (59% and 55%) but had lower specificity because the proportion of subjects who actually had plaques in the high-risk group was lower (50% and 35%) than in those at high risk defined by the FRS algorithms. In conclusion, ultrasound evaluation of the carotid and femoral arteries can identify subjects at risk of ASCVD events missed by traditional risk-predicting algorithms. The large proportion of subjects with femoral plaque only supports the use of including both femoral and carotid arteries in ultrasound evaluation.

  5. Association of Variants in RETN With Plasma Resistin Levels and Diabetes-Related Traits in the Framingham Offspring Study

    PubMed Central

    Hivert, Marie-France; Manning, Alisa K.; McAteer, Jarred B.; Dupuis, Josée; Fox, Caroline S.; Cupples, L. Adrienne; Meigs, James B.; Florez, Jose C.

    2009-01-01

    OBJECTIVE— The RETN gene encodes the adipokine resistin. Associations of RETN with plasma resistin levels, type 2 diabetes, and related metabolic traits have been inconsistent. Using comprehensive linkage disequilibrium mapping, we genotyped tag single nucleotide polymorphisms (SNPs) in RETN and tested associations with plasma resistin levels, risk of diabetes, and glycemic traits. RESEARCH DESIGN AND METHODS— We examined 2,531 Framingham Offspring Study participants for resistin levels, glycemic phenotypes, and incident diabetes over 28 years of follow-up. We genotyped 21 tag SNPs that capture common (minor allele frequency >0.05) or previously reported SNPs at r2 > 0.8 across RETN and its flanking regions. We used sex- and age-adjusted linear mixed-effects models (with/without BMI adjustment) to test additive associations of SNPs with traits, adjusted Cox proportional hazards models accounting for relatedness for incident diabetes, and generated empirical P values (Pe) to control for type 1 error. RESULTS— Four tag SNPs (rs1477341, rs4804765, rs1423096, and rs10401670) on the 3′ side of RETN were strongly associated with resistin levels (all minor alleles associated with higher levels, Pe<0.05 after multiple testing correction). rs10401670 was also associated with fasting plasma glucose (Pe = 0.02, BMI adjusted) and mean glucose over follow-up (Pe = 0.01; BMI adjusted). No significant association was observed for adiposity traits. On meta-analysis, the previously reported association of SNP −420C/G (rs1862513) with resistin levels remained significant (P = 0.0009) but with high heterogeneity across studies (P < 0.0001). CONCLUSIONS— SNPs in the 3′ region of RETN are associated with resistin levels, and one of them is also associated with glucose levels, although replication is needed. PMID:19074981

  6. Hand osteoarthritis in relation to mortality and incidence of cardiovascular disease: data from the Framingham Heart Study

    PubMed Central

    Haugen, Ida K; Ramachandran, Vasan S; Misra, Devyani; Neogi, Tuhina; Niu, Jingbo; Yang, Tianzhong; Zhang, Yuqing; Felson, David T

    2014-01-01

    Objectives To study whether hand osteoarthritis (OA) is associated with increased mortality and cardiovascular events in a large community based cohort (Framingham Heart Study) in which OA, mortality and cardiovascular events have been carefully assessed. Methods We examined whether symptomatic (≥1 joint (s) with radiographic OA and pain in the same joint) and radiographic hand OA (≥1 joint(s) with radiographic OA without pain) were associated with mortality and incident cardiovascular events (coronary heart disease, congestive heart failure and/or atherothrombotic brain infarction) using Cox proportional hazards models. In the adjusted models, we included possible confounding factors from baseline (eg, metabolic factors, medication use, smoking/alcohol). We also adjusted for the number of painful joints in the lower limb and physical inactivity. Results We evaluated 1348 participants (53.8% women) with mean (SD) age of 62.2 (8.2) years, of whom 540 (40.1%) and 186 (13.8%) had radiographic and symptomatic hand OA, respectively. There was no association between hand OA and mortality. Although there was no significant relation to incident cardiovascular events overall or a relation of radiographic hand OA with events, we found a significant association between symptomatic hand OA and incident coronary heart disease (myocardial infarction/coronary insufficiency syndrome) (HR 2.26, 95% CI 1.22 to 4.18). The association remained after additional adjustment for pain in the lower limb or physical inactivity. Conclusions Symptomatic hand OA, but not radiographic hand OA, was associated with an increased risk of coronary heart disease events. The results suggest an effect of pain, which may be a possible marker of inflammation. PMID:24047870

  7. 7 CFR 625.9 - 10-year restoration cost-share agreements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... conditions beyond their control; (2) Compliance with the terms of the 10-year cost-share agreement would work... agreement where forces beyond the participant's control prevented compliance with the agreement....

  8. Longitudinal association between dairy consumption and changes of body weight and waist circumference: the Framingham Heart Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Dairy foods are nutrient dense and may be protective against long-term weight gain. We aimed to examine the longitudinal association between dairy consumption and annualized changes in weight and waist circumference (WC) in adults. Members of the Framingham Heart Study Offspring Cohort who participa...

  9. [Cardiovascular risk factors in women].

    PubMed

    Cengel, Atiye

    2010-03-01

    It is estimated that at least 80% of patients with cardiovascular disease (CVD) have conventional risk factors and optimization of these risk factors can reduce morbidity and mortality due to this disease considerably. Contemporary women have increased burden of some of these risk factors such as obesity, metabolic syndrome and smoking. Turkish women have a worse CV risk profile than Turkish men in some aspects. Risk stratification systems such as Framingham have a tendency of underestimating the risk in women. Coronary artery disease remains in vessel wall for a longer period of time in women; therefore obstructive disease appear later in their lifespan necessitating risk stratification systems for estimating their lifetime risk.

  10. Decreases in human immunodeficiency virus infection rates in Kombolcha, Ethiopia: a 10-year data review

    PubMed Central

    Shiferaw, Melashu Balew; Gebregergs, Gebremedhin Berhe; Sinishaw, Mulusew Alemneh; Yesuf, Yohannes Amede

    2016-01-01

    Introduction Acquired immunodeficiency syndrome is one of the most serious public health and development challenges in sub-Saharan Africa, including Ethiopia. A particular challenge for prevention strategies has been the emergence of hotspot areas. Therefore, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome programs should not be based on national level statistics, but need to be more focused geographically. Kombolcha is one of the high spot areas with different projects and development corridors. Hence, the aim of this study is to assess the trend of HIV infection rates among patients who visited Africa Service Committee clinic from 2005 to 2014. Methods An institutional-based cross-sectional study was conducted from January 1 to January 30, 2016. All records of new patients enrolled from February 8, 2005 to December 31, 2014 were reviewed. Data on sociodemographic information, risky sexual behavior, and HIV test result were collected from each study participant using data collection format. Data were analyzed using SPSS version 20.0. A multivariate logistic regression model was used to identify risk factors of HIV infection. Results The overall HIV infection was 10.8% (2,233/20,674). The rate of infection varied from 13.3% in 2005 to 4.5% in 2014, and its trend had significantly declined from 2008 to 2014. Urban residence (adjusted odds ratio [AOR]: 2.53; 95% confidence interval [CI]: 1.22–5.25), patients who ever had intercourse with penetration (AOR: 5.62; 95% CI: 1.11–28.57), and those who had marriage experience (AOR: 11.65; 95% CI: 4.2–32.3) were more infected with HIV. Conclusion The trend of HIV infection significantly reduced in the last 10 years in Kombolcha area. However, the HIV infection still remains high (4.5%) that needs intervention of those who had marriage experience, risky sexual behavior, and urban dwellers. PMID:27462177

  11. Ethnic Differences in Glucose Homeostasis Markers between the Kyushu-Okinawa Population Study and the Framingham Offspring Study

    PubMed Central

    Ikezaki, Hiroaki; Ai, Masumi; Schaefer, Ernst J.; Otokozawa, Seiko; Asztalos, Bela F.; Nakajima, Katsuyuki; Zhou, Yanhua; Liu, Ching-Ti; Jacques, Paul F.; Cupples, L. Adrienne; Furusyo, Norihiro

    2016-01-01

    We compared markers of glucose homeostasis and their association with diabetes and impaired fasting glucose (IFG) in Fukuoka, Japanese subjects (n = 1108) and age-, gender- and menopausal status-matched participants in the Framingham Offspring Study (n = 1096). The markers examined included fasting glucose, insulin, adiponectin, and glycated albumin, as well as body mass index (BMI), use of medications, and history of diabetes. The results showed that IFG prevalence in Japanese men (15.9%) and women (7.4%) were 50% less than those observed in Framingham men (34.5%) and women (21.4%) (P < 0.001). However, the diabetes prevalence in Japanese men at 13.3% was twice as high (P < 0.01) as the rate in Framingham men at 6.5%, while these rates were similar in women. Median insulin levels in Japanese men (4.6 μIU/mL) and women (4.3 μIU/mL) were about 50% lower (P < 0.001) than those in Framingham men (10.8 μIU/mL) and women (9.9 μIU/mL), as were insulin resistance values (P < 0.001). These population differences were also observed after subjects were stratified by glucose levels. In conclusion, our data indicate that there is significantly less IFG, lower insulin levels, and insulin resistance, but higher diabetes prevalence in Fukuoka men than in Framingham men, indicating that insulin deficiency may be an important cause of diabetes in Japan. PMID:27830830

  12. Tuberculosis Among Foreign-Born Persons Diagnosed ≥10 Years After Arrival in the United States, 2010-2015.

    PubMed

    Tsang, Clarisse A; Langer, Adam J; Navin, Thomas R; Armstrong, Lori R

    2017-03-24

    The majority of tuberculosis (TB) cases in the United States are attributable to reactivation of latent TB infection (LTBI) (1). LTBI refers to the condition when a person is infected with Mycobacterium tuberculosis without signs and symptoms, or radiographic or bacteriologic evidence of TB disease. CDC and the U.S. Preventive Services Task Force (USPSTF) recommend screening populations at increased risk for LTBI, including persons who have lived in congregate settings at high risk and persons who were born in, or are former residents of countries with TB incidence ≥20 cases per 100,000 population (2-4). In 2015, foreign-born persons constituted 66.2% of U.S. TB cases (5). During the past 30 years, screening of persons from countries with high TB rates has focused on overseas screening for immigrants and refugees, and domestic screening for persons who have newly arrived in the United States (6,7). However, since 2007, an increasing number and proportion of foreign-born patients receiving a diagnosis of TB first arrived in the United States ≥10 years before the development and diagnosis of TB disease. To better understand how this group of patients differs from persons who developed TB disease and received a diagnosis <10 years after U.S. arrival, CDC analyzed data for all reported TB cases in the United States since 1993 in the National TB Surveillance System (NTSS). After adjusting for age and other characteristics, foreign-born persons who arrived in the United States ≥10 years before diagnosis were more likely to be residents of a long-term care facility or to have immunocompromising conditions other than human immunodeficiency virus (HIV) infection. These findings support using the existing CDC and USPSTF recommendations for TB screening of persons born in countries with high TB rates regardless of time since arrival in the United States (2,3).

  13. Serum Lipid Levels and Dyslipidaemia Prevalence among 2–10 Year-Old Northern Mexican Children

    PubMed Central

    Bibiloni, Maria del Mar; Salas, Rogelio; Novelo, Hilda I.; Villarreal, Jesús Z.; Sureda, Antoni; Tur, Josep A.

    2015-01-01

    Background and Aims The increase in overweight and obese children may be linked to increased rates of dyslipidaemia. The aim was to assess the prevalence of dyslipidaemia and associated risk factors among the Northern Mexican child population. Methods and Results Four hundred and fifty-one subjects aged between 2 and 10 (47.5% girls) took part in the Nuevo León State Survey of Nutrition and Health 2011–2012. According to the 2011 Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, serum lipid levels (mg/dL) were categorized into three subgroups (acceptable, borderline-high/low or high/low) as follows: TChol: acceptable <170, borderline-high 170–199, high ≥200; LDL-chol: acceptable <110, borderline-high 110–129, high ≥130; non-HDL-chol: acceptable <120, borderline-high 120–144, high ≥145; HDL-chol: acceptable >45, borderline-low 40–45, low <40; and TG: acceptable <75, borderline-high 75–99, high ≥100 in ≤9 year-old children, and acceptable <90, borderline-high 90–129, and high ≥130 in 10 year-old children. The overall prevalence of borderline-high + high TG, non-HDL-chol, TChol, and LDL-chol was 63.0%, 44.1%, 43.5%, and 29.9%, respectively. The overall prevalence of borderline-low + low HDL-chol was 46.3%. The overall frequency of dyslipidaemia was 54.3%. Thirteen children (2.9%) had all five symptoms of dyslipidaemia. The most common dyslipidaemia was high TG in combination (26.2%) and in isolation (10.6%). Conclusions Half of the children had at least one abnormal lipid concentration. A high TG level was the most frequent dyslipidaemia. Obesity was associated with the occurrence of at least one abnormal lipid level. These findings emphasize the need to pay further attention to the prevention of cardiovascular disease and obesity from an early age. PMID:25793380

  14. Anatomical and functional graft survival, 10 years after epikeratoplasty in keratoconus

    PubMed Central

    Panda, Anita; Gupta, Anoop K; Sharma, Namrata; Nindrakrishna, Sasikala; Vajpayee, Rasik

    2013-01-01

    Purpose: To report outcomes of epikeratoplasty in keratoconus (KC), utilizing manually-prepared plano donor lenticules in terms of flattening of the cone, reduction in astigmatism and improvement in the visual acuity. Materials and Methods: Patients with KC, having visual acuity <20/200, astigmatism >12 diopters (D) but without corneal opacity underwent epikeratoplasty, using manually prepared plano donor lenticules from fresh or M.K preserved corneas, between 1990 - 2000 and followed for 10 years, were included in this report. Visual acuity slit-lamp-biomicroscopy, keratometry, and refraction were performed at 8 weeks, 12 weeks, and 6 months for all 59 patients. The same were carried out at 1 year, 5 years, and 10 years depending upon the availability of the patient for that period. Results: Of the 59 patients, only 26 were available for follow-up after 10 years. At 3 months, 1 year and 5 years, best corrected visual acuity of (BCVA) ≥20/60 were achieved in 84.7%, 84.4% and 80.3% of eyes, respectively. BCVA was 73% at 10-year follow- up, which was due to the presence of posterior subcapsular cataract (PSC). The average keratometric astigmatism and average flattening in diopters stabilized at the end of 3 months, which remained constant at 1, 5, and 10-year follow-up. The average diopter of myopia was stabilized by 1 year, which was almost same at 10 year. Graft was clear in all but 1 eye at 10 year follow-up. Conclusion: Epikeratoplasty is a useful technique for keratoconic eyes without apical scarring who fail or unable to use contact lenses. PMID:23275216

  15. Association of depression and anxiety status with 10-year cardiovascular disease incidence among apparently healthy Greek adults: The ATTICA Study.

    PubMed

    Kyrou, Ioannis; Kollia, Natasa; Panagiotakos, Demosthenes; Georgousopoulou, Ekavi; Chrysohoou, Christina; Tsigos, Constantine; Randeva, Harpal S; Yannakoulia, Mary; Stefanadis, Christodoulos; Papageorgiou, Charalabos; Pitsavos, Christos

    2017-01-01

    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.

  16. Socioeconomic Status and Poor Health Outcome at 10 Years of Follow-Up in the Multi-Ethnic Study of Atherosclerosis

    PubMed Central

    Lima, Joao; Diez-Roux, Ana; Jorgensen, Neal W.; McClelland, Robyn L.

    2016-01-01

    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

  17. Cardiovascular risk factors associated with the metabolic syndrome are more prevalent in people reporting chronic pain: results from a cross-sectional general population study.

    PubMed

    Goodson, Nicola J; Smith, Blair H; Hocking, Lynne J; McGilchrist, Mark M; Dominiczak, Anna F; Morris, Andrew; Porteous, David J; Goebel, Andreas

    2013-09-01

    To explore whether chronic pain is associated with cardiovascular risk factors and identify whether increased distribution or intensity of pain is associated with cardiovascular risk, participants in Generation Scotland: The Scottish Family Health study completed pain questionnaires recording the following: presence of chronic pain, distribution of pain, and intensity of chronic pain. Blood pressure, lipids, blood glucose, smoking history, waist-hip ratio, and body mass index were recorded; Framingham 10-year coronary heart disease (CHD) risk scores were calculated and a diagnosis of metabolic syndrome derived. Associations between chronic pain and cardiovascular risk were explored. Of 13,328 participants, 1100 (8.3%) had high CHD risk. Chronic pain was reported by 5209 (39%), 1294 (9.7%) reported widespread chronic pain, and 707 (5.3%) reported high-intensity chronic pain. In age- and gender-adjusted analyses, chronic pain was associated with elevated CHD risk scores (odds ratio 1.11, 95% confidence interval 1.01-1.23) and the metabolic syndrome (odds ratio 1.42, 95% confidence interval 1.24-1.62). Multivariate analyses identified dyslipidaemia, age, gender, smoking, obesity, and high waist-hip ratio as independently associated with chronic pain. Within the chronic pain subgroup, widespread pain did not confer any additional cardiovascular disease risk. However, cardiovascular disease risk factors contributing to metabolic syndrome were more prevalent in those reporting high-intensity chronic pain. This large population-based study has demonstrated that chronic pain, and in particular high-intensity chronic pain, is associated with an increased prevalence of cardiovascular risk factors and metabolic syndrome. The 10-year CHD risk score and metabolic syndrome correlate well with increased pain intensity, but not with widespread pain.

  18. Factors Associated with Overweight and Obesity among Kuwaiti Elementary Male School Children Aged 6-10 Years.

    PubMed

    Al-Isa, Abdulwahab Naser; Campbell, Jennifer; Desapriya, Ediriweera

    2010-01-01

    Background. Childhood obesity is becoming a global epidemic which may result in increased morbidity and mortality during young adulthood. Objectives. To identify factors associated with overweight and that of obesity among Kuwaiti elementary male school children aged 6-10 years. Methods. Weights and heights of 662 students at a randomly selected school were collected to obtain body mass index (BMI). Results. The prevalence of overweight and obesity among the students were 20.2% and 16.8%, respectively. There were a variety of factors associated with overweight and obesity; however, having one or more obese brother, an unemployed father, or a high (>11) number of persons living at home was significantly associated with higher risk of overweight and obesity. Increased age and school level as well as having a chronic disease were associated with the risk of overweight. Conclusion. Health education programs for families should be implemented to help control overweight and obesity in Kuwaiti children.

  19. Prediction of the 10-year probability of gastric cancer occurrence in the Japanese population: the JPHC study cohort II.

    PubMed

    Charvat, Hadrien; Sasazuki, Shizuka; Inoue, Manami; Iwasaki, Motoki; Sawada, Norie; Shimazu, Taichi; Yamaji, Taiki; Tsugane, Shoichiro

    2016-01-15

    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.

  20. Bivariate linkage analysis of cholesterol and triglyceride levels in the Framingham Heart Study

    PubMed Central

    Zhang, Xuyang; Wang, Kai

    2003-01-01

    We performed a bivariate analysis on cholesterol and triglyceride levels on data from the Framingham Heart Study using a new score statistic developed for the detection of potential pleiotropic, or cluster, genes. Univariate score statistics were also computed for each trait. At a significance level 0.001, linkage signals were found at markers GATA48B01 on chromosome 1, GATA21C12 on chromosome 8, and ATA55A11 on chromosome 16 using the bivariate analysis. At the same significance level, linkage signals were found at markers 036yb8 on chromosome 3 and GATA3F02 on chromosome 12 using the univariate analysis. A strong linkage signal was also found at marker GATA112F07 by both the bivariate analysis and the univariate analysis, a marker for which evidence for linkage had been reported previously in a related study. PMID:14975130

  1. Optimism and Resources: Effects on Each Other and on Health over 10 Years

    PubMed Central

    Segerstrom, Suzanne C.

    2007-01-01

    Dispositional optimism may be associated with growth of social and status resources by virtue of optimists' greater persistence and better performance. Conversely, resource growth may give people a more positive view of their future and increase optimism. Changes in dispositional optimism and resources over 10 years were examined in former law students (N = 61). More optimistic first-year law students made more money 10 years later, but income did not predict later optimism. More optimistic students did not have larger social networks 10 years later, but increases in social network size predicted increased optimism. These changes predicted mental and physical health. Dispositional optimism was less stable than many personality traits (r = .35), potentially because it is responsive to resource change. PMID:24347739

  2. Sex differences in cognition are stable over a 10-year period in adulthood and old age.

    PubMed

    de Frias, Cindy M; Nilsson, Lars-Göran; Herlitz, Agneta

    2006-01-01

    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.

  3. Secular trends in echocardiographic left ventricular mass in the community: The Framingham Heart Study

    PubMed Central

    Kaess, Bernhard M; Gona, Philimon; Larson, Martin G; Cheng, Susan; Aragam, Jayashree; Kenchaiah, Satish; Benjamin, Emelia J; Vasan, Ramachandran S

    2014-01-01

    Objective To investigate secular trends in echocardiographically-determined left ventricular mass (LVM). Design, Setting and participants Longitudinal community-based cohort study in Framingham, Massachussetts. LVM was calculated from routine echocardiography in 4,320 participants (52% women) of the Framingham Offspring cohort at examination cycles 4 (1987-91), 5 (1991-95), 6 (1995-98) and 8 (2005-08), totalling 13,971 person-observations. Main outcome measures Sex-specific trends in mean LVM (and its components, LV diastolic diameter [LVDD] and LV wall thickness [LVWT]), and LVM indexed to body surface area (BSA). Results In men, age-adjusted LVM modestly increased from examination 4 to 8 (192 g to 198 g, P-trend=0.0005), whereas in women it decreased from 147 g at examination 4 to 140 g at examination 8 (P-trend<0.0001). The trend for increasing LVM in men tracked with an increasing LVDD (P-trend=0.0002), whereas the decline in LVM in women was accompanied by a decrease in LVWT (P-trend<0.0001). Indexing LVM to BSA abolished the increasing trend in men (P-trend=0.49), whereas the decreasing trend in women was maintained. Conclusions In our longitudinal analysis of a large community-based sample spanning two decades, we observed sex-related differences in trends in LVM, with a modest increase of LVM in men (likely attributable to increasing body size), but a decrease in women. Additional studies are warranted to elucidate the basis for these sex-related differences. PMID:24041649

  4. Genetic links between post-reproductive lifespan and family size in Framingham

    PubMed Central

    Wang, Xiaofei; Byars, Sean G.; Stearns, Stephen C.

    2013-01-01

    Background and objectives: Is there a trade-off between children ever born (CEB) and post-reproductive lifespan in humans? Here, we report a comprehensive analysis of reproductive trade-offs in the Framingham Heart Study (FHS) dataset using phenotypic and genotypic correlations and a genome-wide association study (GWAS) to look for single-nucleotide polymorphisms (SNPs) that are related to the association between CEB and lifespan. Methodology: We calculated the phenotypic and genetic correlations of lifespan with CEB for men and women in the Framingham dataset, and then performed a GWAS to search for SNPs that might affect the relationship between post-reproductive lifespan and CEB. Results: We found significant negative phenotypic correlations between CEB and lifespan in both women (rP = −0.133, P < 0.001) and men (rP = −0. 079, P = 0.036). The genetic correlation was large, highly significant and strongly negative in women (rG = −0.877, P = 0.009) in a model without covariates, but not in men (P = 0.777). The GWAS identified five SNPs associated with the relationship between CEB and post-reproductive lifespan in women; some are near genes that have been linked to cancer. None were identified in men. Conclusions and implications: We identified several SNPs for which the relationship between CEB and post-reproductive lifespan differs by genotype in women in the FHS who were born between 1889 and 1958. That result was not robust to changes in the sample. Further studies on larger samples are needed to validate the antagonistic pleiotropy of these genes. PMID:24481203

  5. Hepatitis C virus recurrence after liver transplantation: A 10-year evaluation

    PubMed Central

    Gitto, Stefano; Belli, Luca Saverio; Vukotic, Ranka; Lorenzini, Stefania; Airoldi, Aldo; Cicero, Arrigo Francesco Giuseppe; Vangeli, Marcello; Brodosi, Lucia; Panno, Arianna Martello; Di Donato, Roberto; Cescon, Matteo; Grazi, Gian Luca; De Carlis, Luciano; Pinna, Antonio Daniele; Bernardi, Mauro; Andreone, Pietro

    2015-01-01

    AIM: To evaluate the predictors of 10-year survival of patients with hepatitis C recurrence. METHODS: Data from 358 patients transplanted between 1989 and 2010 in two Italian transplant centers and with evidence of hepatitis C recurrence were analyzed. A χ2, Fisher’s exact test and Kruskal Wallis’ test were used for categorical and continuous variables, respectively. Survival analysis was performed at 10 years after transplant using the Kaplan-Meier method, and a log-rank test was used to compare groups. A P level less than 0.05 was considered significant for all tests. Multivariate analysis of the predictive role of different variables on 10-year survival was performed by a stepwise Cox logistic regression. RESULTS: The ten-year survival of the entire population was 61.2%. Five groups of patients were identified according to the virological response or lack of a response to antiviral treatment and, among those who were not treated, according to the clinical status (mild hepatitis C recurrence, “too sick to be treated” and patients with comorbidities contraindicating the treatment). While the 10-year survival of treated and untreated patients was not different (59.1% vs 64.7%, P = 0.192), patients with a sustained virological response had a higher 10-year survival rate than both the “non-responders” (84.7% vs 39.8%, P < 0.0001) and too sick to be treated (84.7% vs 0%, P < 0.0001). Sustained virological responders had a survival rate comparable to patients untreated with mild recurrence (84.7% vs 89.3%). A sustained virological response and young donor age were independent predictors of 10-year survival. CONCLUSION: Sustained virological response significantly increased long-term survival. Awaiting the interferon-free regimen global availability, antiviral treatment might be questionable in selected subjects with mild hepatitis C recurrence. PMID:25852276

  6. Overview of saxagliptin efficacy and safety in patients with type 2 diabetes and cardiovascular disease or risk factors for cardiovascular disease

    PubMed Central

    Toth, Peter P

    2015-01-01

    Most individuals with type 2 diabetes mellitus have or will develop multiple independent risk factors for cardiovascular disease, particularly coronary artery disease (CAD). CAD is the leading cause of morbidity and mortality among individuals with type 2 diabetes mellitus, and treating these patients is challenging. The risk of hypoglycemia, weight gain, or fluid retention with some diabetes medications should be considered when developing a treatment plan for individuals with a history of CAD or at risk for CAD. Dipeptidyl peptidase-4 inhibitors are oral antihyperglycemic agents that inhibit the breakdown of the incretin hormones glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide, resulting in increased glucose-dependent insulin secretion and suppression of glucagon secretion. Saxagliptin is a potent and selective dipeptidyl peptidase-4 inhibitor that improves glycemic control and is generally well tolerated when used as monotherapy and as add-on therapy to other antihyperglycemic medications. This review summarizes findings from recently published post hoc analyses of saxagliptin clinical trials that have been conducted in patients with and without a history of cardiovascular disease and in patients with and without various risk factors for cardiovascular disease. The results show that saxagliptin was generally well tolerated and consistently improved glycemic control, as assessed by reductions from baseline in glycated hemoglobin, fasting plasma glucose concentration, and postprandial glucose concentration, regardless of the presence or absence of baseline cardiovascular disease, hypertension, statin use, number of cardiovascular risk factors, or high Framingham 10-year cardiovascular risk score. PMID:25565858

  7. Adiposity, cardiometabolic risk, and vitamin D status: the Framingham Heart Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Objective: Because vitamin D deficiency is associated with a variety of chronic diseases, understanding the characteristics that promote vitamin D deficiency in otherwise healthy adults could have important clinical implications. Few studies relating vitamin D deficiency to obesity have included d...

  8. Multiple biomarkers and risk of clinical and subclinical vascular brain injury: the framingham offspring study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Several biomarkers have been individually associated with vascular brain injury, but no prior study has explored the simultaneous association of a biologically plausible panel of biomarkers with the incidence of stroke/transient ischemic attack and the prevalence of subclinical brain injury. In 3127...

  9. Prevalence of metabolic syndrome and degree of cardiovascular disease risk in patients with Psoriatic Arthritis

    PubMed Central

    Özkan, Sıdıka Gülkan; Yazısız, Hatice; Behlül, Ahmet; Gökbelen, Yüksel Aslı; Borlu, Fatih; Yazısız, Veli

    2017-01-01

    Objective The aim of this study was to identify the prevalence of metabolic syndrome (MetS) and degree of cardiovascular disease (CVD) risk in patients with psoriatic arthritis (PsA). Material and Methods We performed a cross-sectional study on 102 adult patients with PsA and a control group of 102 patients with rheumatoid arthritis (RA). MetS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Federation (IDF) criteria. The Framingham risk scores of 10-year risk of CVDs and coronary heart disease (CHD) were also calculated. Results The prevalence of MetS was higher in patients with PsA than in those with RA, according to the NCEP-ATP III (40.6% vs. 24.7%, respectively; p=0.019) and IDF (46.8% vs. 27.9%, respectively; p=0.05) criteria. The prevalence of MetS was higher in female patients with PsA (p=0.009) than in male patients. A significantly increased prevalence of hypertriglyceridemia was determined in patients with PsA (p=0.019). No significant difference existed between the two groups with respect to 10-year CVD (p=0.333) and CHD (p=0.798) risks. Additionally, there were no significant differences between the clinical subtypes of PsA with regard to MetS (p=0.229). Conclusion MetS prevalence increased in patients with PsA compared with those with RA, whereas the risks were similar for CVDs and CHD. For this reason, optimal protection measures should be taken and guidelines should be applied to achieve adequate metabolic control in patients with PsA. PMID:28293452

  10. 10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial

    PubMed Central

    Halliday, Alison; Harrison, Michael; Hayter, Elizabeth; Kong, Xiangling; Mansfield, Averil; Marro, Joanna; Pan, Hongchao; Peto, Richard; Potter, John; Rahimi, Kazem; Rau, Angela; Robertson, Steven; Streifler, Jonathan; Thomas, Dafydd

    2010-01-01

    Summary Background If carotid artery narrowing remains asymptomatic (ie, has caused no recent stroke or other neurological symptoms), successful carotid endarterectomy (CEA) reduces stroke incidence for some years. We assessed the long-term effects of successful CEA. Methods Between 1993 and 2003, 3120 asymptomatic patients from 126 centres in 30 countries were allocated equally, by blinded minimised randomisation, to immediate CEA (median delay 1 month, IQR 0·3–2·5) or to indefinite deferral of any carotid procedure, and were followed up until death or for a median among survivors of 9 years (IQR 6–11). The primary outcomes were perioperative mortality and morbidity (death or stroke within 30 days) and non-perioperative stroke. Kaplan-Meier percentages and logrank p values are from intention-to-treat analyses. This study is registered, number ISRCTN26156392. Findings 1560 patients were allocated immediate CEA versus 1560 allocated deferral of any carotid procedure. The proportions operated on while still asymptomatic were 89·7% versus 4·8% at 1 year (and 92·1% vs 16·5% at 5 years). Perioperative risk of stroke or death within 30 days was 3·0% (95% CI 2·4–3·9; 26 non-disabling strokes plus 34 disabling or fatal perioperative events in 1979 CEAs). Excluding perioperative events and non-stroke mortality, stroke risks (immediate vs deferred CEA) were 4·1% versus 10·0% at 5 years (gain 5·9%, 95% CI 4·0–7·8) and 10·8% versus 16·9% at 10 years (gain 6·1%, 2·7–9·4); ratio of stroke incidence rates 0·54, 95% CI 0·43–0·68, p<0·0001. 62 versus 104 had a disabling or fatal stroke, and 37 versus 84 others had a non-disabling stroke. Combining perioperative events and strokes, net risks were 6·9% versus 10·9% at 5 years (gain 4·1%, 2·0–6·2) and 13·4% versus 17·9% at 10 years (gain 4·6%, 1·2–7·9). Medication was similar in both groups; throughout the study, most were on antithrombotic and antihypertensive therapy. Net benefits

  11. Comparing 9 to 10 Years Old Children's Performance in Tennis and Physical Fitness Activities

    ERIC Educational Resources Information Center

    Olcucu, Burcin

    2013-01-01

    The aim of the study is to determine the degree of performance-related physical coordination of elementary education children (male and female) that play tennis according to their age and gender and to investigate the relationship between their motor ability tests and performances. A total of 210 children tennis players (9 to 10 years; 105 males…

  12. Getting an Early Start: Communication about Sexuality among Mothers and Children 6-10 Years Old

    ERIC Educational Resources Information Center

    Pluhar, Erika; Jennings, Tanya; DiIorio, Colleen

    2006-01-01

    Little information exists on communication about sexuality between parents and preadolescent children. This study collected qualitative data on family sexuality communication from 3 focus groups conducted with African American mothers of 6-10 year old children. Two broad themes emerged from the data: "Beyond the Birds and the Bees" and "Let's Talk…

  13. Learning Benefits of Self-Controlled Knowledge of Results in 10-Year-Old Children

    ERIC Educational Resources Information Center

    Chiviacowsky, Suzete; Wulf, Gabriele; Laroque de Medeiros, Franklin; Kaefer, Angelica; Tani, Go

    2008-01-01

    The purpose of the present study was to examine whether the learning benefits of self-controlled knowledge of results (KR) would generalize to children. Specifically, the authors chose 10-year-old children representative of late childhood. The authors used a task that required the children to toss beanbags at a target. One group received KR…

  14. Self-Controlled Feedback in 10-Year-Old Children: Higher Feedback Frequencies Enhance Learning

    ERIC Educational Resources Information Center

    Chiviacowsky, Suzete; Wulf, Gabriele; de Medeiros, Franklin Laroque; Kaefer, Angelica; Wally, Raquel

    2008-01-01

    The purpose of the present study was to examine whether learning in 10-year-old children--that is, the age group for which the Chiviacowsky et al. (2006) study found benefits of self-controlled knowledge of results (KR)--would differ depending on the frequency of feedback they chose. The authors surmised that a relatively high feedback frequency…

  15. 24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured...

  16. Computer Card Games in Computer Science Education: A 10-Year Review

    ERIC Educational Resources Information Center

    Kordaki, Maria; Gousiou, Anthi

    2016-01-01

    This paper presents a 10-year review study that focuses on the investigation of the use of computer card games (CCGs) as learning tools in Computer Science (CS) Education. Specific search terms keyed into 10 large scientific electronic databases identified 24 papers referring to the use of CCGs for the learning of CS matters during the last…

  17. Regular aquatic exercise for chronic kidney disease patients: a 10-year follow-up study.

    PubMed

    Pechter, Ülle; Raag, Mait; Ots-Rosenberg, Mai

    2014-09-01

    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.

  18. Relationship between Motor Skill and Body Mass Index in 5- to 10-Year-Old Children

    ERIC Educational Resources Information Center

    D'Hondt, Eva; Deforche, Benedicte; De Bourdeaudhuij, Ilse; Lenoir, Matthieu

    2009-01-01

    The purpose of this study was to investigate gross and fine motor skill in overweight and obese children compared with normal-weight peers. According to international cut-off points for Body Mass Index (BMI) from Cole et al. (2000), all 117 participants (5-10 year) were classified as being normal-weight, overweight, or obese. Level of motor skill…

  19. 24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured...

  20. 24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured...

  1. 24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured...

  2. 24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured...

  3. 7 CFR Exhibit L to Subpart A of... - Insured 10-Year Home Warranty Plan Requirements

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 12 2014-01-01 2013-01-01 true Insured 10-Year Home Warranty Plan Requirements L Exhibit L to Subpart A of Part 1924 Agriculture Regulations of the Department of Agriculture (Continued... Construction and Other Development Pt. 1924, Subpt. A, Exh. L Exhibit L to Subpart A of Part 1924—Insured...

  4. 7 CFR Exhibit L to Subpart A of... - Insured 10-Year Home Warranty Plan Requirements

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 12 2013-01-01 2013-01-01 false Insured 10-Year Home Warranty Plan Requirements L Exhibit L to Subpart A of Part 1924 Agriculture Regulations of the Department of Agriculture (Continued... Construction and Other Development Pt. 1924, Subpt. A, Exh. L Exhibit L to Subpart A of Part 1924—Insured...

  5. 7 CFR Exhibit L to Subpart A of... - Insured 10-Year Home Warranty Plan Requirements

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 12 2011-01-01 2011-01-01 false Insured 10-Year Home Warranty Plan Requirements L Exhibit L to Subpart A of Part 1924 Agriculture Regulations of the Department of Agriculture (Continued... Construction and Other Development Pt. 1924, Subpt. A, Exh. L Exhibit L to Subpart A of Part 1924—Insured...

  6. 7 CFR Exhibit L to Subpart A of... - Insured 10-Year Home Warranty Plan Requirements

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 12 2012-01-01 2012-01-01 false Insured 10-Year Home Warranty Plan Requirements L Exhibit L to Subpart A of Part 1924 Agriculture Regulations of the Department of Agriculture (Continued... Construction and Other Development Pt. 1924, Subpt. A, Exh. L Exhibit L to Subpart A of Part 1924—Insured...

  7. Anticipatory Action Planning Increases from 3 to 10 Years of Age in Typically Developing Children

    ERIC Educational Resources Information Center

    Jongbloed-Pereboom, Marjolein; Nijhuis-van der Sanden, Maria W. G.; Saraber-Schiphorst, Nicole; Craje, Celine; Steenbergen, Bert

    2013-01-01

    The primary aim of this study was to assess the development of action planning in a group of typically developing children aged 3 to 10 years (N = 351). The second aim was to assess reliability of the action planning task and to relate the results of the action planning task to results of validated upper limb motor performance tests. Participants…

  8. Percutaneous transluminal angioplasty for carotid artery stenosis in Takayasu arteritis: persistent benefit over 10 years.

    PubMed

    Murakami, R; Korogi, Y; Matsuno, Y; Matsukawa, T; Hirai, T; Takahashi, M

    1997-01-01

    A 66-year-old man was admitted to our hospital with right hemiplegia due to a cerebral infarction associated with Takayasu arteries. We successfully performed percutaneous transluminal angioplasty for stenoses of the innominate and right common carotid arteries. Improvement of the stenotic lesions persisted over 10 years.

  9. A 10-Year Assessment of Information and Communication Technology Tasks Required in Undergraduate Agriculture Courses

    ERIC Educational Resources Information Center

    Edgar, Leslie D.; Johnson, Donald M.; Cox, Casandra

    2012-01-01

    This study sought to assess required information and communication technology (ICT) tasks in selected undergraduate agriculture courses in a land-grant university during a 10-year period. Selected agriculture faculty members in the fall 1999 (n = 63), 2004 (n = 55), and 2009 (n = 64) semesters were surveyed to determine the ICT tasks they required…

  10. Is the Party Over? Cannabis and Juvenile Psychiatric Disorder: The Past 10 Years

    ERIC Educational Resources Information Center

    Rey, Joseph M.; Martin, Andres; Krabman, Peter

    2004-01-01

    Objective: To critically review cannabis research during the past 10 years in relation to rates of use, behavioral problems, and mental disorders in young people. Method: Studies published in English between 1994 and 2004 were identified through systematic searches of literature databases. The material was selectively reviewed focusing on child…

  11. Psychiatric Aspects of Child and Adolescent Obesity: A Review of the Past 10 Years

    ERIC Educational Resources Information Center

    Zametkin, Alan J.; Zoon, Christine K.; Klein, Hannah W.; Munson, Suzanne

    2004-01-01

    Objective: To review the past 10 years of published research on psychiatric aspects of child and adolescent obesity and highlight information mental health professionals need for preventing obesity in youths and diagnosing and treating it. Method: Researchers performed computerized and manual searches of the literature and summarized the most…

  12. Clinical and Radiographic Evaluation of a Resin-Based Root Canal Sealer: 10-Year Recall Data

    PubMed Central

    Zmener, Osvaldo; Pameijer, Cornelis H.

    2012-01-01

    Objectives. This retrospective clinical and radiographical study evaluated the 10-year outcome of one-visit endodontic treatment with gutta-percha and a methacrylate resin-based sealer. Methods. From an initial sample size of 180 patients, 89 patients with 175 root canals responded to a recall. Treatment outcome was based on predetermined clinical and radiographic criteria. Results. Root canals had been adequately filled to the working length in 80 teeth (89.88%), short in 6 instances (6.74%), while 3 (3.37%) with extrusion immediate postoperatively, showed no sealer in periradicular tissues. The difference in the outcomes of treatments with respect to age, gender, preoperative pulp or periapical status, the size of periapical lesions and the type of permanent restorations were not statistically significantly different (P > 0.05). Overall, 7 (7.86%) cases were considered clinically and radiographically a failure. A life table analysis showed a cumulative probability of success of 92.13% after 10 years with a 95% confidence interval of 83.0 to 94.0. Conclusions. The results of this retrospective clinical and radiographical study suggest that the tested methacrylate-resin based sealer used with gutta-percha performed similarly to other root canal sealers over a period 10 years. Clinical Implications. Considering the success rate after 10 years of this methacrylate resin-based sealer can be recommended as an alternative to other commonly used root canal sealers. PMID:22654909

  13. Psychosocial Family Treatment for a 10-Year-Old with Schizoaffective Disorder

    ERIC Educational Resources Information Center

    Klaus, Nicole M.; Fristad, Mary A.; Malkin, Catherine; Mackinaw-Koons, Barbara

    2008-01-01

    Schizophrenia spectrum disorders are rare in childhood and little is known about their psychosocial treatment. Relevant findings from the adult and child literature are reviewed. The case of 10-year-old "Michael" is presented, who participated in a randomized clinical trial of a psychoeducational family treatment for mood disorders. Following…

  14. Educational Attainment of 10-Year-Old Children with Treated and Untreated Visual Defects.

    ERIC Educational Resources Information Center

    Stewart-Brown, Sarah; And Others

    1985-01-01

    Children with visual impairments who participated in a 10-year survey were compared with peers on measures of intelligence, reading, mathematics, and sporting ability. Results are consistent with earlier findings of increased intelligence among Ss with myopia and slightly reduced intelligence among Ss with amblyopia. It was concluded that the…

  15. Handedness in Swedish 10-year-olds, Some Background and Associated Factors.

    ERIC Educational Resources Information Center

    Gillberg, Christopher; And Others

    1984-01-01

    Aims to obtain prevalence figures for left-handedness among 10-year-old Swedish children; to replicate some findings concerning Bishop's (1980) extended pathological left-handedness hypothesis; to evaluate the influence of factors such as the child's sex and reduced optimality in the pre-, peri-, and neonatal period; and to determine the…

  16. Researching and Understanding Environmental Learning: Hopes for the Next 10 Years

    ERIC Educational Resources Information Center

    Rickinson, Mark

    2006-01-01

    The tenth anniversary of "Environmental Education Research" comes at an interesting time. The next 10 years of the journal overlap with the United Nation's Decade for Education for Sustainable Development, with the possibilities that this may (or may not) bring for those working at the intersections of education and sustainable…

  17. Parent-Child Relations and Adolescent Self-Image Following Divorce: A 10-Year Study.

    ERIC Educational Resources Information Center

    Dunlop, Rosemary; Burns, Ailsa; Bermingham, Suzanne

    2001-01-01

    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…

  18. United States Transportation Command: 10 Years of Excellence, 1987-1997

    DTIC Science & Technology

    1997-01-01

    Military Sealift Command-chartered vessel at the port of Mogadishu, Somalia. 18 10 YEARS OF EXCELLENCE 1993 Acting Secretary of Defense Donald J. Atwood ...thanks are extended to James K. Matthews, Ph.D., and Margaret �Peg� Nigra for their help in the preparation of this book. Citations: In addition to

  19. Individual Oral Exams in Mathematics Courses: 10 Years of Experience at the Air Force Academy

    ERIC Educational Resources Information Center

    Boedigheimer, Ralph; Ghrist, Michelle; Peterson, Dale; Kallemyn, Benjamin

    2015-01-01

    Over the last 10 years faculty members in the Department of Mathematical Sciences at the United States Air Force Academy have incorporated individual oral exams into mathematics courses. We have experimented with various approaches, shared results and ideas with other department members, and refined our techniques. We have found that this…

  20. If We Could Plan the Next 10 Years in Science Education...

    ERIC Educational Resources Information Center

    Mansell, Warwick

    2013-01-01

    Two major sessions at the 2013 ASE Summer Celebration Conference in Hatfield offered teachers (and other educators) the chance to debate and define the key issues facing science education over the next 10 years. Participants were asked to suggest the important issues. Then those with similar proposals were put into groups to develop the idea ready…

  1. Re-Visited: A Tracer Study 10 Years Later--Detective Process

    ERIC Educational Resources Information Center

    Levin-Rozalis, Miry

    2004-01-01

    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:…

  2. Students as Teachers: Effectiveness of a Peer-Led STEM Learning Programme over 10 Years

    ERIC Educational Resources Information Center

    Drane, Denise; Micari, Marina; Light, Gregory

    2014-01-01

    Peer-led small-group learning has been used quite extensively in the US to enhance performance and retention of undergraduate students in science, math, and engineering classes. This study presents the results from an evaluation of a peer-led small-group programme at a research university in the US over a 10-year period across five disciplines…

  3. Effect of meteorology and soil condition on metolachlor and atrazine volatilization over a 10 year period

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Volatilization of pesticides can detrimentally affect the environment by contaminating soil and surface waters far away from where the pesticides were applied. A 10-year study was conducted to focus on the impact of soil and climatic factors governing herbicide volatilization from an agricultural f...

  4. Effect of meteorology and soil condition on metolachlor and atrazine volatilization over a 10 year period

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A 10-year study was conducted to focus on the impact of soil and climatic factors governing herbicide volatilization from an agricultural field. For the first 5 years, metolachlor [2-chloro-N-(2-ethyl-6-methylphenyl)-N-(2-methoxy-1-methylethyl) acetamide] and atrazine [6-chloro-N-ethyl-N’-(1-methyl...

  5. Childhood Peer Reputation as a Predictor of Competence and Symptoms 10 Years Later

    ERIC Educational Resources Information Center

    Gest, Scott D.; Sesma, Arturo, Jr.; Masten, Ann S.; Tellegen, Auke

    2006-01-01

    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…

  6. 10 Years of "Adult Learning": Content Analysis of an Academic Journal

    ERIC Educational Resources Information Center

    Cherrstrom, Catherine A.; Robbins, Stacey E.; Bixby, John

    2017-01-01

    Academic publications provide insights into a discipline's history, knowledge base, and research norms, and thus analyzing publication activity provides learning about the field of study. To learn more about the field of adult and continuing education, this study used content analysis to examine 10 years of "Adult Learning" from 2006…

  7. A Content Analysis of 10 Years of Clinical Supervision Articles in Counseling

    ERIC Educational Resources Information Center

    Bernard, Janine M.; Luke, Melissa

    2015-01-01

    This content analysis follows Borders's (2005) review of counseling supervision literature and includes 184 counselor supervision articles published over the past 10 years. Articles were coded as representing 1 of 3 research types or 1 of 3 conceptual types. Articles were then analyzed for main topics producing 11 topic categories.

  8. Stress Generation, Avoidance Coping, and Depressive Symptoms: A 10-Year Model

    ERIC Educational Resources Information Center

    Holahan, Charles J.; Moos, Rudolf H.; Holahan, Carole K.; Brennan, Penny L.; Schutte, Kathleen K.

    2005-01-01

    This study examined (a) the role of avoidance coping in prospectively generating both chronic and acute life stressors and (b) the stress-generating role of avoidance coping as a prospective link to future depressive symptoms. Participants were 1,211 late-middle-aged individuals (500 women and 711 men) assessed 3 times over a 10-year period. As…

  9. The Impact of 10 Years of War on Combat Casualty Care Research: A Citation Analysis

    DTIC Science & Technology

    2012-01-01

    The impact of 10 years of war on combat casualty care research: A citation analysis Jean A. Orman, ScD, MPH, Brian J. Eastridge, MD, David G. Baer...J. 2011;82Y86. 28. Eastridge BJ, Hardin M, Cantrell J, et al. Died of wounds on the battle- field: causation and implications for improving combat

  10. Gasoline Abuse in a 10-Year-Old Child with Mental Retardation: A Case Report

    PubMed Central

    Joshi, Mohit; Vankar, GK

    2015-01-01

    Inahalant abuse is of increasing interest in India. The age of onset is typically during adolescence. Gasoline inhalant use is rarely reported in adolescents with intellectual deficit. We report a case of petrol dependence in a 10-year-old child with mental retardation. Possible effect of petrol huffing on behavior and cognition is discussed. PMID:25733844

  11. Case Report: Homicide by a 10-Year-Old Girl with Autistic Disorder

    ERIC Educational Resources Information Center

    Mukaddes, Nahit Motavalli; Topcu, Zerrin

    2006-01-01

    This case study presents a 10-year-old girl with a diagnosis of Autistic Disorder, who killed her 6-month-old sister by throwing her out of a window. Her aggressive-impulsive behavior had a persistent pattern. She had a history of epilepsy, and was frequently exposed to physical abuse. She never attended a structured treatment program. Here, we…

  12. Psychopathy and Offending From Adolescence to Adulthood: A 10-Year Follow-Up

    ERIC Educational Resources Information Center

    Gretton, Heather M.; Hare, Robert D.; Catchpole, Rosalind E. H.

    2004-01-01

    This study examined the predictive validity of the Hare Psychopathy Checklist: Youth Version (PCL:YV; A. E. Forth, D. S. Kosson, & R. D. Hare, 2003) from adolescence to early adulthood. The authors coded the PCL:YV using file information and collected criminal record information over a 10-year follow-up period on 157 boys, ages 12 through 18,…

  13. Langerhans cell histiocytosis: recurrent lesions affecting mandible in a 10-year-old patient.

    PubMed

    Loducca, S V; Mantesso, A; Araújo, N S; Magalhães, M H

    2001-01-01

    Hand-Schuller-Christian disease is a multifocal variant of eosinophilic granuloma, characterised by the classical triad of bony lesions, exophthalmos and diabetes insipidus. This case relates recurrent Langerhans' cell histiocytosis lesions presented as destruction of periodontal support associated with diabetes in a 10-year-old patient. Medical history suggests that the case represents a case of Hand-Schuller Christian disease.

  14. Personnel Needs in School Psychology: A 10-Year Follow-Up Study on Predicted Personnel Shortages

    ERIC Educational Resources Information Center

    Castillo, Jose M.; Curtis, Michael J.; Tan, Sim Yin

    2014-01-01

    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…

  15. Optimism, Pessimism, Mutuality, and Gender: Predicting 10-Year Role Strain in Parkinson's Disease Spouses

    ERIC Educational Resources Information Center

    Lyons, Karen S.; Stewart, Barbara J.; Archbold, Patricia G.; Carter, Julie H.

    2009-01-01

    Purpose: There is wide variability in how spouses providing care respond to their care situations. Few studies focus on the roles of both intra- and interpersonal factors in long-term spousal care, particularly in the context of Parkinson's disease (PD). The current study uses longitudinal data over a 10-year period to examine the roles of…

  16. Eastern Michigan University's Automated Storage and Retrieval System: 10 Years Later

    ERIC Educational Resources Information Center

    Bullard, Rita; Wrosch, Jackie

    2009-01-01

    Automated storage/retrieval systems (ASRSs) are playing an integral part in today's library operations and collections management. Eastern Michigan University installed an ASRS as part of the new Halle Library, which opened in May 1998, to provide "storage" for up to 800,000 items. Over the past 10 years our policies and procedures have…

  17. Frontal Electroencephalogram Activation Asymmetry, Emotional Intelligence, and Externalizing Behaviors in 10-Year-Old Children

    ERIC Educational Resources Information Center

    Santesso, L. Diane; Dana, L. Reker; Schmidt, Louis A.; Segalowitz, Sidney J.

    2006-01-01

    The purpose of the present study was to examine the relations among resting frontal brain electrical activity (EEG) (hypothesized to reflect a predisposition to positive versus negative affect and ability to regulate emotions), emotional intelligence, and externalizing behaviors in a sample of non-clinical 10-year-old children. We found that boys…

  18. Motor Skills in Children Aged 7-10 Years, Diagnosed with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Whyatt, Caroline P.; Craig, Cathy M.

    2012-01-01

    This study used the Movement Assessment Battery for Children (M-ABC2) to assess motor skills in children aged 7-10 years with autism (n = 18) in comparison to two groups of age-matched typically developing children; a receptive vocabulary matched group (n = 19) and a nonverbal IQ matched group (n = 22). The results supported previous work, as…

  19. Digital thermal monitoring of vascular function: a novel tool to improve cardiovascular risk assessment.

    PubMed

    Gul, Khawar M; Ahmadi, Naser; Wang, Zhiying; Jamieson, Craig; Nasir, Khurram; Metcalfe, Ralph; Hecht, Harvey S; Hartley, Craig J; Naghavi, Morteza

    2009-05-01

    Digital thermal monitoring (DTM) of vascular function during cuff-occlusive reactive hyperemia relies on the premise that changes in fingertip temperature during and after an ischemic stimulus reflect changes in blood flow. To determine its utility in individuals with and without known coronary heart disease (CHD), 133 consecutive individuals (age 54 +/- 10 years, 50% male, 19 with known CHD) underwent DTM during and after 2 minutes of supra-systolic arm cuff inflation. Fingertip temperatures of the occluded and non-occluded fingertips were measured simultaneously. Post-cuff deflation temperature rebound (TR) was lower in the CHD patients and in those with an increased Framingham risk score (FRS) compared to the normal group. After adjustment for age, sex, and cardiac risk factors, TR was significantly lower in those with CHD compared to those without CHD (p < 0.05). This study demonstrates that vascular dysfunction measured by DTM is associated with CHD and an increased FRS, and could potentially be used to identify high-risk patients.

  20. Serum urate gene associations with incident gout, measured in the Framingham Heart Study, are modified by renal disease and not by body mass index

    PubMed Central

    Reynolds, Richard J.; Vazquez, Ana I.; Srinivasasainagendra, Vinodh; Klimentidis, Yann C.; Bridges, S. Louis; Allison, David B.; Singh, Jasvinder A.

    2015-01-01

    Introduction/objectives We hypothesized that serum urate-associated SNPs, individually or collectively, interact with BMI and renal disease to contribute to risk for incident gout. Method We measured the incidence of gout and associated comorbidities using the Original and Offspring cohorts of the Framingham Heart Study. We used direct and imputed genotypes for eight validated serum urate loci. We fit binomial regression models of gout incidence as a function of the covariates, age, type 2 diabetes, sex, and all main and interaction effects of the eight serum urate SNPs with BMI and renal disease. Models were also fit with a genetic risk score for serum urate levels which corresponds to the sum of risk alleles at the 8 SNPs. Results Model covariates, age (P = 5.95E-06), sex (P = 2.46E-39), diabetes (P = 2.34E-07), BMI (P = 1.14E-11) and the SNPs, rs1967017 (P = 9.54E-03), rs13129697 (P = 4.34E-07), rs2199936 (P = 7.28E-03) and rs675209 (P = 4.84E-02) were all associated with incident gout. No BMI by SNP or BMI by serum urate genetic risk score (GRS) interactions were statistically significant, but renal disease by rs1106766 was statistically significant (P=6.12E-03). Conclusions We demonstrated that minor alleles of rs1106766 (intergenic, INHBC) were negatively associated with the risk of incident gout in subjects without renal disease, but not for individuals with renal disease. These analyses demonstrate that a significant component of the risk for gout may involve complex interplay between genes and environment. PMID:26427508

  1. Serum urate gene associations with incident gout, measured in the Framingham Heart Study, are modified by renal disease and not by body mass index.

    PubMed

    Reynolds, Richard J; Vazquez, Ana I; Srinivasasainagendra, Vinodh; Klimentidis, Yann C; Bridges, S Louis; Allison, David B; Singh, Jasvinder A

    2016-02-01

    We hypothesized that serum urate-associated SNPs, individually or collectively, interact with BMI and renal disease to contribute to risk of incident gout. We measured the incidence of gout and associated comorbidities using the original and offspring cohorts of the Framingham Heart Study. We used direct and imputed genotypes for eight validated serum urate loci. We fit binomial regression models of gout incidence as a function of the covariates, age, type 2 diabetes, sex, and all main and interaction effects of the eight serum urate SNPs with BMI and renal disease. Models were also fit with a genetic risk score for serum urate levels which corresponds to the sum of risk alleles at the eight SNPs. Model covariates, age (P = 5.95E-06), sex (P = 2.46E-39), diabetes (P = 2.34E-07), BMI (P = 1.14E-11) and the SNPs, rs1967017 (P = 9.54E-03), rs13129697 (P = 4.34E-07), rs2199936 (P = 7.28E-03) and rs675209 (P = 4.84E-02) were all associated with incident gout. No BMI by SNP or BMI by serum urate genetic risk score interactions were statistically significant, but renal disease by rs1106766 was statistically significant (P = 6.12E-03). We demonstrated that minor alleles of rs1106766 (intergenic, INHBC) were negatively associated with the risk of incident gout in subjects without renal disease, but not for individuals with renal disease. These analyses demonstrate that a significant component of the risk of gout may involve complex interplay between genes and environment.

  2. FACTORS ASSOCIATED WITH STRESS AND COPING AT 5 AND 10 YEARS AFTER HEART TRANSPLANTATION

    PubMed Central

    Grady, Kathleen L.; Wang, Edward; White-Williams, Connie; Naftel, David C.; Myers, Susan; Kirklin, James K.; Rybarczyk, Bruce; Young, James B.; Pelegrin, Dave; Kobashigawa, Jon; Higgins, Robert; Heroux, Alain

    2013-01-01

    Background Heart transplant-related stressors and coping are related to poor outcomes early after transplant. The purposes of our study were to (1) identify the most frequent and bothersome stressors and most used and effective coping strategies, and (2) compare the most frequent and bothersome stresses and most used and effective coping styles between patients at 5 and 10 years after heart transplantation. We also examined differences in coping styles by patient characteristics, and factors associated with frequency and intensity of stress at both 5 and 10 years after heart transplantation. Methods This report is a secondary analysis of data from a prospective, multi-site study of quality of life outcomes. Data are from 199 and 98 patients at 5 and 10 years after transplant, respectively. Patients completed the Heart Transplant Stressor Scale and Jalowiec Coping Scale. Statistical analyses included frequencies, measures of central tendency, t-tests, Chi-square and generalized linear models. Results At 5 and 10 years after heart transplantation, the most bothersome stressors were regarding work, school, and financial issues. Patients who were 10 years post transplant reported less stress, similar stress intensity, and less use and perceived effectiveness of negative coping than patients who were 5 years post transplant. Long-term after transplant, demographic characteristics, psychological problems, negative coping, and clinical factors were related to stress frequency and/or intensity. Conclusions Heart transplant-related stress occurs long-term after surgery. Types of transplant-related stress and factors related to stress confirm the importance of ongoing psychological and clinical support after heart transplantation. PMID:23498164

  3. Education status determines 10-year (2002-2012) survival from cardiovascular disease in Athens metropolitan area: the ATTICA study, Greece.

    PubMed

    Panagiotakos, Demosthenes; Georgousopoulou, Ekavi; Notara, Venetia; Pitaraki, Evangelia; Kokkou, Eleni; Chrysohoou, Christina; Skoumas, Yannis; Metaxa, Vassiliki; Pitsavos, Christos; Stefanadis, Christodoulos

    2016-05-01

    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

  4. A longitudinal examination of 10-year change in vocational and educational activities for adults with autism spectrum disorders.

    PubMed

    Taylor, Julie Lounds; Mailick, Marsha R

    2014-03-01

    The transition from adolescence to adulthood has been shown to be a time of amplified risk for individuals with autism spectrum disorders (ASD). It is unknown, however, whether problems in educational attainment and employment in the years after high school exit represent momentary perturbations in development or a turning point with long-lasting effects throughout adulthood. The present study addressed this question by examining 10-year trajectories of vocational and educational activities for adults with ASD, as well as the personal characteristics and environmental resources that predicted these activities. Participants were 161 adults with ASD (ages 18-52 years at the start of the study; M = 30.9) who were part of a larger longitudinal study. Data were collected at 6 time points over a 10-year period. Results indicated significant declines in the level of independence and engagement in vocational/educational activities over the study period, particularly for women. Greater independence in vocational activities was found for those with more independence in activities of daily living. After controlling for personal characteristics, receipt of more services was marginally related to greater improvement in vocational independence.

  5. Personality of parents with bipolar disorder and interpersonal functioning among their offspring: a prospective 10-year study.

    PubMed

    Ostiguy, Caroline S; Ellenbogen, Mark A; Hodgins, Sheilagh

    2012-05-01

    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.

  6. Metabolic disorders and cardiovascular risk in treatment-naive HIV-infected patients of sub-saharan origin starting antiretrovirals: impact of westernized lifestyle.

    PubMed

    Eholié, Serge Paul; Lacombe, Karine; Krain, Alysa; Diallo, Zelica; Ouiminga, Mariama; Campa, Pauline; Bouchaud, Olivier; Bissagnene, Emmanuel; Girard, Pierre-Marie

    2015-04-01

    In a cohort of HIV-infected patients of sub-Saharan origin we describe the incidence of metabolic syndrome, insulin resistance, and lipodystrophy after 3 years of combined antiretroviral therapy, and model the 10-year risk of cardiovascular diseases, while taking into account environmental factors. This is a multinational, prospective cohort study conducted in HIV outpatient clinics from four tertiary care centers set in France and Côte d'Ivoire. The participants were HIV-infected, treatment-naive patients eligible to start antiretroviral treatment and were of sub-Saharan African origin. The main outcome measures were the incidence of metabolic syndrome, insulin resistance, and lipodystrophy, and the assessment of the 10-year risk of cardiovascular diseases using Framingham risk prediction, D.A.D. Cardiovascular Disease Risk, and WHO/ISH prediction charts. Of 245 patients followed for up to 3 years, the incidence of metabolic syndrome, insulin resistance, and lipodystrophy was 5.5, 8.5, and 6.8 per 100 person-years of follow-up (cumulative incidence: 14.4%, 19.2%, and 18.1%, respectively). Living in France as well as female gender and being overweight were risk factors for metabolic disorders as whole and only first generation protease inhibitors were marginally associated with metabolic syndrome. Cardiovascular risk as modeled through the three equations was high in all patients with the synergistic and deleterious effect of living in France compared to Côte d'Ivoire. This cohort study shows how the synergy between HIV, antiretroviral (ARV) exposure, and westernization of life style in a cohort of HIV-infected patients of sub-Saharan origin leads to a progressive increase in the risk of lipodystrophy, as well as metabolic syndrome and insulin resistance, all associated with increased cardiovascular risk.

  7. Accelerated Aging Influences Cardiovascular Disease Risk in Rheumatoid Arthritis

    PubMed Central

    Crowson, Cynthia S.; Therneau, Terry M.; Davis, John M.; Roger, Véronique L.; Matteson, Eric L.; Gabriel, Sherine E.

    2014-01-01

    OBJECTIVE To determine whether the impact of aging on cardiovascular disease (CVD) risk in the general population (as estimated by the Framingham risk score [FRS]) differs in patients with rheumatoid arthritis (RA). METHODS A population-based inception cohort of Olmsted County, Minnesota residents aged ≥30 years who fulfilled 1987 ACR criteria for RA in 1988–2008 was assembled and followed until death, migration, or 7-1-2012. Data on CVD events were collected by medical record review. The 10-year FRS for CVD was calculated. Cox models adjusted for FRS were used to examine the influence of age on CVD risk. RESULTS The study included 563 patients with RA without prior CVD (mean age: 55 years, 72% women; 69% seropositive [i.e., rheumatoid factor and/or anti-citrullinated protein antibody positive]). During a mean follow-up of 8.2 years, 98 patients developed CVD (74 seropositive and 24 seronegative), but FRS predicted only 59.7 events (35.4 seropositive and 24.3 seronegative). The gap between observed and predicted CVD risk increased exponentially across age, and the age effect on CVD risk in seropositive RA was nearly double its effect in the general population with additional log(age) coefficients of 2.91 for women (p=0.002) and 2.06 for men (p=0.027). CONCLUSION Age exerts an exponentially increasing effect on CVD risk in seropositive RA, but no increased effect among seronegative patients. The causes of accelerated aging in patients with seropositive RA deserve further investigation. PMID:23818136

  8. Impact of physical activity category on incidence of cardiovascular disease: Results from the 10-year follow-up of the ATTICA Study (2002-2012).

    PubMed

    Tambalis, Konstantinos D; Panagiotakos, Demosthenes B; Georgousopoulou, Ekavi N; Mellor, Duane D; Chrysohoou, Christina; Kouli, Georgia-Maria; Tousoulis, Dimitrios; Stefanadis, Christodoulos; Pitsavos, Christos

    2016-12-01

    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.

  9. Review of 10 years of marketing experience with Chinese domestic inactivated hepatitis A vaccine Healive®

    PubMed Central

    Wu, Jun-Yu; Liu, Yan; Chen, Jiang-Ting; Xia, Ming; Zhang, Xiao-Mei

    2012-01-01

    In 2002, the first Chinese domestic preservative-free inactivated hepatitis A vaccine, Healive®, was introduced in China. It is highly immunogenic, and provides lasting protection in healthy individuals and generates protective levels of antibodies in other at-risk individuals. Over 10 years since its first licensure, postmarketing surveillance data have confirmed the outstanding safety profile of the vaccine. Comparative clinical trials indicated that Healive® induce equal or similar immunogenicity with other currently available inactivated hepatitis A vaccines and are interchangeable for the course of HAV immunization in Chinese children. The vaccine is effective in curbing outbreaks of hepatitis A due to rapid seroconversion and the long incubation period of the disease. Additional issues surrounding the use of the vaccine are also reviewed. PMID:23032165

  10. Rugby injuries to the cervical spine and spinal cord: a 10-year review.

    PubMed

    Scher, A T

    1998-01-01

    A 10-year review (1987-1996) of injuries sustained to the spine and spinal cord in rugby players with resultant paralysis has been undertaken. This article reviews that the incidence of serious rugby spine and spinal cord injuries in South Africa has increased over the 10-year period reviewed, despite stringent new rules instituted in an attempt to decrease the incidence of these injuries. The mechanisms of injury, as previously reported, remain the same as well as the phases of game responsible for injury of the tight scrum, tackle, rucks, and mauls. Two new observations are reported: the first is related to the occurrence of spinal cord concussion with transient paralysis, and the second is related to the increased incidence of osteoarthritis of the cervical spine in rugby players.

  11. Patterns of treatment utilization and methamphetamine use during first 10 years after methamphetamine initiation.

    PubMed

    Brecht, Mary-Lynn; Lovinger, Katherine; Herbeck, Diane M; Urada, Darren

    2013-01-01

    The study examined joint trajectories of methamphetamine (MA) use and substance abuse treatment utilization and identified differences among pattern groups for a sample of 348 treated for MA use. Results from group-based trajectory modeling showed that treatment utilization during the first 10 years after initiation of MA use could be categorized into three distinctive patterns: about half the MA users have a pattern of low treatment utilization; one-fourth follow a quicker-to-treatment trajectory with higher probability of treatment during the first 5 years of MA use and less treatment in the next 5 years; and one-fourth have a slower-to-treatment trajectory with more treatment during the second half of the 10-year period. Four MA use patterns were identified: consistently low use, moderate, and high use, as well as a decreasing use pattern. Periods of greater likelihood of treatment participation were associated with periods of decreasing or lower frequency of MA use.

  12. Physical aggression, compromised social support, and 10-year marital outcomes: Testing a relational spillover model.

    PubMed

    Sullivan, Kieran T; Pasch, Lauri A; Lawrence, Erika; Bradbury, Thomas N

    2015-12-01

    The purpose of the present study was to test a relational spillover model of physical aggression whereby physical aggression affects marital outcomes due to its effects on how spouses ask for and provide support to one another. Newlywed couples (n = 172) reported levels of physical aggression over the past year and engaged in interactions designed to elicit social support; marital adjustment, and stability were assessed periodically over the first 10 years of marriage. Multilevel modeling revealed that negative support behavior mediated the relationship between physical aggression and 10-year marital adjustment levels whereas positive support behavior mediated the relationship between physical aggression and divorce status. These findings emphasize the need to look beyond conflict when explaining how aggression affects relationships and when working with couples with a history of physical aggression who are seeking to improve their relationships.

  13. Stress Generation, Avoidance Coping, and Depressive Symptoms: A 10-Year Model

    PubMed Central

    Holahan, Charles J.; Moos, Rudolf H.; Holahan, Carole K.; Brennan, Penny L.; Schutte, Kathleen K.

    2011-01-01

    This study examined (a) the role of avoidance coping in prospectively generating both chronic and acute life stressors and (b) the stress-generating role of avoidance coping as a prospective link to future depressive symptoms. Participants were 1,211 late-middle-aged individuals (500 women and 711 men) assessed 3 times over a 10-year period. As predicted, baseline avoidance coping was prospectively associated with both more chronic and more acute life stressors 4 years later. Furthermore, as predicted, these intervening life stressors linked baseline avoidance coping and depressive symptoms 10 years later, controlling for the influence of initial depressive symptoms. These findings broaden knowledge about the stress-generation process and elucidate a key mechanism through which avoidance coping is linked to depressive symptoms. PMID:16173853

  14. Laboratory investigation of monoclonal gammopathy during 10 years of screening in a general hospital.

    PubMed Central

    Malacrida, V; De Francesco, D; Banfi, G; Porta, F A; Riches, P G

    1987-01-01

    Protein electrophoresis was carried out on 102,000 samples from the patients of a district general hospital over 10 years, and a monoclonal protein was detected in 730 cases; of these, 114 could be classified as B cell malignancies and 261 as monoclonal gammopathy of undefined significance (MGUS). The various clinical and laboratory features of monoclonal gammopathy were examined with respect to distinguishing the malignant conditions from MGUS at first presentation. PMID:3114329

  15. Design of carbon therapy facility based on 10 years experience at HIMAC

    NASA Astrophysics Data System (ADS)

    Noda, K.; Furukawa, T.; Iwata, Y.; Kanai, T.; Kanazawa, M.; Kanematsu, N.; Kitagawa, A.; Komori, M.; Minohara, S.; Murakami, T.; Muramatsu, M.; Sato, S.; Sato, Y.; Shibuya, S.; Torikoshi, M.; Yamada, S.

    2006-06-01

    Since 1994, the clinical trial for cancer therapy with HIMAC has successfully progressed, and more than 2100 cancer patients have been treated with a carbon beam. Based on the development of the accelerator and irradiation technologies for 10 years, we have designed a new carbon-therapy facility for widespread use in Japan, and key technologies for the new facility have been developed. We describe the conceptual design of the new facility and the status of development for the key technologies.

  16. Changes in Pulmonary Function Up to 10 Years After Locoregional Breast Irradiation

    SciTech Connect

    Erven, Katrien; Weltens, Caroline; Nackaerts, Kristiaan; Fieuws, Steffen; Decramer, Marc; Lievens, Yolande

    2012-02-01

    Purpose: To evaluate the long-term impact of locoregional breast radiotherapy (RT) on pulmonary function tests (PFTs). Methods and Materials: This study included 75 women who underwent postoperative locoregional breast RT. PFTs were performed before RT and 3, 6, and 12 months and 8 to 10 years after RT. By use of univariate and multivariate analyses, the impact of treatment- and patient-related factors on late changes in PFTs was evaluated. Results: During the first year after RT, all PFTs significantly worsened at 3 to 6 months after RT (p < 0.05). At 12 months, forced vital capacity (FVC), vital capacity (VC), and forced expiratory volume in 1 second (FEV{sub 1}) recovered almost to baseline values, whereas total lung capacity (TLC) and diffusion capacity of carbon monoxide (DL{sub CO}) recovered only slightly and were still found to be decreased compared with baseline (p < 0.05). At 8 to 10 years after RT, mean reductions in FEV{sub 1} of 4% (p = 0.03) and in VC, DL{sub CO}, and TLC of 5%, 9%, and 11% (all p < 0.0001), respectively, were observed compared with pre-RT values. On multivariate analysis, tamoxifen use negatively affected TLC at 8 to 10 years after RT (p = 0.033), whereas right-sided irradiation was associated with a late reduction in FEV{sub 1} (p = 0.027). For FEV{sub 1} and DL{sub CO}, an early decrease was predictive for a late decrease (p = 0.003 and p = 0.0009, respectively). Conclusions: The time course of PFT changes after locoregional RT for breast cancer follows a biphasic pattern. An early reduction in PFTs at 3 to 6 months with a partial recovery at 12 months after RT is followed by a late, more important PFT reduction up to 8 to 10 years after RT. Tamoxifen use may have an impact on this late decline in PFTs.

  17. The first 10 years of the American Board of Vascular Medicine.

    PubMed

    Gray, Bruce H; Jaff, Michael R; Slovut, David Paul; Bacharach, J Michael; Carman, Terry; Creager, Mark; Halperin, Jonathon; von Mering, Gregory; Kinlay, Scott

    2015-02-01

    The American Board of Vascular Medicine (ABVM) was conceived through the Society for Vascular Medicine and this year will complete 10 years of certifying physicians who practice vascular medicine and endovascular medicine. The value of certification to our physicians, patients, and field cannot be understated. This paper reviews the highlights of the test development process, quality assurance measures, and management of these high stakes examinations.

  18. The Future of Federated Search, or What Will the World Look like in 10 Years

    ERIC Educational Resources Information Center

    Turner, Rich

    2009-01-01

    In this article, the author contends that in 10 years, federated search--or search of any kind for that matter--won't exist. He elaborates that the "function" of search will exist--but not in a context with which anyone is familiar today. So if "search" doesn't exist in 2018, how will people find the information that they need across vast volumes…

  19. Quality of life 10 years after liver transplantation: The impact of graft histology

    PubMed Central

    Karam, Vincent; Sebagh, Mylène; Rifai, Kinan; Yilmaz, Funda; Bhangui, Prashant; Danet, Colette; Saliba, Faouzi; Samuel, Didier; Castaing, Denis; Adam, René; Feray, Cyrille

    2016-01-01

    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

  20. Examining the 10-year rebuilding dilemma for U.S. fish stocks.

    PubMed

    Patrick, Wesley S; Cope, Jason

    2014-01-01

    Worldwide, fishery managers strive to maintain fish stocks at or above levels that produce maximum sustainable yields, and to rebuild overexploited stocks that can no longer support such yields. In the United States, rebuilding overexploited stocks is a contentious issue, where most stocks are mandated to rebuild in as short a time as possible, and in a time period not to exceed 10 years. Opponents of such mandates and related guidance argue that rebuilding requirements are arbitrary, and create discontinuities in the time and fishing effort allowed for stocks to rebuild due to differences in productivity. Proponents, however, highlight how these mandates and guidance were needed to curtail the continued overexploitation of these stocks by setting firm deadlines on rebuilding. Here we evaluate the statements made by opponents and proponents of the 10-year rebuilding mandate and related guidance to determine whether such points are technically accurate using a simple population dynamics model and a database of U.S. fish stocks to parameterize the model. We also offer solutions to many of the issues surrounding this mandate and its implementation by recommending some fishing mortality based frameworks, which meet the intent of the 10-year rebuilding requirement while also providing more flexibility.

  1. Volumetric growth analysis of an insular dysembryoplastic neuroepithelial tumor over a 10-year follow-up

    PubMed Central

    Uno, Takehiro; Kinoshita, Masashi; Furuta, Takuya; Miyashita, Katsuyoshi; Sabit, Hemragul; Nakada, Mitsutoshi

    2016-01-01

    Background: Dysembryoplastic neuroepithelial tumors (DNETs) are benign tumors characterized by a cortical location; they result in symptoms of drug-resistant partial seizures in children. The development of DNETs is poorly understood because most of them are resected immediately upon diagnosis without any observation period owing to the intractable seizures. Case Description: We report the first DNET case with the growth rate analyzed in the natural course of development for a period of 10 years. The patient was a right-handed man who was initially referred to another hospital with mild head injury when he was 8 years old. A tumor located in the right insular cortex was incidentally detected on magnetic resonance imaging (MRI) and followed-up with annual MRI for 10 years. Conclusion: In this case, the volume of the DNET increased in direct proportion to the length of time in its clinical course. The tumor doubling time was approximately 10 years. This case suggests DNET is a slow-growing but not stable tumor. PMID:28194304

  2. Factors associated with arterial stiffness in children aged 9-10 years

    PubMed Central

    Batista, Milena Santos; Mill, José Geraldo; Pereira, Taisa Sabrina Silva; Fernandes, Carolina Dadalto Rocha; Molina, Maria del Carmen Bisi

    2015-01-01

    OBJECTIVE To analyze the factors associated with stiffness of the great arteries in prepubertal children. METHODS This study with convenience sample of 231 schoolchildren aged 9-10 years enrolled in public and private schools in Vitória, ES, Southeastern Brazil, in 2010-2011. Anthropometric and hemodynamic data, blood pressure, and pulse wave velocity in the carotid-femoral segment were obtained. Data on current and previous health conditions were obtained by questionnaire and notes on the child’s health card. Multiple linear regression was applied to identify the partial and total contribution of the factors in determining the pulse wave velocity values. RESULTS Among the students, 50.2% were female and 55.4% were 10 years old. Among those classified in the last tertile of pulse wave velocity, 60.0% were overweight, with higher mean blood pressure, waist circumference, and waist-to-height ratio. Birth weight was not associated with pulse wave velocity. After multiple linear regression analysis, body mass index (BMI) and diastolic blood pressure remained in the model. CONCLUSIONS BMI was the most important factor in determining arterial stiffness in children aged 9-10 years. PMID:25902563

  3. SY 04-2 LONG-TERM CVD RISK PREDICTION IN LOW-INCIDENCE EUROPEAN POPULATIONS.

    PubMed

    Veronesi, Giovanni

    2016-09-01

    In Italy, the European SCORE Project risk score is the recommended tool for cardiovascular disease risk stratification in the primary prevention setting. Among non-diabetic subjects aged 40 to 64, the model estimates the 10-year probability of death due to cardiovascular disease based on individual's age, total cholesterol, blood pressure and smoking status. A growing body of evidence suggests that in middle-aged adults this stratification may suffer from two major drawbacks. First, mortality risk severely underestimates the global burden of disease incidence. Second, younger individuals and women are likely to be classified in the "low 10-year risk" category despite the presence of risk factors.The latest European and American guidelines have eventually introduced the assessment of long-term risk of disease as additional tool to improve risk communication and increase risk awareness. Long-term risk scores were first developed in the US and in the UK, i.e. in high-risk populations. In low-incidence populations, these models may have poor calibration and discrimination ability, as shown for the Framingham equation. Therefore, our research team developed and validated a 20-year risk score for the Italian population. As part of a collaborative study with the Italian Health Institute, we pooled 7 population-based cohorts of middle-aged individuals recruited in Northern and in Central Italy in mid 1980 s and early 1990 s following a similar protocol with standardized MONICA procedures. Overall, more than 10500 men and women 35-69 years old and free of CVD at baseline, who developed 830 first major atherosclerotic events (coronary heart disease or ischemic strokes) during a median 17 years of follow-up. The score was based on traditional risk factors (age, blood lipids, systolic blood pressure and treatment, smoking and diabetes). In addition, social status and family history of coronary heart disease did improve risk prediction, at least in men. Finally we showed

  4. Cardiovascular risk

    PubMed Central

    Payne, Rupert A

    2012-01-01

    Cardiovascular disease is a major, growing, worldwide problem. It is important that individuals at risk of developing cardiovascular disease can be effectively identified and appropriately stratified according to risk. This review examines what we understand by the term risk, traditional and novel risk factors, clinical scoring systems, and the use of risk for informing prescribing decisions. Many different cardiovascular risk factors have been identified. Established, traditional factors such as ageing are powerful predictors of adverse outcome, and in the case of hypertension and dyslipidaemia are the major targets for therapeutic intervention. Numerous novel biomarkers have also been described, such as inflammatory and genetic markers. These have yet to be shown to be of value in improving risk prediction, but may represent potential therapeutic targets and facilitate more targeted use of existing therapies. Risk factors have been incorporated into several cardiovascular disease prediction algorithms, such as the Framingham equation, SCORE and QRISK. These have relatively poor predictive power, and uncertainties remain with regards to aspects such as choice of equation, different risk thresholds and the roles of relative risk, lifetime risk and reversible factors in identifying and treating at-risk individuals. Nonetheless, such scores provide objective and transparent means of quantifying risk and their integration into therapeutic guidelines enables equitable and cost-effective distribution of health service resources and improves the consistency and quality of clinical decision making. PMID:22348281

  5. Impact of Individual and Neighborhood Factors on Cardiovascular Risk in White Hispanic and Non-Hispanic Women and Men.

    PubMed

    Cohn, Tanya; Miller, Arlene; Fogg, Louis; Braun, Lynne T; Coke, Lola

    2017-04-01

    Cardiovascular disease (CVD) is the leading cause of mortality for adults in the US, regardless of ethnicity. A cross-sectional correlational design was used to describe and compare CVD risk and cardiac mortality in White Hispanic and non-Hispanic women and men. Data from 3,317 individuals (1,523 women and 1,794 men) hospitalized for non-cardiac causes during 2012-2013, and data from the 2010 United States Census were included. The sex-specific 10-year Framingham General Cardiovascular Risk Score (FRS-10) was used to estimate long-term risk for major cardiac events. Approximately three-quarters of the sample was White Hispanic. FRS-10 scores were generally low, but a high prevalence of risk factors not included in the standard FRS-10 scoring formula was seen. White Hispanic women had significantly lower estimated CVD risk scores compared to White Hispanic and non-Hispanic men despite higher non-FRS-10 risks. Neighborhood median household income had a significant negative relationship and Hispanic neighborhood concentration had a significant positive relationship with cardiac mortality. Hispanic concentration was the only predictor of estimated CVD risk in a multilevel model. CVD risk assessment tools that are calibrated for ethnic groups and socioeconomic status may be more appropriate for Hispanic individuals than the FRS-10. Neighborhood-level factors should be included in clinical cardiac assessment in addition to individual characteristics and behavioral risks. Researchers should continue to seek additional risk factors that may contribute to or protect against CVD in order to close the gap between estimated CVD risk and actual cardiac mortality for Hispanics in the US. © 2016 Wiley Periodicals, Inc.

  6. Telomere shortening unrelated to smoking, body weight, physical activity, and alcohol intake: 4,576 general population individuals with repeat measurements 10 years apart.

    PubMed

    Weischer, Maren; Bojesen, Stig E; Nordestgaard, Børge G

    2014-03-01

    Cross-sectional studies have associated short telomere length with smoking, body weight, physical activity, and possibly alcohol intake; however, whether these associations are due to confounding is unknown. We tested these hypotheses in 4,576 individuals from the general population cross-sectionally, and with repeat measurement of relative telomere length 10 years apart. We also tested whether change in telomere length is associated with mortality and morbidity in the general population. Relative telomere length was measured with quantitative polymerase chain reaction. Cross-sectionally at the first examination, short telomere length was associated with increased age (P for trend across quartiles = 3 × 10(-77)), current smoking (P = 8 × 10(-3)), increased body mass index (P = 7 × 10(-14)), physical inactivity (P = 4 × 10(-17)), but not with increased alcohol intake (P = 0.10). At the second examination 10 years later, 56% of participants had lost and 44% gained telomere length with a mean loss of 193 basepairs. Change in leukocyte telomere length during 10 years was associated inversely with baseline telomere length (P<1 × 10(-300)) and age at baseline (P = 1 × 10(-27)), but not with baseline or 10-year inter-observational tobacco consumption, body weight, physical activity, or alcohol intake. Prospectively during a further 10 years follow-up after the second examination, quartiles of telomere length change did not associate with risk of all-cause mortality, cancer, chronic obstructive pulmonary disease, diabetes mellitus, ischemic cerebrovascular disease, or ischemic heart disease. In conclusion, smoking, increased body weight, and physical inactivity were associated with short telomere length cross-sectionally, but not with telomere length change during 10 years observation, and alcohol intake was associated with neither. Also, change in telomere length did not associate prospectively with mortality or morbidity in the general population.

  7. Assessment of the value of a genetic risk score in improving the estimation of coronary risk

    PubMed Central

    Lluis-Ganella, Carla; Subirana, Isaac; Lucas, Gavin; Tomás, Marta; Muñoz, Daniel; Sentí, Mariano; Salas, Eduardo; Sala, Joan; Ramos, Rafel; Ordovas, Jose M; Marrugat, Jaume; Elosua, Roberto

    2013-01-01

    Background The American Heart Association has established criteria for the evaluation of novel markers of cardiovascular risk. In accordance with these criteria, we assessed the association between a multi-locus genetic risk score (GRS) and incident coronary heart disease (CHD), and evaluated whether this GRS improves the predictive capacity of the Framingham risk function. Methods and results Using eight genetic variants associated with CHD but not with classical cardiovascular risk factors (CVRFs), we generated a multi-locus GRS, and found it to be linearly associated with CHD in two population based cohorts: The REGICOR Study (n=2,351) and The Framingham Heart Study (n=3,537) (meta-analyzed HR [95%CI]: ~1.13 [1.01–1.27], per unit). Inclusion of the GRS in the Framingham risk function improved its discriminative capacity in the Framingham sample (c-statistic: 72.81 vs.72.37, p=0.042) but not in the REGICOR sample. According to both the net reclassification improvement (NRI) index and the integrated discrimination index (IDI), the GRS improved re-classification among individuals with intermediate coronary risk (meta-analysis NRI [95%CI]: 17.44 [8.04; 26.83]), but not overall. Conclusions A multi-locus GRS based on genetic variants unrelated to CVRFs was associated with a linear increase in risk of CHD events in two distinct populations. This GRS improves risk reclassification particularly in the population at intermediate coronary risk. These results indicate the potential value of the inclusion of genetic information in classical functions for risk assessment in the intermediate risk population group. PMID:22521901

  8. The Clinical Performance of an Office-Based Risk Scoring System for Fatal Cardiovascular Diseases in North-East of Iran

    PubMed Central

    Sepanlou, Sadaf G.; Malekzadeh, Reza; Poustchi, Hossein; Sharafkhah, Maryam; Ghodsi, Saeed; Malekzadeh, Fatemeh; Etemadi, Arash; Pourshams, Akram; Pharoah, Paul D.; Abnet, Christian C.; Brennan, Paul; Boffetta, Paolo; Dawsey, Sanford M.; Kamangar, Farin

    2015-01-01

    Background Cardiovascular diseases (CVD) are becoming major causes of death in developing countries. Risk scoring systems for CVD are needed to prioritize allocation of limited resources. Most of these risk score algorithms have been based on a long array of risk factors including blood markers of lipids. However, risk scoring systems that solely use office-based data, not including laboratory markers, may be advantageous. In the current analysis, we validated the office-based Framingham risk scoring system in Iran. Methods The study used data from the Golestan Cohort in North-East of Iran. The following risk factors were used in the development of the risk scoring method: sex, age, body mass index, systolic blood pressure, hypertension treatment, current smoking, and diabetes. Cardiovascular risk functions for prediction of 10-year risk of fatal CVDs were developed. Results A total of 46,674 participants free of CVD at baseline were included. Predictive value of estimated risks was examined. The resulting Area Under the ROC Curve (AUC) was 0.774 (95% CI: 0.762-0.787) in all participants, 0.772 (95% CI: 0.753-0.791) in women, and 0.763 (95% CI: 0.747-0.779) in men. AUC was higher in urban areas (0.790, 95% CI: 0.766-0.815). The predicted and observed risks of fatal CVD were similar in women. However, in men, predicted probabilities were higher than observed. Conclusion The AUC in the current study is comparable to results of previous studies while lipid profile was replaced by body mass index to develop an office-based scoring system. This scoring algorithm is capable of discriminating individuals at high risk versus low risk of fatal CVD. PMID:26011607

  9. Methylome-wide Association Study of Atrial Fibrillation in Framingham Heart Study

    PubMed Central

    Lin, Honghuang; Yin, Xiaoyan; Xie, Zhijun; Lunetta, Kathryn L.; Lubitz, Steven A.; Larson, Martin G.; Ko, Darae; Magnani, Jared W.; Mendelson, Michael M.; Liu, Chunyu; McManus, David D.; Levy, Daniel; Ellinor, Patrick T.; Benjamin, Emelia J.

    2017-01-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia, but little is known about the molecular mechanisms associated with AF arrhythmogenesis. DNA methylation is an important epigenetic mechanism that regulates gene expression and downstream biological processes. We hypothesize that DNA methylation might play an important role in the susceptibility to develop AF. A total of 2,639 participants from the Offspring Cohort of Framingham Heart Study were enrolled in the current study. These participants included 183 participants with prevalent AF and 220 with incident AF during up to 9 years follow up. Genome-wide methylation was profiled using the Illumina Infinium HumanMethylation450 BeadChip on blood-derived DNA collected during the eighth examination cycle (2005–2008). Two CpG sites were significantly associated with prevalent AF, and five CpGs were associated with incident AF after correction for multiple testing (FDR < 0.05). Fourteen previously reported genome-wide significant AF-related SNP were each associated with at least one CpG site; the most significant association was rs6490029 at the CUX2 locus and cg10833066 (P = 9.5 × 10−279). In summary, we performed genome-wide methylation profiling in a community-based cohort and identified seven methylation signatures associated with AF. Our study suggests that DNA methylation might play an important role in AF arrhythmogenesis. PMID:28067321

  10. Relation of Smoking Status to a Panel of Inflammatory Markers: The Framingham Offspring

    PubMed Central

    Levitzky, Yamini S.; Guo, Chao-Yu; Rong, Jian; Larson, Martin G.; Walter, Robert E.; Keaney, John F.; Sutherland, Patrice A.; Vasan, Aditi; Lipinska, Izabella; Evans, Jane C.; Benjamin, Emelia J.

    2008-01-01

    Aims We sought to investigate the hypothesis that smoking is accompanied by systemic inflammation. Methods and Results We examined the relation of smoking to 11 systemic inflammatory markers in Framingham Study participants (n=2944, mean age 60 years, 55% women, 12% ethnic minorities) examined from 1998–2001. The cohort was divided into never (n=1149), former (n=1424), and current smokers with last cigarette >6 hours (n=134) or ≤6 hours (n=237) prior to phlebotomy. In multivariable-adjusted models there were significant overall between-smoking group differences (defined as p<0.0045 to account for multiple testing) for every inflammatory marker tested, except for serum CD40 ligand (CD40L), myeloperoxidase (MPO) and tumor necrosis factor receptor-2 (TNFR2). With multivariable-adjustment, pair-wise comparisons with never smokers revealed that former smokers had significantly lower concentrations of plasma CD40L (p<0.0001) and higher concentrations of C-reactive protein (p=0.002). Conclusions As opposed to never smokers, those with acute cigarette smoke exposure (≤6 hours) had significantly higher concentrations of all markers (p<0.0001) except serum CD40L, MPO, and TNFR2; plasma CD40L were significantly lower. Compared with never smokers, cigarette smokers have significantly elevated concentrations of most circulating inflammatory markers, consistent with the hypothesis that smoking is associated with a systemic inflammatory state. PMID:18289552

  11. Longitudinal variance-components analysis of the Framingham Heart Study data

    PubMed Central

    Macgregor, Stuart; Knott, Sara A; White, Ian; Visscher, Peter M

    2003-01-01

    The Framingham Heart Study offspring cohort, a complex data set with irregularly spaced longitudinal phenotype data, was made available as part of Genetic Analysis Workshop 13. To allow an analysis of all of the data simultaneously, a mixed-model- based random-regression (RR) approach was used. The RR accounted for the variation in genetic effects (including marker-specific quantitative trait locus (QTL) effects) across time by fitting polynomials of age. The use of a mixed model allowed both fixed (such as sex) and random (such as familial environment) effects to be accounted for appropriately. Using this method we performed a QTL analysis of all of the available adult phenotype data (26,106 phenotypic records). In addition to RR, conventional univariate variance component techniques were applied. The traits of interest were BMI, HDLC, total cholesterol, and height. The longitudinal method allowed the characterization of the change in QTL effects with aging. A QTL affecting BMI was shown to act mainly at early ages. PMID:14975090

  12. Longitudinal variance-components analysis of the Framingham Heart Study data.

    PubMed

    Macgregor, Stuart; Knott, Sara A; White, Ian; Visscher, Peter M

    2003-12-31

    The Framingham Heart Study offspring cohort, a complex data set with irregularly spaced longitudinal phenotype data, was made available as part of Genetic Analysis Workshop 13. To allow an analysis of all of the data simultaneously, a mixed-model- based random-regression (RR) approach was used. The RR accounted for the variation in genetic effects (including marker-specific quantitative trait locus (QTL) effects) across time by fitting polynomials of age. The use of a mixed model allowed both fixed (such as sex) and random (such as familial environment) effects to be accounted for appropriately. Using this method we performed a QTL analysis of all of the available adult phenotype data (26,106 phenotypic records). In addition to RR, conventional univariate variance component techniques were applied. The traits of interest were BMI, HDLC, total cholesterol, and height. The longitudinal method allowed the characterization of the change in QTL effects with aging. A QTL affecting BMI was shown to act mainly at early ages.

  13. Second primary breast cancer in BRCA1 and BRCA2 mutation carriers: 10-year cumulative incidence in the Breast Cancer Family Registry.

    PubMed

    Menes, Tehillah S; Terry, Mary Beth; Goldgar, David; Andrulis, Irene L; Knight, Julia A; John, Esther M; Liao, Yuyan; Southey, Melissa; Miron, Alexander; Chung, Wendy; Buys, Saundra S

    2015-06-01

    BReast CAncer genes 1 and 2 (BRCA1 and BRCA2) mutation carriers diagnosed with breast cancer are at increased risk of developing a second primary breast cancer. Data from high-risk clinics may be subject to different biases which can cause both over and underestimation of this risk. Using data from a large multi-institutional family registry we estimated the 10-year cumulative risk of second primary breast cancer including more complete testing information on family members. We prospectively followed 800 women diagnosed with breast cancer from the Breast Cancer Family Registry (BCFR) who were carriers of a BRCA1 or BRCA2 pathogenic mutation or a variant of unknown clinical significance. In order to limit survival and ascertainment bias, cases were limited to those diagnosed with a first primary breast cancer from 1994 to 2001 and enrolled in the BCFR within 3 years after their cancer diagnosis. We excluded women enrolled after being diagnosed with a second breast cancer. We calculated 10-year incidence of second primary breast cancers. The 10-year incidence of a second primary breast cancer was highest in BRCA1 mutation carriers (17 %; 95 % CI 11-25 %), with even higher estimates in those first diagnosed under the age of 40 (21 %; 95 % CI 13-34 %). Lower rates were found in BRCA2 mutation carriers (7 %; 95 % CI 3-15 %) and women with a variant of unknown clinical significance (6 %; 95 % CI 4-9 %). Whereas the cumulative 10-year incidence of second primary breast cancer is high in BRCA1 mutation carriers, the estimates in BRCA2 mutation carriers and women with variants of unknown clinical significance are similar to those reported in women with sporadic breast cancer.

  14. The Protective Role of Family Meals for Youth Obesity: 10-year Longitudinal Associations

    PubMed Central

    Berge, Jerica M.; Wall, Melanie; Hsueh, Tsun-Fang; Fulkerson, Jayne A.; Larson, Nicole; Neumark-Sztainer, Dianne

    2014-01-01

    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

  15. Sharing Telescopes With 10-Year Olds to Celebrate the International Year of Astronomy

    NASA Astrophysics Data System (ADS)

    Lyons, Daniel Jonathan; Slater, T. F.; Slater, S. J.; in Astronomy, Cognition; Physics; Earth sciences Research CAPER Team

    2009-05-01

    Precisely four hundred years ago, Italian scientist Galileo's observations of the heavens forever and profoundly altered the way we view our place in the Universe. Throughout 2009, children across Wyoming are joining in a United Nations proclaimed International Year of Astronomy celebration. To commemorate 400 years of the telescope in advancing our understanding of the Universe through astronomy, our goal is that every 10-year old child in Wyoming will experience the excitement and wonder of looking through their very own telescope to observe majestic rings surrounding Saturn, deep craters on the Moon, countless stars lining the Milky Way, brilliant phases of Venus, and orbiting moons of Jupiter. This is being accomplished by a massive, state-wide collaborative effort bringing the collective energy and enthusiasm of professional scientists, amateur astronomers, local teachers, and community outreach enthusiasts together to spark an interest in science among Wyoming's children. Our strategy to bring a telescope to every Wyoming 10-year old child started first with a major year-long fundraising campaign. We estimate the cost of an individual telescope, constructed specifically for the 2009 International Year of Astronomy celebration, to be approximately $13 per child. With 6,489 (in 2007) 10-year old children in Wyoming, this amounts to less than $100,000 as a fund raising goal. University of Wyoming faculty are training teachers in how to use telescopes and how to integrate the excitement of astronomy across the curriculum. To teach children how to use their telescopes, volunteers from around the state are hosting star parties at schools, county fairs, and other regularly scheduled community celebrations.

  16. Sharing the Stars: Bringing Telescopes to 10-year Olds for International Year of Astronomy

    NASA Astrophysics Data System (ADS)

    Slater, S. J.

    2008-12-01

    Precisely four hundred years ago, Italian scientist Galileo's observations of the heavens forever and profoundly altered the way we view our place in the Universe. He dramatically increased our thinking about the size of the known Universe by using his telescope and initiated one of the most important scientific revolutions in history. Throughout 2009, children across Wyoming are joining in a United Nations proclaimed International Year of Astronomy celebration. To commemorate 400 years of the telescope in advancing our understanding of the Universe through astronomy, our goal is that every 10-year old child in Wyoming will experience the excitement and wonder of looking through their very own telescope to observe majestic rings surrounding Saturn, deep craters on the Moon, countless stars lining the Milky Way, brilliant phases of Venus, and orbiting moons of Jupiter. This is being accomplished by a massive, state-wide collaborative effort bringing the collective energy and enthusiasm of professional scientists, amateur astronomers, local teachers, and community outreach enthusiasts together to spark an interest in science among Wyoming's children. Our strategy to bring a telescope to every Wyoming 10-year old child started first with a major year-long fundraising campaign. We estimate the cost of an individual telescope, constructed specifically for the 2009 International Year of Astronomy celebration, to be approximately 13 per child. With 6,489 (in 2007) 10- year old children in Wyoming, this amounts to less than 100,000 as a fund raising goal. University of Wyoming faculty are training teachers in how to use telescopes and how to integrate the excitement of astronomy across the curriculum. To teach children how to use their telescopes, volunteers from around the state are hosting star parties at schools, county fairs, and other regularly scheduled community celebrations.

  17. Vertical scar versus the inverted-T scar reduction mammaplasty: a 10-year follow-up.

    PubMed

    Bouwer, Lesley R; van der Biezen, Jan Jaap; Spronk, Cees A; van der Lei, Berend

    2012-10-01

    A retrospective study was undertaken to evaluate whether the initial outcome of two types of reduction mammaplasty techniques (vertical scar reduction mammaplasty vs. the inverted-T scar reduction mammaplasty) remains stable in the long term: Sixty-nine patients who had undergone breast reduction surgery in the period 1997-2000 at the Department of Reconstructive Plastic Surgery at the Medical Center of Leeuwarden were willing and able to participate in this study. A structured questionnaire was used to assess the degree of patient satisfaction. For subjective evaluation, the Strasser Grading System on photographs at the 3 months after surgery and after long-term follow-up (10 years) was used. The median general appreciation mark for the entire surgical procedure given by patients was 8 (1-10) on a scale from 1 to 10. Forty-six of the 69 patients could be scored according to Strasser: at 3 months in 17 patients (37%) the result was 'good', in 21 patients (46%) 'mediocre' and in eight patients (17%) 'poor'. After 10 years, in 37 of the patients (80%) the result was 'good', in six patients (13%) 'mediocre' and in three patients (7%) 'poor'. At 3 months, there was a higher incidence of bottoming out in the vertical scar group (one on two patients) as compared to the inverted-T scar group (one on 10 patients); however, at the 10-years follow-up bottoming out was 50% in the inverted-T scar group and 20% in the vertical scar group. Despite bottoming out, in both the vertical scar reduction mammaplasty technique and the inverted-T scar reduction mammaplasty technique, high patient satisfaction rates are achieved that remains for years.

  18. Development of 5- and 10-year-old pediatric phantoms based on polygon mesh surfaces

    SciTech Connect

    Melo Lima, V. J. de; Cassola, V. F.; Kramer, R.; Oliveira Lira, C. A. B. de; Khoury, H. J.; Vieira, J. W.

    2011-08-15

    Purpose: The purpose of this study is the development of reference pediatric phantoms for 5- and 10-year-old children to be used for the calculation of organ and tissue equivalent doses in radiation protection. Methods: The study proposes a method for developing anatomically highly sophisticated pediatric phantoms without using medical images. The 5- and 10-year-old male and female phantoms presented here were developed using 3D modeling software applied to anatomical information taken from atlases and textbooks. The method uses polygon mesh surfaces to model body contours, the shape of organs as well as their positions, and orientations in the human body. Organ and tissue masses comply with the corresponding data given by the International Commission on Radiological Protection (ICRP) for the 5- and 10-year-old reference children. Bones were segmented into cortical bone, spongiosa, medullary marrow, and cartilage to allow for the use of micro computer tomographic ({mu}CT) images of trabecular bone for skeletal dosimetry. Results: The four phantoms, a male and a female for each age, and their organs are presented in 3D images and their organ and tissue masses in tables which show the compliance of the ICRP reference values. Dosimetric data, calculated for the reference pediatric phantoms by Monte Carlo methods were compared with corresponding data from adult mesh phantoms and pediatric stylized phantoms. The comparisons show reasonable agreement if the anatomical differences between the phantoms are properly taken into account. Conclusions: Pediatric phantoms were developed without using medical images of patients or volunteers for the first time. The models are reference phantoms, suitable for regulatory dosimetry, however, the 3D modeling method can also be applied to medical images to develop patient-specific phantoms.

  19. Oral Hygiene Facilitators and Barriers in Greek 10 Years Old Schoolchildren

    PubMed Central

    Kavvadia, Katerina; Oulis, Constantine; Reppa, Christina

    2015-01-01

    ABSTRACT Aim: The aim of this study was to determine the oral hygiene facilitators and barriers for 10 years old Greek children, via a questionnaire and clinical examination. Materials and methods: This was a cross-sectional study of 266, 10 years old, children recruited from schools in 3 locations in Greece. Data were collected via questionnaires and clinical examination. Questionnaires referred to Children’s oral hygiene knowledge, behavior and attitude as well as parents’ oral hygiene behavior and educational level. Children were clinically examined by two calibrated pediatric dentists using a WHO probe and artificial light to assess dental plaque (hygiene index-HI), gingivitis (simplified gingival index-GIs) and dental caries (DMFT-BASCD criteria). Results: Regarding oral hygiene knowledge, although 80% of the children were literate of the proper means of oral hygiene, only 58.64% brushed their teeth twice daily and 36.84% used dental floss. Children’s oral hygiene knowledge was positively correlated with both parental brushing frequency (ρ = 0.175, p < 0.05) and educational level (ρ = -0.216, p < 0.05). Toothpaste use was reported by 92.11% of the children. Regarding Children’s attitude, 62.28% were concerned whether their teeth were clean, with girls showing greater concern than boys (p < 0.001). Their reported beliefs regarding brushing avoidance were boredom (84.06%), low oral health literacy (73.91%) and forgetfulness (56.52%). Conclusion: Oral hygiene facilitators were found to be the concern about how clean were their teeth, oral health literacy of both children and parents and toothpaste appeal to children. Oral hygiene barriers were Children’s boredom, low oral health literacy, forgetfulness and low socioeconomic level. How to cite this article: Angelopoulou M, Kavvadia K, Oulis C, Reppa C. Oral Hygiene Facilitators and Barriers in Greek 10 Years Old Schoolchildren. Int J Clin Pediatr Dent 2015;8(2):87-93. PMID:26379373

  20. A scoring system based on artificial neural network for predicting 10-year survival in stage II A colon cancer patients after radical surgery.

    PubMed

    Peng, Jian-Hong; Fang, Yu-Jing; Li, Cai-Xia; Ou, Qing-Jian; Jiang, Wu; Lu, Shi-Xun; Lu, Zhen-Hai; Li, Pei-Xing; Yun, Jing-Ping; Zhang, Rong-Xin; Pan, Zhi-Zhong; Wan, De Sen

    2016-04-19

    Nearly 20% patients with stage II A colon cancer will develop recurrent disease post-operatively. The present study aims to develop a scoring system based on Artificial Neural Network (ANN) model for predicting 10-year survival outcome. The clinical and molecular data of 117 stage II A colon cancer patients from Sun Yat-sen University Cancer Center were used for training set and test set; poor pathological grading (score 49), reduced expression of TGFBR2 (score 33), over-expression of TGF-β (score 45), MAPK (score 32), pin1 (score 100), β-catenin in tumor tissue (score 50) and reduced expression of TGF-β in normal mucosa (score 22) were selected as the prognostic risk predictors. According to the developed scoring system, the patients were divided into 3 subgroups, which were supposed with higher, moderate and lower risk levels. As a result, for the 3 subgroups, the 10-year overall survival (OS) rates were 16.7%, 62.9% and 100% (P < 0.001); and the 10-year disease free survival (DFS) rates were 16.7%, 61.8% and 98.8% (P < 0.001) respectively. It showed that this scoring system for stage II A colon cancer could help to predict long-term survival and screen out high-risk individuals for more vigorous treatment.

  1. Maturogenesis of Two Maxillary Central Incisors: A Case Report with 10 Years of Follow Up

    PubMed Central

    Ghorbanzadeh, Abdollah

    2015-01-01

    This case report describes the treatment of two immature maxillary central incisors in a 7-year-old female patient. She suffered complicated crown fracture because of trauma, and the root formation was incomplete. White mineral trioxide aggregate (MTA) was selected as the pulp-capping material after cervical pulpotomy to preserve the pulp tissue vitality and achieve maturogenesis. Follow-up evaluations showed successful treatment in terms of preservation of pulp vitality and demonstrated marked continuous physiological root development. During 10 years of follow-up, both teeth were clinically asymptomatic, and radiographic evaluations showed apparent root regeneration with apical root-end closure without pulp or periapical pathosis. PMID:26622286

  2. Peroral Endoscopic Myotomy for the Treatment of Achalasia in a 10-Year-Old Male Patient.

    PubMed

    Filser, Jörg; Dick, Anke; Meyer, Thomas; Germer, Christoph-Thomas; von Rahden, Burkard H A

    2015-06-01

    Peroral endoscopic myotomy (POEM) is a new endoscopic treatment for achalasia with very good short-term results in adults. Data about POEM in pediatric patients are missing. We present the case of a 10-year-old male patient with type I (classic) achalasia, successfully treated with POEM. The procedure was accomplished in a similar fashion to the technique used in adults. Short-term results were fine, with a complete control of dysphagia and absence of reflux. We suggest that POEM is a suitable option in pediatric patients-similar to adults-but long-term results must be awaited.

  3. Malignant Nonfunctioning Neuroendocrine Neoplasm of the Pancreas in a 10-Year-Old Child.

    PubMed

    Marwan, Ahmed; Christein, John D

    2009-04-17

    Malignant neoplasms of the pancreas are extremely rare in children and only represent a small percentage of pediatric cancer-related deaths. The paucity of cases reported in the literature, in addition to the lack of understanding of biologic behavior, has led to a lack of consensus concerning optimal management strategy. Presentation differs compared to adult counterparts and generally prognosis is improved even when lymph node metastases occur. Here we review the literature and report the case of a 10-year-old autistic female with a malignant nonfunctioning pancreatic endocrine neoplasm of the head of the pancreas successfully extirpated via pancreaticoduodenectomy.

  4. Fessenheim 1, 1989; The first 10-year outage of a French 900 MW reactor

    SciTech Connect

    Tarby, S.; Naudet, R.; Montane, C. ); Gras, P. )

    1990-01-01

    10 years after the preservice inspection in 1979, French legislation required the Fessenheim 1 900 MW reactor unit to undergo specific inspections necessitating a long-duration shut-down. EDF, the French Electricity Board, decided to take advantage of the shut-down to make major improvements to safety, fire detection and fire-fighting systems. Fessenheim 1 was shut down on April 7th 1989 and reconnected to the grid on October 14th in the same year. The overall operation was brought to a successful conclusion. This paper reviews the objectives and preparatives for the operation, describes the key phases and summarizes the main benefits.

  5. Adolescent drug trafficking trends in the United Kingdom--a 10-year retrospective analysis.

    PubMed

    Vale, Ellen Louise Eva; Kennedy, Patrick John

    2004-12-01

    This paper reports data from HM Customs and Excise (HMCE) of recorded cases of adolescent drug trafficking through all sea and air points of entry into the UK over a 10-year period (May 1992-May 2002). We report the characteristics of 38 cases of mixed gender and nationality ranging in age between 13 and 18 years who have been apprehended by HMCE due to the illegal importation of drugs. Highlighted is an increasing trend in UK national male and female adolescents being apprehended for drug trafficking. Of particular note is the observation that more young adolescent females were apprehended importing large consignments of Class A substances than their male counterparts.

  6. Pulmonary talcosis 10 years after brief teenage exposure to cosmetic talcum powder.

    PubMed

    Shakoor, Amarah; Rahatullah, Arsalan; Shah, Adil Aijaz; Zubairi, Ali Bin Sarwar

    2011-09-19

    Pulmonary talcosis is a rare but debilitating variant of pneumoconiosis often presenting with isolated non-specific symptoms of progressive exertional dyspnoea or cough. Occupational exposure to talc dust and intravenous drug abuse are well-recognised aetiological factors with only a few cases related to cosmetic talc exposure being reported to date. The authors report a case of a young woman in whom a mere 4 month ritual of inhaling cosmetic talcum powder led to full-blown pulmonary talcosis being diagnosed 10 years later. The importance of a taking a pertinent history relating to environmental exposures in all patients presenting with respiratory symptoms is re-established here.

  7. Pulmonary talcosis 10 years after brief teenage exposure to cosmetic talcum powder

    PubMed Central

    Shakoor, Amarah; Rahatullah, Arsalan; Shah, Adil Aijaz; Zubairi, Ali Bin Sarwar

    2011-01-01

    Pulmonary talcosis is a rare but debilitating variant of pneumoconiosis often presenting with isolated non-specific symptoms of progressive exertional dyspnoea or cough. Occupational exposure to talc dust and intravenous drug abuse are well-recognised aetiological factors with only a few cases related to cosmetic talc exposure being reported to date. The authors report a case of a young woman in whom a mere 4 month ritual of inhaling cosmetic talcum powder led to full-blown pulmonary talcosis being diagnosed 10 years later. The importance of a taking a pertinent history relating to environmental exposures in all patients presenting with respiratory symptoms is re-established here. PMID:22679260

  8. Long-term follow-up of heel spur surgery. A 10-year retrospective study.

    PubMed

    Vohra, P K; Giorgini, R J; Sobel, E; Japour, C J; Villalba, M A; Rostkowski, T

    1999-02-01

    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.

  9. Tibial nerve intraneural ganglion cyst in a 10-year-old boy.

    PubMed

    Squires, Judy H; Emery, Kathleen H; Johnson, Neil; Sorger, Joel

    2014-04-01

    Intraneural ganglion cysts are uncommon cystic lesions of peripheral nerves that are typically encountered in adults. In the lower extremity, the peroneal nerve is most frequently affected with involvement of the tibial nerve much less common. This article describes a tibial intraneural ganglion cyst in a 10-year-old boy. Although extremely rare, intraneural ganglion cysts of the tibial nerve should be considered when a nonenhancing cystic structure with intra-articular extension is identified along the course of the nerve. This report also details the unsuccessful attempt at percutaneous treatment with US-guided cyst aspiration and steroid injection, an option recently reported as a viable alternative to open surgical resection.

  10. Hepatic artery thrombosis following orthotopic liver transplantation: a 10-year experience from a single centre in the United Kingdom.

    PubMed

    Silva, Michael A; Jambulingam, Periyathambi S; Gunson, Bridget K; Mayer, David; Buckels, John A C; Mirza, Darius F; Bramhall, Simon R

    2006-01-01

    Hepatic artery thrombosis (HAT) occurs in 3-9% of all liver transplants and acute graft loss is a possible sequelae. We present our experience in the management of HAT over a 10-year period. Prospectively collected data from April 1994 to April 2004 were analyzed. There were 1,257 liver transplants, 669 males, median age 51 (16-73) years. There were 61 (4.9%) cases of HAT. Early HAT occurred in 21 (1.8%). Thirty six had graft dysfunction, 11 required a regraft, and 14 died. Positive CMV serology in the donor, cold ischemia time, duration of operation, transfusions of more than 6 units of blood, and 15 units of plasma, an aortic conduit for arterial reconstruction, Roux-en-Y biliary reconstructions, regrafts and relaparotomy were associated with HAT. At multivariate analysis, type of biliary anastomosis was the only significant factor associated with HAT. Split or reduced liver graft were not risk factors for HAT. Number of hepatic arteries requiring multiple arterial anastomosis was not a risk for HAT. HAT resulted in a reduction in overall survival post liver transplantation. The incidence of HAT was 4.9%; with 1.8% early HAT and HAT impacted on survival. Surgical technique was not an aetiological factor for HAT. In conclusion, while a Roux-en-Y biliary reconstruction was an independent risk factor for HAT, cold ischemia and operative times, the use of blood and plasma and the use of aortic conduits in arterial reconstruction were associated with HAT. Regrafts and reoperation were also identified risk factors.

  11. Major depressive disorder and smoking relapse among adults in the United States: a 10-year, prospective investigation.

    PubMed

    Zvolensky, Michael J; Bakhshaie, Jafar; Sheffer, Christine; Perez, Adriana; Goodwin, Renee D

    2015-03-30

    This study investigated the relation between major depressive disorder (MDD) and smoking relapse in the U.S. over a 10-year period. Data were drawn from the Midlife Development in the United States (MIDUS) Survey Waves I & II. Logistic regression analyses were used to explore the associations between past-year MDD in 1994, past-year MDD in 2005 and persistent depression (1994 and 2005) and risk of smoking relapse in 2005 among former smokers, adjusting for demographics, anxiety disorders, and substance use problems and smoking characteristics. Among former smokers, MDD in 1994, compared to without MDD in 1994, was associated with significantly increased odds of smoking relapse by 2005. Current MDD in 2005 was associated with an even stronger risk of relapse in 2005 and persistent depression even more strongly predicted relapse by 2005. These associations remained significant and were not substantially attenuated by the covariates. In conclusion, MDD appears to confer long-term vulnerability to smoking relapse among adults in the general population. These results suggest interventions for smoking cessation should include screening and treatment for MDD if programs are to be optimally effective at achieving initial quit success as well as enduring abstinence.

  12. Discrimination of facial features by adults, 10-year-olds, and cataract-reversal patients.

    PubMed

    Mondloch, Catherine J; Robbins, Rachel; Maurer, Daphne

    2010-01-01

    In previous studies we created 8 new versions of a single face: 4 differed only in the spacing among features and 4 differed in the shape of the eyes and mouth. Compared to the spacing set, results for this feature set indicated little impairment by inversion, earlier adult-like accuracy (Mondloch et al, 2002 Perception 31 553-566), and normal performance after a history of early visual deprivation from bilateral congenital cataract (Le Grand et al, 2001 Nature 410 890, 412 786). Here we addressed the possibility that this pattern might have resulted from our having inadvertently selected easily discriminated features or including some faces with make-up. We created 20 featural versions of a single female face and asked adults, 10-year-old children, and patients treated for bilateral congenital cataract to make same/different judgments for 120 pairings (half different). The results confirm that adults easily discriminate facial features, even after early visual deprivation from cataract, and that inversion has only a small effect. By the age of 10 years, children are close to, but not quite at, adult levels of accuracy. The previous findings cannot be attributed to our having inadvertently created a feature set that was unusually easy to discriminate.

  13. Hostility, Anger and Depression Predict Increases in C3 over a 10-Year Period

    PubMed Central

    Boyle, Stephen H.; Jackson, William G.; Suarez, Edward C.

    2007-01-01

    We examined the relation of hostility, anger and depression to 10-year changes in the third (C3) and fourth (C4) complement in 313, apparently healthy male participants enrolled in the Air Force Health Study (AFHS), a 20-year study designed to evaluate the health consequences of dioxin exposure. Hostility, depression and anger were assessed using subscales from the Minnesota Multiphasic Personality Inventory (MMPI), which was administered in 1985. Given the high intercorrelations among these psychological scales, we used a principal component analysis to generate a composite score representing the linear combination of the hostility, anger and depression scales. The dependent variables, C3 and C4 levels, were determined from samples collected in 1992, 1997 and 2002. Regression analyses controlling for age, race, alcohol use, body mass index and cigarette use as well as onset of disease and use of lipid lowering and blood pressure medications during follow-up revealed a significant time X composite score interaction for C3 complement (p < .0003), but not C4. Post-hoc analyses revealed that high composite scores were associated with larger 10-year increases in C3. These observations suggest that men who are hostile and are prone to experience frequent and intense feelings of anger and depression show activation of the complement system, and specifically increases in C3, that may contribute to the development of coronary heart disease. PMID:17321106

  14. Hostility, anger, and depression predict increases in C3 over a 10-year period.

    PubMed

    Boyle, Stephen H; Jackson, William G; Suarez, Edward C

    2007-08-01

    We examined the relation of hostility, anger, and depression to 10-year changes in the third (C3), and fourth (C4) complement in 313, apparently healthy male participants enrolled in the Air Force Health Study (AFHS), a 20-year study designed to evaluate the health consequences of dioxin exposure. Hostility, depression, and anger were assessed using subscales from the Minnesota Multiphasic Personality Inventory (MMPI), which was administered in 1985. Given the high intercorrelations among these psychological scales, we used a principal component analysis to generate a composite score representing the linear combination of the hostility, anger, and depression scales. The dependent variables, C3 and C4 levels, were determined from samples collected in 1992, 1997, and 2002. Regression analyses controlling for age, race, alcohol use, body mass index, and cigarette use as well as onset of disease, and use of lipid lowering and blood pressure medications during follow-up revealed a significant timexcomposite score interaction for C3 complement (p<.0003), but not C4. Post-hoc analyses revealed that high composite scores were associated with larger 10-year increases in C3. These observations suggest that men who are hostile and are prone to experience frequent and intense feelings of anger, and depression show activation of the complement system, and specifically increases in C3, that may contribute to the development of coronary heart disease.

  15. Post-Test Analysis of a 10-Year Sodium Heat Pipe Life Test

    NASA Technical Reports Server (NTRS)

    Rosenfeld, John H.; Locci, Ivan E.; Sanzi, James L.; Hull, David R.; Geng, Steven M.

    2011-01-01

    High-temperature heat pipes are being evaluated for use in energy conversion applications such as fuel cells, gas turbine re-combustors, Stirling cycle heat sources; and with the resurgence of space nuclear power both as reactor heat removal elements and as radiator elements. Long operating life and reliable performance are critical requirements for these applications. Accordingly, long-term materials compatibility is being evaluated through the use of high-temperature life test heat pipes. Thermacore, Inc., has carried out a sodium heat pipe 10-year life test to establish long-term operating reliability. Sodium heat pipes have demonstrated favorable materials compatibility and heat transport characteristics at high operating temperatures in air over long time periods. A representative one-tenth segment Stirling Space Power Converter heat pipe with an Inconel 718 envelope and a stainless steel screen wick has operated for over 87,000 hr (10 years) at nearly 700 C. These life test results have demonstrated the potential for high-temperature heat pipes to serve as reliable energy conversion system components for power applications that require long operating lifetime with high reliability. Detailed design specifications, operating history, and post-test analysis of the heat pipe and sodium working fluid are described. Lessons learned and future life test plans are also discussed.

  16. Bibliometric Analysis of Orthopedic Literature on Total Knee Arthroplasty in Asian Countries: A 10-year Analysis

    PubMed Central

    Eom, Sang Hwa; Bamne, Ankur B.; Chowdhry, Madhav; Chae, Ihn Seok

    2015-01-01

    Purpose We aimed to determine the quantity and quality of research output of selected Asian countries in the field of total knee arthroplasty (TKA) in the last 10 years. Materials and Methods Top 15 Asian countries were selected according to their gross domestic product. The Science Citation Index Expanded database was used to search for the literature published between 2004 and 2013 using "Total Knee Arthroplasty". The numbers of articles, journals and citations and the contribution of each country were analyzed. The articles were classified according to the type of study and the relative proportion of each type was analyzed. Results Asian surgeons have increasingly contributed to orthopedic literature on TKA for the past 10 years, but the dominant contribution came from only a few countries. The total number of articles published by Asian countries increased by 261%, with Japan producing most of the studies and China showing the maximum growth rate. The majority of studies were published in low impact factor journals. Korea published the highest proportion of articles in high impact factor journals. Clinical papers were most frequent. Conclusions Our identification of research productivity pertaining to TKA among Asian countries gives a unique insight into the level of academic research in the field of TKA in these countries. There is a need to improve the quality of research to enhance the publishing power in high impact journals as well as the need for more basic research and epidemiological studies considering the unique differences among Asian patients undergoing TKA. PMID:26389067

  17. [10 Years of Quality Management: Perception and Importance from GPs' Point of View].

    PubMed

    Kühlein, T; Madlo-Thiess, F; Wambach, V; Schaffer, S

    2016-10-25

    Background: Quality management (QM) became mandatory for the ambulatory sector of the German health care system 10 years ago. Objectives: The aim of this study was to find out how general practitioners (GPs) perceived the introduction of this measure, how they see it today and what they expect of the future concerning QM. Materials and Methods: In a qualitative study, interviews following a semi-structured guideline with GPs were conducted. Following transcription, interviews were coded in triangulation, first inductively, then deductively until saturation was reached. Main topics and code families were agreed on after discussion. Results: There was consensus on the necessity of standardization of basic processes like hygiene. However, the application of QM to an activity that emphasizes personal relationships and communication was seen as barely possible. GPs stated that they reduced QM to a tolerable and for them reasonable minimum. GPs mostly refused certification. The next 10 years were seen with pessimism in terms of more bureaucratic guidelines. Conclusion: The statutory introduction of QM was an attack on medical professionalism. Instead of passive resistance and reduction of QM to a minimum, engaged independent quality work might help to regain the trust of society we seem to have lost and restore the professional autonomy we need for our work.

  18. Evaluation of 6 and 10 Year-Old Child Human Body Models in Emergency Events

    PubMed Central

    2017-01-01

    Emergency events can influence a child’s kinematics prior to a car-crash, and thus its interaction with the restraint system. Numerical Human Body Models (HBMs) can help understand the behaviour of children in emergency events. The kinematic responses of two child HBMs–MADYMO 6 and 10 year-old models–were evaluated and compared with child volunteers’ data during emergency events–braking and steering–with a focus on the forehead and sternum displacements. The response of the 6 year-old HBM was similar to the response of the 10 year-old HBM, however both models had a different response compared with the volunteers. The forward and lateral displacements were within the range of volunteer data up to approximately 0.3 s; but then, the HBMs head and sternum moved significantly downwards, while the volunteers experienced smaller displacement and tended to come back to their initial posture. Therefore, these HBMs, originally intended for crash simulations, are not too stiff and could be able to reproduce properly emergency events thanks, for instance, to postural control. PMID:28099505

  19. Stump appendicitis 10 years after appendectomy, a rare, but serious complication of appendectomy, a case report.

    PubMed

    Van Paesschen, Carl; Haenen, Filip; Bestman, Raymond; Van Cleemput, Marc

    2017-02-01

    We describe a case of stump appendicitis with the formation of abdominal abscesses in a 41-year-old patient 10 years prior appendectomy. The patient consulted with fever (38.1 °C) and abdominal pain, located at the right iliac fossa. Imaging studies showed signs of abscesses, located at the right iliac fossa, without clear origin of these abscesses. The abscesses were drained through diagnostic laparoscopy, no bowel perforation or clear origin of the abscedation was found during laparoscopy. During postoperative stay, the inflammatory parameters rose and the abscesses reoccurred. Re-laparoscopy was performed, the abscesses were drained and on careful inspection and adhesiolysis, a perforated stump appendicitis was revealed, covered underneath layers of fibrous tissue. Stump appendicitis is a rare complication seen after appendectomy and is generally not considered a possible etiology in patients presenting with fever and right iliac fossa abdominal pain with a history of appendectomy. This often delays the correct diagnosis and results in an associated increased incidence of complications. We describe a case of stump appendicitis occurring 10 years after initial appendectomy.

  20. What factors influence motor complications in Parkinson disease?: a 10-year prospective study.

    PubMed

    García-Ruiz, Pedro J; Del Val, Javier; Fernández, Ignacio Mahillo; Herranz, Antonio

    2012-01-01

    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).

  1. Skeletal maturation, fundamental motor skills and motor coordination in children 7-10 years.

    PubMed

    Freitas, Duarte L; Lausen, Berthold; Maia, José António; Lefevre, Johan; Gouveia, Élvio Rúbio; Thomis, Martine; Antunes, António Manuel; Claessens, Albrecht L; Beunen, Gaston; Malina, Robert M

    2015-01-01

    Relationships between skeletal maturation and fundamental motor skills and gross motor coordination were evaluated in 429 children (213 boys and 216 girls) 7-10 years. Skeletal age was assessed (Tanner-Whitehouse 2 method), and stature, body mass, motor coordination (Körperkoordinations Test für Kinder, KTK) and fundamental motor skills (Test of Gross Motor Development, TGMD-2) were measured. Relationships among chronological age, skeletal age (expressed as the standardised residual of skeletal age on chronological age) and body size and fundamental motor skills and motor coordination were analysed with hierarchical multiple regression. Standardised residual of skeletal age on chronological age interacting with stature and body mass explained a maximum of 7.0% of the variance in fundamental motor skills and motor coordination over that attributed to body size per se. Standardised residual of skeletal age on chronological age alone accounted for a maximum of 9.0% of variance in fundamental motor skills, and motor coordination over that attributed to body size per se and interactions between standardised residual of skeletal age on chronological age and body size. In conclusion, skeletal age alone or interacting with body size has a negligible influence on fundamental motor skills and motor coordination in children 7-10 years.

  2. [Causes of anaemia in African children aged 5 to 10 years].

    PubMed

    Mbanya, Dora; Tagny, Claude Tayou; Akamba, Anastasie; Mekongo, Martin Ondoua; Tetanye, Ekoe

    2008-01-01

    This study was conducted among two groups of 105 children in a hospital in Yaoundé, Cameroon, to determine the causes of anaemia in children aged 5- 10-years-old. The study group included children presenting clinical evidence of anaemia while the control group was made of children without anaemia. Both sets of children were matched for neighbourhoods within the city of Yaoundé. Each child had a complete physical examination, full blood count, haemoglobin electrophoresis, reticulocyte counts, and stool samples examined for parasites and hemoparasites. The mean haemoglobin level was 7.77 +/- 1.54 g/dL in the study group and 12.37 +/- 1.23 in the control group. The anaemia was mainly normocytic, normochromic and regenerative in the study group, usually associated with evidence of haemolysis. Patients with homozygous sickle cell disease were found only in the study group (n = 13; 12.3%). Malaria parasites were noted in 89 children (84.7%) in the study group, compared with 34 (32.4%) in the control group (p = 0.0004). Prevalence of intestinal parasites was similar in both groups (50.8%). Protein-calorie malnutrition was rare and was not associated with anemia. We conclude that both malaria and sickle cell anaemia play an important role in anaemia in children aged 5-10 years.

  3. Enteroviruses in Spain: virological and epidemiological studies over 10 years (1988-97).

    PubMed Central

    Trallero, G.; Casas, I.; Tenorio, A.; Echevarria, J. E.; Castellanos, A.; Lozano, A.; Breña, P. P.

    2000-01-01

    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

  4. Overview of Aqua MODIS 10-year On-orbit Calibration and Performance

    NASA Technical Reports Server (NTRS)

    Xiong, X.; Wenny, B.; Sun, J.; Wu, A.; Chen, H.; Angal, A.; Choi, T.; Madhavan, S.; Geng, X.; Link, D.; Toller, G.; Barnes, W.; Salomonson, V.

    2012-01-01

    Since launch in May 2002, Aqua MODIS has successfully operated for nearly 10 years, continuously collecting global datasets for scientific studies of key parameters of the earth's land, ocean, and atmospheric properties and their changes over time. The quality of these geophysical parameters relies on the input quality of sensor calibrated radiances. MODIS observations are made in 36 spectral bands with wavelengths ranging from visible (VIS) to longwave infrared (LWIR). Its reflective solar bands (RSB) are calibrated using data collected from its on-board solar diffuser and regularly scheduled lunar views. The thermal emissive bands (TEB) are calibrated using an on-board blackbody (BB). The changes in the sensor's spectral and spatial characteristics are monitored by an on-board spectroradiometric calibration assembly (SRCA). This paper presents an overview of Aqua MODIS 10-year on-orbit operation and calibration activities, from launch to present, and summarizes its on-orbit radiometric, spectral, and spatial calibration and characterization performance. In addition, it will illustrate and discuss on-orbit changes in sensor characteristics and corrections applied to continuously maintain the sensor level 1B (L1B) data quality, as well as lessons learned that could benefit future calibration efforts.

  5. Highlights from 10 Years of NASA/KNMI/FMI Collaboration on UV Remote Sensing from Space

    NASA Technical Reports Server (NTRS)

    Bhartia, Pawan K.

    2010-01-01

    The first joint meeting between NASA, KNMI and FMI scientists was held on 13 & 14 June, 2000, almost exactly 10 years ago. NASA had recently selected 14 US scientists to work on instrument calibration, science algorithms, and validation activities related to the Ozone Monitoring Instrument (OMI) that we being built by collaboration between the Netherlands and Finland for flight on NASA's EOS Aura satellite. The progress on this project had been remarkable for a space based instrument. Only two years before this meeting my colleague Ernest Hilsenrath and I had visited Netherlands at the invitation of Fokker Space to persuade KNMI management to collaborate with NASA on this mission. And only 4 years after the first science meeting was held OMI was lunched on the Aura spacecraft. Next month will be the 6 th anniversary of this launch and very successful operation of OMI. All this was possible because of the leadership from Dr. Hennie Kelder and KNMI management who in 1998 saw the opportunity for Netherlands in the mission and stepped up to the challenge by creating a young and talented team of scientists at KNMI under the leadership of Dr. Pieterenel Levelt. This vision has now put Netherlands as the leading country in the world in monitoring air quality from space. Recent selection of TROPOMI by ESA attests to the success of this vision. I will present some selected highlights of our very successful collaboration on this project over the past 10 years.

  6. Visual search and contextual cueing: differential effects in 10-year-old children and adults.

    PubMed

    Couperus, Jane W; Hunt, Ruskin H; Nelson, Charles A; Thomas, Kathleen M

    2011-02-01

    The development of contextual cueing specifically in relation to attention was examined in two experiments. Adult and 10-year-old participants completed a context cueing visual search task (Jiang & Chun, The Quarterly Journal of Experimental Psychology, 54A(4), 1105-1124, 2001) containing stimuli presented in an attended (e.g., red) and unattended (e.g., green) color. When the spatial configuration of stimuli in the attended and unattended color was invariant and consistently paired with the target location, adult reaction times improved, demonstrating learning. Learning also occurred if only the attended stimuli's configuration remained fixed. In contrast, while 10 year olds, like adults, showed incrementally slower reaction times as the number of attended stimuli increased, they did not show learning in the standard paradigm. However, they did show learning when the ratio of attended to unattended stimuli was high, irrespective of the total number of attended stimuli. Findings suggest children show efficient attentional guidance by color in visual search but differences in contextual cueing.

  7. Cannabis use and the course of schizophrenia: 10-year follow-up after first hospitalization

    PubMed Central

    Foti, Daniel J.; Kotov, Roman; Guey, Lin T.; Bromet, Evelyn J.

    2013-01-01

    Objective The authors examined the relationship between cannabis use and the course of illness in schizophrenia over 10 years following first psychiatric hospitalization. Method We assessed 229 patients with a schizophrenia-spectrum disorder five times: during the first admission, and 6 months, 2 years, 4 years, and 10 years later. Ratings of cannabis use and psychiatric symptoms (psychotic, negative, disorganized, and depressive) were made at each assessment. Results The lifetime rate of cannabis use was 66.2%, and survival analysis revealed that this usage was associated with an earlier onset of psychosis. The rates of current use ranged from 10% to 18% across assessments. Cannabis status was moderately stable, with concordance between waves ranging rtet = 0.48 – 0.78. Mixed-effects logistic regression revealed that changes in cannabis use were associated with changes in psychotic symptoms over time even after gender, age, socio-economic status, other drug use, antipsychotic medication use, and other symptoms were controlled. Structural equation modeling indicated that the association with psychotic symptoms was bi-directional. Conclusions Cannabis use is associated with an adverse course of psychotic symptoms in schizophrenia, and vice versa, even after taking into account other clinical, substance, and demographic variables. The specificity of this relationship suggests that clinical interventions to reduce cannabis use may be best targeted at individuals with prominent psychotic symptoms. PMID:20478874

  8. Evaluation of 6 and 10 Year-Old Child Human Body Models in Emergency Events.

    PubMed

    Gras, Laure-Lise; Stockman, Isabelle; Brolin, Karin

    2017-01-01

    Emergency events can influence a child's kinematics prior to a car-crash, and thus its interaction with the restraint system. Numerical Human Body Models (HBMs) can help understand the behaviour of children in emergency events. The kinematic responses of two child HBMs-MADYMO 6 and 10 year-old models-were evaluated and compared with child volunteers' data during emergency events-braking and steering-with a focus on the forehead and sternum displacements. The response of the 6 year-old HBM was similar to the response of the 10 year-old HBM, however both models had a different response compared with the volunteers. The forward and lateral displacements were within the range of volunteer data up to approximately 0.3 s; but then, the HBMs head and sternum moved significantly downwards, while the volunteers experienced smaller displacement and tended to come back to their initial posture. Therefore, these HBMs, originally intended for crash simulations, are not too stiff and could be able to reproduce properly emergency events thanks, for instance, to postural control.

  9. A 10-Year Climatology of Amazonian Rainfall Derived from Passive Microwave Satellite Observations

    NASA Technical Reports Server (NTRS)

    Negri, Andrew J.; Anagnostou, Emmanouil N.; Adler, Robert F.

    1998-01-01

    In this study we present and describe a satellite-derived precipitation climatology over northern South America using a passive microwave technique, the Goddard Profiling Algorithm. A period of data slightly longer than 10 years is examined. The climatologies take the form of the mean estimated (adjusted) rainfall for a 10-year (+) period, with sub-divisions by month and meteorological season. For the six-year period 1992-1997, when two satellites were in operation, diurnal variability (to the extent it is discerned by four unequally spaced observations) is presented. We find an alternating pattern of morning and maxima stretching from the northeast (Atlantic coast) clear across the continent to the Pacific. The effects of topography, coastlines and geography (river valleys) on the rainfall patterns are clear. Interannual variability is examined by computing the deviations of yearly and warm season (DJF) rainfall from their respective long-term means. Interannual variability of the diurnal nature of the rainfall is presented, and the strong El Nino event of 1997-1998 is discussed.

  10. Mortality study of ethylene oxide workers in chemical manufacturing: a 10 year update.

    PubMed Central

    Teta, M J; Benson, L O; Vitale, J N

    1993-01-01

    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

  11. [Food avoidance emotional disorder in 3 to 10-year-old children: a clinical reality].

    PubMed

    Goëb, J-L; Azcona, B; Troussier, F; Malka, J; Giniès, J-L; Duverger, P

    2005-09-01

    We underline the clinical importance of a specific eating disorder in 3 to 10 years old children, when the majority of the works about the prepubertal eating disorders focus either on the period just preceding adolescence (often between 10 and 13 years), or on the second half of the first year of the baby. Within the eating disorders described in the literature, we compare the clinical presentation of most of these 3 to 10 years old children with the food avoidance emotional disorder described during adolescence. These problems of eating behaviour (various selective eating with or without provoked vomiting) are ignored for a long time in these young children because of quite a satisfactory growth, but these children are often seen in emergency rooms because of a brutally complete eating refusal. Therapeutic consultations allow these children to express their fears about diseases, poisoning and death, for themselves or for their close relations, in particular the mother, without endangering their body. The early recognition and care of these difficulties of conciliation between the body and the thoughts impose a narrow collaboration between paediatric and psychiatric staffs.

  12. 100% Retention of Snowpack Derived Nitrogen Over 10 Years in High Arctic Tundra

    NASA Astrophysics Data System (ADS)

    Choudhary, S.; Tye, A. M.; Young, S. D.; West, H. M.; Phoenix, G. K.

    2013-12-01

    Tundra ecosystems are susceptible to atmospheric nitrogen (N) deposition, increasing as a result of anthropogenic activities as well as climate change. Depositions that get accumulated within the snowpack during winter months are released in spring during snowmelt, providing a periodic input of reactive N in the melt water to such nutrient limited ecosystems. Identifying ecosystem N retention and allocation and how this change over time is important to understanding the long-term consequences of such N depositions to these ecosystems. We reanalysed 10 years later an atmospheric N deposition study established in Svalbard that in 2001 used 15N isotope tracers to determine the fate of N released from melting snowpack. Applications of 15N (99 atom%) at 0.1 and 0.5 g N m-2 were made immediately after snowmelt in 2001 as either Na15NO3 or 15NH4Cl. These applications were approximately 1 × and 5 × the yearly atmospheric deposition rates. In both the previous short-term (one week to two years after 15N tracer application) and our long-term re-sampling (10 years after 15N tracer application), ~67% of the total applied 15N was retained in the ecosystem, irrespective of the N forms or N dose. This meant the tundra had 100% long-term N retention after initial partitioning, suggesting a highly conservative N cycling. Bryophytes, followed by the organic soil horizon and then the microbial biomass formed the greatest short-term 15N sink. Maximum changes in 15N retention from the short- to long-term were observed in the microbial 15N pools, with ~75% of the 15N in soil located in its biomass during the initial partitioning (July 2001) decreasing to ~17% 10 years later. This indicates significant microbial N turnover mostly into stable humus N. In contrast, vascular plants, particularly Salix polaris, showed significant increases (~60%) in their 15N retention after 10 years, indicating a high capacity for acting as a long-term N sink in this tundra ecosystem. Because the largest

  13. A 10-year Review of the Clinical Presentation and Treatment Outcome of Asherman's Syndrome at a Center with Limited Resources

    PubMed Central

    Takai, IU; Kwayabura, AS; Ugwa, EA; Idrissa, A; Obed, JY; Bukar, M

    2015-01-01

    Background: Many women suffer from some degree of intrauterine adhesions (IUAs) presenting with various clinical symptoms and signs. Hysteroscopy is the mainstay of diagnosis, classification, and treatment of the IUA. Aim: This study was undertaken to review the clinical features and treatment outcome in patients diagnosed with Asherman's syndrome at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, over a 10 years period, 1997–2006. Subjects and Methods: This is a retrospective study of cases of Asherman's syndrome managed at the UMTH over a 10-year period, from January 1, 1997 to December 31, 2006. Case records of the patients were retrieved from medical records' Department. Sociodemographic and clinical information relating to clinical presentations, treatment modalities, and outcomes were collated. The data were analyzed using SPSS 16.0 Statistical Computer Package (SPSS Inc., IL, USA 2006). Chi-square and binary logistic regression were used for inferential statistics. Results: Asherman's syndrome constituted 8.1% (81/996) of all gynecological operations in UMTH during the study period. The case records retrieval rate was 96.3% (78/81 folders). Most of the patients, 59% (46/78) were in their third decade and majority 85.9% (67/78) were married. The most common risk factor was pregnancy-associated, accounting for 61.5% (48/78). Infertility and hypomenorrhea were the most common mode of presentations in 55.1% (43/78) and 32.1% (25/78) of cases, respectively. Most of the patients 85.9% (67/78) were treated by blind dilatation and curettage (D/C), Foley's catheter insertion and estrogen-progesterone combination. Correction of menses was seen in 37.2% (29/78) of the patients while the pregnancy rate was 32.1% (25/78). On binary logistic regression age of the respondents, multigravidity, and previous pelvic surgeries for pregnancy (C/S and D/C for abortion) emerged as the only respondent's related risk factors associated with the development of

  14. Neck Circumference and Incidence of Diabetes Mellitus over 10 Years in the Korean Genome and Epidemiology Study (KoGES).

    PubMed

    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

    2015-12-18

    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.

  15. Cardiovascular Health Status and Incidence of Heart Failure in the Framingham Offspring Study

    PubMed Central

    Nayor, Matthew; Enserro, Danielle M.; Vasan, Ramachandran S.; Xanthakis, Vanessa

    2015-01-01

    Background The American Heart Association Cardiovascular Health (CVH) score is inversely associated with cardiovascular disease, but its relations to cardiac remodeling traits and to heart failure (HF) incidence have not been examined. Methods and Results A 14-point score was constructed for each participant based on the presence of poor, intermediate or ideal status on each of the 7 CVH metrics (ideal score=14). We related the CVH score to echocardiographic traits cross-sectionally, and to HF incidence prospectively in the Framingham Offspring Study. In age- and sex-adjusted models, a higher CVH score was associated with lower left ventricular (LV) mass, LV wall thickness, LV diastolic dimension, and left atrial dimension (p<0.01 for all; N=2392, mean age 58 years, 56% women), and with a 12-15% lower odds of prevalent LV concentric remodeling and concentric hypertrophy, respectively (p<0.0001 for both). On follow-up (mean 12.3 years), 188 incident HF events were observed in 3201 participants (mean age 59 years, 53% women). In age- and sex-adjusted Cox proportional hazards models, the CVH score was inversely associated with HF incidence (hazards ratio [HR] per 1-point higher CVH score 0.77, 95% CI 0.72-0.83). This association was partially attenuated upon adjustment for LV mass and interim myocardial infarction (HR 0.84, 95% CI 0.76-0.93) and was consistent for HF with preserved and reduced ejection fractions. Conclusions In our community-based sample, comprised predominantly of middle-aged white individuals of European descent, better CVH was associated with lower HF incidence, in part due to a lower prevalence of adverse cardiac remodeling. PMID:26699391

  16. Associations of objective physical activity with insulin sensitivity and circulating adipokine profile: the Framingham Heart Study.

    PubMed

    Spartano, N L; Stevenson, M D; Xanthakis, V; Larson, M G; Andersson, C; Murabito, J M; Vasan, R S

    2017-04-01

    The purpose of this study was to explore the relation of physical activity (PA) and sedentary time (SED) to insulin sensitivity and adipokines. We assessed PA and SED using Actical accelerometers and insulin resistance (HOMA-IR) in 2109 participants (free of type 1 and 2 diabetes mellitus) from Framingham Generation 3 and Omni 2 cohorts (mean age 46 years, 54% women). Systemic inflammation (C-reactive protein [CRP]) and circulating adipokines were measured 6 years earlier. Steps per day, moderate-to-vigorous PA (MVPA) and SED per wear time (%SED) were predictor variables in multivariable regression analyses, with HOMA-IR, CRP and circulating adipokines as outcome measures. We reported that higher MVPA and more steps per day were associated with lower HOMA-IR, adjusting for %SED (β = -0.036, P = 0.002; β = -0.041, P = 0.005). Steps were inversely associated with CRP, but were directly associated with insulin-like growth factor (IGF)-1 levels (β = -0.111, P = 0.002; β = 3.293, P = 0.007). %SED was positively associated with HOMA-IR (β = 0.033, P < 0.0001), but non-significant after adjusting for MVPA (P = 0.13). %SED was associated with higher ratio of leptin/leptin receptor (sOB-R) and higher adipocyte fatty acid-binding protein (FABP)4 (β = 0.096, P < 0.0001; β = 0.593, P = 0.002). Our findings suggest differential influences of PA vs. SED on metabolic pathways, with PA modulating insulin resistance and inflammation, whereas SED influences FABPs.

  17. Dairy Intake Is Protective against Bone Loss in Older Vitamin D Supplement Users: The Framingham Study.

    PubMed

    Sahni, Shivani; Mangano, Kelsey M; Kiel, Douglas P; Tucker, Katherine L; Hannan, Marian T

    2017-04-01

    Background: Previous studies showed beneficial effects of specific dairy foods on bone health in middle-aged adults.Objective: We examined the association of milk, yogurt, cheese, cream, fluid dairy (milk + yogurt), and milk + yogurt + cheese intakes with bone mineral density (BMD) and 4-y percentage of change in BMD [▵%BMD; femoral neck, trochanter, and lumbar spine (LS)]. We further assessed whether these associations were modified by vitamin D supplement use in this cohort of older adults.Methods: Food-frequency questionnaire responses, baseline BMD (hip and spine, n = 862 in 1988-1989), and follow-up BMD (n = 628 in 1992-1993) were measured in the Framingham study, a prospective cohort study of older Caucasian men and women aged 67-93 y. Outcomes included baseline BMD and ▵%BMD. Dairy-food intakes (servings per week) were converted to energy-adjusted residuals, and linear regression was used, adjusting for covariates. These associations were further examined by vitamin D supplement use.Results: The mean age of the participants was 75 y. In the full sample, dairy-food items were not associated with BMD (P = 0.11-0.99) or with ▵%BMD (P = 0.29-0.96). Among vitamin D supplement users, but not among nonusers, higher milk, fluid dairy, and milk + yogurt + cheese intakes were associated with higher LS BMD (P = 0.011-0.009). Among vitamin D supplement users, but not among nonusers, higher milk + yogurt + cheese intakes were protective against trochanter BMD loss (P = 0.009).Conclusions: In this population of older adults, higher intakes of milk, fluid dairy, and milk + yogurt + cheese were associated with higher LS BMD, and a higher intake of milk + yogurt + cheese was protective against trochanter BMD loss among vitamin D supplement users but not among nonusers. These findings underscore that the benefits of dairy intake on the skeleton may be dependent on vitamin D intake.

  18. Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study

    PubMed Central

    Haugen, Ida K; Englund, Martin; Aliabadi, Piran; Niu, Jingbo; Clancy, Margaret; Kvien, Tore K; Felson, David T

    2013-01-01

    Objectives To describe the prevalence and longitudinal course of radiographic, erosive and symptomatic hand osteoarthritis (HOA) in the general population. Methods Framingham osteoarthritis (OA) study participants obtained bilateral hand radiographs at baseline and 9-year follow-up. The authors defined radiographic HOA at joint level as Kellgren–Lawrence grade (KLG)≥2, erosive HOA as KLG≥2 plus erosion and symptomatic HOA as KLG≥2 plus pain/aching/stiffness. Presence of HOA at individual level was defined as ≥1 affected joint. The prevalence was age-standardised (US 2000 Population 40–84 years). Results Mean (SD) baseline age was 58.9 (9.9) years (56.5% women). The age-standardised prevalence of HOA was only modestly higher in women (44.2%) than men (37.7%), whereas the age-standardised prevalence of erosive and symptomatic OA was much higher in women (9.9% vs 3.3%, and 15.9% vs 8.2%). The crude incidence of HOA over 9-year follow-up was similar in women (34.6%) and men (33.7%), whereas the majority of those women (96.4%) and men (91.4%) with HOA at baseline showed progression during follow-up. Incident metacarpophalangeal and wrist OA were rare, but occurred more frequently and from an earlier age in men than women. Development of erosive disease occurred mainly in those with non-erosive HOA at baseline (as opposed to those without HOA), and was more frequent in women (17.3%) than men (9.6%). Conclusions The usual female predominance of prevalent and incident HOA was less clear for radiographic HOA than for symptomatic and erosive HOA. With an ageing population, the impact of HOA will further increase. PMID:21622766

  19. Bivariate Linkage Study of Proximal Hip Geometry and Body Size Indices: The Framingham Study

    PubMed Central

    Dupuis, J.; Cupples, L. A.; Beck, T. J.; Mahaney, M. C.; Havill, L. M.; Kiel, D. P.; Demissie, S.

    2008-01-01

    Femoral geometry and body size are both characterized by substantial heritability. The purpose of this study was to discern whether hip geometry and body size (height and body mass index, BMI) share quantitative trait loci (QTL). Dual-energy X-ray absorptiometric scans of the proximal femur from 1,473 members in 323 pedigrees (ages 31–96 years) from the Framingham Osteoporosis Study were studied. We measured femoral neck length, neck-shaft angle, subperiosteal width (outer diameter), cross-sectional bone area, and section modulus, at the narrowest section of the femoral neck (NN), intertrochanteric (IT), and femoral shaft (S) regions. In variance component analyses, genetic correlations (ρG) between hip geometry traits and height ranged 0.30–0.59 and between hip geometry and BMI ranged 0.11–0.47. In a genomewide linkage scan with 636 markers, we obtained nominally suggestive linkages (bivariate LOD scores ≥ 1.9) for geometric traits and either height or BMI at several chromosomes (4, 6, 9, 15, and 21). Two loci, on chr. 2 (80 cM, BMI/shaft section modulus) and chr. X (height/shaft outer diameter), yielded bivariate LOD scores ≥ 3.0; although these loci were linked in univariate analyses with a geometric trait, neither was linked with either height or BMI. In conclusion, substantial genetic correlations were found between the femoral geometric traits, height and BMI. Linkage signals from bivariate linkage analyses of bone geometric indices and body size were similar to those obtained in univariate linkage analyses of femoral geometric traits, suggesting that most of the detected QTL primarily influence geometry of the hip. PMID:17674073

  20. Diagnostic Approach to Childhood-onset Cerebellar Atrophy: A 10-Year Retrospective Study of 300 Patients

    PubMed Central

    Al-Maawali, Almundher; Blaser, Susan; Yoon, Grace

    2013-01-01

    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

  1. Parkin disease in a Brazilian kindred: Manifesting heterozygotes and clinical follow-up over 10 years.

    PubMed

    Khan, Naheed L; Horta, Wagner; Eunson, Louise; Graham, Elizabeth; Johnson, Janel O; Chang, Shannon; Davis, Mary; Singleton, Andrew; Wood, Nicholas W; Lees, Andrew J

    2005-04-01

    We report on a large Brazilian kindred with young-onset parkinsonism due to either a homozygous or heterozygous mutation in parkin. A total of 6 members were affected: 5 were homozygous and 1 heterozygous for a deletion in exon 4. Two other heterozygotes also had extrapyramidal signs. All affected subjects showed characteristic features of parkin disease with foot dystonia and an excellent response to levodopa complicated by motor fluctuations and dyskinesia within 3 years of therapy. Careful clinical follow-up over 10 years showed the phenotype was similar in all the homozygotes with asymmetrical limb bradykinesia and early walking difficulties. Some acceleration of disability was observed in some of the cases as they entered the third decade of illness, but dementia was absent.

  2. A review of Internet pornography use research: methodology and content from the past 10 years.

    PubMed

    Short, Mary B; Black, Lora; Smith, Angela H; Wetterneck, Chad T; Wells, Daryl E

    2012-01-01

    Internet pornography (IP) use has increased over the past 10 years. The effects of IP use are widespread and are both negative (e.g., relationship and interpersonal distress) and positive (e.g., increases in sexual knowledge and attitudes toward sex). Given the possible negative effects of IP use, understanding the definition of IP, the types of IP used, and reasons for IP use is important. The present study reviews the methodology and content of available literature regarding IP use in nondeviant adult populations. The study seeks to determine how the studies defined IP, utilized validated measures of pornography use, examined variables related to IP, and addressed form and function of IP use. Overall, studies were inconsistent in their definitions of IP, measurement, and their assessment of the form and function of IP use. Discussion regarding how methodological differences between studies may impact the results and the ability to generalize findings is provided, and suggestions for future studies are offered.

  3. Radicular Perforation Repair with Mineral Trioxide Aggregate: A Case Report with 10-Year Follow-up

    PubMed Central

    Cosme-Silva, Leopoldo; Carnevalli, Breno; Sakai, Vivien Thiemy; Viola, Naiana Viana; Franco de Carvalho, Leon; Franco de Carvalho, Elaine Manso Oliveira

    2016-01-01

    Background: Iatrogenic complications such as accidental perforation of the root or the floor of the pulp chamber may occur. Case Report: Patient was referred for root canal retreatment of the mandibular left second molar with periapical lesion evidenced through radiographic examination. During post removal, iatrogenic perforation occurred at the mesial face of the distal root. After clinical localization of the perforation and bleeding control, MTA was applied. In a second appointment, the root canal filling was removed and the chemical-surgical retreatment of the canals was performed, followed by the obturation with gutta-percha and sealer. Patient returned after three days reporting no pain. After 6 months, 3, 7 and 10 years of follow-up. Conclusion: Absence of pain, normal periodontal probing and lack of radiolucent area at the region of perforation and the periapices were detected, which evidenced the successful repair of the tooth. PMID:28217189

  4. [10 years after Chernobyl--radioactivity of mother's milk-- measurements from Tirol, Tibet and Nepal].

    PubMed

    Lechner, W; Brunner, P; Bergant, A; Pastner, E; Müller, D

    1997-11-28

    10 years after the Chernobyl disaster gamma radioactivity from Cs-137 was determined in 53 breast milk samples from Tyrol, as well as 9 samples from Tibet and 2 from Nepal by means of a gamma-spectrometer with a germanium detector. In contrast to the values obtained within a few days, and again 1 year after the nuclear plant catastrophe, all samples from Tyrol showed gamma radioactivity levels (median 0.07 nCi/l; range 0.02-0.20 nCi/l) which were now below the limit laid down for baby food in Austria (0.3 nCi/l-11.1 Bq). The samples from Tibet and Nepal registered a slightly higher level of gamma radioactivity (median 0.16 nCi/l; range 0.16-0.41 nCi/l).

  5. Health Care Finance Executive Personalities Revisited: A 10-Year Follow-up Study.

    PubMed

    Lieneck, Cristian; Nowicki, Michael

    2015-01-01

    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.

  6. [Association between Crohn's disease and primary sclerosing cholangitis in a 10 year old girl].

    PubMed

    Muñoz Lozón, Ana; Iglesias Blázquez, Cristina; Menéndez Arias, Cristina; Domínguez Sánchez, Patricia

    2016-06-01

    A 10 year old girl with diarrhea, abdominal pain, weight loss and fever of one month and a half of evolution. Analytical and sonographic findings raised the possibility of inflammatory bowel disease. Endoscopy and histology showed findings consistent with Crohn's disease. Treatment was initiated with mesalazine and exclusive enteral nutrition. Later corticosteroid treatment, immunosuppressive drugs and ursodeoxycholic acid were added due to cholestasis and persistent hypergammaglobulinemia. Magnetic resonance cholangiography and liver biopsy confirmed the diagnosis of concomitant primary sclerosing cholangitis. The association between Crohn's disease and primary sclerosing cholangitis is rare, predominantly in males between 20 and 40 years old and it presents a great clinical variability. The confirmation of the diagnosis requires magnetic resonance cholangiography or endoscopic retrograde cholangiopancreatography. The prognosis is poor and there is no treatment to slow the progression of the disease.

  7. The treatment of acute traumatic rupture of the aorta: a 10-year experience.

    PubMed Central

    Kirsh, M M; Behrendt, D M; Orringer, M B; Gago, O; Gray, L A; Mills, L J; Walter, J F; Sloan, H

    1976-01-01

    Forty-three patients with aortic rupture secondardy to blunt trauma have been treated at the University of Micigan within the past 10 years with an overall salvage rate of 70%. The diagnosis should be suspected in anyone who has sustained a high speed decelerating injury, if the chest roentgenogram shows media-stinal widening, whether or not there is hypertension of the upper extremities; systolic murmur, or external evidence of chest injury. Aortography should be employed to confirm the diagnosis and to determine the site or sites of rupture. Repair of the lesion should be undertaken as soon as possible and takes priority in most instances over associated injuries. Repair in almost all cases can be accomplished safely and quickly using a bypass shunt without the aid of extracorporeal circulation. Images Fig. 1. Fig. 2. PMID:962399

  8. Occupational therapy and the journal citation reports: 10-year performance trajectories.

    PubMed

    Holguin, Jess Anthony

    2009-01-01

    The purpose of this study was to document performance of occupational therapy journals on the metrics of the Journal Citation Reports (JCR), the annually appearing index used as a yardstick to assess the quality of scholarly publications. Outcomes for the field's two indexed journals, the American Journal of Occupational Therapy and OTJR: Occupation, Participation and Health, were assessed over a 10-year period (1996-2005) to determine their overall standing and patterns of change on each of the JCR's five metrics. The mean category ranking for the two journals was generally above the 50th percentile. However, they performed least adequately and evidenced a downward trend over time on the most widely used metric (the journal impact factor). Possible reasons underlying this latter result are explored, pressing implications of the overall findings for practice and research are discussed, and strategic steps toward ethically safeguarding the profession's viability are offered.

  9. A 10-year plan to study the aquifer system of Indian Wells Valley, California

    USGS Publications Warehouse

    Lipinski, Paul; Knochenmus, Darwin D.

    1981-01-01

    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)

  10. From Exotic to Mainstream: A 10-year Odyssey from Internet Speed to Boundary Spanning with Scrum

    NASA Astrophysics Data System (ADS)

    Baskerville, Richard; Pries-Heje, Jan; Madsen, Sabine

    Based on four empirical studies conducted over a 10-year time period from 1999 to 2008 we investigate how local software processes interact with global changes in the software development context. In 1999 companies were developing software at high speed in a desperate rush to be first-to-market. In 2001 a new high speed/quick results development process had become established practice. In 2003 changes in the market created the need for a more balanced view on speed and quality, and in 2008 companies were successfully combining agile and plan driven approaches to achieve the benefits of both. The studies reveal a twostage pattern in which dramatic changes in the market causes disruption of established practices, experimentation, and process adaptations followed by consolidation of lessons learnt into a new (and once again mature) software development process. Limitations, implications, and areas for future research are discussed.

  11. Incontinentia Pigmenti; a Rare Multisystem Disorder: Case Report of a 10-Year-Old Girl

    PubMed Central

    Rafatjoo, Rezvan; Taghdisi Kashani, Amene

    2016-01-01

    Incontinentia pigmenti is a rare genodermatosis in which the skin involvement occurs in all patients. Additionally, other ectodermal tissues may be affected such as the central nervous system, eyes, hair, nails and teeth. The disease has an X-linked dominant inheritance pattern. But in our case, there was a mutation in the body cells due to incontinentia pigmenti. The dermatological findings occur in four successive phases. We report the case of a 10-year-old female presented cutaneous, dental and ophthalmic characteristic with 3 years follow-up. Dental anomalies such as hypodontia, peg-shaped anterior teeth, malformed primary and permanent teeth, and delayed eruption were seen in our patient. PMID:27602400

  12. The World Health Organization European Health in Prisons Project after 10 years: persistent barriers and achievements.

    PubMed

    Gatherer, Alex; Moller, Lars; Hayton, Paul

    2005-10-01

    The recognition that good prison health is important to general public health has led 28 countries in the European Region of the World Health Organization (WHO) to join a WHO network dedicated to improving health within prisons. Within the 10 years since that time, vital actions have been taken and important policy documents have been produced. A key factor in making progress is breaking down the isolation of prison health services and bringing them into closer collaboration with the country's public health services.However, barriers to progress remain. A continuing challenge is how best to move from policy recommendations to implementation, so that the network's fundamental aim of noticeable improvements in the health and care of prisoners is further achieved.

  13. Gastric Banding: Advantages and Complications. A 5- and 10-Year Follow-up.

    PubMed

    Fried; Peskova

    1995-11-01

    BACKGROUND: Gastric banding is one of the simplest surgical procedures for the treatment of morbid obesity. We performed more than 150 'laparotomy' (open) gastric bandings and more than 50 'laparoscopic' bandings in the last 1 0 years. METHODS: In most procedures we used non-adjustable bands, but since the beginning of 1995 we have used adjustable silicone banding. RESULTS: The 5- and 10-year follow-up weight loss results are encouraging. The average long-term weight loss was 35.5 kg. Since 1993, we performed all the procedures laparoscopically, and the postoperative complications decreased from 18.5% in the 'laparotomy' group to 9.5% in the 'laparoscopic' group, with the majority being esophagus and outlet area irritation. CONCLUSION: Gastric banding itself and especially the minimally invasive laparoscopic approach is an easy technical procedure. The long-term weight loss results and the reoperation rate are acceptable for bariatric surgery criteria.

  14. The Effects of Lack of Joint Goal Planning on Divorce over 10 Years

    PubMed Central

    Gere, Judith; Almeida, David M.; Martire, Lynn M.

    2016-01-01

    Given the negative consequences of divorce on health and well-being, it is important to try to identify its predictors. In the current study we used data from the National Survey of Midlife Development (N = 2801) to examine the longitudinal effects of lack of joint goal planning with a romantic relationship partner on divorce over a 10-year period. Multilevel regression analyses showed that lack of joint planning with the relationship partner was associated with a 19% increase in the odds of divorce, even when controlling for various demographic (i.e., age, gender, relationship length, number of children in the household), individual (i.e., neuroticism, positive affect, negative affect, physical symptoms, planning), and relationship (i.e., marital empathy, partner strain, partner disagreement, marital satisfaction, commitment). These results demonstrate the importance of considering one’s partner when making decisions and plans for the future, given that it has clear implications for relationship dissolution. PMID:27668863

  15. The genetic and environmental etiology of high math performance in 10-year-old twins.

    PubMed

    Petrill, Stephen A; Kovas, Yulia; Hart, Sara A; Thompson, Lee A; Plomin, Robert

    2009-07-01

    The genetic and environmental etiology of high math performance (at or above the 85%tile) was examined in a population-based sample of 10-year-old twins (nMZ = 1,279, nDZ = 2,305). Math skills were assessed using a web-based battery of math performance tapping skills related to the UK National Math Curriculum. Probandwise concordance rates and liability threshold models indicated that genetic and shared environmental influences were significant, and that these estimates were generally similar to those obtained across the normal range of ability and did not vary significantly by gender. These results suggest that the genetic and environmental influences at the high end of ability are likely to be continuous with those that affect the entire range of math performance across all children irrespective of gender.

  16. Tuskegee Bioethics Center 10th anniversary presentation: "Commemorating 10 years: ethical perspectives on origin and destiny".

    PubMed

    Prograis, Lawrence J

    2010-08-01

    More than 70 years have passed since the beginning of the Public Health Service syphilis study in Tuskegee, Alabama, and it has been over a decade since President Bill Clinton formally apologized for it and held a ceremony for the Tuskegee study participants. The official launching of the Tuskegee University National Center for Bioethics in Research and Health Care took place two years after President Clinton's apology. How might we fittingly discuss the Center's 10th Anniversary and the topic 'Commemorating 10 Years: Ethical Perspectives on Origin and Destiny'? Over a decade ago, a series of writers, many of them African Americans, wrote a text entitled 'African-American Perspectives on Biomedical Ethics'; their text was partly responsible for a prolonged reflection by others to produce a subsequent work, 'African American Bioethics: Culture, Race and Identity'. What is the relationship between the discipline of bioethics and African American culture? This and related questions are explored in this commentary.

  17. Use of Qualitative Methods in Published Health Services and Management Research: A 10-Year Review

    PubMed Central

    Weiner, Bryan J.; Amick, Halle R.; Lund, Jennifer L.; Lee, Shoou-Yih Daniel; Hoff, Timothy J.

    2011-01-01

    Over the past 10 years, the field of health services and management research has seen renewed interest in the use of qualitative research methods. This article examines the volume and characteristics of qualitative research articles published in nine major health services and management journals between 1998 and 2008. Qualitative research articles comprise 9% of research articles published in these journals. Although the publication rate of qualitative research articles has not kept pace with that of quantitative research articles, citation analysis suggests that qualitative research articles contribute comparably to the field’s knowledge base. A wide range of policy and management topics has been examined using qualitative methods. Case study designs, interviews, and documentary sources were the most frequently used methods. Half of qualitative research articles provided little or no detail about key aspects the study’s methods. Implications are discussed and recommendations are offered for promoting the publication of qualitative research. PMID:20675353

  18. [Epidemiology of neuroblastoma in Brittany over a 10-year period (1980-1989)].

    PubMed

    Blanchot, I; Bergeron, C; Roussey, M; De Parscau, L; Le Gall, E

    1993-01-01

    We report the results of a retrospective epidemiologic study on neuroblastoma in Brittany, a region of France characterized by an homogeneous sedentary population living on a granitic ground. During a period of 10 years (1980-1989), 48 cases of neuroblastoma were observed, which gives an incidence of 7.92 cases per million of children under 15 years. There were 25 boys and 23 girls and 20 infants under 1 year (41%). The localisation was abdominal in 39 cases (81%). Among the 28 children older than 1 year, 25 (89%) had stage III and stage IV neuroblastomas, half of them with metastases. We conclude that the incidence and the clinical presentation of neuroblastoma in Brittany are similar to those reported in other countries.

  19. A 10-year review of outpatient skin biopsy results and skin cancer subtypes.

    PubMed

    DeMarco, Sebastian S; Vos, Paul; Green, Harris; Defazio, Jennifer; Davis, Natalie; Fiz, Lindsey; Phillips, Charles

    2016-01-15

    The results of skin biopsies over a 10 year period were reviewed from the outpatient dermatology clinic at the Brody School of Medicine in Greenville, North Carolina. This research was conducted because there are very few studies that characterize this information over a long-term horizon. The biopsy rate per patient encounter, the clinical reason for the biopsy, the biopsy outcomes, the distribution of cutaneous malignancies per encounter, and the distribution of the subtypes of basal cell carcinoma, squamous cell carcinoma, and melanoma were analyzed. Biopsy logs from January 1, 2001 to December 31, 2010 were reviewed. Our investigation found that 20% of patient encounters resulted in a biopsy. Of these biopsies, 87.9% were performed to rule out malignancy and 12.1% were completed on patients suspected of having inflammatory skin conditions. The basal cell carcinomas diagnosed in Greenville, NC have more aggressive histologic subtypes compared to other studies, whereas the squamous cell carcinomas and melanomas were less aggressive.

  20. The Effects of Lack of Joint Goal Planning on Divorce over 10 Years.

    PubMed

    Gere, Judith; Almeida, David M; Martire, Lynn M

    Given the negative consequences of divorce on health and well-being, it is important to try to identify its predictors. In the current study we used data from the National Survey of Midlife Development (N = 2801) to examine the longitudinal effects of lack of joint goal planning with a romantic relationship partner on divorce over a 10-year period. Multilevel regression analyses showed that lack of joint planning with the relationship partner was associated with a 19% increase in the odds of divorce, even when controlling for various demographic (i.e., age, gender, relationship length, number of children in the household), individual (i.e., neuroticism, positive affect, negative affect, physical symptoms, planning), and relationship (i.e., marital empathy, partner strain, partner disagreement, marital satisfaction, commitment). These results demonstrate the importance of considering one's partner when making decisions and plans for the future, given that it has clear implications for relationship dissolution.

  1. Predictors Associated with Changes of Weight and Total Cholesterol among two Occupational Cohorts over 10 Years

    PubMed Central

    Stanford, Joseph B.; Murtaugh, Maureen A.; Greenwood, Jessica L.J.; Gren, Lisa H.; Hegmann, Kurt T.; Thiese, Matthew S.

    2015-01-01

    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

  2. Effects of background and classroom characteristics on the science achievement of 10-year-old students

    NASA Astrophysics Data System (ADS)

    Rosier, Malcolm

    1990-01-01

    Effects of characteristics of science classrooms on the science achievement of students were examined in the context of a simple model. The model incorporated prior attributes of the students in terms of home background, sex, and verbal and quantitative ability. The model was estimated by means of partial least squares multivariate procedures using data for 10-year-old Queensland students from the Second International Science Study. The results demonstrated the dominant influence of home background and verbal/mathematical ability. Female students tended to have lower scores after allowing for the influence of the other variables in the model. Students who stated that there were more student initiated activities in their science lessons tended to have lower achievement.

  3. Tracking 10-year competitive winning performance of judo athletes across age groups.

    PubMed

    Julio, Ursula F; Takito, Monica Y; Mazzei, Leandro; Miarka, Bianca; Sterkowicz, Stanislaw; Franchini, Emerson

    2011-08-01

    Little information is available concerning early specialization and competitive success in judo across the early training years. Thus, the present objective was to verify the stability of individual competitive performance of a state-level championship for judo athletes who had been previously successful. For this, 406 athletes from six age groups (9 to 20+ years old) of each sex were followed for 10 years. Using recorded data from the São Paulo State Judo Federation beginning in 1999, the scores and standings for these judo players were analyzed. The proportion of medal winners during this period was not constant, differing from the grand mean in all groups of both 204 males and 202 females. At the end of this period, only 7% of the male and 5% of the female athletes had maintained their competitive levels. Successful competitive performance in early judo competition was not associated with success later in adulthood.

  4. Intercostal myositis ossificans misdiagnosed as osteosarcoma in a 10-year-old child.

    PubMed

    Koob, Mériam; Durckel, Jean; Dosch, Jean-Claude; Entz-Werle, Natacha; Dietemann, Jean-Louis

    2010-12-01

    Myositis ossificans (MO) is a rare benign cause of heterotopic bone formation within soft tissue. It most commonly affects adolescents and young adults, typically in the limbs and following trauma. Very few cases have been reported in children. We report here a case of nontraumatic MO occurring in a 10-year-old girl with an uncommon location in the 5th right intercostal space; it was initially misdiagnosed and treated as osteosarcoma. Imaging findings including plain radiographs, CT, MRI, bone scintigraphy and PET-CT are described. This case highlights the central role played by imaging in diagnosis, thus avoiding biopsy that can erroneously suggest osteosarcoma as the diagnosis, as occurred in this case.

  5. Nitrogen containing bisphosphonates associated osteonecrosis of the jaws: A review for past 10 year literature

    PubMed Central

    Kumar, Vijay; Shahi, Ashish Kumar

    2014-01-01

    Nitrogen containing bisphosphonate (N-BP) therapy is used extensively to treat osteoporosis and osteolytic bone lesions. Recently, a special form of osteonecrosis limited to the maxillofacial skeleton has been discovered especially within those patients who are receiving either long-term N-BP therapy alone and/or associated with invasive dental procedure. Bisphosphonates accumulate almost exclusively in maxillofacial skeleton owing to high bone turn over remodeling to maintain the mechanical competence. The pathogenesis and why it commonly appears in maxillofacial skeleton and the fixed treatment strategies remains unknown. The aim of this study was to improve the clinician understanding of N-BPs associated osteonecrosis of maxillofacial skeleton by reviewing the past 10 year literature. PMID:24932183

  6. 10-year results of the uncemented Allofit press-fit cup in young patients

    PubMed Central

    Streit, Marcus R; Weiss, Stefan; Andreas, Franziska; Bruckner, Thomas; Walker, Tilman; Kretzer, J Philippe; Ewerbeck, Volker; Merle, Christian

    2014-01-01

    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

  7. Community structure and quality after 10 years in two central Ohio mitigation bank wetlands.

    PubMed

    Spieles, Douglas J; Coneybeer, Meagan; Horn, Jonathan

    2006-11-01

    We evaluate two 10-year-old mitigation bank wetlands in central Ohio, one created and one with restored and enhanced components, by analysis of vegetation characteristics and by comparison of the year-10 vegetation and macroinvertebrate communities with reference wetlands. To assess different measures of wetland development, we compare the prevalence of native hydrophytes with an index of floristic quality and we evaluate the predictability of these parameters in year 10, given 5 years of data. Results show that the mitigation wetlands in this study meet vegetation performance criteria of native hydrophyte establishment by year 5 and maintain these characteristics through year 10. Species richness and floristic quality, as well as vegetative similarity with reference wetlands, differ among mitigation wetlands in year 1 and also in their rate of change during the first 10 years. The prevalence of native hydrophytes is reasonably predictable by year 10, but 5 years of monitoring is not sufficient to predict future trends of floristic quality in either the created or restored wetland. By year 10, macroinvertebrate taxa richness does not statistically differ among these wetlands, but mitigation wetlands differ from reference sites by tolerance index and by trophic guild dominance. The created wetland herbivore biomass is significantly smaller than its reference, whereas detritivore biomass is significantly greater in the created wetland and smaller in the restored wetland as compared with respective reference wetlands. These analyses illustrate differences in measures of wetland performance and contrast the monitoring duration necessary for legal compliance with the duration required for development of more complex indicators of ecosystem integrity.

  8. Community Structure and Quality After 10 Years in Two Central Ohio Mitigation Bank Wetlands

    NASA Astrophysics Data System (ADS)

    Spieles, Douglas J.; Coneybeer, Meagan; Horn, Jonathan

    2006-11-01

    We evaluate two 10-year-old mitigation bank wetlands in central Ohio, one created and one with restored and enhanced components, by analysis of vegetation characteristics and by comparison of the year-10 vegetation and macroinvertebrate communities with reference wetlands. To assess different measures of wetland development, we compare the prevalence of native hydrophytes with an index of floristic quality and we evaluate the predictability of these parameters in year 10, given 5 years of data. Results show that the mitigation wetlands in this study meet vegetation performance criteria of native hydrophyte establishment by year 5 and maintain these characteristics through year 10. Species richness and floristic quality, as well as vegetative similarity with reference wetlands, differ among mitigation wetlands in year 1 and also in their rate of change during the first 10 years. The prevalence of native hydrophytes is reasonably predictable by year 10, but 5 years of monitoring is not sufficient to predict future trends of floristic quality in either the created or restored wetland. By year 10, macroinvertebrate taxa richness does not statistically differ among these wetlands, but mitigation wetlands differ from reference sites by tolerance index and by trophic guild dominance. The created wetland herbivore biomass is significantly smaller than its reference, whereas detritivore biomass is significantly greater in the created wetland and smaller in the restored wetland as compared with respective reference wetlands. These analyses illustrate differences in measures of wetland performance and contrast the monitoring duration necessary for legal compliance with the duration required for development of more complex indicators of ecosystem integrity.

  9. Lamont-Doherty's Secondary School Field Research Program: 10 years of field research-based education.

    NASA Astrophysics Data System (ADS)

    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.

    2014-12-01

    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".

  10. Treatment of Bilateral Refractive Amblyopia in Children 3 to <10 Years Old

    PubMed Central

    Wallace, David; Chandler, Danielle L.; Beck, Roy W.; Arnold, Robert W.; Bacal, Darron A.; Birch, Eileen E.; Felius, Joost; Frazier, Marcela; Holmes, Jonathan M.; Hoover, Darren; Klimek, Deborah A.; Lorenzana, Ingryd; Quinn, Graham E.; Repka, Michael X.; Suh, Donny W.; Tamkins, Susanna

    2007-01-01

    Purpose To determine the amount and time course of binocular visual acuity improvement during treatment of bilateral refractive amblyopia in children age 3 to <10 years old Design Prospective, multicenter noncomparative intervention Methods 113 children (mean age = 5.1 years) with previously untreated bilateral refractive amblyopia were enrolled at 27 community- and university-based sites and were provided optimal spectacle correction. Bilateral refractive amblyopia was defined as 20/40 to 20/400 best-corrected binocular acuity in the presence of ≥ 4.00 D hypermetropia by spherical equivalent and/or ≥ 2.00 D astigmatism in each eye. Best-corrected binocular and monocular visual acuities were measured at baseline and at 5, 13, 26 and 52 weeks. The primary study outcome was binocular acuity at one year. Results Mean binocular visual acuity improved from 0.50 logMAR (20/63) at baseline to 0.11 l