scholarly journals P2-411: EFFECTS OF ANTICHOLINERGIC BURDEN ON GREY BRAIN MATTER VOLUMES IN A POPULATION-BASED COHORT ACROSS THE ENTIRE ADULT AGE RANGE

2019 ◽  
Vol 15 ◽  
pp. P765-P765
Author(s):  
Ingo Kilimann ◽  
Wittfeld Katharina ◽  
Diana Wucherer ◽  
Till Ittermann ◽  
Henry Voelzke ◽  
...  
GeroScience ◽  
2021 ◽  
Author(s):  
Ingo Kilimann ◽  
Diana Wucherer ◽  
Till Ittermann ◽  
Henry Völzke ◽  
Robin Bülow ◽  
...  

AbstractMany medications of different indications have a relevant anticholinergic activity. The anticholinergic burden of medication has been shown to have significant effects on the cognition and the risk for cognitive impairment and dementia particularly in older patients. So far, most of the studies used data from geriatric patients and the effect of the anticholinergic burden on brain structures is still unexplored. Our study aimed to analyze possible associations of hippocampus and cholinergic basal forebrain volumes as vulnerable brain structures for the development of dementia and the anticholinergic burden in a population-based cohort of non-demented participants spanning the adult age range from 21 to 80 years. We analyzed associations between medication-related anticholinergic burden and structural MRI volumes from participants (n = 3087, 52.2% female) of the population-based “Study of Health in Pomerania” (SHIP). Anticholinergic burden was obtained from the current medication plan using the Anticholinergic Burden Scale (ACB). All analyses were adjusted for age, sex, education, and total intracranial volume. We found statistically significant associations between the ACB and the left and right hippocampus volume but not for the basal forebrain cholinergic system. Complementary voxel-based analysis across all participants revealed FWE-corrected (p =  < 0.05) clusters in the temporo-parietal regions reaching into frontal areas, showing reduced volumes with higher ACB scores. We identified an association between anticholinergic burden of medication on hippocampal volume suggesting a potential inverse effect of such medication. This association highlights the importance of a careful prescription of medication with anticholinergic activity at any adult age.


2019 ◽  
Vol 15 ◽  
pp. P95-P95
Author(s):  
Ingo Kilimann ◽  
Wittfeld Katharina ◽  
Diana Wucherer ◽  
Till Ittermann ◽  
Henry Voelzke ◽  
...  

2021 ◽  
Vol 10 (7) ◽  
pp. 1381
Author(s):  
Hun-Ju Yu ◽  
Meng-Ni Chuang ◽  
Chiao-Lun Chu ◽  
Pei-Lin Wu ◽  
Shu-Chen Ho ◽  
...  

Kawasaki disease (KD) is a systemic vasculitis that primarily affects children under the age of 5 years old. The most significant complication is coronary artery lesions, but several ocular manifestations have also been reported. Recently, one study revealed an increasing incidence of myopia among KD patients. Therefore, the aim of this study was to assess the difference in myopic incidence between Kawasaki disease (KD) patients treated with aspirin and intravenous immunoglobulin (IVIG). Materials and methods: We carried out a nationwide retrospective cohort study by analyzing the data of KD patients (ICD-9-CM code 4461) from Taiwan’s National Health Insurance Research Database (NHIRD) during the period of 1996–2013. Results: A total of 14,102 diagnosed KD were found in Taiwan during the study period. After excluded missing data, treatment strategy and age distribution, a total of 1446 KD patients were enrolled for analysis including 53 of which received aspirin (without IVIG) and 1393 of which were treated with IVIG. Patients who had myopia, astigmatism, glaucoma, cataract, etc. prior to their KD diagnosis were excluded. The age range was 0 to 6 years old. According to the cumulative curves, our results demonstrated that the myopic incidence in the IVIG group was significantly lower than the aspirin group (hazard ratio: 0.59, 95% confidence intervals: 0.36~0.96, p = 0.02). Treatment with IVIG for KD patients may have benefit for myopia control. Conclusion: Compared to aspirin, IVIG may decrease the myopic risk in KD patients. However, it needs further investigation including clinical vision survey of myopia due to the limitations of this population-based study.


2019 ◽  
pp. 1-4
Author(s):  
Darwin Firmansyah Siregar ◽  
Frank Bietra Buchari ◽  
Utama Abdi Tarigan ◽  
Aznan Lelo

Introduction: According to data from Perhimpunan Dokter Bedah Plastik Rekonstruksi dan Estetik Indonesia (PERAPI), there are only 193 plastic surgeons throughout Indonesia. There is no sufcient data that described pattern of incidence, workload, and role of Plastic Surgery in trauma cases at Indonesian Referral Center Hospital, especially in the Province of North Sumatra. Methods: This research is a descriptive study with a retrospective approach. Sample of this study was medical records of trauma patients who required Plastic Surgery who came to the H. Adam Malik General Hospital Medan Emergency Room (1 January 2016-31 December 2018). This study used total sampling method. Results: This study involved 536 patients and 40.85% included in the adult age range. Men vs women ratio is 3:1 (405 vs 131). Based on type of injury, the most common injury is facial trauma, followed by burns and soft tissue injuries (291, 178 and 66). The most common etiology is trafc accidents (90 cases). Most of facial bone fractures located at mandibular bone (segmental fracture). Inhalation trauma due to burns only occurred in 6 cases (3.24%). Most of soft tissue injuries occurred at lower extremities (upper limbs). Conclusion: Trafc accidents are the most common etiology for trauma in Plastic Surgery. Most of the patients are men and included in the adult age range. Facial trauma is the most common injury in Plastic Surgery. Most facial bone fractures located at mandible (symphysis and parasymphysis). Most of burns injury are re burns. Most soft tissue injuries are located at lower extremities (upper limbs).


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
David Conen ◽  
Stefanie Aeschbacher ◽  
Lutgarde Thijs ◽  
Yan Li ◽  
José Boggia ◽  
...  

Introduction: Mean daytime ambulatory blood pressure (ABP) values are considered to be lower than conventional BP (CBP) values, but data on this relation among younger individuals <50 years are scarce. To address this issue, we performed a collaborative analysis in a large group of participants representing a wide age range. Methods: CBP and 24-hour ABP were measured in 9550 individuals not taking BP lowering treatment from 13 population based cohorts. We compared the individual differences between daytime ABP and CBP according to 10-year age categories. Age-specific prevalences of white-coat hypertension and masked hypertension were calculated based on guideline-recommended thresholds. Results: Among individuals aged 18-30, 30-40 and 40-50 years, mean daytime systolic and diastolic ABP were significantly higher than the corresponding CBP (6.0, 5.2 and 4.7 mmHg for systolic BP; 2.5, 2.7 and 1.7 mmHg for diastolic BP, all p<0.0001) (Figure). Systolic and diastolic BP indices were similar in participants aged 50-60 years (p=0.20 and 0.11, respectively). In individuals aged 60-70 and ≥70 years, CBP was significantly higher than daytime ABP (5.0 and 13.0 mmHg for systolic BP; 2.0 and 4.2 mmHg for diastolic BP, all p<0.0001) (Figure). Accordingly, the prevalence of white coat hypertension exponentially increased from 2.2% to 19.5% from those aged 18-30 years to those aged ≥70 years, with some variation between men and women (prevalence 8.0% versus 6.1%, p=0.0003). Masked hypertension was more prevalent among men (21.1% versus 11.4%, p<0.0001). The age-specific prevalence of masked hypertension was 18.2%, 27.3%, 27.8%, 20.1% 13.6% and 10.2% in men, and 9.0%, 9.9%, 12.2%, 11.9%, 14.7% and 12.1% in women. Conclusions: In this large collaborative analysis we found that the relation between daytime ABP and CBP strongly varies by age. These findings may have important implications for the diagnosis of hypertension and its subtypes in clinical practice.


Neurology ◽  
2020 ◽  
Vol 94 (8) ◽  
pp. e797-e801 ◽  
Author(s):  
Sara Nuovo ◽  
Ilaria Bacigalupo ◽  
Monia Ginevrino ◽  
Roberta Battini ◽  
Enrico Bertini ◽  
...  

ObjectiveTo estimate the prevalence of Joubert syndrome (JS) in Italy applying standards of descriptive epidemiology and to provide a molecular characterization of the described patient cohort.MethodsWe enrolled all patients with a neuroradiologically confirmed diagnosis of JS who resided in Italy in 2018 and calculated age and sex prevalence, assuming a Poisson distribution. We also investigated the correlation between proband chronological age and age at diagnosis and performed next-generation sequencing (NGS) analysis on probands' DNA when available.ResultsWe identified 284 patients with JS: the overall, female- and male-specific population-based prevalence rates were 0.47 (95% confidence interval [CI] 0.41–0.53), 0.41 (95% CI 0.32–0.49), and 0.53 (95% CI 0.45–0.61) per 100,000 population, respectively. When we considered only patients in the age range from 0 to 19 years, the corresponding population-based prevalence rates rose to 1.7 (95% CI 1.49–1.97), 1.62 (95% CI 1.31–1.99), and 1.80 (95% CI 1.49–2.18) per 100,000 population. NGS analysis allowed identifying the genetic cause in 131 of 219 screened probands. Age at diagnosis was available for 223 probands, with a mean of 6.67 ± 8.10 years, and showed a statistically significant linear relationship with chronological age (r2 = 0.79; p < 0.001).ConclusionsWe estimated for the first time the age and sex prevalence of JS in Italy and investigated the patients’ genetic profile. The obtained population-based prevalence rate was ≈10 times higher than that available in literature for children population.


2005 ◽  
Vol 91 (2) ◽  
pp. 116-120 ◽  
Author(s):  
Ausilia Maria Manganoni ◽  
Tullio Cainelli ◽  
Giuseppe Zumiani ◽  
Rosaria Bufalino ◽  
Piergiacomo Calzavara-Pinton ◽  
...  

Aims and background Sunburn during childhood is associated with an increased risk for developing melanoma in an adult age. The aim of the present study was to define the validity of our educational program in order to teach the positive effects and risks of sun exposure during childhood. Patients and methods We conducted a population-based, case-control study in primary schools of three towns in Northern Italy (Brescia, Bergamo and Trento) between 2001 and 2002. The study was carried out on 1945 pupils (aged 8-9 years) and included 1309 case children who received an educational program before the summer to increase awareness towards sun exposure and 636 control children who did not. Parents of case and control children were interviewed using a questionnaire about their children's skin characteristics, sun protective behavior and sunburns. The questionnaire was completed twice, before and after the summer, to verify the changes of sun exposure habits. Results A significant decrease in sunburns was demonstrated in the group of subjects who received the educational program, indicating the validity of our operative procedure (from 14.6% to 10%, P = 4 × 10−4). Conclusions Our educational melanoma program may be important to disseminate in a wider range of children a correct education on sun exposure during childhood.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yahya Pasdar ◽  
Shima Moradi ◽  
Jalal Moludi ◽  
Somaiyeh Saiedi ◽  
Mehdi Moradinazar ◽  
...  

Abstract It has been suggested that abdominal obesity might be a better cardiovascular diseases (CVDs) discriminator than overall obesity. The most appropriate obesity measures for estimating CVD events in Kurdish populations have not been well-recognized. The objective of the present study was, therefore, to determine the cutoff points of BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist to height ratio (WHtR) as the diagnostic cut-offs to discriminate the prevalent cardiovascular diseases. The data collected from Ravansar Non-Communicable Disease (RaNCD) cohort, the first Kurdish population-based study, was analyzed. The information related to BMI, WC, WHR and WHtR of 10,065 adult participants in the age range of 35–65 was analyzed in this study. Receiver operating characteristic (ROC) analyses were conducted to evaluate the optimum cut-off values and to predict the incidence of cardiac events. The results showed that WHtR had the largest areas under the ROC curve for cardiac events in both male and female participants, and this was followed by WHR, WC, and BMI. The optimal cut-off values for determining the cardiac events in the Kurdish population were BMI = 27.02 kg/m2 for men and BMI = 27.60 kg/m2 for women, WC = 96.05 cm in men and 99.5 cm for women, WHRs = 0.96 in both sexes, and WHtR = 0.56 for men and 0.65 for women. The current study, therefore, showed that WHtR might serve as a better index of prevalent cardiac event than BMI, WHR and WC.


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