scholarly journals Subsequent urinary stone events are predicted by the magnitude of urinary oxalate excretion in enteric hyperoxaluria

2020 ◽  
Author(s):  
Matthew R D’Costa ◽  
Annamaria T Kausz ◽  
Kevin J Carroll ◽  
Jóhann P Ingimarsson ◽  
Felicity T Enders ◽  
...  
Keyword(s):  
Kidney Stones ◽  
Failure Time ◽  
Population Based ◽  
Accelerated Failure Time ◽  
Urinary Oxalate ◽  
Diagnostic Codes ◽  
Time Modeling ◽  
The Relationship ◽  
Annual Risk

Abstract   Data directly demonstrating the relationship between urinary oxalate (UOx) excretion and stone events in those with enteric hyperoxaluria (EH) are limited. Therefore, we assessed the relationship between UOx excretion and risk of kidney stone events in a retrospective population-based EH cohort. In all, 297 patients from Olmsted County, Minnesota were identified with EH based upon having a 24-h UOx ≥40 mg/24 h preceded by a diagnosis or procedure associated with malabsorption. Diagnostic codes and urologic procedures consistent with kidney stones during follow-up after baseline UOx were considered a new stone event. Logistic regression and accelerated failure time modeling were performed as a function of UOx excretion to predict the probability of new stone event and the annual rate of stone events, respectively, with adjustment for urine calcium and citrate. Mean ± standard deviation age was 51.4 ± 11.4 years and 68% were female. Median (interquartile range) UOx was 55.4 (46.6–73.0) mg/24 h and 81 patients had one or more stone event during a median follow-up time of 4.9 (2.8–7.8) years. Higher UOx was associated with a higher probability of developing a stone event (P < 0.01) and predicted an increased annual risk of kidney stones (P = 0.001). Estimates derived from these analyses suggest that a 20% decrease in UOx is associated with 25% reduction in the annual odds of a future stone event. Thus, these data demonstrate an association between baseline UOx and stone events in EH patients and highlight the potential benefit of strategies to reduce UOx in this patient group. Background Data directly demonstrating the relationship between urinary oxalate (UOx) excretion and stone events in those with enteric hyperoxaluria (EH) are limited. Methods We assessed the relationship between UOx excretion and risk of kidney stone events in a retrospective population-based EH cohort. In all, 297 patients from Olmsted County, Minnesota were identified with EH based upon having a 24-h UOx ≥40 mg/24 h preceded by a diagnosis or procedure associated with malabsorption. Diagnostic codes and urologic procedures consistent with kidney stones during follow-up after baseline UOx were considered a new stone event. Logistic regression and accelerated failure time modeling were performed as a function of UOx excretion to predict the probability of new stone event and the annual rate of stone events, respectively, with adjustment for urine calcium and citrate. Results Mean ± SD age was 51.4 ± 11.4 years and 68% were female. Median (interquartile range) UOx was 55.4 (46.6–73.0) mg/24 h and 81 patients had ≥1 stone event during a median follow-up time of 4.9 (2.8–7.8) years. Higher UOx was associated with a higher probability of developing a stone event (P < 0.01) and predicted an increased annual risk of kidney stones (P = 0.001). Estimates derived from these analyses suggest that a 20% decrease in UOx is associated with 25% reduction in the annual odds of a future stone event. Conclusions These data demonstrate an association between baseline UOx and stone events in EH patients and highlight the potential benefit of strategies to reduce UOx in this patient group.

Cognitive Activity and Onset Age of Incident Alzheimer Disease Dementia

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012388
Author(s):  
Robert S. Wilson ◽  
Tianhao Wang ◽  
Lei Yu ◽  
Francine Grodstein ◽  
David A. Bennett ◽  
...  
Keyword(s):  
Failure Time ◽  
Cognitive Activity ◽  
Older Age ◽  
Activity Score ◽  
Accelerated Failure Time Model ◽  
Accelerated Failure Time ◽  
Onset Age ◽  
Time Model ◽  
Dementia Onset

Objective:To test the hypothesis that higher level of cognitive activity predicts older age of dementia onset in Alzheimer's disease (AD) dementia.Methods:As part of a longitudinal cohort study, 1,903 older persons without dementia at enrollment reported their frequency of participation in cognitively stimulating activities. They had annual clinical evaluations to diagnose dementia and AD, and the deceased underwent neuropathologic examination. In analyses, we assessed the relation of baseline cognitive activity to age at diagnosis of incident AD dementia and to postmortem markers of AD and other dementias.Results:During a mean of 6.8 years of follow-up, 457 individuals were diagnosed with incident AD at a mean age of 88.6 (SD = 6.4; range: 64.1-106.5). In an extended accelerated failure time model, higher level of baseline cognitive activity (mean 3.2, SD = 0.7) was associated with older age of AD dementia onset (estimate = 0.026; 95% confidence interval: 0.013. 0.039). Low cognitive activity (score = 2.1, 10th percentile) was associated with a mean onset age of 88.6 compared to a mean onset age of 93.6 associated with high cognitive activity (score = 4.0, 90th percentile). Results were comparable in subsequent analyses that adjusted for potentially confounding factors. In 695 participants who died and underwent a neuropathologic examination, cognitive activity was unrelated to postmortem markers of AD and other dementias.Conclusion:A cognitively active lifestyle in old age may delay the onset of dementia in AD by as much as 5 years.

scholarly journals Poor breakfast habits in adolescence predict the metabolic syndrome in adulthood

2014 ◽  
Vol 18 (1) ◽  
pp. 122-129 ◽  
Author(s):  
Maria Wennberg ◽  
Per E Gustafsson ◽  
Patrik Wennberg ◽  
Anne Hammarström
Keyword(s):  
Metabolic Syndrome ◽  
Central Obesity ◽  
Fasting Glucose ◽  
International Diabetes Federation ◽  
Population Based ◽  
The Metabolic Syndrome ◽  
High Fasting Glucose ◽  
The Relationship ◽  
Metabolic Syndrome Components

AbstractObjectiveTo analyse whether poor breakfast habits in adolescence predict the metabolic syndrome and its components in adulthood. Previous studies suggest that regular breakfast consumption improves metabolic parameters.DesignProspective. Breakfast habits and other lifestyle variables at age 16 years were assessed from questionnaires. Poor breakfast habits were defined as skipping breakfast or only drinking or eating something sweet. At age 43 years, the effective sample consisted of 889 participants defined as having the metabolic syndrome or not, using the International Diabetes Federation criteria. Logistic regression was used to calculate odds ratios and confidence intervals.SettingThe Northern Swedish Cohort, a longitudinal population-based cohort with 27-year follow-up.SubjectsAdolescents (age 16 years).ResultsPrevalence of the metabolic syndrome at age 43 years was 27·0 %. Of the participants, 9·9 % were classified with poor breakfast habits at age 16 years. Adjusted odds for the metabolic syndrome at age 43 years was OR = 1·68 (95 % CI 1·01, 2·78) for those with poor breakfast habits at age 16 years compared with breakfast eaters. Looking at the metabolic syndrome components, poor breakfast habits at age 16 years were associated with central obesity (OR = 1·71; 95 % CI 1·00, 2·92) and high fasting glucose (OR = 1·75; 95 % CI 1·01, 3·02) at age 43 years, even after multivariate adjustments.ConclusionsPoor breakfast habits in adolescence predicted the metabolic syndrome in adulthood. Of the metabolic syndrome components, poor breakfast habits in adolescence predicted central obesity and high fasting glucose in adulthood. Further research is needed to fully understand the relationship between early breakfast habits and adult metabolic syndrome.

scholarly journals Modeling Age at Menopause Using Serum Concentration of Anti-Mullerian Hormone

2013 ◽  
Vol 98 (2) ◽  
pp. 729-735 ◽  
Author(s):  
Fahimeh Ramezani Tehrani ◽  
Masoud Solaymani-Dodaran ◽  
Maryam Tohidi ◽  
Mahmood Reza Gohari ◽  
Fereidoun Azizi
Keyword(s):  
Serum Concentration ◽  
Failure Time ◽  
Population Based ◽  
Accelerated Failure Time Model ◽  
Correct Prediction ◽  
Eligibility Criteria ◽  
Time Model ◽  
Age At Menopause ◽  
Reproductive Aged Women

Abstract Context: Anti-Mullerian hormone (AMH) has already been used for prediction of age at menopause with promising results. Objective: We aimed to improve our previous prediction of age at menopause in a population-based cohort by including all eligible subjects and additional follow-up time. Design and Setting: All reproductive-aged women who met our eligibility criteria were selected from the Tehran Lipid and Glucose Study. The serum concentration of AMH was measured at the time of recruitment, and participant's date of menopause was recorded over a 10-year follow-up. Subjects: A total of 1015 women, aged 20 to 50 years, with regular and predictable menstrual cycles at the initiation of the study were recruited. Main Outcome Measure: The actual ages at menopause were compared with the predicted ones obtained from accelerated failure time model. Results: We observed 277 occurrences of menopause. Median menopausal age was 50 years (range 30.1–58.2 years). The median (SD) of differences between the actual menopausal age and those predicted by our model was 0.5 (2.5) years. Model adequacy (measured by C-statistics) for correct prediction of age at menopause was 92%. The estimated ages at menopause and their 95% confidence intervals for a range of values of AMH and age were calculated and summarized in a table. Conclusions: Using a model built on age and AMH, we can predict age at menopause many years earlier. This could provide opportunities for interventions in those who are at risk of early or late menopause.

scholarly journals Associations between thyroid function and mortality: the influence of age

2014 ◽  
Vol 171 (2) ◽  
pp. 183-191 ◽  
Author(s):  
Annenienke C van de Ven ◽  
Romana T Netea-Maier ◽  
Femmie de Vegt ◽  
H Alec Ross ◽  
Fred C G J Sweep ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Age Groups ◽  
Population Based ◽  
Normal Range ◽  
Population Based Study ◽  
Middle Range ◽  
The Relationship ◽  
Subclinical Thyrotoxicosis ◽  
Tsh Levels

ObjectiveThe aim of this study was to investigate the influence of age on the association between thyroid function and mortality.DesignThe Nijmegen Biomedical Study is a population-based study, comprising 5816 randomly selected adults of all age groups without previously known thyroid disease.MethodsTSH, free thyroxine (FT4) and peroxidase antibodies were measured in 2002–2003. The number of deaths were established in 2012 (median follow-up time 9.4 years).ResultsSubclinical thyrotoxicosis was associated with mortality in subjects aged <65 years (hazard ratio (HR) 2.5, 95% CI 1.1–5.7), but not in subjects aged >65 years. As for thyroid function within the normal range: in the 493 participants aged 80 years or older, an FT4 level in the high-normal range (18.5–22 pmol/l) was associated with a higher mortality in comparison with FT4 levels in the middle range (11.5–15.0 pmol/l): HR 1.7 (95% CI 1.0–2.9). In these elderly, TSH levels within the high-normal range (3.0–4.0 mIU/l) were also associated with a higher mortality in comparison with TSH levels within the middle range (1.0–2.0 mIU/l): HR 1.8 (95% CI 1.0–3.1).ConclusionsThe relationship between thyroid function and mortality differs according to age. This finding might (partially) explain the discrepant results of previous studies examining the relationship between thyroid function and mortality in different age groups.

scholarly journals The Predictive Effect of Health Examination in the Incidence of Diabetes Mellitus in Chinese Adults: A Population-Based Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Xiaomin Fu ◽  
Yingmin Jia ◽  
Jing Liu ◽  
Qinghua Lei ◽  
Lele Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cox Regression ◽  
Population Based ◽  
Health Examination ◽  
The Public ◽  
Kaplan Meier ◽  
Potential Risk Factors ◽  
The Relationship ◽  
Predictive Effect

Background. The incidence of diabetes mellitus (DM) was increasing in recent years, and it is important to screen those nondiabetic populations through health examination to detect the potential risk factors for DM. We aimed to find the predictive effect of health examination on DM. Methods. We used the public database from Rich Healthcare Group of China to evaluate the potential predictive effect of health examination in the onset of DM. The colinear regression was used for estimating the relationship between the dynamics of the health examination index and the incident year of DM. The time-dependent ROC was used to calculate the best cutoff in predicting DM in the follow-up year. The Kaplan-Meier method and Cox regression were used to evaluate the HR of related health examination. Results. A total of 211,833 participant medical records were included in our study, with 4,172 participants diagnosing as DM in the following years (among 2-7 years). All the initial health examination was significantly different in participants’ final diagnosing as DM to those without DM. We found a negative correlation between the incidence of years of DM and the average initial FPG ( r = − 0.1862 , P < 0.001 ). Moreover, the initial FPG had a strong predictive effect in predicting the future incidence of DM ( AUC = 0.961 ), and the cutoff was 5.21 mmol/L. Participants with a higher initial FPG (>5.21 mmol/L) had a 2.73-fold chance to develop as DM in follow-up ( 95 % CI = 2.65 – 2.81 , P < 0.001 ). Conclusion. Initial FPG had a good predictive effect for detecting DM. The FPG should be controlled less than 5.21 mmol/L.

scholarly journals EPCT-11. RURALITY INDEX SCORE AND PEDIATRIC NEURO-ONCOLOGICAL OUTCOME IN ONTARIO

2021 ◽  
Vol 23 (Supplement_1) ◽  
pp. i49-i49
Author(s):  
Michelle Kameda-Smith ◽  
Gregory Pond ◽  
Forough Farrokhyar ◽  
Hsien Seow
Keyword(s):  
Critical Infrastructure ◽  
Oncological Outcome ◽  
Population Based ◽  
Index Score ◽  
Administrative Databases ◽  
Income Quintile ◽  
Oncological Patients ◽  
The Relationship ◽  
Pediatric Brain

Abstract Introduction Rapid access to neurosurgical decisions and definitive management are vital for the outcome of neurocritical patients. There are increased challenges of providing services and to maintain critical infrastructure for rural citizens. The relationship between rurality, marginalization and health outcomes has been identified as associated with higher mortality rates and higher rates of many diseases[G1]. Methods Employing linked administrative databases, we retrospectively analyzed a population based cohort of patients diagnosed with a pediatric brain tumour between 1996 to 2017 in Ontario, Canada. The Ontario Marginalization Index was employed as a surrogate for rurality providing an overall Rurality Index for Ontario (RIO) in addition to the 2016 Ontario Marginalization Index (ON-MARG). Results Of 1457 patients included, 54.0% were male, 277 of whom were diagnosed in infancy (i.e., &lt; 3 years of age). Income quintile was evenly distributed with 11.5% classified as living in a rural area of Ontario. The median[G2] distance to the nearest pediatric neurosurgical hospital was 59.6km. The rurality index score (RIO) was 0 in 38.8% of children with the majority of patients with a RIO score of &lt;39. The ON-MARG identified 51.9% of patients living in communities with low concentration of individuals without income from employment. A higher RIO score was not a significant factor (Continuous p=0.092/Ordinal p=0.20) associated with length[G3] of follow up, indicating rurality was not a significant factor for determining compliance to[G4] clinical follow-up. However, a trend towards reduced follow-up compliance in the higher RIO score cohort was identified. Conclusion Rurality and social determinants of health of the region pediatric neuro-oncological patients reside were not associated with patient outcome but a trend towards lower follow-up compliance was identified when children were from regions with RIO&gt;39. Implementation of telehealth follow-up for these patients may overcome barrier to clinical follow-up.[G5]

scholarly journals Children With Appendectomy Have Increased Risk of Future Sepsis: Real-world Data in Taiwan

2021 ◽  
Author(s):  
Liao Tzu-Han ◽  
Meng Che Wu ◽  
Cheng-Li Lin ◽  
Chien-Heng Lin ◽  
James Cheng-Chung Wei
Keyword(s):  
Cox Regression ◽  
Propensity Score Analysis ◽  
Population Based ◽  
Research Database ◽  
Real World Data ◽  
Parental Occupation ◽  
Increased Risk ◽  
Future Risk ◽  
The Relationship

Backgrounds Appendectomy is one of the most commonly performed surgeries worldwide. Sepsis is an major etiology of morbidity and mortality in children. Our preliminary research revealed a positive correlation among appendectomy and future risk of sepsis in adults. However, to date, the relationship among appendectomy and future risk of sepsis in children remains unknown. The aim of this research was to investigate the relationship among appendectomy and hazard of future sepsis in children. Methods We applied a nationwide population-based cohort to assess whether children who received appendectomy were at increased risk of subsequent sepsis. Overall, 57261 subjects aged below 18 undergoing appendectomy as appendectomy group and 57261 matched controls were identified as non-appendectomy group from the National Health Insurance Research Database in Taiwan. We use propensity score analysis to match age, sex, urbanization level, and parental occupation at the ratio to 1:1. Multiple Cox regression and stratified analyses were used to appraise the adjusted hazard ratio (aHR) for developing sepsis in children. Results Children who received appendectomy had a 2.63 times higher risk of developing sepsis than those who did not, and the risk was even higher in children aged under 6 years. Patients with <1 year follow-up showed a 5.64-fold risk of sepsis in the appendectomy cohort. Patients with 1–4 and ≥5 years’ follow-up showed a 2.41- and 2.02-times risk of sepsis. Conclusion Appendectomy was correlative to a 2.63-fold increased future sepsis risk in children, and the risk in younger patients aged <6 years was even higher. More studies to interpret the possible biological mechanisms of the associations among sepsis and appendectomy are warrant

scholarly journals Physical Activity and the Risk of Hemorrhagic Stroke: A Population-Based Longitudinal Follow-Up Study in Taiwan

2021 ◽  
Vol 8 ◽  
Author(s):  
Shih-Hao Feng ◽  
Li-Sheng Chen ◽  
Kuo-Cheng Yeh ◽  
Shin-Liang Pan
Keyword(s):  
Physical Activity ◽  
Hemorrhagic Stroke ◽  
Screening Program ◽  
Population Based ◽  
Beneficial Effects ◽  
Follow Up Study ◽  
Asian Populations ◽  
Cox Proportional Hazard Regression ◽  
The Relationship

Background: Data on the relationship between physical activity (PA) and hemorrhagic stroke (HS) are limited in Asian populations. This population-based longitudinal follow-up study therefore investigates whether PA is associated with a reduced risk of HS in Taiwan.Methods: A total of 58,857 subjects who had participated in the Keelung Community-based Integrated Screening Program between 2005 and 2012 were enrolled. Information about their PA, obtained using questionnaires, was used to categorize them into three groups according to their average weekly time engaged in it: (1) no PA, (2) low PA (&lt;90 min weekly), and (3) high PA (90 min per week or more). Cox proportional hazard regression was used to evaluate the effect of PA on HS. Stratified analysis by sex and comorbidities (diabetes mellitus, hypertension, and hyperlipidemia) were conducted to evaluate their impact on the relationship between PA and HS.Results: Compared to the no-PA group, the adjusted hazard ratio of HS for the low-PA group was 0.74 (95% CI, 0.57–0.96, p = 0.0219), and for the high-PA group, 0.72 (95% CI, 0.58–0.90, p = 0.004). The stratified analyses showed that, for the non-comorbidity strata, the beneficial effect of PA on reducing HS risk became stronger as PA increased. However, in the diabetes and hypertension strata, high PA did not appear to have any greater protective effect than low PA.Conclusions: Our findings suggested that even &lt;90 min of PA per week might be beneficial to reduce HS risk. Such a low level of PA is likely to be more achievable and easier to maintain for the general population. Additionally, personalized recommendations based on pre-existing comorbidities may help optimize the beneficial effects of PA on HS prevention.

Improving Prediction of Age at Menopause Using Multiple Anti-Müllerian Hormone Measurements: the Tehran Lipid-Glucose Study

2020 ◽  
Vol 105 (5) ◽  
pp. 1589-1598 ◽  
Author(s):  
Fahimeh Ramezani Tehrani ◽  
Razieh Bidhendi Yarandi ◽  
Masoud Solaymani-Dodaran ◽  
Maryam Tohidi ◽  
Faezeh Firouzi ◽  
...  
Keyword(s):  
Failure Time ◽  
Reproductive Age ◽  
Accelerated Failure Time Model ◽  
Accelerated Failure Time ◽  
Time Model ◽  
Age At Menopause ◽  
Decline Rate ◽  
Accelerated Failure ◽  
Failure Time Model

Abstract Context Several statistical models were introduced for the prediction of age at menopause using a single measurement of anti-müllerian hormone (AMH); however, individual prediction is challenging and needs to be improved. Objective The objective of this study was to determine whether multiple AMH measurements can improve the prediction of age at menopause. Design All eligible reproductive-age women (n = 959) were selected from the Tehran Lipid and Glucose Study. The serum concentration of AMH was measured at the time of recruitment and twice after that at an average of 6-year intervals. An accelerated failure-time model with Weibull distribution was used to predict age at menopause, using a single AMH value vs a model that included the annual AMH decline rate. The adequacy of these models was assessed using C statistics. Results The median follow-up period was 14 years, and 529 women reached menopause. Adding the annual decline rate to the model that included single AMH improved the model’s discrimination adequacy from 70% (95% CI: 67% to 71%) to 78% (95% CI: 75% to 80%) in terms of C statistics. The median of differences between actual and predicted age at menopause for the first model was –0.48 years and decreased to –0.21 in the model that included the decline rate. The predicted age at menopause for women with the same amount of age-specific AMH but an annual AMH decline rate of 95 percentiles was about one decade lower than in those with a decline rate of 5 percentiles. Conclusion Prediction of age at menopause could be improved by multiple AMH measurements; it will be useful in identifying women at risk of early menopause.

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