scholarly journals Kidney transplant outcomes in recipients with visual, hearing, physical and walking impairments: a prospective cohort study

2019 ◽  
Vol 35 (7) ◽  
pp. 1262-1270
Author(s):  
Alvin G Thomas ◽  
Jessica M Ruck ◽  
Nadia M Chu ◽  
Dayawa Agoons ◽  
Ashton A Shaffer ◽  
...  
Keyword(s):  
Cohort Study ◽  
Visual Impairment ◽  
Kidney Transplant ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cox Regression ◽  
Targeted Interventions ◽  
The Us ◽  
Independent Association ◽  
Poor Outcomes

Abstract Background Disability in general has been associated with poor outcomes in kidney transplant (KT) recipients. However, disability can be derived from various components, specifically visual, hearing, physical and walking impairments. Different impairments may compromise the patient through different mechanisms and might impact different aspects of KT outcomes. Methods In our prospective cohort study (June 2013–June 2017), 465 recipients reported hearing, visual, physical and walking impairments before KT. We used hybrid registry-augmented Cox regression, adjusting for confounders using the US KT population (Scientific Registry of Transplant Recipients, N = 66 891), to assess the independent association between impairments and post-KT outcomes [death-censored graft failure (DCGF) and mortality]. Results In our cohort of 465 recipients, 31.6% reported one or more impairments (hearing 9.3%, visual 16.6%, physical 9.1%, walking 12.1%). Visual impairment was associated with a 3.36-fold [95% confidence interval (CI) 1.17–9.65] higher DCGF risk, however, hearing [2.77 (95% CI 0.78–9.82)], physical [0.67 (95% CI 0.08–3.35)] and walking [0.50 (95% CI 0.06–3.89)] impairments were not. Walking impairment was associated with a 3.13-fold (95% CI 1.32–7.48) higher mortality risk, however, visual [1.20 (95% CI 0.48–2.98)], hearing [1.01 (95% CI 0.29–3.47)] and physical [1.16 (95% CI 0.34–3.94)] impairments were not. Conclusions Impairments are common among KT recipients, yet only visual impairment and walking impairment are associated with adverse post-KT outcomes. Referring nephrologists and KT centers should identify recipients with visual and walking impairments who might benefit from targeted interventions pre-KT, additional supportive care and close post-KT monitoring.

scholarly journals HIV diagnosis period influences ART initiation: findings from a prospective cohort study in China

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Tinglong Yang ◽  
Xueying Yang ◽  
Linghua Li ◽  
Huifang Xu ◽  
Lirui Fan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cox Regression ◽  
Hiv Diagnosis ◽  
Initiation Rate ◽  
Art Initiation ◽  
Significant Difference ◽  
New Strategy ◽  
New Treatment

Abstract Background We estimated the predictive effects of ART-related perceptions on the actual ART uptake behavior among ART naïve PLWH stratified by different time of HIV diagnosis under the new strategy. Methods A prospective cohort study was conducted among ART naïve PLWH in Guangzhou, China from June 2016 to June 2017. Cox regression model was used to evaluate the predictive effects of ART-related perceptions on ART initiation among PLWH stratified by different timepoint of HIV diagnosis (i.e., before or after the update of the new treatment policy). Results Among 411 participants, 150 and 261 were diagnosed before (pre-scaleup group) and after (post-scaleup group) the implementation of the new strategy, respectively. The ART initiation rate in the post-scaleup group (88.9%) was higher than that in the pre-scaleup group (73.3%) (p < 0.001). A significant difference of mean score was detected in each HBM construct between pre- and post-scaleup groups (p < 0.05). After adjusting for significant background variables, among all participants, only the self-efficacy [adjusted HR (HRa) = 1.23, 95% CI 1.06 to 1.43, p = 0.006], has a predictive effect on ART initiation; in pre-scaleup group, all constructs of HBM-related ART perceptions were predictors of ART initiation (HRa = 0.71 to 1.83, p < 0.05), while in post-scaleup group, no significant difference was found in each construct (p > 0.05). Conclusions The ART initiation rate was high particularly among participants who diagnosed after the new treatment strategy. The important role of the time of HIV diagnosis on ART initiation identified in this study suggested that future implementation interventions may consider to modify the ART-related perceptions for HIV patients who diagnosed before the implementation of the new ART strategy, while expand the accessibility of ART service for those who diagnosed after the implementation of the new strategy.

Sugar in Beverage and the Risk of Incident Dementia, Alzheimer’s Disease and Stroke: A Prospective Cohort Study

2020 ◽  
pp. 1-6
Author(s):  
H. Miao ◽  
K. Chen ◽  
X. Yan ◽  
F. Chen
Keyword(s):  
Cohort Study ◽  
Alzheimer Disease ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Community Based ◽  
Incident Dementia ◽  
Heart Study ◽  
Increased Risk ◽  
The Us

Background: This study aimed to investigate the association between sugar in beverage and dementia, Alzheimer Disease (AD) dementia and stroke. Methods: This prospective cohort study were based on the US community-based Framingham Heart Study (FHS). Sugar in beverage was assessed between 1991 and 1995 (5th exam). Surveillance for incident events including dementia and stroke commenced at examination 9 through 2014 and continued for 15-20 years. Results: At baseline, a total of 1865 (63%) subjects consumed no sugar in beverage, whereas 525 (18%) subjects consumed it in 1-7 servings/week and 593 (29%) in over 7 servings/week. Over an average follow-up of 19 years in 1384 participants, there were 275 dementia events of which 73 were AD dementia. And 103 of 1831 participants occurred stroke during the follow-up nearly 16 years. After multivariate adjustments, individuals with the highest intakes of sugar in beverage had a higher risk of all dementia, AD dementia and stroke relative to individuals with no intakes, with HRs of 2.80(95%CI 2.24-3.50) for all dementia, 2.55(95%CI 1.55-4.18) for AD dementia, and 2.11(95%CI 1.48-3.00) for stroke. And the same results were shown in the subgroup for individuals with median intakes of sugar in beverage. Conclusion: Higher consumption of sugar in beverage was associated with an increased risk of all dementia, AD dementia and stroke.

Low Plasma 25-Hydoxyvitamin D at Diagnosis Predicts Poor Outcomes in Patients with Bladder Cancer: A Prospective Cohort Study

2020 ◽  
pp. 1-7
Author(s):  
Mohamed Kacem Ben Fradj ◽  
Mokhtar Bibi ◽  
Mohamed Bassem Hammami ◽  
Amani Kallel ◽  
Yassine Nouira ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Poor Outcomes

scholarly journals Delayed Lactogenesis Is Associated with Suboptimal Breastfeeding Practices: A Prospective Cohort Study

2019 ◽  
Vol 150 (4) ◽  
pp. 894-900 ◽  
Author(s):  
Li Huang ◽  
Shangzhi Xu ◽  
Xi Chen ◽  
Qian Li ◽  
Lixia Lin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cox Regression ◽  
Normal Weight ◽  
Face To Face ◽  
Gestational Weight ◽  
Breastfeeding Practices ◽  
Suboptimal Breastfeeding ◽  
Adjusted Model

ABSTRACT Background Breastfeeding has many established health benefits to both babies and mothers. There is limited evidence on the association between delayed lactogenesis and breastfeeding practices. Objective We assessed the association between delayed lactogenesis and breastfeeding practices in women initiating breastfeeding. Design We used data from a prospective cohort study in Wuhan, China, which enrolled pregnant women at 8–16 weeks of gestation and followed up to postpartum. Women were included who had a singleton live birth, initiated breastfeeding, and provided information on infant feeding. Maternal lactogenesis status was assessed by face-to-face interview at day 4 postpartum. Breastfeeding practices (full breastfeeding and/or any breastfeeding) were queried by telephone interview at 3, 6, and 12 mo postpartum. Poisson regression and Cox regression were used to identify the association between delayed lactogenesis and breastfeeding practices. Results Delayed lactogenesis was reported by 17.9% of the 2877 participants. After adjusting for potential confounders, when compared with timely lactogenesis, delayed lactogenesis was significantly associated with higher risk of inability to sustain full breastfeeding at 3 mo postpartum (RR: 1.24, 95% CI: 1.10, 1.39) and 6 mo postpartum (RR: 1.14, 95% CI: 1.04, 1.24). Delayed lactogenesis was also significantly associated with early termination of any breastfeeding (HR: 1.15, 95% CI: 1.01, 1.30) in the adjusted model. In a combined analysis, women with higher gestational weight gain (GWG, ≥16 kg for underweight and normal weight, 15 kg for overweight/obesity) and who subsequently experienced delayed lactogenesis had the highest risk of ending any breastfeeding earlier (adjusted HR: 1.32, 95% CI: 1.11, 1.55) compared with those who gained less GWG and experienced timely lactogenesis. Conclusions This study shows that delayed lactogenesis was associated with low rate of full breastfeeding and shorter duration of any breastfeeding. Greater efforts to promote breastfeeding should be targeted towards women with delayed lactogenesis.

P6143Body-mass index, blood pressure, diabetes and cardiovascular mortality in Cuba: prospective cohort study of 146,665 participants

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B W H Lacey ◽  
N Armas ◽  
J A Burrett ◽  
R Peto ◽  
A Duenas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cox Regression ◽  
Metabolic Risk Factors ◽  
Metabolic Risk ◽  
Reverse Causality ◽  
Cvd Mortality

Abstract Background Cardiovascular disease (CVD) is a leading cause of premature death in Cuba, accounting for about one third of all deaths under age 70 years. Substantial uncertainty remains, however, about the relevance of major metabolic risk factors to CVD mortality in this population. Purpose To relate body-mass index (BMI), systolic blood pressure (SBP), and diabetes to risk of CVD death in Cuba. Methods In a prospective cohort study, 146,665 adults were recruited from the general population in five areas of Cuba between 1996 and 2002. Participants were interviewed, measured (height, weight and blood pressure) and followed up by electronic linkage to Cuban national death registries to Jan 1 2017; 24,345 participants were resurveyed between 2006 and 2008. After excluding all with missing data or chronic disease at recruitment or, to further limit reverse causality, those who died in the first 5 years, Cox regression (adjusted for age, sex, education, smoking, alcohol and, where appropriate, BMI) was used to relate mortality rate ratios (RRs) at ages 35–79 years to BMI, SBP and diabetes. Correlations of baseline and resurvey values were used to corrected RRs for regression dilution, and thereby estimate associations with long-term average (“usual”) levels of SBP and BMI. Results After exclusions, there were 117,008 participants age 35–79 (mean age 52 [SD 12]; 55% women). At recruitment, mean SBP was 124 mm Hg (SD 15), mean BMI was 24.2 kg/m2 (SD 3.6) and 5% had diabetes; mean SBP and diabetes prevalence were both strongly related to BMI. Correlations of resurvey and baseline measurements were 0.48 for SBP and 0.60 for BMI. At ages 35–79 years, there were 3780 CVD deaths (1871 ischaemic heart disease [IHD], 766 stroke, and 1143 other). CVD mortality was positively associated with BMI (down to about 22–23 kg/m2; figure), SBP and diabetes: 10 kg/m2 higher usual BMI approximately doubled CVD mortality (RR 1.90, 95% CI 1.61–2.24), as did 20 mmHg higher usual SBP (2.03, 1.88–2.20), and a prior diagnosis of diabetes (2.18, 1.97–2.42). The associations were similar in men and women. Given these associations, about one quarter (27%) of CVD deaths in this study were attributable to these metabolic risk factors combined. Conclusion These associations differ to those reported from other parts of Latin America, and are more consistent with studies in Europe and North America, highlighting the need for many more large-scale prospective studies in low and middle income countries. This study provides direct evidence for the expected benefit on CVD mortality of addressing major metabolic risk factors in Cuba. As the levels of these metabolic risk factors are increasing in Cuba, so too is their importance as determinants of premature CVD death. Acknowledgement/Funding Medical Research Council, British Heart Foundation, Cancer Research UK

scholarly journals Serum magnesium and cardiovascular mortality in peritoneal dialysis patients: a 5-year prospective cohort study

2018 ◽  
Vol 120 (4) ◽  
pp. 415-423 ◽  
Author(s):  
Hongjian Ye ◽  
Peiyi Cao ◽  
Xiaodan Zhang ◽  
Jianxiong Lin ◽  
Qunying Guo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peritoneal Dialysis ◽  
Prospective Cohort Study ◽  
Cardiovascular Mortality ◽  
Prospective Cohort ◽  
Cox Regression ◽  
Serum Magnesium ◽  
Study Endpoint ◽  
Lower Serum ◽  
All Cause Mortality

AbstractThe aim of this study was to explore the association between serum Mg and cardiovascular mortality in the peritoneal dialysis (PD) population. This prospective cohort study included prevalent PD patients from a single centre. The primary outcome of this study was cardiovascular mortality. Serum Mg was assessed at baseline. A total of 402 patients (57 % male; mean age 49·3±14·9 years) were included. After a median of 49·9 months (interquartile range: 25·9–68·3) of follow-up, sixty-two patients (25·4 %) died of CVD. After adjustment for conventional confounders in multivariate Cox regression models, being in the lower quartile for serum Mg level was independently associated with a higher risk of cardiovascular mortality, with hazards ratios of 2·28 (95 % CI 1·04, 5·01), 1·41 (95 % CI 0·63, 3·16) and 1·62 (95 % CI 0·75, 3·51) for the lowest, second and third quartiles, respectively. A similar trend was observed when all-cause mortality was used as the study endpoint. Further analysis showed that the relationships between lower serum Mg and higher risk of cardiovascular and all-cause mortality were present only in the female subgroup, and not among male patients. The test for interaction indicated that the associations between lower serum Mg and cardiovascular and all-cause mortality differed by sex (P=0·008 andP=0·011, respectively). In conclusion, lower serum Mg was associated with a higher risk of cardiovascular and all-cause mortality in the PD population, especially among female patients.

scholarly journals Is subjective well-being independently associated with mortality? A 14-year prospective cohort study in a representative sample of 25 139 US men and women

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031776
Author(s):  
Steven D Barger ◽  
Timothy W Broom ◽  
Michael V Esposito ◽  
Taylor S Lane
Keyword(s):  
Socioeconomic Status ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Representative Sample ◽  
Cox Regression ◽  
Well Being ◽  
Inverse Association ◽  
Subjective Well Being ◽  
Self Rated Health

ObjectivesTo examine whether the inverse association of subjective well-being with mortality is independent of self-rated health and socioeconomic status in healthy adults.DesignA population-based prospective cohort study based on an in-person interview. Cox regression was used to examine mortality hazards for happiness alone and for a standardised summary well-being measure that included happiness, life satisfaction and negative emotions. Using prespecified analyses, we first adjusted for age and then additionally adjusted for self-rated health and then race/ethnicity, marital status, smoking and socioeconomic status.SettingProbability sample of adult US residents interviewed in their homes in 2001.Participants25 139 adults free of cardiovascular disease and cancer at baseline.Primary outcome measureAll-cause mortality 14 years after the baseline interview as assessed by probabilistic matching using the National Death Index.ResultsAge-adjusted unhappiness was associated with mortality (HR 1.27; 95% CI 1.11 to 1.45, p=0.001) but the association attenuated after adjusting for self-rated health (HR 1.01; 95% CI 0.88 to 1.16, p=0.85). A similar pattern was seen for the summary well-being measure in fully adjusted models (HR 1.00; 95% CI 0.99 to 1.00, p=0.30). In contrast, self-rated health was strongly associated with mortality. In the fully adjusted model with the summary well-being measure the hazards for good, very good and excellent self-rated health were 0.71 (95% CI 0.62 to 0.80, p<0.001), 0.63 (95% CI 0.55 to 0.71, p<0.001) and 0.45 (95% CI 0.39 to 0.51, p<0.001), respectively.ConclusionsIn this representative sample of US adults, the association between well-being and mortality was strongly attenuated by self-rated health and to a lesser extent socioeconomic status.

scholarly journals Multifactorial individualised programme for hamstring muscle injury risk reduction in professional football: protocol for a prospective cohort study

2020 ◽  
Vol 6 (1) ◽  
pp. e000758
Author(s):  
Johan Lahti ◽  
Jurdan Mendiguchia ◽  
Juha Ahtiainen ◽  
Luis Anula ◽  
Tuomas Kononen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Risk Reduction ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Injury Risk ◽  
Cox Regression ◽  
University Hospital ◽  
Professional Football ◽  
Hamstring Muscle ◽  
Cox Regression Analysis

IntroductionHamstring muscle injuries (HMI) continue to plague professional football. Several scientific publications have encouraged a multifactorial approach; however, no multifactorial HMI risk reduction studies have been conducted in professional football. Furthermore, individualisation of HMI management programmes has only been researched in a rehabilitation setting. Therefore, this study aims to determine if a specific multifactorial and individualised programme can reduce HMI occurrence in professional football.Methods and analysisWe conducted a prospective cohort study over two seasons within the Finnish Premier League and compare the amount of HMI sustained during a control season to an intervention season. Injury data and sport exposure were collected during the two seasons (2019–2020), and a multifactorial and individualised HMI risk reduction programme will be implemented during intervention season (2020). After a hamstring screening protocol is completed, individual training will be defined for each player within several categories: lumbo-pelvic control, range of motion, posterior chain strength, sprint mechanical output and an additional non-individualised ‘training for all players’ category. Screening and respective updates to training programmes were conducted three times during the season. The outcome will be to compare if there is a significant effect of the intervention on the HMI occurrence using Cox regression analysis.Ethics and disseminationApproval for the injury and sport exposure data collection was obtained by the Saint-Etienne University Hospital Ethics Committee (request number: IORG0007394; record number IRBN322016/CHUSTE). Approval for the intervention season was obtained from the Central Finland healthcare District (request and record number: U6/2019).

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