scholarly journals Retinal oxygen delivery and extraction in ophthalmologically healthy subjects with different blood pressure status

2021 ◽  
Author(s):  
Konstantinos Pappelis ◽  
Nomdo Jansonius
Keyword(s):  
Blood Pressure ◽  
Oxygen Delivery ◽  
Healthy Subjects ◽  
Large Scale ◽  
Population Based ◽  
Retinal Blood Flow ◽  
Increased Risk ◽  
Scale Population ◽  
Post Hoc ◽  
Control Study

Purpose: To compare retinal oxygen delivery (DO2) and extraction (VO2) in ophthalmologically healthy subjects with different blood pressure (BP) status. Methods: In this case-control study, we prospectively included 93 eyes of 93 subjects (age 50-65) from a large-scale population-based Dutch cohort (n=167,000) and allocated them to four groups (low BP, normal BP [controls], treated arterial hypertension [AHT], untreated AHT). We estimated vascular calibers from fundus images and fractal dimension (FD) from optical coherence tomography angiography scans. We combined calibers, FD, BP, and intraocular pressure measurements in a proxy of total retinal blood flow (RBF), using a validated Poiseuille-based model. We measured arterial and venous oxygen saturations (SaO2, SvO2) with a two-wavelength scanning laser ophthalmoscope. We calculated DO2 and VO2 from RBF, SaO2, and SvO2. We compared DO2 and VO2 between groups and investigated the DO2-VO2 association. Results: DO2 and VO2 were different between groups (P=0.009, P=0.036, respectively). In post hoc analysis, the low BP group had lower DO2 than the untreated AHT group (P=4.9⋅10-4), while both the low BP group and the treated AHT group had lower VO2 than the untreated AHT group (P=0.021, P=0.034, respectively). There was a significant DO2-VO2 correlation (R[obs]=0.65, b[obs]=0.51, P=2.4⋅10-12). After correcting for shared measurement error, the slope was no longer significant (b[cor]=0.19, P=0.29), while the correlation coefficient could not be calculated. Conclusions: DO2 and VO2 were altered in ophthalmologically healthy subjects with different BP status. Future studies could elucidate whether these changes can explain the increased risk of several ophthalmic pathologies in those subjects.

scholarly journals U-shaped effect of blood pressure on structural OCT metrics and retinal blood flow autoregulation in ophthalmologically healthy subjects

2021 ◽  
Author(s):  
Konstantinos Pappelis ◽  
Nomdo M. Jansonius
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Outcome Measures ◽  
Healthy Subjects ◽  
Large Scale ◽  
Multivariable Analysis ◽  
Retinal Blood Flow ◽  
Retinal Layer ◽  
Inner Plexiform Layer ◽  
Fiber Layer

AbstractObjective1) To investigate the effect of low blood pressure (BP), treated arterial hypertension (AHT), and untreated AHT on the ganglion cell-inner plexiform layer (GCIPL) and the retinal nerve fiber layer (RNFL) thickness of non-glaucomatous eyes and 2) to elucidate whether this effect is related to crossing the lower limit of retinal blood flow (RBF) autoregulation.DesignCross-sectional, case-control.SubjectsWe included 96 eyes of 96 ophthalmologically healthy subjects (age 50-65). Participants were prospectively recruited from a large-scale cohort study in the northern Netherlands (n=167,000; Lifelines Biobank). They were allocated to four groups (low BP, normal BP [controls], treated AHT, untreated AHT), based on information from previous visits and strict distribution criteria.MethodsInner retinal layer thicknesses were obtained with optical coherence tomography (OCT). Fractal dimension of the superficial microvasculature was quantified with OCT-angiography and customized software. Central retinal vessel diameters were obtained from fundus images. BP and intraocular pressure measurements were also acquired. Measurements were combined with a validated physiological model to estimate vascular outcome measures. Structural and vascular metrics were compared across groups and mediation analysis was performed.Main outcome measuresStructural: macular GCIPL and RNFL (mRNFL), peripapillary RNFL (pRNFL) thickness. Vascular: RBF, retinal vascular resistance (RVR), autoregulatory reserve (AR).ResultsCompared to controls, GCIPL was thinner in the low BP group (P=0.013), treated hypertensives (P=0.007), and untreated hypertensives (P=0.007). Treated hypertensives exhibited the thinnest mRNFL (P=0.001), temporal pRNFL (P=0.045), and inferior pRNFL (P=0.034). In multivariable analysis, RBF was mediating the association of GCIPL thickness with BP within the combined low BP group and controls (P=0.003), RVR together with AR were mediating the same association within the combined treated hypertensives and controls (P=0.001 and P=0.032), and RVR was mediating the association within the combined untreated antihypertensives and controls (P=0.022).ConclusionsWe uncovered GCIPL and RNFL thinning related to both tails of the BP distribution. GCIPL thinning was associated with reduced RBF autoregulatory capacity. This predisposition to glaucomatous damage could explain the frequent epidemiological finding of increased glaucoma risk in certain subgroups, such as subjects with nocturnal BP dipping or aggressively treated AHT. Longitudinal studies could confirm this postulation.

scholarly journals Green tea drinking and risk of pancreatic cancer: A large-scale, population-based case–control study in urban Shanghai

2012 ◽  
Vol 36 (6) ◽  
pp. e354-e358 ◽  
Author(s):  
Jing Wang ◽  
Wei Zhang ◽  
Lu Sun ◽  
Herbert Yu ◽  
Quan-Xing Ni ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Green Tea ◽  
Large Scale ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
Scale Population ◽  
Tea Drinking ◽  
Control Study

scholarly journals Patients with pemphigus are at an increased risk of developing rheumatoid arthritis: a large-scale cohort study

2020 ◽  
Vol 68 (6) ◽  
pp. 373-378
Author(s):  
Khalaf Kridin ◽  
Virginia A. Jones ◽  
Payal M. Patel ◽  
Shira Zelber-Sagi ◽  
Christoph M. Hammers ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Sensitivity Analysis ◽  
Cohort Study ◽  
Large Scale ◽  
Cox Regression ◽  
Matched Control ◽  
Population Based ◽  
Control Subjects ◽  
Increased Risk ◽  
Scale Population

AbstractData regarding the association between pemphigus and rheumatoid arthritis (RA) is inconclusive and yet to be firmly established. In the current study, we aimed to evaluate the risk of developing RA during the course of pemphigus. A large-scale population-based longitudinal cohort study was conducted to evaluate the hazard ratio (HR) of RA among 1985 patients with pemphigus relative to 9874 age-, sex-, and ethnicity-matched control subjects. A multivariate Cox regression model was utilized. The incidence of RA was 1.07 (95% CI, 0.62–1.72) and 0.36 (95% CI, 0.24–0.52) per 1000 person-years among patients with pemphigus and controls, respectively. The lifetime prevalence of RA was 2.3% (95% CI, 1.7–3.1%) among cases and 1.8% (95% CI, 1.5–2.0%) among controls. Patients with pemphigus were more than twice as likely to develop RA as compared to control subjects (adjusted HR, 2.54; 95% confidence interval [CI], 1.31–4.92). The increased risk was robust to a sensitivity analysis that included only cases managed by pemphigus-related systemic medications (adjusted HR, 2.56; 95% CI, 1.30–5.05). In conclusion, pemphigus is associated with an increased risk of RA. Physicians treating patients with pemphigus should be aware of this possible association. Further research is required to better understand the mechanism underlying this association.

scholarly journals P137 Epidemiological study of influenza vaccination and RA

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Nirmin Juber ◽  
Arnat Wannasri ◽  
Tam Minh Do ◽  
Hsin-Jen Chen ◽  
Yi-Fang Chuang ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Large Scale ◽  
Medical Expenditure Panel Survey ◽  
Smoking Status ◽  
Population Based ◽  
Activity Level ◽  
Medical Expenditure ◽  
Increased Risk ◽  
Scale Population

Abstract Background/Aims  Rheumatoid arthritis (RA) has been known as an autoimmune and inflammatory disease. Previous studies found individuals with RA had a two-fold increased risk of infections compared to general population. For infectious disease as influenza, vaccination may confer protection. However, whether or not influenza vaccination is safe to be given to genetically predisposed individuals with RA still on debate since there is an evidence that influenza vaccine as inflammatory stimulus could induce RA. Methods  This study aims to provide an up-to-date epidemiological evidence between influenza vaccination and RA among American adults from 18 years old. Methods  With case-control study design using 2014 Full year consolidated data in Medical Expenditure Panel Survey (MEPS), the association between influenza vaccination and RA among adult 18 years old and above were assessed using logistic regression analysis adjusted for potential covariates (age, sex, comorbidity, body mass index (BMI), education, smoking status, and insurance status) to estimate odds ratio (OR). Results  In the crude model, individuals who reported receiving influenza vaccine were 2.02 (95% CI: 0.97-4.22) times more likely to develop RA, although the association were not significant. In the full adjusted model, the magnitude of association was decreased to 0.25 (95% CI: 0.06-1.05), but the significance was still not reached. Conclusion  Analysing a comprehensive and large-scale population-based survey dataset (MEPS 2014) with adjustment for potential confounders suggested that receiving influenza vaccine did not increase the risk of RA and we have no evidence to suggest that influenza vaccination is not safe to be given to genetically predisposed individuals with RA. Further studies with more complete confounders, such as physical activity level and nutrition intake are strongly recommended. Disclosure  N. Juber: None. A. Wannasri: None. T. Do: None.

scholarly journals COVID-19 and Its Symptoms’ Panoply: A Case-Control Study of 919 Suspected Cases in Locked-Down Ovar, Portugal

2021 ◽  
pp. 1-8
Author(s):  
Regina Sá ◽  
Tiago Pinho-Bandeira ◽  
Guilherme Queiroz ◽  
Joana Matos ◽  
João Duarte Ferreira ◽  
...  
Keyword(s):  
Large Scale ◽  
Case Control Study ◽  
Statistical Significance ◽  
Case Control ◽  
Case Definition ◽  
Suspected Case ◽  
Risk Characteristics ◽  
Increased Risk ◽  
Wide Range ◽  
Control Study

<b><i>Background:</i></b> Ovar was the first Portuguese municipality to declare active community transmission of SARS-CoV-2, with total lockdown decreed on March 17, 2020. This context provided conditions for a large-scale testing strategy, allowing a referral system considering other symptoms besides the ones that were part of the case definition (fever, cough, and dyspnea). This study aims to identify other symptoms associated with COVID-19 since it may clarify the pre-test probability of the occurrence of the disease. <b><i>Methods:</i></b> This case-control study uses primary care registers between March 29 and May 10, 2020 in Ovar municipality. Pre-test clinical and exposure-risk characteristics, reported by physicians, were collected through a form, and linked with their laboratory result. <b><i>Results:</i></b> The study population included a total of 919 patients, of whom 226 (24.6%) were COVID-19 cases and 693 were negative for SARS-CoV-2. Only 27.1% of the patients reporting contact with a confirmed or suspected case tested positive. In the multivariate analysis, statistical significance was obtained for headaches (OR 0.558), odynophagia (OR 0.273), anosmia (OR 2.360), and other symptoms (OR 2.157). The interaction of anosmia and odynophagia appeared as possibly relevant with a borderline statistically significant OR of 3.375. <b><i>Conclusion:</i></b> COVID-19 has a wide range of symptoms. Of the myriad described, the present study highlights anosmia itself and calls for additional studies on the interaction between anosmia and odynophagia. Headaches and odynophagia by themselves are not associated with an increased risk for the disease. These findings may help clinicians in deciding when to test, especially when other diseases with similar symptoms are more prevalent, namely in winter.

Elevation of pulse pressure in middle age is associated with the risk of dementia: data from a population-based cohort

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Kim ◽  
H Jung ◽  
P.S Yang ◽  
H.T Yu ◽  
T.H Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulse Pressure ◽  
Middle Age ◽  
Population Based ◽  
Entire Cohort ◽  
Incident Dementia ◽  
Increased Risk ◽  
Diagnosis Of Dementia ◽  
History Of ◽  
The Mean

Abstract Aims Pulse pressure (PP) is a well-known risk factor for cardiovascular disease. However, the association between the PP and dementia is not well identified. This study aimed to determine the effect of PP on the risk of dementia development in different age subgroups using a longitudinal, population-based, and stroke-free cohort from the general population. Methods The association of PP with the development of incident dementia was assessed from January 1, 2005, to December 31, 2013, in 433,154 participants without a history of dementia or stroke from the Korea National Health Insurance Service-Health Screening cohort. The diagnosis of dementia was defined using the 10th revision of the International Classification of Disease codes. Results The mean age of the cohort was 55.7±9.2 years, 45.7% were women. Hypertension was 23.6%. The mean systolic and diastolic blood pressure of the entire cohort were 125.9±16.6 and 78.4±10.7 mmHg, respectively. Mean PP was 47.5±10.9 mmHg. In the middle-age group (40 to 50 year-old), increasing of 10 mmHg of PP was associated with incident dementia after adjusting mean blood pressure and clinical variables with a hazard ratio (HR) of 1.21 (95% confidence interval [CI]: 1.19–1.23, p&lt;0.001). The association was still significant even after censoring for stroke (HR: 1.16, 95% CI: 1.08–1.22, p&lt;0.001). In the older population, elevation of PP was not associated with dementia development (HR: 0.98, 95% CI: 0.95–1.01, p=0.247) Conclusion PP was associated with increased risk of dementia only in middle-aged population beyond that of mean arterial pressure. Funding Acknowledgement Type of funding source: None

scholarly journals Publisher Correction: A link between appendectomy and gastrointestinal cancers: a large-scale population-based cohort study in Korea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Youn Young Park ◽  
Kil‑yong Lee ◽  
Seong Taek Oh ◽  
Sang Hyun Park ◽  
Kyung Do Han ◽  
...  
Keyword(s):  
Cohort Study ◽  
Large Scale ◽  
Population Based ◽  
Gastrointestinal Cancers ◽  
Scale Population

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