scholarly journals Postpartum trend in blood pressure and renal function in women with severe preeclampsia and eclampsia: A prospective cohort-study at Mulago hospital, Kampala, Uganda

2019 ◽  
Author(s):  
Kasereka Muteke ◽  
Jolly Beyeza ◽  
Milton W Musaba ◽  
Julius Wandabwa ◽  
Paul Kiondo
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Severe Preeclampsia ◽  
Urine Protein ◽  
The Mean ◽  
Mean Time

AbstractBackgroundPreeclampsia/Eclampsia is a multisystem disorder of pregnancy with kidney involvement. Our objective was to assess the postpartum trend in blood pressure, renal function and proteinuria and, to investigate their predictors in Ugandan women with severe preeclampsia and eclampsia.MethodsThis was a prospective cohort study that involved 97 women with severe preeclampsia and Eclampsia, conducted at Mulago National referral hospital from August 2017 to April 2018. The clinical and laboratory variables were collected from the women on day1, 7, 21 and day 42 after delivery. Kaplan-Meier Survival analysis, Cox-proportional Regression and Log-Rank tests were used to compare the baseline and the follow-up variables with changes in blood pressure, renal function and urine protein.ResultsMost women (93.8%) recovered from hypertension within 6 weeks of childbirth with the mean time to resolution of 2.49 weeks (95% CI: 2.13-2.82). About 81% of the women recovered their renal function and the mean time to recovery was 24.54 days (95% CI: 20.14-28.95). Proteinuria resolved in approximately 84% of the women and the mean time resolution of urine protein of 32.85 days (95% CI: 30.31-35.39). Having multiple pregnancy versus a singleton pregnancy was associated with persistence of hypertension six weeks after child birth (P-value = 0.013).ConclusionIn this study, the blood pressure and renal function of most women with severe preeclampsia and eclampsia normalized within six weeks after childbirth. A special interdisciplinary follow up for patients with preeclampsia/eclampsia by an obstetrician and physician is needed in the postpartum period to reduce the maternal morbidity and mortality associated with this condition in our community.

scholarly journals Bidirectional association between blood pressure and depressive symptoms in young and middle-age adults: A cohort study

2020 ◽  
Vol 29 ◽  
Author(s):  
Sang Won Jeon ◽  
Yoosoo Chang ◽  
Se-Won Lim ◽  
Juhee Cho ◽  
Han-Na Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Depressive Symptoms ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Heart Association ◽  
Epidemiologic Studies ◽  
Incident Hypertension ◽  
Bidirectional Association

Abstract Aims To evaluate the bidirectional relationship between blood pressure (BP) and depressive symptoms using a large prospective cohort study. Methods Prospective cohort study was performed in 276 244 adults who participated in a regular health check-up and were followed annually or biennially for up to 5.9 years. BP levels were categorised according to the 2017 American College of Cardiology and American Heart Association hypertension guidelines. Depressive symptoms were assessed using Centre for Epidemiologic Studies-Depression (CESD) questionnaire and a cut-off score of ≥25 was regarded as case-level depressive symptoms. Results During 672 603.3 person-years of follow-up, 5222 participants developed case-level depressive symptoms. The multivariable-adjusted hazard ratios (HRs) [95% confidence interval (CI)] for incident case-level depressive symptoms comparing hypotension, elevated BP, hypertension stage 1 and hypertension stage 2 to normal BP were 1.07 (0.99–1.16), 0.93 (0.82–1.05), 0.89 (0.81–0.97) and 0.81 (0.62–1.06), respectively (p for trend <0.001). During 583 615.3 person-years of follow-up, 27 787 participants developed hypertension. The multivariable-adjusted HRs (95% CI) for incident hypertension comparing CESD 16–24 and ⩾25 to CESD < 16 were 1.05 (1.01–1.11) and 1.12 (1.03–1.20), respectively (p for trend <0.001) and in the time-dependent models, corresponding HRs (95% CI) were 1.12 (1.02–1.24) and 1.29 (1.10–1.50), respectively (p for trend <0.001). Conclusions In this large cohort study of young and middle-aged individuals, higher BP levels were independently associated with a decreased risk for developing case-level depressive symptoms and depressive symptoms were also associated with incident hypertension. Further studies are required to elucidate the mechanisms underlying the bidirectional association between BP levels and incident depression.

scholarly journals Cost of Living with Parkinson’s Disease over 12 Months in Australia: A Prospective Cohort Study

2017 ◽  
Vol 2017 ◽  
pp. 1-13 ◽  
Author(s):  
Shalika Bohingamu Mudiyanselage ◽  
Jennifer J. Watts ◽  
Julie Abimanyi-Ochom ◽  
Lisa Lane ◽  
Anna T. Murphy ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health System ◽  
Prospective Cohort Study ◽  
Resource Use ◽  
Prospective Cohort ◽  
Annual Cost ◽  
Severe Disease ◽  
Medicare Data ◽  
The Mean

Background. Parkinson disease (PD) is a costly chronic condition in terms of managing both motor and nonmotor symptoms. The burden of disease is high for individuals, caregivers, and the health system. The aim of this study is to estimate the annual cost of PD from the household, health system, and societal perspectives. Methods. A prospective cohort study of newly referred people with PD to a specialist PD clinic in Melbourne, Australia. Participants completed baseline and monthly health resource use questionnaires and Medicare data were collected over 12 months. Results. 87 patients completed the 12-month follow-up assessments. The mean annual cost per person to the health care system was $32,556 AUD. The burden to society was an additional $45,000 per annum per person with PD. The largest component of health system costs were for hospitalisation (69% of total costs). The costs for people with moderate to severe disease were almost 4 times those with mild PD ($63,569 versus $17,537 p<0.001). Conclusion. PD is associated with significant costs to individuals and to society. Costs escalated with disease severity suggesting that the burden to society is likely to grow with the increasing disease prevalence that is associated with population ageing.

scholarly journals Vitamin D intake and risk of CVD and all-cause mortality: evidence from the Caerphilly Prospective Cohort Study

2017 ◽  
Vol 20 (15) ◽  
pp. 2744-2753 ◽  
Author(s):  
Jing Guo ◽  
John R Cockcroft ◽  
Peter C Elwood ◽  
Janet E Pickering ◽  
Julie A Lovegrove ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Vitamin D ◽  
Cohort Study ◽  
Diastolic Blood Pressure ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cvd Risk ◽  
Vitamin D Intake ◽  
All Cause Mortality

AbstractObjectiveProspective data on the associations between vitamin D intake and risk of CVD and all-cause mortality are limited and inconclusive. The aim of the present study was to investigate the associations between vitamin D intake and CVD risk and all-cause mortality in the Caerphilly Prospective Cohort Study.DesignThe associations of vitamin D intake with CVD risk markers were examined cross-sectionally at baseline and longitudinally at 5-year, 10-year and >20-year follow-ups. In addition, the predictive value of vitamin D intake for CVD events and all-cause mortality after >20 years of follow-up was examined. Logistic regression and general linear regression were used for data analysis.SettingParticipants in the UK.SubjectsMen (n452) who were free from CVD and type 2 diabetes at recruitment.ResultsHigher vitamin D intake was associated with increased HDL cholesterol (P=0·003) and pulse pressure (P=0·04) and decreased total cholesterol:HDL cholesterol (P=0·008) cross-sectionally at baseline, but the associations were lost during follow-up. Furthermore, higher vitamin D intake was associated with decreased concentration of plasma TAG at baseline (P=0·01) and at the 5-year (P=0·01), but not the 10-year examination. After >20 years of follow-up, vitamin D was not associated with stroke (n72), myocardial infarctions (n142), heart failure (n43) or all-cause mortality (n281), but was positively associated with increased diastolic blood pressure (P=0·03).ConclusionsThe study supports associations of higher vitamin D intake with lower fasting plasma TAG and higher diastolic blood pressure.

scholarly journals Validity of self-reported diagnoses of gynaecological and breast cancers in a prospective cohort study: the Japan Nurses’ Health Study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045491
Author(s):  
Kiyoshi Takamatsu ◽  
Yuki Ideno ◽  
Mami Kikuchi ◽  
Toshiyuki Yasui ◽  
Naho Maruoka ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Predictive Value ◽  
Prospective Cohort ◽  
Health Study ◽  
Breast Cancers ◽  
Expert Review ◽  
The Mean

ObjectivesTo validate the self-reported diagnoses of gynaecological and breast cancers in a nationwide prospective cohort study of nursing professionals: the Japan Nurses’ Health Study (JNHS).Design and settingRetrospective analysis of the JNHS.Participants and measuresData were reviewed for 15 717 subjects. The mean age at baseline was 41.6±8.3 years (median: 41), and the mean follow-up period was 10.5±3.8 years (median: 12). Participants are regularly mailed a follow-up questionnaire once every 2 years. Respondents who self-reported a positive cancer diagnosis were sent an additional confirmation questionnaire and contacted the diagnosing facility to confirm the diagnosis based on medical records. A review panel of experts verified the disease status. Regular follow-up, confirmation questionnaires and expert review were validated for their positive predictive value (PPV) and negative predictive value (NPV).ResultsNew incidences were verified in 37, 47, 26 and 300 cervical, endometrial, ovarian and breast cancer cases, respectively. The estimated incidence rates were 22.0, 25.4, 13.8 and 160.4 per 100 000 person-years. These were comparable with those of national data from regional cancer registries in Japan. For regular follow-up, the corresponding PPVs for cervical, endometrial, ovarian and breast cancer were 16.9%, 54.2%, 45.1% and 81.4%, and the NPVs were 100%, 99.9%, 99.9% and 99.9%, respectively. Adding the confirmation questionnaire improved the PPVs to 31.5%, 88.9%, 76.7% and 99.9%; the NPVs were uniformly 99.9%. Expert review yielded PPVs and NPVs that were all ~100%.ConclusionsGynaecological cancer cannot be accurately assessed by self-reporting alone. Additionally, the external validity of cancer incidence in this cohort was confirmed.

scholarly journals Ultra-Processed Food Consumption is Associated with Renal Function Decline in Older Adults: A Prospective Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 428
Author(s):  
Jimena Rey-García ◽  
Carolina Donat-Vargas ◽  
Helena Sandoval-Insausti ◽  
Ana Bayan-Bravo ◽  
Belén Moreno-Franco ◽  
...  
Keyword(s):  
Older Adults ◽  
Renal Function ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Community Dwelling ◽  
Processed Food ◽  
Renal Function Decline ◽  
Increased Risk

Ultra-processed food (UPF) consumption has been associated with increased risk of cardiovascular risk factors and mortality. However, little is known on the UPF effect on renal function. The aim of this study is to assess prospectively the association between consumption of UPF and renal function decline. This is a prospective cohort study of 1312 community-dwelling individuals aged 60 and older recruited during 2008–2010 and followed up to December 2015. At baseline, a validated dietary history was obtained. UPF was identified according to NOVA classification. At baseline and at follow-up, serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) levels were ascertained and changes were calculated. A combined end-point of renal decline was considered: SCr increase or eGFR decreased beyond that expected for age. Logistic regression with adjustment for potential confounders was performed. During follow-up, 183 cases of renal function decline occurred. The fully adjusted odds ratios (95% CI) of renal function decline across terciles of percentage of total energy intake from UPF were 1.56 (1.02–2.38) for the second tercile, and 1.74 (1.14–2.66) for the highest tercile; p-trend was 0.026. High UPF consumption is independently associated with an increase higher than 50% in the risk of renal function decline in Spanish older adults.

Prospective Cohort Study of the Incidence, Risk Factors and Long-Term Sequelae of Symptomatic Catheter-Related Thrombosis in Adults with Cancer.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2200-2200
Author(s):  
Agnes Y. Lee ◽  
Carolyn Webb ◽  
Qing Guo ◽  
Lorrie Costantini ◽  
Greg Butler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Dwell Time ◽  
History Of ◽  
The Mean ◽  
Catheter Related Thrombosis

Abstract Long-term indwelling central venous catheters (CVCs) are used for delivering chemotherapy, parenteral nutrition, antibiotics, and blood products, as well as for facilitating blood drawing, in many patients with malignancy. Although the important supportive role of CVCs is unquestioned, there is uncertainty regarding the prevention and treatment of catheter-related thrombosis (CRT) because there is a lack of prospective and contemporary data on the natural history of this complication. As a first step towards improving CRT management, we conducted a prospective cohort study to examine the incidence, clinical risk factors, and the long-term sequelae of symptomatic CRT in adults with cancer. Consecutive patients undergoing insertion of a CVC at a tertiary care center were enrolled and followed for the duration of their catheter-dwell time plus 4 weeks or a maximum of 52 weeks, whichever comes first. Scheduled assessments were done at weeks 1, 2, 4, 8, 12, 24, 36 and 52 weeks after insertion. Patients with symptomatic CRT were treated with anticoagulants and were followed for an additional 52 weeks from the date of CRT diagnosis. Baseline information and follow-up data regarding catheter patency, thromboprophylaxis, clinical symptoms, and thrombotic events was collected. Standardized regional guidelines for catheter care were followed and symptomatic CRT was diagnosed based on objective testing and satisfaction of prespecified criteria. Between March 2002 and July 2003, 444 patients underwent 500 catheter insertions. The mean patient age was 56 y (range 18–91 y) and 55% of patients were female. Catheters inserted included PICCs (65%), ports (18%), pheresis (11%), and Hickman catheters (6%). As of July 22, 2004, 442 patients had completed follow-up. The total catheter-dwell time was 59,959 d (median 88 d), while the total follow-up was 73,654 pt-d (median 151 d). Colorectal was the most common tumor type in 18% of patients and 41% of all patients at enrolment had metastatic solid tumor. Overall, there were 19 episodes of symptomatic CRT, representing an incidence of 4.3% (95% CI 2.6–6.6%) of patients or 0.3 CRTs per 1000 catheter-dwell days (95% CI 0.2–0.5 per 1000 d). The mean time to CRT was 53 d (range 6–162 d). Development of CRT was not associated with age, ECOG performance status, cancer treatment, catheter type, side of insertion, thromboprophylaxis, infection, or previous history of thrombosis. The only significant risk factor was ovarian cancer (P=0.02). In patients with symptomatic CRT, 89% (17/19) of CRTs were treated with anticoagulant therapy alone, 5.3% (1/19) had the catheter removed, and 5.3% (1/19) were treated with both; none had symptomatic pulmonary embolism or post-thrombotic syndrome during follow-up. In summary, the incidence of symptomatic CRT in adults with cancer is low and treatment with anticoagulant therapy alone was not associated with any serious long-term sequelae. Due to the small number of CRTs observed, larger studies are required to further evaluate risk factors and identify the optimal therapeutic approach for CRTs.

Effect of Laparoscopic Cystectomy for Ovarian Endometriomas on Ovarian Reserve, as Measured by Anti-Müllerian Hormone: A Prospective Cohort Study

2019 ◽  
Vol 15 (3) ◽  
pp. 207-213 ◽  
Author(s):  
Vaughan Marshall ◽  
Thomas Ignatius Siebert
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Ovarian Reserve ◽  
Prospective Cohort ◽  
Secondary Outcome ◽  
Unilateral Disease ◽  
Laparoscopic Cystectomy ◽  
The Mean ◽  
Ovarian Endometriomas

Background: Cystectomy for ovarian endometriomas is commonly performed, however recent publications have shown a deleterious effect of cystectomy on ovarian reserve. Objectives: The study aimed to evaluate what effect laparoscopic cystectomy for ovarian endometriomas has on the ovarian reserve. Methods: This is a prospective cohort study performing standard laparoscopic cystectomies for ovarian endometriomas. The primary outcome was the assessment of the ovarian reserve using Anti-Müllerian hormone (AMH), done pre- and six months postoperatively. Secondary outcome was spontaneous pregnancy during follow up. Results: We enrolled 59 participants. Twenty-five participants were lost to follow up and a further 3 were excluded from the analysis. The average age was 33.1 years. Thirty-one participants completed the six months follow up. The mean preoperative and postoperative AMH value was 3.21ng/mL [95% CI: 2.24 - 4.18ng/mL, SD 2.64] and 1.48ng/mL [95% CI: 1.06 - 1.91ng/mL, SD 1.17] respectively: equating to a 53.89% decline, P=0.002. Twenty participants had unilateral cysts whilst the remaining 11 had bilateral endometriomas. The mean preoperative and postoperative AMH for unilateral cysts was 3.22ng/mL [95% CI:1.93 - 4.51ng/mL, SD 2.76] and 1.82ng/mL [95% CI: 1.23 – 2.41ng/mL, SD 1.26] respectively, representing a 43.48% decrease, P=0.072. Of the 11 with bilateral endometriomas, the mean preoperative AMH was 3.19ng/mL [95% CI: 1.49 - 4.89ng/mL, SD 2.54] with 0.88ng/mL [95% CI: 0.43 - 1.33ng/mL, SD 0.67] representing the postoperative AMH, equating to a 72.41% reduction, P=0.005. Conclusion: Serum AMH is negatively affected by laparoscopic cystectomy for ovarian endometriomas, with a significant decline in ovarian reserve as measured six months postoperatively. A greater decline was seen in patients with bilateral endometriomas compared to unilateral disease.

scholarly journals Short-term results of a new self-locking cementless femoral stem: a prospective cohort study of the Lima MasterSL

2020 ◽  
Author(s):  
C. E. Dlaska ◽  
I. A. Jovanovic ◽  
A. L. Grant ◽  
G. Graw ◽  
M. P. Wilkinson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Standard Deviation ◽  
Total Hip Arthroplasty ◽  
Prospective Cohort Study ◽  
Hip Arthroplasty ◽  
Prospective Cohort ◽  
Femoral Stem ◽  
Short Term ◽  
The Mean

Abstract Background Total hip arthroplasty is a successful treatment for hip osteoarthritis. Primary and secondary implant fixation is dependent on implant design and plays an important role in the longevity of an implant. In this study, we assessed the self-locking cementless MasterSL femoral stem. Materials and methods In this single-centre prospective study, 50 consecutive hips with the indication for total hip arthroplasty, who met the inclusion criteria, received the MasterSL stem from LIMA Corporate. Patients had pre- and post-operative clinical and radiological assessment and completed patient-reported outcome measures [Oxford Hip Score (OHS), Harris Hip Score (HHS) and Forgotten Joint Score (FJS)] at the 6-week and 6-, 12- and 24-month mark. Post-operative X-rays were assessed for osteointegration (Engh Score), alignment and subsidence. Results After 2 years, aseptic survival was 100%. One hip had to be explanted due to early deep infection and was excluded from the study. At 2 years, the patients reported a significant improved HHS and OHS of 95.3 ± 5.8 and 46.1 ± 3.6 (mean ± standard deviation), respectively, compared to preoperatively. The mean ± standard deviation for the FJS was 86.4 ± 18.7 with two-thirds of the patients reporting a score above 85. The mean Engh score is 15.1 ± 5.9 (mean ± standard deviation) with no patient scoring below 1 which suggests good osteointegration in all femoral stems. Conclusions The MasterSL femoral stem performed well in this short-term follow-up study, with high patient satisfaction and good signs of osteointegration. Long-term follow-up will be necessary to evaluate longevity. Level of evidence Level 3, Prospective cohort study. Trial registration The study was registered on the 30.03.2016 with Australia New Zealand Clinical Trials Registry (ACTRN12617000550303).

scholarly journals Snoring and incident chronic kidney disease: a community-based prospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030671 ◽  
Author(s):  
Changhyun Lee ◽  
Young Su Joo ◽  
Sangmi Lee ◽  
Shinchan Kang ◽  
Joohwan Kim ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Cohort Study ◽  
Kidney Disease ◽  
Prospective Cohort Study ◽  
Normal Renal Function ◽  
Prospective Cohort ◽  
Community Based ◽  
Incident Chronic Kidney Disease

ObjectivesPrevious studies have shown that symptoms of sleep-disordered breathing are associated with metabolic derangements and vascular disease development. However, the relationship between snoring and renal function is not well investigated. The association between snoring and the development of incident chronic kidney disease (CKD) in subjects with normal renal function was evaluated.DesignProspective cohort study.SettingAnsung (rural community) and Ansan (urban community) cities.ParticipantsCommunity-based cohort participants aged 40–69 years.MethodsA total of 9062 participants in the Ansung–Ansan cohort study were prospectively followed up from 2001 to 2014. The participants were classified into three groups: non-snorer, <1 day/week and ≥1 day/week. The main outcome was incident CKD, which was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m2during the follow-up period.Primary outcomeIncident CKD.ResultsThe mean subject age was 52.0±8.9 years, and 4372 (48.2%) subjects were male. The non-snorer,<1 day/week and ≥1 day/week groups included 3493 (38.5%), 3749 (41.4%), and 1820 (20.1%) subjects, respectively. Metabolic syndrome was more prevalent in the snoring groups than in the non-snoring group. Snoring frequency showed a significant positive relationship with age, waist:hip ratio, fasting glucose, total cholesterol (Tchol) and low-density lipoprotein cholesterol. During a mean follow-up of 8.9 years, 764 (8.4%) subjects developed CKD. Cox proportional hazards model analysis revealed that the risk of CKD development was significantly higher in subjects who snored ≥1 day/week than in non-snorers, even after adjustments for confounding factors (HR 1.23, 95% CI 1.09 to 1.38, p<0.01).ConclusionSnoring may increase the risk of CKD development in subjects with normal renal function.

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