scholarly journals Cohort profile: the clinical ‘Psoriasis in Adolescents’ (PIA) cohort in Denmark

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031448 ◽  
Author(s):  
Christoffer Blegvad ◽  
Anne-Marie Nybo Andersen ◽  
Jonathan Groot ◽  
Claus Zachariae ◽  
Lone Skov
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Clinical Examination ◽  
Childhood And Adolescence ◽  
Physical And Mental Health ◽  
Individual Level ◽  
Physical Measurements ◽  
Population Comparison ◽  
The Individual

PurposePsoriasis is a chronic inflammatory skin disease that frequently debuts in childhood and adolescence. We wished to determine environmental and genetic risk factors for the development of psoriasis in children and adolescents, as well as to investigate debut type, trigger factors, course of disease, nature and influence of stress related to both child and family and risk factors for comorbidity. The ‘Psoriasis in Adolescents’ (PIA) cohort will provide data on the relationship between psoriasis and, respectively, genetic disposition, early-life exposures, quality of life and comorbidity.ParticipantsThe PIA cohort is nested in the large general population Danish National Birth Cohort (DNBC). We invited 390 adolescents with psoriasis and corresponding maternally predisposed and non-predisposed controls. Participants underwent an interview and a clinical examination consisting of a skin inspection and physical measurements including blood sampling and microbiological swabs. Additionally, four self-administered questionnaires on physical and mental health were completed.Findings to dateThe final PIA cohort consists of 81 adolescents with psoriasis, 110 parentally predisposed and 124 non-predisposed psoriasis-free adolescents. The validity of the maternally reported psoriasis status from the DNBC was found to be low on clinical examination (47.5%). In contrast, the self-reported psoriasis status of the DNBC mothers was clinically confirmed in 80.8% of the cases.Future plansThe PIA cohort offers the possibility of assessing the clinical characteristics, course of psoriasis and development of comorbidities in adolescents with clinically confirmed disease from a general population. Comparison with predisposed and non-predisposed controls is possible and genetic analyses are scheduled. We plan to invite the participants for a follow-up in 5–10 years. Furthermore, we plan to include newly diagnosed adolescents with psoriasis from the 18-year DNBC follow-up. All information is linkable on the individual level with data from the DNBC and nationwide registries in Denmark.

scholarly journals Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis

2021 ◽  
Vol 10 (6) ◽  
pp. 1314
Author(s):  
Rebeca Lorca ◽  
Isaac Pascual ◽  
Andrea Aparicio ◽  
Alejandro Junco-Vicente ◽  
Rut Alvarez-Velasco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Young Women ◽  
Artery Dissection ◽  
Men And Women ◽  
High Prevalence

Background: Coronary artery disease (CAD) is the most frequent cause of ST-segment elevation myocardial infarction (STEMI). Etiopathogenic and prognostic characteristics in young patients may differ from older patients and young women may present worse outcomes than men. We aimed to evaluate the clinical characteristics and prognosis of men and women with premature STEMI. Methods: A total 1404 consecutive patients were referred to our institution for emergency cardiac catheterization due to STEMI suspicion (1 January 2014–31 December 2018). Patients with confirmed premature (<55 years old in men and <60 in women) STEMI (366 patients, 83% men and 17% women) were included (359 atherothrombotic and 7 spontaneous coronary artery dissection (SCAD)). Results: Premature STEMI patients had a high prevalence of classical cardiovascular risk factors. Mean follow-up was 4.1 years (±1.75 SD). Mortality rates, re-hospitalization, and hospital stay showed no significant differences between sexes. More than 10% of women with premature STEMI suffered SCAD. There were no significant differences between sexes, neither among cholesterol levels nor in hypolipemiant therapy. The global survival rates were similar to that expected in the general population of the same sex and age in our region with a significantly higher excess of mortality at 6 years among men compared with the general population. Conclusion: Our results showed a high incidence of cardiovascular risk factors, a high prevalence of SCAD among young women, and a generally good prognosis after standardized treatment. During follow-up, 23% suffered a major cardiovascular event (MACE), without significant differences between sexes and observed survival at 1, 3, and 6 years of follow-up was 96.57% (95% CI 94.04–98.04), 95.64% (95% CI 92.87–97.35), and 94.5% (95% CI 91.12–97.66). An extra effort to prevent/delay STEMI should be invested focusing on smoking avoidance and optimal hypolipemiant treatment both in primary and secondary prevention.

scholarly journals AB0533 ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA) IN GENERAL POPULATION WITHOUT ANCA ASSOCIATED VASCULITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1563.3-1563
Author(s):  
H. Tamaki ◽  
S. Fukui ◽  
T. Nakai ◽  
G. Kidoguchi ◽  
S. Kawaai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Autoimmune Disease ◽  
General Population ◽  
Granulomatosis With Polyangiitis ◽  
Dietary Habits ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Anca Associated Vasculitis ◽  
The Mean

Background:Currently it is hypothesized that many systemic autoimmune diseases occur due to environmental risk factors in addition to genetic risk factors. Anti-Neutrophil Cytoplasmic Antibody (ANCA) is mainly associated with three systemic autoimmune disease including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA). It is known that ANCA can be positive before clinical symptoms in patients with known diagnosis of GPA and ANCA titers rise before clinical manifestations appear. However, prevalence of ANCA among general population is not well known. It has not been described as well how many of people with positive ANCA eventually develop clinical manifestations of ANCA associated Vasculitis.Objectives:This study aims to estimate prevalence of ANCA in general population without ANCA associated Vasculitis. It also describes natural disease course of people with positive ANCA without ANCA associated Vasculitis. Risk factors for positive ANCA are also analyzed.Methods:This is a single center retrospective study at Center for Preventive Medicine of St. Luke’s International Hospital in Tokyo. ANCA was checked among the patients who wished to between 2018 and 2019. St. Luke’s Health Check-up Database (SLHCD) was utilized to collect the data. The patients whose serum was measured for ANCA were identified. The data for basic demographics, social habits, dietary habits and laboratory data were extracted. The charts of the patients with positive ANCA were reviewed.Results:Sera of total 1204 people were checked for ANCA. Of these 1204 people, 587 (48.8%) are male and the mean age was 55.8 years (32.6 to 79). There were total 11 patients with positive ANCA. Myeloperoxidase ANCA (MPO-ANCA) was positive for 3 patients and proteinase 3 ANCA (PR3-ANCA) was positive for 8 patients. Of these 11 patients, 5 were male (45.5%) and the mean age was 54.6 years. Two patients had history of autoimmune disease (primary biliary cirrhosis and ulcerative colitis). Five patients were evaluated by rheumatologists with the median follow-up period of 274 days. None of them developed clinical signs and symptoms of ANCA associated Vasculitis. Four out of five patients had ANCA checked later, two of which turned negative. The prevalence of ANCA in this cohort was 0.9% (95% confidence interval [95% CI]: 0.5% to 1.6%). Univariate analysis was performed to identify risk factors of positive ANCA. The variables analyzed include age, gender, body mass index (BMI), smoking habits, alcohol intake, dietary habits (fruits, fish, red meat), hypertension, dyslipidemia, and laboratory data. None of these variables demonstrated statistically significant differences except for positive rheumatoid factor (ANCA positive group: 33 % vs ANCA negative group: 9.1%, p value = 0.044).Conclusion:The prevalence of ANCA in this cohort was 0.9% (95% CI: 0.5% to 1.6%). None of them who had a follow-up developed ANCA associated Vasculitis during the follow-up period. Longer follow-up and more patients are necessary to determine natural course of people with positive ANCA.Disclosure of Interests:None declared

scholarly journals Nationwide COVID-19-EII Study: Incidence, Environmental Risk Factors and Long-Term Follow-Up of Patients with Inflammatory Bowel Disease and COVID-19 of the ENEIDA Registry

2022 ◽  
Vol 11 (2) ◽  
pp. 421
Author(s):  
Yamile Zabana ◽  
Ignacio Marín-Jiménez ◽  
Iago Rodríguez-Lago ◽  
Isabel Vera ◽  
María Dolores Martín-Arranz ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Prospective Observational Study ◽  
Similar Data ◽  
Protection Measures ◽  
Long Term Follow Up ◽  
Immunosuppressed Patients ◽  
Inflammatory Bowel

We aim to describe the incidence and source of contagion of COVID-19 in patients with IBD, as well as the risk factors for a severe course and long-term sequelae. This is a prospective observational study of IBD and COVID-19 included in the ENEIDA registry (53,682 from 73 centres) between March–July 2020 followed-up for 12 months. Results were compared with data of the general population (National Centre of Epidemiology and Catalonia). A total of 482 patients with COVID-19 were identified. Twenty-eight percent were infected in the work environment, and 48% were infected by intrafamilial transmission, despite having good adherence to lockdown. Thirty-five percent required hospitalization, 7.9% had severe COVID-19 and 3.7% died. Similar data were reported in the general population (hospitalisation 19.5%, ICU 2.1% and mortality 4.6%). Factors related to death and severe COVID-19 were being aged ≥ 60 years (OR 7.1, 95% CI: 1.8–27 and 4.5, 95% CI: 1.3–15.9), while having ≥2 comorbidities increased mortality (OR 3.9, 95% CI: 1.3–11.6). None of the drugs for IBD were related to severe COVID-19. Immunosuppression was definitively stopped in 1% of patients at 12 months. The prognosis of COVID-19 in IBD, even in immunosuppressed patients, is similar to that in the general population. Thus, there is no need for more strict protection measures in IBD.

scholarly journals Drug Use Changes at the Individual Level: Results from a Longitudinal, Multisite Survey in Young Europeans Frequenting the Nightlife Scene

2021 ◽  
pp. 1-6
Author(s):  
Meryem Grabski ◽  
Jon Waldron ◽  
Tom P. Freeman ◽  
Claire Mokrysz ◽  
Ruben J.J. van Beek ◽  
...  
Keyword(s):  
Drug Use ◽  
Online Survey ◽  
Prescription Opioids ◽  
Alkyl Nitrates ◽  
Cross Sectional ◽  
Individual Level ◽  
The Past ◽  
Frequency Of Use ◽  
The Individual

<b><i>Background:</i></b> Monitoring emerging trends in the increasingly dynamic European drug market is vital; however, information on change at the individual level is scarce. In the current study, we investigated changes in drug use over 12 months in European nightlife attendees. <b><i>Method:</i></b> In this longitudinal online survey, changes in substances used, use frequency in continued users, and relative initiation of use at follow-up were assessed for 20 different substances. To take part, participants had to be aged 18–34 years; be from Belgium, Italy, the Netherlands, Sweden, or the UK; and have attended at least 6 electronic music events in the past 12 months at baseline. Of 8,045 volunteers at baseline, 2,897 completed the survey at both time points (36% follow-up rate), in 2017 and 2018. <b><i>Results:</i></b> The number of people using ketamine increased by 21% (<i>p</i> &#x3c; 0.001), and logarithmized frequency of use in those continuing use increased by 15% (<i>p</i> &#x3c; 0.001; 95% CI: 0.07–0.23). 4-Fluoroamphetamine use decreased by 27% (<i>p</i> &#x3c; 0.001), and logarithmized frequency of use in continuing users decreased by 15% (<i>p</i> &#x3c; 0.001, 95% CI: −0.48 to −0.23). The drugs with the greatest proportion of relative initiation at follow-up were synthetic cannabinoids (73%, <i>N</i> = 30), mephedrone (44%, <i>N</i> = 18), alkyl nitrites (42%, <i>N</i> = 147), synthetic dissociatives (41%, <i>N</i> = 15), and prescription opioids (40%, <i>N</i> = 48). <b><i>Conclusions:</i></b> In this European nightlife sample, ketamine was found to have the biggest increase in the past 12 months, which occurred alongside an increase in frequency of use in continuing users. The patterns of uptake and discontinuation of alkyl nitrates, novel psychoactive substances, and prescription opioids provide new information that has not been captured by existing cross-sectional surveys. These findings demonstrate the importance of longitudinal assessments of drug use and highlight the dynamic nature of the European drug landscape.

Indirect aggression, anxiety, and empathy: Disaggregating between and within person longitudinal associations during childhood and adolescence

2021 ◽  
pp. 1-13
Author(s):  
Ann H. Farrell ◽  
Tracy Vaillancourt
Keyword(s):  
Anxiety Symptoms ◽  
Empathic Concern ◽  
Indirect Aggression ◽  
Childhood And Adolescence ◽  
Acting Out ◽  
Individual Level ◽  
Self Confidence ◽  
Latent Trajectory ◽  
Longitudinal Associations ◽  
The Individual

Abstract Although indirectly aggressive behavior and anxiety symptoms can co-occur, it is unclear whether anxiety is an antecedent or outcome of indirect aggression at the individual level and whether other personality traits can contribute to these longitudinal associations. Therefore, the between- and within-person associations among indirect aggression, anxiety symptoms, and empathic concern were examined across adolescence from ages 11 to 16 in a cohort of individuals followed annually (N = 700; 52.9% girls; 76.0% White) controlling for direct aggression and demographic variables. Results of autoregressive latent trajectory models with structured residuals supported an acting out model at the within-person level. Specifically, anxiety symptoms positively predicted indirect aggression and indirect aggression negatively predicted empathic concern at each adjacent time point. These findings suggest that methods of reducing worries about the self and increasing healthy self-confidence could prevent indirect aggression and help build concern and compassion toward others.

Abstract 360: Neighborhood-level Poverty and Incident Atrial Fibrillation: Analysis of Electronic Health Records From 2005-2018

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Utibe R Essien ◽  
Megan McCabe ◽  
Sadiya S Khan
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Census Tract ◽  
Individual Level ◽  
Neighborhood Poverty ◽  
Cardiovascular Morbidity And Mortality ◽  
Race Ethnicity ◽  
Neighborhood Level

Introduction: Atrial fibrillation (AF) is a leading cause of cardiovascular morbidity and mortality. Disparities in AF outcomes have been related to individual-level social determinants of health, including race/ethnicity and socioeconomic status. While neighborhood-level factors, such as poverty, have been related to prevalence of key risk factors (e.g. obesity, hypertension), the association between neighborhood poverty and incident AF has not been previously examined. Methods: Using the Northwestern Medicine Enterprise Data Warehouse, we identified adults free of cardiovascular disease, with at least 5 years of follow-up from January 1, 2005 - December 31, 2013. Residential addresses were geocoded and matched to census tract level poverty estimates from the American Community Survey. Neighborhood poverty was defined as the proportion of residents in the census tract living below the US-defined poverty threshold. We categorized neighborhood poverty levels into tertiles. Generalized linear mixed effects models were used to examine the association between tertiles of neighborhood poverty and incident AF, adjusting for demographic (age, sex, race/ethnicity, insurance type) and AF risk factors (hypertension, diabetes, obesity and smoking status). Results: The cohort comprised 29,069 adults with a mean (SD) age of 51.4 (11.3) years, which included 58% women and 10% non-Hispanic Blacks. Higher rates of obesity, diabetes, hypertension, and smoking were observed in higher poverty groups. Approximately, 3.4% of patients developed incident AF over a follow-up of 5 years. The adjusted odds of incident AF were higher for the medium poverty compared to the low poverty group (adjusted odds ratio, aOR 1.30 (95% CI 1.05-1.56). The aOR of incident AF was similarly higher in the high poverty compared to low poverty group though not statistically significant (Table). Conclusions: In a cohort of adults free of cardiovascular disease at baseline, we found that residence in a more deprived neighborhood was associated with higher rates of incident AF, even after adjustment for traditional risk factors. Understanding how neighborhood and individual-level clinical factors interact to increase the incidence of AF is critical to developing equitable prevention strategies in this increasingly common condition.

Pre-rheumatoid arthritis

2020 ◽  
pp. 121-132
Author(s):  
Karim Raza ◽  
Catherine McGrath ◽  
Laurette van Boheemen ◽  
Dirkjan van Schaardenburg
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
At Risk ◽  
Genetic Risk ◽  
Inflammatory Arthritis ◽  
Primary Site ◽  
Individual Level ◽  
Mucosal Surfaces ◽  
Risk Patients ◽  
The Individual

The typical evolution of rheumatoid arthritis (RA) is that a person, with genetic risk factors, develops autoantibodies and subclinical inflammation under relevant environmental influences. There are indications that the primary site of the pathology is at mucosal surfaces (e.g. in the gums, lungs, and/or the gut), after which the disease translocates to the joints. Preclinical RA can be defined at the phase during which no clinically apparent features are present (i.e. no symptoms of inflammatory arthritis or clinically apparent joint swelling) but during which RA related biologic derangements such as the presence of autoantibodies are present. This chapter presents an overview of the risk factors, stages, and events occurring during the pre-RA phase. A better understanding of the factors involved will enable more accurate prediction of RA at the individual level and selection of high-risk individuals for inclusion in preventive studies. Several pharmacologic and non-pharmacologic studies aiming to prevent or delay the onset of RA in at-risk individuals are currently underway. It is hoped that such interventions in the pre-RA and indeed in the preclinical-RA phases will allow us to reduce the risk of RA and prevent RA developing in at least a proportion of at-risk patients.

scholarly journals Cohort profile: the Hortega Study for the evaluation of non-traditional risk factors of cardiometabolic and other chronic diseases in a general population from Spain

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e024073 ◽  
Author(s):  
Maria Tellez-Plaza ◽  
Laisa Briongos-Figuero ◽  
Gernot Pichler ◽  
Alejandro Dominguez-Lucas ◽  
Fernando Simal-Blanco ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Phase I ◽  
Chronic Diseases ◽  
University Hospital ◽  
Phase Iii ◽  
Event Data ◽  
Time To Event ◽  
Time To Event Data

PurposeThe Hortega Study is a prospective study, which investigates novel determinants of selected chronic conditions with an emphasis on cardiovascular health in a representative sample of a general population from Spain.ParticipantsIn 1997, a mailed survey was sent to a random selection of public health system beneficiaries assigned to the University Hospital Rio Hortega’s catchment area in Valladolid (Spain) (n=11 423, phase I), followed by a pilot examination in 1999–2000 of 495 phase I participants (phase II). In 2001–2003, the examination of 1502 individuals constituted the Hortega Study baseline examination visit (phase III, mean age 48.7 years, 49% men, 17% with obesity, 27% current smokers). Follow-up of phase III participants (also termed Hortega Follow-up Study) was obtained as of 30 November 2015 through review of health records (9.5% of participants without follow-up information).Findings to dateThe Hortega Study integrates baseline information of traditional and non-traditional factors (metabolomic including lipidomic and oxidative stress metabolites, genetic variants and environmental factors, such as metals), with 14 years of follow-up for the assessment of mortality and incidence of chronic diseases. Preliminary analysis of time to event data shows that well-known cardiovascular risk factors are associated with cardiovascular incidence rates, which add robustness to our cohort.Future plansIn 2020, we will review updated health and mortality records of this ongoing cohort for a 5-year follow-up extension. We will also re-examine elder survivors to evaluate specific aspects of ageing and conduct geolocation to study additional environmental exposures. Stored biological specimens are available for analysis of new biomarkers. The Hortega Study will, thus, enable the identification of novel factors based on time to event data, potentially contributing to the prevention and control of chronic diseases in ageing populations.

scholarly journals Syncope in a Working-Age Population: Recurrence Risk and Related Risk Factors

2019 ◽  
Vol 8 (2) ◽  
pp. 150 ◽  
Author(s):  
Franca Barbic ◽  
Franca Dipaola ◽  
Giovanni Casazza ◽  
Marta Borella ◽  
Maura Minonzio ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Recurrence Risk ◽  
Multivariable Logistic Regression Analysis ◽  
Related Risk ◽  
Working Age ◽  
Working Age Population ◽  
The Individual ◽  
Syncope Episode

Syncope in a worker undertaking risky tasks may result in fatalities for the individual or for third parties. We aimed at assessing the rate of syncope recurrence and the risk factors underlying the likelihood of syncope relapse in a working-age population. A prospective cohort of all patients aged 18–65 years consecutively admitted to the Emergency Department for syncope was enrolled. Risk of syncope relapse was assessed at a six-month, 1-year, and 5-year follow-up. Predictors of syncope recurrence have been evaluated at six months and 1 year from the syncope index by a multivariable logistic regression analysis. 348 patients were enrolled. Risk of syncope relapse was 9.2% at 6 months, 11.8% at 1 year, and 23.4% at 5 years. At 6-month follow-up, predictor of syncope recurrence was ≥3 prior lifetime syncope episodes. At 1-year, ≥3 prior lifetime syncope episodes, diabetes mellitus, and anaemia were risk factors for syncope relapse. There was an exceeding risk of recurrence in the first 6 months and a reduced risk of 3.5% per year after the first year. Anaemia, diabetes mellitus, and prior lifetime syncope burden are of importance when giving advice about the resumption of “high risk” jobs following a syncope episode.

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