scholarly journals Predisposing factors of long-term responsiveness in a cardio-metabolic cohort: Tehran Lipid and Glucose Study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leila Cheraghi ◽  
Parisa Amiri ◽  
Golnaz Vahedi-Notash ◽  
Sara Jalali-Farahani ◽  
Davood Khalili ◽  
...  

Abstract Background Non-participation in cohort studies, if associated with both the exposure and occurrence of the event, can introduce bias in the estimates of interest. This study aims to identify factors associated with follow-up participation in Tehran Lipid and Glucose Study, a large-scale community-based prospective study in West Asia. Methods A sample of 10,368 adults from TLGS was included in the analysis. All analyses were split according to sex and age groups (20–39, 40–59, and 60 years). The associations between socio-demographic, health, and lifestyle factors with response rate were identified using the Generalized Estimating Equations model. Results Over the median of 15.7 years of follow up the response rate was 64.5%. The highest response rate was observed in those aged 40–59 years for both sexes. Current smokers had lower odds of response in both sexes for all age groups, ranging from 0.51 to 0.74, p < 0.01. In young adults, being single (OR = 0.79, OR = 0.57, p ≤ 0.01, respectively for men and women) and unemployed (OR = 0.73, OR = 0.76, p ≤ 0.01, respectively for men and women) in both sexes, high physical activity in men (OR = 0.77, p < 0.01), high education (OR = 0.75, p = 0.02) and obesity (OR = 0.85, p = 0.05) in women were associated with lower response rate. For the middle-aged group, diabetes in men (OR = 0.77, p = 0.05) and hypertension (OR = 0.84, p = 0.05), and having a history of cancer (OR = 0.43, p = 0.03) in women were factors associated with lower response rates. Finally, interventions for both sexes (OR = 0.75, OR = 0.77, p ≤ 0.05, respectively for men and women) and being divorced/widow in women (OR = 0.77, p = 0.05) were the factors associated with the lower response rate in the elderly. Conclusions Long-term participation was influenced by socio-demographic, health, and lifestyle factors in different sex- and age-specific patterns in TLGS. Recruitment strategies targeting these factors may improve participant follow-up in longitudinal studies.

2021 ◽  
pp. oemed-2020-107094
Author(s):  
Kathryn Badarin ◽  
Tomas Hemmingsson ◽  
Lena Hillert ◽  
Katarina Kjellberg

ObjectivesMusculoskeletal pain (MSP) is prevalent among the workforce. This study investigates the long-term association between physical workload (PWL) and increased frequency of MSP among male and female employees with pre-existing occasional MSP.MethodsThis study uses the Stockholm Public Health cohort survey data from the baseline 2006. The sample includes 5715 employees with baseline occasional MSP (no more than a few days per month). Eight PWL exposures and overall PWL were estimated using a job-exposure matrix (JEM). The JEM was assigned to occupational titles from a national register in 2006. Follow-up survey data on frequent MSP (a few or more times a week) were collected from 2010. Logistic regressions produced sex-specific ORs with 95% CIs and were adjusted for education, health conditions, psychological distress, smoking, BMI, leisure-time physical activity and decision authority.ResultsAssociations were observed between several aspects of heavy PWL and frequent MSP for men (eg, OR 1.57, 95% CI 1.13 to 2.20, among those in the highest exposure quartile compared with those in the lowest quartile for heavy lifting) and women (eg, OR 1.76, 95% CI 1.35 to 2.29, among those in the highest exposure quartile compared with those in the the lowest quartile for physically strenuous work). Small changes were observed in the OR after adjustment, but most of the ORs for PWL exposures among the men were no longer statistically significantly increased.ConclusionA high level of exposure to heavy PWL was associated with increased frequency of MSP 4 years later for men and women with baseline occasional pain.


2020 ◽  
Vol 7 (12) ◽  
Author(s):  
Hélène Chaussade ◽  
Camille Tumiotto ◽  
Fabien Le Marec ◽  
Olivier Leleux ◽  
Lucile Lefèvre ◽  
...  

Abstract Background Ritonavir-boosted darunavir (DRV/r) is a protease inhibitor (PI) indicated for the treatment of naïve and pretreated HIV-infected patients since 2007. Our study aims to describe DRV/r-treated patients experiencing virological failure (VF) documented with HIV resistance testing. Methods Data from patients belonging to the ANRS CO3 Aquitaine Cohort treated with a regimen including DRV/r between February 2007 and December 2015 were analyzed. Baseline characteristics of patients experiencing VF (defined by 2 consecutive plasma viral loads &gt;50 copies/mL) were compared with those without VF. We then described factors associated with VF as emergence of IAS DRV resistance–associated mutations (RAMs). Results Among the 1458 patients treated at least once with a DRV/r-based regimen, 270 (18.5%) patients experienced VF during follow-up, including 240 with at least 1 genotype resistance test (GRT). DRV RAMs were detected in 29 patients (12%). Among them, 25/29 patients had ≥2 DRV RAMs before DRV/r initiation, all of whom had experienced VF during previous PI treatments. For 18/29, DRV/r was maintained after VF, and controlled viremia was restored after modification of DRV-associated antiretroviral molecules or increased DRV dose. Finally, only 6/29 patients selected new DRV RAMs after DRV/r initiation. All of these experienced previous VFs while on other PIs. Conclusions These results highlight the efficacy and robustness of DRV/r, as the emergence of DRV RAMs appeared in &lt;0.4% of patients receiving a DRV/r-based regimen in our large cohort.


GastroHep ◽  
2021 ◽  
Vol 3 (2) ◽  
pp. 107-115
Author(s):  
Inka Koskinen ◽  
Kaisa Hervonen ◽  
Eero Pukkala ◽  
Timo Reunala ◽  
Katri Kaukinen ◽  
...  

Author(s):  
Dan-Yu Lin ◽  
Donglin Zeng ◽  
Peter B Gilbert

Abstract Large-scale deployment of safe and durably effective vaccines can curtail the COVID-19 pandemic.1−3 However, the high vaccine efficacy (VE) reported by ongoing phase 3 placebo-controlled clinical trials is based on a median follow-up time of only about two months4−5 and thus does not pertain to long-term efficacy. To evaluate the duration of pro- tection while allowing trial participants timely access to efficacious vaccine, investigators can sequentially cross participants over from the placebo arm to the vaccine arm according to priority groups. Here, we show how to estimate potentially time-varying placebo-controlled VE in this type of staggered vaccination of participants. In addition, we compare the per- formance of blinded and unblinded crossover designs in estimating long-term VE.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Janice E Williams ◽  
Sharon B Wyatt ◽  
Kathryn M Rose ◽  
David J Couper ◽  
Anna Kucharska-Newton

Though several large epidemiologic studies have demonstrated the positive association of anger with coronary heart disease (CHD) onset, a dearth of population-based evidence exists regarding the relationship of anger to the clinical course of CHD among people with established disease. Trait anger is conceptualized as a stable personality trait and defined as the tendency to experience frequent and intense anger. Therefore, it is plausible that the effects of trait anger on CHD are long standing. We assessed the hypothesis that trait anger predicts short-term and long-term risk for recurrent CHD among middle-aged men and women. Participants were 611 black or white men and women, ages 48 - 67, who had a history of CHD at the second clinical examination (1990-1992) of the Atherosclerosis Risk in Communities (ARIC) Study. They were followed for the recurrence of CHD (myocardial infarction or fatal CHD) from 1990 through three different time intervals: 1995, 2003, and 2009 (maximum follow-up = 19.0 years). Trait anger (measured at Visit 2) was assessed using the Spielberger Trait Anger Scale, with scores categorized as high, moderate, and low. Cox proportional hazards regression analyses were adjusted for age, sex, race-center, educational level, waist-to-hip ratio, plasma LDL-and HDL-cholesterol levels, hypertension, diabetes, cigarette smoking status, and pack-years of cigarette smoking. After 3 - 5 years of follow-up, the risk for recurrent CHD among participants with high trait anger was more than twice that of their counterparts with low trait anger (2.24 [95% C.I: 1.14 to 4.40]). After 11 - 13 years, the risk was 80% greater (1.80 [95% C.I: 1.17 to 2.78]) and after 17 - 19 years, it was 70% greater (1.70 [95% C.I: 1.15 to 2.52]). The risk for recurrent CHD was strongest in the first time interval but remained strong and statistically significant through 19 years of follow-up. In conclusion, the experience of frequent and intense anger increases short-term and long-term risk for recurrent CHD in middle-aged men and women.


Author(s):  
Xiaoyin Bai ◽  
Huimin Zhang ◽  
Gechong Ruan ◽  
Hong Lv ◽  
Yue Li ◽  
...  

Abstract Background There is lack of real-world data for disease behavior and surgery of Crohn’s disease (CD) from large-scale Chinese cohorts. Methods Hospitalized patients diagnosed with CD in our center were consecutively included from January 2000 to December 2018. Disease behavior progression was defined as the initial classification of B1 to the progression to B2 or B3. Clinical characteristics including demographics, disease classification and activity, medical therapy, development of cancers, and death were collected. Results Overall, 504 patients were included. Two hundred and thirty one (45.8%) patients were initially classified as B1; 30 (13.0%), 71 (30.7%), and 95 (41.1%) of them had disease progression at the 1-year follow-up, 5-year follow-up, and overall, respectively. Patients without location transition before behavior transition were less likely to experience behavior progression. However, patients without previous exposure to a corticosteroid, immunomodulator, or biological agent had a greater chance of experiencing behavior progression. When the long-term prognosis was evaluated, 211 (41.9%) patients underwent at least one CD-related surgery; 108 (21.4%) and 120 (23.8%) of these patients underwent surgery before and after their diagnosis, respectively. An initial classification as B1, no behavior transition, no surgery prior to diagnosis, and previous corticosteroid exposure during follow-up were associated with a lower risk of undergoing surgery. Conclusions This study depicts the clinical features and factors associated with behavior progression and surgery among hospitalized CD patients in a Chinese center. Behavior progression is associated with a higher probability of CD-related surgery, and strengthened therapies are necessary for them in the early phase.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S339-S340
Author(s):  
Kathleen R Sheridan ◽  
Joshua Wingfield ◽  
Lauren McKibben ◽  
Natalie Clouse

Abstract Background OPAT is a well-established model of care for the monitoring of patients requiring long-term IV antibiotics1. We have previously reported a reduction in the 30-day readmission rate to our facility for patients managed in our OPAT program. However, little has been published to date regarding outcomes in OPAT patients over 80 years of age 2–3. Our OPAT program was established in 2013. Patients can be discharged to a facility or home to complete their course of antibiotics. Methods We conducted a retrospective chart review of all OPAT patients discharged from our facility from 2015 to 2018. Patients were divided into two groups based on age, <80 (n = 4618) and >80 (n = 562). Results Patient demographics are listed in Table 1. The overall 30-day readmission rate for patients older than 80 was 27.8%. For patients over 80 that had a follow-up ID clinic appointment, the 30-day readmission rate decreased to 15.7%. For patients younger than 80, the 30-day readmission rate was 36.0% with a decrease to 16.2% if patients were evaluated in the outpatient clinic. Figure 1. Staphylococcus Aureus was the predominant organism in both age categories. Vancomycin was the most common antibiotic used in both age groups followed by β lactams. Conclusion In general, patients aged over 80 years were more likely to be discharged to a facility to complete their antibiotic course than younger patients. These patients also were more likely to have other comorbidities. The 30-day readmission rate in each age group was relatively similar. OPAT in patients over age 80 can have similar 30-day readmission rates as for patients less than 80 years of age Disclosures All authors: No reported disclosures.


2021 ◽  
Author(s):  
Feng Sha ◽  
Ziyi Zhao ◽  
Chang Wei ◽  
Zhirong Yang ◽  
Bingyu Li

Abstract Background Previous studies found that about 24% of the mild cognitive impairment (MCI) patients reverse to cognitively normal (CN) status. However, it is unclear which modifiable factors are associated with this reversion. Method We conducted a prospective community-based cohort study based on 2002-2018 Chinese Longitudinal Health Longevity Survey (CLHLS). Of 35,474 older adults from 22 provinces in China in the 5 waves of CLHLS, 7,422 eligible participants with MCI were included. Multivariable Cox regression with least absolute shrinkage and selection operator (LASSO) penalty for variable selection was adopted to investigate the associations between reversion to CN and potential modifiable dietary/lifestyle, cardiometabolic, and psychological factors. Results Our analysis included 7,422 MCI participants [average age: 90.0 (SD 9.5) years]. Among these participants, 1,604 (21.6%) reversed from MCI to CN with a mean (SD) follow-up of 2.9 (1.8) years. Several dietary/lifestyle factors, including daily consumption of fresh fruits (Hazard Ratio [HR]: 1.28, 95% CI: 1.15 to 1.42; P༜.001), engagement in reading (HR: 1.24, 95% CI: 1.00 to 1.54; P =.047), housework (HR: 1.21, 95% CI: 1.08 to 1.35; P =.001), and mah-jong or other card games (HR: 1.23, 95% CI: 1.08 to 1.39; P =.001), were positively associated with possibility of reversion. Cigarette smoking (HR: 0.92, 95% CI: 0.84 to 1.00; P= .041) and duration of alcohol drinking (HR: 0.97, 95% CI: 0.94 to 0.99; P = .012) were negatively associated with possibility of reversion. None of the modifiable cardiometabolic and psychological factors was found to be significantly associated with reversion to CN. Difference was identified among different age and gender group. Conclusion This study identified several dietary/lifestyle factors associated with MCI reversion that may transfer into large-scale dementia prevention practices.


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