Bladder dysfunction in human T cell lymphotropic virus infection: A prospective cohort study

Background While bladder dysfunction is observed in the majority of patients with human T cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy (HAM), it is also observed in patients who do not fulfill all diagnostic criteria for HAM. These patients are classified as having possible or probable HAM/TSP. However, it remains unclear whether the severity and progression of bladder dysfunction occurs similarly between these two groups. Objective Compare the severity and evolution of bladder dysfunction in HTLV-1-infected patients with possible and definite HAM/TSP. Methods The present prospective cohort study followed 90 HTLV-1 patients with possible HAM/TSP and 84 with definite HAM/TSP between April 2011 and February 2019. Bladder dysfunction was evaluated by bladder diary, overactive bladder symptoms scores (OABSS) and urodynamic studies. Bladder dysfunction progression was defined as the need for clean self-intermittent catheterization (CIC). Results At baseline, nocturia, urgency and OABSS scores were worse in definite compared to possible HAM/TSP patients. The main urodynamic finding was detrusor overactivity, present in 77.8% of the patients with definite HAM/TSP versus 58.7% of those with possible HAM/TSP (P = 0.05). Upon study conclusion, the cumulative frequency of patients requiring CIC increased in both groups, from 2 to 6 in possible HAM/TSP and from 28 to 44 in definite HAM/TSP patients. The estimated time to need for CIC was 6.7 years (95%CI 6.5–7.0) in the possible HAM/TSP group compared to 5.5 years (95%CI 4.8–6.1) in the definite HAM/TSP group. Conclusions Although both groups showed similarities in bladder dysfunction and tended to progress to requiring CIC over time, patients with possible HAM/TSP presented less severe manifestations at baseline and progressed more slowly than those with definite HAM/TSP.

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Incidence of Human T Cell Lymphotropic Virus Type 1-Associated Myelopathy/Tropical Spastic Paraparesis in a Long-Term Prospective Cohort Study of Initially Asymptomatic Individuals in Brazil

AIDS Research and Human Retroviruses ◽

10.1089/aid.2013.0086 ◽

2013 ◽

Vol 29 (9) ◽

pp. 1199-1202 ◽

Cited By ~ 18

Author(s):

Luiz Cláudio Ferreira Romanelli ◽

Paulo Caramelli ◽

Marina Lobato Martins ◽

Denise Utsch Gonçalves ◽

Fernando Augusto Proietti ◽

...

Keyword(s):

Cohort Study ◽

T Cell ◽

Virus Type ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Spastic Paraparesis ◽

Human T Cell ◽

Asymptomatic Individuals

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Rapid Weight Change Over Time Is a Risk Factor for Adverse Outcomes in Patients With Predialysis Chronic Kidney Disease: A Prospective Cohort Study

Journal of Renal Nutrition ◽

10.1053/j.jrn.2021.01.026 ◽

2021 ◽

Author(s):

Hyunjin Ryu ◽

Yeji Hong ◽

Eunjeong Kang ◽

Minjung Kang ◽

Jayoun Kim ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Risk Factor ◽

Cohort Study ◽

Kidney Disease ◽

Prospective Cohort Study ◽

Weight Change ◽

Prospective Cohort ◽

Adverse Outcomes ◽

Change Over Time ◽

Over Time

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Association between maternal gluten intake and type 1 diabetes in offspring: national prospective cohort study in Denmark

BMJ ◽

10.1136/bmj.k3547 ◽

2018 ◽

pp. k3547 ◽

Cited By ~ 14

Author(s):

Julie C Antvorskov ◽

Thorhallur I Halldorsson ◽

Knud Josefsen ◽

Jannet Svensson ◽

Charlotta Granström ◽

...

Keyword(s):

Type 1 Diabetes ◽

Cohort Study ◽

Confidence Interval ◽

Prospective Cohort Study ◽

Food Frequency Questionnaire ◽

Prospective Cohort ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Food Frequency

Abstract Objective To examine the association between prenatal gluten exposure and offspring risk of type 1 diabetes in humans. Design National prospective cohort study. Setting National health information registries in Denmark. Participants Pregnant Danish women enrolled into the Danish National Birth Cohort, between January 1996 and October 2002, Main outcome measures Maternal gluten intake, based on maternal consumption of gluten containing foods, was reported in a 360 item food frequency questionnaire at week 25 of pregnancy. Information on type 1 diabetes occurrence in the participants’ children, from 1 January 1996 to 31 May 2016, were obtained through registry linkage to the Danish Registry of Childhood and Adolescent Diabetes. Results The study comprised 101 042 pregnancies in 91 745 women, of whom 70 188 filled out the food frequency questionnaire. After correcting for multiple pregnancies, pregnancies ending in abortions, stillbirths, lack of information regarding the pregnancy, and pregnancies with implausibly high or low energy intake, 67 565 pregnancies (63 529 women) were included. The average gluten intake was 13.0 g/day, ranging from less than 7 g/day to more than 20 g/day. The incidence of type 1 diabetes among children in the cohort was 0.37% (n=247) with a mean follow-up period of 15.6 years (standard deviation 1.4). Risk of type 1 diabetes in offspring increased proportionally with maternal gluten intake during pregnancy (adjusted hazard ratio 1.31 (95% confidence interval 1.001 to 1.72) per 10 g/day increase of gluten). Women with the highest gluten intake versus those with the lowest gluten intake (≥20 v <7 g/day) had double the risk of type 1 diabetes development in their offspring (adjusted hazard ratio 2.00 (95% confidence interval 1.02 to 4.00)). Conclusions High gluten intake by mothers during pregnancy could increase the risk of their children developing type 1 diabetes. However, confirmation of these findings are warranted, preferably in an intervention setting.

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Serum Uric Acid Levels and Their Changes and Risk of Stroke: A 7-Year Prospective Cohort Study in Northwest China

Cerebrovascular Diseases ◽

10.1159/000519142 ◽

2021 ◽

pp. 1-10

Author(s):

Shan Zheng ◽

Yan Luo ◽

Qian Miao ◽

Zhiyuan Cheng ◽

Yanli Liu ◽

...

Keyword(s):

Uric Acid ◽

Cohort Study ◽

Serum Uric Acid ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Reference Group ◽

Northwest China ◽

Stroke Incidence ◽

Increased Risk ◽

Over Time

Introduction: It is not clear whether serum uric acid (SUA) levels and their changes over time are associated with the risk of stroke. A 7-year prospective cohort study in northwest China was conducted to analyze effects of SUA and their changes on the risk of stroke. Methods: A total of 23,262 individuals without cardiovascular disease in the Jinchang cohort were followed up for an average of 5.26 years. The Cox proportional hazard model was used to estimate the hazard ratios (HRs) and 95% confidence interval (95% CI) of stroke incidence to SUA and relative changes in SUA. Sensitivity analysis was performed after controlling the effect of renal insufficiency. Results: Baseline SUA and relative changes in SUA were positively correlated with the incidence of stroke in both males and females (p for overall association <0.0001). Stroke risk increased by 4.6% per 10% increase in the relative change of SUA (HR = 1.046, 95% CI, 1.007–1.086). The fully adjusted regression analysis demonstrated that only the large gain (>30%) in SUA was associated with an increased risk of stroke by 36.5% (95% CI, 1.8–83.0%), compared with the reference group (participants within ±10% changes in SUA). The same trend was observed in people with normal baseline SUA. In the unadjusted model, the risk of stroke associated with elevated SUA was significantly higher in the hyperuricemia group than in the normal SUA group. Conclusion: High initial SUA concentration and an increase in SUA concentration over time would increase the risk of stroke, and this means that there is no safe increase in SUA.

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