Cardiovascular risk factors, living and ageing in Halle: the CARLA study

The CARLA study (Cardiovascular Disease, Living and Ageing in Halle) is a longitudinal population-based cohort study of the general population of the city of Halle (Saale), Germany. The primary aim of the cohort was to investigate risk factors for cardiovascular diseases based on comprehensive cardiological phenotyping of study participants and was extended to study factors associated with healthy ageing. In total, 1779 probands (812 women and 967 men, aged 45–83 years) were examined at baseline (2002–2005), with a first and second follow-up performed 4 and 8 years later. The response proportion at baseline was 64.1% and the reparticipation proportion for the first and second follow-up was 86% and 77% respectively. Sixty-four percent of the study participants were in retirement while 25% were full- or partially-employed and 11% were unemployed at the time of the baseline examination. The currently running third follow-up focuses on the assessment of physical and mental health, with an intensive 4 h examination program, including measurement of cardiovascular, neurocognitive, balance and gait parameters. The data collected in the CARLA Study resulted in answering various research questions in over 80 publications, of which two thirds were pooled analyses with other similar population-based studies. Due to the extensiveness of information on risk factors, subclinical conditions and evident diseases, the biobanking concept for the biosamples, the cohort representativeness of an elderly population, and the high level of quality assurance, the CARLA cohort offers a unique platform for further research on important indicators for healthy ageing.

Efeito de um programa de higiene oral sobre gengivite em escolares

An attempt was made to assess the effect of a prophylaxís programme on gingivitis in schoolchildren. A total oÍ 182 children, aged 8 - l0 years and attending an elementary school in Porto Alegre, participated. Ninetyone of the 182 children were used as an experimental group; the remaining 91, as a control Soup. The state of the gingiva were determined in a baseline examination. The prophylaxis programme was given to the experimental group and consisted of the following measures: supervised brushing of the teeth (with the help of disclosing solution) and dental flossing once a week at school; supply of toothbrushes and dental floss for daily use at home; and instruction in oral hygiene and diet. The results after nine months of treatment showed that the test group had low lG (molars and proximal surfaces).

Dermatomal Somatosensory Evoked Potentials And Cortical Somatosensory Evoked Potentials Assessment In Congenital Scoliosis

Background: The aim of this study was to assess the value of dermatomal somatosensory evoked potentials (DSEPs) and cortical somatosensory evoked potentials (SSEPs) in monitoring spinal cord function for patients with congenital scoliosis (CS). Methods: This study retrospectively analyzed the neurophysiological signals recorded in 62 patients from our orthopedic department who underwent MRI, CT and a specialist physical examination by a surgeon to confirm the diagnosis of CS. To observe the incidence of abnormal DSEPs and SSEPs in CS patients and to analyze the difference in sensitivity and reliability between the two in the examination of scoliosis patients. Results: All patients were evaluated with total spine magnetic resonance imaging (MRI). Only 23 patients (37.09%) showed intradural lesions in the MRI findings. Abnormal waveforms were observed in the DSEPs of 60 patients (96.8%) , 25 of which (40.3%) had abnormal waveforms in the tibial SSEPs, and the difference was statistically significant (P＜0.05). Of the 10 patients with clinical symptoms, 2 (20%) had abnormal tibial SSEPs waveforms , and 23 (44.2%) of 52 patients without clinical symptoms had abnormal tibial SSEPs waveforms. DSEPs are more sensitive to microscopic posterior column dysfunction in patients with CS that cannot be detected by either imaging or routine clinical examination. Conclusion: DSEPs provide evidence for the type of neurophysiological dysfunction in patients with congenital scoliosis. Preoperative DSEPs assessment is recommended as a baseline examination for intraoperative monitoring and comparison with the postoperative situation. DSEPs recording complements the information obtained from routine clinical and radiological evaluation.

AB0210 COMPARISON OF EFFICACY AND SAFETY OF BIOSIMILAR RITUXIMAB AND ORIGINATOR RITUXIMAB IN REAL CLINICAL PRACTICE

Background:Due to the expiration of many originator biologics patents, their biosimilars (BS) have appeared and were put into clinical practice. The introduction of such drugs reduces the cost of treatment and thereby increases its availability. BS rituximab (RTX) Acellbia was developed by the Russian company “BIOCAD”. Its effectiveness and safety have been proven in two clinical trials. It was licensed in Russia for the treatment of rheumatoid arthritis (RA) in 2017.Objectives:To compare efficacy and safety of BSRTX and originator RTX (ORTX) in real clinical practice.Methods:RA patients fulfilling the EULAR/ACR 2010 criteria and followed-up at the V. A. Nasonova Research Institute of Rheumatology were included. All of them had previously received methotrexate without effect. They were divided into 4 groups. The first and second groups included patients who had not previously received biologics. Treatment with BSRTX was started in the first group, ORTX was administered in the second group. The third and fourth groups included patients who received ORTX with significant improvement. Patients of the third group were switched to BSRTX, in the fourth group treatment with ORTX was continued. ORTX and BSRTX were administered twice 500 mg over 2 weeks. The indication for repeated administration of ORTX and BSRTX was an exacerbation of RA. Patients were examined before the first or regular administration of ORTX or BSRTX and before the planned repeat course of treatment with these drugs. RA activity was evaluated with the DAS28. Adverse events (AE) were recorded. Data were tested for normality using the Kolmogorov-Smirnov test. Continuous variables are presented as mean ±SD if they obey normal distribution, and as median [quartile interval] if they were not consistent with normal distribution. Mann–Whitney U test was used for comparison between groups.Results:127 patients with RA were included. 66 patients had not previously received biologics. BSRTX was started in 35 of them and ORTX – in 31. 61 patients already received ORTHX with clinical improvement. 31 of them were switched to BSRTX, and 30 continued therapy with ORTX. The median interval between the baseline examination and the assessment before the second treatment course in the BSRTX group was 6 [5; 13] months, in the ORTX group – 7 [7; 11] months. In group 1 median DAS28 during follow-up decreased from 5,8 [5,2; 6,9] to 3,9 [3,1; 4,5], in group 2 – from 5,7 [5,2; 6,0] to 4,1 [3,8; 4,6], respectively. These changes were comparable in both groups. The mean duration of the interval between infusion of BSRTX or ORTX and repeated examination – 11,3±8,2 and 10,1±4,8 months, respectively. These differences are not significant. In group 3 median DAS28 at the baseline examination was 5,1 [3,9; 5,9], at the second one – 4,3 [3,8; 5,3], in group 4 – 4,6 [3,7; 5,4] and 4,2 [3,5; 5,2] respectively. These values did not differ significantly. The frequency and nature of adverse events during treatment with ORTX and BSRTX did not significantly differ. We did not observe serious AE and unexpected AE.Conclusion:The results of the present study show that efficacy and safety of BSRTX and ORTX were comparable when they were used as the first biologics and when switching from ORTX to BSRTX. BSRTX can be used in routine clinical practice for the treatment of RA.Disclosure of Interests:None declared

Chronic Kidney Disease Risk of Isolated Systolic or Diastolic Hypertension in Young Adults: A Nationwide Sample Based‐Cohort Study

Background Hypertension among young adults is common. However, the effect of isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), or systolic and diastolic hypertension (SDH) among young adults on chronic kidney disease (CKD) development is unknown. Methods and Results From a nationwide health screening database, we included 3 030 884 participants aged 20 to 39 years who were not taking antihypertensives at baseline examination in 2009 to 2010. Participants were categorized as having normal blood pressure (BP), elevated BP, stage 1 IDH, stage 1 ISH, stage 1 SDH, stage 2 IDH, stage 2 ISH, and stage 2 SDH. The primary outcome was incident CKD. A total of 5853 (0.19%) CKD events occurred. With normal BP as the reference, multivariable‐adjusted hazard ratios (HRs) (95% CIs) for CKD were 1.14 (95% CI, 1.04–1.26), elevated BP; 1.19 (95% CI, 1.10–1.28), stage 1 IDH; 1.24 (95% CI, 1.08–1.42), stage 1 ISH; 1.39 (95% CI, 1.28–1.51), stage 1 SDH; 1.88 (95% CI, 1.63–2.16), stage 2 IDH; 1.84 (95% CI, 1.54–2.19), stage 2 ISH; 2.70 (95% CI, 2.44–2.98), stage 2 SDH. The HRs for CKD were attenuated in the patients who were antihypertensive and began medication within 1 year of medical checkup than in those without antihypertensives. Conclusions Among Korean young adults, those with elevated BP, stage 1 IDH, stage 1 ISH, stage 1 SDH, stage 2 IDH, stage 2 ISH, and stage 2 SDH were associated with a higher CKD risk than those with normal BP. The CKD risk in ISH and IDH groups was similar but lower than that in the SDH group. Antihypertensives attenuated the risk of CKD in young adults with hypertension.

Obesity, Abdominal Obesity and Chronic Kidney Disease in Young Adults: A Nationwide Population-Based Cohort Study

Obesity has become a pandemic. It is one of the strongest risk-factors of new-onset chronic kidney disease (CKD). However, the effects of obesity and abdominal obesity on the risk of developing CKD in young adults has not been elucidated. From a nationwide health screening database, we included 3,030,884 young adults aged 20–39 years without CKD during a baseline examination in 2009–2010, who could follow up during 2013–2016. Patients were stratified into five levels based on their baseline body mass index (BMI) and six levels based on their waist circumference (WC; 5-cm increments). The primary outcome was the development of CKD. During the follow up, until 2016, 5853 (0.19%) participants developed CKD. Both BMI and WC showed a U-shaped relationship with CKD risk, identifying the cut-off values as a BMI of 21 and WC of 72 cm in young adults. The obesity group (odd ratio [OR] = 1.320, 95% confidence interval [CI]: 1.247–1.397) and abdominal obesity group (male WC ≥ 90, female WC ≥ 85) (OR = 1.208, 95%CI: 1.332–1.290) showed a higher CKD risk than the non-obesity or non-abdominal obesity groups after adjusting for covariates. In the CKD risk by obesity composite, the obesity displayed by the abdominal obesity group showed the highest CKD risk (OR = 1.502, 95%CI: 1.190–1.895), especially in those under 30 years old. During subgroup analysis, the diabetes mellitus (DM) group with obesity or abdominal obesity paradoxically showed a lower CKD risk compared with the non-obesity or non-abdominal obesity group. Obesity and abdominal obesity are associated with increased risk of developing CKD in young adults but a decreased risk in young adults with diabetes.

Kongcun Town Asymptomatic Intracranial Artery Stenosis study in Shandong, China: cohort profile

PurposeThe population-based Kongcun Town Asymptomatic Intracranial Artery Stenosis (KT-aICAS) study aims to investigate the prevalence of aICAS and major cardiovascular risk factors (CRFs) or biomarkers related to the development and prognosis of aICAS.ParticipantsThe KT-aICAS study included 2311 rural residents who were aged ≥40 years and living in Kongcun Town, Shandong Province, China. Baseline examination was conducted from October 2017 to October 2018, during which information on demographics, socioeconomics, personal and family medical history, and lifestyle factors was collected through face-to-face interviews, physical examination and blood tests. aICAS was initially screened using transcranial Doppler examination and then diagnosed using magnetic resonance angiography. Atherosclerosis in carotid arteries was diagnosed via carotid ultrasonography. High-resolution MRI was further used to evaluate the vessel wall of aICAS. Neuropsychological assessments were performed in the participants diagnosed with aICAS and the age-matched and sex-matched controls.Findings to dateOf the 2311 participants, 2027 (87.7%) completed the diagnostic procedure and aICAS was detected in 154 persons, resulting in an overall prevalence of 7.6%. The prevalence of aICAS increased with advancing age from 5.1% in participants aged 40–49 years to 12.7% in those aged ≥70 years (p<0.001). aICAS was detected in 305 intracranial arteries, including 221 (72.5%) in the anterior circulation and 84 (27.5%) in the posterior circulation (p<0.001). In addition, major CRFs were highly prevalent among middle-aged and elderly rural dwellers who were free of clinical stroke.Future plansFollow-up examinations will be performed every 3 years following the baseline examination. This study will increase our knowledge about the natural history of aICAS and facilitate studies of aICAS-associated disorders among rural-dwelling Chinese adults, such as ischaemic stroke and vascular cognitive impairment.Trial registration numberChiCTR1800017197.

Cardiovascular Risk of Isolated Systolic or Diastolic Hypertension in Young Adults

Background: Little is known regarding health outcomes associated with isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), or systolic and diastolic hypertension (SDH) among young adults with stage 1 hypertension, defined using the 2017 American College of Cardiology/American Heart Association blood pressure (BP) guideline. Methods: From a nationwide health screening database, we included 6 424 090 participants, aged 20 to 39 years, who were not taking antihypertensive medication at the baseline examination in 2003 to 2007. Participants were categorized as having normal BP (untreated systolic BP [SBP] <120/diastolic BP [DBP] <80 mm Hg; n=2 665 310); elevated BP (SBP 120–129/DBP <80 mm Hg; n=705 344); stage 1 IDH (SBP <130/DBP 80–89 mm Hg; n=1 271 505); stage 1 ISH (SBP 130–139/DBP <80 mm Hg; n=255 588); stage 1 SDH (SBP 130–139/DBP 80–89 mm Hg; n=711 503); and stage 2 hypertension (SBP ≥140, DBP ≥90 mm Hg; n=814 840). The primary outcome was composite cardiovascular disease (CVD) events, including myocardial infarction, stroke, heart failure, and CVD-related death. Results: The median age of the participants was 30 years and 60.9% were male. Over a median follow-up of 13.2 years, 44 070 new CVD events occurred. With normal BP as the reference, multivariable-adjusted hazard ratios (95% CIs) for CVD events were 1.14 (1.09–1.18) for elevated BP, 1.32 (1.28–1.36) for stage 1 IDH, 1.36 (1.29–1.43) for stage 1 ISH, 1.67 (1.61–1.72) for stage 1 SDH, and 2.40 (2.33–2.47) for stage 2 hypertension. Conclusions: Among young adults, stage 1 ISH, IDH, and SDH were all associated with higher CVD risks than normal BP. The CVD risks of stage 1 ISH and IDH were similar to each other but lower than the risk of stage 1 SDH. Categorizing young adults with stage 1 hypertension further into stage 1 ISH, IDH, and SDH may improve risk stratification for identifying high-risk individuals.

Baseline growth of the Trinidad freshwater crab Poppiana dentata () under laboratory conditions

Poppiana dentata (Randall, 1840) is widely distributed throughout riverine habitats in Trinidad. However, there is a scarcity of information on the biology of this species. This study provides the first baseline examination that describes growth aspects for P. dentata. Juvenile crabs were obtained from berried females collected in northwest Trinidad. Carapace width (CW), length (CL), moult incident, intermoult period and qualitative aspects were recorded for crabs (N = 23) over 9 months. CW, CL and intermoult period were used to derive percentage size increment, specific growth rate (SGR) and size at structural maturity for both sexes. Growth curves and logistic equations were also generated for each sex. Hatched crabs (< 5 mm CW) underwent rapid hardening after their first moult, indicating a fast turnover of moult cycles. SGR and CW percent increment were also the highest for this initial moult (P < 0.05). CW, CL, intermoult period, size increment and SGR did not differ between sexes (P > 0.05), with logistic equations expressed as CW = 32.81 (1+exp (1.481 ̵ 0.031t))-1 for males and CW = 34.07 (1+exp (1.516 ̵ 0.027t))-1 for females. Yet, breakpoint analyses indicated dissimilar sizes for structural maturity (male: 28.40 mm CW; female: 16.84 mm CW). These patterns reflect a shorter life span for this species in comparison to what has been reported for other trichodactylid relatives. This can have implications for P. dentata populations residing in anthropogenically disturbed habitats; thus, highlighting the need for conservation strategies to ensure preservation of native wild stock.

Correlation between Endobutton Position and Functional Outcome After ACL Reconstruction: Plain Xray Evaluation

The correct positioning of the femoral tunnel and endobutton position determine the success of ACL reconstruction (ACLR). Improper femoral tunnel placement most common errors in failed ACLR. However, plain post-operative imaging in the early state is not routinely performed. EndoButton position evaluation by XRay was made because this technique was cheap and reliable in Indonesia. There is no consensus on the ideal positioning of EndoButton in compare with functional outcome after ACLR. The study aimed to evaluate anatomic positions of tunnel and fixation devices, and also provide a baseline examination for future controls regarding tunnel placement and fixation devices, and also evaluation functional outcome after ACL procedure and also evaluation of functional outcome after ACLR with IKDC score. Between February 2019 to July 2019, 20 patients aged 17 to 59 years, with post ACL reconstruction were involved in this study. We are evaluating sex, age, affected the side of the knee, complication after an operation, related activity with injury, and evaluation postoperatively with femoral angle measurement Xray AP and lateral view. We also evaluated and correlate post ACRL and functional outcomes with the International Knee Documentation Committee (IKDC) score. The mean age of patients was 28,38 ± 9,3 years, (87,15% men and 12,5% women). There is no complication after the operation in all patients. Nine patients (56,3%) affected on the left side, and seven patients (43,8%) affected right-sided. All patients are performed single-bundle augmentation techniques for ACL reconstruction. Five (31,3%) patient has history fall and eleven (68,8%) patients caused by sports activity. All patient has Femoral angle measurement from knee AP view x-rays more than 17o, with minimum 39o and maximum 54o, with mean 46,63 ± 4,2. From lateral x rays, we interpreted nine patients (45%) interpreted as shallow and high, and 55% others interpreted as deep and low (optimal). The mean of IKDC score pre-op was 58,1±4,6 and means IKDC postoperatively 6 months was 84,68 ± 5,1. There was a significant difference in functional outcome between optimal endobutton and not optimal endobutton position group with p-value < 0,05. Early post-operative imaging (knee x-rays) provides useful information regarding tunnel placement and fixation devices. It also serves as a baseline examination for future reference. In this study, a single bundle ACL reconstruction shows a satisfying outcome. Keywords: Anterior cruciate ligament; knee; postoperative reconstruction; radiograph.