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Stratification epidemiology

Rossella Letizia Mancusi, Massimo Andreoni, Daniela d'Angela, Cesare Sarrecchia, Federico Spandonaro
Between western European countries, the hepatitis C virus (HCV) endemic is highest in Italy. The main objective of this paper is to estimate the endemic diffusion of hepatitis C at the national level and by geographical area, with an extrapolation at the regional level and by uniform cohorts of subjects (by sex and year of birth). The secondary objective is a stratification by gravity of the estimated statistical figures to provide an overview of possible targets of the new anti-HCV treatments.PubMed and the Cochrane Library were searched for relevant Italian populations studies regarding HCV prevalence...
October 2016: Medicine (Baltimore)
Julie C Fitzgerald, Scott L Weiss, Niranjan Kissoon
OBJECTIVE: To review important articles in the field of pediatric shock and pediatric septic shock published subsequent to the Fifth Edition of the Rogers' Textbook of Pediatric Intensive Care. DATA SOURCES: The U.S. National Library of Medicine PubMed ( was searched for combination of the term "pediatric" and the following terms: "sepsis, septic shock, shock, antibiotics, extracorporeal membrane oxygenation, and steroid." The abstract lists generated by these searches were screened for potential inclusion...
September 30, 2016: Pediatric Critical Care Medicine
Mauro Maniscalco, Debora Paris, Dominique J Melck, Maria D'Amato, Anna Zedda, Matteo Sofia, Cristiana Stellato, Andrea Motta
BACKGROUND: Epidemiological and clinical evidence supports the existence of an obesity-related asthma phenotype. No distinct pathophysiological elements or specific biomarkers have been identified so far but increased oxidative stress has been reported. OBJECTIVE: We aimed at verifying whether metabolomics of exhaled breath condensate (EBC) from obese asthmatic (OA), lean asthmatic (LA) and obese non-asthmatic (ONA) patients could recognize specific, statistically validated biomarkers for a separate "asthma-obesity" respiratory metabolic phenotype, here defined as "metabotype"...
October 13, 2016: Journal of Allergy and Clinical Immunology
Catherine M Phillips
In recent years, different subphenotypes of obesity have been described, including metabolically healthy obesity (MHO), in which a proportion of obese individuals, despite excess body fat, remain free of metabolic abnormalities and increased cardiometabolic risk. In the absence of a universally accepted set of criteria to classify MHO, the reported prevalence estimates vary widely. Our understanding of the determinants and stability of MHO over time and the associated cardiometabolic and mortality risks is improving, but many questions remain...
October 10, 2016: Annals of the New York Academy of Sciences
Anne Tournadre, Sylvain Mathieu, Martin Soubrier
Patients with inflammatory arthritis, such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis, have higher rates of cardiovascular mortality. While the increased cardiovascular risk is only explained to some extent, a lot of research is currently conducted to improve our understanding of its pathogenesis, risk stratification, and optimal cardiovascular risk management. This review sought to report epidemiological data pertaining to the cardiovascular disease burden in patients with inflammatory arthritis, underlying mechanisms accounting for excessive cardiovascular risk, along with recommendations regarding risk assessment and management in this patient population...
October 2016: Therapeutic Advances in Musculoskeletal Disease
Rui Zhou, Jingwen Zhang, Huiying Sun, Yulin Liao, Wangjun Liao
BACKGROUND: The optimal lymph node (LN) classification system for prognostic assessment in distant metastatic gastric cancer (DMGC) patients who undergo LN dissection remains unclear. Therefore, we compared the prognostic performance of positive LN (PLN), LN ratio (LNR), and log odds of positive LNs (LODDS) in DMGC patients. METHODS: A total of 1999 DMGC patients who underwent lymphadenectomy recorded in the Surveillance Epidemiology and End Results database from 2004 to 2012 were reviewed...
October 3, 2016: International Journal of Surgery
Federico Guerra, Lorena Scappini, Alessandro Maolo, Gianluca Campo, Rita Pavasini, Matilda Shkoza, Alessandro Capucci
BACKGROUND: Stroke is a rare but serious complication of acute coronary syndrome. At present, no specific score exists to identify patients at higher risk. The aim of the present study is to test whether each clinical variable included in the CHA2DS2-VASc score retains its predictive value in patients with recent acute coronary syndrome, irrespective of atrial fibrillation. METHODS: The meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines...
October 5, 2016: European Heart Journal. Acute Cardiovascular Care
Ioannis Vogiatzis, Irena Dapcevic, Antonis Datsios, Kostas Koutsambasopoulos, Argirios Gontopoulos, Savas Grigoriadis
INTRODUCTION: The propeptide of brain natriuretic peptide (ProBNP) is used for the diagnosis of left ventricle dysfunction and heart failure. In patients with an Acute Coronary Syndrome (ACS) it can contribute to both short and long term prognosis of cardiovascular events that could be very important for management and therapy of these patients. AIM: The aim of this study was to evaluate the prognostic value of ProBNP for the clinical course after an acute coronary syndrome, compared with that of cardiac troponine T (cTnT) and the risk stratification of patients with acute coronary syndrome, both during hospitalization and six months later...
July 27, 2016: Medical Archives
Robert Wieder, Basit Shafiq, Nabil Adam
BACKGROUND: African American race negatively impacts survival from localized breast cancer but co-variable factors confound the impact. METHODS: Data sets were analyzed from the Surveillance, Epidemiology and End Results (SEER) directories from 1973 to 2011 consisting of patients with designated diagnosis of breast adenocarcinoma, race as White or Caucasian, Black or African American, Asian, American Indian or Alaskan Native, Native Hawaiian or Pacific Islander, age, stage I, II or III, grade 1, 2 or 3, estrogen receptor or progesterone receptor positive or negative, marital status as single, married, separated, divorced or widowed and laterality as right or left...
2016: Journal of Cancer
María-Victoria Mateos, Ola Landgren
Monoclonal gammopathy of undetermined significance (MHUS) is characterized by the presence of a serum M-protein less than 3 g/dL, less than 10 % clonal plasma cells in the bone marrow, and the absence of myeloma-defining event. Smoldering multiple myeloma (SMM) is an asymptomatic disorder characterized by the presence of ≥3 g/dL serum M-protein and/or 10-60 % bone marrow plasma cell infiltration with no myeloma-defining event. The risk of progression to multiple myeloma (MM) requiring therapy varies greatly for individual patients, but it is uniform and 1 % per year for MGUS, while higher (10 % per year) and not uniform for SMM patients...
2016: Cancer Treatment and Research
Jung-Woo Son, Joong Kyung Sung, Jun-Won Lee, Young Jin Youn, Min-Soo Ahn, Sung Gyun Ahn, Byung-Su Yoo, Seung-Hwan Lee, Junghan Yoon, Sang Baek Koh, Jang-Young Kim
Although central obesity is a more powerful predictor of cardiovascular disease (CVD) than general obesity, there is limited information on structural and functional changes of the heart in central obesity. Therefore, we evaluated the association between abdominal obesity and geometric and functional changes of the heart in healthy males. A total of 1460 healthy males aged 40 to 70 years without known CVD from the Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population were included...
September 2016: Medicine (Baltimore)
I Tinhofer, A Stenzinger, T Eder, R Konschak, F Niehr, V Endris, L Distel, M G Hautmann, R Mandic, C Stromberger, W Weichert, V Budach
BACKGROUND: Based on epidemiological (HPV status, smoking habits) and clinical risk factors (T/N stage), three subgroups of patients suffering from locally advanced oropharyngeal carcinoma with significantly different outcome after concurrent chemoradiation (cCRTX) can be distinguished. Mutational profiling by targeted next-generation sequencing (NGS) might further improve risk stratification. PATIENTS AND METHODS: Patients with stage IV squamous cell carcinoma of the oropharynx and hypopharynx who had been enrolled in a randomized phase III trial (ARO-0401) comparing two regimens of cCRTX and from whom archival tumor specimens were available were included...
September 28, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Srijita Sen-Chowdhry, Daniel Jacoby, James C Moon, William J McKenna
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disorder, affecting 1 in 500 individuals worldwide. Existing epidemiological studies might have underestimated the prevalence of HCM, however, owing to limited inclusion of individuals with early, incomplete phenotypic expression. Clinical manifestations of HCM include diastolic dysfunction, left ventricular outflow tract obstruction, ischaemia, atrial fibrillation, abnormal vascular responses and, in 5% of patients, progression to a 'burnt-out' phase characterized by systolic impairment...
November 2016: Nature Reviews. Cardiology
Rita Nguyen, Kirsten M Fiest, Jane McChesney, Churl-Su Kwon, Nathalie Jette, Alexandra D Frolkis, Callie Atta, Sarah Mah, Harinder Dhaliwal, Aylin Reid, Tamara Pringsheim, Jonathan Dykeman, Clare Gallagher
BACKGROUND: Understanding the epidemiology of traumatic brain injury (TBI) is essential to shape public health policy, implement prevention strategies, and justify allocation of resources toward research, education, and rehabilitation in TBI. There is not, to our knowledge, a systematic review of population-based studies addressing the epidemiology of TBI that includes all subtypes. We performed a comprehensive systematic review and meta-analysis of the worldwide incidence of TBI. METHODS: A search was conducted on May 23, 2014, in Medline and EMBASE according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
September 27, 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
K Berger, D Schopohl, G Lowe, P A Holme, R C Tait, C Combescure, S Rauchensteiner, R Klamroth
INTRODUCTION: Studies on the prevalence of cardiovascular disease (CVD) and risk factors in patients with haemophilia (PWH) in comparison to the general population have generated inconsistent results. The ADVANCE Working Group collected data on CV comorbidities in PWH aged ≥40 years (H(3) Study). AIM: Identification of German epidemiological data on CVD for the general population, evaluation for appropriateness, and execution of comparisons with PWH. METHODS: Identification of data sources by structured literature (EMBASE, MEDLINE) searches...
September 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
Peter J Kelly, Eoin Kavanagh, Sean Murphy
Significant advances have been made in recent years in primary stroke prevention, improved stroke outcomes in high-income populations, emergency stroke therapy, and stroke prevention. In this article, we review recent trends in stroke epidemiology, improvements in delivery of intravenous thrombolysis (via stroke system-wide approaches, application of 'Lean Principles' to improve workflow processes, and re-evaluation of exclusion criteria), recent stroke thrombectomy trials, and new developments in stroke prevention, with emphasis on risk prediction in transient ischemic attack, choice and timing of anticoagulation therapy for secondary stroke prevention, and emerging concepts in risk stratification for management of symptomatic carotid stenosis...
August 2016: Seminars in Neurology
Kazuaki Shimamoto
There are some discrepancies among several international guidelines. I summarise the discrepancies among these guidelines for patients with diabetes, CKD and old age, and describe how-to reconcile.A very controversial topic involves controlling the blood pressure target for hypertension with diabetes. In the treatment for the hypertension with diabetes, until 2012, it was almost universally accepted that the blood pressure control target should be below 130/80 mmHg. However, recent guidelines have increased the target blood pressure to 140 mmHg in systolic blood pressure...
September 2016: Journal of Hypertension
Xiong Xiao, Albert Jan van Hoek, Michael G Kenward, Alessia Melegaro, Mark Jit
OBJECTIVE: Infectious disease spread depends on contact rates between infectious and susceptible individuals. Transmission models are commonly informed using empirically collected contact data, but the relevance of different contact types to transmission is still not well understood. Some studies select contacts based on a single characteristic such as proximity (physical/non-physical), location, duration or frequency. This study aimed to explore whether clusters of contacts similar to each other across multiple characteristics could better explain disease transmission...
August 26, 2016: Epidemics
Víctor Gil, Òscar Miró, Michael J Schull, Pere Llorens, Pablo Herrero, Javier Jacob, José Ríos, Douglas S Lee, Francisco J Martín-Sánchez
OBJECTIVE: The Emergency Heart Failure Mortality Risk Grade (EHMRG) scale, derived in 86 Canadian emergency departments (EDs), stratifies patients with acute-decompensated heart failure (ADHF) according to their 7-day mortality risk. We evaluated its external validity in a Spanish cohort. PATIENTS AND METHODS: We applied the EHMRG scale to ADHF patients consecutively included in the Epidemiology of Acute Heart Failure in Emergency departments (EAHFE) registry (29 Spanish EDs) and measured its performance...
September 10, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
S Avinash, V P Singh, A K Agarwal, S Chatterjee, V Arya
BACKGROUND: Cystatin C is a low molecular weight protein produced by all nucleated human cells, with a stable production rate. Its levels are not influenced by inflammation, infections, hepatic or renal diseases, or by dietary or constitutional factors. We compared serum cystatin C and serum creatinine based predicting equations to estimate glomerular filteration rate (GFR) in type 2 diabetes mellitus, using the staging of chronic kidney disease (CKD) defined by the National Kidney Foundation...
November 2015: Journal of the Association of Physicians of India
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