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PubMed1988

Lung function, smoking and survival in severe alpha 1-antitrypsin deficiency, PiZZ.

Lung function, smoking, age and mortality data in 158 adult severe alpha 1-antitrypsin deficient, PiZZ individuals, followed from 1963 to 1982 were analyzed. Low initial FEV1 value was significantly associated with increased mortality (p less than 0.005). A 3 yr mortality rate of 40% was found in individuals whose initial FEV1 values were less than 30% of that predicted. In contrast, the corresponding 3-yr mortality among those whose initial FEV1 values were between 30 and 65% of that predicted was only 7%. Smokers were found to have significantly lower FEV1 levels (p = 0.008) and higher mortality (p less than 0.005) than non-smokers. The difference between current and ex-smokers in mortality and FEV1 level were not statistically significant (p = 0.9 and p greater than 0.25, respectively). Cross-sectional analysis of the initial FEV1 values indicated a significant decline (p less than 0.005) of FEV1 with increasing age. This decline was greater among smokers than non-smokers. Longitudinal analysis of FEV1 rates of decline in 80 cases with follow-up FEV1 measurements failed to detect any significant differences between smokers and non-smokers, but was performed late in the disease process. The application of these results to the planning of studies on replacement therapy, smoking intervention strategy and longitudinal follow-up is discussed.

Adolescent↗
PubMed1981

Clinical studies on multiple sclerosis. I. Presentation of an incidence material from Gothenburg.

Probable and possible MS cases with a debut during the years 1950-1964 within the city of Gothenburg were identified (312 cases). This corresponds to an incidence of 5.3 per 100,000. The material was stratified according to diagnostic probability into three categories. For the final analysis cases with the lowest diagnostic probability were omitted (about 9%). The follow-up was completed during 1977, i.e. 13-27 years from onset. A longitudinal analysis of each case was based upon a mixed prospective/retrospective study in which the authors personally examined the majority of the cases during most of the years. The female/male ratio was 1.5-1.6. The mortality rate was higher for males due in part to an earlier progressive development of multiple sclerosis and in part to a higher trend for acquisition of other mortal diseases. Bouts, as the first manifestation of the disease, were more frequent in young ages than in old, and more frequent among females than in males. The averages bout frequency decreased significantly with the duration of the disease as well as with the age of onset. The opposite trend was characteristic for development of a progressive course. Among symptoms at onset, those indicating lesions of long sensory and/or motor tracts (particularly the sensory) dominated. Such initial symptoms were seen in 30-40% of the younger patients and 70% of the older patients. The rest was divided between cases with optic nerve lesions (20-30% among younger, 12-15% among older patients) and brain stem lesions (approx. 25% among younger, 10-19% among older patients). The occurrence of various symptoms during the first two decades of the disease was also analyzed and the pattern of symptoms presented graphically. These results will be treated further in subsequent studies.

Adolescent↗
PubMed2000

Serum triglycerides, HIV infection, and highly active antiretroviral therapy, Aquitaine Cohort, France, 1996 to 1998. Groupe d'Epidémiologie Clinique du Sida en Aquitaine (GECSA).

The aim of this study was to identify factors associated with serum triglyceride (TG) evolution in HIV-1-infected patients when highly active antiretroviral treatment (HAART) with or without protease inhibitors (PI) was introduced. Among 3191 patients of the Aquitaine Cohort (multirisk, both genders, multiple treatment patterns) observed during 1996 through 1998, 1429 had at least two measurements of TG, viral load, and CD4 cell count. Median follow-up was 21 months (interquartile range [IQR], 11-26) and median number of TG measures was 6 (IQR, 3-10). Median TG at baseline was 1.32 mmol/L (IQR, 0.91-2.05) and increased significantly over time (+2.5% for 100 days; 95% confidence interval [CI], 1.9-3.1). Longitudinal analysis of variations of TG was performed using mixed models. In crude analysis, baseline TG was higher in men, in those aged over 36 years, and in homosexuals. The following time-dependent variables were associated with an increase of TG: body weight increasing to >65 kg, diagnosis of AIDS, CD4 cell count falling to <50 cells/mm3, viral load falling to <500 cp/ml, and introduction of nucleoside analogues and PIs. In multivariate analysis, age >36 years (change of +17% of the TG level; 95% CI, 11-24), homosexuals (+13%; 95% CI, 4-23), AIDS stage (+12%; 95% CI, 5-19), weight >65 kg (+7%; 95% CI, 2-12) and PI (+21%; 95% CI, 17-27) remained significant. Factors identified before the availability of PI remain important but HAART with PI is a new major contributing factor to increased TG levels.

Adult↗
PubMed2003

Objectively measured physical activity in a representative sample of 3- to 4-year-old children.

OBJECTIVE: This study aimed to describe levels of physical activity in a representative sample of preschool children and to quantify tracking of activity over 1 year. RESEARCH METHODS AND PROCEDURES: Physical activity (mean accelerometry counts/minute) was assessed over 3 days using the Computer Science and Applications accelerometer in 3- to 4-year-old children (n = 104; 52 boys; mean age, 3.7 +/- 0.4 years). In 60 children (30 boys), measurements were repeated 1 year later. RESULTS: Mean total activity at baseline was 777 +/- 207 counts/minute in boys and 657 +/- 172 counts/minute for girls; this gender difference was significant (p < 0.001). In the cross-sectional analysis, total activity was significantly positively related to age (r = 0.37, p = 0.007). In the sample followed up for 1 year, mean total activity was 849 +/- 252. The longitudinal analysis confirmed that total physical activity increased over the 1-year period (paired Student's t test, p < 0.001). The tracking rank order correlation coefficient of total activity count over 1 year was r = 0.40 (p < 0.001). DISCUSSION: This study suggests that total activity increases during the preschool period in Scottish children and that gender differences in total activity are present early in life. Tracking of total activity was only modest, but adequate assessment of tracking requires methodological research aimed at elucidating the biological meaning of accelerometer output.

Body Height↗
PubMedDate not supplied

Teenage childbearing and long-term socioeconomic consequences: a case study in Sweden.

CONTEXT: Whether long-term socioeconomic problems experienced by many teenage mothers are a reflection of preexisting disadvantage or are consequences of teenage motherhood per se remains unclear. METHODS: National data on all women born in Sweden from 1941 to 1970 who were younger than age 30 when they first gave birth (N=888,044) were analyzed. The outcome measures, assessed during adulthood, were employment status, socioeconomic status, educational attainment, single motherhood, family size, receipt of disability pension and dependence on welfare. Multiple logistic regression techniques were used to adjust for maternal birth cohort and for socioeconomic background of the woman's family. RESULTS: Compared with Swedish women who first gave birth at ages 20-24, those who were teenage mothers had significantly increased odds of each unfavorable socioeconomic outcome in later life, even after the data were adjusted for family socioeconomic situation and maternal birth cohort. For example, teenage motherhood was positively associated with low educational attainment (odds ratios of 1.7-1.9, depending on the specific age during adolescence when the woman gave birth), with single living arrangements (odds ratios, 1.5-2.3), with high parity (odds ratios, 2.6-6.0), with collecting a disability pension (odds ratios, 1.6-1.9) and with welfare dependency (odds ratios, 1.9-2.6). These trends were usually linear, with the highest odds ratios corresponding to women who had had their first child at the youngest ages. CONCLUSIONS: A longitudinal analysis of record-linkage data from Sweden supports the view that childbearing during adolescence poses a risk for socioeconomic disadvantage in later life--even for adolescents from relatively comfortable backgrounds and for those who studied beyond elementary school.

Adolescent↗
PubMed2006

Efficacy profile of bucillamine in rheumatoid arthritis patients in a large observational cohort study, IORRA.

Bucillamine (Buc) is a disease-modifying antirheumatic drug (DMARD) developed in Japan, which has been used as one of the first-line DMARDs for the treatment of rheumatoid arthritis (RA) in Japan. However, direct comparison of this drug with standard DMARDs including sulfasalazine (SASP) and methotrexate (MTX) has been scarcely reported. We therefore tried to evaluate the clinical efficacy of Buc by analyzing the database from the long-term observational cohort study IORRA (previously known as J-ARAMIS). The cross-sectional analysis revealed that responses to Buc treatment were better in males, patients with shorter duration of illness, and those who were rheumatoid factor-negative. In the longitudinal analysis, although there was no marked difference among the baseline variables of patients with Buc, SASP, and MTX, the percentage of patients exhibiting moderate or good response to treatment, as rated using the European League Against Rheumatism improvement criteria, was higher in the Buc group (41.0%) than in the MTX (32.6%) and SASP groups (25.6%). These data support Buc as a candidate for being a first-line drug for the treatment of patients with RA.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2024

Cardiovascular Risk Factors and Genetic Risk in Transthyretin V142I Carriers.

BACKGROUND: Nearly 3% to 4% of Black individuals in the United States carry the transthyretin V142I variant, which increases their risk of heart failure. However, the role of cardiovascular (CV) risk factors (RFs) in influencing the risk of clinical outcomes among V142I variant carriers is unknown. OBJECTIVES: This study aimed to assess the impact of CV RFs on the risk of heart failure in V142I carriers. METHODS: This study included self-identified Black individuals without prevalent heart failure from 6 TOPMed (Trans-Omics for Precision Medicine) cohorts, the REGARDS (Reasons for Geographic And Racial Differences in Stroke) study, and the All of Us Research Program. The cohort was stratified based on the V142I genotype and the number of CV RFs (hypertension, diabetes, obesity, and hypercholesterolemia). Adjusted Cox models were used to assess the association of heart failure with the V142I genotype and CV RF profile, taking noncarriers with a favorable CV RF profile as reference. RESULTS: The cross-sectional analysis, including 1,625 V142I carriers among 48,365 Black individuals, found that the prevalence of CV RFs did not vary by V142I carrier status. In the longitudinal analysis, there were 587 (3.2%) V142I carriers among 18,407 Black individuals (median age: 60 years [Q1-Q3: 52-68 years], 63.0% female). Among carriers, the heart failure risk was attenuated with a favorable (0 or 1 RF) CV RF profile (adjusted HR: 2.26; 95%&#xa0;CI: 1.58-3.23) compared with an unfavorable (3 or 4 RFs) CV RF profile (adjusted HR: 4.14; 95%&#xa0;CI: 2.79-6.14). CONCLUSIONS: A favorable CV RF profile lowers but does not abrogate V142I variant-associated heart failure risk. This study highlights the importance of having a favorable CV RF profile among V142I carriers for risk reduction of heart failure.

Aged↗
PubMed1992

An acute mercuric mercury poisoning: chemical speciation of hair mercury shows a peak of inorganic mercury value.

A woman ingested a dose of sublimate (approximately 0.9 g) in an attempted suicide. She survived and recovered in response to a combination of therapies including chelate (BAL) therapy, plasma exchange, haemodialysis and peritoneal dialysis. Serum inorganic mercury concentration, urinary inorganic mercury excretion and hair inorganic and organic mercury and selenium concentrations, along the length from the scalp to the distal part, were measured. Longitudinal analysis of hair, revealed a peak in inorganic mercury corresponding to the time of mercury ingestion. Organic mercury and selenium in the hair had different patterns of longitudinal variation from that of inorganic mercury. The biological half-life (23.5 d) of serum inorganic mercury levels was in good agreement with values previously reported in the literature.

Adult↗
PubMed1997

Peak expiratory flow from maximum expiratory flow volume curves in a community population: cross-sectional and longitudinal analyses.

The data from a longitudinal population study in Tucson, Arizona, were used to describe the development and decline with age of the peak expiratory flows (PEF) from maximum expiratory flow-volume (MEFV) curves derived using a computer-linked pneumotachometer. Subjects had performed at least one technically acceptable MEFV test in 9 of the first 11 surveys (1972-1989). There were 2,724 subjects with adequate MEFV curves, and thus PEF, in the first survey, but only 1315 in the 11th survey. The subjects were stratified based on responses to questionnaires into nonsmoking healthy subjects and others. The PEF were analysed cross-sectionally and longitudinally using data from the 6th-11th surveys (1979-1989). For longitudinal analysis, the reference population had 397 males with 1,153 observations, and 534 females with 1,700 observations. The resulting equations were compared, evaluating differences between the longitudinal and cross-sectional equations, and between reference and nonreference longitudinal populations. The results show that there were effort-dependent effects in absolute values of PEF, even after editing. Nevertheless, as with most MEFV measures in reference populations, PEF had an early increase in the rate of development, followed by a plateau phase, followed by a constant rate of decline. The ages at which changes in growth rates of PEF occurred differed by gender. The longitudinal data in adults showed a less steep decline with age compared to the cross-sectional data, as found previously for the other MEFV variables. Males in the nonreference group did not reach the same maximum level and had a steeper decline throughout adult life than did males in the reference group; females were similar. Asthmatics of both genders had slightly greater declines compared to the other nonreference subjects.

Adolescent↗
PubMed2001

N100 evoked potential latency variation and startle in schizophrenia.

The contribution of evoked potential (EP) latency jitter, a measure of CNS temporal variability, on startle and EP gating defects in schizophrenic subjects has not been characterized. The amplitude of the N100/P200 EP complex (peak to trough) derived using a time-locked averaging procedure, N100 EP latency jitter derived from single trial analysis, acoustic startle response and clinical symptoms were measured in 51 schizophrenic subjects. N100 latency jitter was inversely correlated with N100/P200 EP amplitude in both cross-sectional and longitudinal analysis. Subjects with elevated EP gating ratios (>0.5) had similar latency jitter values for initial (S1) and test (S2) stimuli, while subjects with a low gating ratio (0-0.5) had a lower level of S1 latency jitter. Temporal variability thus plays a significant and complex role in previously reported sensory gating deficits in schizophrenic subjects.

Cross-Sectional Studies↗
PubMed2006

Factors influencing the need for target vessel revascularization after renal artery stenting.

PURPOSE: To provide additional insight into factors that may be associated with the need for target vessel revascularization (TVR) following de novo renal artery stenting during long-term follow-up. METHODS: A retrospective chart and database review was conducted to analyze the progress of all patients with de novo symptomatic renal artery stenosis who underwent stent-supported angioplasty under the auspices of the Single Operator, Single Center, Renal Stent Retrospective Study (SOCRATES). The records review identified 782 patients who were enrolled in the study between 1993 and 2004; after excluding 34 (4.5%) patients (lost to follow-up or inadequate data), 748 consecutive patients (412 women; mean age 70.7+/-9.7 years, range 37-92) were suitable for longitudinal analysis. The need for TVR was based on strict clinical criteria (> or =20% rise in serum creatinine, worsening hypertension, and/or recurrent flash pulmonary edema), and all patients underwent multidisciplinary evaluation before stenting and during follow-up. RESULTS: Follow-up spanned a mean 45.8+/-26.5 months. TVR was needed in 88 (10.03%) of 877 arteries and was best predicted by patient age < or =67 years (OR 2.91, p=0.0001), stent diameter < or =5.0 mm (OR 2.31, p=0.001), solitary functioning kidney (OR 2.01, p=0.048), history of lower extremity peripheral artery disease (OR 1.87, p=0.008), and antecedent history of stroke (OR 1.73, p=0.026). CONCLUSION: Renal artery stenting appears to be durable, with only 10% of stented arteries requiring TVR during clinically-based long-term follow-up. Arteries with a final stent diameter < or =5.0 mm were more than twice as likely to need TVR, as were patients with a solitary kidney. The authors acknowledge that clinical recurrence is not a surrogate for ultrasound surveillance after renal artery stenting, so prospective controlled trials will be needed to determine risk factors for restenosis.

Adult↗
PubMed2006

Television exposure and overweight risk in preschoolers.

OBJECTIVE: To test the independent effect of television exposure in preschool-aged children on overweight risk. DESIGN: Cross-sectional and longitudinal analysis of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. SETTING: Ten US sites. PARTICIPANTS: One thousand sixteen children selected via conditional random sampling. MAIN EXPOSURE: Being awake in the room with the television on for 2 hours or more per day, by maternal report at age 36 months. MAIN OUTCOME MEASURES: Child overweight (body mass index [calculated as weight in kilograms divided by the square of height in meters] > or =95th percentile) calculated from measured anthropometrics at ages 36 and 54 months. Covariates tested included child sex and race; maternal marital status, education, age, and depressive symptoms; income-needs ratio, child behavior problems; Home Observation for Measurement of the Environment total score; hours per week in nonparental care; and proportion of television exposure that was educational. RESULTS: At age 36 months, 5.8% of children were overweight; at age 54 months, 10.0% were overweight. Exposure to 2 or more hours of television per day was associated with an increased risk of overweight at both age 36 months (odds ratio, 2.92; 95% confidence interval, 1.36-6.24) and age 54 months (odds ratio, 1.71; 95% confidence interval, 1.03-2.83) in unadjusted analyses. Only maternal age altered the concurrent relationship, and the effect of television remained significant (odds ratio, 2.61; 95% confidence interval, 1.21-5.62). Television exposure at age 36 months was no longer a significant predictor of overweight at age 54 months when controlling for covariates. CONCLUSION: Excessive television exposure is a risk factor for overweight in preschoolers independent of a number of potential confounders associated with the quality of the home environment.

Analysis of Variance↗
PubMed2002

Persistent HIV-1 infection of natural killer cells in patients receiving highly active antiretroviral therapy.

We have identified a subset of CD56(+)CD3(-) human natural killer (NK) cells that express CD4 and the HIV coreceptors CCR5 and CXCR4. These cells can be productively infected in vitro by both CCR5- and CXCR4-using molecular clones of HIV-1 in a CD4-dependent manner. Analysis of HIV-infected persons showed that viral DNA is present in purified NK cells, and virus could be rescued from these cells after in vitro cultivation. Longitudinal analysis of the HIV-1 DNA levels in NK cells from patients after 1-2 years of highly active antiretroviral therapy indicated that NK cells remain persistently infected and account for a substantial amount of the viral DNA in peripheral blood mononuclear cells. These results demonstrate that a subset of non-T cells with NK markers are persistently infected and suggest that HIV infection of NK cells is important for virus persistence. The properties of the virus reservoir in these cells should be considered in attempts to further optimize antiretroviral therapies.

Anti-HIV Agents↗
PubMed2006

Risk factors for HIV infection among men who have sex with men.

OBJECTIVES: Risk factors for HIV acquisition were examined in a recent cohort of men who have sex with men (MSM). DESIGN: A longitudinal analysis of 4295 HIV-negative MSM enrolled in a randomized behavioral intervention trial conducted in six US cities. METHODS: MSM were enrolled and assessed for HIV infection and risk behaviors semi-annually, up to 48 months. RESULTS: In multivariate analysis, men reporting four or more male sex partners, unprotected receptive anal intercourse with any HIV serostatus partners and unprotected insertive anal intercourse with HIV-positive partners were at increased risk of HIV infection, as were those reporting amphetamine or heavy alcohol use and alcohol or drug use before sex. Some depression symptoms and occurrence of gonorrhea also were independently associated with HIV infection. The attributable fractions of high number of male partners, use of alcohol or drugs before sex, and unprotected receptive anal intercourse with unknown status partners and the same with presumed negative partners accounted for 32.3, 29.0, 28.4 and 21.6% of infections, respectively. CONCLUSIONS: The challenge is to develop strategies to identify men in need. Interventions are needed to help men reduce their number of sexual partners, occurrences of unprotected anal intercourse, alcohol or drug use before sex and address other mental health issues.

Adult↗
PubMed2002

Time-course of adiposity and fasting insulin from childhood to young adulthood in offspring of parents with coronary artery disease: the Bogalusa Heart Study.

PURPOSE: Obesity and the attendant insulin resistance/hyperinsulinemia related to coronary artery disease (CAD) morbidity and mortality are well documented. However, information is lacking on the time-course relation of adiposity and fasting insulin from childhood to young adulthood in offspring of parents with CAD, a surrogate measure of future risk. METHODS: Longitudinal analysis was performed on data collected from the Bogalusa Heart Study cohort with (n = 271) and without (n = 805) a parental history of CAD followed since childhood by repeated surveys from 1973 to 1991. RESULTS: Lowess smoothing and multivariate analyses using Generalized Estimating Equations revealed that body mass index, triceps, and subscapular skinfolds were consistently higher from childhood to adulthood in offspring of parents with CAD history. Insulin levels during childhood and adolescence were lower in the offspring with affected parents. On the other hand, higher levels of fasting insulin from offspring were associated with positive parental history of CAD after age 20 and this association remained significant even after adjusting for body mass index. There was no significant interaction with race or sex in these relationships. CONCLUSION: These results indicate that the offspring at high risk for CAD develop excess body fatness beginning in childhood and then later manifest hyperinsulinemia in young adulthood. These observations have important implications for prevention.

Adipose Tissue↗
PubMed1984

Age changes and sex differences in serum dehydroepiandrosterone sulfate concentrations throughout adulthood.

In a cross-sectional study, serum dehydroepiandrosterone sulfate (DS) concentrations were measured in 981 men and 481 women, aged 11-89, yr. The resulting data were asymetrically distributed and were normalized by logarithmic transformation and analyzed by 5-yr age grouping (e.g. 15-19 yr, 20-24 yr, etc.). The DS concentration peaked at age 20-24 yr in men (logarithmic mean, 3470 ng/ml) and at age 15-19 yr in women (log mean, 2470 ng/ml). Mean values then declined steadily in both sexes (log mean at greater than 70 yr of age, 670 ng/ml in men and 450 ng/ml in women) and were significantly higher in men than women at ages from 20-69 yr. Analysis of 517 randomly selected sera (from women) which had been stored frozen for 10-15 yr gave results indistinguishable from values obtained from fresh specimens. In a supplementary study, a longitudinal analysis of weekly specimens from 4 normal men, aged 36-59 yr, revealed individual variability (mean coefficient of variation, 19%) and failed to demonstrate any monthly, seasonal, or annual rhythmicity. Based on the above analyses, a table of normal serum DS ranges for adult men and women is presented for use as a clinical reference.

Adolescent↗
PubMedDate not supplied

Violence risk and protective factors among youth held back in school.

OBJECTIVE: To identify risk and protective factors for violence perpetration among youth with a history of grade retention. DESIGN: Longitudinal analysis of in-home interviews of 13,781 adolescents in grades 7 through 12 conducted in 1995 and 1996. METHODS AND MEASURES: Serious interpersonal violence perpetration at time 2 by time 1 independent variables including measures of community and school context, family context, and individual characteristics. RESULTS: The 20% of girls and 28% of boys who had repeated 1 or more grades were more likely than those who had not to be in the top quintile of violence perpetration at time 2 (P <.001). For both girls and boys with a history of grade repetition, predictive risk factors with an odds ratio of 3 or greater (P <.001) included time 1 violence perpetration, violence victimization, weapon carrying, school problems, and alcohol and marijuana use. Although a high grade point average was a significant protective factor against violence perpetration for both girls (odds ratio, 0.36; P <.05) and boys (odds ratio, 0.23; P <.001), performance on a validated measure of verbal knowledge was not associated with violence perpetration over the study period. School connectedness, parent-family connectedness, and emotional well-being were also significant universal protectors against violence perpetration. CONCLUSIONS: Youth who are held back in school are at heightened risk for violence perpetration. Violence-related behaviors and substance use considerably increase the likelihood of this outcome. The findings suggest that schools can participate in violence prevention by providing youth with a positive community and academic experience.

Adolescent↗
PubMed2004

[The National Diabetes Registry 1996-2003. Quality assessment shows improved diabetic care].

The Swedish National Diabetes Register presents results during the period 1996-2003. Quality of care data from more than 75,000 diabetic patients (2003) treated at medical departments and primary health care centres are evaluated concerning national goals of HbA1c < 6.5% and BP < 140/85 mm Hg, the prevalence of lipid treatment, smoking etc. The national goals of HbA1c and BP were reached with increasing degree in cross-sectional analysis during the period, and were achieved by 33% and 71% at medical departments, and by 61% and 48% in primary health care in 2003. A similar tendency was also seen in longitudinal analysis of subgroups 1996-2003. The use of antihypertensive and lipid-lowering drugs was also considerably increased. This should imply a reduction of the risk for diabetic complications. As the national goals are still difficult to reach, individual goals should be set for the treatment.

Adult↗