To compare characteristics of both continent and incontinent residents in Nursing Homes (NHs) and to explore what predicts continence and severity of incontinence.
A population-based cross-sectional study was performed in nursing homes in one Norwegian municipality. Registered nurses filled in a questionnaire on behalf of the patients.
We found that 25.4% of the NH residents were continent, 31.8% had urinary incontinence alone, 2.6% had fecal incontinence alone and 40.2% had double incontinence. Continent residents were characterized by being in short-term care, shorter stay in NH, less cognitive and physical impairment, less Parkinson's disease, stroke, constipation, and less diarrhea and more independence in activities of daily living (ADL). Residents with fecal incontinence alone were characterized by more diarrhea, less cognitive impairment and less dependency in ADL such as feeding and grooming. Residents with urinary incontinence alone were characterized by having some degree of ADL dependency, less diarrhea, and less diabetes. Residents with double incontinence were characterized by being in long-term care, a longer length of stay in NH, cognitive impairment, stroke, constipation, diarrhea, and dependency in ADL. Severity of incontinence was associated with dependency in ADL and cognitive impairment, diarrhea, length of stay in NH and lower age.
About 25% of NH residents were continent. Double incontinence and urinary incontinence only were prevalent conditions in NHs, while FI alone was rarer. With the exception of diarrhea as a cause of FI, it appears that FI alone, UI alone, and DI may have common causes and development.
To assess the extent to which adherence to statins is associated with the incidence of cardiovascular (CV) events and all-cause mortality in the primary prevention of CV diseases and whether different analytical approaches influence the observed associations.
This population-based cohort study used data from Finnish registers. The cohort included 97,575 new statin users aged 45 to 75 years in 2001 to 2004 with no CV diseases at baseline. Exposure was defined as adherence to statins (proportion of days covered [PDC]). The primary outcome was any CV event or death during a 3-year follow-up. Different analytical approaches, including multivariable-adjusted Cox regression, inverse probability weighting with time-varying adherence, and propensity score calibration, were used.
During the first year of follow-up, 53% displayed good (PDC =80%), 26% had intermediate (PDC 40%-79%), and 21% exhibited poor (PDC
Anal human papillomavirus (HPV) is prevalent among men who have sex with men (MSM), but has not been studied in the Russian Federation. A cross-sectional survey and HPV genotyping were conducted among HIV seropositive (n=58) and seronegative MSM (n=65)in Moscow. Multivariable logistic regression was performed to identify correlates of infection with oncogenic HPV genotypes 16 and/or 18 (HPV 16/18). Forty per cent (49/124) of all MSM were infected with at least one anal HPV genotype, 31.5% (39/124) had HPV16/18,and 11.5% (14/121) had high-grade squamous intraepithelial lesions (HSIL). HPV 16/18 was more prevalent in HIV seropositive than seronegative men (24/58,41.4% vs 15/65, 23.1%; p=0.03). HIV infection was independently associated with HPV 16/18 (adjusted odds ratio (AOR): 5.08; 95% confidence intervals (CI):1.49-17.34, p=0.01), as was having 2-4 steady male sex partners in the last year (vs = 1 partner; AOR: 6.99;95%CI: 1.94–25.24, p
Erratum In: Euro Surveill. 2015;20(17). pii: 2111025955778
Although nonesterified fatty acids (NEFAs) are essential as energy substrate for the myocardium, an excess of circulating NEFAs can be harmful. This study aimed to assess plausible relationships between serum NEFA and mortality due to cardiovascular disease (CVD) in individuals with CKD.
This was a prospective cohort study from the third examination cycle of the Uppsala Longitudinal Study of Adult Men, a population-based survey of 1221 elderly men aged 70-71 years residing in Uppsala, Sweden. Data collection took place during 1991-1995. All participants had measures of kidney function; this study investigated 623 (51.7%) of these patients with manifest CKD (defined as either eGFR
Opioids have immunosuppressive properties, yet their impact on HIV disease progression remains unclear. Using longitudinal data from HIV-infected antiretroviral therapy-naïve Russian individuals (n = 77), we conducted a pilot study to estimate the effect of heroin use on HIV disease progression. Heroin use was categorized based on past 30 days self-reported use at baseline, 6 and 12 months as none, intermittent or persistent. We estimated the effect of heroin use on HIV disease progression, measured as change in CD4 count from baseline to 12 months, using multivariable linear regression. Those with intermittent (n = 21) and no heroin use (n = 39) experienced mean decreases in CD4 count from baseline to 12 months (-103 and -10 cells/mm(3), respectively; adjusted mean difference (AMD) -93; 95 % CI -245, 58). Those with persistent use (n = 17) showed a mean increase of 53 cells/mm(3) (AMD 63; 95 % CI -95, 220). Future studies exploring the effects of heroin withdrawal on HIV disease progression are warranted.
Cites: Curr Opin Support Palliat Care. 2008 Mar;2(1):14-818685388
Cites: Addiction. 2015 Jan;110(1):80-9025170994
Cites: J Acquir Immune Defic Syndr. 2009 Mar 1;50(3):241-919194320
Cites: J Acquir Immune Defic Syndr. 2009 Jan 1;50(1):93-919295339
Opioids alter resting state brain oscillations by multiple and complex factors, which are still to be elucidated. To increase our knowledge, multi-channel electroencephalography (EEG) was subjected to multivariate pattern analysis (MVPA), to identify the most descriptive frequency bands and scalp locations altered by remifentanil in healthy volunteers. Sixty-two channels of resting EEG followed by independent measures of pain scores to heat and bone pain were recorded in 21 healthy males before and during remifentanil infusion in a placebo-controlled, double-blind crossover study. EEG frequency distributions were extracted by a continuous wavelet transform and normalized into delta, theta, alpha, beta and gamma bands. Alterations relative to pre-treatment responses were calculated for all channels and used as input to the MVPA. Compared to placebo, remifentanil increased the delta band and decreased the theta and alpha band oscillations as a mean over all channels (all p = 0.007). The most discriminative channels in these frequency bands were F1 in delta (83.33%, p = 0.0023) and theta bands (95.24%, p
The aim of the present study was to examine the associations of sugary drink consumption and its substitution with alternative beverages with body weight gain among young children predisposed to future weight gain. Secondary analysis of the Healthy Start Study, a 1·5-year randomised controlled trial designed to prevent overweight among Danish children aged 2-6 years (n 366), was carried out. Multivariate linear regression models were used to investigate the associations of beverage consumption with change in body weight (?weight) or BMI(?BMI) z-score. Substitution models were used to extrapolate the influence of replacing sugary drinks with alternative beverages (water, milk and diet drinks) on ?weight or ?BMI z-score. Sugary drink intake at baseline and substitution of sugary drinks with milk were associated with both ?weight and ?BMI z-score. Every 100 g/d increase in sugary drink intake was associated with 0·10 kg and 0·06 unit increases in body weight (P=0·048) and BMI z-score (P=0·04), respectively. Substitution of 100 g/d sugary drinks with 100 g/d milk was inversely associated with ?weight (ß=-0·16 kg; P=0·045) and ?BMI z-score (ß=-0·07 units; P=0·04). The results of this study suggest that sugary drink consumption was associated with body weight gain among young children with high predisposition for future overweight. In line with the current recommendations, sugary drinks, whether high in added or natural sugar, should be discouraged to help prevent childhood obesity. Milk may be a good alternative to sugary drinks with regard to weight management among young obesity-predisposed children.
AIM: The aim of this study is to examine associations between caregiver burden, perceived health and sense of coherence in family caregivers to persons with dementia living at home. BACKGROUND: Most of the studies on family caregivers have focused on burden and morbidity. However, the caregiver's sense of coherence and perceived health have not been studied earlier in relation to caregiver burden. DESIGN: A cross-sectional investigation design was used. METHODS: Older persons, 2238 subjects, with any form of social services, were invited to an assessment of cognitive capacity. Those who had cognitive decline (255) were invited for a medical examination and 130 persons were diagnosed as having dementia. The family caregivers to persons with dementia answered a questionnaire including a caregiver burden scale, the Nottingham health profile scale, sense of coherence scale and the Euroqol instrument. RESULTS: The family caregivers experienced moderate burden, and strong associations were noted between burden, especially isolation, disappointment and emotional involvement with perceived health and sense of coherence, adjusted for age and relationship. Caregivers with lower burden reported significantly better perceived health and higher mean score of sense of coherence than caregivers with higher burden. CONCLUSIONS: Assessment of status of family caregivers of persons with dementia living at home seems to be gaining considerable importance. The caregiver burden scale and the sense of coherence scale seem to be highly useful for identifying carers at risk of stress, pattern of burden and coping strategies. RELEVANCE TO CLINICAL PRACTICE: Nurses can help family caregivers to identify their negative experiences about caregiving and can help them reflect upon their coping strategies to find balance in their situation. Risk groups of caregivers may be identified, especially those with low perceived health and sense of coherence, for early interventions to reduce burden.
OBJECTIVE: Despite profound differences in the neurohumoral milieu in patients undergoing on-pump and off-pump coronary artery bypass grafting, it is uncertain how this affects graft blood flow. METHODS: We prospectively recorded intraoperative transit-time flow measurements (MediStim BF 2004; MediStim AS, Oslo, Norway) in all internal thoracic artery, radial artery, and long saphenous vein conduits in patients undergoing off-pump and on-pump bypass grafting by a single surgeon. We calculated a flow/pressure ratio as a ratio of mean graft flow to mean arterial pressure for all the conduits just before chest closure. RESULTS: Transit-time flow measurements were recorded in 266 grafts (203 off-pump; 63 on-pump) in 100 patients (80 off-pump; 20 on-pump). Overall, mean graft flow (milliliters per minute) was higher for all grafts in the on-pump group despite a significantly lower mean arterial pressure compared with the off-pump group (P
BACKGROUND: Autoimmune thyroid diseases are common and the prevalence of circulating thyroid antibodies (thyroid peroxidase antibody, TPO-Ab and thyroglobulin antibody, Tg-Ab) is high in the population. The knowledge of a possible association between lifestyle factors and circulating thyroid antibodies is limited. AIM: To evaluate the correlation between smoking habits and the presence of circulating TPO-Ab and Tg-Ab. MATERIAL AND METHODS: In a cross-sectional comparative population study performed in two areas of Denmark with moderate and mild iodine deficiency, 4649 randomly selected subjects from the population in some predefined age groups between 18 and 65 years were examined. Blood tests were analysed for TPO-Ab and Tg-Ab using assays based on the RIA technique. The participants answered questionnaires, were clinically examined and blood and urine samples collected. RESULTS: Data were analysed in multivariate logistic regression models. There was a negative association between smoking and the presence of thyroid autoantibodies in serum. This association was observed for the presence of TPO-Ab and/or Tg-Ab, TPO-Ab (without respect to Tg-Ab status), Tg-Ab (without respect to TPO-Ab status) and both antibodies together. The association between smoking and thyroid autoantibodies was stronger for Tg-Ab than for TPO-Ab. There was no association between smoking and TPO-Ab measured alone or between smoking and TPO-Ab when Tg-Ab was included in the model as an explanatory variable. CONCLUSION: Smoking was negatively associated with the presence of thyroid autoantibodies with the strongest association between smoking and Tg-Ab. The study design precludes any conclusions as to the cause of the negative association between smoking thyroid autoantibodies.