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Assisted Peritoneal Dialysis for Older People with End-Stage Renal Disease: The French and Danish Experience.

https://arctichealth.org/en/permalink/ahliterature276580
Source
Perit Dial Int. 2015 Nov;35(6):663-6
Publication Type
Article
Date
Nov-2015
Author
Clémence Béchade
Thierry Lobbedez
Per Ivarsen
Johan V Povlsen
Source
Perit Dial Int. 2015 Nov;35(6):663-6
Date
Nov-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Denmark
Female
France
Geriatric Assessment - methods
Health Care Costs
Humans
Insurance, Health - economics
Insurance, Health, Reimbursement - economics
Kidney Failure, Chronic - diagnosis - economics - therapy
Male
Medical Assistance - economics
Outcome Assessment (Health Care) - economics
Peritoneal Dialysis - economics - methods - statistics & numerical data
Prognosis
Risk assessment
Socioeconomic Factors
Abstract
Older people are the largest and fastest growing group of patients with end-stage renal disease (ESRD), and, due to advanced age and a heavy burden of comorbidities, they are usually not candidates for renal transplantation or home-based dialysis treatment. Some of the barriers for home treatment are non-modifiable, but the majority of physical disabilities and psychosocial problems can be overcome provided that assistance is offered to the patients at home.In the present review, we describe the programs for assisted peritoneal dialysis (PD) in France and Denmark, respectively. In both nations, assisted PD is totally publicly funded, and the cost of assisted PD is comparable to the cost of in-center HD. Assisted continuous ambulatory PD (aCAPD) is the preferred modality in France whereas assisted automated PD (aAPD) is the preferred modality in Denmark. Assistants are professional nurses or healthcare technicians briefly educated by expert PD nurses from the dialysis unit.The establishment of a program for assisted PD may increase the number of patients actually treated with PD and may reduce the risk of PD technique failure and prolong PD duration. Compared with autonomous PD patients, patients on assisted PD may have shorter patient survival and peritonitis-free survival indicating that, besides advanced age and the burden of comorbidities, dependency on help may be an independent risk factor for poorer outcome.Assisted PD is an evolving dialysis modality, and may in the future prove to be a feasible complementary alternative to in-center hemodialysis (HD) for the growing group of dependent older patients with ESRD.
PubMed ID
26702010 View in PubMed
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Lifecycle effects of a recession on health behaviors: Boom, bust, and recovery in Iceland.

https://arctichealth.org/en/permalink/ahliterature276585
Source
Econ Hum Biol. 2016 Mar;20:90-107
Publication Type
Article
Date
Mar-2016
Author
Tinna Laufey Ásgeirsdóttir
Hope Corman
Kelly Noonan
Nancy E Reichman
Source
Econ Hum Biol. 2016 Mar;20:90-107
Date
Mar-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alcohol Drinking - economics - epidemiology
Confounding Factors (Epidemiology)
Diet - adverse effects - economics - trends
Dietary Sucrose - adverse effects - economics
Economic Development - trends
Economic Recession
Fast Foods - adverse effects - statistics & numerical data
Female
Health Behavior
Health Surveys
Humans
Iceland
Longitudinal Studies
Male
Middle Aged
Smoking - economics - epidemiology
Sunbathing - economics - trends
Young Adult
Abstract
This study uses individual-level longitudinal data from Iceland, a country that experienced a severe economic crisis in 2008 and substantial recovery by 2012, to investigate the extent to which the effects of a recession on health behaviors are lingering or short-lived and to explore trajectories in health behaviors from pre-crisis boom, to crisis, to recovery. Health-compromising behaviors (smoking, heavy drinking, sugared soft drinks, sweets, fast food, and tanning) declined during the crisis, and all but sweets continued to decline during the recovery. Health-promoting behaviors (consumption of fruit, fish oil, and vitamins/minerals and getting recommended sleep) followed more idiosyncratic paths. Overall, most behaviors reverted back to their pre-crisis levels or trends during the recovery, and these short-term deviations in trajectories were probably too short-lived in this recession to have major impacts on health or mortality. A notable exception is for binge drinking, which declined by 10% during the 2 crisis years, continued to fall (at a slower rate of 8%) during the 3 recovery years, and did not revert back to the upward pre-crisis trend during our observation period. These lingering effects, which directionally run counter to the pre-crisis upward trend in consumption and do not reflect price increases during the recovery period, suggest that alcohol is a potential pathway by which recessions improve health and/or reduce mortality.
PubMed ID
26687768 View in PubMed
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Protein profiling reveals consequences of lifestyle choices on predicted biological aging.

https://arctichealth.org/en/permalink/ahliterature276594
Source
Sci Rep. 2015;5:17282
Publication Type
Article
Date
2015
Author
Stefan Enroth
Sofia Bosdotter Enroth
Åsa Johansson
Ulf Gyllensten
Source
Sci Rep. 2015;5:17282
Date
2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Aging - blood
Alcohol Drinking - blood
Blood Proteins - metabolism
Body mass index
Female
Humans
Life Style
Male
Middle Aged
Norway
Smoking - blood
Abstract
Ageing is linked to a number of changes in how the body and its organs function. On a molecular level, ageing is associated with a reduction of telomere length, changes in metabolic and gene-transcription profiles and an altered DNA-methylation pattern. Lifestyle factors such as smoking or stress can impact some of these molecular processes and thereby affect the ageing of an individual. Here we demonstrate by analysis of 77 plasma proteins in 976 individuals, that the abundance of circulating proteins accurately predicts chronological age, as well as anthropometrical measurements such as weight, height and hip circumference. The plasma protein profile can also be used to identify lifestyle factors that accelerate and decelerate ageing. We found smoking, high BMI and consumption of sugar-sweetened beverages to increase the predicted chronological age by 2-6 years, while consumption of fatty fish, drinking moderate amounts of coffee and exercising reduced the predicted age by approximately the same amount. This method can be applied to dried blood spots and may thus be useful in forensic medicine to provide basic anthropometrical measures for an individual based on a biological evidence sample.
Notes
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PubMed ID
26619799 View in PubMed
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Risk and course of motor complications in a population-based incident Parkinson's disease cohort.

https://arctichealth.org/en/permalink/ahliterature276603
Source
Parkinsonism Relat Disord. 2016 Jan;22:48-53
Publication Type
Article
Date
Jan-2016
Author
Anders Bjornestad
Elin B Forsaa
Kenn Freddy Pedersen
Ole-Bjorn Tysnes
Jan Petter Larsen
Guido Alves
Source
Parkinsonism Relat Disord. 2016 Jan;22:48-53
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Antiparkinson Agents - adverse effects
Cohort Studies
Disease Progression
Dyskinesia, Drug-Induced - epidemiology - etiology
Dyskinesias - epidemiology - etiology - physiopathology
Female
Humans
Incidence
Kaplan-Meier Estimate
Levodopa - adverse effects
Male
Middle Aged
Movement Disorders - epidemiology - etiology - physiopathology
Norway - epidemiology
Parkinson Disease - complications - drug therapy - epidemiology - physiopathology
Proportional Hazards Models
Prospective Studies
Risk factors
Sex Factors
Superior Sagittal Sinus
Abstract
Motor complications may become major challenges in the management of patients with Parkinson's disease. In this study, we sought to determine the incidence, risk factors, evolution, and treatment of motor fluctuations and dyskinesias in a population-representative, incident Parkinson's disease cohort.
In this prospective population-based 5-year longitudinal study, we followed 189 incident and initially drug-naïve Parkinson's disease patients biannually for detailed examination of dyskinesias and motor fluctuations as defined by the Unified Parkinson's disease Rating Scale. We performed Kaplan-Meier survival and Cox regression analyses to assess cumulative incidence and risk factors of these motor complications.
The 5-year cumulative incidence of motor complications was 52.4%. Motor fluctuations occurred in 42.9% and dyskinesias in 24.3%. Besides higher motor severity predicting both motor fluctuations (p = 0.016) and dyskinesias (p 0.1) independently predicted development of motor complications. Motor fluctuations reversed in 37% and dyskinesias in 49% of patients on oral treatment and remained generally mild in those with persistent complications. No patients received device-aided therapies during the study.
More than 50% in the general Parkinson's disease population develop motor complications within 5 years of diagnosis. However, they remain mild in the vast majority and are reversible in a substantial proportion of patients.
PubMed ID
26585090 View in PubMed
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Borderline Personality Disorder and Posttraumatic Stress Disorder at Psychiatric Discharge Predict General Hospital Admission for Self-Harm.

https://arctichealth.org/en/permalink/ahliterature276606
Source
J Trauma Stress. 2015 Dec;28(6):556-62
Publication Type
Article
Date
Dec-2015
Author
Liv Mellesdal
Rolf Gjestad
Erik Johnsen
Hugo A Jørgensen
Ketil J Oedegaard
Rune A Kroken
Lars Mehlum
Source
J Trauma Stress. 2015 Dec;28(6):556-62
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Bipolar Disorder - epidemiology - psychology
Borderline Personality Disorder - epidemiology - psychology
Comorbidity
Depressive Disorder, Major - epidemiology - psychology
Female
Hospitalization - statistics & numerical data
Hospitals, Psychiatric - statistics & numerical data
Humans
Inpatients - statistics & numerical data
Interview, Psychological
Male
Middle Aged
Norway - epidemiology
Random Allocation
Regression Analysis
Risk assessment
Risk factors
Self-Injurious Behavior - epidemiology - psychology
Stress Disorders, Post-Traumatic - epidemiology - psychology
Suicide - prevention & control - psychology - statistics & numerical data
Young Adult
Abstract
We investigated whether posttraumatic stress disorder (PTSD) was predictor of suicidal behavior even when adjusting for comorbid borderline personality disorder (BPD) and other salient risk factors. To study this, we randomly selected 308 patients admitted to a psychiatric hospital because of suicide risk. Baseline interviews were performed within the first days of the stay. Information concerning the number of self-harm admissions to general hospitals over the subsequent 6 months was retrieved through linkage with the regional hospital registers. A censored regression analysis of hospital admissions for self-harm indicated significant associations with both PTSD (? = .21, p
Notes
Erratum In: J Trauma Stress. 2016 Feb;29(1):10626915448
PubMed ID
26581019 View in PubMed
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Global Longitudinal Strain Is a Superior Predictor of All-Cause Mortality in Heart Failure With Reduced Ejection Fraction.

https://arctichealth.org/en/permalink/ahliterature276607
Source
JACC Cardiovasc Imaging. 2015 Dec;8(12):1351-9
Publication Type
Article
Date
Dec-2015
Author
Morten Sengeløv
Peter Godsk Jørgensen
Jan Skov Jensen
Niels Eske Bruun
Flemming Javier Olsen
Thomas Fritz-Hansen
Kotaro Nochioka
Tor Biering-Sørensen
Source
JACC Cardiovasc Imaging. 2015 Dec;8(12):1351-9
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Analysis of Variance
Cardiac Output, Low - ultrasonography
Cause of Death
Cohort Studies
Databases, Factual
Denmark
Echocardiography - methods
Female
Heart Failure - mortality - physiopathology - ultrasonography
Humans
Image Processing, Computer-Assisted
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Predictive value of tests
Proportional Hazards Models
Retrospective Studies
Risk assessment
Severity of Illness Index
Sex Factors
Stroke Volume - physiology
Survival Analysis
Ultrasonography, Doppler, Pulsed - methods
Abstract
The purpose of this study was to investigate the prognostic value of global longitudinal strain (GLS) in heart failure with reduced ejection fraction (HFrEF) patients in relation to all-cause mortality.
Measurement of myocardial deformation by 2-dimensional speckle tracking echocardiography, specifically GLS, may be superior to conventional echocardiographic parameters, including left ventricular ejection fraction, in predicting all-cause mortality in HFrEF patients.
Transthoracic echocardiographic examinations were retrieved for 1,065 HFrEF patients admitted to a heart failure clinic. The echocardiographic images were analyzed, and conventional and novel echocardiographic parameters were obtained.
Many of the conventional echocardiographic parameters proved to be predictors of mortality. However, GLS remained an independent predictor of mortality in the multivariable model after adjusting for age, sex, body mass index, total cholesterol, mean arterial pressure, heart rate, ischemic cardiomyopathy, percutaneous transluminal coronary angioplasty, coronary artery bypass graft surgery, noninsulin dependent diabetes mellitus, and conventional echocardiographic parameters (hazard ratio [HR]: 1.15; 95% confidence interval [CI]: 1.04 to 1.27; p = 0.008, per 1% decrease). No other echocardiographic parameter remained an independent predictor after adjusting for these variables. Furthermore, GLS had the highest C-statistics of all the echocardiographic parameters and added incremental prognostic value with a significant increase in the net reclassification improvement (p = 0.009). Atrial fibrillation (AF) modified the relationship between GLS and mortality (p value for interaction = 0.036); HR: 1.08 (95% CI: 0.97 to 1.19), p = 0.150 and HR: 1.22 (95% CI: 1.15 to 1.29), p
Notes
Comment In: JACC Cardiovasc Imaging. 2015 Dec;8(12):1360-326699105
PubMed ID
26577264 View in PubMed
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Light-to-moderate drinking and incident heart failure--the Norwegian HUNT study.

https://arctichealth.org/en/permalink/ahliterature276609
Source
Int J Cardiol. 2016 Jan 15;203:553-60
Publication Type
Article
Date
Jan-15-2016
Author
Katalin Gémes
Imre Janszky
Staffan Ahnve
Krisztina D László
Lars E Laugsand
Lars J Vatten
Kenneth J Mukamal
Source
Int J Cardiol. 2016 Jan 15;203:553-60
Date
Jan-15-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alcohol drinking - epidemiology
Female
Follow-Up Studies
Heart Failure - epidemiology - etiology
Humans
Incidence
Male
Middle Aged
Norway - epidemiology
Proportional Hazards Models
Prospective Studies
Retrospective Studies
Risk Assessment - methods
Risk factors
Survival Rate - trends
Time Factors
Abstract
We analyzed the association between light-to-moderate alcohol intake and the risk of heart failure (HF).
We studied 60,665 individuals free of HF who provided information on alcohol consumption in a population-based cohort study conducted in 1995-97 in Norway. Sociodemographic factors, cardiovascular risk factors and common chronic disorders were assessed by questionnaires and/or by a clinical examination. The cohort was followed for a first HF event for an average of 11.2 ± 3.0 years. Mean alcohol consumption was 2.95 ± 4.5 g/day; 1588 HF cases occurred during follow-up. The quantity of alcohol consumption was inversely associated with incident HF in this low-drinking population. The risk was lowest for consumption over three but less than six drinks/week; the multivariate hazard ratio when comparing this category to non-drinkers was 0.67 (95% CI: 0.50-0.92). Among problem drinkers based on CAGE questionnaires, total consumption showed no favorable association with HF, even when overall consumption was otherwise moderate. Excluding former drinkers and controlling for common chronic diseases had minimal effect on these associations. Frequent alcohol consumption, i.e. more than five times/month, was associated with the lowest HF risk; the adjusted hazard ratio comparing this group to alcohol intake less than once/month was 0.83 (95% CI: 0.68-1.03). We found no evidence for a differential effect according to beverage type, nor that the competing risks of death from other causes modified the association.
Frequent light-to-moderate alcohol consumption without problem drinking was associated with a lower HF risk in this population characterized by a low average alcohol intake.
PubMed ID
26569362 View in PubMed
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Long-Term Surveillance of Treated Hyperparathyroidism for Multiple Endocrine Neoplasia Type 1: Recurrence or Hypoparathyroidism?

https://arctichealth.org/en/permalink/ahliterature276613
Source
World J Surg. 2016 Mar;40(3):615-21
Publication Type
Article
Date
Mar-2016
Author
Ellen Fyrsten
Olov Norlén
Ola Hessman
Peter Stålberg
Per Hellman
Source
World J Surg. 2016 Mar;40(3):615-21
Date
Mar-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Female
Follow-Up Studies
Forecasting
Humans
Hyperparathyroidism, Primary - epidemiology - etiology - therapy
Hypoparathyroidism - diagnosis - etiology
Incidence
Male
Middle Aged
Multiple Endocrine Neoplasia Type 1 - surgery
Parathyroidectomy - adverse effects
Population Surveillance
Postoperative Complications
Sweden - epidemiology
Young Adult
Abstract
Primary hyperparathyroidism (HPT) in multiple endocrine neoplasia type 1 (MEN1) is surgically treated with either a subtotal parathyroidectomy removing 3 or 3,5 glands (SPX), less than 3 glands (LSPX), or a total parathyroidectomy with autotransplantation (TPX). Previous studies with shorter follow-up have shown that LSPX and SPX are associated with recurrent HPT, and TPX with hypocalcemia and substitution therapy. We examined the situation after long-term follow-up (median 20,6 years).
Sixty-nine patients with MEN1 HPT underwent 110 operations, the first operation being 31 LSPX, 30 SPX, and 8 TPX. Thirty patients underwent reoperative surgery in median 120 months later, as completion to TPX (n = 12), completion of LSPX to SPX (n = 9), extirpation of single glands (n = 3) still resulting in LSPX, and resection of forearm grafts (n = 3). Nine patients underwent a second, and 2 a third reoperation. In 24 patients genetic testing confirmed MEN1, and in the remaining heredity and phenotype led to the diagnosis.
TPX had higher risk for hypoparathyroidism necessitating substitution therapy, at latest follow-up 50%, compared to SPX (16% after 3-6 months; none at latest follow-up). Recurrent HPT was common after LSPX, leading to 24 reoperations in 17 patients. No need for substitution therapy after SPX indicated forthcoming recurrent disease. Not having hypocalcemia in the postoperative period and less radical surgery than TPX were significantly associated to risk for recurrence. Further, mutation in exon 3 in the MEN1 gene may eventually be linked to risk of recurrence.
LSPX is highly associated with recurrence and TPX with continuous hypoparathyroidism, also after long-term follow-up. SPX should be the chosen method in the majority of patients with MEN1 HPT.
PubMed ID
26541865 View in PubMed
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Risk of revisits to the emergency department in admitted versus discharged patients with chest pain but without myocardial infarction in relation to high-sensitivity cardiac troponin T levels.

https://arctichealth.org/en/permalink/ahliterature276616
Source
Int J Cardiol. 2016 Jan 15;203:341-6
Publication Type
Article
Date
Jan-15-2016

70079 records – page 1 of 7008.