•RSV and influenza infections are frequent causes of child hospitalization.•Influenza immunization is possible; RSV vaccines are tested in phase III trials.•Identification of high-risk groups ...facilitate influenza/RSV vaccination policies.•Vaccines should be prioritized for children with asthma/chronic disease or siblings.
To pave the way for universal or risk factor-based vaccination strategies, the present study aimed to describe the epidemiology and compare risk factors for hospitalization associated with respiratory syncytial virus (RSV) and influenza virus infections in Danish children.
National register-based cohort study among 403,422 Danish children born 2010–2016.
Prior asthma hospitalization, number of children in the household, chronic disease and maternal history of asthma hospitalization were the most important risk factors for both RSV and influenza hospitalization. The incidence of influenza increased at school start.
Our findings enable targeted vaccination programs for high-risk children with asthma-like disease, chronic disease, siblings in the household, or maternal history of asthma hospitalization.
This study implicates five genetic loci in bone mineral density. Two of these loci are new; three implicate genes known to be involved in bone remodeling, such as the receptor activator of nuclear ...factor-κB ligand gene (
RANKL
). Analyses showed that three of the loci are associated with osteoporotic fracture.
This study implicates five genetic loci in bone mineral density. Two of these loci are new; three implicate genes known to be involved in bone remodeling.
Osteoporosis confers substantive morbidity and mortality and associated costs and predisposes people to fragility fractures at the hip, spine, forearm, or other skeletal sites.
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It is a common disease affecting both sexes in populations of various ancestries, although elderly women of European descent are at the highest risk.
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Bone density is the single best predictor of osteoporotic fractures and is a valuable tool in evaluation of the risk of fractures.
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There is abundant evidence for a genetic contribution to variation in bone mineral density, with heritability estimates between 0.6 and 0.8.
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Bone mineral density is also influenced by environmental . . .
Dementia and type 2 diabetes are both characterized by long prodromal phases, challenging the study of potential risk factors and their temporal relation. The progressive relation among metabolic ...syndrome, insulin resistance (IR), and dementia has recently been questioned, wherefore the aim of this study was to assess the potential association among these precursors of type 2 diabetes and cognitive dysfunction. Using data from the Prospective Epidemiological Risk Factor (PERF) Study (
= 2,103), a prospective study of elderly women in Denmark, we found that impaired fasting plasma glucose concentration was associated with 44% (9-91%) larger probability of cognitive dysfunction. In addition, subjects above the HOMA-IR threshold (HOMA-IR >2.6) had 47% (9-99%) larger odds of cognitive dysfunction. The associations could indicate that a significant proportion of dementia cases in women is likely to be preventable by effective prevention and control of the insulin homeostasis.
Excessive cartilage degradation is a known characteristic of osteoarthritis (OA). Biochemical markers, such as uCTX-II, have been shown to be associated with disease severity, yet the tissue origin ...of CTX-II has been disputed. This analysis investigates the association between OA knee joints at different radiographic stages and pain categories with levels of uCTX-II and biomarkers of bone resorption and formation.
Baseline data of two randomised clinical trials (NCT00486434 and NCT00704847) in patients with radiographic OA and presence of pain were analysed post hoc. A subgroup with available urine samples and evaluable radiographs for both knees (N = 1241) was analysed. Urine CTX-I, urine CTX-II and serum osteocalcin were analysed for associations with combined Kellgren-Lawrence (KL) scores, gender and pain for both knees to assess the contribution of joints at different stages.
Pain, BMI, age, gender and KL grade were all significantly associated with uCTX-II. The association between pain and CTX-II appeared to be driven by weight-bearing pain. The level of uCTX-II incrementally increased with higher radiographic severity of each knee. Levels of bone markers CTX-I and osteocalcin were both significantly associated with BMI and gender, but neither were associated with radiographic severity. Biomarker levels between male or female groups of identical KL scores were found to be higher in females compared to males in some but not all KL score groups.
These results indicate that levels of uCTX-II are independently associated with radiographic severity of OA and pain intensity. CTX-II was associated with weight-bearing pain, but not non-weight-bearing pain, independent of co-variates. Bilateral OA knee joints appear to contribute to uCTX-II levels in an incremental manner according to radiographic severity of single joints. The data suggest that biomarker differences between genders should be taken into account when evaluating these markers in the context of structural features of OA.
Background
Trials comparing programmed, intermittent boluses (PIB) and continuous infusion in catheter‐based nerve blocks found no analgesic differences. However, as these trials used equal doses of ...local anesthetic (LA), the time of action of each bolus was not accounted for. Therefore, the dose‐sparing benefits of PIB may have been overlooked. We compared the analgesic effect of boluses administered in intervals resembling the time of action of each bolus with continuous infusion. We hypothesized that PIB provided non‐inferior analgesia despite consuming less LA.
Methods
Eighty‐one patients undergoing fore‐ and midfoot surgery receiving a catheter‐based sciatic nerve block were randomized to ropivacaine 0.2% as PIB of 10 ml every 8th hour or as continuous infusion, 6 ml h−1. All participants could also receive boluses of 10 ml every 4th hour as needed. A non‐inferiority randomized controlled design was used. Primary outcome was pain (VAS, 0–100 mm) for 72 h using area under curve (AUC) calculation. We assumed a linear relationship between mean VAS and AUC‐VAS and used a non‐inferiority margin of VAS = 20 mm, corresponding to AUC‐VAS = 1440 mm h.
Results
Mean difference in AUC‐VAS was −416 mm h (95% CI −1076 to 244; p = .217) between continuous infusion (mean AUC‐VAS 1206 mm h) and PIB (mean AUC‐VAS 1621 mm h), establishing non‐inferiority. Mean total LA consumption was significantly larger for continuous infusion compared to PIB ((468 ml (95% CI 458 to 478) vs. 136 ml (95% CI 123 to 148); p < 0.0001)).
Conclusions
PIB provided non‐inferior analgesia compared to continuous infusion for 72 postoperative hours despite using significantly less LA.
New risk areas for tick-borne encephalitis (TBE) are emerging and the spread of disease and vaccine coverage is unclear in Sweden. We wanted to study the prevalence and levels of TBE-virus (TBEV) ...antibodies in southern Sweden, and to investigate whether there were individuals with undiagnosed TBE.
Two cohorts of sera were collected: One group of anonymous individuals in rural areas (AIRA) in Skåne and one group of volunteers who often got tick-bites (tick-bitten individuals TBI). An enzyme-linked immunosorbent assay for TBEV IgM and IgG was performed, as well as a TBEV neutralization test (NT) in selected individuals.
In the AIRA group, there was an IgG seropositivity of 5.3%. There were individuals with high antibody levels both in areas previously considered as risk areas (Bromölla and Knislinge), as well as in another area (Tyringe). In the TBI group, 45% of the individuals were vaccinated according to the questionnaires and IgG seropositivity was 28%. A lower seroprevalence and levels of antibodies were seen in the middle-aged group (50-69 years) compared with younger or elderly study participants. A positive NT revealed several individuals with suspected undiagnosed episodes of TBE.
Subclinical or misdiagnosed cases have probably occurred in Skåne. Middle-aged individuals had lower levels of IgG, which could indicate either less tick exposure or a lower vaccine response. Less than half of the TBI were vaccinated, an indication that more information about the disease and vaccine might be needed. We conclude that the study motivates an increased awareness of TBEV in the region.
We have previously reported suggestive linkage of type 2 diabetes mellitus to chromosome 10q. We genotyped 228 microsatellite markers in Icelandic individuals with type 2 diabetes and controls ...throughout a 10.5-Mb interval on 10q. A microsatellite, DG10S478, within intron 3 of the transcription factor 7-like 2 gene (TCF7L2; formerly TCF4) was associated with type 2 diabetes (P = 2.1 × 10−9). This was replicated in a Danish cohort (P = 4.8 × 10−3) and in a US cohort (P = 3.3 × 10−9). Compared with non-carriers, heterozygous and homozygous carriers of the at-risk alleles (38% and 7% of the population, respectively) have relative risks of 1.45 and 2.41. This corresponds to a population attributable risk of 21%. The TCF7L2 gene product is a high mobility group box-containing transcription factor previously implicated in blood glucose homeostasis. It is thought to act through regulation of proglucagon gene expression in enteroendocrine cells via the Wnt signaling pathway.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The heterogeneous nature of osteoarthritis (OA) and the need to subtype patients is widely accepted in the field. The biomarker CRPM, a metabolite of C-reactive protein (CRP), is released to the ...circulation during inflammation. Blood CRPM levels have shown to be associated with disease activity and response to treatment in rheumatoid arthritis (RA). We investigated the level of blood CRPM in OA compared to RA using data from two phase III knee OA and two RA studies (N = 1591). Moreover, the association between CRPM levels and radiographic progression was investigated. The mean CRPM levels were significantly lower in OA (8.5 95% CI 8.3-8.8 ng/mL, n = 781) compared to the RA patients (12.8 9.5-16.0 ng/mL, n = 60); however, a significant subset of OA patients (31%) had CRPM levels (≥ 9 ng/mL) comparable to RA. Furthermore, OA patients (n = 152) with CRPM levels ≥ 9 ng/mL were more likely to develop contra-lateral knee OA assessed by X-ray over a two-year follow-up period with an odds ratio of 2.2 1.0-4.7. These data suggest that CRPM is a blood-based biochemical marker for early identification OA patients with an inflammatory phenotype.
In this trial, tibolone, which has estrogenic, progestogenic, and androgenic effects, was compared with placebo in women between 60 and 85 who had osteoporosis or a vertebral fracture. Tibolone was ...associated with a reduced risk of fracture, breast cancer, and possibly colon cancer. But the drug was associated with an increased risk of stroke and therefore should generally be avoided in elderly women and in women with risk factors for stroke.
Tibolone has estrogenic, progestogenic, and androgenic effects. In this trial, tibolone was associated with a reduced risk of fracture, breast cancer, and possibly colon cancer. But the drug was associated with an increased risk of stroke.
Tibolone is approved in 90 countries to treat menopausal symptoms and in 45 countries to prevent osteoporosis. Tibolone metabolites have estrogenic, progestogenic, and androgenic activities.
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Tibolone preserves bone mineral density,
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reduces hot flushes,
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and may increase libido and vaginal lubrication.
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Tibolone treatment has little effect on levels of low-density-lipoprotein cholesterol but decreases levels of high-density-lipoprotein (HDL) cholesterol and triglycerides.
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Our study, called the Long-Term Intervention on Fractures with Tibolone (LIFT), tested the primary hypothesis that treatment with tibolone reduces the risk of vertebral fracture and, secondarily, modifies the risks of nonvertebral fracture, breast cancer, deep-vein . . .
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