The ophthalmic branch of the Gutenberg Health Study: study design, cohort profile and self-reported diseases.
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ABSTRACT:
SUBMITTER: Hohn R
PROVIDER: S-EPMC4361691 | biostudies-other | 2015
REPOSITORIES: biostudies-other
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Project description:Golimumab and etanercept both exhibit good efficacy in treating rheumatic diseases, while the patient self-reported measurement of treatment improvement and injection experience lacks sufficient evidence. Hence, this study aimed to compare the satisfaction with disease improvement and injection experience and the level of injection site reactions (ISRs) between golimumab-treated and etanercept-treated patients with rheumatic diseases. A total of 312 patients with rheumatic diseases were serially enrolled. Among them, 158 patients received golimumab (golimumab group); the other 154 patients were treated with etanercept (etanercept group) according to the actual disease status, physician advice, and patient willingness. Satisfaction with disease improvement was assessed using the 7-point Likert scale; satisfaction with injection experience and level of ISRs were both determined by the 5-point Likert scale. Satisfaction degrees with global injection experience (P = .025), injection device (P = .008), injection frequency (P = .010), and injection convenience (P = .003) were superior in the golimumab group to the etanercept group, while satisfaction degrees with global disease improvement, symptom relief, and speed of action did not vary (all P > .050) between the 2 groups. Discomfort (P = .005), swelling (P < .001), pain (P = .028), and burning (P = .035) levels were lower in the golimumab group than in the etanercept group. In addition, among 56 patients with a history of tumor necrosis factor inhibitor treatment before golimumab, 40 (71.4%) patients preferred golimumab to other tumor necrosis factor inhibitor. After switching to golimumab treatment, the level of ISRs in most patients was reduced or comparable. Golimumab achieves a satisfying injection experience and relieves the level of ISRs over etanercept in patients with rheumatic diseases.
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Project description:In1998, the Boston Birth Cohort (BBC) was initiated at Boston Medical Center (BMC) in response to persistently high rates of preterm birth (PTB, defined as birth before 37 weeks of gestation) in the US population and the longstanding profound PTB disparity among Black, Indigenous, and people of color (BIPOC). The BBC encompasses two linked study protocols: The PTB Study serves as the baseline recruitment in the BBC. It aims to address fundamental questions about the causes and consequences of PTB. The study oversamples preterm babies using a case/control study design, in which cases are defined as mothers who deliver a preterm and/or low birthweight baby (<2500 grams regardless of gestational age). Controls are enrolled at a 2:1 control/case ratio and matched by maternal age (±5 years), self-reported race and ethnicity, and date of delivery (± 7 days for case delivery). From inception, it was designed as a comprehensive gene-environmental study of PTB. As a natural extension, the Children's Health Study, under a separate but linked Institutional Review Board protocol, is a longitudinal follow-up study of the participants who were recruited at birth in the PTB Study and who continue pediatric care at BMC. This linked model allows for investigation of early life origins of pediatric and chronic disease in a prospective cohort design. The BBC is one of the largest and longest National Institutes of Health-funded prospective birth cohort studies in the United States, consisting of 8733 mother-child dyads enrolled in the PTB Study at birth, and of those, 3592 children have been enrolled in the Children's Health Study, with a median follow-up of 14.5 years. The BBC mirrors the urban, underresourced, and underrepresented BIPOC population served by BMC. A high proportion of BBC children were born prematurely and had chronic health conditions (e.g., asthma, obesity, and elevated blood pressure) in childhood. The BBC's long-term goal has been to build a large, comprehensive database (epidemiological, clinical, and multiomics) and biospecimen repository to elucidate early life origins of pediatric and chronic diseases and identify modifiable upstream factors (e.g., psychosocial, environmental, and nutritional) to improve health across the life course for BIPOC mothers and children.
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Project description:BackgroundIdentifying the medical conditions that are associated with poor health is crucial to prioritize decisions for future research and organizing care. However, assessing the burden of disease in the general population is complex, lengthy, and expensive. Claims databases that include self-reported health status can be used to assess the impact of medical conditions on the health in a population.ObjectiveThis study aimed to identify medical conditions that are highly predictive of poor health status using claims databases.MethodsTo determine the medical conditions most highly predictive of poor health status, we used a retrospective cohort study using 2 US claims databases. Subjects were commercially insured patients. Health status was measured using a self-report health status response. All medical conditions were included in a least absolute shrinkage and selection operator regression model to assess which conditions were associated with poor versus excellent health.ResultsA total of 1,186,871 subjects were included; 61.64% (731,587/1,186,871) reported having excellent or very good health. The leading medical conditions associated with poor health were cancer-related conditions, demyelinating disorders, diabetes, diabetic complications, psychiatric illnesses (mood disorders and schizophrenia), sleep disorders, seizures, male reproductive tract infections, chronic obstructive pulmonary disease, cardiomyopathy, dementia, and headaches.ConclusionsUnderstanding the impact of disease in a commercially insured population is critical to identify subjects who may be at risk for reduced productivity and job loss. Claims database studies can measure the impact of medical conditions on the health status in a population and to assess changes overtime and could limit the need to collect prospective collection of information, which is slow and expensive, to assess disease burden. Leading medical conditions associated with poor health in a commercially insured population were the ones associated with high burden of disease such as cancer-related conditions, demyelinating disorders, diabetes, diabetic complications, psychiatric illnesses (mood disorders and schizophrenia), infections, chronic obstructive pulmonary disease, cardiomyopathy, and dementia. However, sleep disorders, seizures, male reproductive tract infections, and headaches were also part of the leading medical conditions associated with poor health that had not been identified before as being associated with poor health and deserve more attention.
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Project description:Sulforaphane (SFN) is an organosulfur compound categorized as an isothiocyanate (ITC), primarily extracted from cruciferous vegetables like broccoli and cabbage. The molecular formula of sulforaphane (SFN) is C6H11NOS2. SFN is generated by the hydrolysis of glucoraphanin (GRP) through the enzyme myrosinase, showing notable properties including anti-diabetic, anti-inflammatory, antimicrobial, anti-angiogenic, and anticancer attributes. Ongoing clinical trials are investigating its potential in diseases such as cancer, neurodegenerative diseases, diabetes-related complications, chronic kidney disease, cardiovascular disease, and liver diseases. Several animal carcinogenesis models and cell culture models have shown it to be a very effective chemopreventive agent, and the protective effects of SFN in ophthalmic diseases have been linked to multiple mechanisms. In murine models of diabetic retinopathy and age-related macular degeneration, SFN delays retinal photoreceptor cell degeneration through the Nrf2 antioxidative pathway, NF-κB pathway, AMPK pathway, and Txnip/mTOR pathway. In rabbit models of keratoconus and cataract, SFN has been shown to protect corneal and lens epithelial cells from oxidative stress injury by activating the Keap1-Nrf2-ARE pathway and the Nrf-2/HO-1 antioxidant pathway. Oral delivery or intraperitoneal injection at varying concentrations are the primary strategies for SFN intake in current preclinical studies. Challenges remain in the application of SFN in eye disorders due to its weak solubility in water and limited bioavailability because of the presence of blood-ocular barrier systems. This review comprehensively outlines recent research on SFN, elucidates its mechanisms of action, and discusses potential therapeutic benefits for eye disorders such as age-related macular degeneration (AMD), diabetic retinopathy (DR), cataracts, and other ophthalmic diseases, while also indicating directions for future clinical research to achieve efficient SFN treatment for ophthalmic diseases.
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Project description:Resveratrol, a naturally occurring plant polyphenol found in grapes, is the principal biologically active component in red wine. Clinical studies have shown that resveratrol due to its potent anti-oxidant and anti-inflammatory properties are cardio-protective, chemotherapeutic, neuroprotective, and display anti-aging effects. Oxidative stress and inflammation play a critical role in the initiation and progression of age-related ocular diseases (glaucoma, cataract, diabetic retinopathy and macular degeneration) that lead to progressive loss of vision and blindness. In vitro and in vivo (animal model) experimental studies performed so far have provided evidence for the biological effects of resveratrol on numerous pathways including oxidative stress, inflammation, mitochondrial dysfunction, apoptosis, pro-survival or angiogenesis that are implicated in the pathogenesis of these age-related ocular disorders. In this review, we provide a brief overview of current scientific literature on resveratrol, its plausible mechanism(s) of action, its potential use and current limitations as a nutritional therapeutic intervention in the eye and its related disorders.
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Project description:Oral health status can be affected by some factors including drug abuse, systemic conditions and environmental pollutants. The present study was designed to investigate the most important and prevalent dental and oral conditions in adult population of Rafsanjan with the age of 35-70 years. Dental and oral health cohort center as part of the Rafsanjan Cohort Study (RCS) included in the prospective epidemiological research studies in IrAN was established in 2015. Of 9991 subjects enrolled in the RCS, 8682 people participated in the Oral Health Branch of Rafsanjan Cohort Study (OHBRCS). The OHBRCS included 4021 men and 4661 women with the mean age of 49.94 ± 9.51. The most prevalent of oral lesion in total population was candidiasis and the least was aphthous lesion. The prevalence of candidiasis, white and red lesions, periodontal pocket, dental calculus, CAL and the mean of DMFT were higher in the male group than that of female group (p < 0.05). Candidiasis, herpes, oral cancer, white and red lesions were more prevalent in the older age groups (p < 0.05). The mean of DMFT index in total population was 21.30 and was higher among opium users, men and older age (p < 0.05). Also, the opium users had a higher rate of CAL, periodontal pocket, red and white lesions, and candidiasis but a lower rate of BOP (p < 0.05). Younger people had more decayed and filling teeth compared to other age groups, whereas older people had more missing teeth and a higher DMFT index (p < 0.001).
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Project description:BackgroundInvestigation of frailty among elderly adults and development of prevention strategies to address this are critical in delaying progression of functional decline and thus extending healthy life expectancy. However, there has been no Japanese epidemiologic cohort study of frailty. The Hatoyama Cohort Study was launched in 2010 to identify factors that predict functional decline and to establish strategies to prevent frailty among community-dwelling elderly Japanese. This report describes the study design and the profile of the participants at baseline.MethodsThe Hatoyama Cohort Study is a prospective study of community-dwelling individuals aged 65 years or older living in the town of Hatoyama in Saitama Prefecture, Japan. Comprehensive information, including socioeconomic status, physiological indicators, physical, psychological, and cognitive function, social capital, neighborhood environment, and frailty, was collected in a baseline survey using face-to-face interviews in September 2010. Survival time, long-term care insurance certification, and medical and long-term care costs after the baseline survey will be followed. In addition, a follow-up survey will be conducted in the same manner as the baseline survey every 2 years.ResultsA total of 742 people participated in the baseline survey (mean age: 71.9 ± 5.2 years, men: 57.7%, living alone: 7.7%). Almost all participants were independent in their daily lives, and approximately 10% were categorized as frail on the kaigo-yobo (care prevention) checklist.ConclusionsThe Hatoyama Cohort Study is expected to contribute to the development of strategies that prevent frailty in later life and extend healthy life expectancy in Japan's rapidly aging society.
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Project description:BackgroundFurther evidence into the effects of social relationships on health (including those at both the individual and community levels) is needed in Japan. The Yabu Cohort Study was launched in 2012 to identify the associations between social relationships and health among community-dwelling older Japanese people and to evaluate population approaches for preventive long-term care in the community. This report describes the study design and the profile of the participants at baseline.MethodsThe Yabu Cohort Study is a prospective study of community-dwelling individuals aged 65 years and older in Yabu, Hyogo Prefecture, Japan. The baseline survey, using a mailed self-administered questionnaire, was conducted from July through August 2012. It included information on socioeconomic status, general and psychological health, and social relationships (social network, social support, and social capital). Survival time, long-term care insurance certification, and medical and long-term care costs after the baseline survey will be followed.ResultsOf 7271 questionnaires distributed, a total of 6652 were returned (91.5% response rate), and 6241 were included in the analysis. Mean age was 71.9 ± 5.2 years, 43.2% were men, and 83.8% had lived in their neighborhood for more than 40 years. Approximately 45.2% expressed general trust. About 82.4%, 49.9%, and 55.5% have participated in neighborhood association activities, municipal seminars for preventive long-term care, and salon activities in the community, respectively.ConclusionsThe study is expected to provide valuable evidence on the effects of social relationships on health and to suggest the usefulness of population approaches for preventive long-term care in Japanese communities.
| S-EPMC4213228 | biostudies-literature
Project description:BackgroundCystic fibrosis (CF) is characterized by recurrent respiratory infections and progressive lung disease. Whereas exercise may contribute to preserving lung function, its benefit is difficult to ascertain given the selection bias of healthier patients being more predisposed to exercise. Our objective was to examine the role of self-reported exercise with longitudinal lung function and body mass index (BMI) measures in CF.MethodsA total of 1038 subjects with CF were recruited through the U.S. CF Twin-Sibling Study. Questionnaires were used to determine exercise habits. Questionnaires, chart review, and U.S. CF Foundation Patient Registry data were used to track outcomes.ResultsWithin the study sample 75% of subjects self-reported regular exercise. Exercise was associated with an older age of diagnosis (p = 0.002), older age at the time of ascertainment (p < 0.001), and higher baseline FEV1 (p = 0.001), but not CFTR genotype (p = 0.64) or exocrine pancreatic function (p = 0.19). In adjusted mixed models, exercise was associated with both a reduced decline in FEV1 (p < 0.001) and BMI Z-score (p = 0.001) for adults, but not children aged 10-17 years old.ConclusionsIn our retrospective study, self-reported exercise was associated with improved longitudinal nutritional and pulmonary outcomes in cystic fibrosis for adults. Although prospective studies are needed to confirm these associations, programs to promote regular exercise among individuals with cystic fibrosis would be beneficial.
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Project description:BackgroundThe relationships between periodontitis and non-communicable diseases (NCDs) have been investigated through several different case-definitions. The differences in methodology may have hindered the basis of comparison between these studies. The classification from the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions offers a unison platform that may facilitate future comparison of such research. The present study aimed to reproduce associations between periodontitis and other NCDs using the 2017 Classification, in the Trøndelag Health Study (HUNT).Material and methodsThe fourth HUNT-survey was carried out between 2017 and 2019. Clinical variables, blood samples and answers to questionnaires were collected from 4933 participants. Periodontal status was assessed based on the latest staging system, and its associations with NCDs were estimated by logistic regression models adjusted for potential confounders.ResultsCompared to no or Stage I periodontitis, participants with Stage III/IV periodontitis (radiographic bone loss exceeding 33%) were associated with cardiovascular disease, hyperglycemia in participants with diabetes and chronic obstructive pulmonary disease (COPD)/emphysema. Associations with hyperglycemia in participants with diabetes and COPD/emphysema were also observed in participants with Stage II periodontitis. The only observed association when considering never-smokers alone, was with COPD/emphysema.ConclusionPeriodontitis Stage II and III/IV were associated with major NCDs. Effect sizes increased with increasing periodontitis stages, which implies greater occurrence of coincident comorbidities in patients with severe periodontitis.
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