Study protocol for the Maule Cohort (MAUCO) of chronic diseases, Chile 2014-2024.
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ABSTRACT:
SUBMITTER: Ferreccio C
PROVIDER: S-EPMC4743396 | biostudies-other | 2016
REPOSITORIES: biostudies-other
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Project description:PurposeThe Hainan Cohort was established to investigate the incidence, morbidity and mortality of non-communicable diseases and their risk factors in the community population.ParticipantsThe baseline investigation of the Hainan Cohort study was initiated in five main areas of Hainan, China, from June 2018 to October 2020. A multistage cluster random-sampling method was used to obtain samples from the general population. Baseline assessments included a questionnaire survey, physical examination, blood and urine sample collection, and laboratory measurements, and outdoor environmental data were obtained.Findings to dataA total of 14 443 participants aged 35-74 years were recruited at baseline, with a participation rate of 90.1%. The mean age of the participants was 48.8 years; 51.8% were men, and 83.7% had a secondary school or higher education. The crude prevalence of diabetes, coronary heart disease, stroke, hypertension, hyperuricaemia, chronic bronchitis, pulmonary tuberculosis, asthma, cancer, chronic hepatitis and metabolic syndrome were 8.6%, 9.2%, 2.0%, 37.1%, 7.1%, 2.3%, 1.4%, 2.1%, 4.1%, 2.2% and 14.5%, respectively.Future plansThe Hainan Cohort is a dynamic cohort with no end date. All participants will be monitored annually for cause-specific mortality and morbidity until death. Long-term follow-up will be conducted every 5 years. The baseline population is considered to expand in the next wave of follow-up, depending on the availability of funding support.
| S-EPMC9677015 | biostudies-literature
Project description:Introduction: Infectious diseases have a major impact on morbidity and mortality in hospital. Microbial diagnosis remains elusive for most cases of suspected infection which impacts on the use of antibiotics. Rapid advances in genomic technologies combined with high-quality phenotypic data have great potential to improve the diagnosis, management and clinical outcomes of infectious diseases. The aim of the Bioresource in Adult Infectious Diseases (BioAID) is to provide a platform for biomarker discovery, trials and clinical service developments in the field of infectious diseases, by establishing a registry linking clinical phenotype to microbial and biological samples in adult patients who attend hospital with suspected infection. Methods and analysis: BioAID is a cohort study which employs deferred consent to obtain an additional 2.5mL RNA blood sample from patients who attend the Emergency Department (ED) with suspected infection when they undergo peripheral blood culture sampling. Clinical data and additional biological samples including DNA, serum and microbial isolates are obtained from BioAID participants during hospital admission. Participants are also asked to consent to be recalled for future studies. BioAID aims to recruit 10,000 patients from 5-8 sites across England. Since February 2014 >4000 individuals have been recruited to the study. The final cohort will be characterised using descriptive statistics including information on the number of cases that can be linked to biological and microbial samples to support future research studies. Ethical approval and section 251 exemption have been obtained for BioAID researchers to seek deferred consent from patients from whom a RNA specimen has been collected. Samples and meta-data obtained through BioAID will be made available to researchers worldwide following submission of an application form and research protocol. Conclusions: BioAID will support a range of study designs spanning discovery science, biomarker validation, disease pathogenesis and epidemiological analyses of clinical infection syndromes.
| S-EPMC6171553 | biostudies-literature
Project description: Not available
| S-EPMC4378481 | biostudies-literature
Project description:BACKGROUND:There is a strong spatial correlation between demographics and chronic diseases in urban areas. Thus, most of the public policies aimed at improving prevention plans and optimizing the allocation of resources in health networks should be designed specifically for the socioeconomic reality of the population. One way to tackle this challenge is by exploring within a small geographical area the spatial patterns that link the sociodemographic attributes that characterize a community, its risk of suffering chronic diseases, and the accessibility of health treatment. Due to the inherent complexity of cities, soft clustering methods are recommended to find fuzzy spatial patterns. Our main motivation is to provide health planners with valuable spatial information to support decision-making. For the case study, we chose to investigate diabetes in Santiago, Chile. METHODS:To deal with spatiality, we combine two statistical techniques: spatial microsimulation and a self-organizing map (SOM). Spatial microsimulation allows spatial disaggregation of health indicators data to a small area level. In turn, SOM, unlike classical clustering methods, incorporates a learning component through neural networks, which makes it more appropriate to model complex adaptive systems, such as cities. Thus, while spatial microsimulation generates the data for the analysis, the SOM method finds the relevant socio-economic clusters. We selected age, sex, income, prevalence of diabetes, distance to public health services, and type of health insurance as input variables. We used public surveys as input data. RESULTS:We found four significant spatial clusters representing 75 percent of the whole population in Santiago. Two clusters correspond to people with low educational levels, low income, high accessibility to public health services, and a high prevalence of diabetes. However, one presents a significantly higher level of diabetes than the other. The second pair of clusters is made up of people with high educational levels, high income, and low prevalence of diabetes. What differentiates both clusters is accessibility to health centers. The average distance to the health centers of one group almost doubles that of the other. CONCLUSIONS:In this study, we combined two statistical techniques: spatial microsimulation and selforganising maps to explore the relationship between diabetes and socio-demographics in Santiago, Chile. The results have allowed us to corroborate the importance of the spatial factor in the analysis of chronic diseases as a way of suggesting differentiated solutions to spatially explicit problems. SOM turned out to be a good choice to deal with fuzzy health and socioeconomic data. The method explored and uncovered valuable spatial patterns for health decision-making. In turn, spatial microsimulation.
| S-EPMC7310447 | biostudies-literature
Project description:Chile is a mining country, where waste mining is frequently found in the vicinity of inhabited areas. To explore the association between metal exposure and alterations in glucose metabolism, inflammatory status, and oxidative stress in individuals with chronic exposure to metals, a cross-sectional study was performed with 25 volunteers, between 45-65 years old. Inductive coupled plasma mass spectrometry (ICP-MS) was used to measure urinary levels of total arsenic (As) and its metabolites, cooper, nickel, chromium, and lead. Lipid profile, glucose, and insulin were measured in blood, as well as inflammation (interleukin-6, IL-6) and oxidative stress (8-hydroxy-2'deoxyguanosine, 8-OHdG) markers. Increased levels of Low-density lipoprotein, high-density lipoproteins, cholesterol and 8-OHdG, and the index for homeostasis model assessment-insulin resistance (HOMA-IR) were observed in 72%, 60%, and 56% of the volunteers, respectively. Blood-glucose levels were correlated with dimethylarsinic acid (DMA) (R2 = 0.47, p = 0.019), inorganic As (Asi) (R2 = 0.40, p = 0.012), and Ni (R2 = 0.56; p = 0.044). The models with these compounds explained 72% of the glycemia variability (βDMA = -6.47; βAsi = 6.68; βNi = 6.87). Ni showed a significantly influence on IL-6 variability (β = 0.85: R2 = 0.36). Changes in glycemia could be related to exposure to low levels of Asi and Ni, representing risk factors for metabolic diseases. Body mass index would confuse the relation between IL-6 and Ni levels, probably due to known chronic inflammation present in obese people.
| S-EPMC7913508 | biostudies-literature
Project description:BACKGROUND:Growing evidence shows that atopic dermatitis (AD), food allergy (FA), allergic rhinitis, and asthma are largely determined during the first 1000?days (time elapsed from conception to the 2nd birthday). The ARIES birth cohort aims to determine prenatal and perinatal conditions, as well as genetic and epigenetic factors, that participate in the early setting of immune responses, and the role of these in the later determination of the risk of allergic diseases and asthma in the offspring. METHODS:We have designed a birth cohort of 250 families with prenatal recruitment (~?14?weeks). We will genotype relevant allergy/asthma-associated variants in trios and will perform immunophenotyping and evaluation of allergy biomarkers in cord blood. At 1 and 2?years of age we will assess if infants have developed allergic sensitization, AD, FA, as well as biomarkers of asthma including the asthma predictive index. We will also evaluate how maternal conditions modify immune programming through epigenetic modifications and will then depict newborn epigenetic cues of allergy/asthma risk. Next, we will assess composition/diversity of maternal gut, placenta, breastmilk and infant gut microbiome and their association with immunophenotype and biomarkers at birth, and clinical outcomes at age 1 and 2. Finally, we plan to assess how environmental exposures (perinatal outdoor and indoor pollution, allergens and endotoxin) affect the incidence of allergic sensitization, AD, FA, and risk of asthma. DISCUSSION:The in-depth study of the ARIES birth cohort shall provide crucial information to understand the rising incidence of allergies and asthma in developing countries, and hopefully provide cues on how to prevent and treat these diseases. TRIAL REGISTRATION:clinicaltrials.gov NCT04186949, retrospectively registered on December 5, 2019.
| S-EPMC7158062 | biostudies-literature
Project description:ObjectiveAnemia of chronic disease (ACD) refers to hypoproliferative anemia in the context of acute or chronic activation of the immune system. There is a paucity of prospective data addressing the risk factors for ACD development. An association between common chronic diseases and ACD was examined cross-sectionally and longitudinally.MethodA cohort of 265,459 healthy participants without ACD at baseline were prospectively followed annually or biennially.ResultsDuring average follow-up period of 62 months, 4,906 participants developed ACD (incidence rate 3.58 per 1000 person-years). Multivariable-adjusted hazard ratio (HR) [95% confidence interval (CI)] for incident ACD comparing estimated glomerular filtration rate 30-60 and < 30 vs. ≥ 60 ml/min/1.73 m2 were 3.93 [3.18-4.85] and 39.11 [18.50-82.69]; HRs [95% CI] for ACD comparing prediabetes and diabetes vs. normal were 1.19 [1.12-1.27] and 2.46 [2.14-2.84], respectively. HRs [95% CI] for incident ACD comparing body-mass-index (BMI) of < 18.5, 23-24.9 and ≥ 25 vs. 18.5-22.9 kg/m2 were 0.89 [0.78-1.00], 0.89 [0.80-0.99] and 0.78 [0.66-0.91], respectively. HRs [95% CI] for incident ACD comparing prehypertension and hypertension vs. normal were 0.79 [0.73-0.86] and 1.10 [0.99-1.23], respectively. Metabolic syndrome, hypertension, chronic liver disease, and chronic obstructive pulmonary disease were not associated with incident ACD.ConclusionsThe severity of chronic kidney disease and diabetic status were independently associated with an increased incidence of ACD, whereas prehypertension and an increasing BMI were significantly associated with decreased risk of ACD.
| S-EPMC6502324 | biostudies-literature
Project description:Gallbladder cancer (GBC) is a highly fatal cancer that can be cured through cholecystectomy if identified early. The presence of gallstones is the primary risk factor for GBC, but few people with gallstones develop GBC. A key question is what drives the development of GBC among persons with gallstones. We initiated the Chile Biliary Longitudinal Study (Chile BiLS) to address this question. From 2016 to 2019, Chile BiLS enrolled 4,726 women aged 50-74 years with ultrasound-detected gallstones from southern-central Chile, accounting for an estimated 36% of eligible women with gallstones in the study area. The median age was 59 years; 25% of the women were Amerindian (Mapuche), 60% were obese, 25% had diabetes, and 6% had cardiovascular disease. Participants will be followed for gallbladder dysplasia or cancer for 6 years. As of April 30, 2020, over 91% of those eligible completed the year 2 follow-up visit. Data being collected include epidemiologic and sociodemographic information, anthropometric measurements, blood pressure, and tooth counts. Biosamples being taken include baseline plasma, buffy coat, red blood cells, serum, blood clot from serum, and PAXgene whole blood (PreAnalytiX GmbH, Hombrechtikon, Switzerland). Complete gallbladder sampling is conducted for most participants undergoing cholecystectomy. The Chile BiLS cohort study will increase our understanding of GBC etiology and could identify potential risk stratification and early detection strategies in high-risk areas.
| S-EPMC7850058 | biostudies-literature
Project description:ObjectivesTo assess the independent and joint associations of major chronic diseases and disease markers with cancer risk and to explore the benefit of physical activity in reducing the cancer risk associated with chronic diseases and disease markers.DesignProspective cohort study.SettingStandard medical screening program in Taiwan.Participants405 878 participants, for whom cardiovascular disease markers (blood pressure, total cholesterol, and heart rate), diabetes, chronic kidney disease markers (proteinuria and glomerular filtration rate), pulmonary disease, and gouty arthritis marker (uric acid) were measured or diagnosed according to standard methods, were followed for an average of 8.7 years.Main outcome measuresCancer incidence and cancer mortality.ResultsA statistically significantly increased risk of incident cancer was observed for the eight diseases and markers individually (except blood pressure and pulmonary disease), with adjusted hazard ratios ranging from 1.07 to 1.44. All eight diseases and markers were statistically significantly associated with risk of cancer death, with adjusted hazard ratios ranging from 1.12 to 1.70. Chronic disease risk scores summarizing the eight diseases and markers were positively associated with cancer risk in a dose-response manner, with the highest scores associated with a 2.21-fold (95% confidence interval 1.77-fold to 2.75-fold) and 4.00-fold (2.84-fold to 5.63-fold) higher cancer incidence and cancer mortality, respectively. High chronic disease risk scores were associated with substantial years of life lost, and the highest scores were associated with 13.3 years of life lost in men and 15.9 years of life lost in women. The population attributable fractions of cancer incidence or cancer mortality from the eight chronic diseases and markers together were comparable to those from five major lifestyle factors combined (cancer incidence: 20.5% v 24.8%; cancer mortality: 38.9% v 39.7%). Among physically active (versus inactive) participants, the increased cancer risk associated with chronic diseases and markers was attenuated by 48% for cancer incidence and 27% for cancer mortality.ConclusionsChronic disease is an overlooked risk factor for cancer, as important as five major lifestyle factors combined. In this study, chronic diseases contributed to more than one fifth of the risk for incident cancer and more than one third of the risk for cancer death. Physical activity is associated with a nearly 40% reduction in the cancer risk associated with chronic diseases.
| S-EPMC5791146 | biostudies-literature
Project description:Most training programs for self-management of chronic diseases in Korea currently involve face-to-face interactions primarily in a health care setting. Therefore, older Koreans living in the community continue to seek other training opportunities for the management of chronic diseases. This has led to the development of new training methods, such as mobile health (mHealth) care, which are valuable in community centers and homes.This feasibility study (1) developed an mHealth training protocol to empower community-dwelling elderly individuals to manage their chronic diseases; (2) examined the feasibility of delivering this mHealth training protocol to elderly individuals through mobile tablets and applications (apps); and (3) discussed the contextual and methodological challenges associated with the development of this protocol.The mHealth training protocol was developed based on the eHealth Enhanced Chronic Care Model and comprised of four phases. Phase 1 included standardized technology (mobile tablets) training using guidebooks, demonstrations, and guided practice. Phase 2 included provision of standardized information about disease management that was obtained from governmental and professional health care organizations. Phase 3 included provision of training on the use of high-quality mHealth apps that were selected based on individual diagnoses. Phase 4 included encouraging the patients to practice using self-selected mHealth apps based on their individual needs. Quantitative descriptive statistics and qualitative content analyses of user evaluations were used to assess the feasibility and user acceptance of this protocol.Of the 27 older adults included in this study, 25 completed all 4 weeks of the mHealth training. The attrition rate was 7% (2/27), and the reasons included time conflicts, emotional distress, and/or family discouragement. The men required little or no training for Phase 1, and in comparison with men, women seemed to depend more on the mHealth trainers in Phase 3. Gender, level of education, and previous experience of using smartphones were associated with the speed of learning, level of confidence, and overall competence.A tailored and personalized approach is required to develop mHealth training protocols for older adults. Self-management of chronic diseases via mHealth training requires careful consideration of the complex nature of human behavior, emotional responses, and familial influences. Therefore, integration of a theoretical, clinical, and technical approach is necessary for the successful development and implementation of an mHealth training program that targets older adults with chronic diseases in a community setting.
| S-EPMC6045790 | biostudies-other