Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 605
Filtrar
Mais filtros

Tipo de documento
Intervalo de ano de publicação
1.
Eur Heart J ; 45(20): 1819-1827, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38606837

RESUMO

BACKGROUND AND AIMS: Female sex has been linked with higher risk of ischaemic stroke (IS) in atrial fibrillation (AF), but no prior study has examined temporal trends in the IS risk associated with female sex. METHODS: The registry-linkage Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) study included all patients with AF in Finland from 2007 to 2018. Ischaemic stroke rates and rate ratios were computed. RESULTS: Overall, 229 565 patients with new-onset AF were identified (50.0% women; mean age 72.7 years). The crude IS incidence was higher in women than in men across the entire study period (21.1 vs. 14.9 events per 1000 patient-years, P < .001), and the incidence decreased both in men and women. In 2007-08, female sex was independently associated with a 20%-30% higher IS rate in the adjusted analyses, but this association attenuated and became statistically non-significant by the end of the observation period. Similar trends were observed when time with and without oral anticoagulant (OAC) treatment was analysed, as well as when only time without OAC use was considered. The decrease in IS rate was driven by patients with high IS risk, whereas in patients with low or moderate IS risk, female sex was not associated with a higher IS rate. CONCLUSIONS: The association between female sex and IS rate has decreased and become non-significant over the course of the study period from 2007 to 2018, suggesting that female sex could be omitted as a factor when estimating expected IS rates and the need for OAC therapy in patients with AF.


Assuntos
Anticoagulantes , Fibrilação Atrial , AVC Isquêmico , Sistema de Registros , Humanos , Fibrilação Atrial/complicações , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/tratamento farmacológico , Feminino , Idoso , AVC Isquêmico/epidemiologia , AVC Isquêmico/prevenção & controle , AVC Isquêmico/etiologia , Finlândia/epidemiologia , Masculino , Anticoagulantes/uso terapêutico , Incidência , Fatores Sexuais , Fatores de Risco , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade
2.
Ecol Lett ; 27(5): e14430, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38714364

RESUMO

Wintering birds serve as vital climate sentinels, yet they are often overlooked in studies of avian diversity change. Here, we provide a continental-scale characterization of change in multifaceted wintering avifauna and examine the effects of climate change on these dynamics. We reveal a strong functional reorganization of wintering bird communities marked by a north-south gradient in functional diversity change, along with a superimposed mild east-west gradient in trait composition change. Assemblages in the northern United States saw contractions of the functional space and increases in functional evenness and originality, while the southern United States saw smaller contractions of the functional space and stasis in evenness and originality. Shifts in functional diversity were underlined by significant reshuffling in trait composition, particularly pronounced in the western and northern United States. Finally, we find strong contributions of climate change to this functional reorganization, underscoring the importance of wintering birds in tracking climate change impacts on biodiversity.


Assuntos
Biodiversidade , Aves , Mudança Climática , Estações do Ano , Animais , Aves/fisiologia , Estados Unidos
3.
BMC Med ; 22(1): 264, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38915094

RESUMO

BACKGROUND: Ureteral cancer is a rare cancer. This study aimed to provide an up-to-date and comprehensive analysis on the global trends of ureteral cancer incidence and its association with lifestyle and metabolic risk factors. METHODS: The incidence of ureteral cancer was estimated from the Cancer Incidence in Five Continents Plus and Global Cancer Observatory databases. We analyzed the (1) global incidence of ureteral cancer by region, country, sex, and age group by age-standardized rates (ASR); (2) associated risk factors on a population level by univariable linear regression with logarithm transformation; and (3) incidence trend of ureteral cancer by sex and age group in different countries by Average Annual Percentage Change (AAPC). RESULTS: The global age-standardized rate of ureteral cancer incidence in 2022 was 22.3 per 10,000,000 people. Regions with higher human development index (HDI), such as Europe, Northern America, and East Asia, were found to have a higher incidence of ureteral cancer. Higher HDI and gross domestic product (GDP) and a higher prevalence of smoking, alcohol drinking, physical inactivity, unhealthy dietary, obesity, hypertension, diabetes, and lipid disorder were associated with higher incidence of ureteral cancer. An overall increasing trend of ureteral cancer incidence was observed for the past decade, especially among the female population. CONCLUSIONS: Although ureteral cancer was relatively rare, the number of cases reported was rising over the world. The rising trends among females were more evident compared with the other subgroups, especially in European countries. Further studies could be conducted to examine the reasons behind these epidemiological changes and confirm the relationship with the risk factors identified.


Assuntos
Sistema de Registros , Neoplasias Ureterais , Humanos , Fatores de Risco , Feminino , Masculino , Incidência , Pessoa de Meia-Idade , Idoso , Neoplasias Ureterais/epidemiologia , Adulto , Saúde Global , Adulto Jovem , Adolescente , Idoso de 80 Anos ou mais , Carga Global da Doença/tendências
4.
Rheumatology (Oxford) ; 63(9): 2442-2449, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-38656941

RESUMO

OBJECTIVE: Excess mortality has been demonstrated in patients with SLE compared with the general population. We aimed to investigate the 5-year and 10-year all-cause mortality in patients with SLE compared with the general population in recent decades. METHODS: This was a Danish nationwide population-based exposure-matched cohort study. Incident cases of SLE diagnosed between 1996 and 2015 were identified using administrative health registries and followed until 2020, allowing for 5 and 10 years of follow-up. Patients with SLE were matched 1:5 on age and sex with individuals from the Danish general population. Time-to-event analyses were performed using the pseudo-observation approach. RESULTS: In total, 1351 incident cases of SLE and 6755 matched controls were identified. The crude risk difference (RD) for 5-year mortality decreased over the study period, from 10.3% (95% CI 6.5-14.1%) to 4.6% (95% CI 1.4-7.8%) for patients with SLE compared with controls. The relative risk (RR) for 5-year mortality decreased similarly in the same period. Adjustment for comorbidities revealed lower RD and RR for mortality in patients with SLE compared with controls, but the decreasing trend remained. The crude and adjusted RD and RR for 10-year mortality did not change over the calendar period. The 10-year RR was highest in young patients with SLE (<50 years of age). CONCLUSION: The 5-year mortality risk decreased over time for both patients with SLE and matched controls. However, excess 5-year mortality for patients with SLE in the most recent calendar period and excess mortality late in their disease course remained. Continued focus on preventing disease progression and comorbidity is required.


Assuntos
Lúpus Eritematoso Sistêmico , Humanos , Lúpus Eritematoso Sistêmico/mortalidade , Dinamarca/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Estudos de Coortes , Sistema de Registros , Idoso , Estudos de Casos e Controles , Causas de Morte/tendências , Comorbidade , Mortalidade/tendências , Adulto Jovem
5.
Glob Chang Biol ; 30(8): e17485, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39187993

RESUMO

Lianas profoundly affect tropical forests dynamics, reducing productivity and carbon storage, which underscores the importance of monitoring change in their abundance in projecting the future of the global terrestrial carbon store. While increasing liana populations are documented within the Neotropics, the global consistency of these patterns is questioned, and remains to be determined. To evaluate pantropical trends in liana abundance comprehensively and quantitatively, we conducted a systematic literature review and meta-analysis. This approach allowed us to synthesize data from published longitudinal studies examining liana trends across the tropics. We calculated standardized effect sizes and standard errors, and applied a Bayesian hierarchical meta-analytic model to adjust for publication bias. Our analysis reveals an overall pan-tropical increase in lianas abundance, occurring at an average rate of 1.7 ± 0.7 SE% per year (~10% to 24% per decade). This upward trend, confirmed to be robust against publication bias, extends beyond Neotropical regions, indicating a widespread phenomenon. Although a global trend of increasing liana abundance is evident, significant local variation exist, attributable to differences in life cycle stages, abundance metrics, forest successional stages, and biogeographical realms. Notably, increases in stem density of saplings and biomass of canopy lianas, especially in old-growth forests, point to global climatic drivers and heightened turnover rates in tropical forests as factors promoting sustained liana growth in the canopy and clonal colonization in the understory. These trends suggest that the rise in liana abundance may not only persist but could also intensify under climate change. Considering both previous and current research on lianas, our findings confirm growing concerns about lianas' expanding impact on pan-tropical carbon storage, highlighting their significant potential effect on global carbon dynamics.


Assuntos
Florestas , Clima Tropical , Teorema de Bayes , Biodiversidade , Biomassa , Mudança Climática , Árvores/crescimento & desenvolvimento
6.
Eur J Clin Invest ; 54(1): e14107, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37823410

RESUMO

AIMS: To investigate sex-specific temporal trends in the initiation of oral anticoagulant (OAC) therapy among patients diagnosed with atrial fibrillation (AF) in Finland between 2007 and 2018. METHODS: The registry-linkage Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) Study included all patients with incident AF in Finland from 2007 to 2018. The primary outcome was the initiation of any OAC therapy. RESULTS: We identified 229,565 patients with new-onset AF (50.0% women; mean age 72.7 years). The initiation of OAC therapy increased continuously during the observation period. While women were more likely to receive OAC therapy overall, after adjusting for age, stroke risk factors and other confounding factors, female sex was associated with a marginally lower initiation of OACs (unadjusted and adjusted hazard ratios comparing women to men: 1.08 (1.07-1.10) and 0.97 (0.96-0.98), respectively). Importantly, the gender disparities in OAC use attenuated and reached parity by the end of the observation period. Furthermore, when only patients eligible for OAC therapy according to the contemporary guidelines were included in the analyses, the gender inequalities in OAC initiation appeared minimal. Implementation of direct OACs for stroke prevention was slightly slower among women. CONCLUSION: This nationwide retrospective cohort study covering all patients with incident AF in Finland from 2007 to 2018 observed that although female sex was initially associated with a lower initiation of OAC therapy, the sex-related disparities resolved over the course of the study period.


Assuntos
Fibrilação Atrial , Acidente Vascular Cerebral , Masculino , Humanos , Feminino , Idoso , Anticoagulantes/uso terapêutico , Fibrilação Atrial/complicações , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/prevenção & controle , Acidente Vascular Cerebral/complicações , Administração Oral
7.
Psychol Med ; 54(4): 663-674, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37605881

RESUMO

BACKGROUND: Common mental disorders (CMDs) including depression, anxiety, and stress are very common, but it is unclear whether the last decades of social, economic, and political change have impacted incidence of CMD. This study explored temporal trends in the recorded incidence of CMD in the United Kingdom. METHODS: We used data from general practices in the United Kingdom (Clinical Practice Research Datalink) to estimate the annual recorded incidence of CMD for 2000-2020, including symptoms, diagnosis, or pharmaceutical treatment. Trends were explored by sex, age, ethnicity, region, deprivation, and comorbidity. RESULTS: We included 29 480 164 individuals who were followed up for 12.5 years on average (s.d. = 6.4 years). The recorded incidence of CMD episodes was 55.9 per 1000 person-years in 2000 [95% confidence interval (CI) 55.8-56.1], increasing to 79.6 per 1000 person-years in 2019 (95% CI 79.5-79.8). Females had higher recorded incidence rates, as did those living in more deprived areas. We observed striking patterns by age over time, with rates in ages 16-24 increasing from 40.2 per 1000 in 2000 (95% CI 39.8-40.5), to 107.8 per 1000 in 2019 (95% CI 107.0-108.6). In contrast, the rates in those aged ≥55 years decreased since 2014. There were differing patterns of incidence by ethnic group, with a steeper increase in Asian, Black, and mixed groups in recent years. CONCLUSIONS: Overall, the incidence of recorded CMD in the UK general practice increased between 2000 and 2019 with a small decrease in 2020. The overall trends obscured important differences across population subgroups, which may have implications for prevention.


Assuntos
Transtornos Mentais , Feminino , Humanos , Estudos de Coortes , Incidência , Reino Unido/epidemiologia , Transtornos Mentais/epidemiologia , Atenção Primária à Saúde
8.
Am J Obstet Gynecol ; 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38460833

RESUMO

OBJECTIVE: This study aimed to assess global trends in mean birthweights at term, as reported in peer-reviewed literature. DATA SOURCES: We electronically searched PubMed, Embase, and Web of Science up to September 2023, using combinations of the search terms: "birth weight"; "birth-weight"; "birthweight"; "trend". There were no restrictions based on language or geographic area. STUDY ELIGIBILITY CRITERIA: We included all ecological and observational studies reporting mean birthweight at term as a continuous numerical variable over time. METHODS: We assessed the quality of included studies using the Dufault and Klar checklist modified by Betran et al. Univariate and multivariate linear models were used to examine the effects of time (years) and geographical origins. Subgroup analyses focused on national data sources and on data collected from 1950 onward. RESULTS: Among 6447 reviewed articles, 29 met our criteria, reporting mean birthweight data from over 183 million infants worldwide. Most studies were hospital-based (48.3%), 44.8% used national data, and a minority used municipality, community, or regional data (6.9%). Geographically, North America (31.0%) had the highest representation, followed by Asia and Europe (27.6% each), and South America and Oceania (6.9% each). Our univariate linear regression model (Model 1) revealed a significant increase in mean birthweight at term over time (4.74 g/y; 95% confidence interval, 3.95-5.53; P<.001). Model 2, incorporating continental dummy variables into the first model, confirmed this trend (3.85 g/y; 95% confidence interval, 2.96-4.74; P<.001). Model 3, focusing on available national data, did not find a significant relationship. Model 4 narrowed its focus on records from 1950 onward, reporting a robust annual increase of 7.26 g/y (95% confidence interval, 6.19-8.33; P<.001). Model 5, adjusting for the number of participants included in each study, reported a conclusive mean term birthweight increase of 1.46 g/y (95% confidence interval, 0.74-2.18; P<.001). CONCLUSION: This systematic review of 29 studies shows an increase in term birthweights over time, particularly when considering data since 1950. Limitations include study quality variations, data source diversity, and data sparsity, underscoring the need for future research to use precise gestational age distinctions and predetermined time frames to gain a deeper understanding of this trend and its implications for maternal and child health.

9.
Br J Nutr ; 131(9): 1633-1640, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38225928

RESUMO

Carbonated soft-drink consumption is detrimental to multiple facets of adolescent health. However, little is known about temporal trends in carbonated soft-drink consumption among adolescents, particularly in non-Western countries. Therefore, we aimed to examine this trend in representative samples of school-going adolescents from eighteen countries in Africa, Asia and the Americas. Cross-sectional data from the Global School-based Student Health Survey 2009-2017 were analysed. Carbonated soft-drink consumption referred to drinking carbonated soft-drinks at least once per day in the past 30 d. The prevalence of carbonated soft-drink consumption was calculated for each survey, and crude linear trends were assessed by linear regression models. Data on 74 055 students aged 12-15 years were analysed (mean age 13·9 (sd 1·0) years; 49·2 % boys). The overall mean prevalence of carbonated soft-drink consumption was 42·1 %. Of the eighteen countries included in the study, significant decreasing, increasing and stable trends of carbonated soft-drink consumption were observed in seven, two and nine countries, respectively. The most drastic decrease was observed in Kuwait between 2011 (74·4 %) and 2015 (51·7 %). Even in countries with significant decreasing trends, the decrease was rather modest, while some countries with stable trends had very high prevalence across time (e.g. Suriname 80·5 % in 2009 and 79·4 % in 2016). The prevalence of carbonated soft-drink consumption was high in all countries included in the present analysis, despite decreasing trends being observed in some. Public health initiatives to reduce the consumption of carbonated soft-drink consumption among adolescents are urgently required.


Assuntos
Bebidas Gaseificadas , Humanos , Bebidas Gaseificadas/estatística & dados numéricos , Adolescente , Feminino , Masculino , Estudos Transversais , África/epidemiologia , Criança , Ásia/epidemiologia , América/epidemiologia , Prevalência , Estudantes/estatística & dados numéricos
10.
Environ Sci Technol ; 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38335968

RESUMO

Young children may experience higher per- and polyfluoroalkyl substances (PFAS) exposure than adults due to breastfeeding, higher dust ingestion rates, and frequent hand-to-mouth activities. We explored temporal trends and determinants of child serum PFAS concentrations and their correlations with paired maternal PFAS concentrations. From 2009 to 2017, we collected one blood sample from each of 541 children aged 2-5 years participating in the Childhood Autism Risks from Genetics and Environment (CHARGE) study and quantified 14 PFAS in serum. For nine frequently detected PFAS (>65% of samples), we performed multiple regression adjusting for potential determinants to estimate mean percent concentration changes. For a subset of 327 children, we also quantified nine PFAS in their mother's serum collected at the same visit and computed Spearman correlation coefficients (rsp) between maternal and child PFAS concentrations. During 2009-2017, child serum concentrations of all nine PFAS decreased by 6-25% annually. Several PFAS concentrations were higher among non-Hispanic white children and those with highly educated parents. Most maternal and child PFAS concentrations were moderately correlated (rsp = 0.13-0.39), with a strong correlation for N-methyl perfluorooctane sulfonamido acetic acid (rsp = 0.68). Breastfeeding duration appeared to contribute to higher child and lower maternal PFAS concentrations, resulting in relatively weak correlations between maternal and child PFAS concentrations for samples collected in early childhood. Considering that more than half of our study children had neurodevelopmental concerns, the generalizability of our findings might be limited.

11.
BMC Infect Dis ; 24(1): 46, 2024 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-38177991

RESUMO

BACKGROUND: Uganda has a high incidence and prevalence of tuberculosis (TB). Analysis of spatial and temporal distribution of TB is an important tool for supporting spatial decision-making, planning, and policy formulations; however, this information is not readily available in Uganda. We determined the spatial distribution and temporal trends of tuberculosis notifications in Uganda, 2013-2022. METHODS: We conducted a retrospective analysis of routinely-generated program data reported through the National TB and Leprosy Programme (NTLP) surveillance system. We abstracted data on all TB cases diagnosed from 2013 to 2022 by district and region. We drew choropleth maps for Uganda showing the TB case notification rates (CNR) per 100,000 and calculated the CNR using the cases per district as the numerator and individual district populations as the denominators. Population estimates were obtained from the 2014 National Population and Housing Census, and a national growth rate of 3% was used to estimate the annual population increase. RESULTS: Over the entire study period, 568,957 cases of TB were reported in Uganda. There was a 6% annual increase in TB CNR reported from 2013 (134/100,000) to 2022 (213/100,000) (p-value for trend p < 0.00001). Cases were reported from all 12 Ministry of Health regions during the entire period. The distribution of CNR was heterogeneous throughout the country and over time. Moroto, Napak and Kampala districts had consistently high CNR throughout the ten years. Kalangala district had lower CNR from 2013 to 2018 but high CNR from 2019 to 2022. Moroto region, in the northeast, had consistently high CNR while Mbale and Soroti regions in Eastern Uganda had the lowest CNR throughout the ten years. CONCLUSION: There was an overall increasing trend in TB CNR from 2013 to 2022. We recommend that the National TB program institutes intensified measures aided by more funding to mitigate and reverse the negative impacts of the COVID-19 pandemic on TB.


Assuntos
Hanseníase , Tuberculose , Humanos , Estudos Retrospectivos , Uganda/epidemiologia , Pandemias , Tuberculose/epidemiologia , Tuberculose/diagnóstico , Hanseníase/epidemiologia
12.
Int J Equity Health ; 23(1): 178, 2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-39227932

RESUMO

BACKGROUND: Lower extremity amputations (LEAs) significantly contribute to mortality and morbidity, often resulting from peripheral artery disease and diabetes mellitus (DM). Traumatic injuries also account for many LEAs. Despite the global burden, the epidemiology of LEAs, particularly in the Middle East and North Africa (MENA) region, remains underexplored. This study utilizes the Global Burden of Disease (GBD) dataset to analyze temporal trends in LEAs in the MENA region from 1990 to 2019. METHODS: The study utilized the 2019 GBD dataset, which includes estimates for incidence, prevalence, and disability-adjusted life-years (DALYs) across 369 diseases. Age-standardized incidence rates (ASIRs) for LEAs were extracted for 21 MENA countries. Trends were analyzed using percentage change calculations and Joinpoint regression to identify significant shifts in LEA rates over time. RESULTS: From 1990 to 2019, male LEA rates generally decreased, while female rates increased. Significant increases in LEA rates were observed in Syria, Yemen, and Afghanistan, correlating with periods of conflict and instability. Conversely, countries like Iraq, Palestine, Sudan, Lebanon, Iran, and Kuwait saw marked decreases. The study highlighted a complex interplay of socio-political factors, natural disasters, and chronic diseases like DM in shaping LEA trends across the region. CONCLUSION: The study reveals variable LEA trends in the MENA region, influenced by conflicts, natural disasters, and chronic diseases. These findings underscore the need for targeted public health interventions, improved healthcare access, and robust data collection systems to reduce the burden of LEAs and improve patient outcomes in the MENA region.


Assuntos
Amputação Cirúrgica , Carga Global da Doença , Extremidade Inferior , Humanos , Oriente Médio/epidemiologia , África do Norte/epidemiologia , Amputação Cirúrgica/estatística & dados numéricos , Amputação Cirúrgica/tendências , Masculino , Feminino , Extremidade Inferior/cirurgia , Carga Global da Doença/tendências , Prevalência , Incidência , Pessoa de Meia-Idade , Anos de Vida Ajustados por Deficiência/tendências , Adulto
13.
Anal Bioanal Chem ; 416(13): 3205-3222, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38580889

RESUMO

Routine analysis of inorganic analytes in whole water samples from rivers (unfiltered river water) is rarely reported in scientific publications. However, this sample type is valuable and often used in long-term monitoring, regulation, and catchment element budgets, as it includes the dissolved, colloidal, and particulate fraction in one sample type. Preservation measures are not needed and solid-liquid partitioning can be disregarded, which simplifies automated sampling and storage procedures. In this study, we provide several digestion protocols for whole water samples from rivers and the subsequent multi-element analysis of 67 major, minor, and trace elements: Li, Be, B, Na, Mg, Al, Si, P, S, K, Ca, Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Ga, Ge, As, Se, Br, Rb, Sr, Y, Zr, Nb, Mo, Ru, Ag, Cd, In, Sn, Sb, Te, Cs, Ba, La, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, Yb, Lu, Hf, Ta, W, Ir, Pt, Au, Hg, Tl, Pb, Bi, Th, U. In the absence of whole water reference materials for inorganic analytes, we introduce simulated whole water samples by suspending sediment reference materials as quality control measures. The applicability for improved routine water quality monitoring was successfully tested on samples from different rivers revealing variations of the element fingerprints over time.

14.
Pediatr Nephrol ; 39(6): 1917-1925, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38108933

RESUMO

BACKGROUND: We aimed to examine temporal changes in the annual rate of acute kidney injury (AKI) in Danish children and associated changes in patient characteristics including potential underlying risk factors. METHODS: In this population-based cohort study, we used plasma creatinine measurements from Danish laboratory databases to identify AKI episodes in children aged 0-17 years from 2007 to 2021. For each child, the first AKI episode per calendar year was included. We estimated the annual crude and sex- and age-standardized AKI rate as the number of children with an AKI episode divided by the total number of children as reported by census numbers. Using Danish medical databases, we assessed patient characteristics including potential risk factors for AKI, such as use of nephrotoxic medication, surgery, sepsis, and perinatal factors. RESULTS: In total, 14,200 children contributed with 16,345 AKI episodes over 15 years. The mean annual AKI rate was 148 (95% CI: 141-155) per 100,000 children. From 2007 to 2021, the annual AKI rate demonstrated minor year-to-year variability without any discernible overall trend. The highest AKI rate was recorded in 2007 at 174 (95% CI: 161-187) per 100,000 children, while the lowest rate occurred in 2012 at 129 (95% CI: 118-140) per 100,000 children. In 2021, the AKI rate was 148 (95% CI: 141-155) per 100,000 children. Characteristics of children with AKI were similar throughout the study period. CONCLUSION: The rate of AKI among Danish children was stable from 2007 to 2021 with little variation in patient characteristics over time.


Assuntos
Injúria Renal Aguda , Sepse , Criança , Humanos , Estudos de Coortes , Injúria Renal Aguda/etiologia , Fatores de Risco , Sepse/complicações , Dinamarca , Estudos Retrospectivos
15.
Pharmacoepidemiol Drug Saf ; 33(6): e5816, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38773801

RESUMO

BACKGROUND: Antisecretory drugs are commonly prescribed with clopidogrel-based dual antiplatelet therapy (DAPT) to prevent gastrointestinal bleeding in high-risk patients after percutaneous coronary intervention (PCI). However, omeprazole and esomeprazole (inhibiting proton pump inhibitors [PPIs]) may increase cardiovascular event rates on co-administration with clopidogrel. This study aimed to examine trends in the use of antisecretory agents in patients administered clopidogrel-based DAPT and the concomitant use of clopidogrel and inhibiting PPIs. METHODS: We used National Inpatient Sample data compiled by the Health Insurance Review & Assessment Service from 2009 to 2020. Further, we identified patients who were prescribed clopidogrel-based DAPT after PCI and investigated the concomitant use of antisecretory agents with clopidogrel. To verify the annual trend of drug utilization, we used the Cochran-Armitage trend test. RESULTS: From 2009 to 2020, the percentage of H2 receptor antagonist users decreased steadily (from 82.5% in 2009 to 25.3% in 2020); instead, the percentage of PPI users increased (from 23.7% in 2009 to 82.0% in 2020). The use of inhibiting PPI also increased (from 4.2% in 2009 to 30.7% in 2020). Potassium competitive acid blockers (P-CABs) were rarely used before 2019; however, in 2020, it accounted for 7.8% of the antisecretory users. CONCLUSIONS: Our study demonstrates that the use of inhibiting PPIs increased steadily in patients administered clopidogrel-based DAPT therapy. This is a major concern since the concomitant use of inhibiting PPIs with clopidogrel could increase the risk of cardiovascular events.


Assuntos
Clopidogrel , Hemorragia Gastrointestinal , Intervenção Coronária Percutânea , Inibidores da Agregação Plaquetária , Inibidores da Bomba de Prótons , Humanos , Clopidogrel/administração & dosagem , Clopidogrel/uso terapêutico , Clopidogrel/efeitos adversos , Intervenção Coronária Percutânea/efeitos adversos , Inibidores da Agregação Plaquetária/administração & dosagem , Inibidores da Agregação Plaquetária/uso terapêutico , Inibidores da Agregação Plaquetária/efeitos adversos , Inibidores da Bomba de Prótons/administração & dosagem , Inibidores da Bomba de Prótons/uso terapêutico , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Hemorragia Gastrointestinal/induzido quimicamente , Hemorragia Gastrointestinal/epidemiologia , Hemorragia Gastrointestinal/prevenção & controle , Terapia Antiplaquetária Dupla/métodos , Esomeprazol/administração & dosagem , Esomeprazol/uso terapêutico , Omeprazol/administração & dosagem , Omeprazol/uso terapêutico , Omeprazol/efeitos adversos , Interações Medicamentosas , Quimioterapia Combinada , Antagonistas dos Receptores H2 da Histamina/administração & dosagem , Antagonistas dos Receptores H2 da Histamina/uso terapêutico
16.
Environ Res ; 259: 119432, 2024 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-38944104

RESUMO

The Mediterranean Basin has experienced substantial land use changes as traditional agriculture decreased and population migrated from rural to urban areas, which have resulted in a large forest cover increase. The combination of Landsat time series, providing spectral information, with lidar, offering three-dimensional insights, has emerged as a viable option for the large-scale cartography of forest structural attributes across large time spans. Here we develop and test a comprehensive framework to map forest above ground biomass, canopy cover and forest height in two regions spanning the most representative biomes in the peninsular Spain, Mediterranean (Madrid region) and temperate (Basque Country). As reference, we used lidar-based direct estimates of stand height and forest canopy cover. The reference biomass and volume were predicted from lidar metrics. Landsat time series predictors included annual temporal profiles of band reflectance and vegetation indices for the 1985-2023 period. Additional predictor variables including synthetic aperture radar, disturbance history, topography and forest type were also evaluated to optimize forest structural attributes retrieval. The estimates were independently validated at two temporal scales, i) the year of model calibration and ii) the year of the second lidar survey. The final models used as predictor variables only Landsat based metrics and topographic information, as the available SAR time-series were relatively short (1991-2011) and disturbance information did not decrease the estimation error. Model accuracies were higher in the Mediterranean forests when compared to the temperate forests (R2 = 0.6-0.8 vs. 0.4-0.5). Between the first (1985-1989) and the last (2020-2023) decades of the monitoring period the average forest cover increased from 21 ± 2% to 32 ± 1%, mean height increased from 6.6 ± 0.43 m to 7.9 ± 0.18 m and the mean biomass from 31.9 ± 3.6 t ha-1 to 50.4 ± 1 t ha-1 for the Mediterranean forests. In temperate forests, the average canopy cover increased from 55 ± 4% to 59 ± 3%, mean height increased from 15.8 ± 0.77 m to 17.3 ± 0.21m, while the growing stock volume increased from 137.8 ± 8.2 to 151.5 ± 3.8 m3 ha-1. Our results suggest that multispectral data can be successfully linked with lidar to provide continuous information on forest height, cover, and biomass trends.


Assuntos
Biomassa , Monitoramento Ambiental , Florestas , Espanha , Monitoramento Ambiental/métodos , Tecnologia de Sensoriamento Remoto , Árvores/crescimento & desenvolvimento
17.
Environ Res ; 261: 119705, 2024 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-39084505

RESUMO

Long-term biomonitoring of urinary metal ions is an essential tool for the epidemiological assessment of chronic exposure levels, enabling us to track changes in metal exposure over time and better understand its health implications. In this study, we evaluated the temporal trends of urinary metal ions among 1962 residents of Guangzhou, China, from 2018 to 2022. The total metal ion concentrations in the urine of the population did not change significantly between 2018 and 2019. With the onset of the COVID-19 pandemic in 2020, urinary total metal ion concentrations began to decline dramatically, reaching their lowest level in 2021. A rebound in concentrations was observed in 2022, which returned to the initial levels observed in 2018. Urine chromium and cadmium concentrations peaked in 2020, while urinary lead levels were the highest in 2021, and urinary nickel concentrations were the highest in 2022. Males consistently displayed higher urinary concentrations of lead and arsenic throughout each year of the study. Furthermore, minors consistently had higher urinary nickel levels than adults, whereas adults consistently had higher urinary cadmium concentrations than minors. Cluster analyses were conducted annually on urinary metal ions to examine the differences in their distribution and to evaluate changes in metal exposure patterns over time. The Monte Carlo simulations indicate that the whole population exhibits a high non-carcinogenic risk from arsenic exposure and significant carcinogenic risks associated with exposure to nickel, arsenic, chromium, and cadmium. The next two years were predicted by a gray prediction model, and the results are tested using mean absolute percentage error which demonstrating high accuracy.

18.
Environ Res ; 262(Pt 1): 119777, 2024 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-39155039

RESUMO

Perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA) are persistent contaminants detected in human blood worldwide, raising significant health concerns. In response, countries such as the United States and Australia have implemented regulatory measures to limit their use. This study analysed temporal trends in serum concentrations of these four PFAS and how these trends align with regulatory measures, using data from NHANES (2003-2004 to 2017-2018) and the Australian Human Biomonitoring Program (2002-2003 to 2020-2021). Multiple regression analyses adjusted for age and gender were performed to estimate mean concentration changes over time, and differences within each dataset were assessed. Results indicated significant reductions (p < 0.001) in PFOS, PFOA, and PFHxS concentrations post-2002-2003, while PFNA concentrations increased until 2009-2010 before declining in both Australia and the U.S. Age-related trends in the U.S. during the last monitoring period showed higher PFAS concentrations in the oldest age groups, while in Australia, this trend was evident for PFOS and PFHxS. In Australia, the age group of 0-5 years had PFOA and PFNA concentrations similar to those of adults over 46 years, indicating ongoing exposure. Gender differences were consistent in both programs, with females aged 6-15, 31-45, and 46-60 years exhibiting lower serum concentrations, particularly in the 31-45 years age group. These findings support Australian and U.S. efforts to reduce PFAS exposure through regulatory actions, highlight the need to address ongoing exposure in young children, and consider gender-specific factors affecting PFAS concentrations.

19.
Artif Organs ; 2024 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-39105561

RESUMO

BACKGROUND: Temporal trends of routinely obtained parameters may provide valuable information for predicting BSIs, but this association has not yet been established in LVAD patients. METHODS: This retrospective analysis included data from 347 consecutive recipients of three rotary LVAD types. Study endpoints included the incidence of BSI, the association of temporal trends of routinely obtained blood biomarkers with the development of BSIs, the incidence of BSIs, and survival on LVAD support. RESULTS: During follow-up, 47.8% (n = 166) of the patients developed BSI. In multivariate analyses, the development of BSI was a significant predictor of mortality (HR 5.78, 95% CI 4.08-8.19, p < 0.0001). In univariate analyses, after adjusting for potential confounders, albumin (SHR 0.94, 95% CI 0.91-0.97, p < 0.00010), creatinine (SHR 1.49, 95% CI 1.03-2.15, p = 0.033), and C-reactive protein (SHR 1.19, 95% CI 1.08-1.32, p = 0.0007) significantly predicted the development of BSIs during LVAD support. Notably, the strength of the association of parameter changes with the prediction of BSIs demonstrated a time-dependent correlation in the cases of albumin (p = 0.045) and creatinine (p = 0.003). CONCLUSION: Bloodstream infections are highly prevalent among LVAD recipients and are independent predictors of mortality. Temporal biomarker trends significantly predict the development of BSIs. These findings suggest opportunities for interventions aiming to reduce the incidence of BSIs.

20.
Scand J Med Sci Sports ; 34(6): e14669, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39031563

RESUMO

OBJECTIVES: The aim of this study was to analyze the temporal trends in cardiorespiratory fitness (CRF) and body mass index (BMI) among children and adolescents from 1985 to 2019. METHODS: A total of 1 840 212 children and adolescents aged 7-18 years (921 223 boys) were tested for CRF from 1985 to 2019. CRF was tested by 50-m × 8 shuttle run for boys and girls aged 7-12 years, 1000-m run for boys aged 13-18 years, and 800-m run for girls aged 13-18 years. Trends in BMI from 2000 to 2019 were also investigated. RESULTS: Cardiorespiratory fitness decreased during the entire 34 years among children and adolescents in all sex and age categories, and the most rapid decline occurred from 1995 to 2005. Some positive trends in CRF were observed among adolescents aged 13-15 years from 2005 to 2019 and among girls aged 16-18 years from 2014 to 2019. The variation in the CRF distribution was not uniform, with Z-scores for participants with high CRF levels changing little or increasing (CRF stabilized or improved) and Z-scores for participants with low CRF levels continuing to decrease (CRF decreased). BMI increased over time for boys and girls in all age categories, with an acceleration of the increase for adolescents in recent years. CONCLUSIONS: This study revealed that the overall CRF levels of Chinese children and adolescents decreased over three decades but stabilized or improved in recent years. BMI continued to increase. Our findings are important for the focus on future domestic physical fitness and public health.


Assuntos
Índice de Massa Corporal , Aptidão Cardiorrespiratória , Humanos , Adolescente , Feminino , Masculino , Criança , China , Teste de Esforço , População do Leste Asiático
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA