Kristiansenladefoged9826
To explore the 10-year tolerability profile of GC use in patients with early RA.
Analysis of 10-year outcome from the early arthritis ESPOIR cohort. Patients were stratified in two groups, without or with GC treatment at least once during their follow-up. The primary outcome was a composite of deaths, cardiovascular diseases (CVD), severe infections and fractures. The weighted Cox time-dependent analysis model was used with inverse probability of treatment weighting (IPTW) propensity score method.
Among the 608 patients (480 women, mean age of 47.5 ± 12.1 years), 397 (65%) received low-dose GC (median 1.9 mg/day [IQR 0.6-4.2], mean cumulative prednisone dose 8468 mg ±8376, mean duration 44.6 months ± 40.1). In univariate analysis, over 95 total events (10 deaths, 18 CVDs, 32 fractures and 35 severe infections), patients taking GC experienced more events (n = 71) than those without GC (n = 24) (p= 0.035). Highest cumulative exposure of GC (≥8.4 g) was associated with highest risk of occurrence of the primary outcome (24.3%, p= 0.007), CVDs (7.9%, p= 0.001) and severe infections (9.9%, p= 0.024). The risk of events over time was significantly associated with GC, age, hypertension and erythrocyte sedimentation rate. The risk associated with GC treatment increased between the first follow-up visit (HR at 1 year = 0.46, 95% CI 0.23 - 0.90) and 10 years (HR = 6.83, 95% CI 2.29-20.35).
The 10-year analysis of this prospective early RA cohort supports a dose and time-dependent impact of low-dose GC treatment, with a long-term high risk of severe outcomes.
(NCT03666091).
(NCT03666091).Tail length and tail lesions are the major triggers for tail biting in pigs. Against this background, 2 datasets were analyzed to estimate genetic parameters for tail characteristics and growth traits. Dataset 1 considered measurements for trait tail length (T-LEN) and for the growth traits birth weight (BW), weaning weight (WW), postweaning weight (PWW), and average daily gain (ADG) from 9,348 piglets. Piglets were born in the period from 2015 to 2018 and kept on the university Gießen research station. Dataset 2 included 4,943 binary observations from 1,648 pigs from the birth years 2016 to 2019 for tail lesions (T-LES) as indicators for nail necrosis, tail abnormalities, or tail biting. T-LES were recorded at 30 ± 7 d after entry for rearing (T-Les-1), at 50 ± 7 d after entry for rearing (end of the rearing period, T-LES-2), and 130 ± 20 d after entry for rearing (end of fattening period, T-LES-3). Genetic statistical model evaluation for dataset 1 based on Akaike's information criterion and likelihood rati of 0.29) from the threshold model. The breeding value correlations between T-LES-3 with breeding values from the repeatability models were quite large (0.74 to 0.90), suggesting trait lesion recording at the end of the rearing period. To understand all genetic mechanisms in detail, ongoing studies are focusing on association analyses between T-LEN and T-LES, and the identification of tail biting from an actor's perspective.
US adolescent nicotine vaping increased at a record pace from 2017 to 2019, prompting new national policies to reduce access to flavors of vaping products preferred by youth.
To estimate prevalence, perceived harm, and accessibility of nicotine vaping products among US adolescents from 2017 to 2020.
This survey study includes data from Monitoring the Future, which conducted annual, cross-sectional, school-based, nationally representative surveys from 2017 to 2020 of 10th- and 12th-grade students (results pooled grades, n = 94 320) about vaping and other topics.
Prevalence of self-reported nicotine vaping; vaping brand and flavor used most often; perceived risk of nicotine vaping; and perceived ease of getting vaping devices, nicotine solutions for vaping, and flavored solutions.
In 2020, Monitoring the Future surveyed 8660 students in 10th and 12th grade, of whom 50.6% (95% CI, 47%-54%) were female, 13% (95% CI, 8%-21%) were non-Hispanic Black, 29% (95% CI, 21%-40%) were Hispanic, and 53% (95% CI, 4nicotine vaping increased from 2019 to 2020.
Increasing US adolescent nicotine vaping trends from 2017 to 2019 halted in 2020, including a decline in daily vaping. Decreases in perceived accessibility of some vaping products, as well as increases in perceived risk of nicotine vaping, occurred from 2019 to 2020. Yet, adolescent nicotine vaping remains highly prevalent, flavors remain highly accessible, and declines in JUUL use were countered by increased use of other brands.
Increasing US adolescent nicotine vaping trends from 2017 to 2019 halted in 2020, including a decline in daily vaping. Decreases in perceived accessibility of some vaping products, as well as increases in perceived risk of nicotine vaping, occurred from 2019 to 2020. Yet, adolescent nicotine vaping remains highly prevalent, flavors remain highly accessible, and declines in JUUL use were countered by increased use of other brands.HIV infection is associated with increased systemic microbial translocation, neuro-inflammation and occasionally neuronal injury. selleck products Whether systemic LPS penetrates into the brain and contributes to neuro-inflammation remain unknown in HIV. Here, we measured plasma and cerebrospinal fluid (CSF) LPS levels along with biomarkers of neuro-inflammation (white blood cell counts and 40 soluble markers) and neurofilament light chain (NfL). Notably, CSF LPS was undetectable in all samples, including three HIV-infected individuals with dementia. Increased plasma LPS, neuro-inflammation, and blood-brain barrier (BBB) dysfunction were found in untreated HIV-infected individuals, but not in healthy or treated HIV-infected individuals. Plasma LPS levels were directly correlated with various markers of inflammation in both plasma and CSF, as well as with degree of BBB permeability but not with CSF NfL in HIV-infected subjects. These results suggest that the magnitude of microbial translocation associates with neuro-inflammation and BBB permeability in HIV without direct penetration into the central nervous system (CNS).
An estimated 862 000 persons in the US are living with chronic infection with hepatitis B virus (HBV). Persons born in regions with a prevalence of HBV infection of 2% or greater, such as countries in Africa and Asia, the Pacific Islands, and parts of South America, often become infected at birth and account for up to 95% of newly reported chronic infections in the US. Other high-prevalence populations include persons who inject drugs; men who have sex with men; persons with HIV infection; and sex partners, needle-sharing contacts, and household contacts of persons with chronic HBV infection. Up to 60% of HBV-infected persons are unaware of their infection, and many remain asymptomatic until onset of cirrhosis or end-stage liver disease.
To update its 2014 recommendation, the USPSTF commissioned a review of new randomized clinical trials and cohort studies published from 2014 to August 2019 that evaluated the benefits and harms of screening and antiviral therapy for preventing intermediate outcomes or health outcomes and the association between improvements in intermediate outcomes and health outcomes. New key questions focused on the yield of alternative HBV screening strategies and the accuracy of tools to identify persons at increased risk.
This recommendation statement applies to asymptomatic, nonpregnant adolescents and adults at increased risk for HBV infection, including those who were vaccinated before being screened for HBV infection.
The USPSTF concludes with moderate certainty that screening for HBV infection in adolescents and adults at increased risk for infection has moderate net benefit.
The USPSTF recommends screening for HBV infection in adolescents and adults at increased risk for infection. (B recommendation).
The USPSTF recommends screening for HBV infection in adolescents and adults at increased risk for infection. (B recommendation).
A 2014 review for the US Preventive Services Task Force (USPSTF) found antiviral therapy for hepatitis B virus (HBV) infection associated with improved intermediate outcomes, although evidence on clinical outcomes was limited.
To update the 2014 HBV screening review in nonpregnant adolescents and adults to inform the USPSTF.
Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and Ovid MEDLINE (2014 to August 2019); with surveillance through July 24, 2020.
Randomized clinical trials (RCTs) on screening and antiviral therapy; cohort studies on screening, antiviral therapy clinical outcomes, and the association between achieving intermediate outcomes after antiviral therapy and clinical outcomes.
One investigator abstracted data; a second investigator checked accuracy. Two investigators independently assessed study quality. Random-effects profile likelihood meta-analysis was performed.
Thirty trials and 20 cohort studies, with a total of 94 168 participants, wieve intermediate outcomes. Based on 16 trials (n = 4809), antiviral therapy might be associated with improved clinical outcomes, but data were sparse and imprecise. Nine cohort studies (n = 3893) indicated an association between achieving an intermediate outcome following antiviral therapy and improved clinical outcomes but were heterogeneous (hazard ratios ranged from 0.07 to 0.87). Antiviral therapy was associated with higher risk of withdrawal due to adverse events vs placebo or no antiviral therapy.
There was no direct evidence for the clinical benefits and harms of HBV screening vs no screening. Antiviral therapy for HBV infection was associated with improved intermediate outcomes and may improve clinical outcomes.
There was no direct evidence for the clinical benefits and harms of HBV screening vs no screening. Antiviral therapy for HBV infection was associated with improved intermediate outcomes and may improve clinical outcomes.
It is uncertain whether depressive symptoms are independently associated with subsequent risk of cardiovascular diseases (CVDs).
To characterize the association between depressive symptoms and CVD incidence across the spectrum of lower mood.
A pooled analysis of individual-participant data from the Emerging Risk Factors Collaboration (ERFC; 162 036 participants; 21 cohorts; baseline surveys, 1960-2008; latest follow-up, March 2020) and the UK Biobank (401 219 participants; baseline surveys, 2006-2010; latest follow-up, March 2020). Eligible participants had information about self-reported depressive symptoms and no CVD history at baseline.
Depressive symptoms were recorded using validated instruments. ERFC scores were harmonized across studies to a scale representative of the Center for Epidemiological Studies Depression (CES-D) scale (range, 0-60; ≥16 indicates possible depressive disorder). The UK Biobank recorded the 2-item Patient Health Questionnaire 2 (PHQ-2; range, 0-6; ≥3 indicates possible de depressive disorder. However, the magnitude of associations was modest.
Vitreous hemorrhage from proliferative diabetic retinopathy can cause loss of vision. The best management approach is unknown.
To compare initial treatment with intravitreous aflibercept vs vitrectomy with panretinal photocoagulation for vitreous hemorrhage from proliferative diabetic retinopathy.
Randomized clinical trial at 39 DRCR Retina Network sites in the US and Canada including 205 adults with vison loss due to vitreous hemorrhage from proliferative diabetic retinopathy who were enrolled from November 2016 to December 2017. The final follow-up visit was completed in January 2020.
Random assignment of eyes (1 per participant) to aflibercept (100 participants) or vitrectomy with panretinal photocoagulation (105 participants). Participants whose eyes were assigned to aflibercept initially received 4 monthly injections. Both groups could receive aflibercept or vitrectomy during follow-up based on protocol criteria.
The primary outcome was mean visual acuity letter score (range, 0-100; higher scores indicate better vision) over 24 weeks (area under the curve); the study was powered to detect a difference of 8 letters.
