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Pubblicazioni recenti - cardiovascular
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[Seguridad del alta temprana en pacientes con histerectomía laparoscópica en una institución de alto nivel de complejidad en Bogotá, Colombia, 2013 - 2019. Cohorte histórica].
Rev Colomb Obstet Ginecol2021 Mar;72(1):24-32. doi: 10.18597/rcog.3589.
Guerrero-Machado Mónica, Pascuas Juan Sebastián, Miranda Ángel David, Castro-Cuenca Carlos Giovani, Rodríguez-Daza Henry Octavio,
Abstract
Objetivo: describir la seguridad del alta en las primeras 12 horas del posoperatorio en mujeres cometidas histerectomía por laparoscopia por patología benigna de útero. Materiales y métodos: estudio de cohorte histórica descriptiva. Se incluyeron todas las mujeres llevadas a histerectomía laparoscópica por patología benigna, quienes fueron dadas de alta después de 12 horas del procedimiento en un hospital de alta complejidad en Bogotá, Colombia, entre enero del 2013 y abril del 2019. Se excluyeron pacientes con comorbilidades (diabetes, enfermedad cardiovascular y pulmonar obstructiva crónica), limitaciones para la movilización y aquellas que presentaron complicaciones intraoperatorias. Se realizó un muestreo consecutivo. Se evaluaron variables demográficas, y como variables de seguridad, el reingreso por urgencias y complicaciones clasificadas según la escala de Dindo a los 15 días del postoperatorio. Se hace análisis descriptivo. Resultados: durante el período de estudio se realizaron 860 histerectomías por laparoscopia, de estas, 67 (7,8%) cumplieron con los criterios de selección. Once pacientes (16,4%) reingresaron por el servicio de urgencias, de las cuales, siete (63,6%) acudieron por dolor, una (9%) por sangrado activo, una (9%) por fiebre, y dos (18%) por síntomas urinarios. Se presentaron seis (8,9%) complicaciones postoperatorias de las cuales dos pacientes (2,9%) tuvieron hematoma de cúpula vaginal, dos (2,9%) hemoperitoneo, una (1,4%) infección urinaria y una (1,4%) lesión ureteral; cuatro pacientes (5,9%) requirieron hospitalización, estas últimas se clasificaron en el estadio IIIb de Dindo. Conclusiones: el alta temprana surge como alternativa al cuidado hospitalario para este tipo de población. Se requieren estudios con grupo control y asignación aleatoria para aportar mejor evidencia respecto a este manejo.
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Differential Effects of Various Androgens on Polycystic Ovary Syndrome.
Horm Metab Res2021 Apr;():. doi: 10.1055/a-1422-3243.
de Medeiros Sebastião Freitas, Barbosa Bruna Barcelo, de Medeiros Ana Karine Lin Winck Yamamoto, de Medeiros Matheus Antônio Souto, Yamamoto Márcia Marly Winck,
Abstract
The hyperandrogenism in polycystic ovary syndrome (PCOS) is associated with the risk for the future development of the cardiovascular disease. The objective of the study is to verify whether different androgens have the same harmful effect. This cross-sectional study enrolled 823 women with PCOS: 627 (76.2%) with biochemical hyperandrogenism and 196 (23.8%) with normal androgen levels. The role of individual androgen was evaluated using univariate and multivariate logistic regression. In normoandrogenemic PCOS (NA-PCOS), free androgen index (FAI) predicted significant abnormality in visceral adipose index (VAI, OR=9.2, p=0.002) and dehydroepiandrosterone (DHEA) predicted against alteration in ?-cell function (OR=0.5, p=0.007). In hyperandrogenemic PCOS (HA-PCOS), FAI predicted derangements in waist triglyceride index (WTI), VAI, and lipid accumulation product (LAP) (OR ranging from 1.6 to 5.8, p<0.05). DHEA weakly predicted against VAI (OR 0.7, p=0.018), dehydroepiandrosterone sulfate (DHEAS) tended to predict against the conicity index (OR=0.7, p=0.037). After multiple regression, FAI retained significant strength to predict various anthropometric and metabolic abnormalities (OR ranging from 1.1 to 3.0, p<0.01), DHEA was kept as a protector factor against WTI, LAP, and VAI (OR ranging from 0.6 to 0.9; p<0.01) and DHEAS against the conicity index (OR=0.5, p<0.001). In conclusion, the free androgen index was the most powerful predictor of anthropometric and metabolic abnormalities of polycystic ovary syndrome. Conversely, DHEA and DHEAS demonstrated protective effects against disorders in some markers of obesity and abnormal metabolism.
Thieme. All rights reserved.
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Fibrinolysis in Acute and Chronic Cardiovascular Disease.
Semin Thromb Hemost2021 Apr;():. doi: 10.1055/s-0040-1718923.
Kietsiriroje Noppadol, Ariëns Robert A S, Ajjan Ramzi A,
Abstract
The formation of an obstructive thrombus within an artery remains a major cause of mortality and morbidity worldwide. Despite effective inhibition of platelet function by modern antiplatelet therapies, these agents fail to fully eliminate atherothrombotic risk. This may well be related to extensive vascular disease, beyond the protective abilities of the treatment agents used. However, recent evidence suggests that residual vascular risk in those treated with modern antiplatelet therapies is related, at least in part, to impaired fibrin clot lysis. In this review, we attempt to shed more light on the role of hypofibrinolysis in predisposition to arterial vascular events. We provide a brief overview of the coagulation system followed by addressing the role of impaired fibrin clot lysis in acute and chronic vascular conditions, including coronary artery, cerebrovascular, and peripheral vascular disease. We also discuss the role of combined anticoagulant and antiplatelet therapies to reduce the risk of arterial thrombotic events, addressing both efficacy and safety of such an approach. We conclude that impaired fibrin clot lysis appears to contribute to residual thrombosis risk in individuals with arterial disease on antiplatelet therapy, and targeting proteins in the fibrinolytic system represents a viable strategy to improve outcome in this population. Future work is required to refine the antithrombotic approach by modulating pathological abnormalities in the fibrinolytic system and tailoring therapy according to the need of each individual.
Thieme. All rights reserved.
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EHRA expert consensus statement and practical guide on optimal implantation technique for conventional pacemakers and implantable cardioverter-defibrillators: endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), and the Latin-American Heart Rhythm Society (LAHRS).
Europace2021 Apr;():. doi: euaa367.
Burri Haran, Starck Christoph, Auricchio Angelo, Biffi Mauro, Burri Mafalda, D'Avila Andre Lahrs Representative, Deharo Jean-Claude, Glikson Michael, Israel Carsten, Lau Chu-Pak Aphrs Representative, Leclercq Christophe, Love Charles J Hrs Representative, Nielsen Jens Cosedis, Vernooy Kevin, , Dagres Nikolaos Review Coordinator, Boveda Serge Review Coordinator, Butter Christian, Marijon Eloi, Braunschweig Frieder, Mairesse Georges H, Gleva Marye, Defaye Pascal, Zanon Francesco, Lopez-Cabanillas Nestor, Guerra Jose M, Vassilikos Vassilios P, Martins Oliveira Mario,
Abstract
With the global increase in device implantations, there is a growing need to train physicians to implant pacemakers and implantable cardioverter-defibrillators. Although there are international recommendations for device indications and programming, there is no consensus to date regarding implantation technique. This document is founded on a systematic literature search and review, and on consensus from an international task force. It aims to fill the gap by setting standards for device implantation.
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.
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Validity of the 6-Minute Walk Test in Patients with End-Stage Lung Diseases Wearing an Oronasal Surgical Mask in Times of the COVID-19 Pandemic.
Respiration2021 Apr;():1-6. doi: 10.1159/000515606.
Just Isabell Anna, Schoenrath Felix, Passinger Philipp, Stein Julia, Kemper Dagmar, Knosalla Christoph, Falk Volkmar, Knierim Jan,
Abstract
BACKGROUND AND OBJECTIVES:
The 6-minute walk test (6MWT), as a clinical assessment tool for functional exercise capacity, is an integral component of lung allocation scores (LASs). In times of the coronavirus disease (COVID-19) pandemic, patients underwent 6MWTs wearing a surgical mask in ambulatory care. We investigated the impact of wearing a mask on 6-minute walk distances (6MWDs).
METHOD:
6MWDs of 64 patients with end-stage lung diseases wearing an oronasal surgical mask were retrospectively compared to previously investigated 6MWDs of the same cohort, in a pre-COVID-19 pandemic era, without wearing a mask. Four patients were excluded due to a primary vascular disease, 29 patients due to clinically unstable pulmonary functions, and 1 patient due to a psychiatric disorder.
RESULTS:
The median age of the patients included was 55 (46-58) years; 15 (48%) were male. Ten (32.2%) were on the Eurotransplant lung transplant waiting list with a median LAS of 34.3 (31.9-36.2). Twenty (64.5%) patients had chronic obstructive pulmonary diseases, 7 (22.6%) had interstitial lung diseases, and 4 (12.9%) had other end-stage lung diseases. The mean 6MWD without versus with wearing a mask was 306.9 (101.9) versus 305.7 (103.8) m, with a mean difference of -1.19 m (95% confidence interval -13.4 to 11.03). The observed difference is statistically equivalent to zero (p < 0.001). No significant differences in 6MWDs were observed between the clinical groups.
CONCLUSION:
Wearing an oronasal surgical mask did not affect the 6MWDs of patients with advanced lung diseases. Therefore, a masked 6MWT appears to provide a reliable examination of functional exercise capacity in this cohort.
© 2021 The Author(s) Published by S. Karger AG, Basel.
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Application of intravenous immunoglobulin (IVIG) to modulate inflammation in critical COVID-19 - A theoretical perspective.
Med Hypotheses2021 Apr;151():110592. doi: S0306-9877(21)00110-9.
Yaqinuddin Ahmed, Ambia Ayesha Rahman, Elgazzar Tasnim Atef, AlSaud Maha Bint Mishari, Kashir Junaid,
Abstract
COVID-19 is an airway disease that has affected ~125 million people worldwide, caused by a novel coronavirus termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), spread through respiratory droplets, direct contact, and aerosol transmission. Although most patients presenting with absent or mild symptoms recover completely, the highest morbidity and mortality rates are seen in the elderly, and patients with comorbidities such as cardiovascular diseases, cancer, immunosuppressive diseases, diabetes, and pre-existing respiratory illnesses. Several therapeutic strategies have been examined, but a wide-ranging therapeutic option for particularly severe cases of COVID-19 remains to be elucidated. Considering the indications presented by COVID-19 patients who present similarly with inflammatory conditions, intravenous immunoglobulin (IVIG) administration has been examined as a possible route to reduce proinflammatory markers such as ESR, CRP and ferritin by reducing inflammation, based on its anti-inflammatory effects as indicated by utilisation of IVIG for numerous other inflammatory conditions. Herein, summarising the recent key clinical evaluations of IVIG administration, we present our hypothesis that administration of IVIG within a specific dosage would be extremely beneficial towards reducing mortality and perhaps even the length of hospitalisation of patients exhibiting severe COVID-19 symptoms.
Copyright © 2021 Elsevier Ltd. All rights reserved.
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Association between long-term exposure to fine particulate matter and diabetic retinopathy among diabetic patients: A national cross-sectional study in China.
Environ Int2021 Apr;154():106568. doi: S0160-4120(21)00193-8.
Shan Anqi, Chen Xi, Yang Xueli, Yao Baoqun, Liang Fengchao, Yang Ze, Liu Fangchao, Chen Song, Yan Xiaochang, Huang Jianfeng, Bo Shaoye, Tang Nai-Jun, Gu Dongfeng, Yan Hua,
Abstract
BACKGROUND:
While the relationship between ambient air pollution and diabetes mellitus has recently been reported, data on the association between fine particulate matter (PM) and diabetic complications are limited, especially in microvascular diseases such as diabetic retinopathy.
OBJECTIVES:
To investigate the associations between long-term exposure to PM and the prevalence of diabetic retinopathy in adult diabetic patients in rural China.
METHODS:
The study population was based on the Rural Epidemiology for Glaucoma in China (REG-China), a national cross-sectional survey conducted in rural China. This analysis selected diabetic patients with or without diabetic retinopathy. A satellite-based spatiotemporal model was used to estimate personal PM exposure. Logistic regression models were used to investigate the effect of long-term PM exposure on diabetic retinopathy.
RESULTS:
The analysis included 3111 diabetic participants, 329 of whom were diagnosed with diabetic retinopathy. The median level of exposure to PM from 2000 to2016 was 59.9 ?g/m. For each 10 ?g/m increase in PM, the adjusted odds ratio (95% confidence interval) for diabetic retinopathy was 1.41 (1.27, 1.57). In subgroup analyses, the effect of PM on diabetic retinopathy was significantly stronger in participants who self-reported alcohol consumption.
CONCLUSION:
These findings suggest that long-term exposure to high PM was associated with the risk of diabetic retinopathy among diabetic patients in rural China.
Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.
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Perinatal determinants of neonatal hair glucocorticoid concentrations.
Psychoneuroendocrinology2021 Apr;128():105223. doi: S0306-4530(21)00097-4.
Stoye David Q, Sullivan Gemma, Galdi Paola, Kirschbaum Clemens, Lamb Gillian J, Black Gill S, Evans Margaret J, Boardman James P, Reynolds Rebecca M,
Abstract
Adult hair glucocorticoid concentrations reflect months of hypothalamic-pituitary-adrenal axis activity. However, little is known about the determinants of neonatal hair glucocorticoids. We tested associations between perinatal exposures and neonatal hair glucocorticoids. Cortisol and cortisone were measured by LC-MS/MS in paired maternal and infant hair samples collected within 10 days of birth (n = 49 term, n = 47 preterm), with neonatal samples collected at 6-weeks in n = 54 preterm infants. We demonstrate cortisol accumulation in hair increases with fetal maturity, with hair cortisol being higher in term than preterm born infants after delivery (median 401 vs 106 pg/mg; p < 0.001). In term born infants, neonatal hair cortisol is positively associated with maternal hair cortisol concentration (? = 0.240, p = 0.045) and negatively associated with birthweight z-score (? = -0.340, p = 0.006). Additionally, being born without maternal labour is associated with lower hair cortisol concentrations (? = -0.489, p < 0.001) and a lower ratio of cortisol to cortisone (? = -0.484, p = 0.001). In preterm infants, histological chorioamnionitis is associated with a higher cortisol to cortisone ratio in hair (? = 0.459, p = 0.001). In samples collected 6 weeks after preterm birth, hair cortisol concentration is associated with cortisol hair concentrations measured after birth (? = 0.523, p < 0.001), chorioamnionitis (? = 0.250, p = 0.049) and postnatal exposures including intravenous hydrocortisone therapy (? = 0.343, p < 0.007) and neonatal sepsis (? = 0.290, p = 0.017). In summary, neonatal hair cortisol is associated with birth gestation, maternal hair cortisol concentration and fetal growth. Additionally, exposures at delivery are important determinants of hair cortisol, and should be considered in the design of future research investigating how neonatal hair cortisol relates to prenatal exposures or fetal development.
Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Preventing sepsis; how can artificial intelligence inform the clinical decision-making process? A systematic review.
Int J Med Inform2021 Apr;150():104457. doi: S1386-5056(21)00083-6.
Hassan Nehal, Slight Robert, Weiand Daniel, Vellinga Akke, Morgan Graham, Aboushareb Fathy, Slight Sarah P,
Abstract
BACKGROUND AND OBJECTIVES:
Sepsis is a life-threatening condition that is associated with increased mortality. Artificial intelligence tools can inform clinical decision making by flagging patients at risk of developing infection and subsequent sepsis. This systematic review aims to identify the optimal set of predictors used to train machine learning algorithms to predict the likelihood of an infection and subsequent sepsis.
METHODS:
This systematic review was registered in PROSPERO database (CRD42020158685). We conducted a systematic literature review across 3 large databases: Medline, Cumulative Index of Nursing and Allied Health Literature, and Embase. Quantitative primary research studies that focused on sepsis prediction associated with bacterial infection in adults in all care settings were eligible for inclusion.
RESULTS:
Seventeen articles met our inclusion criteria. We identified 194 predictors that were used to train machine learning algorithms, with 13 predictors used on average across all included studies. The most prevalent predictors included age, gender, smoking, alcohol intake, heart rate, blood pressure, lactate level, cardiovascular disease, endocrine disease, cancer, chronic kidney disease (eGFR<60 mL/min), white blood cell count, liver dysfunction, surgical approach (open or minimally invasive), and pre-operative haematocrit < 30 %. All included studies used artificial intelligence techniques, with average sensitivity 75.7 ± 17.88, and average specificity 63.08 ± 22.01.
CONCLUSION:
The type of predictors influenced the predictive power and predictive timeframe of the developed machine learning algorithm. Predicting the likelihood of sepsis through artificial intelligence can help concentrate finite resources to those patients who are most at risk. Future studies should focus on developing more sensitive and specific algorithms.
Copyright © 2021 Elsevier B.V. All rights reserved.
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Rapid, ultrasensitive and non-enzyme electrochemiluminescence detection of hydrogen peroxide in food based on the ssDNA/g-CN nanosheets hybrid.
Food Chem2021 Apr;357():129753. doi: S0308-8146(21)00759-7.
Liu Zhijun, Wang Li, Liu Pengfei, Zhao Kairen, Ye Shuying, Liang Guoxi,
Abstract
Hydrogen peroxide (HO) is usually used as a fungicide in food, it is carcinogenic, accelerates aging or inducing toxic effects such as cardiovascular disease. Herein, to meet the demand for effective and fast detection of HO in food, a novel non-enzymatic electrochemiluminescence (ECL) sensor based on single-stranded DNA (ssDNA)/g-CN nanosheets (NS) was established. The ssDNA/g-CN NS hybrid was prepared by simple mixing g-CN NS and ssDNA solution together. The prepared ssDNA/g-CN NS exhibited improved peroxidase-like activity and was modified on a glassy carbon electrode to catalyze the ECL reaction of luminol-HO to amplify the luminescence signal. Under the optimized conditions, the proposed sensor exhibits high sensitivity with a limit of detection (LOD) as low as 33 aM HO, which is much lower than the vast majority of reported methods. This method enables the reliable responding to HO from the milk samples within 1 min.
Copyright © 2021 Elsevier Ltd. All rights reserved.
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Non-rigid image registration using a modified fuzzy feature-based inference system for 3D cardiac motion estimation.
Comput Methods Programs Biomed2021 Apr;205():106085. doi: S0169-2607(21)00160-7.
Hosseini Monire Sheikh, Moradi Mahammad Hassan, Tabassian Mahdi, D'hooge Jan,
Abstract
BACKGROUND AND OBJECTIVE:
Non-rigid image registration is a well-established method for estimating cardiac motion on 3D echocardiographic images. However, such images have relatively poor spatio-temporal resolution making registration challenging. Some of the main challenges are extracting features relevant to the registration problem and defining a suitable geometrical transformation to be applied. The latter can be tackled using a fuzzy inference system considering its potential in transformation modeling. From this point of view, feature-based image registration can be considered an identification problem in which the transformation parameters are computed through an optimization process. This study, thus, aims to estimate cardiac motion on 3D echocardiographic images based on feature-based non-rigid image registration through sets of modified fuzzy rules.
METHODS:
The 3D volume features were extracted with the popular scale-invariant feature transform (SIFT) descriptors in 3D space. Sets of fuzzy rules were generated according to the extracted features to register every two consecutive frames. Finally, some supplementary rules modified the registration rule for estimating cardiac motion.
RESULTS:
Applying the fuzzy feature-based inference system on the STRAUS synthetic database showed the proposed method to be competitive with other well-established registration algorithms in terms of tracking error and accuracy of strain estimates. The proposed algorithm yielded a tracking error of 1 mm and a relative circumferential strain error of 0.82±4.69%. In addition, the potential of the proposed algorithm for clinical applications was confirmed by evaluating its performance on an in-vivo database called CETUS.
CONCLUSION:
This paper proposes a novel registration method based on fuzzy logic which was shown to enable tracking complex cardiac deformations in 3D echocardiographic images with high accuracy.
Copyright © 2021 Elsevier B.V. All rights reserved.
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Polyphenols: Natural compounds with promising potential in treating polycystic ovary syndrome.
Reprod Biol2021 Apr;21(2):100500. doi: S1642-431X(21)00021-8.
Mihanfar Aynaz, Nouri Mohammad, Roshangar Leila, Khadem-Ansari Mohammad Hassan,
Abstract
Polyphenols are natural compounds used by plants as a defense system against various stresses. In recent years, the importance of these polyhydroxyphenols has extensively increased due to their potent cardioprotection, anti-carcinogenic, anti-oxidant, anti-apoptotic, and anti-inflammatory properties. Therefore, various studies have reported promising results from the studies investigating their efficacy as a therapeutic strategy in various disorders such as human malignancies, cardiovascular diseases, nervous system impairments, diabetes, metabolic syndrome, aging, and inflammation-associated disorders, as well as a polycystic ovarian syndrome (PCOS). Since oxidative stress, hormonal, metabolic, and endocrine disturbances have been shown to play a crucial role in the initiation/progression of PCOS, polyphenols are suggested to be an effective treatment for this disorder. Therefore, this study aimed to discuss the therapeutic potential of multiple polyphenols in PCOS.
Copyright © 2021. Published by Elsevier B.V.
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Association of Adenoma Detection Rate and Adenoma Characteristics with Colorectal Cancer Mortality after screening colonoscopy.
Clin Gastroenterol Hepatol2021 Apr;():. doi: S1542-3565(21)00457-2.
Waldmann Elisabeth A, Kammerlander Andreas A, Gessl Irina, Penz Daniela, Majcher Barbara, Hinterberger Anna, Bretthauer Michael, Trauner Michael H, Ferlitsch Monika,
Abstract
BACKGROUND & AIMS:
The adenoma detection rate (ADR) and characteristics of previously resected adenomas are associated with colorectal cancer (CRC) incidence and mortality. However, the combined effect of both factors on CRC mortality is unknown.
PATIENTS AND METHODS:
Using data of the Austrian quality assurance program for screening colonoscopy, we evaluated the combined effect of ADR and lesion characteristics on subsequent risk for CRC mortality. We analyzed mortality rates for individuals with low risk adenomas (1-2 adenomas <10 mm), individuals with high risk adenomas (advanced adenomas or ?3 adenomas), and after negative colonoscopy (negative colonoscopy or small hyperplastic polyps) performed by endoscopists with an ADR <25% compared with ?25%. Cox-regression was used to determine the association of combined risk groups with CRC mortality, adjusted for age and sex.
RESULTS:
We evaluated 259,885 colonoscopies performed by 361 endoscopists. A total of 165 CRC related deaths occurred during the follow-up period, up to 12.2 years. In all risk groups, CRC mortality was higher when colonoscopy was performed by an endoscopist with an ADR < 25%. Compared to negative colonoscopy with an ADR ?25%, CRC mortality was similar for individuals with low risk adenomas irrespective of ADR (adj. HR 1.22, 95% CI 0.59-2.49 for ADR ?25%, and adj. HR 1.25, 95%CI 0.64-2.43 for ADR <25%) and after negative colonoscopy with ADR < 25% (adj. HR 1.27, 95%CI 0.81-2.00). Individuals with high risk adenomas were at significantly higher risk for CRC death if colonoscopy was performed by an endoscopist with an ADR <25% (adj. HR 2.25, 95% CI 1.18-4.31), but not if performed by an endoscopist with an ADR ?25% (adj. HR 1.35, 95% CI 0.61-3.02).
CONCLUSIONS:
Our study adds important evidence for mandatory assessment and monitoring of performance quality in screening colonoscopy. High quality colonoscopy was associated with a lower risk for CRC death, and the impact of ADR was strongest for individuals with high risk adenomas.
Copyright © 2021 AGA Institute. Published by Elsevier Inc. All rights reserved.
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Taking the heavy load off Arrhythmogenic Right Ventricular Cardiomyopathy: Editorial comment on the paper by Kalantarian et al in Heart Rhythm.
Heart Rhythm2021 Apr;():. doi: S1547-5271(21)00348-9.
Fabritz Larissa, Patten Monica, Kirchhof Paulus,
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Adverse associations of sedentary behavior with cancer incidence and all-cause mortality: A prospective cohort study: Sedentary behavior, cancer and mortality.
J Sport Health Sci2021 Apr;():. doi: S2095-2546(21)00046-6.
Lin Yuan, Liu Qiong, Liu Fangchao, Huang Keyong, Li Jianxin, Yang Xueli, Wang Xinyan, Chen Jichun, Liu Xiaoqing, Cao Jie, Shen Chong, Yu Ling, Lu Fanghong, Wu Xianping, Zhao Liancheng, Li Ying, Hu Dongsheng, Lu Xiangfeng, Huang Jianfeng, Gu Dongfeng,
Abstract
BACKGROUND:
Inconsistent results have been reported in developed countries for relationships between sedentary behavior and cancer incidence and mortality, but evidence from the Chinese population is scarce. This study aimed to investigate such relationships in large Chinese population-based prospective cohorts and to explore the joint effect and interaction of sedentary behavior and moderate-to-vigorous physical activity (MVPA) on these relationships.
METHODS:
We included 95,319 Chinese adults without cancer from 3 large cohorts and assessed their sedentary behavior and physical activity with a unified questionnaire. Cancer incidence and mortality were confirmed by interviewing participants or their proxies and checking hospital records and death certificates. Hazard ratios (HRs) and 95% confidence intervals (95%CIs) for cancer and mortality were estimated using Cox proportional hazards regression models.
RESULTS:
During 559,002 person-years of follow-up, 2388 cancer events, 1571 cancer deaths, and 4562 all-cause deaths were recorded. Sedentary behavior was associated with increased risk of developing cancer and deaths in a dose-response manner. The multivariable-adjusted HRs (95%CIs) were: HR?=?1.16, 95%CI: 1.01?1.33; HR?=?1.24, 95%CI: 1.04?1.48; and HR?=?1.15, 95%CI: 1.04?1.28 for cancer incidence, cancer mortality, and all-cause mortality, respectively, for those having ?10 h/day of sedentary time compared to those having <6 h/day of sedentary time. Sedentary populations (?10 h/day) developed cancer or died 4.09 and 2.79 years earlier, respectively, at the index age of 50 years. Failure to achieve the recommended level of MVPA may further aggravate the adverse associations, with the highest cancer and mortality risks being observed among participants with both ?10 h/day of sedentary time and <150 min/week of MVPA. Limitations of this study include the fact that physical activity information was obtained via questionnaire instead of objective measurement and that there were insufficient incident cases for the analysis of associations between sedentary behavior and site-specific cancers.
CONCLUSION:
Sedentary behavior was associated with an increased risk of cancer and all-cause mortality among Chinese adults, especially for those with ?10 h/day of sedentary time. It is necessary to reduce sedentary time, in addition to increasing MVPA levels, for the prevention of cancer and premature death.
Copyright © 2021. Production and hosting by Elsevier B.V.
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Commentary: Donor-recipient size mismatch in heart transplantation: an independent risk factor for worse outcomes or a marker for cofounders?
Semin Thorac Cardiovasc Surg -
Commentary: Fontan conversion: the good news and bad news.
Semin Thorac Cardiovasc Surg2021 Apr;():. doi: S1043-0679(21)00171-4.
Burkhart Harold M, Henry Emilie D, Schwartz Randall M,
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Commentary: Less may be More: Once You Get to Transplant.
Semin Thorac Cardiovasc Surg -
Commentary: A wild goose chase. Meeting esophagectomy numbers for board certification.
Semin Thorac Cardiovasc Surg -
Prorenin periconceptionally and in pregnancy: Does it have a physiological role?
Mol Cell Endocrinol2021 Apr;():111281. doi: S0303-7207(21)00125-8.
Wiegel Rosalieke E, von Versen-Höynck Frauke, Steegers-Theunissen Régine P M, Steegers Eric A P, Danser A H Jan,
Abstract
Pregnancy demands major cardiovascular, renal and endocrine changes to provide an adequate blood supply for the growing fetus. The renin-angiotensin-aldosterone system plays a key role in this adaptation process. One of its components, prorenin, is released in significant amounts from the ovary and uteroplacental unit. This review describes the sources of prorenin in the periconception period and in pregnancy, including its modulation by in-vitro fertilization protocols, and discusses its potential effects, among others focusing on preeclampsia. It ends with discussing the long-term consequences, even in later life, of inappropriate renin-angiotensin-aldosterone system activity in pregnancy and offers directions for future research. Ultimately, a full understanding of the role of prorenin periconceptionally and during pregnancy will help to develop tools to diagnose and/or prevent reproductive complications.
Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.
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