-
Current Obesity Reports Sep 2022The purpose of this review is to provide an update on the available data regarding the associations of Ultra-processed food (UPF) consumption with food intake and... (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to provide an update on the available data regarding the associations of Ultra-processed food (UPF) consumption with food intake and possible underlying mechanisms relating UPF consumption to weight gain and co-morbidities.
RECENT FINDINGS
In primarily observational studies, UPF consumption is consistently associated with an increased risk for weight gain among adults and children and increased risk for adiposity-related co-morbidities in adults. In a single mechanistic study, consumption of UPFs led to increased energy intake and weight gain relative to whole foods. UPFs tend to be more energy-dense than nutrient-dense, and UPF consumption is associated with increased adiposity and co-morbidity risk. These data suggest that recommendations to limit UPF consumption may be beneficial to health - though further mechanistic studies are needed.
Topics: Adult; Child; Diet; Fast Foods; Food Handling; Humans; Morbidity; Obesity; Weight Gain
PubMed: 34677812
DOI: 10.1007/s13679-021-00460-y -
Current Rheumatology Reports Jan 2022The epidemiology of antiphospholipid syndrome (APS) is poorly understood. Here, we review the current understanding of the epidemiology of antiphospholipid syndrome in... (Review)
Review
PURPOSE OF REVIEW
The epidemiology of antiphospholipid syndrome (APS) is poorly understood. Here, we review the current understanding of the epidemiology of antiphospholipid syndrome in the general population and the frequency of antiphospholipid antibodies in the general population in patients with obstetric morbidity, arterial events, and venous thromboembolism.
RECENT FINDINGS
There have been few population-based studies that estimated the prevalence and incidence of APS. The estimated incidence and prevalence among most these studies ranged between 1 and 2 cases per 100,000 and 40 and 50 cases per 100,000 respectively. The prevalence of antiphospholipid antibodies in patients with obstetric morbidity was 6-9%, while in arterial events and venous thromboembolism is 9-10%. However, this data remains limited. Mortality of patients with APS is 50-80% higher than the general population. The epidemiology of APS has been difficult to elucidate. Population-based studies patients with diverse age, racial, and ethnic backgrounds are needed.
Topics: Antibodies, Antiphospholipid; Antiphospholipid Syndrome; Female; Humans; Incidence; Pregnancy; Prevalence
PubMed: 34985614
DOI: 10.1007/s11926-021-01038-2 -
Seminars in Vascular Surgery Mar 2021End-stage kidney disease (ESKD) is a common and morbid disease that affects patients' quality and length of life, representing a large portion of health care expenditure... (Review)
Review
End-stage kidney disease (ESKD) is a common and morbid disease that affects patients' quality and length of life, representing a large portion of health care expenditure in the United States. These patients commonly have associated diabetes and cardiovascular disease, with high rates of cardiovascular-related death. Management of ESKD requires renal replacement therapy via dialysis or transplantation. While transplantation provides the greatest improvement in survival and quality of life, the vast majority of patients are treated initially with hemodialysis. However, outcomes differ significantly among patient populations. Barriers in access to care have particularly affected at-risk populations, such as Black and Hispanic patients. These patients receive less pre-ESKD nephrology care, are less likely to initiate dialysis with a fistula, and wait longer for transplants-even in pediatric populations. Priorities for ESKD care moving into the future include increasing access to nephrology care in underprivileged populations, providing patient-centered care based on each patient's "life plan," and focusing on team-based approaches to ESKD care. This review explores ESKD from the perspective of epidemiology, costs, vascular access, patient-reported outcomes, racial disparities, and the impact of the COVID-19 crisis.
Topics: COVID-19; Comorbidity; Global Health; Humans; Kidney Failure, Chronic; Morbidity; Pandemics; Renal Dialysis
PubMed: 33757639
DOI: 10.1053/j.semvascsurg.2021.02.010 -
Circulation Sep 2016Epidemiological evidence is accumulating that indicates greater time spent in sedentary behavior is associated with all-cause and cardiovascular morbidity and mortality... (Review)
Review
Epidemiological evidence is accumulating that indicates greater time spent in sedentary behavior is associated with all-cause and cardiovascular morbidity and mortality in adults such that some countries have disseminated broad guidelines that recommend minimizing sedentary behaviors. Research examining the possible deleterious consequences of excess sedentary behavior is rapidly evolving, with the epidemiology-based literature ahead of potential biological mechanisms that might explain the observed associations. This American Heart Association science advisory reviews the current evidence on sedentary behavior in terms of assessment methods, population prevalence, determinants, associations with cardiovascular disease incidence and mortality, potential underlying mechanisms, and interventions. Recommendations for future research on this emerging cardiovascular health topic are included. Further evidence is required to better inform public health interventions and future quantitative guidelines on sedentary behavior and cardiovascular health outcomes.
Topics: American Heart Association; Cardiovascular Diseases; Humans; Morbidity; Motor Activity; Prevalence; Risk Factors; Sedentary Behavior; United States
PubMed: 27528691
DOI: 10.1161/CIR.0000000000000440 -
Sante Publique (Vandoeuvre-les-Nancy,... 2022Introduction : Maternal morbidity is a public health problem in developing countries.Purpose of research : The aim of this study was to determine the...
Introduction : Maternal morbidity is a public health problem in developing countries.Purpose of research : The aim of this study was to determine the prevalence of maternal morbidity among women of reproductive age in the province of Essaouira (Morocco) and to describe the factors associated with it. The authors conducted a cross-sectional structured interview survey of 1300 married women aged 18 to 49. Data entry and statistical processing were performed by the SPSS-PC 18 program.Results : The prevalence of maternal morbidity was 66.8%. The main morbidities were sexually transmitted infections (48.8%) and anemia (46.6%). Multivariate analysis showed that frequency of postnatal visits, literacy of the couple and socioeconomic level were statistically associated with maternal morbidity.Conclusion : The use of postnatal care, the fight against illiteracy and the improvement of the socio-economic level of households, are factors that would reduce maternal morbidity.
Topics: Female; Pregnancy; Humans; Morocco; Cross-Sectional Studies; Morbidity; Prevalence; Sexually Transmitted Diseases; Socioeconomic Factors
PubMed: 36577684
DOI: 10.3917/spub.224.0581 -
Health Technology Assessment... Jun 2015It is uncertain which simple measures of childhood obesity are best for predicting future obesity-related health problems and the persistence of obesity into adolescence... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
It is uncertain which simple measures of childhood obesity are best for predicting future obesity-related health problems and the persistence of obesity into adolescence and adulthood.
OBJECTIVES
To investigate the ability of simple measures, such as body mass index (BMI), to predict the persistence of obesity from childhood into adulthood and to predict obesity-related adult morbidities. To investigate how accurately simple measures diagnose obesity in children, and how acceptable these measures are to children, carers and health professionals.
DATA SOURCES
Multiple sources including MEDLINE, EMBASE and The Cochrane Library were searched from 2008 to 2013.
METHODS
Systematic reviews and a meta-analysis were carried out of large cohort studies on the association between childhood obesity and adult obesity; the association between childhood obesity and obesity-related morbidities in adulthood; and the diagnostic accuracy of simple childhood obesity measures. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and a modified version of the Quality in Prognosis Studies (QUIPS) tool. A systematic review and an elicitation exercise were conducted on the acceptability of the simple measures.
RESULTS
Thirty-seven studies (22 cohorts) were included in the review of prediction of adult morbidities. Twenty-three studies (16 cohorts) were included in the tracking review. All studies included BMI. There were very few studies of other measures. There was a strong positive association between high childhood BMI and adult obesity [odds ratio 5.21, 95% confidence interval (CI) 4.50 to 6.02]. A positive association was found between high childhood BMI and adult coronary heart disease, diabetes and a range of cancers, but not stroke or breast cancer. The predictive accuracy of childhood BMI to predict any adult morbidity was very low, with most morbidities occurring in adults who were of healthy weight in childhood. Predictive accuracy of childhood obesity was moderate for predicting adult obesity, with a sensitivity of 30% and a specificity of 98%. Persistence of obesity from adolescence to adulthood was high. Thirty-four studies were included in the diagnostic accuracy review. Most of the studies used the least reliable reference standard (dual-energy X-ray absorptiometry); only 24% of studies were of high quality. The sensitivity of BMI for diagnosing obesity and overweight varied considerably; specificity was less variable. Pooled sensitivity of BMI was 74% (95% CI 64.2% to 81.8%) and pooled specificity was 95% (95% CI 92.2% to 96.4%). The acceptability to children and their carers of BMI or other common simple measures was generally good.
LIMITATIONS
Little evidence was available regarding childhood measures other than BMI. No individual-level analysis could be performed.
CONCLUSIONS
Childhood BMI is not a good predictor of adult obesity or adult disease; the majority of obese adults were not obese as children and most obesity-related adult morbidity occurs in adults who had a healthy childhood weight. However, obesity (as measured using BMI) was found to persist from childhood to adulthood, with most obese adolescents also being obese in adulthood. BMI was found to be reasonably good for diagnosing obesity during childhood. There is no convincing evidence suggesting that any simple measure is better than BMI for diagnosing obesity in childhood or predicting adult obesity and morbidity. Further research on obesity measures other than BMI is needed to determine which is the best tool for diagnosing childhood obesity, and new cohort studies are needed to investigate the impact of contemporary childhood obesity on adult obesity and obesity-related morbidities.
STUDY REGISTRATION
This study is registered as PROSPERO CRD42013005711.
FUNDING
The National Institute for Health Research Health Technology Assessment programme.
Topics: Adolescent; Adult; Body Mass Index; Child; Child, Preschool; Female; Forecasting; Humans; Infant; Male; Middle Aged; Morbidity; Pediatric Obesity; Young Adult
PubMed: 26108433
DOI: 10.3310/hta19430 -
Archives of Cardiovascular Diseases Oct 2021Heart failure remains a health challenge in Africa, associated with significant rates of hospitalization, morbidity and mortality. The current review aims to summarize... (Review)
Review
Heart failure remains a health challenge in Africa, associated with significant rates of hospitalization, morbidity and mortality. The current review aims to summarize the most recent data on the epidemiology, aetiology, risk factors and management of heart failure, comparing countries in North Africa and sub-Saharan Africa. There is a paucity of data on heart failure epidemiology, aetiology and management, and on the sociodemographic characteristics of African patients with heart failure. Heart failure prevalence has been evaluated among all medical admissions or admissions to cardiac units or emergency departments in a few hospital-based studies conducted in countries in North Africa and sub-Saharan Africa. Common causes of heart failure in Africa include ischaemic heart disease, hypertensive heart disease, dilated cardiomyopathy and valvular heart disease. The aetiology of heart failure differs between countries in North Africa and sub-Saharan Africa. Diagnosing heart failure proves challenging in Africa because of a lack of basic tools and the necessary human resources. The principal drugs used frequently for heart failure therapy are lacking in sub-Saharan Africa. The clinical profile of heart failure in sub-Saharan Africa differs from that in North African countries; this is related to aetiological factors, socioeconomic status and availability of diagnostic tools. There is an evident need to establish a large multicentre registry to evaluate the heart failure burden in almost all African countries, and to highlight the major cardiovascular risk factors and co-morbidities. The present review highlights the importance of this syndrome in Africa, and calls for improvements in its early diagnosis, treatment and, possibly, prevention.
Topics: Heart Failure; Humans; Hypertension; Morbidity; Myocardial Ischemia; Prevalence
PubMed: 34563468
DOI: 10.1016/j.acvd.2021.07.001 -
BJOG : An International Journal of... Feb 2022To apply the iceberg model, quantifying absolute and relative incidence, to the four main causes of maternal morbidity and mortality in Ireland: haemorrhage,...
OBJECTIVE
To apply the iceberg model, quantifying absolute and relative incidence, to the four main causes of maternal morbidity and mortality in Ireland: haemorrhage, hypertension, sepsis and thrombosis.
DESIGN
Secondary analysis of national data on maternal morbidity and mortality.
SETTING
Republic of Ireland.
POPULATION OR SAMPLE
Approximately 715 000 maternities, 1 200 000 maternal hospitalisations, 2138 cases of severe maternal morbidity (SMM) and 54 maternal deaths.
METHODS
Incidence rates and case-fatality ratios were calculated.
MAIN OUTCOME MEASURES
Maternal death, SMM and hospitalisation.
RESULTS
At the 'tip of the iceberg', the incidence of maternal death per 10 000 maternities was 0.09 (95% CI 0.03-0.20) due to thrombosis and 0.03 (95% CI 0-0.11) due to haemorrhage, hypertension disorders or sepsis. For one death due to thrombosis there were 35 cases of pulmonary embolism and 257 thrombosis hospitalisations. For one death due to eclampsia, there were 58 eclampsia cases, 13 040 hospitalisations with pre-existing hypertension and 40 781 hospitalisations with gestational hypertension. For one death due to pregnancy-related sepsis, there were 92 cases of septicaemic shock and 9005 hospitalisations with obstetric sepsis. For one maternal death due to haemorrhage, there were 1029 cases of major obstetric haemorrhage and 53 715 maternal hospitalisations with haemorrhage. For every 100 maternities, there were approximately 16 hospitalisations associated with haemorrhage, 12 associated with hypertension disorders, three with sepsis and 0.2 with thrombosis.
CONCLUSIONS
Haemorrhage and hypertension disorders are leading causes of maternal morbidity in Ireland but they have very low case fatality. This indicates that these morbidities are managed effectively but their prevention requires more focus.
TWEETABLE ABSTRACT
Study shows that haemorrhage and hypertension are main causes of #maternalmorbidity in Ireland. Timely interventions for #maternalhealth and focus on prevention of severe and non-severe morbidities are needed. @NPEC #maternityservices #clinicalaudit #qualityimprovement.
Topics: Adult; Female; Hospitalization; Humans; Incidence; Ireland; Maternal Death; Maternal Mortality; Morbidity; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications; Sepsis; Thrombosis
PubMed: 34455672
DOI: 10.1111/1471-0528.16880 -
Obstetrics and Gynecology Clinics of... Sep 2020Post-traumatic stress disorder (PTSD) accompanies miscarriage, intrauterine fetal demise, and preterm birth. Levels of PTSD may be higher for women who experience acute,... (Review)
Review
Post-traumatic stress disorder (PTSD) accompanies miscarriage, intrauterine fetal demise, and preterm birth. Levels of PTSD may be higher for women who experience acute, life-threatening events during labor and delivery. Severe maternal morbidities or near misses for maternal death disproportionately impact African American, Hispanic, American Indian, and women in rural communities. Expanding research demonstrates association between severe maternal morbidity or near-miss events and PTSD. Multiple preceding conditions and intrapartum and postpartum events place women at higher risk for PTSD. Postpartum evaluation provides an opportunity for PTSD screening. Untreated perinatal PTSD impacts long-term maternal and child health and contributes to health disparities.
Topics: Abortion, Spontaneous; Adult; Delivery, Obstetric; Ethnicity; Female; Fetal Death; Healthcare Disparities; Humans; Labor, Obstetric; Maternal Mortality; Morbidity; Parturition; Postpartum Period; Pregnancy; Pregnancy Complications; Premature Birth; Prevalence; Rural Population; Stress Disorders, Post-Traumatic
PubMed: 32762930
DOI: 10.1016/j.ogc.2020.04.004 -
The Canadian Journal of Cardiology Jul 2015Obstructive sleep apnea is more prevalent in patients with hypertension than in the general population and many with obstructive sleep apnea also have hypertension.... (Review)
Review
Obstructive sleep apnea is more prevalent in patients with hypertension than in the general population and many with obstructive sleep apnea also have hypertension. Obstructive sleep apnea increases the risk of hypertension-related morbidities such as stroke, heart failure, and premature death. Are such associations coincidental or causal and if the latter, what are their implications for clinical practice? Despite compelling epidemiological and mechanistic links between obstructive sleep apnea and hypertension, the effect in clinical trials of the treatment of obstructive sleep apnea on blood pressure has been modest and variable. The purpose of this review is to summarize our present understanding of: (1) the relevant epidemiology and mechanisms that might be responsible for the bidirectional relationship between obstructive sleep apnea and hypertension; and (2) available evidence regarding the effect of treating obstructive sleep apnea on blood pressure.
Topics: Blood Pressure; Global Health; Humans; Hypertension; Morbidity; Risk Factors; Sleep Apnea Syndromes
PubMed: 26112299
DOI: 10.1016/j.cjca.2015.05.003