Depressive Symptoms in a General Population: Associations with Obesity, Inflammation, and Blood Pressure

To determine whether obesity, inflammation, or conventional risk factors are related to depressive symptoms (DeprSy) in the general population. Responses to 3 questions served to assess sense of depression. Body mass index (BMI), C-reactive protein (CRP), and other epidemiologic data of participants were available. In 1940, individuals who consulted a psychiatrist in the preceding year, or felt depressed (together DeprSy), 248 were female. Logistic regressions for adjusted associations of BMI with DeprSy were not significant as was serum CRP level. Diabetes and, in men, fasting glucose concentrations were associated with DeprSy. Systolic blood pressure (SBP) was robustly inversely associated with DeprSy in diverse models at ORs of 0.74 (95%CI 0.63; 0.89) independent of confounders, including antihypertensive and lipid-lowering medication. The use of antidepressants could not explain the reduced BP. Women are predisposed to depression with which, not BMI and CRP, but SBP is inversely associated. Anti-inflammatory substances produced in depressed persons might explain the slightly lower BP

Adeziv güçlendiricinin kompozitin daimi dişe mikrogerilim bağlanma dayanımına etkisi

Amaç: Bu çalışmanın amacı adeziv güçlendiricinin daimi diş dentinine bağlanma performansını değerlendirmektir. Gereç ve Yöntemler: Bu çalışmada on adet çürüksüz mandibular molar diş kullanıldı. Dişlerin okluzal yüzeyleri tüm mineyi ortadan kalkacak şekilde su soğutması altında elmas separe ile uzaklaştırılarak dentin yüzeyleri açığa çıkarıldı. Dentin yüzeyleri 600-800-1000-1200 grit zımparalarla su altında zımparalandı ve dişler rastgele iki gruba ayrıldı; Grup 1: Total etch (Adper Scotchbond Multi Purpose Plus, 3M ESPE, UK), Grup 2: Total etch + adezyon güçlendirici (Enhance, Reliance, USA). Kompozit rezin restorasyonlar 4-5 mm yükseklikte olacak şekilde yerleştirildi. Su içerisinde (37oC) 24 saat bekletilen dişler 1mm2'lik örnekler elde edilecek şekilde kesitler alındı ve 62 örnek elde edildi. Tüm örneklere mikrogerilim bağlanma testi 1mm/dak hız ile kırılma meydana meydana gelene kadar uygulandı. Kırılma yüzeyleri stereomikroskop altında incelendi. İstatistiksel analiz bağımsız t testi ile değerlendirildi. Bulgular: Grup 1 ve Grup 2’den elde edilen mikrogerilme bağlanma dayanımı değerleri sırasıyla 27,47 MPa ve 27,66 MPa olarak kaydedildi. Gruplar arasında istatistiksel olarak anlamlı farklılık bulunmadı (p > 0,05). Sonuç: Elde edilen sonuçlara göre Enhance adezyon güçlendirici kompozit rezinin daimi dişe bağlanma dayanımını geliştirmemiştir

Farklı yüzey hazırlama yöntemlerinin fissür örtücülerin bağlanma dayanımı üzerine olan etkisi

Amaç: Bu çalışmada amacı kurutma ajanı/ kurutma ajanı olmaksızın mine yüzeyinin hazırlanmasında asitle pürüzlendirme ve Er:YAG lazerin (QSP ve MSP mod) fissür örtücünün bağlanma dayanımı üzerine etkisini değerlendirmek amaçlandı. Gereç ve Yöntemler: Bu çalışmada 30 adet çürüksüz daimi diş kullanıldı. Dişler mine-sement sınırının 2 mm üstünden kesildi ve kökler uzaklaştırıldı. Dişler meziodistal olarak ikiye ayrıldı. Elde edilen 60 yarım diş akrilik reçine içine gömüldü. Mine yüzeyinde fissure örtücüler için 2 mm çapında alan oluşturuldu. Bütün gruplara Ultraseal XT plus (Fissür örtücü:FÖ) uygulandı. Örnekler randomize olarak 6 gruba ayrıldı (n:10); G1:% 37 fosforik asit + Prima Dry + FÖ, G2:% 37 fosforik asit + FÖ, G3: Er: YAG (MSP modu) + Prima Dry + FÖ; G4: Er: YAG (MSP modu) + FÖ; G5: Er: YAG (QSP modu) + Prima Dry + FÖ; G6: Er: YAG (QSP modu) + FÖ. Örnekler 24 saat distile su içinde bekletildikten sonra bağlanma kuvvetleri, üniversal test makinesi ile test edildi. Verileri karşılaştırmak için Kruskal-Wallis ve Mann-Whitney U-testi kullanıldı. Bulgular: Gruplara ait bağlanma dayanımları şöyledir (MPa) G1: 11.33, G2: 9.76, G3: 8.65, G4: 7.72, G5: 4.49, G6: 2.73. Gruplar arasında istatistiksel fark olduğu gözlendi (p < 0.05). Sonuç: Mine yüzeyine asit uygulaması, Er:YAG lazer QSP ve MSP moda göre daha iyi sonuçlar verdiği görülmüştür. Fissür örtücü uygulanmadan önce kurutma ajanı uygulanabilir

Obesity attenuates gender differences in cardiovascular mortality

Peer reviewe

Use of Repeated Blood Pressure and Cholesterol Measurements to Improve Cardiovascular Disease Risk Prediction: An Individual-Participant-Data Meta-Analysis

The added value of incorporating information from repeated blood pressure and cholesterol measurements to predict cardiovascular disease (CVD) risk has not been rigorously assessed. We used data on 191,445 adults from the Emerging Risk Factors Collaboration (38 cohorts from 17 countries with data encompassing 1962-2014) with more than 1 million measurements of systolic blood pressure, total cholesterol, and high-density lipoprotein cholesterol. Over a median 12 years of follow-up, 21,170 CVD events occurred. Risk prediction models using cumulative mean values of repeated measurements and summary measures from longitudinal modeling of the repeated measurements were compared with models using measurements from a single time point. Risk discrimination (Cindex) and net reclassification were calculated, and changes in C-indices were meta-analyzed across studies. Compared with the single-time-point model, the cumulative means and longitudinal models increased the C-index by 0.0040 (95% confidence interval (CI): 0.0023, 0.0057) and 0.0023 (95% CI: 0.0005, 0.0042), respectively. Reclassification was also improved in both models; compared with the single-time-point model, overall net reclassification improvements were 0.0369 (95% CI: 0.0303, 0.0436) for the cumulative-means model and 0.0177 (95% CI: 0.0110, 0.0243) for the longitudinal model. In conclusion, incorporating repeated measurements of blood pressure and cholesterol into CVD risk prediction models slightly improves risk prediction

Association of Cardiometabolic Multimorbidity With Mortality.

IMPORTANCE: The prevalence of cardiometabolic multimorbidity is increasing. OBJECTIVE: To estimate reductions in life expectancy associated with cardiometabolic multimorbidity. DESIGN, SETTING, AND PARTICIPANTS: Age- and sex-adjusted mortality rates and hazard ratios (HRs) were calculated using individual participant data from the Emerging Risk Factors Collaboration (689,300 participants; 91 cohorts; years of baseline surveys: 1960-2007; latest mortality follow-up: April 2013; 128,843 deaths). The HRs from the Emerging Risk Factors Collaboration were compared with those from the UK Biobank (499,808 participants; years of baseline surveys: 2006-2010; latest mortality follow-up: November 2013; 7995 deaths). Cumulative survival was estimated by applying calculated age-specific HRs for mortality to contemporary US age-specific death rates. EXPOSURES: A history of 2 or more of the following: diabetes mellitus, stroke, myocardial infarction (MI). MAIN OUTCOMES AND MEASURES: All-cause mortality and estimated reductions in life expectancy. RESULTS: In participants in the Emerging Risk Factors Collaboration without a history of diabetes, stroke, or MI at baseline (reference group), the all-cause mortality rate adjusted to the age of 60 years was 6.8 per 1000 person-years. Mortality rates per 1000 person-years were 15.6 in participants with a history of diabetes, 16.1 in those with stroke, 16.8 in those with MI, 32.0 in those with both diabetes and MI, 32.5 in those with both diabetes and stroke, 32.8 in those with both stroke and MI, and 59.5 in those with diabetes, stroke, and MI. Compared with the reference group, the HRs for all-cause mortality were 1.9 (95% CI, 1.8-2.0) in participants with a history of diabetes, 2.1 (95% CI, 2.0-2.2) in those with stroke, 2.0 (95% CI, 1.9-2.2) in those with MI, 3.7 (95% CI, 3.3-4.1) in those with both diabetes and MI, 3.8 (95% CI, 3.5-4.2) in those with both diabetes and stroke, 3.5 (95% CI, 3.1-4.0) in those with both stroke and MI, and 6.9 (95% CI, 5.7-8.3) in those with diabetes, stroke, and MI. The HRs from the Emerging Risk Factors Collaboration were similar to those from the more recently recruited UK Biobank. The HRs were little changed after further adjustment for markers of established intermediate pathways (eg, levels of lipids and blood pressure) and lifestyle factors (eg, smoking, diet). At the age of 60 years, a history of any 2 of these conditions was associated with 12 years of reduced life expectancy and a history of all 3 of these conditions was associated with 15 years of reduced life expectancy. CONCLUSIONS AND RELEVANCE: Mortality associated with a history of diabetes, stroke, or MI was similar for each condition. Because any combination of these conditions was associated with multiplicative mortality risk, life expectancy was substantially lower in people with multimorbidity

Testosterone, Sex Hormone-Binding Globulin and the Metabolic Syndrome in Men: An Individual Participant Data Meta-Analysis of Observational Studies

Peer reviewe

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe