Combined healthy behaviors and healthcare services use in older adults

Data on the combined impact of healthy behaviors on healthcare use in older adults are limited. Methods Study with community-dwelling individuals aged ≥60 years from the Spanish Seniors-ENRICA cohort, recruited in 2008–2010, followed through 2012–2013, and analyzed in 2016 (N=2,021). At baseline, the following healthy behaviors were self-reported: three traditional (never smoking, being physically active, having a healthy diet) and three emerging (sleeping 7–8 hours/day, sitting < 8 hours/day, not living alone). Outcomes were self-reported polypharmacy (five or more drugs per day), primary care physician visits (one or more per month), medical specialist visits (more than one per year), and hospitalization (one or more in the last year). The associations between baseline healthy behaviors and healthcare services used in 2012–2013 were summarized with ORs and 95% CIs from multiple logistic regression, adjusting for demographics, lifestyles, comorbidities, and baseline health services used. Results Most single healthy behaviors were associated with lower use of most health services. Compared with participants with zero or one healthy behavior, those with five or six healthy behaviors showed lower risk of polypharmacy (OR=0.46, 95% CI=0.24, 0.85, p-trend=0.001), visits to the primary care physician (OR=0.50, 95% CI=0.26, 0.96, p-trend=0.013), and hospitalization (OR=0.50, 95% CI=0.24, 1.01, p-trend=0.016). No association was found with visits to the medical specialist. Conclusions The combination of five to six healthy behaviors in older adults is associated with half the risk of polypharmacy and using several healthcare services. In an era of constrained resources in most countries, this information may help inform health policy to control healthcare spending in the futureSpecific funding for this study was obtained from Fondo de Investigación Sanitaria (FIS) grant PI13/02321 and PI16/ 01460 (Instituto de Salud Carlos III and FEDER/FSE). RFP-T was supported by the National Government of Ecuador through the National Institution of Higher Education, Science, Technology and Innovation (SENESCYT

Important abnormalities of bone mineral metabolism are present in patients with coronary artery disease with a mild decrease of the estimated glomerular filtration rate

The final publication is avilable at: Journal of Bone and Mineral Metabolism 30.9 (2015): 1-34Chronic kidney disease (CKD)–mineral and bone disorder (MBD) is characterized by increased circulating levels of parathormone (PTH) and fibroblast growth factor 23 (FGF23), bone disease, and vascular calcification, and is associated with adverse outcomes. We studied the prevalence of mineral metabolism disorders, and the potential relationship between decreased estimated glomerular filtration rate (eGFR) and CKD-MBD in coronary artery disease patients in a cross-sectional study of 704 outpatients 7.5 ± 3.0 months after an acute coronary syndrome. The mean eGFR (CKD Epidemiology Collaboration formula) was 75.8 ± 19.1 ml/min/1.73 m2. Our patients showed lower calcidiol plasma levels than a healthy cohort from the same geographical area. In the case of men, this finding was present despite similar creatinine levels in both groups and older age of the healthy subjects. Most patients (75.6 %) had an eGFR below 90 ml/min/1.73 m2 (eGFR categories G2–G5), with 55.3 % of patients exhibiting values of 60–89 ml/min/1.73 m2 (G2). PTH (r = −0.3329, p < 0.0001) and FGF23 (r = −0.3641, p < 0.0001) levels inversely correlated with eGFR, whereas calcidiol levels and serum phosphate levels did not. Overall, PTH levels were above normal in 34.9 % of patients. This proportion increased from 19.4 % in G1 category patients, to 33.7 % in G2 category patients and 56.6 % in G3–G5 category patients (p < 0.001). In multivariate analysis, eGFR and calcidiol levels were the main independent determinants of serum PTH. The mean FGF23 levels were 69.9 (54.6–96.2) relative units (RU)/ml, and 33.2 % of patients had FGF23 levels above 85.5 RU/ml (18.4 % in G1 category patients, 30.0 % in G2 category patients, and 59.2 % in G3–G5 category patients; p < 0.001). In multivariate analysis, eGFR was the main predictor of FGF23 levels. Increased phosphate levels were present in 0.7 % of the whole sample: 0 % in G1 category patients, 0.3 % in G2 category patients, and 2.8 % in G3–G5 category patients (p = 0.011). Almost 90 % of patients had calcidiol insufficiency without significant differences among the different degrees of eGFR. In conclusion, in patients with coronary artery disease there is a large prevalence of increased FGF23 and PTH levels. These findings have an independent relationship with decreased eGFR, and are evident at an eGFR of 60–89 ml/min/1.73 m2. Then, mild decreases in eGFR must be taken in consideration by the clinician because they are associated with progressive abnormalities of mineral metabolismFondo de Investigaciones Sanitarias (PI10/00072, PI14/00386, PIE13/00051, PI05/0451, PI05/1497, PI05/52475, PI05/1043, PS09/01405, PI14/1567) y FRIAT, Spanish Society of Cardiology, Spanish Heart Foundation, Spanish Society of Arteriosclerosis, REDINREN (RD012/0021), Biobank grants from Instituto de Salud Carlos III FEDER, RD09/0076/00101 (FJD Biobank) and Abbvie Laboratories. PN I+D+I 2008-2011 and ISCIII co-financed by FEDER, CIBERDEM and e-PREDIC

Konsumsi Minyak Goreng dan Vitamin A pada Beberapa Kelompok Umur di Dua Kabupaten

Indonesia plans to implement mandatory vitamin A fortification of cooking oil. A pilot study of voluntary vitamin A fortification in unbranded cooking oil showed that vitamin A status improved significantly a year afterfortification for five age groups except for children 12-23 months of age. The objective of the study was to measure cooking oil consumption and dietary consumption of vitamin A in children, women of reproductive age(WRA), and lactating mothers. The study was a cross-sectional study in Tasikmalaya and Ciamis, Indonesia, covering 1.594 samples randomly selected of poor households. Cooking oil was collected at household byrecall of usual cooking oil purchase and individual sample by 2x24h recall of food consumption. The results showed that households prefer bought unbranded cooking oil sold in plastic pouch at foodstall (warung) nearbyhome (96.2%), purchased oil every 1-3 days (60.6%), each purchace contained &lt; 250 mL oil (73.9%). The average (mean+SE) cooking oil consumption at household was 27.5+1.0 mL/capita/day. Cooking oilconsumption at individual level on the average was 22.3+0.5 mL/capita/day lower compared to household consumption of oil, varied significantly of 2.4+0.4, 13.3+0.8, 23.0+1.0, 30.5+1.3, 33.5+1.2, 33.1+1.3 mL/day in 6-11, 12-23, 24-59 month old, 6-9 year old, WRA, and lactating mothers respectively. Cooking oil consumptionwas lower in children 6-11 and 12-23 months old which contributed to non-significant improvement of serum vitamin A level particularly in children 12-23 months old but not other groups since they consumed higher intake of cooking oil or still brestfed for children 6-11 month old

Correction : Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885

The authors wish to make the following corrections to this paper [...]

Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain : Large-Scale Epidemiological Study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Impacto de los niveles plasmáticos de pro-péptido natriurético tipo B aminoterminal, proteína quimiotáctica de monocitos-1 y galectina 3 en la capacidad predictiva de eventos de la escala clínica LIPID en la enfermedad coronaria estable

This is the peer reviewed version of the following article: Clínica e Investigación en Arterioesclerosis 27.2 (2015) which has been published in final form at http://dx.doi.org/10.1016/j.arteri.2014.06.003Introducción: No existe ninguna herramienta validada para la estratificación de riesgo de lospacientes con enfermedad coronaria estable (ECE). Se ha visto que los niveles plasmáticos dela proteína quimioatractante de monocitos-1 (MCP-1), galectina-3 y pro-péptido natriuréticotipo B aminoterminal (NT-proBNP) tienen valor pronóstico en esta población. Objetivo: Analizar la utilidad pronóstica de la escala clínica de riesgo del estudio Long-TermIntervention with Pravastatin in Ischemic Disease (LIPID) y la mejora de su capacidad predictivaal combinarla con los niveles plasmáticos de MCP-1, galectina-3 y NT-proBNP en pacientes conECE.Métodos y resultados:Se analizaron 706 pacientes con ECE y antecedentes de síndrome coro-nario agudo (SCA). Se realizó un seguimietno de 2,2 ± 0,99 a˜nos. El objetivo primario era laaparición de un evento isquémico (cualquier SCA, infarto cerebral o accidente isquémico tran-sitorio), insuficiencia cardiaca o muerte.La escala clínica de riesgo predijo significativamente el desarrollo del objetivo primario, conun área bajo la curva receiver operating characteristic (ROC) de 0,642 (0,579-0,705); p 21,5 mostró una sensibilidad del 74% y una especificidad del 61% para el desarrollodel objetivo primario (p < 0,001; test de log-rank).Conclusión: Los niveles plasmáticos de MCP-1, galectina-3 y NT-proBNP mejoran la capacidadde la escala clínica LIPID para predecir el pronóstico de los pacientes con ECEIntroduction: At present, there is no tool validated by scientific societies for risk stratificationof patients with stable coronary artery disease (SCAD). It has been shown that plasma levelsof monocyte chemoattractant protein-1 (MCP-1), galectin-3 and pro-B-type natriuretic peptideamino-terminal (NT-proBNP) have prognostic value in this population.Objetive: To analyze the prognostic value of a clinical risk scale published in Long-term Inter-vention with Pravastatin in Ischemic Disease (LIPID) study and determining its predictivecapacity when combined with plasma levels of MCP-1, galectin-3 and NT-proBNP in patientswith SCAD.Methods and results: A total of 706 patients with SCAD and a history of acute coronary syndrome(ACS) were analyzed over a follow up period of 2.2 ± 0.99 years. The primary endpoint was theoccurrence of an ischemic event (any SCA, stroke or transient ischemic attack), heart failure,or death.A clinical risk scale derived from the LIPID study significantly predicted the development ofthe primary endpoint, with an area under the ROC curve (Receiver Operating Characteristic) of0.642 (0.579 to 0.705); P < 0.001. A composite score was developed by adding the scores of theLIPID and scale decile levels of MCP -1, galectin -3 and NT-proBNP. The predictive value improvedwith an area under the curve of 0.744 (0.684 to 0.805); P < 0.001 (P = 0.022 for comparison). Ascore greater than 21.5 had a sensitivity of 74% and a specificity of 61% for the development ofthe primary endpoint (P < 0.001, log -rank test).Conclusion: Plasma levels of MCP-1, galectin -3 and NT-proBNP improve the ability of the LIPIDclinical scale to predict the prognosis of patients with SCADFinanciación Sociedad Española de Arteriosclerosis, FIS (PI: 05/451,05/1497, 05/2475, 05/1043, 09/01405, 10/0234, Programa Estabilización a LBC), Sociedad Española de Cardiología,Fundación Española del Corazón, Ministerio de Ciencia e Innovación (SAF 2010/21852), Comunidad de Madrid (sGEN/0247/2006), Becas de Biobancos del Instituto Car-los III FEDER, RD09/0076/00101 (Biobanco FJD

Correction: Combined Impact of Traditional and Non-Traditional Healthy Behaviors on Health-Related Quality of Life: A Prospective Study in Older Adults.

[This corrects the article DOI: 10.1371/journal.pone.0170513.]