Why causality, and not prediction, should guide obesity prevention policy - Comment.

Comment on : Obesity and loss of disease-free years owing to major non-communicable diseases: a multicohort study. [Lancet Public Health. 2018] The large increase in obesity worldwide is a major public health crisis. Obesity has been associatedwith several non-communicable diseases, such as diabetes, cardiovascular diseases, and cancers, and is a major cause of premature death. According to WHO, at least 2·8 million deaths and more than 35 million (2·3%) global disability-adjusted life-years are linked to overweight or obesity. Furthermore, obesity is a major cause of osteoarthritis and chronic disabilities. Owing to the increase of obesity and population ageing, especially in low-income and middle-income countries, the obesity-related burden of disease will rise

Amerikanische und Europäische Hypertonie-Richtlinien: welche Auswirkungen haben die transatlantischen Differenzen in der Praxis?

[Zusammenfassung] Vor kurzem wurden europäische und amerikanische Leitlinien für die Behandlung der Hypertonie veröffentlicht. Sie unterscheiden sich in einigen Punkten, die sich auf die klinische Praxis auswirken könnten. Die amerikanischen wie die europäischen Leitlinien messen der Evaluation des absoluten kardiovaskulären Risikos eines Patienten auf der Basis der Blutdruckwerte und anderer kardiovaskulärer Risikofaktoren besondere Bedeutung zu. Jedoch wird in den amerikanischen Empfehlungen mehr Gewicht auf den Blutdruckwert per se gelegt und eine neue Kategorie, die so genannte «Prähypertonie», definiert. Auch in der Initialbehandlung unterscheiden sich die beiden Expertengruppen. [Autoren] [Résumé] Récemment, européens et américains ont publié des recommandations de pratique clinique pour la prise en charge de l'hypertension artérielle. Elles différent sur certains points qui peuvent avoir un impact sur la pratique clinique. Américains comme européens insistent sur l'importance de l'évaluation du risque cardiovasculaire absolu de chaque patient en fonction de la pression artérielle et des autres facteurs de risque cardiovasculaire. Toutefois, dans les recommandations américaines, une plus grande importance est donnée à la valeur de la pression artérielle per se. Ainsi, ils définissent une nouvelle catégorie de pression artérielle, la «pré-hypertension» (pour de pression de 120-139 / 80-89 mmHg) qui correspond aux catégories «normale» ou «normale haute» des européens. Le but de cet article est de résumer quelques points clé de ces recommandations et de discuter l'implication que cela peut avoir pour la pratique. [Auteurs]]]> Hypertension ; Practice Guidelines as Topic oai:serval.unil.ch:BIB_4E95F9F3518B 2022-05-07T01:17:37Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_4E95F9F3518B A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the upper extremity. info:doi:10.1111/jth.13008 info:eu-repo/semantics/altIdentifier/doi/10.1111/jth.13008 info:eu-repo/semantics/altIdentifier/pmid/25980766 Rosa-Salazar, V. Trujillo-Santos, J. Díaz Peromingo, J.A. Apollonio, A. Sanz, O. Malý, R. Muñoz-Rodriguez, F.J. Serrano, J.C. Soler, S. Monreal, M. RIETE Investigators Decousus, H. Prandoni, P. Brenner, B. Barba, R. Di Micco, P. Bertoletti, L. Schellong, S. Tzoran, I. Reis, A. Bosevski, M. Bounameaux, H. Wells, P. Papadakis, M. Adarraga, MD. Alibalic, A. Alvarado-Faria, A. Arcelus, JI. Auguet, T. Ballaz, A. Barrón, M. Barrón-Andrés, B. Bascuñana, J. Benítez, JF. Blanco-Molina, A. Bueso, T. Cañas, A. Casado, A. Castejón-Pina, N. Chaves, EL. Del Molino, F. Del Toro, J. Falgá, C. Fernández-Capitán, C. Font, L. Gallego, P. García-Bragado, F. García-Ortega, A. Gómez, V. González, J. González-Marcano, D. Grau, E. Guijarro, R. Guil, M. Guirado, L. Gutiérrez-Guisado, J. Hernández-Blasco, L. Jara-Palomares, L. Jaras, MJ. Jiménez, D. Jiménez, R. Lacruz, B. Lecumberri, R. Lobo, JL. López-Jiménez, L. López-Montes, L. López-Reyes, R. López-Sáez, JB. Lorente, MA. Lorenzo, A. Madridano, O. Maestre, A. Marchena, PJ. Martín-Antorán, JM. Martín-Martos, F. Morales, MV. Nauffal, D. Nieto, JA. Núñez, MJ. Otalora, S. Otero, R. Pagán, B. Pedrajas, JM. Peris, ML. Pons, I. Porras, JA. Riera-Mestre, A. Rivas, A. Rodríguez-Dávila, MA. Ruiz-Giménez, N. Sabio, P. Sampériz, A. Sánchez, R. Soto, MJ. Suriñach, JM. Tiberio, G. Tirado, R. Tolosa, C. Uresandi, F. Valero, B. Valle, R. Vela, J. Villalobos, A. Villalta, J. Malfante, P. Verhamme, P. Vanassche, T. Tomko, T. Hirmerova, J. Bura-Riviere, A. Farge-Bancel, D. Hij, A. Mahe, I. Merah, A. Moustafa, F. Quere, I. Babalis, D. Tzinieris, I. Braester, A. Barillari, G. Bucherini, E. Campodomico, J. Ciammaichella, M. Ferrazzi, P. Maida, R. Pace, F. Pasca, S. Pesavento, R. Piovella, C. Rota, L. Tiraferri, E. Tufano, A. Visonà, A. Skride, A. Belovs, A. Moreira, M. Ribeiro, JL. Sousa, MS. Alatri, A. Calanca, L. Mazzolai, L. info:eu-repo/semantics/article article 2015 Journal of Thrombosis and Haemostasis : Jth, vol. 13, no. 7, pp. 1274-1278 info:eu-repo/semantics/altIdentifier/eissn/1538-7836 urn:issn:1538-7836 <![CDATA[BACKGROUND: No studies have identified which patients with upper-extremity deep vein thrombosis (DVT) are at low risk for adverse events within the first week of therapy. METHODS: We used data from Registro Informatizado de la Enfermedad TromboEmbólica to explore in patients with upper-extremity DVT a prognostic score that correctly identified patients with lower limb DVT at low risk for pulmonary embolism, major bleeding, or death within the first week. RESULTS: As of December 2014, 1135 outpatients with upper-extremity DVT were recruited. Of these, 515 (45%) were treated at home. During the first week, three patients (0.26%) experienced pulmonary embolism, two (0.18%) had major bleeding, and four (0.35%) died. We assigned 1 point to patients with chronic heart failure, creatinine clearance levels 30-60 mL min(-1) , recent bleeding, abnormal platelet count, recent immobility, or cancer without metastases; 2 points to those with metastatic cancer; and 3 points to those with creatinine clearance levels &lt; 30 mL min(-1) . Overall, 759 (67%) patients scored ≤ 1 point and were considered to be at low risk. The rate of the composite outcome within the first week was 0.26% (95% confidence interval [CI] 0.004-0.87) in patients at low risk and 1.86% (95% CI 0.81-3.68) in the remaining patients. C-statistics was 0.73 (95% CI 0.57-0.88). Net reclassification improvement was 22%, and integrated discrimination improvement was 0.0055. CONCLUSIONS: Using six easily available variables, we identified outpatients with upper-extremity DVT at low risk for adverse events within the first week. These data may help to safely treat more patients at home

Reliability of Self-Reported Height and Weight in Children: A School-Based Cross-Sectional Study and a Review.

Since anthropometric measurements are not always feasible in large surveys, self-reported values are an alternative. Our objective was to assess the reliability of self-reported weight and height values compared to measured values in children with (1) a cross-sectional study in Switzerland and (2) a comprehensive review with a meta-analysis. We conducted a secondary analysis of data from a school-based study in Switzerland of 2616 children and a review of 63 published studies including 122,629 children. In the cross-sectional study, self-reported and measured values were highly correlated (weight: r = 0.96; height: r = 0.92; body mass index (BMI) r = 0.88), although self-reported values tended to underestimate measured values (weight: -1.4 kg; height: -0.9 cm; BMI: -0.4 kg/m2). Prevalence of underweight was overestimated and prevalence of overweight was underestimated using self-reported values. In the meta-analysis, high correlations were found between self-reported and measured values (weight: r = 0.94; height: r = 0.87; BMI: r = 0.88). Weight (-1.4 kg) and BMI (-0.7 kg/m2) were underestimated, and height was slightly overestimated (+0.1 cm) with self-reported values. Self-reported values tended to be more reliable in children above 11 years old. Self-reported weight and height in children can be a reliable alternative to measurements, but should be used with caution to estimate over- or underweight prevalence

Life Course Socioeconomic Conditions and Multimorbidity in Old Age - A Scoping Review.

Multimorbidity disproportionally affects individuals exposed to socioeconomic disadvantage. It is, however, unclear how adverse socioeconomic conditions (SEC) at different periods of the life course predict the occurrence of multimorbidity in later life. In this scoping review, we investigate the association between life course SEC and later-life multimorbidity, and assess to which extent it supports different life course causal models (critical period, sensitive period, accumulation, pathway, or social mobility). We identified four studies (25,209 participants) with the first measure of SEC in childhood (before age 18). In these four studies, childhood SEC was associated with multimorbidity in old age, and the associations were partially or fully attenuated upon adjustment for later-life SEC. These results are consistent with the sensitive period and the pathway models. We identified five studies (91,236 participants) with the first measure of SEC in young adulthood (after age 18), and the associations with multimorbidity in old age as well as the effects of adjustment for later-life SEC differed from one study to the other. Among the nine included studies, none tested the social mobility or the accumulation models. In conclusion, SEC in early life could have an effect on multimorbidity, attenuated at least partly by SEC in adulthood