Changes in Waist Circumference and the Incidence of Acute Myocardial Infarction in Middle-Aged Men and Women

BACKGROUND: Waist circumference (WC) measured at one point in time is positively associated with the risk of acute myocardial infarction (MI), but the association with changes in WC (DWC) is not clear. We investigated the association between DWC and the risk of MI in middle-aged men and women, and evaluated the influence from concurrent changes in BMI (DBMI). METHODOLOGY/PRINCIPAL FINDINGS: Data on 38,593 participants from the Danish Diet, Cancer and Health study was analysed. Anthropometry was assessed in 1993-97 and 1999-02. Information on fatal and non-fatal MI was obtained from National Registers. Cases were validated by review of the medical records. Hazard ratios (HR) were calculated from Cox proportional hazard models with individuals considered at risk from 1999-02 until December 30 2009. During 8.4 years of follow-up, 1,041 incident cases of MI occurred. WC was positively associated with the risk of MI, but weakly after adjustment for BMI. DWC was not associated with the risk of MI (HR per 5 cm change = 1.01 (0.95, 1.09) with adjustment for covariates, baseline WC, BMI and DBMI). Associations with DWC were not notably different in sub-groups stratified according to baseline WC or DBMI, or when individuals with MI occurring within the first years of follow-up were excluded. CONCLUSIONS/SIGNIFICANCE: WC was positively associated with the risk of MI in middle-aged men and women, but changes in WC were not. These findings suggest that a reduction in WC may be an insufficient target for prevention of MI in middle-aged men and women

Epidemic Microclusters of Blood-Culture Proven Sepsis in Very-Low-Birth Weight Infants: Experience of the German Neonatal Network

INTRODUCTION: We evaluated blood culture-proven sepsis episodes occurring in microclusters in very-low-birth-weight infants born in the German Neonatal Network (GNN) during 2009-2010. METHODS: Thirty-seven centers participated in GNN; 23 centers enrolled ≥50 VLBW infants in the study period. Data quality was approved by on-site monitoring. Microclusters of sepsis were defined as occurrence of at least two blood-culture proven sepsis events in different patients of one center within 3 months with the same bacterial species. For microcluster analysis, we selected sepsis episodes with typically cross-transmitted bacteria of high clinical significance including gram-negative rods and Enterococcus spp. RESULTS: In our cohort, 12/2110 (0.6%) infants were documented with an early-onset sepsis and 235 late-onset sepsis episodes (≥72 h of age) occurred in 203/2110 (9.6%) VLBW infants. In 182/235 (77.4%) late-onset sepsis episodes gram-positive bacteria were documented, while coagulase negative staphylococci were found to be the most predominant pathogens (48.5%, 95%CI: 42.01-55.01). Candida spp. and gram-negative bacilli caused 10/235 (4.3%, 95%CI: 1.68% -6.83%) and 43/235 (18.5%) late-onset sepsis episodes, respectively. Eleven microclusters of blood-culture proven sepsis were detected in 7 hospitals involving a total 26 infants. 16/26 cluster patients suffered from Klebsiella spp. sepsis. The median time interval between the first patient's Klebsiella spp. sepsis and cluster cases was 14.1 days (interquartile range: 1-27 days). First patients in the cluster, their linked cases and sporadic sepsis events did not show significant differences in short term outcome parameters. DISCUSSION: Microclusters of infection are an important phenomenon for late-onset sepsis. Most gram-negative cluster infections occur within 30 days after the first patient was diagnosed and Klebsiella spp. play a major role. It is essential to monitor epidemic microclusters of sepsis in surveillance networks to adapt clinical practice, inform policy and further improve quality of care

Localization and broadband follow-up of the gravitational-wave transient GW150914

A gravitational-wave transient was identified in data recorded by the Advanced LIGO detectors on 2015 September 14. The event candidate, initially designated G184098 and later given the name GW150914, is described in detail elsewhere. By prior arrangement, preliminary estimates of the time, significance, and sky location of the event were shared with 63 teams of observers covering radio, optical, near-infrared, X-ray, and gamma-ray wavelengths with ground- and space-based facilities. In this Letter we describe the low-latency analysis of the gravitational wave data and present the sky localization of the first observed compact binary merger. We summarize the follow-up observations reported by 25 teams via private Gamma-ray Coordinates Network Circulars, giving an overview of the participating facilities, the gravitational wave sky localization coverage, the timeline and depth of the observations. As this event turned out to be a binary black hole merger, there is little expectation of a detectable electromagnetic signature. Nevertheless, this first broadband campaign to search for a counterpart of an Advanced LIGO source represents a milestone and highlights the broad capabilities of the transient astronomy community and the observing strategies that have been developed to pursue neutron star binary merger events. Detailed investigations of the electromagnetic data and results of the electromagnetic follow-up campaign will be disseminated in the papers of the individual teams

Vitamin D in women of reproductive age and during pregnancy - Focus on intake, status and adiposity

Vitamin D is attained either through synthesis in the skin by sun exposure or through diet. Vitamin D status is important for skeletal health but optimal vitamin D status may also be important in the development of other diseases such as type 2 diabetes, gestational diabetes, preeclampsia, and cancer. Circulating vitamin D is known to be decreased in obese compared to non-obese individuals. There is a lack of documented knowledge on vitamin D status and intake in Swedish women of reproductive age and during pregnancy. The aim of this thesis was to compare vitamin D status and intake between obese and normal-weight women. In a cross-sectional study in women of reproductive age and in a longitudinal study during pregnancy, blood samples, adipose tissue biopsies, and information on dietary intake were collected. Data on lifestyle including physical activity and sun exposure were also collected. Vitamin D status, measured as serum 25-hydroxyvitamin D [25(OH)D], was lower in obese women of reproductive age compared with normal-weight women. In contrast, circulating vitamin D-binding protein was higher in the obese women. Despite reporting a higher vitamin D intake, the obese pregnant women had lower serum 25(OH)D compared with normal-weight women in early pregnancy. A higher proportion of the obese compared with normal-weight women had 25(OH)D concentrations that might be defined as insufficient. Circulating 25(OH)D concentrations below 25 nmol/L were uncommon in both pregnant and non-pregnant women. Dietary vitamin D intake was between 7.2 and 8.8 µg/day during pregnancy and in non-pregnant obese and normal-weight women, and a major part did not reach national dietary recommendations. There were no major differences in vitamin D intake between obese and normal-weight women. Vitamin D and its metabolites were detected in adipose tissue and were localized in the lipid droplet in the adipocyte. The present studies show that Swedish obese women of reproductive age and during pregnancy have lower circulating 25(OH)D compared with normal-weight women but few had very low concentrations. However, what effects an increased circulating 25(OH)D would have on long-term health in obese individuals is yet to be studied. The fact that obese women had higher circulating vitamin D-binding protein is interesting and should be further examined to clarify why, and what impact that may have on the action of vitamin D. We found no evidence of a lower vitamin D intake in obese women, thus, the intake was not contributing to the lower circulating 25(OH)D. Many women do not reach the recommendations for vitamin D intake. Actions should be taken to improve dietary intake of vitamin D in women of reproductive age and during pregnancy, this might have future implications not only for women’s health but for generations to come. Intervention studies are urgently needed to explore the effect of vitamin D status and intake during pregnancy and in obese subjects

Low Calcium Intake Is Related to Increased Risk of Tooth Loss in Men

Our aim was to investigate the association between calcium (Ca) intake and number of teeth and tooth loss. The Danish Monica (Monitoring Trends and Determinants in Cardiovascular Disease) study is a prospective observational study from 1982-83 to 1993-94. The study population included 1602 adults (30-60 y) with information on dietary Ca intake and number of teeth and a subset of 511 participants with information on tooth loss from 1987-88 to 1993-94. Ca intake less than the recommendations, estimated by a 7-d food record or a diet history interview in 1982-83, was more frequent among females (55%) than males (45%; P <0.001). Low Ca intake was associated with low number of teeth (1-25 vs. 26-32 teeth) in males [odds ratio (OR) = 1.57 (95% CI = 1.10-2.29)] and females [OR = 1.44 (95% CI = 1.10-2.05)] after adjustment for age, education, smoking, alcohol and sucrose consumption, subjective oral dryness, and time since last dental care visit. The reference group (26-32 teeth) and edentulous participants did not significantly differ. A Ca intake below recommendations was significantly associated with increased risk of subsequent tooth loss in males [incidence-rate ratio = 1.70 (95% CI = 1.15-2.48)]. There was no association in women. Ca intake below recommendations was significantly associated with fewer teeth in both sexes. However, there was a significant, negative association between Ca intake below recommendations and tooth loss in males only. Given the high percentage of individuals with Ca intake below recommendations, consumption of foods rich in Ca should be promoted to preserve oral health