Reproducibility and relative validity of dietary glycaemic index and glycaemic load assessed by the food-frequency questionnaire used in the Dutch cohorts of the European prospective investigation into Cancer and Nutrition

Limited information is available on the reproducibility and validity of dietary glycaemic index (GI) and glycaemic load (GL) estimated by habitual diet assessment methods such as FFQ, including the FFQ used in the Dutch cohorts of the European Prospective Investigation into Cancer and Nutrition study. To examine the reproducibility and relative validity of GI and GL, we used data from 121 Dutch men and women aged 23–72 years. They completed the FFQ three times at intervals of 6 months and twelve 24-h dietary recalls (24HDR) monthly during 1991–2. GI and GL were calculated using published values. Intra-class correlation coefficients of the three repeated FFQ were 0·78 for GI and 0·74 for GL. Pearson correlation coefficients between the first FFQ and the weighted average of the 24HDR were 0·63 for both GI and GL. Weighted ¿ values between the first FFQ and the average of the 24HDR (in quintiles) were 0·40 for GI and 0·41 for GL. Bland–Altman plots showed a proportional bias in GI (ß = 0·46), but not in GL (ß = 0·06). In conclusion, this FFQ can be used in epidemiological studies to investigate the relationship of GI and GL with disease risks, but the proportional bias should be taken into account when using this FFQ to assess the absolute GI values

Analysis of Content Shared in Online Cancer Communities: Systematic Review

Computer Systems, Imagery and Medi

Reproducibility and relative validity of dietary glycaemic index and glycaemic load assessed by the food-frequency questionnaire used in the Dutch cohorts of the European prospective investigation into Cancer and Nutrition

Limited information is available on the reproducibility and validity of dietary glycaemic index (GI) and glycaemic load (GL) estimated by habitual diet assessment methods such as FFQ, including the FFQ used in the Dutch cohorts of the European Prospective Investigation into Cancer and Nutrition study. To examine the reproducibility and relative validity of GI and GL, we used data from 121 Dutch men and women aged 23–72 years. They completed the FFQ three times at intervals of 6 months and twelve 24-h dietary recalls (24HDR) monthly during 1991–2. GI and GL were calculated using published values. Intra-class correlation coefficients of the three repeated FFQ were 0·78 for GI and 0·74 for GL. Pearson correlation coefficients between the first FFQ and the weighted average of the 24HDR were 0·63 for both GI and GL. Weighted ¿ values between the first FFQ and the average of the 24HDR (in quintiles) were 0·40 for GI and 0·41 for GL. Bland–Altman plots showed a proportional bias in GI (ß = 0·46), but not in GL (ß = 0·06). In conclusion, this FFQ can be used in epidemiological studies to investigate the relationship of GI and GL with disease risks, but the proportional bias should be taken into account when using this FFQ to assess the absolute GI values

Paediatric asthma outpatient care by asthma nurse, paediatrician or general practitioner: Randomised controlled trial with two-year follow-up

Aims: For children with stable asthma, to test non-inferiority of care provided by a hospital-based specialised asthma nurse versus a general practitioner (GP) or paediatrician. Methods: Randomised controlled trial evaluating standard care by a GP, paediatrician or an asthma nurse, with two-year follow-up. Results: 107 children were recruited, 45 from general practice and 62 from hospital. After two years, no significant differences between groups were found for airway responsiveness, FEV1, asthma control, medication, school absence or parental work absence. In the general practice group there was a significantly lower frequency of regular review visits ('regular' = at least one review per six months) compared to the paediatrician and specialised asthma nurse group, both after one year [45.7% versus 87.9% and 94.3%, respectively, (p<0.0005)] and after two years [26.5% versus 87.9% and 75.8%, respectively, (p<0.0005)]. We found no significant differences in unplanned visits. In most cases the asthma nurse was able to provide care without consultation with the paediatrician. Conclusion: The degree of disease control in stable childhood asthma managed by an asthma nurse is not inferior to traditional management by primary or secondary care physicians. The results also suggest that a lower review frequency does not detract from good disease control

For what endpoint does myocardial I-123-MIBG scintigraphy have the greast prognostic value in patients with chronic heart failure? Results of a pooled individual patient data meta-analysis

Cardiolog

The influence of carvedilol vs. metoprolol on sympathetic activity and hemostasis in patients with heart failure

Background: Carvedilol, a non-selective beta-blocker, may be more effective in reducing the risk of thromboembolic events in heart failure, compared to metoprolol, a selective beta-blocker (De Peuter et al., Eur J Heart Fail, in press/ISTH 2009). We hypothesized that carvedilol lowers this risk through more effective downregulation of the sympathetic hyperactivity and the associated prothrombotic state compared to metoprolol. This effect may be mediated through common haplotypes of the beta2-adrenergic receptor. Methods: In this prospective, randomized, open-label with blinded outcome assessments, crossover study, stable heart failure patients (left ventricular ejection fraction <40%) homozygous for the Arg16/Gln27 (n = 13) or Gly16/Glu27 haplotype (n = 8) of the beta2-receptor were randomized to equipotent dosages of carvedilol or metoprolol for two 6-week periods. Primary outcome was sympathetic activity as measured by 123I-meta-iodobenzylguanidine (MIBG) myocardial washout. Secondary outcomes included markers of hemostasis. Data are presented as mean ± standard error of the mean. Results: 123I-MIBG washout was lower during carvedilol than metoprolol treatment (12.9 ± 3.9% vs. 22.1 ± 2.8%, respectively, P = 0.01). This difference was present in both Arg16/Gln27 and Gly16/Glu27 individuals. Treatment with carvedilol lowered von Willebrand factor (149 ± 13% vs. 157 ± 13%, respectively, P = 0.01). There were no differences in other hemostatic markers. Conclusion: Treatment with carvedilol resulted in greater reduction of sympathetic activity after 6-weeks treatment and lower von Willebrand factor concentrations, compared to metoprolol, in both Arg16/ Gln27 and Gly16/Glu27 individuals. Carvedilol may reduce the risk of thromboembolic event risk in heart failure, irrespective of beta2- receptor haplotype status

Position paper of the EACVI and EANM on artificial intelligence applications in multimodality cardiovascular imaging using SPECT/CT, PET/CT, and cardiac CT

In daily clinical practice, clinicians integrate available data to ascertain the diagnostic and prognostic probability of a disease or clinical outcome for their patients. For patients with suspected or known cardiovascular disease, several anatomical and functional imaging techniques are commonly performed to aid this endeavor, including coronary computed tomography angiography (CCTA) and nuclear cardiology imaging. Continuous improvement in positron emission tomography (PET), single-photon emission computed tomography (SPECT), and CT hardware and software has resulted in improved diagnostic performance and wide implementation of these imaging techniques in daily clinical practice. However, the human ability to interpret, quantify, and integrate these data sets is limited. The identification of novel markers and application of machine learning (ML) algorithms, including deep learning (DL) to cardiovascular imaging techniques will further improve diagnosis and prognostication for patients with cardiovascular diseases. The goal of this position paper of the European Association of Nuclear Medicine (EANM) and the European Association of Cardiovascular Imaging (EACVI) is to provide an overview of the general concepts behind modern machine learning-based artificial intelligence, highlights currently prefered methods, practices, and computational models, and proposes new strategies to support the clinical application of ML in the field of cardiovascular imaging using nuclear cardiology (hybrid) and CT techniques. © 2021, The Author(s)

Risk factors for intensive care admission in children with severe acute asthma in the Netherlands: a prospective multicentre study

RATIONALE: Severe acute asthma (SAA) can be fatal, but is often preventable. We previously observed in a retrospective cohort study, a three-fold increase in SAA paediatric intensive care (PICU) admissions between 2003 and 2013 in the Netherlands, with a significant increase during those years of numbers of children without treatment of inhaled corticosteroids (ICS). OBJECTIVES: To determine whether steroid-naïve children are at higher risk of PICU admission among those hospitalised for SAA. Furthermore, we included the secondary risk factors tobacco smoke exposure, allergic sensitisation, previous admissions and viral infections. METHODS: A prospective, nationwide multicentre study of children with SAA (2-18 years) admitted to all Dutch PICUs and four general wards between 2016 and 2018. Potential risk factors for PICU admission were assessed using logistic regression analyses. MEASUREMENTS AND MAIN RESULTS: 110 PICU and 111 general ward patients were included. The proportion of steroid-naïve children did not differ significantly between PICU and ward patients. PICU children were significantly older and more exposed to tobacco smoke, with symptoms >1 week prior to admission. Viral susceptibility was not a significant risk factor for PICU admission. CONCLUSIONS: Children with SAA admitted to a PICU were comparable to those admitted to a general ward with respect to ICS treatment prior to admission. Preventable risk factors for PICU admission were >7 days of symptoms without adjustment of therapy and exposure to tobacco smoke. Physicians who treat children with asthma must be aware of these risk factors