Lung density in the trajectory path — a strong indicator of patients sustaining a pneumothorax during CT-guided lung biopsy

Introduction: The purpose is to evaluate the prognostic significance of lung parenchymal density during percutaneous coaxial cutting needle lung biopsy (PNLB). Materials and methods: Retrospective analysis of 179 consecutive patients (106 males, 73 females; mean age 59.16 ± 16.34 years) undergoing PNLB was included. Mean lobar parenchymal lung density, mean densities anterior to the lesion and posterior to the chest wall in the needle trajectory path were measured in HU. Lesion location and needle trajectory were also measured. Fisher’s exact test and Chi-square test were conducted to analyze the categorical variables. ANOVA test was done to examine continuous and normally distributed variables. Statistical significance was considered when p < 0.05. Results: Mean lobar parenchymal lung density (p < 0.05) and mean parenchymal lung density relative to the needle trajectory path were below -800 HU in patients who sustained a pneumothorax. Increase in the number of pleural passes was significantly associated with the risk of patients having pneumothorax (p < 0.05). The mean distance from the skin to the lesion and needle trajectory angle were not statistically different among patients with and without pneumothorax (p > 0.05). Conclusion: Lobar parenchymal density and lung parenchymal density anterior to the lesion and posterior to the chest wall in the needle trajectory path could be used as predicting parameters in patients undergoing PNLB who sustained a pneumothorax. These findings can help interventional radiologist further assess risk of pneumothorax when preforming such procedure

Depression and risk of cardiovascular disease : role of hostility and adherence to medical preventive measures

L’association entre dépression et maladies cardiovasculaires pourrait être partiellement expliquée par le rôle confondant de l'hostilité ou médiateur de la faible adhésion au traitement préventif. Nos objectifs étaient d’étudier : 1) si l’hostilité explique la relation prospective entre symptômes dépressifs et évènements cardiaques incidents ; 2) si les symptômes dépressifs modifient la relation prospective entre les facteurs de risque cardiovasculaire modifiables par un traitement médicamenteux (hypertension, diabète, dyslipidémies) et les évènements cardiaques incidents ; 3) la relation prospective entre les symptômes dépressifs et la non-adhésion aux traitements médicamenteux de ces facteurs de risque. Nous avons utilisé les données de deux grandes cohortes prospectives françaises (GAZEL et CONSTANCES) et des modèles de régression de Cox à risque proportionnel et de régression logistique. Trois résultats ont été obtenus : 1) la relation entre les symptômes dépressifs et les évènements cardiaques était indépendante des traits d’hostilité ; 2) les symptômes dépressifs ne modifiaient pas l’impact des facteurs de risque cardiovasculaire modifiables par un traitement médicamenteux sur les évènements cardiaques ; 3) les symptômes dépressifs n’étaient pas associés à la non-adhésion aux traitements médicamenteux de ces facteurs de risque. Nos résultats suggèrent que la dépression doit être considérée comme un facteur de risque cardiovasculaire en soi et des recherches supplémentaires sont nécessaires pour identifier les mécanismes qui sous-tendent son association avec l’incidence des maladies cardiovasculaires.Depression is associated with increased risk of cardiovascular disease, but the mechanisms remain mostly unknown and may involve hostility or poor medical adherence. The objectives were: to examine whether hostile traits explain the prospective association between depressive symptoms and incident cardiac events; to examine whether depressive symptoms modify the prospective association between treatable cardiovascular risk factors (hypertension, diabetes and dyslipidemia) and incident cardiac events; and to study the prospective association between depressive symptoms and non-adherence to medications for treatable cardiovascular risk factors. We addressed these objectives using two large French population-based prospective cohorts (GAZEL and CONSTANCES cohorts) with Cox proportional hazard regression models and logistic regression models. Three findings were obtained. First, the association between depressive symptoms and cardiac events was independent of hostile traits. Second, the association between depressive symptoms and cardiac events was not explained by a heightened impact of these cardiovascular risk factors in the presence of depression. Third, depressive symptoms were not associated with non-adherence to medications for these cardiovascular risk factors. Hence, according to these findings, depression should be considered as a cardiovascular risk factor on its own. Further research is needed to identify the mechanisms underlying the association between depression and incident cardiovascular disease

Dépression et risque cardiovasculaire : rôle de l'hostilité et de l'adhésion au traitement préventif médicamenteux

Depression is associated with increased risk of cardiovascular disease, but the mechanisms remain mostly unknown and may involve hostility or poor medical adherence. The objectives were: to examine whether hostile traits explain the prospective association between depressive symptoms and incident cardiac events; to examine whether depressive symptoms modify the prospective association between treatable cardiovascular risk factors (hypertension, diabetes and dyslipidemia) and incident cardiac events; and to study the prospective association between depressive symptoms and non-adherence to medications for treatable cardiovascular risk factors. We addressed these objectives using two large French population-based prospective cohorts (GAZEL and CONSTANCES cohorts) with Cox proportional hazard regression models and logistic regression models. Three findings were obtained. First, the association between depressive symptoms and cardiac events was independent of hostile traits. Second, the association between depressive symptoms and cardiac events was not explained by a heightened impact of these cardiovascular risk factors in the presence of depression. Third, depressive symptoms were not associated with non-adherence to medications for these cardiovascular risk factors. Hence, according to these findings, depression should be considered as a cardiovascular risk factor on its own. Further research is needed to identify the mechanisms underlying the association between depression and incident cardiovascular disease.L’association entre dépression et maladies cardiovasculaires pourrait être partiellement expliquée par le rôle confondant de l'hostilité ou médiateur de la faible adhésion au traitement préventif. Nos objectifs étaient d’étudier : 1) si l’hostilité explique la relation prospective entre symptômes dépressifs et évènements cardiaques incidents ; 2) si les symptômes dépressifs modifient la relation prospective entre les facteurs de risque cardiovasculaire modifiables par un traitement médicamenteux (hypertension, diabète, dyslipidémies) et les évènements cardiaques incidents ; 3) la relation prospective entre les symptômes dépressifs et la non-adhésion aux traitements médicamenteux de ces facteurs de risque. Nous avons utilisé les données de deux grandes cohortes prospectives françaises (GAZEL et CONSTANCES) et des modèles de régression de Cox à risque proportionnel et de régression logistique. Trois résultats ont été obtenus : 1) la relation entre les symptômes dépressifs et les évènements cardiaques était indépendante des traits d’hostilité ; 2) les symptômes dépressifs ne modifiaient pas l’impact des facteurs de risque cardiovasculaire modifiables par un traitement médicamenteux sur les évènements cardiaques ; 3) les symptômes dépressifs n’étaient pas associés à la non-adhésion aux traitements médicamenteux de ces facteurs de risque. Nos résultats suggèrent que la dépression doit être considérée comme un facteur de risque cardiovasculaire en soi et des recherches supplémentaires sont nécessaires pour identifier les mécanismes qui sous-tendent son association avec l’incidence des maladies cardiovasculaires

Mesoporous Zirconium Oxide Prepared by Anchoring W, Mo, Nb, Ta Using Peroxo Precursors:Influence of the Oxoanions on the Pores Size and the Hydrothermal Catalysts Stability for Cellulose Conversion

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Depression and non-adherence to medications targeting treatable cardiovascular risk factors in the CONSTANCES cohort

International audienceINTRODUCTION - Depression is associated with increased risk of cardiovascular disease but the mechanisms remain mostly unknown. OBJECTIVES - To study the association between depression and non-adherence to medications targeting type 2 diabetes, hypertension and dyslipidemia (i.e. treatable cardiovascular risk factors) in the Constances population-based French cohort. METHODS - We used Constances data linked to the French administrative health care database (SNDS) to study the longitudinal association between depression (assessed at inclusion with the Center for Epidemiological Studies Depression scale) and non-adherence to medications treating diabetes, hypertension and dyslipidemia over two subsequent periods of 18 months. Binary logistic regression models were adjusted for socio-demographics, body mass index, physical activity, prescribed and followed diet, and normal/abnormal levels of blood pressure, glycaemia, cholesterol and triglycerides at inclusion. RESULTS - Among 4,325 individuals with hypertension, 691 with diabetes and 3,329 with dyslipidemia, 535, 50 and 904 were non-adherent over the first 18 months, and 638, 65 and 1,207 between 19-36 months. Depression was neither associated with non-adherence to medications for hypertension and dyslipidemia over the first 18 months, nor afterwards. However, depression was associated with non-adherence to anti-diabetic medications (odds ratio [95% confidence interval]: 2.32 [1.19-4.52]) over the first 18 months only. Depression was only associated with uncontrolled dyslipidemia level (1.24 [1.02-1.52]), although a similar trend was observed for glycaemia level (1.45 [0.96-2.19]). CONCLUSIONS - In a population-based cohort, depression was only associated with non-adherence to anti-diabetic medications in the short run, thus urging clinicians to search for and treat depression in individuals with diabetes

Depression, treatable cardiovascular risk factors and incident cardiac events in the Gazel cohort

International audienceBackgroundDepression is an important risk factor of cardiovascular disease (CVD), a leading cause of death worldwide. One of the reasons underlying this association may be that depression modifies the association between treatable cardiovascular risk factors and cardiac events (angina pectoris or myocardial infarction). We tested this hypothesis in a cohort study of middle-aged men and women in France followed for 20 years.Methods10,541 Gazel working men and women free of cardiovascular disease at baseline (1993) were followed-up over 20 years for validated incident cardiac events. Depression was measured at baseline and every three years with the Center for Epidemiological Studies-Depression (CES-D). We used time-dependent Cox regression models to calculate hazard ratios (HR) of cardiac events associated with depression, main treatable cardiovascular risk factors (hypertension, diabetes, and dyslipidemia), and their interactions, adjusting for demographic, lifestyle and clinical characteristics.ResultsOver 20 years of follow-up, 592 incident cases of cardiac events were identified. Depression was significantly associated with incident cardiac events (HR 1.55, P = 0.002), as was hypertension (HR 1.49, P = 0.02), diabetes (HR 2.54, P = 0.001), and dyslipidemia (HR 1.55, P = 0.003). No statistically significant interactions were observed between depression and hypertension, diabetes or dyslipidemia in relation to incident cardiac events (all P ≥ 0.16).ConclusionsThe association between depression and cardiac events is unlikely to be explained by a heightened impact of hypertension, diabetes or dyslipidemia

Atypical working hours are associated with tobacco, cannabis and alcohol use: longitudinal analyses from the CONSTANCES cohort

International audienceBACKGROUND: This study examined prospective associations between atypical working hours with subsequent tobacco, cannabis and alcohol use as well as sugar and fat consumption. METHODS: In the French population-based CONSTANCES cohort, 47,288 men and 53,324 women currently employed included between 2012 and 2017 were annually followed for tobacco and cannabis use. Among them, 35,647 men and 39,767 women included between 2012 and 2016 were also followed for alcohol and sugar and fat consumption. Three indicators of atypical working hours were self-reported at baseline: working at night, weekend work and non-fixed working hours. Generalized linear models computed odds of substance use and sugar and fat consumption at follow-up according to atypical working hours at baseline while adjusting for sociodemographic factors, depression and baseline substance use when appropriate. RESULTS: Working at night was associated with decreased smoking cessation and increased relapse in women [odds ratios (ORs) of 0.81 and 1.25], increased cannabis use in men [ORs from 1.46 to 1.54] and increased alcohol use [ORs from 1.12 to 1.14] in both men and women. Weekend work was associated with decreased smoking cessation in women [ORs from 0.89 to 0.90] and increased alcohol use in both men and women [ORs from 1.09 to 1.14]. Non-fixed hours were associated with decreased smoking cessation in women and increased relapse in men [ORs of 0.89 and 1.13] and increased alcohol use in both men and women [ORs from 1.12 to 1.19]. Overall, atypical working hours were associated with decreased sugar and fat consumption. CONCLUSIONS: The potential role of atypical working hours on substance use should be considered by public health policy makers and clinicians in information and prevention strategies

Atypical working hours are associated with substance use in women: Longitudinal analyses from the CONSTANCES cohort

International audienceBACKGROUND - We examined the prospective associations between atypical working hours and substance use, including also sugar and fat consumption. METHODS - In the CONSTANCES cohort, a total of 47,288 men and 53,324 women currently employed were included from 2012 to 2017 for tobacco and cannabis outcomes, and 35,647 and 39,767, respectively from 2012 to 2016 for alcohol and sugar and fat outcomes, and they were then followed up annually. Atypical working hours were self-reported at baseline and considered three different indicators: night shifts, weekend work and non-fixed working hours. Generalized linear models computed odds of substance use and sugar and fat consumption at follow-up according to atypical working hours at baseline while adjusting for sociodemographic factors, baseline depression and baseline level of consumption. RESULTS - Night shifts increased significantly the odds of using tobacco in women (Odds ratios, ORs varying from 1.55 to 1.62) and cannabis in men (ORs varying from 1.80 to 1.95). Weekend work increased the odds of using tobacco (ORs varying from 1.51 to 1.67) and alcohol (OR of 1.16) in women. Non-fixed working hours increased the odds of using tobacco and alcohol in men and women (ORs varying from 1.15 to 1.19 and 1.12 to 1.14, respectively). Dose-dependent relationships were found for tobacco use in women (P for trendsb0.0001). No significant associations were found for sugar and fat consumption. CONCLUSION - The role of atypical working hours on substance use should be taken into account by public health policy makers and clinicians for information and prevention strategies, especially among women

Lung Density in the Trajectory Path—A Strong Indicator of Patients Sustaining a Pneumothorax during CT-Guided Lung Biopsy

Introduction: The purpose is to evaluate the prognostic significance of lung parenchymal density during percutaneous coaxial cutting needle lung biopsy (PNLB). Materials and methods: Retrospective analysis of 179 consecutive patients (106 males, 73 females; mean age 59.16 ± 16.34 years) undergoing PNLB was included. Mean lobar parenchymal lung density, mean densities anterior to the lesion and posterior to the chest wall in the needle trajectory path were measured in HU. Lesion location and needle trajectory were also measured. Fisher’s exact test and Chi-square test were conducted to analyze the categorical variables. ANOVA test was done to examine continuous and normally distributed variables. Statistical significance was considered when p < 0.05. Results: Mean lobar parenchymal lung density (p < 0.05) and mean parenchymal lung density relative to the needle trajectory path were below -800 HU in patients who sustained a pneumothorax. Increase in the number of pleural passes was significantly associated with the risk of patients having pneumothorax (p < 0.05). The mean distance from the skin to the lesion and needle trajectory angle were not statistically different among patients with and without pneumothorax (p > 0.05). Conclusion: Lobar parenchymal density and lung parenchymal density anterior to the lesion and posterior to the chest wall in the needle trajectory path could be used as predicting parameters in patients undergoing PNLB who sustained a pneumothorax. These findings can help interventional radiologist further assess risk of pneumothorax when preforming such procedure

Hostility, depression and incident cardiac events in the GAZEL cohort

International audienceBackground: Psychological factors such as hostility and depression have been associated with cardiovascular disease. However, their role in predicting incident cardiac events independently one of another is not clear.Methods: Among 10,304 GAZEL middle-aged workers free of cardiovascular diseases in 1993, 581 incident cardiac events were validated from 1994–2014. Hostile traits (cognitive hostility, behavioral hostility, irritability and negativism) were assessed with the Buss and Durkee Hostility Inventory at baseline. Depressive symptoms were assessed at baseline and every three years with the Center for Epidemiological Studies Depression scale. We used Cox proportional hazards models to calculate hazard ratios (HR) of hostile traits for incident cardiac events adjusting for baseline self-reported socio-demographics and family history of coronary heart diseases (model 1), then additionally for time-dependent depressive symptoms (either as a binary or continuous variable) (model 2) and for yearly self-reported modifiable cardiovascular risk factors (physical activity, smoking, body mass index, diabetes, dyslipidemia and hypertension) (model 3).Results: In Model 1, the only hostile trait associated with incident cardiac events was irritability (HR for one interquartile range: 1.16, 95% confidence interval: 1.02–1.32). This association was no longer statistically significant when further adjusting for depressive symptoms. Depressive symptoms, in turn, remained significant predictors of cardiac events with HRs ranging from 1.40–1.49 (binary).Limitations: Hostility traits were measured only once.Conclusions: Depressive symptoms might explain the association between irritability and cardiac events and should therefore be prioritized in interventions aiming to prevent cardiovascular disease. Further research is needed to identify the mechanisms underlying this association