454 research outputs found
No association between genetic markers and hypertension control in multiple cross-sectional studies.
We aimed to assess whether genetic markers are associated with hypertension control using two cross-sectional surveys conducted in Lausanne, Switzerland. Management of hypertension was assessed as per ESC guidelines using the 140/90 or the 130/80 mm Hg thresholds. One genetic risk score (GRS) for hypertension (18 SNPs) and 133 individual SNPs related to response to specific antihypertensive drugs were tested. We included 1073 (first) and 1157 (second survey) participants treated for hypertension. The prevalence of controlled participants using the 140/90 threshold was 58.8% and 63.6% in the first and second follow-up, respectively. On multivariable analysis, only older age was consistently and negatively associated with hypertension control. No consistent associations were found between GRS and hypertension control (140/90 threshold) for both surveys: Odds ratio and (95% confidence interval) for the highest vs. the lowest quartile of the GRS: 1.06 (0.71-1.58) p = 0.788, and 1.11 (0.71-1.72) p = 0.657, in the first and second survey, respectively. Similar findings were obtained using the 130/80 threshold: 1.23 (0.79-1.90) p = 0.360 and 1.09 (0.69-1.73) p = 0.717, in the first and second survey, respectively. No association between individual SNPs and hypertension control was found. We conclude that control of hypertension is poor in Switzerland. No association between GRS or SNPs and hypertension control was found
Trends in glycemic, blood pressure, and lipid control in adults with diabetes in Switzerland: the CoLaus|PsyCoLaus Study.
To assess the 15-year trends in the level of glycemic, blood pressure, and cholesterol control in adults with diabetes in a Swiss population-based cohort.
CoLaus|PsyCoLaus is a prospective cohort study of 6733 adults aged 35-75 years in Lausanne, Switzerland. Baseline recruitment was conducted in 2003-6 and was followed by three subsequent follow-ups in 2009-12, 2014-17 and 2018-21. In adults with diabetes, glycemic control was defined as fasting plasma glucose <7 mmol/L, blood pressure control as systolic and diastolic pressures of <140/90 mm Hg, and lipid control as non-high-density lipoprotein (non-HDL) cholesterol control <3.4 mmol/L.
Rates of glycemic control improved from 23.2% (95% CI 19.5 to 27.3) in 2003-6 to 32.8% (95% CI 28.1 to 37.8) in 2018-21. Blood pressure control also improved, from 51.5% at baseline (95% CI 46.8 to 56.2) to 63.3% (95% CI 58.2 to 68.1) 15 years later. The largest improvement was in cholesterol control, from 29.1% (95% CI 25.1 to 33.6) in 2003-6 to 56.3% (95% CI 51.1 to 61.4) in 2018-21. Overall, simultaneous control of all three improved from 5.5% (95% CI 3.7 to 8.1) at baseline to 17.2% (95% CI 13.7 to 21.5) 15 years later. Improvements in risk factor control tallied with an increase in the use of glucose-lowering agents, blood pressure-lowering medication, and statins. Men were less likely to achieve blood pressure control but presented with a better control of non-HDL cholesterol. Caucasians were less likely to achieve simultaneous control than non-Caucasians.
Cardiovascular risk factor control in adults with diabetes in Switzerland has increased in the last 15 years, but there remains a margin for improvement
Ultra-large Rydberg dimers in optical lattices
We investigate the dynamics of Rydberg electrons excited from the ground
state of ultracold atoms trapped in an optical lattice. We first consider a
lattice comprising an array of double-well potentials, where each double well
is occupied by two ultracold atoms. We demonstrate the existence of molecular
states with equilibrium distances of the order of experimentally attainable
inter-well spacings and binding energies of the order of 10^3 GHz. We also
consider the situation whereby ground-state atoms trapped in an optical lattice
are collectively excited to Rydberg levels, such that the charge-density
distributions of neighbouring atoms overlap. We compute the hopping rate and
interaction matrix elements between highly-excited electrons separated by
distances comparable to typical lattice spacings. Such systems have tunable
interaction parameters and a temperature ~10^{-4} times smaller than the Fermi
temperature, making them potentially attractive for the study and simulation of
strongly correlated electronic systems.Comment: 10 pages, 6 figures, PRA format, version to be published in PR
The beliefs and attitudes of UK registered osteopaths towards chronic pain and the management of chronic pain sufferers ::a cross-sectional questionnaire based survey
Objectives: This study investigated the beliefs and attitudes of UK registered osteopaths towards chronic pain and
the management of chronic pain sufferers.
Methods: A cross-sectional questionnaire based survey of UK registered osteopaths was performed to test the
hypothesis that osteopaths have a more biopsychosocial approach to treating and managing chronic pain patients
than other healthcare professionals. Sociodemographic determinants of the participants were explored and
the original HC-PAIRS and the PABS-PT used as measurement tools. They assess practitioners' attitudes and
beliefs towards perceived harmfulness of physical activities for patients with cLBP and participants' knowledge
of pain. International meta-analyses were performed with both measurement tools to allow comparison with
other healthcare professionals.
Results: UK registered osteopaths (n=216) had mean PABS-PT subscale scores of 31.37 ± 6.26 [CI95%
30.53–32.21] (biomedical) and 32.72 ± 4.29 [CI95% 32.14–33.29] (biopsychosocial). The mean HC-PAIRS
total score was 45.45 ± 10.05 [CI95% 44.11–46.8]. These indicate a wide spread of beliefs and knowledge
towards chronic pain with a tendency to agree that physical activity is not necessarily harmful for patients with
cLBP. Post-graduate education had a significant positive effect on questionnaire results. Meta-analyses revealed
that UK registered osteopaths have significantly better HC-PAIRS scores than most physiotherapy students,
nurses and pharmacists, and had similar PABS-PT scores to most other healthcare professionals.
Conclusions: The hypothesis of UK registered osteopaths having a more biopsychosocial approach to treating and
managing chronic pain patients in comparison to other healthcare providers has been rejected. This seems in
contrast to the typically claimed unique concepts of osteopathy. Nevertheless, this study supports their ability to
engage with psychosocial factors of the patients' pain experience, but shows that it can be improved. This paper
suggests that training is needed to increase osteopaths' expertise in knowledge of chronic pain, and their attitudes
towards the management of chronic pain sufferers
Temporal Trends in Low-Dose Aspirin Use (from the CoLaus|PsyCoLaus Study).
Although established in secondary prevention, the use of low-dose aspirin for primary cardiovascular prevention remains uncertain. We assessed the temporal trend of low-dose aspirin use in people at primary and secondary prevention over 14 years. We used data from the population-based CoLaus|PsyCoLaus study. A baseline survey was conducted from 2003 to 2006, involving 6,733 participants. The first and second follow-up investigations were performed from 2009 to 2012 and 2014 to 2017, respectively. Low-dose aspirin use was defined as ≤300 mg/daily oral administration or administration of an anticoagulant for similar indications. For primary prevention analysis, 6,555, 4,695, and 3,893 participants were included in the analysis at baseline, first and second follow-ups, respectively. Overall, low-dose aspirin use doubled between baseline (4.1%) and second follow-up (8.1%). Appropriate use of low-dose aspirin rose from 32% at baseline to 64% at the second follow-up for primary prevention. In secondary prevention, 71.8%, 75.9%, and 71.7% of participants were taking low-dose aspirin at baseline, first, and second follow-up, respectively. On the basis of a population-based cohort, the appropriateness of low-dose aspirin use increased over a 10-year follow-up in primary prevention, but its inappropriate use still concerned 44% of subjects. In secondary prevention, a quarter of individuals were not taking low-dose aspirin which remained stable over the analyzed period
Population and economic impact of the 2013 ACC/AHA guidelines compared with European guidelines to prevent cardiovascular disease.
Depression with atypical features and increase in obesity, body mass index, waist circumference, and fat mass: a prospective, population-based study.
IMPORTANCE: Depression and obesity are 2 prevalent disorders that have been repeatedly shown to be associated. However, the mechanisms and temporal sequence underlying this association are poorly understood.
OBJECTIVE: To determine whether the subtypes of major depressive disorder (MDD; melancholic, atypical, combined, or unspecified) are predictive of adiposity in terms of the incidence of obesity and changes in body mass index (calculated as weight in kilograms divided by height in meters squared), waist circumference, and fat mass.
DESIGN, SETTING, AND PARTICIPANTS: This prospective population-based cohort study, CoLaus (Cohorte Lausannoise)/PsyCoLaus (Psychiatric arm of the CoLaus Study), with 5.5 years of follow-up included 3054 randomly selected residents (mean age, 49.7 years; 53.1% were women) of the city of Lausanne, Switzerland (according to the civil register), aged 35 to 66 years in 2003, who accepted the physical and psychiatric baseline and physical follow-up evaluations.
EXPOSURES: Depression subtypes according to the DSM-IV. Diagnostic criteria at baseline and follow-up, as well as sociodemographic characteristics, lifestyle (alcohol and tobacco use and physical activity), and medication, were elicited using the semistructured Diagnostic Interview for Genetic Studies.
MAIN OUTCOMES AND MEASURES: Changes in body mass index, waist circumference, and fat mass during the follow-up period, in percentage of the baseline value, and the incidence of obesity during the follow-up period among nonobese participants at baseline. Weight, height, waist circumference, and body fat (bioimpedance) were measured at baseline and follow-up by trained field interviewers.
RESULTS: Only participants with the atypical subtype of MDD at baseline revealed a higher increase in adiposity during follow-up than participants without MDD. The associations between this MDD subtype and body mass index (β = 3.19; 95% CI, 1.50-4.88), incidence of obesity (odds ratio, 3.75; 95% CI, 1.24-11.35), waist circumference in both sexes (β = 2.44; 95% CI, 0.21-4.66), and fat mass in men (β = 16.36; 95% CI, 4.81-27.92) remained significant after adjustments for a wide range of possible cofounding.
CONCLUSIONS AND RELEVANCE: The atypical subtype of MDD is a strong predictor of obesity. This emphasizes the need to identify individuals with this subtype of MDD in both clinical and research settings. Therapeutic measures to diminish the consequences of increased appetite during depressive episodes with atypical features are advocated
Driving under drugs in Switzerland : a descriptive cross-sectional study
Objectives: Many drugs, both illicit or for medication, are known to influence driving abilities and increase risks of accidents.
We explored the prevalence of psychoactive substances in a random sample of drivers in Switzerland.
Methods: Saliva samples from 1078 random drivers were collected at 24 different locations in Western Switzerland
from October 2006 to April 2008 for complete toxicological analysis using liquid chromatography/tandem
mass spectrometry.
Results: Provisional results are available for 437 drivers. 6.2% (CI95% 4.1 to 8.9) were under the influence of illicit
drugs and 8.7% under psychoactive medication (CI95% 6.2 to 11.7). 37 drivers (8.5%) were under the influence
of alcohol of which 14 (3.2%) were above 0.8 mg/L. 21 drivers (4.8%) were under the combined influence
of more than one psychoactive substance; however only 4 drivers (0.9%) were under both the
influence of medication and alcohol. Looking more specifically at illicit substances, 22 (5.0%) were positive
to cocaine, 5 (1.1%) to cannabis, and 2 (0.5%) to amphetamines ; for psychoactive medication, 17
(3.9%) were positive to benzodiazepines, 16 (3.7%) to antidepressors, 7 (1.6%) to opiates, 7 (1.6%) to
neuroleptics, and 3 (0.7%) to other substances influencing driving abilities. 17/21 drivers did not self-report
their consumption of drugs whereas only 9/35 failed mentioning their medication. Men drivers were
3.2 times (CI95% 1.1 to 9.5) more likely to be under the influence of illicit drugs than women. Full results
will be reported when laboratory data will be available in April.
Conclusions: Driving under the influence of psychoactive substances is common. In Western Switzerland, prevention
messages could focus on men, driving under medication or cocaine
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