Risk of End-stage Renal Disease Associated with Alcohol Consumption

Alcohol consumption has been linked to kidney disorders in selected patient groups, but whether it contributes to the burden of end-stage renal disease (ESRD) in the general population is unknown. The authors conducted population-based case-control study to asess the realation between alcohol consumption and risk of ESRD. The study took place in Maryland, Virginia, West Virginia, and Washington, DC, in 1991. Participants were 716 patients who had started treatment for ESRD and 361 control subjects of similar age (20-64 years) selected by random digit dialing. The main risk factor of interest was self-reported consumption of alcoholic beverages (frequency of drinking days and number of drinks consumed per drinking day). In univariate analysis, consumption of alcohol exhibited a J-shaped association with risk of ESRD. The J shape disappeared after exclusion of persons who had ever consumed home-distilled whiskey ("moonshine”) and adjustment for age, race, sex, income, history of hypertension, history of diabetes mellitus, use of acetaminophen, use of opiates, and cigarette smoking; however, the odds ratio for ESRD remained significantly increased (odds ratio = 4.0; 95% confidence interval: 1.2, 13.0) among persons who consumed an average of >2 alcoholic drinks per day. The corresponding population attributable risk was 9 percent. Thus, consumption of more than two alcoholic drinks per day, on average, was associated with an increased risk of kidney failure In the general population. A lower intake of alcohol did not appear to be harmful. Because these results are based on self-reports in a case-control study, they should be seen as preliminary. Am J Epidemiol 1999; 150:1275-8

Toothbrushing rules: power dynamics and toothbrushing in children

Dental caries is a disease of childhood social disa dvantage being considered as a marker of family dep rivation and relative poverty. School-based programmes such as, ‘Winning Smiles’ (WS) have been used to promote toothbrushing with luoride toothpaste in children r esiding in areas of high social deprivation. Withou t a clear understanding of the underlying toothbrushing dynam ic how could WS achieve its deined aim to promote toothbrushing as a self-care practice in children r esiding in areas of greatest deprivation? The need to research the dynamics of childhood toothbrushing remained. T he aim of this qualitative exploration was twofold, irst to explore children’s views of toothbrushing and se condly, to relect, if possible, on the degree to wh ich the children’s views and experiences can aid an underst anding of the power dynamics of toothbrushing pract ices in childhood. In order to achieve these aims it was necessary to use a child-centred approach to glean the thoughts, values and opinions of the participating children. The children who participated were aged b e- tween 8-9-years-old and resided and attended school s in the most deprived parts of Dublin and Belfast. The data analysis was theoretically underpinned by the work of Foucault and Nettleton. The children had a series of toothbrushing rules which were a conglomerate of ‘do’s’ and ‘don’ts’. The rules relected an element of con - lict in the children’s behaviour since they describ ed what the children felt they ‘should’ do (‘toothb rushing rules’), as well as what they ‘actually’ did (‘toot hbrushing practices’). The toothbrushing rules were mainly based on their parental household rules which the c hildren incorporated into their toothbrushing pract ices. It is suggested that children incorporate informati on from parents, school-based programmes and the de ntist into their toothbrushing practices. This qualitativ e exploration has allowed the process of understand ing the power dynamics associated with children’s toothbrushing t o begin. In order to gain a greater understanding from the child’s perspective greater time is need t o appreciate how children incorporate what appears to be a rather mundane aspect of everyday life into their health repertoire

Ethnic Comparison of Weight Loss in Trial of Nonpharmacologic Interventions in the Elderly

https://onlinelibrary.wiley.com/doi/epdf/10.1038/oby.2002.1

The dietary impact of the Norman Conquest: A multiproxy archaeological investigation of Oxford, UK

Archaeology has yet to capitalise on the opportunities offered by bioarchaeological approaches to examine the impact of the 11th-century AD Norman Conquest of England. This study utilises an integrated multiproxy analytical approach to identify and explain changes and continuities in diet and foodways between the 10th and 13th centuries in the city of Oxford, UK. The integration of organic residue analysis of ceramics, carbon (δ13C) and nitrogen (δ15N) isotope analysis of human and animal bones, incremental analysis of δ13C and δ15N from human tooth dentine and palaeopathological analysis of human skeletal remains has revealed a broad pattern of increasing intensification and marketisation across various areas of economic practice, with a much lesser and more short-term impact of the Conquest on everyday lifestyles than is suggested by documentary sources. Nonetheless, isotope data indicate short-term periods of instability, particularly food insecurity, did impact individuals. Evidence of preferences for certain foodstuffs and cooking techniques documented among the elite classes were also observed among lower-status townspeople, suggesting that Anglo-Norman fashions could be adopted across the social spectrum. This study demonstrates the potential for future archaeological research to generate more nuanced understanding of the cultural impact of the Norman Conquest of England, while showcasing a method which can be used to elucidate the undocumented, everyday implications of other large-scale political events on non-elites

School based health-education programmes, health-learning capacity and child oral health-related quality of life

Objective: To use a model of health learning to examine the role of health-learning capacity and the effect of a school-based oral health education intervention (Winning Smiles) on the health outcome, child oral health–related quality of life (COHRQoL). Setting: Primary schools, high social deprivation, Ireland/Northern Ireland. Design: Cluster randomised controlled trial. Method: A total of 383, 7- to 8-year-old children were invited to participate and randomly allocated into intervention and control conditions. Baseline and 12-month follow-up assessments of COHRQoL, self-esteem, toothbrushing–fluoride toothpaste knowledge and unstimulated saliva samples were made. An 18-hour post-brushing, saliva fluoride concentration was used to assess toothbrushing with fluoride toothpaste (behaviour). The data were entered onto SPSSv22. Structural equation modelling was applied using AMOSv22 to test for the role of health-learning capacity (baseline self-esteem and COHRQoL) and simultaneous effects of Winning Smiles upon knowledge, behaviour and COHRQoL (at follow-up). Results: A total of 238 children participated at baseline and follow-up. A partial latent hybrid model fitted the data reasonably well (χ2 = 65.6, df = 50, p = .07) as shown in addition by a Comparative Fit Index of .97 and a Root Mean Square Error of Approximation (RMSEA) value of .042 (90% confidence interval [CI]: .00, .06). The intervention had a significant effect on toothbrushing–fluoride toothpaste knowledge (p < .03) and an effect on COHRQoL at the 6% level (p < .06). Knowledge was strongly associated with saliva fluoride concentration (p < .002). Conclusion: The model of health-learning capacity assisted in explaining the effect of a school-based intervention upon knowledge, toothbrushing behaviour and tentatively on COHRQoL

Hipertensión arterial inducida por el tratamiento con antiangiogénicos en el paciente oncológico

Introduction: high blood pressure is a multifactorial disease; there is a wide range of stimuli that can trigger it, including drugs.Objective: to describe the pathophysiological mechanisms involved in the development of hypertension induced by treatment with antiangiogenic drugs in oncological patients.Methods: a search for information was carried out in the PubMed/MEDLINE, SciELO and Scopus databases. Twenty-four bibliographic references were chosen.Development: the mechanisms of blood pressure elevation in patients treated with antiangiogenic agents are multifactorial. The mechanisms involved are not seen in isolation, but some are cause and/or effect of others. This interrelationship is shown during inhibition of vascular endothelial growth factor A, which is associated with a decrease in serum levels of nitric oxide metabolites, which triggers sodium retention and increased local and systemic blood pressure, showing changes in renal dynamics. Monitoring is necessary to allow early diagnosis and adequate treatment. This suggests that the use of appropriate antihypertensive drugs may be necessary for maintenance therapy to avoid dose interruption/discontinuation. Conclusions: there are several pathophysiological mechanisms related to the development of hypertension during treatment with antiangiogenic drugs such as induction of vascular endothelial growth factor A, variations in nitric oxide production, increased expression of pre-hypertensive agents such as endothelin-1, microvascular rare- fraction, activation of the renin-angiotensin system and oxidative stress.Introducción: la hipertensión arterial una enfermedad multifactorial; existe una alta gama de estímulos que pueden desencadenarla, entre ellos, los medicamentos.Objetivo: describir los mecanismos fisiopatológicos que intervienen en el desarrollo de hipertensión arterial inducida por el tratamiento con antiangiogénicos en pacientes oncológicos.Métodos: se realizó una búsqueda de información en las bases de datos PubMed/MEDLINE, SciELO y Scopus. Se seleccionaron 24 referencias bibliográficas.Desarrollo: los mecanismos de elevación de la presión arterial en pacientes tratados con antiangiogénicos son multifactoriales. Los mecanismos implicados no se ven de forma aislada, sino que unos son causa y/o efecto de otros. Esta interrelación se muestra durante la inhibición del factor A del crecimiento endotelial vascular, que se asocia con una disminución de los niveles séricos de los metabolitos del óxido nítrico, el cual desencadena la retención de sodio y aumento de la presión arterial local y sistémica, mostrando cambios en la dinámica renal. Es necesaria una monitorización que permita un diagnóstico temprano y tratamiento adecuado. Esto sugiere que el uso de medicamentos antihipertensivos apropiados puede ser necesario para la terapia de mantenimiento, a fin de evitar la interrupción/discontinuación de la dosis.Conclusiones: existen varios mecanismos fisiopatológicos relacionados al desarrollo de hipertensión arterial durante el tratamiento con antiangiogénicos como la inducción del factor A de crecimiento endotelial vascular, las variaciones de la producción de óxido nítrico, aumento de la expresión de agentes prehipertensivos como la endotelina-1, la rarefracción microvascular, la activación del sistema renina-angiotensina y el estrés oxidativo

Estimated Impact of Achieving Optimal Cardiovascular Health Among US Adults on Cardiovascular Disease Events

Background Better cardiovascular health (CVH) scores are associated with lower risk of cardiovascular disease (CVD). However, estimates of the potential population-level impact of improving CVH on US CVD event rates are not currently available. Methods and Results Using data from the National Health and Nutrition Examination Survey 2011 to 2016 (n=11 696), we estimated the proportions of US adults in CVH groups. Levels of 7 American Heart Association CVH metrics were scored as ideal (2 points), intermediate (1 point), or poor (0 points), and summed to define overall CVH (low, 0-8 points; moderate, 9-11 points; or high, 12-14 points). Using individual-level data from 7 US community-based cohort studies (n=30 447), we estimated annual incidence rates of major CVD events by levels of CVH. Using the combined data sources, we estimated population attributable fractions of CVD and the number of CVD events that could be prevented annually if all US adults achieved high CVH. High CVH was identified in 7.3% (95% CI, 6.3%-8.3%) of US adults. We estimated that 70.0% (95% CI, 56.5%-79.9%) of CVD events were attributable to low and moderate CVH. If all US adults attained high CVH, we estimated that 2.0 (95% CI, 1.6-2.3) million CVD events could be prevented annually. If all US adults with low CVH attained moderate CVH, we estimated that 1.2 (95% CI, 1.0-1.4) million CVD events could be prevented annually. Conclusions The potential benefits of achieving high CVH in all US adults are considerable, and even a partial improvement in CVH scores would be highly beneficial

Do patients with well-functioning total hip arthroplasty achieve typical sagittal plane hip kinematics? A proof of concept study

Background: Total hip arthroplasty (THA) patients have been shown to not achieve normal sagittal plane hip kinematics. However, previous studies have only conducted group level analysis and as such lack the sensitivity to highlight whether individual patients do achieve normal hip kinematics. As such this study looked to determine whether some patients with well-functioning THA achieve typical sagittal plane hip kinematics. Methods: Sagittal plane hip kinematics were collected on 11 well-functioning THA patients (Oxford Hip Score = 46 ± 3) and 10 asymptomatic controls using a 3-dimensional motion analysis system during self-paced walking. High-functioning THA patients were identified as those who displayed sagittal plane hip kinematics that were within the variance of the control group on average, and low-functioning patients as those who did not. Results: 5 THA patients were identified as high-functioning, displaying hip kinematics within the variance of the control group. High-functioning THA patients displayed peak hip flexion and extension values more closely aligned to asymptomatic control group than low-functioning patients. However, hip range of motion was comparable between high- and low-functioning total hip arthroplasty patients and reduced compared to controls. Conclusion: The presence of high-functioning THA patients who display comparable sagittal plane hip kinematics to controls suggests these patients do achieve normative function and challenges the conclusions of previous group level analysis. Understanding why some patients achieve better function post-operatively will aid pre- and post-operative practices to maximise functional recovery