• MeSH
• artritida MeSH
• epidemiologické studie MeSH
• kohortové studie MeSH
• tuberkulóza MeSH
• Publikační typ
• vysokoškolské kvalifikační práce MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• pneumologie a ftizeologie
• ortopedie

OBJECTIVES: The aim of this study was to identify dietary patterns in a Czech pregnancy cohort established in the early postcommunist era and investigate associations between dietary patterns, maternal characteristics and birth outcomes. METHODS: Pregnant women were recruited for the Czech part of the European Longitudinal Study of Pregnancy and Childhood. A self-reported questionnaire answered in late pregnancy was used to assess information about the weekly intake of 43 food items. Information about birth outcomes (birth weight, height, ponderal index, head circumference, cephalisation index, gestational length and Apgar score) was obtained from the National Registry of Newborns. Complete details on diet and birth outcomes were available for 4320 mother-infant pairs. RESULTS AND CONCLUSION: The food items were aggregated into 28 variables and used for extraction of two dietary patterns by principal component factor analysis. The patterns were denoted 'unhealthy' and 'healthy/traditional' based on the food items with the highest factor loadings on each pattern. The 'unhealthy' pattern had high positive loadings on meat, processed food and confectionaries. In contrast, the 'healthy/traditional' pattern had high positive loadings on vegetables, dairy, fruits and wholemeal bread. Following adjustment for covariates, we found that high adherence to the unhealthy pattern (expressed as beta for 1 unit increase in pattern score), that is, the higher consumption of less healthy foods, was associated with lower birth weight: -23.8 g (95% CI -44.4 to -3.2) and length: -0.10 cm (95% CI -0.19 to -0.01) and increased cephalisation index: 0.91 μm/g (95% CI 0.23 to 1.60). The 'healthy/traditional' pattern was not associated with any birth outcomes. This study supports the recommendation to eat a healthy and balanced diet during pregnancy.

• MeSH
• dieta * MeSH
• dítě MeSH
• kohortové studie MeSH
• lidé MeSH
• longitudinální studie MeSH
• novorozenec MeSH
• porodní hmotnost MeSH
• těhotenství MeSH
• zelenina * MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVES: Epidemiological studies of underground miners have provided clear evidence that inhalation of radon decay products causes lung cancer. Moreover, these studies have served as a quantitative basis for estimation of radon-associated excess lung cancer risk. However, questions remain regarding the effects of exposure to the low levels of radon decay products typically encountered in contemporary occupational and environmental settings on the risk of lung cancer and other diseases, and on the modifiers of these associations. These issues are of central importance for estimation of risks associated with residential and occupational radon exposures. METHODS: The Pooled Uranium Miner Analysis (PUMA) assembles information on cohorts of uranium miners in North America and Europe. Data available include individual annual estimates of exposure to radon decay products, demographic and employment history information on each worker and information on vital status, date of death and cause of death. Some, but not all, cohorts also have individual information on cigarette smoking, external gamma radiation exposure and non-radiological occupational exposures. RESULTS: The PUMA study represents the largest study of uranium miners conducted to date, encompassing 124 507 miners, 4.51 million person-years at risk and 54 462 deaths, including 7825 deaths due to lung cancer. Planned research topics include analyses of associations between radon exposure and mortality due to lung cancer, cancers other than lung, non-malignant disease, modifiers of these associations and characterisation of overall relative mortality excesses and lifetime risks. CONCLUSION: PUMA provides opportunities to evaluate new research questions and to conduct analyses to assess potential health risks associated with uranium mining that have greater statistical power than can be achieved with any single cohort.

• MeSH
• hodnocení rizik MeSH
• horníci * MeSH
• kohortové studie MeSH
• kouření cigaret epidemiologie   MeSH
• lidé MeSH
• nádory plic epidemiologie   mortalita   MeSH
• nádory vyvolané zářením epidemiologie   mortalita   MeSH
• nemoci z povolání epidemiologie   MeSH
• pracovní expozice škodlivé účinky   MeSH
• radon škodlivé účinky   MeSH
• uran * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, U.S. Gov't, P.H.S. MeSH
• Geografické názvy
• Evropa MeSH
• Severní Amerika MeSH

The aim of this prospective longitudinal study was to examine the association between Cesarean section (CS) and child development and behavior. The sample consisted of 256 children who were born at term without serious perinatal pathologies. Their development and behavior was assessed at the age of four using Ages and Stages Questionnaire (ASQ-3), Children's Behavior Questionnaire and Strength and Difficulties Questionnaire. Multivariate linear regression analyses were conducted to assess the association between CS and child outcomes. CS was associated with better scores in the Problem Solving domain of the ASQ in the whole sample. After stratifying by child sex, the positive association between CS and the Problem Solving domain was significant in boys, while no association was found in girls. Girls were rated less optimally in the Gross Motor domain of the ASQ when born via CS. Mode of birth was not associated with behavioral outcomes.

• MeSH
• císařský řez * MeSH
• dítě MeSH
• kohortové studie MeSH
• lidé MeSH
• longitudinální studie MeSH
• prospektivní studie MeSH
• těhotenství MeSH
• vývoj dítěte * MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

There are several overlapping clinical practice guidelines in acute pancreatitis (AP), however, none of them contains suggestions on patient discharge. The Hungarian Pancreatic Study Group (HPSG) has recently developed a laboratory data and symptom-based discharge protocol which needs to be validated. (1) A survey was conducted involving all members of the International Association of Pancreatology (IAP) to understand the characteristics of international discharge protocols. (2) We investigated the safety and effectiveness of the HPSG-discharge protocol. According to our international survey, 87.5% (49/56) of the centres had no discharge protocol. Patients discharged based on protocols have a significantly shorter median length of hospitalization (LOH) (7 (5;10) days vs. 8 (5;12) days) p < 0.001), and a lower rate of readmission due to recurrent AP episodes (p = 0.005). There was no difference in median discharge CRP level among the international cohorts (p = 0.586). HPSG-protocol resulted in the shortest LOH (6 (5;9) days) and highest median CRP (35.40 (13.78; 68.40) mg/l). Safety was confirmed by the low rate of readmittance (n = 35; 5%). Discharge protocol is necessary in AP. The discharge protocol used in this study is the first clinically proven protocol. Developing and testifying further protocols are needed to better standardize patients' care.

• MeSH
• akutní nemoc MeSH
• hospitalizace MeSH
• kohortové studie MeSH
• lidé MeSH
• pankreatitida * terapie   MeSH
• propuštění pacienta * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Cíle: Kohortová studie si kladla za cíl zjistit úroveň úmrtnosti mezi různě definovanými skupinami (kohortami) uživatelů drog a porovnat ji s úrovní úmrtnosti v běžné populaci. Zároveň se studie zaměřila na rozdíly v úmrtnosti uživatelů drog z hlediska pohlaví a typu užívané drogy. Metodika: Pro analýzu úmrtnosti byla použita metoda retrospektivní kohortové studie; v období 1997–2002 byly sledovány čtyři předem definované skupiny uživatelů drog. V ČR byly pro studii k dispozici dva soubory osob hospitalizovaných pro poruchy související s užíváním drog (12 207 a 2 824 osob), soubor injekčních uživatelů s hlášenou virovou hepatitidou (3 037 osob) a soubor uživatelů v opiátové substituční léčbě (704 osob). Výsledky: Přímo standardizovaná míra úmrtnosti dosahuje podle kohorty 16–33 na 1000 osoboroků sledování, u všech kohort je vyšší u mužů než u žen. V průběhu sledovaného období byl zaznamenán pokles úrovně úmrtnosti. Mortalita uživatelů drog je 8–11krát vyšší než úmrtnost v běžné populaci, nejvyšší je mezi polyvalentními uživateli a uživateli opiátů, relativně nejnižší mezi uživateli stimulancií. Závěr: Úroveň úmrtnosti uživatelů drog v ČR je srovnatelná s mortalitou v jiných evropských zemích – ve srovnání s dalšími kohortami dosahuje dokonce nižší úrovně. Potvrdila se existence rozdílů v úrovni úmrtnosti mezi jednotlivými kohortami; další studie by se měly zaměřit na vliv léčby na úroveň mortality uživatelů drog.

Aims: The cohort study aimed to find the level of mortality among different groups (cohorts) of drug users and compare it with the mortality rate of the general population. At the same time, the study focused on differences in mortality levels according to gender and type of drug used. Methods: A retrospective cohort mortality study was conducted. In 1997–2002, 4 defined groups of drug users were followed. These included two cohorts of hospitalized persons for drug-related behavioral disorders (12,207 and 2,824 persons), cohort of injecting drug users with reported viral hepatitis (3,037 persons) and substitution treatment clients (704 persons). Findings: Direct standardized mortality rate reached 16–33 per 1000 person-years of follow-up, depending on the cohort. In all cohorts, mortality was higher among men than women. In the follow-up period, mortality observed a consecutive decrease. The level of mortality among drug users was 8–11 times higher compared to general population. The highest mortality was observed for polyvalent and opiate users, relatively lowest for stimulants users. Conclusions: The level of mortality of drug users in the Czech Republic is comparable to mortality in other European countries; compared to other cohorts, the mortality level in CR is relatively lower. The study proved differences in mortality levels by cohorts; further research should focus on the impact of treatment on the mortality levels.

• MeSH
• kohortové studie MeSH
• lidé MeSH
• mortalita trendy   MeSH
• poruchy spojené s užíváním psychoaktivních látek epidemiologie   mortalita   terapie   MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Česká republika MeSH

INTRODUCTION: and Objectives: The clinical presentation of Obstructive Sleep Apnoea (OSA) differs between genders. This study aimed to identify the specific OSA phenotypes of women in the European Sleep Apnoea Database (ESADA) cohort. MATERIALS AND METHODS: Latent class cluster analysis was applied to data from 9710 female OSA patients. Variables used included age, Body Mass Index (BMI), Epworth Sleepiness Scale (ESS), comorbidities (cardiovascular, pulmonary, psychiatric, metabolic, other) and the Apnoea Hypopnea Index (AHI). RESULTS: Four different clusters were found: Cluster 1"Women with ischemic heart disease" (38.3 %):middle aged (59 years [53-65]),overweight to obese (BMI 30.1 kg/m2 [26.9-33.5]), AHI 22.9 events/h[17.4-30], ESS 9 [5,12] with the highest prevalence of ischemic heart disease (56 %). Cluster 2"Elderly women with comorbidities" (23 %): oldest (66 years[60-71]), obese (BMI 36 kg/m2 [31.6-40.4]),AHI 46 events/h [30-60.1]),ESS 9 [6-13] with the highest prevalence of comorbidities. Cluster 3"Sleepy obese women" (16.2 %): the youngest (49 years [42-55]), sleepiest (ESS 12 [8-16]), most obese(BMI 43 kg/m2[37.6-48.9]) females with severe OSA (AHI 53.3 events/h [32-80.5]). Cluster 4 "Women with mild OSA and low comorbidities" (22.5 %): middle aged (53.5 years [46-60]) with BMI 29 kg/m2[25-34.1],ESS9 [5,13]),AHI 8.6events/h[6.9-10.4])and low prevalence of comorbidities. The distribution of the clusters differed across Europe. PAP administration was higher in Clusters 2 and 3 but low in Cluster 4. CONCLUSION: Four distinct female phenotypes were identified with different clinical presentation and comorbidities. Sex-based phenotyping may provide improved risk stratification and personalized treatment.

• MeSH
• fenotyp * MeSH
• index tělesné hmotnosti * MeSH
• kohortové studie MeSH
• komorbidita * MeSH
• lidé středního věku MeSH
• lidé MeSH
• obezita epidemiologie   MeSH
• obstrukční spánková apnoe * epidemiologie   MeSH
• prevalence MeSH
• senioři MeSH
• shluková analýza MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

• MeSH
• fenotyp MeSH
• genotyp MeSH
• idiopatické střevní záněty genetika   MeSH
• kohortové studie MeSH
• sérologické testy MeSH
• těhotenství MeSH
• výsledek těhotenství MeSH
• ženy MeSH
• Check Tag
• těhotenství MeSH
• Geografické názvy
• Evropa MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• gastroenterologie
• genetika, lékařská genetika
• NLK Publikační typ
• studie

BACKGROUND: Meta-analyses confirm increased circulating C-reactive protein (CRP) levels in depression. Longitudinal studies have linked one-off measurements of CRP at baseline with increased risk of developing depressive symptoms subsequently at follow-up, but studies with repeat CRP measures from the same individuals are scarce. METHODS: We have examined whether longitudinal patterns of inflammation, based on three CRP measurements from childhood to early-adulthood, are associated with the risk of depression in early-adulthood in the Avon Longitudinal Study of Parents and Children, a prospective birth cohort. RESULTS: Using Gaussian mixture modelling of available CRP data from age 9, 15 and 18 years, we identified four population clusters/sub-groups reflecting different longitudinal patterns of CRP: persistently low (N=463, 29.5%); persistently high (N=371, 24%); decreasing (N=360, 23%); increasing (N=367, 23.5%). The increasing group showed a steep increase in CRP levels between adolescence and early-adulthood. Participants in this group had a higher risk of moderate/severe depression at age 18 years, compared with those with persistently low CRP; adjusted odds ratio (OR)=3.78 (95% Confidence Interval (CI), 1.46-9.81; p=0.006). The odds of moderate/severe depression were also increased for the persistently high CRP group, but this was not statistically significant; OR=2.54 (95% CI, 0.90-7.16). LIMITATIONS: Repeat CRP measures were available for a subset, who may not be representative of all cohort participants. CONCLUSIONS: The results suggest that an increasing pattern of inflammation from adolescence to early-adulthood is associated with risk of depression in early-adulthood.

• MeSH
• C-reaktivní protein metabolismus   MeSH
• deprese krev   epidemiologie   MeSH
• depresivní poruchy krev   epidemiologie   MeSH
• dítě MeSH
• dospělí MeSH
• kohortové studie MeSH
• lidé MeSH
• longitudinální studie MeSH
• mladiství MeSH
• prospektivní studie MeSH
• riziko MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH

OBJECTIVE: This study is designed to evaluate the potential effects of age, period and cohort (APC) on trends in suicide between 1983 and 2013 in Turkey. METHODS: Mortality data were obtained from the Turkish Statistical Institute. The data were grouped into seven age groups, four periods and ten birth cohorts. A nonlinear regression model was estimated for both sexes. The effects of age, period and cohort were parameterized using natural spline smoothing functions. RESULTS: There were 61,795 deaths recorded as suicides during the investigated time period, where 64.5% occurred in males (n = 39,862) and 35.5% in females (n = 21,933). There is an upward trend in mortality by age until the end of the study period for males and females. Age effect is decreased until the forties, kept decreasing during the middle ages, and sharply increased after the sixties. The death rates for females declined from 1999 until the end of the study period. For males, the death rates increased until the end of the study period. CONCLUSION: If the current trends continue, it can be expected that these effects will continue to reduce female mortality and increase male mortality. Future studies on suicide, strongly focused on specific factors attributed to period effects, are needed in Turkey.

• MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• mortalita trendy   MeSH
• rozložení podle pohlaví MeSH
• sebevražda statistika a číselné údaje   trendy   MeSH
• sexuální chování MeSH
• věkové faktory MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Turecko MeSH