• MeSH
• pediatrie MeSH
• vývoj dítěte MeSH
• výzkumný projekt metody   MeSH
• Publikační typ
• kongresy 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

• 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

• 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

Cohort studies are a robust analytical observational study design that explore the difference in outcomes between two cohorts, differentiated by their exposure status. Despite being observational in nature, they are often included in systematic reviews of effectiveness, particularly when randomized controlled trials are limited or not feasible. Like all studies included in a systematic review, cohort studies must undergo a critical appraisal process to assess the extent to which a study has considered potential bias in its design, conduct, or analysis. Critical appraisal tools facilitate this evaluation. This paper introduces the revised critical appraisal tool for cohort studies, completed by the JBI Effectiveness Methodology Group, who are currently revising the suite of JBI critical appraisal tools for quantitative study designs. The revised tool responds to updates in methodological guidance from the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group and reporting guidance from PRISMA 2020, providing a robust framework for evaluating risk of bias in a cohort study. Transparent and rigorous assessment using this tool will assist reviewers in understanding the validity and relevance of the results and conclusions drawn from a systematic review that includes cohort studies. This may contribute to better evidence-based decision-making in health care. This paper discusses the key changes made to the tool, outlines justifications for these changes, and provides practical guidance on how this tool should be interpreted and applied by systematic reviewers.

• MeSH
• kohortové studie MeSH
• lidé MeSH
• výzkumný projekt * normy   MeSH
• zkreslení výsledků (epidemiologie) * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• dítě MeSH
• dospělí MeSH
• idiopatické střevní záněty epidemiologie   genetika   MeSH
• kohortové studie MeSH
• prospektivní studie MeSH
• sběr dat MeSH
• sérologie MeSH
• vystavení vlivu životního prostředí MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• Publikační typ
• vysokoškolské kvalifikační práce MeSH
• Geografické názvy
• Dánsko MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• gastroenterologie

To update the clinical practice guidelines for nutrition therapy of the European Association for the Study of Diabetes, we conducted a systematic review and meta-analysis of prospective cohort studies and randomized clinical trials (RCTs) to evaluate the effect of the Mediterranean diet (MedDiet) on the prevention of cardiovascular disease (CVD) incidence and mortality. We searched Medline, EMBASE (through April 20, 2018) and Cochrane (through May 7, 2018) databases. Pooled relative risks (RRs) and 95% confidence interval (CI) were calculated by the generic inverse variance method. A total of 41 reports (3 RCTs and 38 cohorts) were included. Meta-analyses of RCTs revealed a beneficial effect of the MedDiet on total CVD incidence (RR: 0.62; 95% CI: 0.50, 0.78) and total myocardial infarction (MI) incidence (RR: 0.65; 95% CI: 0.49, 0.88). Meta-analyses of prospective cohort studies, which compared the highest versus lowest categories of MedDiet adherence, revealed an inverse association with total CVD mortality (RR: 0.79; 95% CI: 0.77, 0.82), coronary heart disease (CHD) incidence (RR: 0.73; 95% CI: 0.62, 0.86), CHD mortality (RR: 0.83; 95% CI: 0.75, 0.92), stroke incidence (RR: 0.80; 95% CI: 0.71, 0.90), stroke mortality (RR: 0.87; 95% CI: 0.80, 0.96) and MI incidence (RR: 0.73; 95% CI: 0.61, 0.88). The present study suggests that MedDiet has a beneficial role on CVD prevention in populations inclusive of individuals with diabetes.

• MeSH
• diabetes mellitus epidemiologie   MeSH
• kardiovaskulární nemoci mortalita   prevence a kontrola   MeSH
• kohortové studie MeSH
• lidé MeSH
• randomizované kontrolované studie jako téma MeSH
• strava středomořská statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH

BACKGROUND: The association between duration of smoking abstinence before non-small-cell lung cancer (NSCLC) diagnosis and subsequent survival can influence public health messaging delivered in lung-cancer screening. We aimed to assess whether the duration of smoking abstinence before diagnosis of NSCLC is associated with improved survival. METHODS: In this retrospective, pooled analysis of cohort studies, we used 26 cohorts participating in Clinical Outcomes Studies of the International Lung Cancer Consortium (COS-ILCCO) at 23 hospitals. 16 (62%) were from North America, six (23%) were from Europe, three (12%) were from Asia, and one (4%) was from South America. Patients enrolled were diagnosed between June 1, 1983, and Dec 31, 2019. Eligible patients had smoking data before NSCLC diagnosis, epidemiological data at diagnosis (obtained largely from patient questionnaires), and clinical information (retrieved from medical records). Kaplan-Meier curves and multivariable Cox models (ie, adjusted hazard ratios [aHRs]) were generated with individual, harmonised patient data from the consortium database. We estimated overall survival for all causes, measured in years from diagnosis date until the date of the last follow-up or death due to any cause and NSCLC-specific survival. FINDINGS: Of 42 087 patients with NSCLC in the COS-ILCCO database, 21 893 (52·0%) of whom were male and 20 194 (48·0%) of whom were female, we excluded 4474 (10·6%) with missing data. Compared with current smokers (15 036 [40·0%] of 37 613), patients with 1-3 years of smoking abstinence before NSCLC diagnosis (2890 [7·7%]) had an overall survival aHR of 0·92 (95% CI 0·87-0·97), patients with 3-5 years of smoking abstinence (1114 [3·0%]) had an overall survival aHR of 0·90 (0·83-0·97), and patients with more than 5 years of smoking abstinence (10 841 [28·8%]) had an overall survival aHR of 0·90 (0·87-0·93). Improved NSCLC-specific survival was observed in 4301 (44%) of 9727 patients who had quit cigarette smoking and was significant at abstinence durations of more than 5 years (aHR 0·87, 95% CI 0·81-0·93). Results were consistent across age, sex, histology, and disease-stage distributions. INTERPRETATION: In this large, pooled analysis of cohort studies across Asia, Europe, North America, and South America, overall survival was improved in patients with NSCLC whose duration of smoking abstinence before diagnosis was as short as 1 year. These findings suggest that quitting smoking can improve overall survival, even if NSCLC is diagnosed at a later lung-cancer screening visit. These findings also support the implementation of public health smoking cessation strategies at any time. FUNDING: The Alan B Brown Chair, The Posluns Family Fund, The Lusi Wong Fund, and the Princess Margaret Cancer Foundation.

• MeSH
• kohortové studie MeSH
• kouření epidemiologie   MeSH
• lidé MeSH
• nádory plic * diagnóza   MeSH
• nemalobuněčný karcinom plic * diagnóza   MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH

BACKGROUND: Physical diseases represent a significant burden for opioid agonist treatment (OAT) patients. This study described physical morbidity in two national cohorts of OAT patients focusing on gender differences. METHODS: This population-based cohort study linking multiple health registers investigated physical diseases (ICD-10) in patients receiving OAT in the Czech Republic (N = 4,280) and Norway (N = 11,389) during 2010-2019. Gender-stratified analysis was performed. RESULTS: Overall, we found a large burden of physical morbidity across gender groups in OAT patients. In the Czech Republic and Norway, women in OAT had a significantly higher prevalence of physical diseases across most diagnostic chapters, notably genitourinary diseases and neoplasms. Injuries/external causes and infectious/parasitic diseases were among the most common diseases in both women and men. Viral hepatitis accounted for over half of infectious morbidity in women and men in both cohorts. CONCLUSIONS: Our findings support the need for early screening, detection, and treatment of diseases and conditions across organ systems and the integration of health promotion activities to reduce physical morbidity in OAT patients. The gender differences underline the need for a tailored approach to address specific medical conditions.

• MeSH
• kohortové studie MeSH
• lidé MeSH
• opiátová substituční terapie MeSH
• opioidní analgetika * terapeutické užití   MeSH
• poruchy spojené s užíváním opiátů * farmakoterapie   epidemiologie   MeSH
• prevalence MeSH
• sexuální faktory MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Norsko MeSH

OBJECTIVE: To investigate the association between serum 25-hydroxyvitamin D concentrations (25(OH)D) and mortality in a large consortium of cohort studies paying particular attention to potential age, sex, season, and country differences. DESIGN: Meta-analysis of individual participant data of eight prospective cohort studies from Europe and the US. SETTING: General population. PARTICIPANTS: 26,018 men and women aged 50-79 years. MAIN OUTCOME MEASURES: All-cause, cardiovascular, and cancer mortality. RESULTS: 25(OH)D concentrations varied strongly by season (higher in summer), country (higher in US and northern Europe) and sex (higher in men), but no consistent trend with age was observed. During follow-up, 6695 study participants died, among whom 2624 died of cardiovascular diseases and 2227 died of cancer. For each cohort and analysis, 25(OH)D quintiles were defined with cohort and subgroup specific cut-off values. Comparing bottom versus top quintiles resulted in a pooled risk ratio of 1.57 (95% CI 1.36 to 1.81) for all-cause mortality. Risk ratios for cardiovascular mortality were similar in magnitude to that for all-cause mortality in subjects both with and without a history of cardiovascular disease at baseline. With respect to cancer mortality, an association was only observed among subjects with a history of cancer (risk ratio, 1.70 (1.00 to 2.88)). Analyses using all quintiles suggest curvilinear, inverse, dose-response curves for the aforementioned relationships. No strong age, sex, season, or country specific differences were detected. Heterogeneity was low in most meta-analyses. CONCLUSIONS: Despite levels of 25(OH)D strongly varying with country, sex, and season, the association between 25(OH)D level and all-cause and cause-specific mortality was remarkably consistent. Results from a long term randomised controlled trial addressing longevity are being awaited before vitamin D supplementation can be recommended in most individuals with low 25(OH)D levels.

• MeSH
• kardiovaskulární nemoci krev   mortalita   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory krev   mortalita   MeSH
• nedostatek vitaminu D komplikace   mortalita   MeSH
• roční období MeSH
• senioři MeSH
• sexuální faktory MeSH
• věkové faktory MeSH
• vitamin D analogy a deriváty   krev   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Evropa MeSH
• Spojené státy americké MeSH