Life course data on obesity may enrich the quality of epidemiologic studies analysing health consequences of obesity. However, achieving such data may require substantial resources. We investigated the use of body silhouettes in adults as a tool to reflect obesity in the past. We used large population-based samples to analyse to what extent self-reported body silhouettes correlated with the previously measured (9–23 years) body mass index (BMI) from both measured (European Community Respiratory Health Survey, N = 3 041) and self-reported (Respiratory Health In Northern Europe study, N = 3 410) height and weight. We calculated Spearman correlation between BMI and body silhouettes and ROC-curve analyses for identifying obesity (BMI ≥30) at ages 30 and 45 years. Spearman correlations between measured BMI age 30 (±2y) or 45 (±2y) and body silhouettes in women and men were between 0.62–0.66 and correlations for self-reported BMI were between 0.58–0.70. The area under the curve for identification of obesity at age 30 using body silhouettes vs previously measured BMI at age 30 (±2y) was 0.92 (95% CI 0.87, 0.97) and 0.85 (95% CI 0.75, 0.95) in women and men, respectively; for previously self-reported BMI, 0.92 (95% CI 0.88, 0.95) and 0.90 (95% CI 0.85, 0.96). Our study suggests that body silhouettes are a useful epidemiological tool, enabling retrospective differentiation of obesity and non-obesity in adult women and men.
Asthma often remains uncontrolled, despite the fact that the pharmacological treatment has undergone large changes. We studied changes in the treatment of asthma over a 20-year period and identified factors associated with the regular use of inhaled corticosteroid (ICS) treatment. Changes in the use of medication were determined in 4617 randomly selected subjects, while changes in adults with persistent asthma were analysed in 369 participants. The study compares data from three surveys in 24 centres in 11 countries. The use of ICSs increased from 1.7% to 5.9% in the general population and the regular use of ICSs increased from 19% to 34% among persistent asthmatic subjects. The proportion of asthmatic subjects reporting asthma attacks in the last 12 months decreased, while the proportion that had seen a doctor in the last 12 months remained unchanged (42%). Subjects with asthma who had experienced attacks or had seen a doctor were more likely to use ICSs on a regular basis. Although ICS use has increased, only one-third of subjects with persistent asthma take ICSs on a regular basis. Less than half had seen a doctor during the last year. This indicates that underuse of ICSs and lack of regular healthcare contacts remains a problem in the management of asthma.
To clarify the mechanisms maintaining chronic atrial fibrillation (CAF), a method for system identification of activation patterns of the atria during sinus rhythm (SR), artificial atrial pacing and atrial fibrillation, was developed. Data were obtained as repeated recordings of 8 sec in duration, each of 56 atrial bipolar electrograms, simultaneously acquired during open-heart surgery at multiple sites in the right atrial-free wall in 12 patients with stable SR and during artificial pacing and 16 patients with CAF. The realization theory was applied to fit the multivariate electrograms corresponding to individual beats during SR and type-I activations during AF, respectively. It was concluded that the local electrogram is a predictable signal during SR, artificial pacing, as well as during type-I atrial activation, and the proposed method may be used for further investigations concerning the deterministic and predictive nature of atrial activation during atrial fibrillation.
Women are often underrepresented at sleep clinics evaluating sleep disordered breathing (SDB). It has been speculated whether this is due to a different symptom profile in women. The aim of the present cohort study was to analyze gender differences in diagnosis and treatment of SDB in men and women with similar symptoms of SDB. Respiratory Health in Northern Europe (RHINE) provided questionnaire information about snoring, daytime sleepiness (EDS), BMI, somatic diseases at baseline (1999-2001) and follow-up (2010-2012) from 5,148 men and 6,113 women aged 30-55 years at baseline. At follow-up participants were furthermore directly asked whether they had the diagnosis of SDB and about treatment for SDB. Symptoms of SDB (= combination of snoring and EDS) was reported by 7.4% of the men and by 4.4% of the women at baseline. In both genders SDB symptoms increased the risk of developing hypertension (1.45, 95% CI 1.17-1.80) and diabetes (OR 1.63, 95% CI 1.12-2.38) during the follow-up period after adjusting for age, BMI and weight gain. Among those with symptoms of SDB at baseline, more men than women had got the diagnosis of SDB (Men 25%, Women 14%, p<0.001), any treatment for SDB (M 17%, W 11%, p=0.05) or CPAP (M 6%, W 3%) at follow-up. Independent predictors of having treatment for SDB at follow-up were age, BMI, SDB symptoms at baseline and weight gain during the follow-up period while female gender was related to a lower chance of receiving any treatment (adj OR 0.3, 95% CI 0.3-0.5). Conclusion: Despite similar symptoms with similar negative impact on hypertension and diabetes risk, women are less often diagnosed or treated for SDB.
The first druglike selective angiotensin II AT2 receptor agonist (21) with a Ki value of 0.4 nM for the AT2 receptor and a Ki >10 μM for the AT1 receptor is reported. Compound 21, with a bioavailability of 20−30% after oral administration and a half-life estimated to 4 h in rat, induces outgrowth of neurite cells, stimulates p42/p44mapk, enhances in vivo duodenal alkaline secretion in Sprague−Dawley rats, and lowers the mean arterial blood pressure in anesthetized, spontaneously hypertensive rats. Thus, the peptidomimetic 21 exerts a similar biological response as the endogenous peptide angiotensin II after selective activation of the AT2 receptor. Compound 21, derived from the prototype nonselective AT1/AT2 receptor agonist L-162,313 will serve as a valuable research tool, enabling studies of the function of the AT2 receptor in more detail.
Background: Children's information about their parents' lifestyle is increasingly used in research, and it is crucial to assess its validity. Aim: To validate offspring's reports of parents' smoking status and examine predictors for discrepant answers. Methods: We studied 5678 offspring (18-51yrs) and one of their parents, n=4151 (38-65yrs) participating in the Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) generation study. Information about parent's smoking status during offspring's childhood was obtained by questionnaires from parents and their offspring. We calculated sensitivity, specificity and Cohens Kappa for agreement (using parent's own report as the gold standard). We performed logistic regression to examine if offspring gender, age, education, asthma, or own smoking status predicted agreement. Results: The sensitivity for correct offspring report of parents smoking status during childhood (0-10yrs) was 0.83 (95% CI 0.82–0.85), specificity was 0.95 (95% CI 0.94–0.96) and a good agreement was seen (κ = 0.79, 95% CI 0.78–0.81). Similar results were seen for childhood defined as 0-18yrs. Logistic regression analysis showed that fewer discrepant answers were related to younger offspring age (<30yrs = odds ratio [OR] 0.66 (95% CI 0.51–0.86), 30-39yrs OR 0.70 (95% CI 0.54–0.90) reference ≥40yrs) and parents amount of smoking (≥10 cigarettes/day OR 0.56 (95% CI 0.44–0.71) reference <10). Offspring's gender, education, smoking or asthma status did not predict discrepant answers. Conclusion: Offspring quite correctly report their parents' smoking status during the offspring's childhood. In the absence of direct report, offspring's reports could be valuable.
Objectives Two spa workers reported such symptoms as fever, shivering, palpitation, arthralgia, and diarrhea after performing seaweed massages on clients at a spa center. This study was carried out to determine whether the symptoms were related to exposure to endotoxin. Methods Personal and stationary air sampling for the measurement of airborne endotoxin was carried out at the spa during the preparation of a bath and the following seaweed massage. In addition, the impact of storage time on the concentration of endotoxin in the seaweed was investigated. Results The measurements confirmed exposure to aerosolized endotoxin at the spa (11 ng/m 2 and 22 ng/m 3 ). The endotoxin concentration in the stored seaweed increased as the storage time increased, from 360 ng/g seaweed for fresh seaweed to 33100 ng/g seaweed for seaweed stored for >20 weeks. Conclusions Organic dust toxic syndrome was diagnosed for two workers who performed seaweed massages at a spa center at which aerosolized endotoxin was measured. In order to minimize entotoxin exposure during massages, it is important to use fresh seaweed or seaweed kept well cooled for no more than 2–3 weeks.