Author: "Enzo, Manzato" - Searchworks@Jio Institute Digital Library Search Results

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347 results on '"Enzo, Manzato"'

1. Physicians’ misperceived cardiovascular risk and therapeutic inertia as determinants of low LDL-cholesterol targets achievement in diabetes

Author: Mario Luca Morieri, Olga Lamacchia, Enzo Manzato, Andrea Giaccari, Angelo Avogardo, and Lipid-Lowering-Relevance Study Group
Subjects: Inertia, Cardiovascular risk, Misperceived risk, Statins, Ezetimibe, PCSK9i, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Abstract Background Greater efforts are needed to overcome the worldwide reported low achievement of LDL-c targets. This survey aimed to dissect whether and how the physician-based evaluation of patients with diabetes is associated with the achievement of LDL-c targets. Methods This cross-sectional self-reported survey interviewed physicians working in 67 outpatient services in Italy, collecting records on 2844 patients with diabetes. Each physician reported a median of 47 records (IQR 42–49) and, for each of them, the physician specified its perceived cardiovascular risk, LDL-c targets, and the suggested refinement in lipid-lowering-treatment (LLT). These physician-based evaluations were then compared to recommendations from EAS/EASD guidelines. Results Collected records were mostly from patients with type 2 diabetes (94%), at very-high (72%) or high-cardiovascular risk (27%). Physician-based assessments of cardiovascular risk and of LDL-c targets, as compared to guidelines recommendation, were misclassified in 34.7% of the records. The misperceived assessment was significantly higher among females and those on primary prevention and was associated with 67% lower odds of achieving guidelines-recommended LDL-c targets (OR 0.33, p
Published: 2022
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2. Correction to: Physicians’ misperceived cardiovascular risk and therapeutic inertia as determinants of low LDL-cholesterol targets achievement in diabetes

Author: Mario Luca Morieri, Olga Lamacchia, Enzo Manzato, Andrea Giaccari, Angelo Avogaro, and Lipid-Lowering-Relevance Study Group
Subjects: Diseases of the circulatory (Cardiovascular) system, RC666-701
Published: 2022
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3. The Association between Cognitive Reserve and Depressive Mood in Older Inpatients: Gender and Age Differences

Author: Alessandra Coin, Maria Devita, Marianna Bizzotto, Alessandro Bubola, Enzo Manzato, Giuseppe Sergi, and Caterina Trevisan
Subjects: Aging, Arts and Humanities (miscellaneous), Geriatrics and Gerontology, General Psychology
Abstract: Cognitive Reserve (CR) plays a protective role in neurological and acute/chronic diseases. Its effect on mood, however, is still unclear, although it may be relevant in a hospital setting. We aimed to explore the relationship between CR and depressive mood in older inpatients, evaluating possible gender- and age-related differences. This study involved 86 inpatients aged ≥65 years with an MMSE ≥15. Participants underwent a multidimensional evaluation that included the assessment of CR with the Cognitive Reserve Index questionnaire, divided into three sections (Education, Working Activity, and Leisure Time). Depressive mood was assessed with the 15-item Geriatric Depression Scale (GDS). The relationship between CR and GDS was evaluated by multivariable linear regressions. Significant inverse associations between CR and GDS scores emerged in the total sample (β = -0.03 [SD = 0.02], p = .047), especially in men (β = -0.05 [SD = 0.02], p = .005) and in individuals aged85 years (β = -0.07 [SD = 0.03], p = .01). Among the single CRI sections, CRI-Leisure Time was significantly associated with GDS in the total sample, in men, and participants85 years. CR seems to be inversely associated with depressive mood in older inpatients. This relationship is particularly marked for CR related to Leisure Time, which may be modifiable even in older age through social support and interaction.
Published: 2023

4. Physicians' misperceived cardiovascular risk and therapeutic inertia as determinants of low LDL-cholesterol targets achievement in diabetes

Author: Mario Luca, Morieri, Olga, Lamacchia, Enzo, Manzato, Andrea, Giaccari, Angelo, Avogaro, and Maria Grazia, Zenti
Subjects: Male, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Cardiovascular Diseases, Heart Disease Risk Factors, Risk Factors, Physicians, Humans, Female, Cholesterol, LDL
Abstract: Greater efforts are needed to overcome the worldwide reported low achievement of LDL-c targets. This survey aimed to dissect whether and how the physician-based evaluation of patients with diabetes is associated with the achievement of LDL-c targets.This cross-sectional self-reported survey interviewed physicians working in 67 outpatient services in Italy, collecting records on 2844 patients with diabetes. Each physician reported a median of 47 records (IQR 42-49) and, for each of them, the physician specified its perceived cardiovascular risk, LDL-c targets, and the suggested refinement in lipid-lowering-treatment (LLT). These physician-based evaluations were then compared to recommendations from EAS/EASD guidelines.Collected records were mostly from patients with type 2 diabetes (94%), at very-high (72%) or high-cardiovascular risk (27%). Physician-based assessments of cardiovascular risk and of LDL-c targets, as compared to guidelines recommendation, were misclassified in 34.7% of the records. The misperceived assessment was significantly higher among females and those on primary prevention and was associated with 67% lower odds of achieving guidelines-recommended LDL-c targets (OR 0.33, p 0.0001). Peripheral artery disease, target organ damage and LLT-initiated by primary-care-physicians were all factors associated with therapeutic-inertia (i.e., lower than expected probability of receiving high-intensity LLT). Physician-suggested LLT refinement was inadequate in 24% of overall records and increased to 38% among subjects on primary prevention and with misclassified cardiovascular risk.This survey highlights the need to improve the physicians' misperceived cardiovascular risk and therapeutic inertia in patients with diabetes to successfully implement guidelines recommendations into everyday clinical practice.
Published: 2021

5. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author: Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Luxia Zhang, Young-Ho Khang, Ellina Rakhimova, Kairit Mikkel, Tiina Vlasoff, Eruke E. Egbagbe, Sidsel Graff-Iversen, Ilona Nenko, Magdalena Klimek, Mathilde Savy, Sanjib Kumar Sharma, Alfonso Siani, Luís Lopes, Vanina Bongard, Gregor Jurak, Jacqueline F. Price, Christina-Paulina Lambrinou, Maria Lc Iurilli, Rainford J. Wilks, Bontha V. Babu, Fereidoun Azizi, Harunobu Nakamura, Marialaura Bonaccio, Angela Döring, Zhenyu Zhang, Naser Ahmadi, Jolanta Słowikowska-Hilczer, Ana Paula Carlos Cândido, Clive Osmond, Thirunavukkarasu Sathish, Robert J. Adams, Themistoklis Tzotzas, Reina Engle-Stone, Atul Trivedi, Shoichiro Tsugane, Niels Møller, Jorge Bezerra, Dénes Molnár, Muhammad Fadhli Mohd Yusoff, Badreya Al-Lahou, J. Jaime Miranda, Bahram Mohajer, Sigmund A. Anderssen, Lital Keinan Boker, Eero Kajantie, Martin Gulliford, Maties Torrent, Sumit Bharadwaj, Toshiharu Ninomiya, Zbigniew Gaciong, Nayu Ikeda, Li Juan Wu, Adrian Richter, Licia Iacoviello, Marc J. Gunter, Wenbin Wei, Norsyamlina Che Abdul Rahim, Eman Aly, Ambady Ramachandran, Nils Lehmann, Soile E. Puhakka, Giovanni Veronesi, Hongsheng Bi, Eiji Oda, Jia Li Duan, Per Tynelius, José María Huerta, Janne Schurmann Tolstrup, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Hanno Ulmer, Shukri F. Mohamed, Anthony Kafatos, Suyeon Park, Mohsen Ibrahim, Hamed Pouraram, Bin Zhou, May Soe Aung, Lars Bo Andersen, Erfan Ghasemi, René Charles Sylva, Himanshu K. Chaturvedi, Luc Dauchet, Ahmad Ali Zainuddin, Angela Chetrit, Dan Zhu, Valérie Deschamps, Ko Ko Zaw, Peter Vollenweider, Tomas Vega, Yves Martin-Prével, Mahfuzar Rahman, Dorja Vočanec, Roman Topor-Madry, Vinay Nangia, Herculina S. Kruger, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Aleksander Giwercman, Elżbieta Dziankowska-Zaborszczyk, Cecilia Björkelund, Tatjana Hejgaard, Maria Puiu, Maria Benedetta Donati, Andrew Wong, Carlos P. Boissonnet, Santosh K. Bhargava, Patrick Kolsteren, Dermot O'Reilly, Bahareh Kheiri, Wolfgang Kratzer, Susanne R. de Rooij, H. Bas Bueno-de-Mesquita, Günther Fink, José R. Banegas, Michele Monroy-Valle, Drude Molbo, Mahmudur Rahman, Hynek Pikhart, Rafael N. Pichardo, Massimo Salvetti, Hui Cai, Sarah Filippi, Georg Posch, Hung-Kwan So, Yonghua Hu, Katsuyasu Kouda, Joana Carvalho, Gailute Bernotiene, Hannu Uusitalo, Thein Thein Htay, Felix Kaducu, Maigeng Zhou, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Michel Joffres, Sabina Zambon, Ronald D. Gregor, Vayia Rarra, Seyed Mohammad Hashemi-Shahri, Loreto Santa Marina, Galina Obreja, Rudolf Kaaks, Aya Mostafa, Maria do Carmo Franco, Beata Gurzkowska, Chien-Jen Chen, Marie Moitry, Nizal Sarrafzadegan, Xiangjun Wang, Diego Giulliano Destro Christofaro, Imperia Brajkovich, Fangfang Chen, Francesco Panza, Ling Yang, Holly E. Syddall, Cecily Kelleher, Michael Tornaritis, Ningli Wang, Lutgarde Thijs, Marjolein Visser, Angelika Schaffrath Rosario, María José Tormo, Jostein Steene-Johannessen, Norbert Amougou, Emmanuella Magriplis, Mar Alvarez-Pedrerol, Jingli Gao, Stig E. Bojesen, Giuseppe Grosso, Seongjun Ha, Lauren Lissner, Mikhail Benet, Anastasia Markaki, Sanjay Rampal, Antônio Augusto Moura da Silva, Maria Lorenza Muiesan, Angelique Chan, Yvonne T. van der Schouw, Annamari Lundqvist, Philippe Amouyel, Kristyna Zejglicova, Charalambos Hadjigeorgiou, João Breda, Jørgen Meisfjord, Fatima Zahra Laamiri, Carl Lachat, Kai-Uwe Saum, Vilma Irazola, Leng Huat Foo, Óscar Lopes, Dickman Gareta, Flavio Nervi, Imre Janszky, Ruzena Kubinova, Terho Lehtimäki, Mario V. Capanzana, Moyses Szklo, Ramfis Nieto-Martínez, Viswanathan Mohan, Shuohua Chen, Arvind Pandey, Luigi Palmieri, Roya Kelishadi, Srinivasan Kannan, Jie Mi, Robert Beaglehole, Liliana Dacica, Jyrki K. Virtanen, Mohan Deepa, Peter Ueda, Isti Ilmiati Fujiati, Hermann Pohlabeln, Morten Sodemann, Jytte Halkjær, Zbigniew Kułaga, Sophie Visvikis-Siest, Farshad Farzadfar, Mohsen Azimi-Nezhad, Henry Völzke, Karolina Milkowska, Zahra Mohammadi, Belgin Ünal, Magda Gasull, George S. Stergiou, Marshall K. Tulloch-Reid, Seppo Koskinen, James E. Bennett, Marcela González-Gross, Virginija Dulskiene, Idris Guessous, Assembekov Batyrbek, Kamarul Imran Musa, Jeannette Lee, Josep Redon, Bihungum Bista, Luisa M Macieira, Johan Sundström, Andres Metspalu, Lariane M Ono, Flora A. Ukoli, Salar Rahimikazerooni, Andrea Gualtieri, Trevor S. Ferguson, Félicité Tchibindat, Eliza Cinteza, Ha Tp Do, Tajana Zeljkovic Vrkic, Tuyen D Le, Alison J. Hayes, Abdul Basit, Chandini Nekkantti, Teresa Norat, Eunice Ugel, Gulmira Aitmurzaeva, Mariachiara Di Cesare, Abdul Hamid Zargar, Vincenzo Solfrizzi, Garry L. Jennings, Aline Meirhaeghe, Kaare Christensen, Päivi Mäki, Xu Lin, Ali Esmaeili, Joanna Baran, Aneta Grajda, Renata Cifkova, Alexandre C. Pereira, Martin Bobak, Iuliia A Rusakova, Keiu Nelis, Damian K Francis, Guansheng Ma, Axel C. Carlsson, Alejandro Diaz, Alireza Ansari-Moghaddam, N Capkova, Zumin Shi, Maria Turley, Imelda A. Agdeppa, Helena I. S. Nogueira, Marcia Scazufca, Katharina Maruszczak, Natascia Rinaldo, Paulo A. Lotufo, Nuno Lunet, Thor Aspelund, Caroline H.D. Fall, Antonio Cabrera de León, Ahmad Faudzi Yusoff, Holger Theobald, Beatriz D'Agord Schaan, Pedro Marques-Vidal, William A. Neal, Mihai Gafencu, Tandi E. Matsha, Ana B. Crujeiras, Ahmad Reza Dorosty, Alain Morejon, Weili Yan, Dominique Hange, Bekbolat Zholdin, Frédéric Gottrand, Jorge Mota, Jana Námešná, Stevo Popovic, Louise Eriksen, Line Lund Kårhus, Cihangir Erem, Juergen Breckenkamp, Mathilde Kersting, Yi Song, Martin McKee, Aleksandra Gomula, Rafaela Rosário, Enzo Manzato, S. Goya Wannamethee, Sounnia Mediene Benchekor, Azim Nejatizadeh, Krishna Kumar Aryal, Juan P. González-Rivas, Vedrana Sember, Stephen T. McGarvey, Jukka T. Salonen, Patrick Pasquet, Patricia Varona-Pérez, Amelia C. Crampin, Ramin Heshmat, Violeta Iotova, Juvenal Soares Dias-da-Costa, Oye Gureje, Aletta E. Schutte, João Luiz Bastos, Anelise Reis Gaya, Konrad Jamrozik, Dalia Luksiene, Amina Barkat, Maria Paula Santos, José Camolas, Azli Baharudin, Diego Vanuzzo, Doris Stöckl, Rosalynn Siantar, Jouko Saramies, Albertino Damasceno, Davood Khalili, Simona Bo, Martina Müller-Nurasyid, Dominique Cottel, Markku Peltonen, Fikru Tullu, Ana Isabel Rito, Angélica Ochoa-Avilés, Annette J. Dobson, Christopher T. Cowell, Charumathi Sabanayagam, Rildo de Souza Wanderley Júnior, Oanh T. H. Trinh, Farahnaz Joukar, Mostafa K. Mohamed, Mostafa Qorbani, Jeongseon Kim, Helmut Schröder, Machi Suka, Natasja M. van Schoor, Jussi Kauhanen, Teresa Haugsgjerd, Goodarz Danaei, M. Fernanda Lima-Costa, Yong Tao, Elisabetta L. Romeo, Grazyna Jasienska, Victor Guillermo Sequera, Kazem Mohammad, Yanina Zócalo, Fernanda Cunha Soares, Jianfeng Wu, Mohammad Esmaeel Motlagh, María Elena Díaz-Sánchez, Monika Zuziak, Eldridge Ferrer, Anette Varbo, Leila Beltrami Moreira, Jeremy M. Jacobs, Kenneth James, Elena Sacchini, Pascal Bovet, Mahboubeh Parsaeian, Tania Lopez, Ya Xing Wang, Wojciech Drygas, Jody C Miller, Svetlana A. Shalnova, Maria Elisa Zapata, Chung T Nguyen, Nimmathota Arlappa, Edwige Landais, Thorkild I. A. Sørensen, Jeannette Klimont, Amirabbas Momenan, Erik J. Timmermans, Mari-Liis Tammesoo, Jost B. Jonas, Stefania Toselli, Maria Teresa Anselmo Olinto, Bahman Cheraghian, Kouamelan Doua, Esteban Carmuega, Marjeta Mišigoj-Duraković, Bo Werner, M. Arfan Ikram, Breige A. McNulty, Christa Meisinger, Clara Homs, Namuna Shrestha, Alina Kerimkulova, Youcef Laid, Claes Ohlsson, Alicia Matijasevich, Alison J Price, Ala'a Alkerwi, Kristine H. Allin, Lorenza Pilotto, Mohannad Al Nsour, Ingunn Holden Bergh, Marianna Noale, Heba Fouad, Vilnis Dzerve, Novie O. Younger-Coleman, Peter Willeit, Andrea R. V. R. Horimoto, Freda Pitakaka, Habiba Ben Romdhane, Savvas C. Savva, Rajeev Gupta, Jennifer Servais, Cristina Padez, Sarah P. Garnett, Maria del Cristo Rodriguez-Perez, Michala Lustigová, Tien Yin Wong, Rosa Haghshenas, Jonathan Giovannelli, Christina Howitt, Marleen E. Hendriks, Fadia AlBuhairan, Huashuai Chen, Gretchen A Stevens, Luís B. Sardinha, David Goltzman, Jenny M. Kindblom, Karina Mary de Paiva, Yousef Khader, Eric Monterrubio-Flores, Rajendra Pradeepa, Yi-Ting Lin, Martin Neovius, Juan Francisco Miquel, Ellis Owusu-Dabo, Anil Poudyal, Marzieh Katibeh, Tanja Stocks, Veronica Mocanu, Ulla Roggenbuck, Robespierre Ribeiro, Gabriele Eiben, Mary Simon, Christine Cameron, Hamid Hakimi, Kamel Ajlouni, Jakub Stokwiszewski, Iulia Jurca Simina, Pietro Amedeo Modesti, Frederick C. W. Wu, Peter Kristensen, Charles Mondo, Felix Gutzwiller, Mariana Sbaraini, Martijn Huisman, Betina H. Thuesen, Queenie Chan, Antonisamy Belavendra, Artur Mazur, Ulf Ekelund, Laura A. Rodríguez-Villamizar, Marcos André Moura-dos-Santos, Jean Ferrières, Farhad Zamani, Shina Avi, Yves Kameli, Luis Paulo Gomes Mascarenhas, Aluísio J D Barros, Thomas Meinertz Dantoft, Hossein Poustchi, Farid Najafi, Giovanni de Gaetano, Azaliia M Tuliakova, Vera Lanska, Tint Swe Latt, Matthias Bopp, Abbas Rezaianzadeh, Rod Jackson, Johan Van der Heyden, Reecha Sofat, Koen Van Herck, Allan G. Hill, Con Burns, Emanuela Pettenuzzo, Ming-Dong Wang, Stela McLachlan, Ulrike Gehring, Ranko Stevanovic, Nagalla Balakrishna, Lekhraj Rampal, Marjolijn C. E. Bragt, Saeid Eslami, Napoleón Pérez-Farinós, G. K. Mini, Viktoria Anna Kovacs, Rosemarie Martin, Nahla Hwalla, Wei Zheng, Hoang Van Minh, Edward D Janus, Laetitia Huiart, Farhad Pourfarzi, Sudha Ramachandra Rao, Fred Paccaud, Marcia Makdisse, Aye Aye Sein, Enrique Gutiérrez-González, Yang Yang, Anneke Blokstra, Henrike Galenkamp, Jaume Marrugat, Nazan Yardim, Wan Nazaimoon Wan Mohamud, Jesús Ibarluzea, Julio Zuñiga Cisneros, Laura Lauria, Argyro Karakosta, Dragana P Jovic, Jun Hata, Elio Riboli, Piotr Bandosz, Xun Tang, Parvina Mukhtorova, Jean Dallongeville, Jean-Bernard Ruidavets, Anne Tjønneland, Guillermo Frontera, Rahul Malhotra, Thomas Ferrao, Aleksandra Piwońska, Dusan Grafnetter, Mette Rasmussen, Daniel Weghuber, Sherali Rakhmatulloev, Martine Vrijheid, Johann Willeit, Motahareh Kheradmand, Małgorzata Mossakowska, Lechaba Tshepo, Dongfeng Gu, Hyeon Chang Kim, Vilmundur Gudnason, Maria Forsner, Peter Bjerregaard, Leon A. Simons, Rachael McLean, Japhet Killewo, Ramón Suárez-Medina, Y Nikitin, Eng Joo Tan, Jean Claude Mbanya, Aroor Bhagyalaxmi, Renata Kuciene, Kairat Davletov, Jose Eugenio Lozano, Afshin Ostovar, Niloofar Peykari, Guy De Backer, Soheir H Ahmed, Nicholas J. Wareham, Sai Yin Ho, Constanta Huidumac Petrescu, Maria Hassapidou, Iris Pigeot, Myriam Galfo, Susana Cararo Confortin, Blanca Sandra Ruiz-Betancourt, W. M. Monique Verschuren, Catterina Ferreccio, Fabio Galvano, Leila Houti, Daniel Bia, Annika Rosengren, Marcin Rutkowski, Biruta Velika, Joana Araújo, Fernando Rigo, Angela Spinelli, Scott B. McLean, Shirin Djalalinia, Marie Kunešová, Boban Mugoša, Sania Nishtar, Mangesh S. Pednekar, Shahla AlDhukair, Helle-Mai Loit, Antonis Zampelas, Altan Onat, Maciej Banach, Shohreh Naderimagham, Hajer Aounallah-Skhiri, Maja Bæksgaard Jørgensen, Yin Guo, Ewelina Czenczek-Lewandowska, Parasmani Dasgupta, Elvis Oa Wambiya, Inge Huybrechts, Raimund Erbel, Jari Jokelainen, Ana P. Ortiz, Stefan Kiechl, Emmanuel Cohen, Caleb Ochimana, Shynar Abdrakhmanova, Laura Censi, Iqbal Bata, Geetha R Menon, Snehalatha Chamukuttan, Pedro Plans-Rubio, Domenico Palli, Ana Azevedo, Slawomir Koziel, Benoît Salanave, Parinaz Mehdipour, Shu Ti Chiou, Lela Sturua, Lubica Ticha, Felipe Vogt Cureau, Jin Soo Moon, Ming-Hui Zhao, Urho M. Kujala, Nathalie Michels, Ertugrul Celikcan, Jaakko Tuomilehto, Judith Benedics, Tobias F. Rinke de Wit, Agnès Le Port, Reza Homayounfar, Andrea Rodriguez-Martinez, Tai Hing Lam, Yn-Tz Sung, Jürgen König, Kodavanti Mallikharjuna Rao, Hazzaa M. Al-Hazzaa, Karen Morgan, Bogdan Wojtyniak, Cynthia M. Pérez, Ilse Khouw, Manoli Garcia-de-la-Hera, Dong Wook Shin, Genc Burazeri, Ausra Petrauskiene, Charles Sossa Jérome, Kenisha Russell Jonsson, José Boggia, Daniela Galeone, Alice Bonilla-Vargas, Han Cg Kemper, Rahman Shiri, Stefaan Demarest, Else Karin Grøholt, San-Lin You, Adelheid Weber, Juha Auvinen, Aida Pilav, Sibel Gogen, Suzanne N Morin, Wan Mohamad Wan Bebakar, Viviane Cunha Cardoso, Kavumpurathu Raman Thankappan, Hana Zamrazilová, Frank Claessens, Karien Stronks, Helen Gonçalves, Tahir Aris, Luis Revilla, Sérgio Viana Peixoto, Zhamilya Battakova, Jing Liu, Eliza Markidou Ioannidou, Leticia Hernandez Cadena, Priscilla Duboz, Sandjaja, Tiina Laatikainen, Rafel Ramos, Sareh Eghtesad, Judith Simons, Orn Olafsson, E. Shyong Tai, Louise A. Baur, Nihal Thomas, Aung Soe Htet, Bente Sparboe-Nilsen, Paul Elliott, Soon-Woo Park, Angel R. Gonzalez, Ying-Wei Wang, Rob M. van Dam, Ryutaro Ohtsuka, Ludmila Sevcikova, Suhaila Abdul Ghaffar, Lynell V Maniego, Fariborz Mansour-Ghanaei, Maria Dorobantu, Giovanni Viegi, Xiaoguang Yang, Honor Bixby, Prakash C. Gupta, Ofra Kalter-Leibovici, Eugene Sobngwi, Ričardas Radišauskas, Jurate Medzioniene, Roy A Wong-McClure, Kim F. Michaelsen, Antonia Trichopoulou, Tania Tello, Francesco Branca, Johanna Gunnlaugsdottir, Els Clays, Wei-Yen Lim, Suzanne C. Ho, Toomas Veidebaum, Rebecca Goldsmith, Margot González-León, Matthias Nauck, Alibek Mereke, Marta Buoncristiano, Jakob Tarp, Rosalba Rojas-Martínez, Maya Tanrygulyyeva, Reza Malekzadeh, Abdonas Tamosiunas, Dimitrios Poulimeneas, Pedro Ordunez, Isabelle Herter-Aeberli, Khanh Le Nguyen Bao, Anne Juolevi, Vassilis Zafiropulos, Emanuela Gualdi-Russo, Jordi Sunyer, Manu Raj, Chaoqiang Jiang, Sofia Malyutina, Efthymios Kapantais, Maria Lazo-Porras, Maung Maung Than Htike, Michael Hobbs, Ranjit Mohan Anjana, Merike Liivak, Johan G. Eriksson, Margarita Samoutian, Andreia N. Pizarro, Mohammed Rasoul Tarawneh, Jean Woo, Kaspar Staub, Maria Teresa Menzano, Mojtaba Farjam, Adroaldo Cesar Araujo Gaya, Mohammad El-khateeb, Zulfiqar A Bhutta, Mukharram M. Bikbov, Hsien-Ho Lin, Oscar Noboa, Thomas Waldhör, Garry Brian, Simona Costanzo, Frank Tanser, Nor Azwany Yaacob, Michelle Cilia, Ivo Rakovac, Bill Stavreski, Ioannis Pagkalos, Ivan Pećin, Carlo M. Barbagallo, Abla M. Sibai, Yuna He, Matsuda Fumihiko, Bharathi Viswanathan, Ali Reza Safarpour, Wei Cheng Lo, Abdullatif Husseini, Jiang He, Liv Elin Torheim, Nipa Rojroongwasinkul, Aicha Soumare, Astrid Petersmann, Tomasz Grodzicki, Davide Noto, Panayiotis K. Yiallouros, Kelias P. Msyamboza, William R. Tebar, Yingfeng Zheng, Eha Nurk, Bhawesh Koirala, Ana Jelakovic, Suhad Bahijri, Freja B Kampmann, Qi Sheng You, Marika Ferrari, María-Elena González-Villalpando, Aline Wagner, Olfa Saidi, Anwar Batieha, Eduardo Capuano, Coimbatore Subramaniam Shanthirani, Dong Wook Kim, Albina A Fakhretdinova, Tom Wilsgaard, Maria Avdicova, Moesijanti Soekatri, Chiara Donfrancesco, Salim Mohanna, Paola Russo, Uruwan Yamborisut, Rafael dos Santos Henrique, Martin Nankap, Allan Linneberg, Khairil Si-Ramlee, Kirsten Mehlig, Christina Mavrogianni, Raluca Pop, Lèlita Santos, Graziella Bruno, Valentina Peterkova, Iná S. Santos, Georg Lappas, Alberto Palloni, Malay K. Mridha, Andrzej Pajak, Marta García-Solano, Stefaan De Henauw, Daniel Ferrante, Rute Santos, Anders Grøntved, Lucjan Szponar, Mihaela Vladulescu, Chien-An Sun, Jan A. Staessen, Paula Duarte de Oliveira, Norazizah Ibrahim Wong, Maria Nordendahl, Elaine M. Dennison, Jeonghee Lee, Diego Salmerón, Ida Maria Schmidt, Gao Pei, Noushin Mohammadifard, Igor Spiroski, Fernando Rodríguez-Artalejo, Xu Ma, Elin Pettersen Sørgjerd, Valéria Regecová, Cláudia S. Minderico, Johanna A. Otero, Jamila Abubakar Garba, Vesselka Duleva, Rui Ornelas, Ilpo Huhtaniemi, Cesar G. Victora, Lijuan Liu, Rody G. Sy, Mahmood Moosazadeh, Ali Ahmadi, Antonio Pedro Graça, Natalia Nowak-Szczepanska, Miao Li Chee, Michael Sjöström, Charles Agyemang, Shiqi Zhen, Xiu-Hua Guo, Pawel Kurjata, Jardena J. Puder, Mehrdad Azmin, Neil Murphy, Kaosar Afsana, Alireza Sadjadi, Johanna M. Geleijnse, Prashant Mathur, Elysée Claude Bika Lele, Raphael Mendes Ritti-Dias, Yannis Manios, Majid Shirani, Rosemary B. Duda, Liis Nelis, Jurate Klumbiene, Zhengming Chen, Wichai Aekplakorn, Alun Evans, Andrzej Wiecek, Lars Lind, Denise Eldemire-Shearer, Bernardo L. Horta, Macia Enguerran, Seyed Rasoul Zakavi, Daniel Fernández-Bergés, Kumiko Ohara, Ursula Kiechl-Kohlendorfer, Hermann Brenner, Przemyslaw Slusarczyk, Espen Bjertness, Jutta Stieber, Augusto Di Castelnuovo, Joel G. R. Roy, Aryeh D. Stein, Ruth Frikke-Schmidt, Vera Musil, Amaneh Shayanrad, Marcel Goldberg, Ramon O. Jimenez, Mohammad Reza Fattahi, Jolanda Hyska, Amir Houshang Mehrparvar, Elin Kolle, Mohamed Bamoshmoosh, Michelle Holdsworth, Felipe F. Casanueva, Børge G. Nordestgaard, Niels Wedderkopp, Eva Corpeleijn, Elias F. Gudmundsson, Antonio Mistretta, Daniel Lemogoum, Larissa Pruner Marques, Slavica Sović, Olli T. Raitakari, Marco Aurélio Peres, Alexandra Cucu, Gregorio Varela-Moreiras, Janine Clarke, Andrea Gazzinelli, Mieczysław Litwin, Sara Schramm, Xenophon Theodoridis, Harshpal Singh Sachdev, Mohammad Reza Mirjalili, Dimitrios Papandreou, Peter T. Katzmarzyk, Benjamin Acosta-Cazares, Ben Schöttker, Prabhdeep Kaur, Norlaila Mustafa, Shariq Rashid Masoodi, Sadaf G. Sepanlou, Adolfo Rubinstein, Francis Delpeuch, Julianne Williams, Abbas Dehghan, Leanne M. Riley, Heloisa Bettiol, Gabriele Nagel, Ellisiv B. Mathiesen, Ekaterina Stoyanova, Alisha N. Wade, Zhamyila Usupova, Arnaud Chiolero, Oonagh Markey, Jacqueline Ramke, Elena Bogova, Niveen M E Abu-Rmeileh, Nguyen D Nguyen, Tomasz Zdrojewski, Marjo-Riitta Järvelin, Jose Sanchez-Abanto, Rômulo Araújo Fernandes, Lourdes Ribas-Barba, Nalan Uysal, Mohamad Hasnan Ahmad, Krista Fischer, Maria Wany Louzada Strufaldi, Ramiro Guerrero, Farnam Mohebi, Tran Quoc Bao, Flávio Danni Fuchs, Salim Berkinbayev, Enisa Kujundzic, Sari Voutilainen, Farzad Hadaegh, Robert Lundqvist, Saeid Safiri, Iraj Mohebbi, George Luiz Lins Machado-Coelho, Annette Peters, Gonzalo Valdivia, Magdalena Korzycka, Rajiv T Erasmus, Masanori Iwasaki, Charmaine A. Duante, Sheikh Mohammed Shariful Islam, Quang Ngoc La, Ricky Eddie, Petra Rust, Daniela Rodrigues, Dirk De Bacquer, Karen Sparrenberger, Agneta Sjöberg, Thet Thet Mu, Katarzyna Dereń, Cora L. Craig, Jorge Motta, Janina Petkeviciene, Boyd Swinburn, Paibul Suriyawongpaisal, Visnja Djordjic, Ramón Alberto Rascón-Pacheco, Pradeep Joshi, Daan Kromhout, Marius B. Bjertness, Stefano Marventano, Juel Jarani, Alireza Khosravi, Eva Martos, David De Ridder, Lizzy M. Brewster, Nico Dragano, Liam Smeeth, Kenji Shibuya, Emma Ruiz Moreno, Hashem Jaddou, Grzegorz Sobek, Dimitrios Trichopoulos, Marvin Cervantes-Loaiza, Abu Am Hanif, Elaine M. Murtagh, Carlos A. Aguilar-Salinas, Graziella D'Arrigo, Kyungwon Oh, Heiner Boeing, Regina Heidinger-Felso, André Luiz Sena Guimarães, Balkish M. Naidu, Avula Laxmaiah, Ana M. B. Menezes, Marie Eliasen, Francesco Pistelli, Yuan He, Dusko Bjelica, José A. Casajús, Guang Ning, Lutgart Braeckman, Dirk Vanderschueren, Jochanan Stessman, Ivana Radic, Yi Zeng, Hans Concin, Damaskini Valvi, Sari Hantunen, Catherine Kyobutungi, Diego Augusto Santos Silva, Wenhua Zhao, Sok King Ong, Anne W. Taylor, Iraj Nabipour, Justyna Godos, Cyrus Cooper, Mattias Johansson, Samuel C. Dumith, Magdalena Muc, Sabine Schipf, Idowu O Senbanjo, Jim Mann, Rajaa Al-Raddadi, Yih Chung Tham, Kay-Tee Khaw, Joseph Cacciottolo, Ana Henriques, Sahar Saeedi Moghaddam, Reza Mohammadpourhodki, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Camilla T. Damsgaard, Takafumi Ishida, Ekaterina Chikova-Iscener, Mirjam M. Heinen, Tazeen H. Jafar, Semánová Csilla, Constance Schultsz, Santiago F. Gomez, Raija Korpelainen, Edward W. Gregg, Laura Gutierrez, Pierre Traissac, Victor M. Herrera, Aristides M. Machado-Rodrigues, Fatemeh Malekzadeh, Shouling Wu, Jennifer L. Baker, Clicerio González-Villalpando, Eleonora d'Orsi, Irene G. M. van Valkengoed, Anna Fijałkowska, Wen-Harn Pan, Gregor Starc, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Abdullah Alkandari, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Saeed Dastgiri, Lien Braeckevelt, Nasheeta Peer, Radka Taxová Braunerová, Mohamed M. Ali, Steiner Krokstad, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Silvana Donoso, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Felix K. Assah, Juan A Rivera, Peter H. Whincup, Oana-Florentina Gheorghe-Fronea, Cassiano Ricardo Rech, Paul Ferdinand M. Reganit, Rachakulla Hari Kumar, Jaakko Mursu, Luis A. Moreno, Glen Gironella, Jelena Kos, Tilema Cama, Haakon E. Meyer, Jun Ma, Raphael E. Arku, Ziad Abdeen, Dianna J. Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paola Nardone, Alberto Barceló, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Miquel Porta, Vesna Jureša, Alexander D. Deev, David Faeh, Antonio Bernabe-Ortiz, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Anjani Kumar Jha, Thamara Hubler Figueiró, Jana Kratenova, Claudia M. Hormiga, Maria Tsigga, Zivka Dika, Indrapal I. Meshram, Ei Ei K. Nang, Ian Rouse, Rusidah Selamat, Paul Korrovits, Grethe S. Tell, Julie Taylor, Anabela Mota-Pinto, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Frank J Rühli, Shelly R. McFarlane, Sara Santos Sanz, Edyta Łuszczki, Maria G. Stathopoulou, Tara Coppinger, Karin De Ridder, Lucie Viet, Anna Bugge, Mehdi Yaseri, Safiah Md Yusof, Sandra C. Fuchs, Muhammad Islam, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Maria Ruiz-Castell, Daniela Pierannunzio, Cristina Taddei, Gowri Mahasampath, Gustavo Velasquez-Melendez, Hanna Tolonen, Sudhir Kowlessur, Bagher Larijani, Laura Torres-Collado, Susi Kriemler, Ali Akbar Shayesteh, Cynthia Robitaille, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Line Tang Møllehave, Vincent Jr DeGennaro, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Kodanda R Kanala, Gert B. M. Mensink, Abhijit Sen, Sergej M. Ostojic, Hanan F. Abdul Rahim, Hélène Delisle, Francisco J. Félix-Redondo, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Bethlehem D. Solomon, Erik Lykke Mortensen, Nikhil D. Patel, Reynaldo Martorell, Ching-Yu Cheng, Stine Schramm, Hana Shimizu-Furusawa, Jacek Jóźwiak, Radwan Qasrawi, Herman Borghs, Zhanna Kalmatayeva, Heidi Klakk, Akram Pourshams, Naomi S. Levitt, Son Thai Pham, Simona Giampaoli, Dong Zhao, Indah Suci Widyahening, Merete Osler, Paula Margozzini, Silvia Bel-Serrat, Dora Romaguera, Monira Alarouj, Winsome R. Parnell, Marloes Cardol, Giota Touloumi, Janice Luisa Lukrafka, Adela Chirita-Emandi, Maryam Kavousi, Sanja Musić Milanović, Jean-Michel Gaspoz, Jalila El Ati, Sauli Herrala, Liang Xu, Pilar Guallar-Castillón, Bee Koon Poh, Luis Serra-Majem, Jonathan E. Shaw, Belong Cho, Daphne Mirkopoulou, Salvador Villalpando, Yuki Fujita, Tiffany K. Gill, Nish Chaturvedi, Erkin M. Mirrakhimov, Günay Can, Mark Woodward, Esther Lopez-Garcia, Mauro Virgílio Gomes de Barros, Ahmed A. Madar, Shoaib Afzal, Melanie J. Cowan, Gareth Stratton, Eduardo Salazar Martinez, Sameer Narake, Norie Sawada, Deepak Amarapurkar, Deepa Weerasekera, Diana A. Santos, Marjeta Majer, Herman Schargrodsky, Bruna Gonçalves Cordeiro da Silva, Ebrahim Eftekhar, Jesús Vioque, Marisa K. Sophiea, Teresa Shamah-Levy, María Dolores Chirlaque, Mohd Azahadi Omar, Stefan Söderberg, Isabel O. Oliveira, Joanne Katz, Xingwang Ye, Christophe Tzourio, Marie Zins, Aneta Weres, Ulrich Keil, Haiquan Xu, Akihiro Yoshihara, Rachel Dankner, Gabriella Gruden, Maroje Sorić, Hanspeter Stamm, Kim Overvad, Yanping Li, Carsten Oliver Schmidt, Christa L. Lilly, Veikko Salomaa, Gilad Twig, Senthil K Vasan, Qian Wang, Liufu Cui, Andrzej Galbarczyk, Sylvain Sebert, Wilma M. Hopman, Karl-Heinz Jöckel, Ari Voutilainen, Peter Schnohr, Jerzy Chudek, Katia Vergetti Bloch, Vincenzo Capuano, Jyh Eiin Wong, Torben Jørgensen, Anja Schienkiewitz, Nader Saki, Carolina Tarqui-Mamani, Maria Cecília Formoso Assunção, Kazi M. Jamil, Juraci Almeida Cesar, Pedro J Ortiz, Delphine De Smedt, Luciana Zaccagni, Lynne M. Boddy, Jie Hao, David Alejandro González-Chica, Romana Roccaldo, Sara Magnacca, Peter Stehle, Victoria Farrugia Sant'Angelo, Gry Skodje, Maryam Keramati, Tabara Yasuharu, Ali Ghanbari, Gyulli M. Kazakbaeva, Takuro Furusawa, Felicia Cañete, Kari Kuulasmaa, Justina Vaitkeviciute, (NCD-RisC), NCD Risk Factor Collaboration, Imperial College London, Harvard T.H. Chan School of Public Health, Middlesex University [London], Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Montpellier Interdisciplinary center on Sustainable Agri-food systems (Social and nutritional sciences) (UMR MoISA), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Centre International de Hautes Etudes Agronomiques Méditerranéennes - Institut Agronomique Méditerranéen de Montpellier (CIHEAM-IAMM), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Interactions Gène-Environnement en Physiopathologie Cardio-Vasculaire (IGE-PCV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Wellcome TrustEuropean Commission, Clinical Developmental Psychology, APH - Mental Health, Sociology, The Social Context of Aging (SoCA), Nutrition and Health, Iurilli, Maria LC [0000-0003-0409-1635], Zhou, Bin [0000-0002-1741-8628], Ezzati, Majid [0000-0002-2109-8081], Apollo - University of Cambridge Repository, Epidemiology and Data Science, APH - Aging & Later Life, APH - Societal Participation & Health, Public and occupational health, APH - Health Behaviors & Chronic Diseases, VU University medical center, APH - Personalized Medicine, AGEM - Endocrinology, metabolism and nutrition, ACS - Diabetes & metabolism, APH - Global Health, ARD - Amsterdam Reproduction and Development, Adult Psychiatry, Global Health, APH - Quality of Care, APH - Methodology, ACS - Atherosclerosis & ischemic syndromes, Gómez Santos, Santiago Felipe, NCD Risk Factor Collaboration (NCD-RisC), Faculdade de Desporto, Faculdade de Ciências da Nutrição e Alimentação, Faculdade de Medicina, Tampere University, Clinical Medicine, Department of Clinical Chemistry, Eye Centre, Harvard TH Chan School of Public Health, Middlesex University, World Health Organization, Ministry of Health, University of Lausanne, Eduardo Mondlane University, Victor Babes University of Medicine and Pharmacy Timisoara, University of Sydney, Health and Nutrition, University of Auckland, Seoul National University, ICMR - National Institute of Nutrition, Capital Medical University Beijing An Zhen Hospital, Universidad Peruana Cayetano Heredia, University Tunis El Manar, University of Oulu, University of Zagreb, University of Ljubljana, Caja Costarricense de Seguro Social, Al-Quds University, National Center of Public Healthcare, Qatar University, Birzeit University, Usmanu Danfodiyo University Teaching Hospital, Instituto Mexicano del Seguro Social, Flinders University, Mahidol University, BRAC James P Grant School of Public Health, University of Copenhagen, Copenhagen University Hospital, Food and Nutrition Research Institute, Urmia University of Medical Sciences, Instituto Nacional de Ciencias Médicas y Nutrición, University of Amsterdam, Shahrekord University of Medical Sciences, Non-Communicable Diseases Research Center, University of Oslo, University of Bremen, Republican Center for Health Promotion, Endocrinology and Genetics, Princess Nourah bint Abdulrahman University, Kuwait Institute for Scientific Research, King Abdulaziz University, Dasman Diabetes Institute, Aldara Hospital and Medical Center, King Abdullah International 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Children, Aga Khan University, Shandong University of Traditional Chinese Medicine, Jiao-Tong University School of Medicine, Universidad de la República, Institute of Medical Research and Medicinal Plant Studies, Ufa Eye Research Institute, Nepal Health Research Council, University of Montenegro, University of Southern Denmark, University of Gothenburg, Universidade Federal do Rio de Janeiro (UFRJ), National Institute for Public Health and the Environment, University of Turin, University College London, Liverpool John Moores University, Nanyang Technological University Singapore, German Institute of Human Nutrition, Endocrinology Research Centre, Centro de Educación Médica e Investigaciones Clínicas, IRCCS Neuromed, Toulouse University School of Medicine, University of Zurich, University Hospital KU Leuven, Flemish Agency for Care and Health, Ghent University, FrieslandCampina, Universidad Central de Venezuela, Bielefeld University, World Health Organization Regional Office for Europe, 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Basel, University of New South Wales, World Health Organization Country Office, Guilan University of Medical Sciences, University of Opole, Finnish Institute for Health and Welfare, Gulu University, University of Crete, Sri Venkateswara University, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Hellenic Medical Association for Obesity, National and Kapodistrian University of Athens, Maharajgunj Medical Campus, Aarhus University, Johns Hopkins Bloomberg School of Public Health, Pennington Biomedical Research Center, National Institute of Epidemiology, University of Münster, Israel Center for Disease Control, Research Institute for Primordial Prevention of Non- communicable Disease, Amsterdam UMC Public Health Research Institute, South African Medical Research Council, Kyrgyz State Medical Academy, Research Institute of Child Nutrition, Shahid Beheshti University of Medical Sciences, University of Cambridge, Mazandaran University of Medical Sciences, Hypertension Research Center, Medical University of Innsbruck, VASCage, Muhimbili University of Health and Allied Sciences, Yonsei University College of Medicine, National Cancer Center, Sahlgrenska University Hospital, University College South Denmark, Statistics Austria, B P Koirala Institute of Health Sciences, University of Vienna, Oulu Deaconess Institute Foundation, Tartu University Clinics, Kansai Medical University, Hungarian School Sport Federation, Ministry of Health and Quality of Life, University Hospital Ulm, North-West University, University of Jyväskylä, Amrita Institute of Medical Sciences, Institute of Endocrinology, All India Institute of Medical Sciences, African Population and Health Research Center, Hanoi University of Public Health, Hassan First University of Settat, Harokopio University, Sahlgrenska Academy, Endocrinology and Metabolism Research Center, University of Public Health, International Food Policy Research Institute, National University of Singapore, Hong Kong Polytechnic University, Tampere University Hospital, University of Douala, University of Cape Town, National Institute for Health Development, West Virginia University, Oswaldo Cruz Foundation Rene Rachou Research Institute, National Taiwan University, University of Chinese Academy of Sciences, Uppsala University, Taipei Medical University, Sports Medical Center of Minho, Universidad San Martín de Porres, Consejería de Sanidad Junta de Castilla y León, Universidade Federal de Ciências da Saúde de Porto Alegre, Norrbotten County Council, Ilembula Lutheran Hospital, Universidade Federal de Ouro Preto, University of Coimbra, Coimbra University Hospital Center, Institute of Neuroscience of the National Research Council, Baker Heart and Diabetes Institute, Agricultural University of Athens, Hospital Israelita Albert Einstein, SB RAS Federal Research Center Institute of Cytology and Genetics, University of Otago, University of Padua, Hellenic Mediterranean University, Loughborough 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Guatemala, University of Limpopo, University of Medical Sciences of Cienfuegos, Royal College of Surgeons in Ireland, La Trobe University, International Institute of Molecular and Cell Biology, Instituto Conmemorativo Gorgas de Estudios de la Salud, University of Brescia, Ministry of Health and Social Protection, University of Limerick, Croatian Institute of Public Health, Universiti Kebangsaan Malaysia, Bushehr University of Medical Sciences, Ulm University, Kobe University, Suraj Eye Institute, UNICEF, University Medicine Greifswald, National Institute of Hygiene and Epidemiology, University of Medicine and Pharmacy at Ho Chi Minh City, Hanoi Medical University, LifeDoc Health, Heartfile, Eastern Mediterranean Public Health Network, University of Manchester, State University of Medicine and Pharmacy, Tachikawa General Hospital, Korea Centers for Disease Control and Prevention, Japan Wildlife Research Center, Istanbul University, Universidade Federal do Paraná (UFPR), University of Madeira, University of Puerto Rico, Center for Clinical Research and Prevention, MRC Lifecourse Epidemiology Unit, Kwame Nkrumah University of Science and Technology, UniSanté, Prevention and Clinical Network, University of Wisconsin-Madison, Ruprecht-Karls-University of Heidelberg, IRCCS Ente Ospedaliero Specializzato in Gastroenterologia S. de Bellis, Zayed University, Catholic University of Daegu, Science and Technology of Târgu Mures, Jivandeep Hospital, Healis- Sekhsaria Institute for Public Health, National Dental Care Centre Singapore, Universidad de Málaga, University Hospital of Varese, Vietnam National Heart Institute, Clínica de Medicina Avanzada Dr. Abel González, Leibniz Institute for Prevention Research and Epidemiology - BIPS, University of Sarajevo, Cardiovascular Prevention Centre Udine, Pisa University Hospital, Public Health Agency of Catalonia, Ardabil University of Medical Sciences, Centre for Disease Prevention and Control, Alborz University of Medical Sciences, Pure Earth, Institute of Epidemiology Disease Control and Research, University of Turku, Institut Universitari d’Investigacióen AtencióPrima` ria Jordi Gol, Universiti Putra Malaysia, University of Malaya, Sotiria Hospital, University of Valencia, University of the Philippines, Slovak Academy of Sciences, Nutrition Research Foundation, Minas Gerais State Secretariat for Health, CS S. Agustín Ibsalut, Amsterdam Institute for Global Health and Development, National Institute of Health Doutor Ricardo Jorge, Universidade Nove de Julho, Public Health Agency of Canada, Canarian Health Service, Universidad Industrial de Santander, Associazione Calabrese di Epatologia, University of Minho, Fiji National University, Spanish Nutrition Foundation, Public Health Agency of Sweden, Institute of Food Sciences of the National Research Council, Sitaram Bhartia Institute of Science and Research, Kindergarten of Avlonari, National Institute of Health, Catalan Department of Health, Biodonostia Health Research Institute, Instituto de Saúde Ambiental, South Karelia Social and Health Care District, McMaster University, University of Saõ Paulo Clinics Hospital, Hospital Italiano de Buenos Aires, Rigshospitalet, Academic Medical Center of University of Amsterdam, The George Institute for Global Health, Center for Oral Health Services and Research Mid-Norway, Lagos State University College of Medicine, University of Las Palmas de Gran Canaria, Comenius University, National Center for Disease Control and Public Health, Nippon Medical School, Sungkyunkwan University, Finnish Institute of Occupational Health, Public Health Promotion and Development Organization, St Vincent’s Hospital, Nes Municipality, Health Polytechnic Jakarta II Institute, Diponegoro University, University of Bari, Institut Régional de SantéPublique, University of Bordeaux, Oslo Metropolitan University, Ss. Cyril and Methodius University, University of Leuven, Lamprecht und Stamm Sozialforschung und Beratung AG, Bonn University, National Institute of Public Health - National Institute of Hygiene, Kalina Malina Kindergarten, The Jikei University School of Medicine, Fu Jen Catholic University, National Statistical Office, Scientific Research Institute of Maternal and Child Health, University of Lincoln, Central University of Kerala, Amsterdam Public Health Research Institute, Health Service of Murcia, Institut d’Investigacio Sanitaria Illes Balears, University of Bologna, Hellenic Health Foundation, Government Medical College, Sefako Makgatho Health Science University, Addis Ababa University, Universidad Centro-Occidental Lisandro Alvarado, Meharry Medical College, Dokuz Eylul University, University of Tampere Tays Eye Center, Sabiha Gokcen Ilkokulu, Polytechnic Institute of Porto, Icahn School of Medicine at Mount Sinai, Universidad CEU San Pablo, University Miguel Hernandez, Vrije Universiteit Amsterdam, Sunflower Nursery School, North Karelia Center for Public Health, University of the Witwatersrand, Medical University of Vienna, Cork Institute of Technology, Institute for Medical Research, Xinjiang Medical University, Shanghai Educational Development Co. Ltd, Orebro University, University of London, Universitas Indonesia, Institute of Food and Nutrition Development of Ministry of Agriculture and Rural Affairs, Children’s Hospital of Fudan University, University of Cyprus, Niigata University, International Medical University, Iran University of Medical Sciences, Center for Diabetes and Endocrine Care, Peking University First Hospital, Jiangsu Provincial Center for Disease Control and Prevention, Sun Yat-sen University, West Kazakhstan Medical University, Inner Mongolia Medical University, University of Ghana, Maria Lc Iurilli , Bin Zhou , James E Bennett , Rodrigo M Carrillo-Larco , Marisa K Sophiea , Andrea Rodriguez-Martinez , Honor Bixby , Bethlehem D Solomon , Cristina Taddei , Goodarz Danaei , Mariachiara Di Cesare , Gretchen A Stevens , Leanne M Riley , Stefan Savin , Melanie J Cowan , Pascal Bovet , Albertino Damasceno , Adela Chirita-Emandi , Alison J Hayes , Nayu Ikeda , Rod T Jackson , Young-Ho Khang , Avula Laxmaiah , Jing Liu , J Jaime Miranda , Olfa Saidi , Sylvain Sebert , Maroje Sorić , Gregor Starc , Edward W Gregg , Leandra Abarca-Gómez , Ziad A Abdeen , Shynar Abdrakhmanova , Suhaila Abdul Ghaffar , Hanan F Abdul Rahim , Niveen M Abu-Rmeileh , Jamila Abubakar Garba , Benjamin Acosta-Cazares , Robert J Adams , Wichai Aekplakorn , Kaosar Afsana , Shoaib Afzal , Imelda A Agdeppa , Javad Aghazadeh-Attari , Carlos A Aguilar-Salinas , Charles Agyemang , Mohamad Hasnan Ahmad , Noor Ani Ahmad , Ali Ahmadi , Naser Ahmadi , Soheir H Ahmed , Wolfgang Ahrens , Gulmira Aitmurzaeva , Kamel Ajlouni , Hazzaa M Al-Hazzaa , Badreya Al-Lahou , Rajaa Al-Raddadi , Monira Alarouj , Fadia AlBuhairan , Shahla AlDhukair , Mohamed M Ali , Abdullah Alkandari , Ala'a Alkerwi , Kristine Allin , Mar Alvarez-Pedrerol , Eman Aly , Deepak N Amarapurkar , Parisa Amiri , Norbert Amougou , Philippe Amouyel , Lars Bo Andersen , Sigmund A Anderssen , Lars Ängquist , Ranjit Mohan Anjana , Alireza Ansari-Moghaddam , Hajer Aounallah-Skhiri , Joana Araújo , Inger Ariansen , Tahir Aris , Raphael E Arku , Nimmathota Arlappa , Krishna K Aryal , Thor Aspelund , Felix K Assah , Maria Cecília F Assunção , May Soe Aung , Juha Auvinen , Mária Avdicová , Shina Avi , Ana Azevedo , Mohsen Azimi-Nezhad , Fereidoun Azizi , Mehrdad Azmin , Bontha V Babu , Maja Bæksgaard Jørgensen , Azli Baharudin , Suhad Bahijri , Jennifer L Baker , Nagalla Balakrishna , Mohamed Bamoshmoosh , Maciej Banach , Piotr Bandosz , José R Banegas , Joanna Baran , Barbagallo CM, Alberto Barceló , Amina Barkat , Aluisio Jd Barros , Mauro Virgílio Gomes Barros , Abdul Basit , Joao Luiz D Bastos , Iqbal Bata , Anwar M Batieha , Rosangela L Batista , Zhamilya Battakova , Assembekov Batyrbek , Louise A Baur , Robert Beaglehole , Silvia Bel-Serrat , Antonisamy Belavendra , Habiba Ben Romdhane , Judith Benedics , Mikhail Benet , Ingunn Holden Bergh , Salim Berkinbayev , Antonio Bernabe-Ortiz , Gailute Bernotiene , Heloísa Bettiol , Jorge Bezerra , Aroor Bhagyalaxmi , Sumit Bharadwaj , Santosh K Bhargava , Zulfiqar A Bhutta , Hongsheng Bi , Yufang Bi , Daniel Bia , Elysée Claude Bika Lele, Mukharram M Bikbov , Bihungum Bista , Dusko J Bjelica , Peter Bjerregaard , Espen Bjertness , Marius B Bjertness , Cecilia Björkelund , Katia V Bloch , Anneke Blokstra , Simona Bo , Martin Bobak , Lynne M Boddy , Bernhard O Boehm , Heiner Boeing , Jose G Boggia , Elena Bogova , Carlos P Boissonnet , Stig E Bojesen , Marialaura Bonaccio , Vanina Bongard , Alice Bonilla-Vargas , Matthias Bopp , Herman Borghs , Lien Braeckevelt , Lutgart Braeckman , Marjolijn Ce Bragt , Imperia Brajkovich , Francesco Branca , Juergen Breckenkamp , João Breda , Hermann Brenner , Lizzy M Brewster , Garry R Brian , Lacramioara Brinduse , Sinead Brophy , Graziella Bruno , H Bas Bueno-de-Mesquita , Anna Bugge , Marta Buoncristiano , Genc Burazeri , Con Burns , Antonio Cabrera de León , Joseph Cacciottolo , Hui Cai , Tilema Cama , Christine Cameron , José Camolas , Günay Can , Ana Paula C Cândido , Felicia Cañete , Mario V Capanzana , Nadežda Capková , Eduardo Capuano , Vincenzo Capuano , Marloes Cardol , Viviane C Cardoso , Axel C Carlsson , Esteban Carmuega , Joana Carvalho , José A Casajús , Felipe F Casanueva , Ertugrul Celikcan , Laura Censi , Marvin Cervantes-Loaiza , Juraci A Cesar , Snehalatha Chamukuttan , Angelique W Chan , Queenie Chan , Himanshu K Chaturvedi , Nish Chaturvedi , Norsyamlina Che Abdul Rahim , Miao Li Chee , Chien-Jen Chen , Fangfang Chen , Huashuai Chen , Shuohua Chen , Zhengming Chen , Ching-Yu Cheng , Bahman Cheraghian , Angela Chetrit , Ekaterina Chikova-Iscener , Arnaud Chiolero , Shu-Ti Chiou , María-Dolores Chirlaque , Belong Cho , Kaare Christensen , Diego G Christofaro , Jerzy Chudek , Renata Cifkova , Michelle Cilia , Eliza Cinteza , Frank Claessens , Janine Clarke , Els Clays , Emmanuel Cohen , Hans Concin , Susana C Confortin , Cyrus Cooper , Tara C Coppinger , Eva Corpeleijn , Simona Costanzo , Dominique Cottel , Chris Cowell , Cora L Craig , Amelia C Crampin , Ana B Crujeiras , Semánová Csilla , Alexandra M Cucu , Liufu Cui , Felipe V Cureau , Ewelina Czenczek-Lewandowska , Graziella D'Arrigo , Eleonora d'Orsi , Liliana Dacica , María Ángeles Dal Re Saavedra , Jean Dallongeville , Camilla T Damsgaard , Rachel Dankner , Thomas M Dantoft , Parasmani Dasgupta , Saeed Dastgiri , Luc Dauchet , Kairat Davletov , Guy De Backer , Dirk De Bacquer , Giovanni de Gaetano , Stefaan De Henauw , Paula Duarte de Oliveira , David De Ridder , Karin De Ridder , Susanne R de Rooij , Delphine De Smedt , Mohan Deepa , Alexander D Deev , Vincent Jr DeGennaro , Abbas Dehghan , Hélène Delisle , Francis Delpeuch , Stefaan Demarest , Elaine Dennison , Katarzyna Dereń , Valérie Deschamps , Meghnath Dhimal , Augusto F Di Castelnuovo , Juvenal Soares Dias-da-Costa , María Elena Díaz-Sánchez , Alejandro Diaz , Zivka Dika , Shirin Djalalinia , Visnja Djordjic , Ha Tp Do , Annette J Dobson , Maria Benedetta Donati , Chiara Donfrancesco , Silvana P Donoso , Angela Döring , Maria Dorobantu , Ahmad Reza Dorosty , Kouamelan Doua , Nico Dragano , Wojciech Drygas , Jia Li Duan , Charmaine A Duante , Priscilla Duboz , Rosemary B Duda , Vesselka Duleva , Virginija Dulskiene , Samuel C Dumith , Anar Dushpanova , Vilnis Dzerve , Elzbieta Dziankowska-Zaborszczyk , Ricky Eddie , Ebrahim Eftekhar , Eruke E Egbagbe , Robert Eggertsen , Sareh Eghtesad , Gabriele Eiben , Ulf Ekelund , Mohammad El-Khateeb , Jalila El Ati , Denise Eldemire-Shearer , Marie Eliasen , Paul Elliott , Reina Engle-Stone , Macia Enguerran , Rajiv T Erasmus , Raimund Erbel , Cihangir Erem , Louise Eriksen , Johan G Eriksson , Jorge Escobedo-de la Peña , Saeid Eslami , Ali Esmaeili , Alun Evans , David Faeh , Albina A Fakhretdinova , Caroline H Fall , Elnaz Faramarzi , Mojtaba Farjam , Victoria Farrugia Sant'Angelo , Farshad Farzadfar , Mohammad Reza Fattahi , Asher Fawwad , Francisco J Felix-Redondo , Trevor S Ferguson , Romulo A Fernandes , Daniel Fernández-Bergés , Daniel Ferrante , Thomas Ferrao , Marika Ferrari , Marco M Ferrario , Catterina Ferreccio , Eldridge Ferrer , Jean Ferrieres , Thamara Hubler Figueiró , Anna Fijalkowska , Günther Fink , Krista Fischer , Leng Huat Foo , Maria Forsner , Heba M Fouad , Damian K Francis , Maria do Carmo Franco , Ruth Frikke-Schmidt , Guillermo Frontera , Flavio D Fuchs , Sandra C Fuchs , Isti I Fujiati , Yuki Fujita , Matsuda Fumihiko , Takuro Furusawa , Zbigniew Gaciong , Mihai Gafencu , Andrzej Galbarczyk , Henrike Galenkamp , Daniela Galeone , Myriam Galfo , Fabio Galvano , Jingli Gao , Manoli Garcia-de-la-Hera , Marta García-Solano , Dickman Gareta , Sarah P Garnett , Jean-Michel Gaspoz , Magda Gasull , Adroaldo Cesar Araujo Gaya , Anelise Reis Gaya , Andrea Gazzinelli , Ulrike Gehring , Harald Geiger , Johanna M Geleijnse , Ali Ghanbari , Erfan Ghasemi , Oana-Florentina Gheorghe-Fronea , Simona Giampaoli , Francesco Gianfagna , Tiffany K Gill , Jonathan Giovannelli , Glen Gironella , Aleksander Giwercman , Konstantinos Gkiouras , Justyna Godos , Sibel Gogen , Marcel Goldberg , Rebecca A Goldsmith , David Goltzman , Santiago F Gómez , Aleksandra Gomula , Bruna Goncalves Cordeiro da Silva , Helen Gonçalves , David A Gonzalez-Chica , Marcela Gonzalez-Gross , Margot González-Leon , Juan P González-Rivas , Clicerio González-Villalpando , María-Elena González-Villalpando , Angel R Gonzalez , Frederic Gottrand , Antonio Pedro Graça , Sidsel Graff-Iversen , Dušan Grafnetter , Aneta Grajda , Maria G Grammatikopoulou , Ronald D Gregor , Tomasz Grodzicki , Else Karin Grøholt , Anders Grøntved , Giuseppe Grosso , Gabriella Gruden , Dongfeng Gu , Emanuela Gualdi-Russo , Pilar Guallar-Castillón , Andrea Gualtieri , Elias F Gudmundsson , Vilmundur Gudnason , Ramiro Guerrero , Idris Guessous , Andre L Guimaraes , Martin C Gulliford , Johanna Gunnlaugsdottir , Marc J Gunter , Xiu-Hua Guo , Yin Guo , Prakash C Gupta , Rajeev Gupta , Oye Gureje , Beata Gurzkowska , Enrique Gutiérrez-González , Laura Gutierrez , Felix Gutzwiller , Seongjun Ha , Farzad Hadaegh , Charalambos A Hadjigeorgiou , Rosa Haghshenas , Hamid Hakimi , Jytte Halkjær , Ian R Hambleton , Behrooz Hamzeh , Dominique Hange , Abu Am Hanif , Sari Hantunen , Jie Hao , Rachakulla Hari Kumar , Seyed Mohammad Hashemi-Shahri , Maria Hassapidou , Jun Hata , Teresa Haugsgjerd , Jiang He , Yuan He , Yuna He , Regina Heidinger-Felso , Mirjam Heinen , Tatjana Hejgaard , Marleen Elisabeth Hendriks , Rafael Dos Santos Henrique , Ana Henriques , Leticia Hernandez Cadena , Sauli Herrala , Victor M Herrera , Isabelle Herter-Aeberli , Ramin Heshmat , Allan G Hill , Sai Yin Ho , Suzanne C Ho , Michael Hobbs , Michelle Holdsworth , Reza Homayounfar , Clara Homs , Wilma M Hopman , Andrea Rvr Horimoto , Claudia M Hormiga , Bernardo L Horta , Leila Houti , Christina Howitt , Thein Thein Htay , Aung Soe Htet , Maung Maung Than Htike , Yonghua Hu , José María Huerta , Ilpo Tapani Huhtaniemi , Laetitia Huiart , Constanta Huidumac Petrescu , Martijn Huisman , Abdullatif Husseini , Chinh Nguyen Huu , Inge Huybrechts , Nahla Hwalla , Jolanda Hyska , Licia Iacoviello , Jesús M Ibarluzea , Mohsen M Ibrahim , Norazizah Ibrahim Wong , M Arfan Ikram , Violeta Iotova , Vilma E Irazola , Takafumi Ishida , Muhammad Islam , Sheikh Mohammed Shariful Islam , Masanori Iwasaki , Jeremy M Jacobs , Hashem Y Jaddou , Tazeen Jafar , Kenneth James , Kazi M Jamil , Konrad Jamrozik , Imre Janszky , Edward Janus , Juel Jarani , Marjo-Riitta Jarvelin , Grazyna Jasienska , Ana Jelakovic , Bojan Jelakovic , Garry Jennings , Anjani Kumar Jha , Chao Qiang Jiang , Ramon O Jimenez , Karl-Heinz Jöckel , Michel Joffres , Mattias Johansson , Jari J Jokelainen , Jost B Jonas , Jitendra Jonnagaddala , Torben Jørgensen , Pradeep Joshi , Farahnaz Joukar , Dragana P Jovic , Jacek J Jóźwiak , Anne Juolevi , Gregor Jurak , Iulia Jurca Simina , Vesna Juresa , Rudolf Kaaks , Felix O Kaducu , Anthony Kafatos , Eero O Kajantie , Zhanna Kalmatayeva , Ofra Kalter-Leibovici , Yves Kameli , Freja B Kampmann , Kodanda R Kanala , Srinivasan Kannan , Efthymios Kapantais , Argyro Karakosta , Line L Kårhus , Khem B Karki , Marzieh Katibeh , Joanne Katz , Peter T Katzmarzyk , Jussi Kauhanen , Prabhdeep Kaur , Maryam Kavousi , Gyulli M Kazakbaeva , Ulrich Keil , Lital Keinan Boker , Sirkka Keinänen-Kiukaanniemi , Roya Kelishadi , Cecily Kelleher , Han Cg Kemper , Andre P Kengne , Maryam Keramati , Alina Kerimkulova , Mathilde Kersting , Timothy Key , Yousef Saleh Khader , Davood Khalili , Kay-Tee Khaw , Bahareh Kheiri , Motahareh Kheradmand , Alireza Khosravi , Ilse Msl Khouw , Ursula Kiechl-Kohlendorfer , Stefan Kiechl , Japhet Killewo , Dong Wook Kim , Hyeon Chang Kim , Jeongseon Kim , Jenny M Kindblom , Heidi Klakk , Magdalena Klimek , Jeannette Klimont , Jurate Klumbiene , Michael Knoflach , Bhawesh Koirala , Elin Kolle , Patrick Kolsteren , Jürgen König , Raija Korpelainen , Paul Korrovits , Magdalena Korzycka , Jelena Kos , Seppo Koskinen , Katsuyasu Kouda , Viktoria A Kovacs , Sudhir Kowlessur , Slawomir Koziel , Jana Kratenova , Wolfgang Kratzer , Susi Kriemler , Peter Lund Kristensen , Steinar Krokstad , Daan Kromhout , Herculina S Kruger , Ruzena Kubinova , Renata Kuciene , Urho M Kujala , Enisa Kujundzic , Zbigniew Kulaga , R Krishna Kumar , Marie Kunešová , Pawel Kurjata , Yadlapalli S Kusuma , Kari Kuulasmaa , Catherine Kyobutungi , Quang Ngoc La , Fatima Zahra Laamiri , Tiina Laatikainen , Carl Lachat , Youcef Laid , Tai Hing Lam , Christina-Paulina Lambrinou , Edwige Landais , Vera Lanska , Georg Lappas , Bagher Larijani , Tint Swe Latt , Laura Lauria , Maria Lazo-Porras , Gwenaëlle Le Coroller , Khanh Le Nguyen Bao , Agnès Le Port , Tuyen D Le , Jeannette Lee , Jeonghee Lee , Paul H Lee , Nils Lehmann , Terho Lehtimäki , Daniel Lemogoum , Naomi S Levitt , Yanping Li , Merike Liivak , Christa L Lilly , Wei-Yen Lim , M Fernanda Lima-Costa , Hsien-Ho Lin , Xu Lin , Yi-Ting Lin , Lars Lind , Allan Linneberg , Lauren Lissner , Mieczyslaw Litwin , Lijuan Liu , Wei-Cheng Lo , Helle-Mai Loit , Khuong Quynh Long , Luis Lopes , Oscar Lopes , Esther Lopez-Garcia , Tania Lopez , Paulo A Lotufo , José Eugenio Lozano , Janice L Lukrafka , Dalia Luksiene , Annamari Lundqvist , Robert Lundqvist , Nuno Lunet , Charles Lunogelo , Michala Lustigová , Edyta Łuszczki , Guansheng Ma , Jun Ma , Xu Ma , George Ll Machado-Coelho , Aristides M Machado-Rodrigues , Luisa M Macieira , Ahmed A Madar , Stefania Maggi , Dianna J Magliano , Sara Magnacca , Emmanuella Magriplis , Gowri Mahasampath , Bernard Maire , Marjeta Majer , Marcia Makdisse , Päivi Mäki , Fatemeh Malekzadeh , Reza Malekzadeh , Rahul Malhotra , Kodavanti Mallikharjuna Rao , Sofia K Malyutina , Lynell V Maniego , Yannis Manios , Jim I Mann , Fariborz Mansour-Ghanaei , Enzo Manzato , Paula Margozzini , Anastasia Markaki , Oonagh Markey , Eliza Markidou Ioannidou , Pedro Marques-Vidal , Larissa Pruner Marques , Jaume Marrugat , Yves Martin-Prevel , Rosemarie Martin , Reynaldo Martorell , Eva Martos , Katharina Maruszczak , Stefano Marventano , Luis P Mascarenhas , Shariq R Masoodi , Ellisiv B Mathiesen , Prashant Mathur , Alicia Matijasevich , Tandi E Matsha , Christina Mavrogianni , Artur Mazur , Jean Claude N Mbanya , Shelly R McFarlane , Stephen T McGarvey , Martin McKee , Stela McLachlan , Rachael M McLean , Scott B McLean , Breige A McNulty , Sounnia Mediene Benchekor , Jurate Medzioniene , Parinaz Mehdipour , Kirsten Mehlig , Amir Houshang Mehrparvar , Aline Meirhaeghe , Jørgen Meisfjord , Christa Meisinger , Ana Maria B Menezes , Geetha R Menon , Gert Bm Mensink , Maria Teresa Menzano , Alibek Mereke , Indrapal I Meshram , Andres Metspalu , Haakon E Meyer , Jie Mi , Kim F Michaelsen , Nathalie Michels , Kairit Mikkel , Karolina Milkowska , Jody C Miller , Cláudia S Minderico , G K Mini , Juan Francisco Miquel , Mohammad Reza Mirjalili , Daphne Mirkopoulou , Erkin Mirrakhimov , Marjeta Mišigoj-Durakovic , Antonio Mistretta , Veronica Mocanu , Pietro A Modesti , Sahar Saeedi Moghaddam , Bahram Mohajer , Mostafa K Mohamed , Shukri F Mohamed , Kazem Mohammad , Zahra Mohammadi , Noushin Mohammadifard , Reza Mohammadpourhodki , Viswanathan Mohan , Salim Mohanna , Muhammad Fadhli Mohd Yusoff , Iraj Mohebbi , Farnam Mohebi , Marie Moitry , Drude Molbo , Line T Møllehave , Niels C Møller , Dénes Molnár , Amirabbas Momenan , Charles K Mondo , Michele Monroy-Valle , Eric Monterrubio-Flores , Kotsedi Daniel K Monyeki , Jin Soo Moon , Mahmood Moosazadeh , Leila B Moreira , Alain Morejon , Luis A Moreno , Karen Morgan , Suzanne N Morin , Erik Lykke Mortensen , George Moschonis , Malgorzata Mossakowska , Aya Mostafa , Anabela Mota-Pinto , Jorge Mota , Mohammad Esmaeel Motlagh , Jorge Motta , Marcos André Moura-Dos-Santos , Malay K Mridha , Kelias P Msyamboza , Thet Thet Mu , Magdalena Muc , Boban Mugoša , Maria L Muiesan , Parvina Mukhtorova , Martina Müller-Nurasyid , Neil Murphy , Jaakko Mursu , Elaine M Murtagh , Kamarul Imran Musa , Sanja Music Milanovic , Vera Musil , Norlaila Mustafa , Iraj Nabipour , Shohreh Naderimagham , Gabriele Nagel , Balkish M Naidu , Farid Najafi , Harunobu Nakamura , Jana Námešná , Ei Ei K Nang , Vinay B Nangia , Martin Nankap , Sameer Narake , Paola Nardone , Matthias Nauck , William A Neal , Azim Nejatizadeh , Chandini Nekkantti , Keiu Nelis , Liis Nelis , Ilona Nenko , Martin Neovius , Flavio Nervi , Chung T Nguyen , Nguyen D Nguyen , Quang Ngoc Nguyen , Ramfis E Nieto-Martínez , Yury P Nikitin , Guang Ning , Toshiharu Ninomiya , Sania Nishtar , Marianna Noale , Oscar A Noboa , Helena Nogueira , Teresa Norat , Maria Nordendahl , Børge G Nordestgaard , Davide Noto , Natalia Nowak-Szczepanska , Mohannad Al Nsour , Irfan Nuhoglu , Eha Nurk , Terence W O'Neill , Dermot O'Reilly , Galina Obreja , Caleb Ochimana , Angélica M Ochoa-Avilés , Eiji Oda , Kyungwon Oh , Kumiko Ohara , Claes Ohlsson , Ryutaro Ohtsuka , Örn Olafsson , Maria Teresa A Olinto , Isabel O Oliveira , Mohd Azahadi Omar , Altan Onat , Sok King Ong , Lariane M Ono , Pedro Ordunez , Rui Ornelas , Ana P Ortiz , Pedro J Ortiz , Merete Osler , Clive Osmond , Sergej M Ostojic , Afshin Ostovar , Johanna A Otero , Kim Overvad , Ellis Owusu-Dabo , Fred Michel Paccaud , Cristina Padez , Ioannis Pagkalos , Elena Pahomova , Karina Mary de Paiva , Andrzej Pajak , Domenico Palli , Alberto Palloni , Luigi Palmieri , Wen-Harn Pan , Songhomitra Panda-Jonas , Arvind Pandey , Francesco Panza , Dimitrios Papandreou , Soon-Woo Park , Suyeon Park , Winsome R Parnell , Mahboubeh Parsaeian , Ionela M Pascanu , Patrick Pasquet , Nikhil D Patel , Ivan Pecin , Mangesh S Pednekar , Nasheeta Peer , Gao Pei , Sergio Viana Peixoto , Markku Peltonen , Alexandre C Pereira , Marco A Peres , Napoleón Pérez-Farinós , Cynthia M Pérez , Valentina Peterkova , Annette Peters , Astrid Petersmann , Janina Petkeviciene , Ausra Petrauskiene , Emanuela Pettenuzzo , Niloofar Peykari , Son Thai Pham , Rafael N Pichardo , Daniela Pierannunzio , Iris Pigeot , Hynek Pikhart , Aida Pilav , Lorenza Pilotto , Francesco Pistelli , Freda Pitakaka , Aleksandra Piwonska , Andreia N Pizarro , Pedro Plans-Rubió , Bee Koon Poh , Hermann Pohlabeln , Raluca M Pop , Stevo R Popovic , Miquel Porta , Georg Posch , Anil Poudyal , Dimitrios Poulimeneas , Hamed Pouraram , Farhad Pourfarzi , Akram Pourshams , Hossein Poustchi , Rajendra Pradeepa , Alison J Price , Jacqueline F Price , Rui Providencia , Jardena J Puder , Iveta Pudule , Soile E Puhakka , Maria Puiu , Margus Punab , Radwan F Qasrawi , Mostafa Qorbani , Tran Quoc Bao , Ivana Radic , Ricardas Radisauskas , Salar Rahimikazerooni , Mahfuzar Rahman , Mahmudur Rahman , Olli Raitakari , Manu Raj , Ellina Rakhimova , Sherali Rakhmatulloev , Ivo Rakovac , Sudha Ramachandra Rao , Ambady Ramachandran , Jacqueline Ramke , Elisabete Ramos , Rafel Ramos , Lekhraj Rampal , Sanjay Rampal , Vayia Rarra , Ramon A Rascon-Pacheco , Mette Rasmussen , Cassiano Ricardo Rech , Josep Redon , Paul Ferdinand M Reganit , Valéria Regecová , Luis Revilla , Abbas Rezaianzadeh , Lourdes Ribas-Barba , Robespierre Ribeiro , Elio Riboli , Adrian Richter , Fernando Rigo , Natascia Rinaldo , Tobias F Rinke de Wit , Ana Rito , Raphael M Ritti-Dias , Juan A Rivera , Cynthia Robitaille , Romana Roccaldo , Daniela Rodrigues , Fernando Rodríguez-Artalejo , María Del Cristo Rodriguez-Perez , Laura A Rodríguez-Villamizar , Ulla Roggenbuck , Rosalba Rojas-Martinez , Nipa Rojroongwasinkul , Dora Romaguera , Elisabetta L Romeo , Rafaela V Rosario , Annika Rosengren , Ian Rouse , Joel Gr Roy , Adolfo Rubinstein , Frank J Rühli , Jean-Bernard Ruidavets , Blanca Sandra Ruiz-Betancourt , Maria Ruiz-Castell , Emma Ruiz Moreno , Iuliia A Rusakova , Kenisha Russell Jonsson , Paola Russo , Petra Rust , Marcin Rutkowski , Charumathi Sabanayagam , Elena Sacchini , Harshpal S Sachdev , Alireza Sadjadi , Ali Reza Safarpour , Saeid Safiri , Nader Saki , Benoit Salanave , Eduardo Salazar Martinez , Diego Salmerón , Veikko Salomaa , Jukka T Salonen , Massimo Salvetti , Margarita Samoutian , Jose Sánchez-Abanto , Sandjaja , Susana Sans , Loreto Santa Marina , Diana A Santos , Ina S Santos , Lèlita C Santos , Maria Paula Santos , Osvaldo Santos , Rute Santos , Sara Santos Sanz , Jouko L Saramies , Luis B Sardinha , Nizal Sarrafzadegan , Thirunavukkarasu Sathish , Kai-Uwe Saum , Savvas Savva , Mathilde Savy , Norie Sawada , Mariana Sbaraini , Marcia Scazufca , Beatriz D Schaan , Angelika Schaffrath Rosario , Herman Schargrodsky , Anja Schienkiewitz , Sabine Schipf , Carsten O Schmidt , Ida Maria Schmidt , Peter Schnohr , Ben Schöttker , Sara Schramm , Stine Schramm , Helmut Schröder , Constance Schultsz , Aletta E Schutte , Aye Aye Sein , Rusidah Selamat , Vedrana Sember , Abhijit Sen , Idowu O Senbanjo , Sadaf G Sepanlou , Victor Sequera , Luis Serra-Majem , Jennifer Servais , Ludmila Ševcíková , Svetlana A Shalnova , Teresa Shamah-Levy , Morteza Shamshirgaran , Coimbatore Subramaniam Shanthirani , Maryam Sharafkhah , Sanjib K Sharma , Jonathan E Shaw , Amaneh Shayanrad , Ali Akbar Shayesteh , Lela Shengelia , Zumin Shi , Kenji Shibuya , Hana Shimizu-Furusawa , Dong Wook Shin , Majid Shirani , Rahman Shiri , Namuna Shrestha , Khairil Si-Ramlee , Alfonso Siani , Rosalynn Siantar , Abla M Sibai , Antonio M Silva , Diego Augusto Santos Silva , Mary Simon , Judith Simons , Leon A Simons , Agneta Sjöberg , Michael Sjöström , Gry Skodje , Jolanta Slowikowska-Hilczer , Przemyslaw Slusarczyk , Liam Smeeth , Hung-Kwan So , Fernanda Cunha Soares , Grzegorz Sobek , Eugène Sobngwi , Morten Sodemann , Stefan Söderberg , Moesijanti Ye Soekatri , Agustinus Soemantri , Reecha Sofat , Vincenzo Solfrizzi , Mohammad Hossein Somi , Emily Sonestedt , Yi Song , Thorkild Ia Sørensen , Elin P Sørgjerd , Charles Sossa Jérome , Victoria E Soto-Rojas , Aïcha Soumaré , Slavica Sovic , Bente Sparboe-Nilsen , Karen Sparrenberger , Angela Spinelli , Igor Spiroski , Jan A Staessen , Hanspeter Stamm , Maria G Stathopoulou , Kaspar Staub , Bill Stavreski , Jostein Steene-Johannessen , Peter Stehle , Aryeh D Stein , George S Stergiou , Jochanan Stessman , Ranko Stevanovic , Jutta Stieber , Doris Stöckl , Tanja Stocks , Jakub Stokwiszewski , Ekaterina Stoyanova , Gareth Stratton , Karien Stronks , Maria Wany Strufaldi , Lela Sturua , Ramón Suárez-Medina , Machi Suka , Chien-An Sun , Johan Sundström , Yn-Tz Sung , Jordi Sunyer , Paibul Suriyawongpaisal , Boyd A Swinburn , Rody G Sy , Holly E Syddall , René Charles Sylva , Moyses Szklo , Lucjan Szponar , E Shyong Tai , Mari-Liis Tammesoo , Abdonas Tamosiunas , Eng Joo Tan , Xun Tang , Maya Tanrygulyyeva , Frank Tanser , Yong Tao , Mohammed Rasoul Tarawneh , Jakob Tarp , Carolina B Tarqui-Mamani , Radka Taxová Braunerová , Anne Taylor , Julie Taylor , Félicité Tchibindat , William R Tebar , Grethe S Tell , Tania Tello , Yih Chung Tham , K R Thankappan , Holger Theobald , Xenophon 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, Luxia Zhang , Zhen-Yu Zhang , Dong Zhao , Ming-Hui Zhao , Wenhua Zhao , Shiqi Zhen , Wei Zheng , Yingfeng Zheng , Bekbolat Zholdin , Maigeng Zhou , Dan Zhu , Marie Zins , Emanuel Zitt , Yanina Zocalo , Julio Zuñiga Cisneros , Monika Zuziak , Majid Ezzati , Sarah Filippi, Epidemiology, Iurilli, Maria LC, Zhou, Bin, Bennett, James E, Carrillo-Larco, Rodrigo M, Sophiea, Marisa K, Rodriguez-Martinez, Andrea, Bixby, Honor, Solomon, Bethlehem D, Taddei, Cristina, Danaei, Goodarz, Di Cesare, Mariachiara, Stevens, Gretchen A, Riley, Leanne M, Savin, Stefan, Cowan, Melanie J, Bovet, Pascal, Damasceno, Albertino, Chirita-Emandi, Adela, Hayes, Alison J, Ikeda, Nayu, Jackson, Rod T, Khang, Young-Ho, Laxmaiah, Avula, Liu, Jing, Miranda, J Jaime, Saidi, Olfa, Sebert, Sylvain, Sorić, Maroje, Starc, Gregor, Gregg, Edward W, Abarca-Gómez, Leandra, Abdeen, Ziad A, Abdrakhmanova, Shynar, Ghaffar, Suhaila Abdul, Rahim, Hanan F Abdul, Abu-Rmeileh, Niveen M, Garba, Jamila Abubakar, Acosta-Cazares, 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Kazakbaeva, Gyulli M, Keil, Ulrich, Boker, Lital Keinan, Keinänen-Kiukaanniemi, Sirkka, Kelishadi, Roya, Kelleher, Cecily, Kemper, Han CG, Kengne, Andre P, Keramati, Maryam, Kerimkulova, Alina, Kersting, Mathilde, Key, Timothy, Khader, Yousef Saleh, Khalili, Davood, Khaw, Kay-Tee, Kheiri, Bahareh, Kheradmand, Motahareh, Khosravi, Alireza, Khouw, Ilse MSL, Kiechl-Kohlendorfer, Ursula, Kiechl, Stefan, Killewo, Japhet, Kim, Dong Wook, Kim, Hyeon Chang, Kim, Jeongseon, Kindblom, Jenny M, Klakk, Heidi, Klimek, Magdalena, Klimont, Jeannette, Klumbiene, Jurate, Knoflach, Michael, Koirala, Bhawesh, Kolle, Elin, Kolsteren, Patrick, König, Jürgen, Korpelainen, Raija, Korrovits, Paul, Korzycka, Magdalena, Kos, Jelena, Koskinen, Seppo, Kouda, Katsuyasu, Kovacs, Viktoria A, Kowlessur, Sudhir, Koziel, Slawomir, Kratenova, Jana, Kratzer, Wolfgang, Kriemler, Susi, Kristensen, Peter Lund, Krokstad, Steiner, Kromhout, Daan, Kruger, Herculina S, Kubinova, Ruzena, Kuciene, Renata, Kujala, Urho M, Kujundzic, Enisa, Kulaga, Zbigniew, Kumar, R Krishna, Kunešová, Marie, Kurjata, Pawel, Kusuma, Yadlapalli S, Kuulasmaa, Kari, Kyobutungi, Catherine, La, Quang Ngoc, Laamiri, Fatima Zahra, Laatikainen, Tiina, Lachat, Carl, Laid, Youcef, Lam, Tai Hing, Lambrinou, Christina-Paulina, Landais, Edwige, Lanska, Vera, Lappas, Georg, Larijani, Bagher, Latt, Tint Swe, Lauria, Laura, Lazo-Porras, Maria, Le Coroller, Gwenaëlle, Le Nguyen Bao, Khanh, Le Port, Agnè, Le, Tuyen D, Lee, Jeannette, Lee, Jeonghee, Lee, Paul H, Lehmann, Nil, Lehtimäki, Terho, Lemogoum, Daniel, Levitt, Naomi S, Li, Yanping, Liivak, Merike, Lilly, Christa L, Lim, Wei-Yen, Lima-Costa, M Fernanda, Lin, Hsien-Ho, Lin, Xu, Lin, Yi-Ting, Lind, Lar, Linneberg, Allan, Lissner, Lauren, Litwin, Mieczyslaw, Liu, Lijuan, Lo, Wei-Cheng, Loit, Helle-Mai, Long, Khuong Quynh, Lopes, Lui, Lopes, Oscar, Lopez-Garcia, Esther, Lopez, Tania, Lotufo, Paulo A, Lozano, José Eugenio, Lukrafka, Janice L, Luksiene, Dalia, Lundqvist, Annamari, Lundqvist, Robert, Lunet, Nuno, Lunogelo, Charle, Lustigová, Michala, Łuszczki, Edyta, Ma, Guansheng, Ma, Jun, Ma, Xu, Machado-Coelho, George LL, Machado-Rodrigues, Aristides M, Macieira, Luisa M, Madar, Ahmed A, Maggi, Stefania, Magliano, Dianna J, Magnacca, Sara, Magriplis, Emmanuella, Mahasampath, Gowri, Maire, Bernard, Majer, Marjeta, Makdisse, Marcia, Mäki, Päivi, Malekzadeh, Fatemeh, Malekzadeh, Reza, Malhotra, Rahul, Rao, Kodavanti Mallikharjuna, Malyutina, Sofia K, Maniego, Lynell V, Manios, Yanni, Mann, Jim I, Mansour-Ghanaei, Fariborz, Manzato, Enzo, Margozzini, Paula, Markaki, Anastasia, Markey, Oonagh, Ioannidou, Eliza Markidou, Marques-Vidal, Pedro, Marques, Larissa Pruner, Marrugat, Jaume, Martin-Prevel, Yve, Martin, Rosemarie, Martorell, Reynaldo, Martos, Eva, Maruszczak, Katharina, Marventano, Stefano, Mascarenhas, Luis P, Masoodi, Shariq R, Mathiesen, Ellisiv B, Mathur, Prashant, Matijasevich, Alicia, Matsha, Tandi E, Mavrogianni, Christina, Mazur, Artur, Mbanya, Jean Claude N, McFarlane, Shelly R, McGarvey, Stephen T, McKee, Martin, McLachlan, Stela, McLean, Rachael M, McLean, Scott B, McNulty, Breige A, Benchekor, Sounnia Mediene, Medzioniene, Jurate, Mehdipour, Parinaz, Mehlig, Kirsten, Mehrparvar, Amir Houshang, Meirhaeghe, Aline, Meisfjord, Jørgen, Meisinger, Christa, Menezes, Ana Maria B, Menon, Geetha R, Mensink, Gert BM, Menzano, Maria Teresa, Mereke, Alibek, Meshram, Indrapal I, Metspalu, Andre, Meyer, Haakon E, Mi, Jie, Michaelsen, Kim F, Michels, Nathalie, Mikkel, Kairit, Milkowska, Karolina, Miller, Jody C, Minderico, Cláudia S, Mini, GK, Miquel, Juan Francisco, Mirjalili, Mohammad Reza, Mirkopoulou, Daphne, Mirrakhimov, Erkin, Mišigoj-Durakovic, Marjeta, Mistretta, Antonio, Mocanu, Veronica, Modesti, Pietro A, Moghaddam, Sahar Saeedi, Mohajer, Bahram, Mohamed, Mostafa K, Mohamed, Shukri F, Mohammad, Kazem, Mohammadi, Zahra, Mohammadifard, Noushin, Mohammadpourhodki, Reza, Mohan, Viswanathan, Mohanna, Salim, Yusoff, Muhammad Fadhli Mohd, Mohebbi, Iraj, Mohebi, Farnam, Moitry, Marie, Molbo, Drude, Møllehave, Line T, Møller, Niels C, Molnár, Déne, Momenan, Amirabba, Mondo, Charles K, Monroy-Valle, Michele, Monterrubio-Flores, Eric, Monyeki, Kotsedi Daniel K, Moon, Jin Soo, Moosazadeh, Mahmood, Moreira, Leila B, Morejon, Alain, Moreno, Luis A, Morgan, Karen, Morin, Suzanne N, Mortensen, Erik Lykke, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mota-Pinto, Anabela, Mota, Jorge, Motlagh, Mohammad Esmaeel, Motta, Jorge, Moura-dos-Santos, Marcos André, Mridha, Malay K, Msyamboza, Kelias P, Mu, Thet Thet, Muc, Magdalena, Mugoša, Boban, Muiesan, Maria L, Mukhtorova, Parvina, Müller-Nurasyid, Martina, Murphy, Neil, Mursu, Jaakko, Murtagh, Elaine M, Musa, Kamarul Imran, Milanovic, Sanja Music, Musil, Vera, Mustafa, Norlaila, Nabipour, Iraj, Naderimagham, Shohreh, Nagel, Gabriele, Naidu, Balkish M, Najafi, Farid, Nakamura, Harunobu, Námešná, Jana, Ei K Nang, Ei, Nangia, Vinay B, Nankap, Martin, Narake, Sameer, Nardone, Paola, Nauck, Matthia, Neal, William A, Nejatizadeh, Azim, Nekkantti, Chandini, Nelis, Keiu, Nelis, Lii, Nenko, Ilona, Neovius, Martin, Nervi, Flavio, Nguyen, Chung T, Nguyen, Nguyen D, Nguyen, Quang Ngoc, Nieto-Martínez, Ramfis E, Nikitin, Yury P, Ning, Guang, Ninomiya, Toshiharu, Nishtar, Sania, Noale, Marianna, Noboa, Oscar A, Nogueira, Helena, Norat, Teresa, Nordendahl, Maria, Nordestgaard, Børge G, Noto, Davide, Nowak-Szczepanska, Natalia, Al Nsour, Mohannad, Nuhoglu, Irfan, Nurk, Eha, O'Neill, Terence W, O'Reilly, Dermot, Obreja, Galina, Ochimana, Caleb, Ochoa-Avilés, Angélica M, Oda, Eiji, Oh, Kyungwon, Ohara, Kumiko, Ohlsson, Clae, Ohtsuka, Ryutaro, Olafsson, Örn, Olinto, Maria Teresa A, Oliveira, Isabel O, Omar, Mohd Azahadi, Onat, Altan, Ong, Sok King, Ono, Lariane M, Ordunez, Pedro, Ornelas, Rui, Ortiz, Ana P, Ortiz, Pedro J, Osler, Merete, Osmond, Clive, Ostojic, Sergej M, Ostovar, Afshin, Otero, Johanna A, Overvad, Kim, Owusu-Dabo, Elli, Paccaud, Fred Michel, Padez, Cristina, Pagkalos, Ioanni, Pahomova, Elena, de Paiva, Karina Mary, Pajak, Andrzej, Palli, Domenico, Palloni, Alberto, Palmieri, Luigi, Pan, Wen-Harn, Panda-Jonas, Songhomitra, Pandey, Arvind, Panza, Francesco, Papandreou, Dimitrio, Park, Soon-Woo, Park, Suyeon, Parnell, Winsome R, Parsaeian, Mahboubeh, Pascanu, Ionela M, Pasquet, Patrick, Patel, Nikhil D, Pecin, Ivan, Pednekar, Mangesh S, Peer, Nasheeta, Pei, Gao, Peixoto, Sergio Viana, Peltonen, Markku, Pereira, Alexandre C, Peres, Marco A, Pérez-Farinós, Napoleón, Pérez, Cynthia M, Peterkova, Valentina, Peters, Annette, Petersmann, Astrid, Petkeviciene, Janina, Petrauskiene, Ausra, Pettenuzzo, Emanuela, Peykari, Niloofar, Pham, Son Thai, Pichardo, Rafael N, Pierannunzio, Daniela, Pigeot, Iri, Pikhart, Hynek, Pilav, Aida, Pilotto, Lorenza, Pistelli, Francesco, Pitakaka, Freda, Piwonska, Aleksandra, Pizarro, Andreia N, Plans-Rubió, Pedro, Poh, Bee Koon, Pohlabeln, Hermann, Pop, Raluca M, Popovic, Stevo R, Porta, Miquel, Posch, Georg, Poudyal, Anil, Poulimeneas, Dimitrio, Pouraram, Hamed, Pourfarzi, Farhad, Pourshams, Akram, Poustchi, Hossein, Pradeepa, Rajendra, Price, Alison J, Price, Jacqueline F, Providencia, Rui, Puder, Jardena J, Pudule, Iveta, Puhakka, Soile E, Puiu, Maria, Punab, Margu, Qasrawi, Radwan F, Qorbani, Mostafa, Bao, Tran Quoc, Radic, Ivana, Radisauskas, Ricarda, Rahimikazerooni, Salar, Rahman, Mahfuzar, Rahman, Mahmudur, Raitakari, Olli, Raj, Manu, Rakhimova, Ellina, Rakhmatulloev, Sherali, Rakovac, Ivo, Rao, Sudha Ramachandra, Ramachandran, Ambady, Ramke, Jacqueline, Ramos, Elisabete, Ramos, Rafel, Rampal, Lekhraj, Rampal, Sanjay, Rarra, Vayia, Rascon-Pacheco, Ramon A, Rasmussen, Mette, Rech, Cassiano Ricardo, Redon, Josep, Reganit, Paul Ferdinand M, Regecová, Valéria, Revilla, Lui, Rezaianzadeh, Abba, Ribas-Barba, Lourde, Ribeiro, Robespierre, Riboli, Elio, Richter, Adrian, Rigo, Fernando, Rinaldo, Natascia, de Wit, Tobias F Rinke, Rito, Ana, Ritti-Dias, Raphael M, Rivera, Juan A, Robitaille, Cynthia, Roccaldo, Romana, Rodrigues, Daniela, Rodríguez-Artalejo, Fernando, del Cristo Rodriguez-Perez, María, Rodríguez-Villamizar, Laura A, Roggenbuck, Ulla, Rojas-Martinez, Rosalba, Rojroongwasinkul, Nipa, Romaguera, Dora, Romeo, Elisabetta L, Rosario, Rafaela V, Rosengren, Annika, Rouse, Ian, Roy, Joel GR, Rubinstein, Adolfo, Rühli, Frank J, Ruidavets, Jean-Bernard, Ruiz-Betancourt, Blanca Sandra, Ruiz-Castell, Maria, Moreno, Emma Ruiz, Rusakova, Iuliia A, Jonsson, Kenisha Russell, Russo, Paola, Rust, Petra, Rutkowski, Marcin, Sabanayagam, Charumathi, Sacchini, Elena, Sachdev, Harshpal S, Sadjadi, Alireza, Safarpour, Ali Reza, Safiri, Saeid, Saki, Nader, Salanave, Benoit, Martinez, Eduardo Salazar, Salmerón, Diego, Salomaa, Veikko, Salonen, Jukka T, Salvetti, Massimo, Samoutian, Margarita, Sánchez-Abanto, Jose, Sandjaja, null, Sans, Susana, Marina, Loreto Santa, Santos, Diana A, Santos, Ina S, Santos, Lèlita C, Santos, Maria Paula, Santos, Osvaldo, Santos, Rute, Sanz, Sara Santo, Saramies, Jouko L, Sardinha, Luis B, Sarrafzadegan, Nizal, Sathish, Thirunavukkarasu, Saum, Kai-Uwe, Savva, Savva, Savy, Mathilde, Sawada, Norie, Sbaraini, Mariana, Scazufca, Marcia, Schaan, Beatriz D, Rosario, Angelika Schaffrath, Schargrodsky, Herman, Schienkiewitz, Anja, Schipf, Sabine, Schmidt, Carsten O, Schmidt, Ida Maria, Schnohr, Peter, Schöttker, Ben, Schramm, Sara, Schramm, Stine, Schröder, Helmut, Schultsz, Constance, Schutte, Aletta E, Sein, Aye Aye, Selamat, Rusidah, Sember, Vedrana, Sen, Abhijit, Senbanjo, Idowu O, Sepanlou, Sadaf G, Sequera, Victor, Serra-Majem, Lui, Servais, Jennifer, Ševcíková, Ludmila, Shalnova, Svetlana A, Shamah-Levy, Teresa, Shamshirgaran, Morteza, Shanthirani, Coimbatore Subramaniam, Sharafkhah, Maryam, Sharma, Sanjib K, Shaw, Jonathan E, Shayanrad, Amaneh, Shayesteh, Ali Akbar, Shengelia, Lela, Shi, Zumin, Shibuya, Kenji, Shimizu-Furusawa, Hana, Shin, Dong Wook, Shirani, Majid, Shiri, Rahman, Shrestha, Namuna, Si-Ramlee, Khairil, Siani, Alfonso, Siantar, Rosalynn, Sibai, Abla M, Silva, Antonio M, Silva, Diego Augusto Santo, Simon, Mary, Simons, Judith, Simons, Leon A, Sjöberg, Agneta, Sjöström, Michael, Skodje, Gry, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, So, Hung-Kwan, Soares, Fernanda Cunha, Sobek, Grzegorz, Sobngwi, Eugène, Sodemann, Morten, Söderberg, Stefan, Soekatri, Moesijanti YE, Soemantri, Agustinu, Sofat, Reecha, Solfrizzi, Vincenzo, Somi, Mohammad Hossein, Sonestedt, Emily, Song, Yi, Sørensen, Thorkild IA, Sørgjerd, Elin P, Jérome, Charles Sossa, Soto-Rojas, Victoria E, Soumaré, Aïcha, Sovic, Slavica, Sparboe-Nilsen, Bente, Sparrenberger, Karen, Spinelli, Angela, Spiroski, Igor, Staessen, Jan A, Stamm, Hanspeter, Stathopoulou, Maria G, Staub, Kaspar, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Stevanovic, Ranko, Stieber, Jutta, Stöckl, Dori, Stocks, Tanja, Stokwiszewski, Jakub, Stoyanova, Ekaterina, Stratton, Gareth, Stronks, Karien, Strufaldi, Maria Wany, Sturua, Lela, Suárez-Medina, Ramón, Suka, Machi, Sun, Chien-An, Sundström, Johan, Sung, Yn-Tz, Sunyer, Jordi, Suriyawongpaisal, Paibul, Swinburn, Boyd A, Sy, Rody G, Syddall, Holly E, Sylva, René Charle, Szklo, Moyse, Szponar, Lucjan, Tai, E Shyong, Tammesoo, Mari-Lii, Tamosiunas, Abdona, Tan, Eng Joo, Tang, Xun, Tanrygulyyeva, Maya, Tanser, Frank, Tao, Yong, Tarawneh, Mohammed Rasoul, Tarp, Jakob, Tarqui-Mamani, Carolina B, Braunerová, Radka Taxová, Taylor, Anne, Taylor, Julie, Tchibindat, Félicité, Tebar, William R, Tell, Grethe S, Tello, Tania, Tham, Yih Chung, Thankappan, KR, Theobald, Holger, Theodoridis, Xenophon, Thijs, Lutgarde, Thomas, Nihal, Thuesen, Betina H, Tichá, Lubica, Timmermans, Erik J, Tjonneland, Anne, Tolonen, Hanna K, Tolstrup, Janne S, Topbas, Murat, Topór-Madry, Roman, Torheim, Liv Elin, Tormo, María José, Tornaritis, Michael J, Torrent, Matie, Torres-Collado, Laura, Toselli, Stefania, Touloumi, Giota, Traissac, Pierre, Tran, Thi Tuyet-Hanh, Trichopoulos, Dimitrio, Trichopoulou, Antonia, Trinh, Oanh TH, Trivedi, Atul, Tshepo, Lechaba, Tsigga, Maria, Tsugane, Shoichiro, Tuliakova, Azaliia M, Tulloch-Reid, Marshall K, Tullu, Fikru, Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Turley, Maria L, Twig, Gilad, Tynelius, Per, Tzotzas, Themistokli, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice, Ukoli, Flora AM, Ulmer, Hanno, Unal, Belgin, Usupova, Zhamyila, Uusitalo, Hannu MT, Uysal, Nalan, Vaitkeviciute, Justina, Valdivia, Gonzalo, Vale, Susana, Valvi, Damaskini, van Dam, Rob M, Van der Heyden, Johan, van der Schouw, Yvonne T, Van Herck, Koen, Van Minh, Hoang, Van Schoor, Natasja M, van Valkengoed, Irene GM, Vanderschueren, Dirk, Vanuzzo, Diego, Varbo, Anette, Varela-Moreiras, Gregorio, Varona-Pérez, Patricia, Vasan, Senthil K, Vega, Toma, Veidebaum, Tooma, Velasquez-Melendez, Gustavo, Velika, Biruta, Veronesi, Giovanni, Verschuren, WM Monique, Victora, Cesar G, Viegi, Giovanni, Viet, Lucie, Villalpando, Salvador, Vineis, Paolo, Vioque, Jesu, Virtanen, Jyrki K, Visser, Marjolein, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vladulescu, Mihaela, Vlasoff, Tiina, Vocanec, Dorja, Vollenweider, Peter, Völzke, Henry, Voutilainen, Ari, Voutilainen, Sari, Vrijheid, Martine, Vrijkotte, Tanja GM, Wade, Alisha N, Wagner, Aline, Waldhör, Thoma, Walton, Janette, Wambiya, Elvis OA, Bebakar, Wan Mohamad Wan, Mohamud, Wan Nazaimoon Wan, de Souza Wanderley Júnior, Rildo, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nichola, Weber, Adelheid, Wedderkopp, Niel, Weerasekera, Deepa, Weghuber, Daniel, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H, Widhalm, Kurt, Widyahening, Indah S, Wiecek, Andrzej, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Julianne, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Jyh Eiin, Wong, Tien Yin, Woo, Jean, Woodward, Mark, Wu, Frederick C, Wu, Jianfeng, Wu, Li Juan, Wu, Shouling, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yamborisut, Uruwan, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yardim, Nazan, Yaseri, Mehdi, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K, Yoosefi, Moein, Yoshihara, Akihiro, You, Qi Sheng, You, San-Lin, Younger-Coleman, Novie O, Md Yusof, Safiah, Yusoff, Ahmad Faudzi, Zaccagni, Luciana, Zafiropulos, Vassili, Zainuddin, Ahmad A, Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antoni, Zamrazilová, Hana, Zapata, Maria Elisa, Zargar, Abdul Hamid, Ko Zaw, Ko, Zdrojewski, Tomasz, Zejglicova, Kristyna, Vrkic, Tajana Zeljkovic, Zeng, Yi, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhao, Wenhua, Zhen, Shiqi, Zheng, Wei, Zheng, Yingfeng, Zholdin, Bekbolat, Zhou, Maigeng, Zhu, Dan, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Cisneros, Julio Zuñiga, Zuziak, Monika, Ezzati, Majid, Filippi, Sarah, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro - Montpellier SupAgro, and Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)
Subjects: Population -- Health aspects, Leanness, Baixo peso/Underweight, none, Double burden, alipainoisuus, tulotaso, global health, systematic analysis, Sedentary behaviors, RC1200, Prospective associations, 0302 clinical medicine, underweight, nälänhätä, Biology (General), skin and connective tissue diseases, Children, ComputingMilieux_MISCELLANEOUS, Body mass index, Human Nutrition & Health, education.field_of_study, Humane Voeding & Gezondheid, ylipaino, General Medicine, kansainvälinen vertailu, 3. Good health, World health, Medicine, A100 Pre-clinical Medicine, Population distribution, medicine.medical_specialty, QH301-705.5, Science, Socio-culturale, Nursing, Social sciences, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Thinness, SDG 3 - Good Health and Well-being, BMI, epidemiology, obesity, None, Humans, Obesidade/Obesity, SDG 2 - Zero Hunger, education, VLAG, US adults, Omvårdnad, body mass index, malnutrition, obesity, underweight, nutritional and metabolic diseases, medicine.disease, terveellisyys, Obesity, Faculdade de Ciências Sociais, Body Mass Index, Prevalence, Risk Factors, General Biochemistry, WIAS, lihavuus, RA, Demography, N.A, double burden, Settore MED/09 - Medicina Interna, alueelliset erot, Nutrition and Disease, Animal Nutrition, [SDV]Life Sciences [q-bio], Medizin, 030204 cardiovascular system & hematology, 0601 Biochemistry and Cell Biology, Change distribution of body mass index, RA0421, Voeding en Ziekte, Epidemiology, Medicine and Health Sciences, Global health, Índice de massa corporal/Body Mass Index, 030212 general & internal medicine, Underweight, painoindeksi, 2. Zero hunger, General Neuroscience, aliravitsemus, elintarvikkeet, health, Public Health, Global Health, Social Medicine and Epidemiology, Diervoeding, 3142 Public health care science, environmental and occupational health, purl.org/pe-repo/ocde/ford#3.01.03 [https], Chinese adults, pooled analysis, medicine.symptom, Diet quality, B120 Physiology, Research Article, trends, purl.org/pe-repo/ocde/ford#1.06.03 [https], prevalence, Population, Mothers, Genetics and Molecular Biology, 3121 Internal medicine, medicine, Life Science, ddc:610, 3125 Otorhinolaryngology, ophthalmology, kehonkoostumus, Nutrition, Australian adults, General Immunology and Microbiology, purl.org/pe-repo/ocde/ford#3.01.04 [https], Ciências sociais, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Malnutrition, Epidemiology and Global Health, sense organs, Estilos de Vida e Impacto na Saúde
Abstract: From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions., Wellcome Trust, Medical Research Council, peer-reviewed
Published: 2021
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6. Parkinson’s disease and the non-motor symptoms: hyposmia, weight loss, osteosarcopenia

Author: Sabrina Pigozzo, Giuseppe Sergi, Enzo Manzato, Marina De Rui, Emine Meral Inelmen, and Caterina Trevisan
Subjects: Sarcopenia, Weight loss, Aging, Pediatrics, medicine.medical_specialty, Parkinson's disease, Constipation, Hyposmia, Non-motor symptoms, Older adults, Osteosarcopenia, Parkinson’s disease, Context (language use), Disease, NO, Olfaction Disorders, 03 medical and health sciences, 0302 clinical medicine, Quality of life, medicine, Humans, 030212 general & internal medicine, business.industry, Parkinson Disease, medicine.disease, Dysphagia, Quality of Life, Geriatrics and Gerontology, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract: Non-motor symptoms (NMSs) are common in Parkinson's disease (PD) and can precede, sometimes for several years. NMSs include, other than gastrointestinal symptoms like constipation and dysphagia, also hyposmia, weight loss and osteosarcopenia. These three NMSs seem to be inter-related and affect patients' health and quality of life. Unfortunately, patients with these symptoms usually are not initially seen by a neurologist, and by the time they are consulted, nearly ~ 80% of the dopaminergic neurons in the substantia nigra have died. To date, no guidelines exist for screening, assessment and management of NMSs in general. A better understanding of these specific NMSs, likely in the context of others, will make it possible to approach and optimise the treatment of the motor symptoms thereby enhancing the welfare of PD patients. Identifying the NMSs could be very helpful, and among them, hyposmia, weight loss and osteosarcopenia may play an important role in solving the limitations in the diagnosis of PD. A strict collaboration between general practitioners, clinicians, geriatricians and neurologists can be one approach towards the diagnosis of pre-PD. Waiting until the motor symptoms develop and the patient is finally visited by the neurologist could be too late, considering the catastrophic prognosis of the disease.
Published: 2020
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7. Effect of Oral Beta-Hydroxy-Beta-Methylbutyrate (HMB) Supplementation on Physical Performance in Healthy Old Women Over 65 Years: An Open Label Randomized Controlled Trial.

Author: Linda Berton, Giulia Bano, Sara Carraro, Nicola Veronese, Simona Pizzato, Francesco Bolzetta, Marina De Rui, Elena Valmorbida, Irene De Ronch, Egle Perissinotto, Alessandra Coin, Enzo Manzato, and Giuseppe Sergi
Subjects: Medicine, Science
Abstract: Although older people are particularly liable to sarcopenia, limited research is available on beta-hydroxy-beta-methylbutyrate (HMB) supplementation in this population, particularly in healthy subjects. In this parallel-group, randomized, controlled, open-label trial, we aimed to evaluate whether an oral supplement containing 1.5 g of calcium HMB for 8 weeks could improve physical performance and muscle strength parameters in a group of community-dwelling healthy older women. Eighty healthy women attending a twice-weekly mild fitness program were divided into two equal groups of 40, and 32 of the treated women and 33 control completed the study. We considered a change in the Short Physical Performance Battery (SPPB) score as the primary outcome and changes in the peak torque (PT) isometric and isokinetic strength of the lower limbs, 6-minute walking test (6MWT), handgrip strength and endurance as secondary outcomes. Body composition was assessed with dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computerized tomography (pQCT). The mean difference between the two groups on pre-post change were finally calculated (delta) for each outcome. After 8 weeks, there were no significant differences between the groups’ SPPB, handgrip strength or DXA parameters. The group treated with HMB scored significantly better than the control group for PT isokinetic flexion (delta = 1.56±1.56 Nm; p = 0.03) and extension (delta = 3.32±2.61 Nm; p = 0.03), PT isometric strength (delta = 9.74±3.90 Nm; p = 0.02), 6MWT (delta = 7.67±8.29 m; p = 0.04), handgrip endurance (delta = 21.41±16.28 s; p = 0.02), and muscle density assessed with pQCT. No serious adverse effects were reported in either group. In conclusion, a nutritional supplement containing 1.5 g of calcium HMB for 8 weeks in healthy elderly women had no significant effects on SPPB, but did significantly improve several muscle strength and physical performance parameters.ClinicalTrials.gov NCT02118181.
Published: 2015
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8. Mild polypharmacy and MCI progression in older adults: the mediation effect of drug–drug interactions

Author: Enzo Manzato, Andrea Cignarella, Marianna Noale, Stefania Maggi, Paola Siviero, Federica Limongi, Giuseppe Sergi, and Caterina Trevisan
Subjects: Drug, Aging, Mediation (statistics), medicine.medical_specialty, medicine.drug_class, media_common.quotation_subject, Population, Anticholinergic cognitive burden, Drug interactions, NO, Dementia, Mild cognitive impairment, Polypharmacy, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, mental disorders, medicine, Anticholinergic, Humans, Cognitive Dysfunction, 030212 general & internal medicine, Effects of sleep deprivation on cognitive performance, education, Aged, media_common, Aged, 80 and over, education.field_of_study, business.industry, medicine.disease, Italy, Pharmaceutical Preparations, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, Cohort study
Abstract: Polypharmacy has been associated with worse cognitive performance, but its impact on mild cognitive impairment (MCI) progression to dementia has not been explored. The aims of the study were to investigate the association between multidrug regimens and MCI progression, and the possible mediation of drug–drug interactions and drugs’ anticholinergic effect in such association. This work included 342 older adults with MCI, who were involved in an Italian multicenter population-based cohort study. Information on drugs taken was derived from general practitioners’ records and data on drug–drug interactions and anticholinergic burden [evaluated through the Anticholinergic Cognitive Burden and the Anticholinergic Risk Scale (ARS)] were extracted. Multinomial logistic regressions assessed the associations between mild polypharmacy (≥ 3 drugs/day), drug–drug interactions, and anticholinergic burden with MCI changes after 1-year follow-up. Mediation analysis evaluated potential mediators of that relationship. Approximately, 50% of participants took ≥ 3 drugs/day. During the follow-up, 4.1% of MCI patients progressed to dementia. The odds of developing dementia was sixfold higher in those who took ≥ 3drugs/day (OR = 6.04, 95% CI 1.19–30.74), eightfold higher in those with ≥ 1 drug–drug interaction/s (OR = 8.45, 95% CI 1.70–41.91), and fivefold higher in those with ARS ≥ 1 (OR = 5.10, 95% CI 1.04–24.93). Drug–drug interactions mediated 70.4% of the association between medication number and MCI progression to dementia (p = 0.07). Our study suggests that even mild polypharmacy may increase the risk of MCI progression to dementia, probably due to the presence of drug–drug interactions, which often occur in multidrug regimens. Older people require careful management of pharmacological treatments, with special attention to drug–drug interactions and drug-related anticholinergic effects.
Published: 2019
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9. Dehydroepiandrosterone sulfate and fall risk in older people: Sex differences in the Pro.V.A. longitudinal study

Author: Stefania Maggi, Andrea Rancan, Bruno Micael Zanforlini, Caterina Trevisan, Pamela Carrer, Egle Perissinotto, Alessandro Franchin, Elisabetta Della Volpe, Giuseppe Sergi, Marianna Noale, Maria Chiara Corti, and Enzo Manzato
Subjects: Male, Risk, Longitudinal study, Older age, Recurrent falls, Dehydroepianstosterone sulfate, Falls, Sex differences, Accidental Falls, Aged, Aged, 80 and over, Dehydroepiandrosterone Sulfate, Female, Humans, Independent Living, Longitudinal Studies, Recurrence, Lower risk, General Biochemistry, Genetics and Molecular Biology, NO, Odds, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Dehydroepiandrosterone sulfate, 80 and over, Medicine, 030212 general & internal medicine, Dehydroepianstosterone sulfate, Falls, Older age, Sex differences, 030219 obstetrics & reproductive medicine, business.industry, Confounding, Obstetrics and Gynecology, Fall risk, chemistry, Older people, business, Demography
Abstract: Background The effect of dehydroepiandrosterone sulfate (DHEA-S) on fall risk in older age is still unclear, as is the effect of sex on any relationship between the two. Our aim was to evaluate the association between DHEA-S and the risk of falls and risk of recurrent falls in community-dwelling older men and women. Methods We included 1949 (781 M, 1168 F) older adults enrolled in the Progetto Veneto Anziani study. Baseline serum DHEA-S levels were analyzed by immunoassay. The number of falls reported in the year preceding the 4.4-year follow-up assessment was collected. The association between DHEA-S and falls was analyzed by multinomial logistic regression, adjusting for potential confounders and considering death as alternative outcome. Results After the follow-up, 548 (36.8%) individuals reported at least one fall in the previous year, and 214 (14.4%) reported ≥2 falls (recurrent falls). Each 1-standard deviation (SD) increase in log-transformed DHEA-S level reduced the odds of experiencing at least one fall by 9% (95%CI:0.88-0.95), and the risk of recurrent falls by 16% (95%CI:0.79-0.89). The highest DHEA-S tertile was 27% (95%CI:0.65-0.83) less likely to experience recurrent falls than the lowest tertile. The analyses, stratified by sex, suggested a strong association between DHEA-S and the fall risk for women (OR = 0.91; 95%CI:0.87-0.95 for at least one fall; OR = 0.83, 95%CI:0.78-0.89 for recurrent falls per each 1-SD increase in log-transformed DHEA-S); non-significant results were observed among men. Conclusions Higher levels of DHEA-S are associated with a lower risk of falls and recurrent falls in older people, especially women.
Published: 2019
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10. Parathormone, vitamin D and the risk of atrial fibrillation in older adults: A prospective study

Author: Marina De Rui, Giuseppe Sergi, Maria Chiara Corti, Enzo Manzato, Bruno Micael Zanforlini, Francesca Piovesan, Stefania Maggi, Marianna Noale, Paola Lucato, Egle Perissinotto, and Caterina Trevisan
Subjects: Male, medicine.medical_specialty, Time Factors, Older age, Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous), Parathyroid hormone, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, Atrial fibrillation, Vitamin D, Risk Assessment, Gastroenterology, vitamin D deficiency, NO, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Atrial Fibrillation, Vitamin D and neurology, Humans, Medicine, Prospective Studies, Prospective cohort study, Aged, Aged, 80 and over, Nutrition and Dietetics, business.industry, Proportional hazards model, Hyperparathyroidism, Incidence, Radioimmunoassay, Atrial fibrillation, Older age, Parathyroid hormone, Vitamin D, Prognosis, Vitamin D Deficiency, medicine.disease, Increased risk, Italy, Parathyroid Hormone, Female, Cardiology and Cardiovascular Medicine, business, Biomarkers
Abstract: Background & aims Vitamin D and parathormone (PTH) have been associated with cardiovascular outcomes, but their impact on atrial fibrillation (AF) onset is still unclear. We explored the influence of serum 25-hydroxyvitamin D (25[OH]D) and PTH on AF risk in older adults. Methods and results Data come from 2418 participants enrolled in the Progetto Veneto Anziani study. Serum 25(OH)D and intact PTH were measured using radioimmunoassay and two-site immunoassay, respectively. The associations between 25(OH)D, PTH and adjudicated AF cases over 4-years were explored by Cox regression. Over the follow-up, 134 incident cases of AF were assessed. The incidence rate of the sample was 13.5 (95%CI 11.4–15.9) per 1000 person-years, and was higher among those with high PTH levels (high: 16.4 [95%CI 11.3–24.0] per 1000 person-years), especially when associated to low 25(OH)D (20.3 [95%CI 12.9–32.3] per 1000 person-years). At Cox regression, only high PTH was significantly associated to an increased risk of AF (HR = 1.90, 95%CI 1.27–2.84). A marginal significant interaction (p = 0.06) was found between 25[OH]D and PTH concentrations in influencing AF risk. When exploring the risk of AF for combined categories of 25(OH)D and PTH, we found that those with high PTH and low 25(OH)D levels had an AF risk twice as high as that of people with normal values (HR = 2.09, 95%CI 1.28–3.42). Conclusion The risk of AF may be increased by high PTH levels, especially when associated with 25(OH)D deficiency. The identification and treatment of high PTH or vitamin D deficiency may thus contribute to lower the risk of AF.
Published: 2019
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11. Vitamin D deficiency and leisure time activities in the elderly: are all pastimes the same?

Author: Marina De Rui, Elena Debora Toffanello, Nicola Veronese, Sabina Zambon, Francesco Bolzetta, Leonardo Sartori, Estella Musacchio, Maria Chiara Corti, Giovannella Baggio, Gaetano Crepaldi, Egle Perissinotto, Enzo Manzato, and Giuseppe Sergi
Subjects: Medicine, Science
Abstract: Optimal vitamin D status is important for overall health and well-being, particularly in the elderly. Although vitamin D synthesis in the skin declines with age, exposure to sunlight still seems to help older-aged adults to achieve adequate serum 25-hydroxyvitamin D (25OHD) levels. Elderly people would therefore benefit from outdoor leisure activities, but the effects of different types of pastime on serum 25OHD levels have yet to be thoroughly investigated.To assess the association of different pastimes with 25OHD deficiency in elderly subjects.A sample of 2,349 community-dwelling elderly individuals (1,389 females and 960 males) enrolled in the Progetto Veneto Anziani was analyzed. Brisk walking, cycling, gardening and fishing were classed as outdoor activities, and dancing and gym workouts as indoor pastimes. Any activities undertaken for at least 1 hour/week during the previous month were considered as being practiced regularly. Logistic regression models were used to estimate the association between different pastimes and 25OHD deficiency.Serum 25OHD levels were significantly higher in individuals who engaged in outdoor pastimes (+25% in women, +27.7% in men) compared to those who did not. In particular, subjects regularly practicing gardening or cycling had higher serum 25OHD levels than those who did not, whereas 25OHD levels differed little between subjects who did or did not undertake indoor activities. Among the outdoor pastimes considered, logistic regression analysis confirmed a lower likelihood of vitamin D deficiency (25OHD
Published: 2014
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12. Cardiovascular risk profiles and 20-year mortality in older people: gender differences in the Pro.V.A. study

Author: Marianna Noale, Enzo Manzato, Maria Chiara Corti, Eliana Ferroni, Giovannella Baggio, Giuseppe Sergi, Stefania Maggi, Ugo Fedeli, Giulia Capodaglio, and Caterina Trevisan
Subjects: medicine.medical_specialty, Health (social science), Older age, Socio-culturale, 030204 cardiovascular system & hematology, Risk profile, 03 medical and health sciences, 0302 clinical medicine, Cardiovascular risk factors, Gender differences, Mortality, Diabetes mellitus, Medicine, 030212 general & internal medicine, business.industry, Proportional hazards model, Public health, Oldest old, medicine.disease, Blood pressure, Mortality data, Geriatrics and Gerontology, business, Older people, Demography
Abstract: The age- and gender-related cardio-metabolic changes may limit the applicability of guidelines for the prevention of cardiovascular diseases (CVD) in older people. We investigated the association of cardiovascular risk profile with 20-year all-cause and CVD-mortality in older adults, focusing on age- and gender-specific differences. This prospective study involved 2895 community-dwelling individuals aged ≥65 years who participated in the Pro.V.A study. The sum of achieved target levels (smoking, diet, physical activity, body weight, blood pressure, lipids, and diabetes) recommended by the European Society of Cardiology 2016 guidelines was assessed in each participant. From this sum, cardiovascular risk profile was categorised as very high (0-2), high (3), medium (4), low (5), and very low (6-7 target levels achieved). All-cause and CV mortality data over 20 years were obtained from health registers. At Cox regression, lower cardiovascular risk profile was associated with reduced 20-year all-cause mortality in both genders, with stronger results for women (HR = 0.42 [95%CI:0.25-0.69] and HR = 0.61 [95%CI:0.42-0.89] for very low vs. very high cardiovascular risk profile in women and men, respectively). This trend was more marked for CVD mortality. Lower cardiovascular risk profile was associated with reduced all-cause and CVD mortality only in men 75 years, while the associations persisted in the oldest old women. A lower cardiovascular risk profile, as defined by current guidelines, may reduce all-cause and CVD mortality in older people, with stronger and longer benefits in women. These findings suggest that personalised and life-course approaches considering gender and age differences may improve the delivery of preventive actions in older people.The online version contains supplementary material available at 10.1007/s10433-021-00620-y.
Published: 2021

13. Falls may trigger body weight decline in nursing home residents

Author: Giuseppe Sergi, Giada Ida Greco, Paolo Spinella, Enzo Manzato, Stefania Maggi, A Imoscopi, Marianna Noale, Anna-Karin Welmer, Mattia Mazzochin, and Caterina Trevisan
Subjects: Endocrinology, Diabetes and Metabolism, Nursing homes, Body weight, Health data, NO, Cognition, Risk Factors, 80 and over, Medicine, Humans, Cognitive Dysfunction, Cognitive impairment, Accidental falls, Aged, Aged, 80 and over, Nutrition and Dietetics, Body weight changes, Body Weight, Nursing Homes, Accidental Falls, business.industry, Medical record, Accidental falls, Body weight changes, Cognition, Nursing homes, Oldest old, Confidence interval, business, Demography
Abstract: Objectives The effect of falls on changes in body weight is still unknown. This study investigated the extent to which falls can modify the course of body weight in nursing home residents, and aimed to identify the factors that might modulate this effect. Methods The sample included 132 residents aged ≥60 y who had experienced at least one fall after nursing home admission. Body weight was measured monthly in the 6 mo after the fall in the entire sample, and also in the 6 mo prefall in a subsample (n = 111). Sociodemographic and health data were obtained from medical records. Linear mixed models were used to estimate the average monthly changes in body weight after the fall in the total sample, and as a function of the sociodemographic and medical factors. Results Falls modified the course of body weight in the total sample (β = −0.28, 95% confidence interval, −0.44 to −0.12, for the change in slope before and after fall) in all age classes and especially in individuals with severe cognitive impairment who received less-frequent informal visits (β = −0.55, 95% confidence interval, −0.87 to −0.22). Individuals aged ≥90 y and those with severe cognitive impairment had a steeper monthly weight decline in the 6 mo postfall, of 0.23 and 0.35 kg greater, respectively, than their younger and cognitively healthier counterparts. Conclusions Falls may trigger a body weight loss in nursing home residents, especially in the oldest old people and those with severe cognitive impairment who receive little support from informal caregivers. These findings highlight the importance of monitoring nutritional status of people who live in institutions after falls.
Published: 2021

14. Author response: Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author: Zahra Mohammadi, Abdul Basit, Helena I. S. Nogueira, Soile E. Puhakka, Hongsheng Bi, Ari Voutilainen, Davood Khalili, Bin Zhou, Dermot O'Reilly, Natascia Rinaldo, Paulo A. Lotufo, Bahareh Kheiri, Thein Thein Htay, Simona Giampaoli, Goodarz Danaei, M. Fernanda Lima-Costa, Simona Bo, Peter Schnohr, Jerzy Chudek, Francesco Panza, Ling Yang, Katia Vergetti Bloch, Vincenzo Capuano, Holly E. Syddall, Dong Zhao, Indah Suci Widyahening, Maria Lorenza Muiesan, Leng Huat Foo, Mohsen Azimi-Nezhad, Merete Osler, Laura Torres-Collado, Manu Raj, Adroaldo Cesar Araujo Gaya, Susi Kriemler, Ali Akbar Shayesteh, Aneta Grajda, Anette Varbo, Kazem Mohammad, Leila Beltrami Moreira, Shu Ti Chiou, Iuliia A Rusakova, Jyh Eiin Wong, Torben Jørgensen, Lela Sturua, Lubica Ticha, Hamid Hakimi, Hazzaa M. Al-Hazzaa, Yanina Zócalo, Freda Pitakaka, Savvas C. Savva, Rajeev Gupta, Jennifer Servais, Marie Kunešová, Johanna M. Geleijnse, Elysée Claude Bika Lele, Yannis Manios, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Sibel Gogen, Viviane Cunha Cardoso, Kristine H. Allin, Ana Azevedo, Line Tang Møllehave, Vincent Jr DeGennaro, Novie O. Younger-Coleman, Gretchen A Stevens, Dickman Gareta, Holger Theobald, Anja Schienkiewitz, Bekbolat Zholdin, Janice Luisa Lukrafka, Adela Chirita-Emandi, Ulla Roggenbuck, Kenisha Russell Jonsson, Robespierre Ribeiro, Gabriele Eiben, Eero Kajantie, Sounnia Mediene Benchekor, Fariborz Mansour-Ghanaei, Mary Simon, Prakash C. Gupta, Mohammad Esmaeel Motlagh, Emanuela Gualdi-Russo, María Elena Díaz-Sánchez, Pilar Guallar-Castillón, Bee Koon Poh, Cristina Padez, Azaliia M Tuliakova, Sarah P. Garnett, William R. Tebar, Yingfeng Zheng, Suhad Bahijri, Christina Mavrogianni, Mihaela Vladulescu, Jan A. Staessen, Paula Duarte de Oliveira, Rui Ornelas, Michael Sjöström, Charles Agyemang, Slawomir Koziel, Shohreh Naderimagham, Jari Jokelainen, Stephen T. McGarvey, Patrick Pasquet, Farnam Mohebi, Nader Saki, Aida Pilav, Azim Nejatizadeh, Marianna Noale, Habiba Ben Romdhane, Luís B. Sardinha, Laura Lauria, Jun Hata, Kodanda R Kanala, Gert B. M. Mensink, Nils Lehmann, Elio Riboli, Carolina Tarqui-Mamani, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Luis Serra-Majem, Martina Müller-Nurasyid, Felipe Vogt Cureau, Lekhraj Rampal, Zhamilya Battakova, Ludmila Sevcikova, Suhaila Abdul Ghaffar, Fikru Tullu, Aung Soe Htet, Angel R. Gonzalez, Annette J. Dobson, Kavumpurathu Raman Thankappan, Hélène Delisle, Francisco J. Félix-Redondo, Ramón Suárez-Medina, Annika Rosengren, Sania Nishtar, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Maria Cecília Formoso Assunção, Kazi M. Jamil, Stefano Marventano, Wenbin Wei, Norsyamlina Che Abdul Rahim, Shukri F. Mohamed, Bente Sparboe-Nilsen, Soon-Woo Park, Ana Isabel Rito, David Goltzman, W. M. Monique Verschuren, Catterina Ferreccio, Marta Buoncristiano, Ramón Alberto Rascón-Pacheco, Pradeep Joshi, Edward D Janus, Laetitia Huiart, Ala'a Alkerwi, Lorenza Pilotto, Mohannad Al Nsour, Daan Kromhout, Marius B. Bjertness, Oanh T. H. Trinh, Nico Dragano, Angélica Ochoa-Avilés, Ingunn Holden Bergh, Yuki Fujita, Juraci Almeida Cesar, Hajer Aounallah-Skhiri, Maria Dorobantu, Jordi Sunyer, Wolfgang Kratzer, Susanne R. de Rooij, Drude Molbo, Rebecca Goldsmith, Jean Woo, Mohammad El-khateeb, Tiffany K. Gill, Nish Chaturvedi, Benjamin Acosta-Cazares, Erik Lykke Mortensen, Nikhil D. Patel, Francesco Pistelli, Yuan He, Ivana Radic, Yi Zeng, Ilse Khouw, Reynaldo Martorell, Ching-Yu Cheng, Stine Schramm, Hana Shimizu-Furusawa, Jacek Jóźwiak, Radwan Qasrawi, Isti Ilmiati Fujiati, Charles Sossa Jérome, Ben Schöttker, Mikhail Benet, Anastasia Markaki, Christopher T. Cowell, Bharathi Viswanathan, Renata Kuciene, Jose Eugenio Lozano, Pedro J Ortiz, Delphine De Smedt, Elaine M. Murtagh, Kamel Ajlouni, Carlos A. Aguilar-Salinas, Graziella D'Arrigo, Xiangjun Wang, Lars Lind, Macia Enguerran, Marjeta Mišigoj-Duraković, Bo Werner, Jean-Michel Gaspoz, Kyungwon Oh, Seyed Rasoul Zakavi, Daniel Fernández-Bergés, Felix Kaducu, Ramon O. Jimenez, Jonathan E. Shaw, Nipa Rojroongwasinkul, Aicha Soumare, Astrid Petersmann, Tomasz Grodzicki, Parvina Mukhtorova, Eha Nurk, Bhawesh Koirala, Óscar Lopes, Ana Jelakovic, Karolina Milkowska, Magda Gasull, Regina Heidinger-Felso, Marcela González-Gross, Belong Cho, Daphne Mirkopoulou, Salvador Villalpando, Tran Quoc Bao, José Boggia, Daniela Galeone, Josep Redon, Matthias Bopp, Abbas Rezaianzadeh, Dusko Bjelica, Amir Houshang Mehrparvar, Felipe F. Casanueva, Khairil Si-Ramlee, Soheir H Ahmed, Maria Nordendahl, Luciana Zaccagni, Mahboubeh Parsaeian, Rod Jackson, Jorge Motta, Keiu Nelis, Fernando Rigo, Andrzej Pajak, Christa Meisinger, Clara Homs, Namuna Shrestha, Mar Alvarez-Pedrerol, Xun Tang, Johann Willeit, Motahareh Kheradmand, Jean Dallongeville, Jean-Bernard Ruidavets, Anne Tjønneland, Diana A. Santos, Lynne M. Boddy, Jie Hao, David Alejandro González-Chica, Elin Kolle, Jingli Gao, Małgorzata Mossakowska, Isabel O. Oliveira, Giuseppe Grosso, Seongjun Ha, Olfa Saidi, Albina A Fakhretdinova, Oye Gureje, Raluca Pop, Iulia Jurca Simina, Nuno Lunet, Maria Forsner, Peter Bjerregaard, Rachael McLean, Antonio Cabrera de León, Guy De Backer, José A. Casajús, Guang Ning, Emmanuella Magriplis, Laura Censi, Graziella Bruno, Valentina Peterkova, Angelique Chan, Yvonne T. van der Schouw, Charalambos Hadjigeorgiou, Anjani Kumar Jha, Toomas Veidebaum, Thamara Hubler Figueiró, Jana Kratenova, Michelle Cilia, Ivo Rakovac, Bill Stavreski, Ya Xing Wang, Oscar Noboa, Romana Roccaldo, Sara Magnacca, Johan Sundström, Peter Stehle, Tania Lopez, Francis Delpeuch, Julianne Williams, Ellisiv B. Mathiesen, Leanne M. Riley, Claudia M. Hormiga, Joanne Katz, Ekaterina Stoyanova, Heloisa Bettiol, Gabriele Nagel, Alireza Khosravi, Lars Bo Andersen, João Breda, Jørgen Meisfjord, Ahmad Faudzi Yusoff, Marjeta Majer, Robert Beaglehole, Caleb Ochimana, Shynar Abdrakhmanova, George S. Stergiou, Blanca Sandra Ruiz-Betancourt, Leon A. Simons, Eng Joo Tan, Victoria Farrugia Sant'Angelo, Gry Skodje, Maryam Keramati, Liv Elin Torheim, Seppo Koskinen, Assembekov Batyrbek, Jaakko Tuomilehto, Marjo-Riitta Järvelin, Ming-Hui Zhao, Krista Fischer, Tobias F. Rinke de Wit, Agnès Le Port, Reza Homayounfar, James E. Bennett, Yuna He, Matsuda Fumihiko, Qi Sheng You, Angela Spinelli, Scott B. McLean, Shirin Djalalinia, Thet Thet Mu, Yves Martin-Prével, Rafael N. Pichardo, Gailute Bernotiene, Pietro Amedeo Modesti, Frederick C. W. Wu, Chandini Nekkantti, Daniela Rodrigues, Tandi E. Matsha, Mihai Gafencu, Xingwang Ye, Salar Rahimikazerooni, Trevor S. Ferguson, Christophe Tzourio, Marie Zins, Fernando Rodríguez-Artalejo, Xu Ma, Elin Pettersen Sørgjerd, Lourdes Ribas-Barba, Nalan Uysal, Salim Berkinbayev, Enisa Kujundzic, Sari Voutilainen, Iraj Mohebbi, Heiner Boeing, Jorge Mota, Jana Námešná, Maria Tsigga, Zivka Dika, Gulmira Aitmurzaeva, Xu Lin, Valéria Regecová, Herman Schargrodsky, Stevo Popovic, Amelia C. Crampin, Hannu Uusitalo, André Luiz Sena Guimarães, Ali Esmaeili, Catherine Kyobutungi, Virginija Dulskiene, Diego Augusto Santos Silva, David De Ridder, Lizzy M. Brewster, Hashem Jaddou, Eunice Ugel, José Camolas, Azli Baharudin, Idris Guessous, Sok King Ong, Tabara Yasuharu, Ali Ghanbari, Anne W. Taylor, Iraj Nabipour, Justyna Godos, Cyrus Cooper, Bruna Gonçalves Cordeiro da Silva, Gonzalo Valdivia, Gyulli M. Kazakbaeva, Takuro Furusawa, Pawel Kurjata, Diego Vanuzzo, Marvin Cervantes-Loaiza, Karen Morgan, Mostafa Qorbani, Rute Santos, Marika Ferrari, Diego Salmerón, Ida Maria Schmidt, Gao Pei, Abu Am Hanif, Balkish M. Naidu, Maria Wany Louzada Strufaldi, Moesijanti Soekatri, Marcia Scazufca, Katharina Maruszczak, Jacqueline Ramke, Elvis Oa Wambiya, Kairit Mikkel, Napoleón Pérez-Farinós, Natalia Nowak-Szczepanska, Miao Li Chee, Jose Sanchez-Abanto, Rajaa Al-Raddadi, Michel Joffres, Vayia Rarra, Ningli Wang, Charmaine A. Duante, Sheikh Mohammed Shariful Islam, Manoli Garcia-de-la-Hera, Weili Yan, Dong Wook Shin, Rômulo Araújo Fernandes, Ilona Nenko, Sanjib Kumar Sharma, Alfonso Siani, Indrapal I. Meshram, Imelda A. Agdeppa, Ei Ei K. Nang, Ian Rouse, Avula Laxmaiah, Ana M. B. Menezes, Yih Chung Tham, Ebrahim Eftekhar, María José Tormo, Felicia Cañete, Marie Eliasen, Lutgart Braeckman, Dirk Vanderschueren, Genc Burazeri, Kari Kuulasmaa, Jesús Vioque, Marisa K. Sophiea, Agneta Sjöberg, Katarzyna Dereń, Albertino Damasceno, Jochanan Stessman, Stig E. Bojesen, Aline Meirhaeghe, Else Karin Grøholt, Flávio Danni Fuchs, Robert Lundqvist, Frédéric Gottrand, Jeongseon Kim, Helmut Schröder, Joanna Baran, Karina Mary de Paiva, Yousef Khader, Eric Monterrubio-Flores, Aneta Weres, Hans Concin, Damaskini Valvi, Sari Hantunen, Machi Suka, Elena Sacchini, Norbert Amougou, Ursula Kiechl-Kohlendorfer, Edwige Landais, Viktoria Anna Kovacs, Rosemarie Martin, Kenneth James, Amaneh Shayanrad, Grethe S. Tell, Norazizah Ibrahim Wong, Vedrana Sember, Anelise Reis Gaya, Konrad Jamrozik, Thorkild I. A. Sørensen, Martin Neovius, Urho M. Kujala, Nathalie Michels, Marcel Goldberg, Alexandra Cucu, Liliana Dacica, Adelheid Weber, Hermann Pohlabeln, Sandjaja, Jukka T. Salonen, Patricia Varona-Pérez, Tiina Laatikainen, Jolanta Słowikowska-Hilczer, Ana Paula Carlos Cândido, Julie Taylor, Anabela Mota-Pinto, Cora L. Craig, Teresa Shamah-Levy, María Dolores Chirlaque, Mohd Azahadi Omar, Dominique Cottel, Charumathi Sabanayagam, Andrea Gazzinelli, Mieczysław Litwin, Sadaf G. Sepanlou, Adolfo Rubinstein, Abbas Dehghan, Rildo de Souza Wanderley Júnior, Wenhua Zhao, Aleksandra Piwońska, Yong Tao, Bontha V. Babu, Marc J. Gunter, Harunobu Nakamura, Wojciech Drygas, Eiji Oda, Jia Li Duan, Stefan Söderberg, Anthony Kafatos, Lynell V Maniego, Els Clays, Wei-Yen Lim, Marshall K. Tulloch-Reid, Mariachiara Di Cesare, Mattias Johansson, Simona Costanzo, Margot González-León, Matthias Nauck, Henry Völzke, George Luiz Lins Machado-Coelho, Annette Peters, Rajiv T Erasmus, Juan Francisco Miquel, Andrea Gualtieri, Abdul Hamid Zargar, Kaare Christensen, Peter Willeit, Tanja Stocks, Christine Cameron, Samuel C. Dumith, Janina Petkeviciene, Boyd Swinburn, Magdalena Muc, Sabine Schipf, Tajana Zeljkovic Vrkic, Martin Bobak, Damian K Francis, Veronica Mocanu, Karien Stronks, Antonisamy Belavendra, Artur Mazur, Nagalla Balakrishna, Jardena J. Puder, Mehrdad Azmin, Shelly R. McFarlane, Sara Santos Sanz, Yang Yang, Anneke Blokstra, Rafel Ramos, Ertugrul Celikcan, Jody C Miller, Jesús Ibarluzea, Svetlana A. Shalnova, Maria Elisa Zapata, Guansheng Ma, Fereidoun Azizi, Beatriz D'Agord Schaan, Pedro Marques-Vidal, William A. Neal, Ana B. Crujeiras, Zhenyu Zhang, Naser Ahmadi, Abdullatif Husseini, Alun Evans, Jiang He, Edyta Łuszczki, Maria G. Stathopoulou, Alibek Mereke, Mari-Liis Tammesoo, Axel C. Carlsson, Helen Gonçalves, Idowu O Senbanjo, Jim Mann, Rajendra Pradeepa, Juel Jarani, Eva Martos, Eugene Sobngwi, Themistoklis Tzotzas, Vassilis Zafiropulos, Reina Engle-Stone, Atul Trivedi, Hui Cai, Sarah Filippi, Georg Posch, Galina Obreja, Cecily Kelleher, Sareh Eghtesad, Chung T Nguyen, Kay-Tee Khaw, Joseph Cacciottolo, Ana Henriques, Yi-Ting Lin, Anil Poudyal, Liam Smeeth, Kenji Shibuya, Emma Ruiz Moreno, Annamari Lundqvist, Thor Aspelund, Caroline H.D. Fall, Philippe Amouyel, Kristyna Zejglicova, Argyro Karakosta, Piotr Bandosz, Juvenal Soares Dias-da-Costa, Maria Lazo-Porras, Maung Maung Than Htike, Dalia Luksiene, Jutta Stieber, Augusto Di Castelnuovo, Aryeh D. Stein, Lechaba Tshepo, Judith Benedics, Aletta E. Schutte, Jürgen König, Magdalena Korzycka, Grzegorz Sobek, Dimitrios Trichopoulos, Tai Hing Lam, Yn-Tz Sung, Masanori Iwasaki, Elias F. Gudmundsson, Antonio Mistretta, Daniel Lemogoum, Nimmathota Arlappa, Isabelle Herter-Aeberli, Khanh Le Nguyen Bao, Shoichiro Tsugane, Kaosar Afsana, Alireza Sadjadi, Myriam Galfo, Jean Claude Mbanya, Bernardo L. Horta, Marleen E. Hendriks, M. Arfan Ikram, Fadia AlBuhairan, Huashuai Chen, Marzieh Katibeh, Sidsel Graff-Iversen, Sahar Saeedi Moghaddam, Larissa Pruner Marques, Louise Eriksen, Aleksandra Gomula, Ricky Eddie, Maciej Banach, Jost B. Jonas, Andrea R. V. R. Horimoto, Slavica Sović, Charles Mondo, Felix Gutzwiller, Mariana Sbaraini, Aye Aye Sein, Henrike Galenkamp, Jaume Marrugat, Nazan Yardim, Cecilia Björkelund, Luigi Palmieri, Roya Kelishadi, Jie Mi, Nahla Hwalla, Jing Liu, Davide Noto, Panayiotis K. Yiallouros, Kelias P. Msyamboza, Judith Simons, Sofia Malyutina, Michele Monroy-Valle, Andres Metspalu, Lariane M Ono, Rafaela Rosário, Flora A. Ukoli, Efthymios Kapantais, Enzo Manzato, S. Goya Wannamethee, Alison J Price, Gregorio Varela-Moreiras, Ali Reza Safarpour, Erfan Ghasemi, Janine Clarke, René Charles Sylva, Wan Nazaimoon Wan Mohamud, Zhamyila Usupova, Chaoqiang Jiang, Julio Zuñiga Cisneros, Freja B Kampmann, Wei Cheng Lo, Reza Mohammadpourhodki, Kaspar Staub, Mojtaba Farjam, Vincenzo Solfrizzi, Garry L. Jennings, Fabio Galvano, Monika Zuziak, Karin De Ridder, Lucie Viet, Anna Bugge, Mehdi Yaseri, Safiah Md Yusof, Sandra C. Fuchs, Emmanuel Cohen, Snehalatha Chamukuttan, Maria Ruiz-Castell, Karen Sparrenberger, Pedro Plans-Rubio, Wei Zheng, Eldridge Ferrer, Martijn Huisman, Maria Hassapidou, Iris Pigeot, Jakub Stokwiszewski, Domenico Palli, Ewelina Czenczek-Lewandowska, Ramiro Guerrero, Farzad Hadaegh, Han Cg Kemper, Saeid Safiri, Ivan Pećin, Arnaud Chiolero, Niels Møller, Jorge Bezerra, Ulrike Gehring, Iná S. Santos, Dénes Molnár, Muhammad Fadhli Mohd Yusoff, Marie Moitry, Nizal Sarrafzadegan, Jacqueline F. Price, Ranko Stevanovic, Sai Yin Ho, Georg Lappas, Alberto Palloni, Malay K. Mridha, Elaine M. Dennison, Jeonghee Lee, Saeid Eslami, Rahman Shiri, Japhet Killewo, Juergen Breckenkamp, Mathilde Kersting, Y Nikitin, Iqbal Bata, Geetha R Menon, Maria Avdicova, Sanjay Rampal, Antônio Augusto Moura da Silva, Kirsten Mehlig, Chien-An Sun, Ramin Heshmat, Violeta Iotova, Stefaan Demarest, Mette Rasmussen, Dirk De Bacquer, San-Lin You, Suzanne N Morin, Martin Gulliford, Maties Torrent, Luc Dauchet, Fred Paccaud, Paibul Suriyawongpaisal, Sherali Rakhmatulloev, Hyeon Chang Kim, Markku Peltonen, Ruth Frikke-Schmidt, Vera Musil, Ahmad Ali Zainuddin, Angela Chetrit, Dan Zhu, Gowri Mahasampath, Ulrich Keil, Sérgio Viana Peixoto, Haiquan Xu, Helle-Mai Loit, Valérie Deschamps, Ilpo Huhtaniemi, Lijuan Liu, Marialaura Bonaccio, Altan Onat, Rody G. Sy, José María Huerta, Ko Ko Zaw, Akihiro Yoshihara, Peter Ueda, Belgin Ünal, Rachel Dankner, Andrzej Wiecek, Eman Aly, Ruzena Kubinova, Justina Vaitkeviciute, Hanna Tolonen, Priscilla Duboz, Orn Olafsson, Yin Guo, Chiara Donfrancesco, Salim Mohanna, Dusan Grafnetter, Daniel Weghuber, Ali Ahmadi, Rosemary B. Duda, E. Shyong Tai, Louise A. Baur, Nihal Thomas, Prabhdeep Kaur, Norlaila Mustafa, Shariq Rashid Masoodi, Liis Nelis, Badreya Al-Lahou, J. Jaime Miranda, Lèlita Santos, Aroor Bhagyalaxmi, Mohamed Bamoshmoosh, Børge G. Nordestgaard, Jeannette Lee, Ahmad Reza Dorosty, Alain Morejon, Ying-Wei Wang, Jakob Tarp, Rosalba Rojas-Martínez, Luxia Zhang, Bahram Mohajer, Maja Bæksgaard Jørgensen, Jurate Klumbiene, Zhengming Chen, Ambady Ramachandran, Andrea Rodriguez-Martinez, Alisha N. Wade, Suyeon Park, Janne Schurmann Tolstrup, Lucjan Szponar, Krishna Kumar Aryal, Tahir Aris, Mahfuzar Rahman, Dorja Vočanec, Juan P. González-Rivas, Rob M. van Dam, Daniel Bia, Oonagh Markey, Ryutaro Ohtsuka, Kumiko Ohara, Ričardas Radišauskas, Jurate Medzioniene, Tiina Vlasoff, Tania Tello, Suzanne C. Ho, Kodavanti Mallikharjuna Rao, May Soe Aung, Vesselka Duleva, Michael Hobbs, Lutgarde Thijs, Marjolein Visser, Parasmani Dasgupta, Inge Huybrechts, Raimund Erbel, Alice Bonilla-Vargas, Hermann Brenner, Mohammad Reza Fattahi, Jolanda Hyska, Roman Topor-Madry, Ranjit Mohan Anjana, Merike Liivak, Eruke E. Egbagbe, Mathilde Savy, Herculina S. Kruger, Neil Murphy, Vinay Nangia, Cesar G. Victora, Mostafa K. Mohamed, H. Bas Bueno-de-Mesquita, Gabriella Gruden, Marcos André Moura-dos-Santos, Mohammed Rasoul Tarawneh, Maria Teresa Menzano, Francesco Branca, Abdonas Tamosiunas, Elena Bogova, Niveen M E Abu-Rmeileh, Maroje Sorić, Aleksander Giwercman, Elżbieta Dziankowska-Zaborszczyk, Tatjana Hejgaard, Yves Kameli, Margarita Samoutian, Andreia N. Pizarro, Jin Soo Moon, Frank Claessens, Zulfiqar A Bhutta, Frank Tanser, Nor Azwany Yaacob, Vanina Bongard, Gregor Jurak, Johan G. Eriksson, Christina-Paulina Lambrinou, Hanspeter Stamm, Kim Overvad, Yanping Li, Carsten Oliver Schmidt, Thomas Meinertz Dantoft, Wichai Aekplakorn, Anwar Batieha, Eduardo Capuano, Teresa Haugsgjerd, Jeremy M. Jacobs, Paola Russo, Nguyen D Nguyen, Luis Revilla, Hossein Poustchi, Farid Najafi, Giovanni de Gaetano, Wan Mohamad Wan Bebakar, Paul Elliott, Denise Eldemire-Shearer, Angela Döring, Giovanni Viegi, Xiaoguang Yang, María-Elena González-Villalpando, Maria Puiu, Maria Benedetta Donati, Andrew Wong, Tomasz Zdrojewski, Carlos P. Boissonnet, Mohamad Hasnan Ahmad, Mahmudur Rahman, Günther Fink, Marcia Makdisse, Dragana P Jovic, Aline Wagner, Coimbatore Subramaniam Shanthirani, Pascal Bovet, Dong Wook Kim, Tom Wilsgaard, Anders Grøntved, Thirunavukkarasu Sathish, Antonia Trichopoulou, Noushin Mohammadifard, Igor Spiroski, Natasja M. van Schoor, Cláudia S. Minderico, Betina H. Thuesen, Queenie Chan, Ulf Ekelund, Laura A. Rodríguez-Villamizar, Line Lund Kårhus, Cihangir Erem, Amina Barkat, Maria Paula Santos, Fernanda Cunha Soares, Constanta Huidumac Petrescu, Allan G. Hill, Honor Bixby, Benoît Salanave, Joana Carvalho, Maigeng Zhou, Ofra Kalter-Leibovici, Roy A Wong-McClure, Kim F. Michaelsen, Doris Stöckl, Rosalynn Siantar, Jouko Saramies, José R. Banegas, Quang Ngoc La, Uruwan Yamborisut, Parinaz Mehdipour, Farhad Pourfarzi, Sudha Ramachandra Rao, Katsuyasu Kouda, Chien-Jen Chen, Rafael dos Santos Henrique, Martin Nankap, Allan Linneberg, Ronald D. Gregor, Rudolf Kaaks, Maria do Carmo Franco, Marta García-Solano, Beata Gurzkowska, Bahman Cheraghian, Stefaan De Henauw, Daniel Ferrante, Johanna A. Otero, Jamila Abubakar Garba, Antonio Pedro Graça, Sumit Bharadwaj, Shiqi Zhen, Xiu-Hua Guo, Prashant Mathur, Raphael Mendes Ritti-Dias, Kouamelan Doua, Esteban Carmuega, Majid Shirani, Przemyslaw Slusarczyk, Petra Rust, Visnja Djordjic, Farahnaz Joukar, Johanna Gunnlaugsdottir, Leila Houti, Nayu Ikeda, Imperia Brajkovich, Amirabbas Momenan, Erik J. Timmermans, Marcin Rutkowski, Biruta Velika, Joana Araújo, Jostein Steene-Johannessen, Christa L. Lilly, Per Tynelius, Michael Tornaritis, Anne Juolevi, Fatima Zahra Laamiri, Carl Lachat, Kai-Uwe Saum, Espen Bjertness, Ana P. Ortiz, Joel G. R. Roy, Himanshu K. Chaturvedi, Michelle Holdsworth, Niels Wedderkopp, Johan Van der Heyden, Mukharram M. Bikbov, Hsien-Ho Lin, Eva Corpeleijn, Harshpal Singh Sachdev, Mohammad Reza Mirjalili, Maria del Cristo Rodriguez-Perez, Michala Lustigová, Tuyen D Le, Teresa Norat, Hana Zamrazilová, Garry Brian, Tien Yin Wong, Rosa Haghshenas, Clive Osmond, Diego Giulliano Destro Christofaro, Mahmood Moosazadeh, Vilma Irazola, Olli T. Raitakari, Marco Aurélio Peres, Terho Lehtimäki, Shuohua Chen, Dimitrios Papandreou, Robert J. Adams, Sigmund A. Anderssen, Peter T. Katzmarzyk, Luisa M Macieira, Félicité Tchibindat, Lital Keinan Boker, Toshiharu Ninomiya, Morten Sodemann, Jytte Halkjær, Zbigniew Kułaga, Sophie Visvikis-Siest, Farshad Farzadfar, N Capkova, Zumin Shi, Maria Turley, Zbigniew Gaciong, Giovanni Veronesi, Martin McKee, Veikko Salomaa, Gilad Twig, Elisabetta L. Romeo, Peter Kristensen, Grazyna Jasienska, Victor Guillermo Sequera, Mario V. Capanzana, Con Burns, Emanuela Pettenuzzo, Ming-Dong Wang, Jonathan Giovannelli, Stela McLachlan, Ellis Owusu-Dabo, Stefania Toselli, Maria Teresa Anselmo Olinto, Senthil K Vasan, Sara Schramm, Xenophon Theodoridis, Moyses Szklo, Ramfis Nieto-Martínez, Viswanathan Mohan, Guillermo Frontera, Rahul Malhotra, Thomas Ferrao, Dongfeng Gu, Tomas Vega, Hynek Pikhart, Päivi Mäki, Heba Fouad, Vilnis Dzerve, Christina Howitt, Seyed Mohammad Hashemi-Shahri, Jenny M. Kindblom, Marjolijn C. E. Bragt, G. K. Mini, Qian Wang, Liufu Cui, Andrzej Galbarczyk, Sylvain Sebert, Vilmundur Gudnason, Loreto Santa Marina, Kairat Davletov, Afshin Ostovar, Niloofar Peykari, Nicholas J. Wareham, Wilma M. Hopman, Karl-Heinz Jöckel, Jussi Kauhanen, Breige A. McNulty, Alina Kerimkulova, Youcef Laid, Claes Ohlsson, Stefan Kiechl, Alicia Matijasevich, Boban Mugoša, Srinivasan Kannan, Jyrki K. Virtanen, Mohan Deepa, Mangesh S. Pednekar, Shahla AlDhukair, Cynthia M. Pérez, Vera Lanska, Tint Swe Latt, Dominique Hange, João Luiz Bastos, Eliza Markidou Ioannidou, Leticia Hernandez Cadena, Maya Tanrygulyyeva, Reza Malekzadeh, Dimitrios Poulimeneas, Pedro Ordunez, Thomas Waldhör, Ioannis Pagkalos, Carlo M. Barbagallo, Abla M. Sibai, Peter Vollenweider, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Santosh K. Bhargava, Patrick Kolsteren, Aya Mostafa, Fangfang Chen, Flavio Nervi, Imre Janszky, Arvind Pandey, Renata Cifkova, Alexandre C. Pereira, Alejandro Diaz, Alireza Ansari-Moghaddam, Rachakulla Hari Kumar, Jaakko Mursu, Luis A. Moreno, Glen Gironella, Jelena Kos, Tilema Cama, Haakon E. Meyer, Jun Ma, Raphael E. Arku, Ziad Abdeen, Rusidah Selamat, Dianna J. Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paul Korrovits, Paola Nardone, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Alberto Barceló, Camilla T. Damsgaard, Constance Schultsz, Frank J Rühli, Santiago F. Gomez, Tara Coppinger, Muhammad Islam, Pierre Traissac, Eleonora d'Orsi, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Daniela Pierannunzio, Cristina Taddei, Wen-Harn Pan, Gregor Starc, Abdullah Alkandari, Saeed Dastgiri, Lien Braeckevelt, Gustavo Velasquez-Melendez, Sudhir Kowlessur, Bagher Larijani, Cynthia Robitaille, Mohamed M. Ali, Steiner Krokstad, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Abhijit Sen, Sergej M. Ostojic, Silvana Donoso, Felix K. Assah, Juan A Rivera, Peter H. Whincup, Oana-Florentina Gheorghe-Fronea, Hanan F. Abdul Rahim, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Cassiano Ricardo Rech, Paul Ferdinand M. Reganit, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Bethlehem D. Solomon, Herman Borghs, Zhanna Kalmatayeva, Heidi Klakk, Akram Pourshams, Naomi S. Levitt, Miquel Porta, Vesna Jureša, Alexander D. Deev, Son Thai Pham, Paula Margozzini, Silvia Bel-Serrat, Dora Romaguera, Monira Alarouj, Winsome R. Parnell, Marloes Cardol, David Faeh, Antonio Bernabe-Ortiz, Giota Touloumi, Maryam Kavousi, Sanja Musić Milanović, Jalila El Ati, Sauli Herrala, Liang Xu, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Yi Song, Jianfeng Wu, Jeannette Klimont, Jean Ferrières, Farhad Zamani, Shina Avi, Luis Paulo Gomes Mascarenhas, Aluísio J D Barros, Reecha Sofat, Koen Van Herck, Hoang Van Minh, Enrique Gutiérrez-González, Martine Vrijheid, Susana Cararo Confortin, Antonis Zampelas, Bogdan Wojtyniak, Ausra Petrauskiene, Juha Auvinen, Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Young-Ho Khang, Ellina Rakhimova, Magdalena Klimek, Luís Lopes, Erkin M. Mirrakhimov, Maria Lc Iurilli, Günay Can, Mark Woodward, Esther Lopez-Garcia, Mauro Virgílio Gomes de Barros, Ahmed A. Madar, Rainford J. Wilks, Shoaib Afzal, Melanie J. Cowan, Gareth Stratton, Eduardo Salazar Martinez, Sameer Narake, Norie Sawada, Li Juan Wu, Adrian Richter, Licia Iacoviello, Hanno Ulmer, Deepak Amarapurkar, Mohsen Ibrahim, Hamed Pouraram, Massimo Salvetti, Hung-Kwan So, Yonghua Hu, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Sabina Zambon, Angelika Schaffrath Rosario, Lauren Lissner, Kamarul Imran Musa, Deepa Weerasekera, Bihungum Bista, Takafumi Ishida, Ekaterina Chikova-Iscener, Mirjam M. Heinen, Tazeen H. Jafar, Semánová Csilla, Raija Korpelainen, Edward W. Gregg, Laura Gutierrez, Victor M. Herrera, Aristides M. Machado-Rodrigues, Fatemeh Malekzadeh, Shouling Wu, Jennifer L. Baker, Clicerio González-Villalpando, Irene G. M. van Valkengoed, Anna Fijałkowska, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Nasheeta Peer, Radka Taxová Braunerová, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Eliza Cinteza, Ha Tp Do, and Alison J. Hayes
Subjects: education.field_of_study, business.industry, Population, Distribution (economics), medicine.disease, Obesity, Geography, medicine, Underweight, medicine.symptom, education, business, Body mass index, Demography
Published: 2020
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15. The impact of second hip fracture on rehospitalization and mortality in older adults

Author: Albert March, Enron Shehu, Giuseppe Sergi, Marco Bedogni, Caterina Trevisan, Silvia Pavan, Fabrizio Piazzani, and Enzo Manzato
Subjects: Aging, Pediatrics, medicine.medical_specialty, Health (social science), Multidimensional assessment, Second hip fracture, Disability, Hospitalization, Institutionalization, Mortality, Aged, Humans, Italy, Length of Stay, Risk Factors, Hip Fractures, NO, Older population, 03 medical and health sciences, 0302 clinical medicine, Older patients, Medicine, 030212 general & internal medicine, Hip fracture, 030214 geriatrics, business.industry, After discharge, medicine.disease, Low mobility, Northern italy, Functional status, Second hip fracture, Disability, Hospitalization, Institutionalization, Mortality, Length of Stay, Geriatrics and Gerontology, business, Gerontology
Abstract: Purpose Although a second hip fracture is not uncommon in the older population, the extent to which such an event may affect health-related outcomes has not been fully clarified. We aimed to evaluate the risk of new falls, functional decline, rehospitalization, institutionalization and mortality in older patients admitted for a second vs. a first hip fracture. Methods The sample consisted of 288 older patients admitted to the Orthogeriatric Unit of Bolzano Hospital (northern Italy) and surgically treated for a hip fracture from June 2016 to June 2017. Socio-demographic data and hospitalization-related information were collected and a multidimensional assessment was made upon admission and during the hospital stay. Fifteen months after discharge, data on mobility level, functional status, institutionalization, and new falls were obtained from personal or structured phone interviews. Information on rehospitalization and mortality was obtained from local hospital registers. Results One out of six patients (14.6 %) admitted was suffering a second hip fracture, of which only 16.7 % were on antiresorptive therapies. At the 15-month follow-up, individuals who had been treated for a second hip fracture were more likely than those treated for their first to have low mobility levels (OR = 4.13, 95 %CI:1.23−13.84), to be rehospitalized (OR = 2.57, 95 %CI:1.12−5.90), and to have a higher mortality (HR = 1.81, 95 %CI:1.05–3.12). Conclusions The occurrence of a second hip fracture may further affect the clinical vulnerability and mortality of older adults. These results highlight the need to implement preventive action to minimize the risk of re-fracture after the first event.
Published: 2020

16. Vitamin D and physical performance in elderly subjects: the Pro.V.A study.

Author: Elena D Toffanello, Egle Perissinotto, Giuseppe Sergi, Sabina Zambon, Estella Musacchio, Stefania Maggi, Alessandra Coin, Leonardo Sartori, Maria-Chiara Corti, Giovannella Baggio, Gaetano Crepaldi, and Enzo Manzato
Subjects: Medicine, Science
Abstract: The role of Vitamin D in musculoskeletal functionality among elderly people is still controversial. We investigated the association between serum 25-hydroxyvitamin D (25OHD) levels and physical performance in older adults.2694 community-dwelling elderly women and men from the Progetto Veneto Anziani (Pro.V.A.) were included. Physical performances were assessed by: tandem test, 5 timed chair stands (TCS), gait speed, 6-minute walking (6 mW) distance, handgrip strength, and quadriceps strength. For each test, separate general linear models and loess plots were obtained in both genders, in relation to serum 25OHD concentrations, controlling for several potential confounders.Linear associations with 25OHD levels were observed for TCS, gait speed, 6 mW test and handgrip strength, but not for tandem test and quadriceps strength. After adjusting for potential confounders, linear associations with 25OHD levels were still evident for the 6 mW distance in both genders (p = .0002 in women;
Published: 2012
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17. Reduced incidence of cardiovascular events in hyper-Lp(a) patients on lipoprotein apheresis. The G.I.L.A. (Gruppo Interdisciplinare Aferesi Lipoproteica) pilot study

Author: Giovanni Battista Vigna, Zenti Maria Grazia, Stefano Passalacqua, Luigi Cattin, Daniele Berretti, Sabina Zambon, Federico Bigazzi, Daniela Rafanelli, Beatrice Dal Pino, Enzo Manzato, M. Fonda, Giovanna D’Alessandri, Tiziana Sampietro, Francesco Sbrana, Andrea Ripoli, R. Luciani, Antonia Fabris, and Mascia Pianelli
Subjects: medicine.medical_specialty, Lp(a)-hyperlipoproteinemia, Pilot Projects, Familial hypercholesterolemia, 030204 cardiovascular system & hematology, G.I, Gastroenterology, Cardiovascular events, Coronary artery disease, 03 medical and health sciences, Lipoprotein apheresis, 0302 clinical medicine, Internal medicine, Humans, Medicine, 030212 general & internal medicine, Aged, Retrospective Studies, Hematology, business.industry, Incidence, Incidence (epidemiology), Retrospective cohort study, Middle Aged, medicine.disease, Cardiovascular Diseases, Aortic valve stenosis, business, Lipoprotein(a), Lipoprotein
Abstract: Lipoprotein apheresis (LA) is the elective therapy for homozygous and other forms of Familial Hypercholesterolemia, Familial Combined Hypercholesterolemia, resistant/intolerant to lipid lowering drugs, and hyper-lipoproteinemia(a). Lipoprotein(a) [Lp(a)] has been classified as the most prevalent genetic risk factor for coronary artery disease and aortic valve stenosis.Our multicenter retrospective study has the aim to analyze the incidence of adverse cardiovascular events (ACVE) before and during the LA treatment, in subjects with elevated level of Lp(a) (60 mg/dL) [hyper-Lp(a)] and chronic ischemic heart disease.We collected data of 23 patients (mean age 63 ± 9 years, male 77%; from hospital of Pisa 11/23, Pistoia 7/23, Verona 2/23, Padova 2/23 and Ferrara 1/23), with hyper-Lp(a), pre-apheresis LDL-cholesterol100 mg/dL, cardiovascular disease, on maximally tolerated lipid lowering therapy and LA treatment (median 7 years, interquartile range 3-9 years). The LA treatment was performed by heparin-induced LDL precipitation apheresis (16/23), dextran-sulphate (4/23), cascade filtration (2/23) and immunoadsorption (1/23). The time lapse between first cardiovascular event and beginning of apheresis was 6 years (interquartile range 1-12 years).The recorded ACVE, before and after the LA treatment inception, were 40 and 10 respectively (p 0.05), notably, the AVCE rates/year were 0.43 and 0.11 respectively (p 0.05) with a 74% reduction of event occurrence.Our data confirm long-term efficacy and positive impact of LA on morbidity in patients with hyper-Lp(a) and chronic ischemic heart disease on maximally tolerated lipid lowering therapy.
Published: 2018
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18. Decision tree for ward admissions of older patients at the emergency department after a fall

Author: Eugenio Debiasi, Patrizia Di Gregorio, Giuseppe Sergi, Mario La Guardia, Martina Pedrotti, Enzo Manzato, Caterina Trevisan, and Albert March
Subjects: Polypharmacy, medicine.medical_specialty, business.industry, Decision tree, Emergency department, 030204 cardiovascular system & hematology, medicine.disease, Older population, 03 medical and health sciences, 0302 clinical medicine, Risk Estimate, Older patients, Emergency medicine, medicine, Dementia, Lack of knowledge, 030212 general & internal medicine, business
Abstract: Aim Falls are a prevalent issue for the older population, and for the healthcare system in terms of emergency department (ED) access and hospitalizations. There is still a lack of knowledge and guidelines, however, regarding the need to hospitalize older patients accessing the ED after a fall. In the present study, we aimed to analyze the factors and the decisional process that led to older patients accessing the ED after a fall being admitted to hospital or discharged. Methods The study sample included 2144 older people who accessed the ED after a fall. For each patient, we obtained information on the nature of the fall and the related injuries, previous falls, dementia and ongoing medical therapies. As the outcome variable, we considered the indication for ward admission after the ED visit. Results Of the 2144 individuals who accessed the ED after a fall, 38% had at least one fracture, and 40.1% were admitted to a ward. The decision tree obtained using the chi-squared automatic interaction detection algorithm showed that the indication for ward admission could be accurately predicted (risk estimate 0.205) by just five factors, namely: presence and severity of fall-related injuries, reportedly suspicious fall dynamics, use of anticoagulants, polypharmacy, and dementia. Conclusions The need for ward admission in older patients who access the ED after a fall seems to be determined not only by the severity of fall-related injuries, but also by the fall dynamics and the individual's clinical complexity. Geriatr Gerontol Int 2018; 18: 1388-1392.
Published: 2018
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19. Identification of asymptomatic frailty vertebral fractures in post-menopausal women

Author: Bruno Micael Zanforlini, Giulia Bano, G. Girotti, G. Sergi, Anna Bertocco, Paola Lucato, Francesca Piovesan, Enzo Manzato, Mattia Mazzochin, Caterina Trevisan, S. Pizzato, Marta Dianin, and Francesca Zoccarato
Subjects: medicine.medical_specialty, Pediatrics, Histology, FRAX, Physiology, Endocrinology, Diabetes and Metabolism, Osteoporosis, Post-menopause, 030209 endocrinology & metabolism, Asymptomatic, NO, Bone remodeling, 03 medical and health sciences, Endocrinology, 0302 clinical medicine, Lumbar, Bone Density, Vertebral fractures, X-rays examination, medicine, Humans, Outpatient clinic, 030212 general & internal medicine, Aged, Retrospective Studies, Geriatrics, Bone mineral, Lumbar Vertebrae, Frailty, business.industry, Middle Aged, medicine.disease, Radiography, Diabetes and Metabolism, Spinal Fractures, Female, medicine.symptom, business, Osteoporotic Fractures
Abstract: Vertebral fractures are associated with persistent pain, disability and mortality. However, around two thirds of women with vertebral fractures are unaware of them. We aimed to analyze which factors could mostly be associated to the presence of vertebral fractures in post-menopausal women, and evaluate the effectiveness of current screening criteria for the detection of vertebral fractures in an outpatient setting.We evaluated 1132 post-menopausal women referred to the osteoporosis outpatient clinic of the Geriatrics Department of Padova. For each participant we assessed: anthropometric data, femoral and lumbar bone mineral density (BMD), dorso-lumbar X-rays, bone metabolism markers. Current recommendations for X-ray examinations by SIOMMMS (Società Italiana di Osteoporosi, Metabolismo Minerale e Malattie dello Scheletro) and ISCD (International Society of Clinical Densitometry) versus routine X-ray examinations were considered, and fracture risk was assessed through the derived FRAX (DeFRA) tool.Of the women included in our study, 28% presented vertebral fractures, most of these previously unknown (82.8%). Lumbar BMD did not differ between patients with and without vertebral fractures. According to SIOMMMS guidelines, 50% of patients60 years with unknown vertebral fractures would have been excluded from spinal X-ray examination. According to ISCD recommendations, the number of patients excluded reached 94.6% in the60 age-group and 84.9% in the 60-70 age-group. The under-identification of vertebral fractures led to the 10-year risk of fractures computed by DeFRA being underestimated by around 15%.BMD, particularly in the lumbar site, may not properly predict the presence of vertebral fractures in post-menopausal women. Improvement of the current recommendations for spinal X-ray examination may lead to early identification and better management of patients with vertebral fractures.
Published: 2018
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20. Prognostic value of cardiac troponin I assay in hospitalized elderly patients

Author: Anna Rossi, Francesca Attanasio, Mario Plebani, Enzo Manzato, Sabino Iliceto, Luciano Babuin, Pamela Carrer, Monica Maria Mion, Valter Giantin, Anna Zurlo, and Martina Zaninotto
Subjects: Geriatrics, Aging, medicine.medical_specialty, Cardiac troponin, business.industry, Cardiac troponin I, Mean age, macromolecular substances, Coronary heart disease, Elderly patients, Hospitalization, 03 medical and health sciences, 0302 clinical medicine, Older patients, Geriatrics and Gerontology, Internal medicine, Troponin I, medicine, 030212 general & internal medicine, Risk factor, business, Pathological, Hospital stay, 030217 neurology & neurosurgery
Abstract: Cardiac troponin I (cTnI) has been poorly studied in elderly inpatients. This study wanted to assess factors influencing the increase in cTnI and its prognostic value in hospitalized elderly patients. 354 elderly (mean age of 84.8 ± 6.9 years) patients consecutively admitted in the Geriatrics Division in Padua were tested for cTnI levels assay during the hospital stay. Number of subsequent patient deaths at 6 months and 2 years were registered. Of the 354 patients, 27 (7.6%) died in hospital; their levels were not significantly higher or more frequently positive on cTnI than those of the remainder of the sample. 71 (20.01%) patients died within 6 months of being discharged, and in-hospital positive cTnI levels emerged as a mortality risk factor in this group [unadjusted HR 1.13 (1.04–1.23); p = 0.004]. At 2 years, a total of 174 patients (49.2%) had died, but in-hospital pathological cTnI levels were not a mortality risk factor in this group. It should be noted that cTnI level was a risk factor for mortality at 6 months but no longer at 2 years after an elderly patient’s hospitalization. This finding may relate to patients’ limited physiological reserves or be driven by the fact that the elderly tend to receive fewer evidence-based treatments, and to be managed more conservatively than younger patients. In the multidimensional analysis of older patients, troponin I can be used to stratify patients and assess mortality risk at 6 months, but not at 2 years.
Published: 2018
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21. Autosomal Recessive Hypercholesterolemia

Author: Sandro Muntoni, Maurizio Averna, Juan F. Ascaso, Antonio Nicolucci, Marco Scardapane, Cesare Sirtori, Marcello Arca, Pablo Prieto-Matos, Davide Noto, José T. Real, Anja Vogt, Francisco Fuentes, Chiara Pavanello, Pedro Mata, Sabina Zambon, Angelo B. Cefalù, Luis Masana, Alberto Zambon, Adolfo Pacifico, Paolo Pintus, Giovanni Mario Pes, Ilenia Minicocci, Miguel Pocovi, Laura D'Erasmo, Mariko Harada-Shiba, Stefano Bertolini, Enzo Manzato, Eduardo Esteve Lafuente, Laura Calabresi, Renato Fellin, Rosa M. Sánchez-Hernández, Barbara Sjouke, and Janine E. Roeters Van Lennep
Subjects: 0301 basic medicine, medicine.medical_specialty, Statin, Atherosclerotic cardiovascular disease, business.industry, medicine.drug_class, 030204 cardiovascular system & hematology, Lomitapide, 03 medical and health sciences, chemistry.chemical_compound, 030104 developmental biology, 0302 clinical medicine, Ezetimibe, chemistry, Autosomal Recessive Hypercholesterolemia, Internal medicine, medicine, Effective treatment, lipids (amino acids, peptides, and proteins), In patient, Cardiology and Cardiovascular Medicine, business, Cardiovascular outcomes, medicine.drug
Abstract: Background Autosomal recessive hypercholesterolemia (ARH) is a rare lipid disorder characterized by premature atherosclerotic cardiovascular disease (ASCVD). There are sparse data for clinical management and cardiovascular outcomes in ARH. Objectives Evaluation of changes in lipid management, achievement of low-density lipoprotein cholesterol (LDL-C) goals and cardiovascular outcomes in ARH. Methods Published ARH cases were identified by electronic search. All corresponding authors and physicians known to treat these patients were asked to provide follow-up information, using a standardized protocol. Results We collected data for 52 patients (28 females, 24 males; 31.1 ± 17.1 years of age; baseline LDL-C: 571.9 ± 171.7 mg/dl). During a mean follow-up of 14.1 ± 7.3 years, there was a significant increase in the use of high-intensity statin and ezetimibe in combination with lipoprotein apheresis; in 6 patients, lomitapide was also added. Mean LDL-C achieved at nadir was 164.0 ± 85.1 mg/dl (−69.6% from baseline), with a better response in patients taking lomitapide (−88.3%). Overall, 23.1% of ARH patients reached LDL-C of Conclusions Despite intensive treatment, LDL-C in ARH patients remains far from targets, and this translates into a poor long-term cardiovascular prognosis. Our data highlight the importance of an early diagnosis and treatment and confirm the fact that an effective treatment protocol for ARH is still lacking.
Published: 2018
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22. Phytosterols, Cholesterol Control, and Cardiovascular Disease

Author: Daniela Martini, Francesco Visioli, Andrea Poli, Franca Marangoni, Gerardo Medea, Alberto Corsini, Enzo Manzato, and Walter Marrocco
Subjects: medicine.medical_specialty, Control (management), phytosterols, Context (language use), Review, Disease, plant sterols, supplements, chemistry.chemical_compound, Willingness to pay, Functional Food, cardiovascular disease, medicine, Humans, media_common.cataloged_instance, TX341-641, European union, functional foods, media_common, Nutrition and Dietetics, medicine.diagnostic_test, Nutrition. Foods and food supply, Cholesterol, business.industry, cholesterol, chemistry, Cardiovascular Diseases, Family medicine, Dietary Supplements, Lipid profile, business, Plant sterols, Food Science
Abstract: The use of phytosterols (or plant sterols) for the control of plasma cholesterol concentrations has recently gained traction because their efficacy is acknowledged by scientific authorities and leading guidelines. Phytosterols, marketed as supplements or functional foods, are formally classified as food in the European Union, are freely available for purchase, and are frequently used without any health professional advice; therefore, they are often self-prescribed, either inappropriately or in situations in which no significant advantage can be obtained. For this reason, a panel of experts with diverse medical and scientific backgrounds was convened by NFI—Nutrition Foundation of Italy—to critically evaluate and summarize the literature available on the topic, with the goal of providing medical doctors and all health professionals useful information to actively govern the use of phytosterols in the context of plasma cholesterol control. Some practical indications to help professionals identify subjects who will most likely benefit from the use of these products, optimizing the therapeutic outcomes, are also provided. The panel concluded that the use of phytosterols as supplements or functional foods to control Low Density Lipoprotein (LDL) cholesterol levels should be preceded by the assessment of some relevant individual characteristics: cardiovascular risk, lipid profile, correct understanding of how to use these products, and willingness to pay for the treatment.
Published: 2021
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23. Factors influencing short-term outcomes for older patients accessing emergency departments after a fall: The role of fall dynamics

Author: Albert March, Mario La Guardia, Enzo Manzato, Giuseppe Sergi, Caterina Trevisan, Patrizia Di Gregorio, Eugenio Debiasi, and Martina Pedrotti
Subjects: Male, medicine.medical_specialty, Population, Biophysics, Poison control, Occupational safety and health, NO, Fall dynamics, Falls, Fractures, Hospitalization, Orthopedics and Sports Medicine, Rehabilitation, Fractures, Bone, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Outcome Assessment, Health Care, Injury prevention, Prevalence, medicine, Humans, 030212 general & internal medicine, education, Aged, Aged, 80 and over, Polypharmacy, education.field_of_study, business.industry, Age Factors, 030208 emergency & critical care medicine, Emergency department, Drop attack, Italy, Accidental, Physical therapy, Accidental Falls, Female, Emergency Service, Hospital, business
Abstract: While the relevance of falls in raising the risk of fractures, hospitalization and disability in older age is well recognized, the factors influencing the onset of fractures and the need for ward admission after a fall have yet to be fully elucidated. We investigated which factors and fall dynamics were mainly associated with fall-related injuries and hospitalization among elderly persons accessing the Emergency Department (ED) following a fall.The study involved 2144 older subjects who accessed the ED after a fall. Data on the fall´s nature and related injuries, ward admissions, history of falls, dementia, and medical therapies were examined for all patients. Considering dynamics, we distinguished accidental falls (due to interaction with environmental hazards while in motion) and falls from standing (secondary to syncope, lipothymia, drop attack, or vertigo).The overall prevalence of fractures in our population did not differ significantly with advancing age, though hip fractures were more common in the oldest, and upper limb fractures in the youngest patients. Falls from standing were associated with polypharmacy and with higher ward admission rate despite a lower fractures´ prevalence than accidental falls. The chances of fall-related fractures were more than fourfold as high for accidental dynamics (OR=4.05, 95%CI:3.10-5.29, p0.0001). Ward admission was associated with polypharmacy, dementia, anticoagulants´ use and fall-related fractures (OR=6.84, 95%CI:5.45-8.58, p0.0001), while it correlated inversely with accidental fall dynamics.Outcomes of falls in older age depend not only on any fall-related injuries, but also on factors such as polypharmacy, cognitive status and fall dynamics.
Published: 2017
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24. The effect of childcare activities on cognitive status and depression in older adults: gender differences in a 4.4-year longitudinal study

Author: Giuseppe Sergi, Enzo Manzato, Stefania Maggi, Giovannella Baggio, Egle Perissinotto, Gaetano Crepaldi, Maria Valentina Pamio, Chiara Curreri, Caterina Trevisan, Sabina Zambon, and Leonardo Sartori
Subjects: Gerontology, Longitudinal study, Cognition, Lower risk, Mental health, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, Cognitive status, 030212 general & internal medicine, Geriatrics and Gerontology, Cognitive decline, Psychology, Cognitive impairment, 030217 neurology & neurosurgery, Depression (differential diagnoses)
Abstract: Objectives Although involvement in childcare activities seems to promote better physical and mental health in older adults, its impact on cognitive status and depression has not yet been fully elucidated. We aimed to analyze the association between engagement in childcare activities and cognitive and psychological status over a 4.4-year period in community-dwelling older adults. Methods Two thousand one hundred four subjects older than 65 years without severe cognitive impairment at baseline were categorized according to the frequency of their involvement in childcare activities (everyday, occasionally, never). The participants' cognitive status and depressive symptoms were evaluated at baseline and after 4.4 years. Results During the follow-up, 269 (12.8%) new cases of cognitive impairment and 229 (10.9%) new cases of depression were registered. Men engaged in childcare showed an almost 20% lower risk of cognitive impairment and cognitive decline. Women demonstrated similar results, except for those occasionally involved in childcare, who had a higher risk of cognitive decline compared with women who never engaged in it. The risk of developing depression was reduced in men involved daily (OR = 0.44, 95% CI: 0.30–0.62, p
Published: 2017
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25. The GesTIO protocol experience: safety of a standardized order set for subcutaneous insulin regimen in elderly hospitalized patients

Author: Federica Zanatta, Daniela Bruttomesso, Enzo Manzato, Nicola Sicolo, Alberto Maran, Alessandro Franchin, Maria Luisa Corradin, Gian Maria Barbato, and Francesco Rossi
Subjects: Blood Glucose, Male, Aging, medicine.medical_treatment, Insulin Glargine, Type 2 diabetes, Diabetes mellitus, 0302 clinical medicine, Clinical Protocols, Insulin, 030212 general & internal medicine, Aged, 80 and over, Geriatrics, GesTIO, Hospitalization, Insulin, Long-Acting, Vulnerable inpatients, Female, medicine.drug, Geriatric medicine, medicine.medical_specialty, 030209 endocrinology & metabolism, Hypoglycemia, Drug Administration Schedule, Insulin management protocol, Insulin therapy, Geriatrics and Gerontology, 03 medical and health sciences, Internal medicine, medicine, Humans, Hypoglycemic Agents, Aged, Retrospective Studies, Inpatients, business.industry, Insulin glargine, Retrospective cohort study, medicine.disease, Regimen, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Hyperglycemia, Physical therapy, business
Abstract: In non-critical hospitalized patients with diabetes mellitus, guidelines suggest subcutaneous insulin therapy with basal-bolus regimen, even in old and vulnerable inpatients. To evaluate safety, efficacy, and benefit on clinical management of the GesTIO protocol, a set of subcutaneous insulin administration rules, in old and vulnerable non-ICU inpatients. Retrospective, observational study. Patients admitted to Geriatric Clinic of Padua were studied. 88 patients matched the inclusion criteria: type 2 diabetes or hospital-related hyperglycemia, ≥65 years, regular measurements of capillary glycemia, and basal-bolus subcutaneous insulin regimen managed by “GesTIO protocol” for five consecutive days. Main outcome measures: ratio of patients with blood glucose (BG)
Published: 2017
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26. Frailty and incident depression in community-dwelling older people: results from the ELSA study

Author: Brendon Stubbs, André F. Carvalho, Marianna Noale, Stefania Maggi, Enzo Manzato, Nicola Veronese, Marco Solmi, Michele Fornaro, Giuseppe Sergi, and A. Matthew Prina
Subjects: Gerontology, Longitudinal study, Poison control, Odds ratio, Center for Epidemiologic Studies Depression Scale, Logistic regression, Confidence interval, 3. Good health, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, 030212 general & internal medicine, Geriatrics and Gerontology, Psychology, Prospective cohort study, 030217 neurology & neurosurgery, Depression (differential diagnoses)
Abstract: Objective Frailty and pre-frailty are two common conditions in the older people, but whether these conditions could predict depression is still limited to a few longitudinal studies. In this paper, we aimed to investigate whether frailty and pre-frailty are associated with an increased risk of depression in a prospective cohort of community-dwelling older people. Methods Four thousand seventy-seven community-dwelling men and women over 60 years without depression at baseline were included from the English Longitudinal Study of Ageing. Frailty status was defined according to modified Fried's criteria (weakness, weight loss, slow gait speed, low physical activity and exhaustion) and categorized as frailty (≥3 criteria), pre-frailty (1–2 criteria) or robustness (0 criterion). Depression was diagnosed as ≥4 out of 8 points of Center for Epidemiologic Studies Depression Scale, after 2 years of follow-up. Results Over a 2-year follow-up, 360 individuals developed depression. In a logistic regression analysis, adjusted for 18 potential baseline confounders, pre-frailty (odds ratio (OR) = 0.89; 95% confidence interval (CI), 0.54–1.46; p = 0.64) and frailty (OR = 1.22; 95% CI, 0.90–1.64; p = 0.21) did not predict the onset of depression at follow-up. Among the criteria included in the frailty definition, only slow gait speed (OR = 1.82; 95% CI, 1.00–3.32; p = 0.05) appeared to predict a higher risk of depression. Conclusions Among older community dwellers, frailty and pre-frailty did not predict the onset of depression during 2 years of follow-up, when accounting for potential confounders, whilst slow gait speed considered alone may predict depression in the older people. Copyright © 2017 John Wiley & Sons, Ltd.
Published: 2017
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27. Anthropometric parameters and the incidence of atrial fibrillation in older people: the PRO.V.A study

Author: Marina De Rui, Marianna Noale, Egle Perissinotto, Giuseppe Sergi, Sabina Zambon, Stefania Maggi, Giovanni Nante, Leonardo Sartori, Enzo Manzato, Gaetano Crepaldi, Chiara Curreri, and Caterina Trevisan
Subjects: Body surface area, medicine.medical_specialty, Waist, business.industry, Tall Stature, General Medicine, 030204 cardiovascular system & hematology, Anthropometry, medicine.disease, Obesity, Confidence interval, 03 medical and health sciences, 0302 clinical medicine, Quartile, Internal medicine, Cardiology, medicine, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, Body mass index
Abstract: Background Atrial fibrillation (AF) has been associated with body size and central obesity, but the impact of different anthropometric measures in this relationship has been inadequately investigated. Hypothesis In this study, we examined the association between baseline anthropometric parameters with the incidence of AF in older people, hypothesizing that body size could impact the onset of AF more than fat distribution. Methods Our study included 1764 participants with a mean age of 74.3 ± 6.9 years and no AF at baseline. Body mass index (BMI), body height, body surface area (BSA), waist and hip circumference, waist-to-stature ratio, waist-to-hip ratio, and mid–upper arm circumference (MUAC) were measured by trained physicians. AF was assessed after a 4.4-year follow-up. Results There were 115 new cases of AF observed after the follow-up. Taking lower values of these measures for reference, the adjusted AF risk was 2.42 (95% confidence interval [CI]:1.88-3.12) for the highest stature quartile, 1.36 (95% CI:1.15-1.62) for BMI ≥30 kg/m2, 2.12 (95% CI:1.73–2.59) for the highest BSA quartile, 1.38 (95% CI: 1.21-1.56) for higher MUAC, and 1.39 (95% CI: 1.23-1.58, P < 0.0001) for higher hip circumference values. Central obesity did not seem to relevantly predict the onset of AF in our sample. Stature revealed the strongest impact on the onset of AF (5% higher risk of developing AF per 1 cm increase in height). Conclusions Body size, particularly tall stature and obesity, but not fat distribution, seems to be associated with the risk of AF in the elderly.
Published: 2017
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28. Fibrinogen Levels and the Risk of Cerebrovascular Events in Older Adults With Both Depressive Symptoms and Cognitive Impairment: A Prospective Study

Author: Maria Chiara Corti, Alessandra Bordignon, Silvia Celli, Alessandra Coin, Caterina Trevisan, A. Girardi, Giuseppe Sergi, Maria Devita, Marianna Bizzotto, and Enzo Manzato
Subjects: Male, medicine.medical_specialty, cerebral stroke, cognitive impairment, dementia, depression, depressive symptoms, fibrinogen, Population, Fibrinogen, NO, 03 medical and health sciences, 0302 clinical medicine, depressive symptoms, Risk Factors, Internal medicine, Medicine, Dementia, Humans, Cognitive Dysfunction, 030212 general & internal medicine, Prospective Studies, cerebral stroke, Prospective cohort study, education, Depression (differential diagnoses), Aged, cognitive impairment, Aged, 80 and over, education.field_of_study, medicine.diagnostic_test, business.industry, Hazard ratio, medicine.disease, Psychiatry and Mental health, Cerebrovascular Disorders, Erythrocyte sedimentation rate, depression, dementia, fibrinogen, Geriatric Depression Scale, Female, Neurology (clinical), Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, medicine.drug
Abstract: Depression and cognitive impairment have been identified as risk factors for cerebrovascular events (CVE), and one of their potential etiological pathways is inflammatory status. This prospective study aims to investigate the association between inflammatory markers and the risk of CVE in a population of 2659 older adults, enrolled in the Progetto Veneto Anziani (Pro.V.A.), with depressive symptoms, cognitive impairment, or both conditions. For each individual, we assessed at baseline the presence of depressive symptoms (defined as a Geriatric Depression Scale ≥11), cognitive impairment (defined as a Mini-Mental State Examination
Published: 2020

29. Malnutrition is associated with increased risk of hospital admission and death in the first 18 months of institutionalization

Author: A Imoscopi, Giuseppe Sergi, Elena Valmorbida, Enzo Manzato, Mattia Mazzochin, and Caterina Trevisan
Subjects: 0301 basic medicine, Male, Time Factors, Overweight, Critical Care and Intensive Care Medicine, Body Mass Index, 0302 clinical medicine, Patient Admission, Risk Factors, Odds Ratio, Homes for the Aged, Lymphocytes, Prospective Studies, Prospective cohort study, Calf circumference, Aged, 80 and over, Nutrition and Dietetics, Anthropometry, Nursing home, Circumference, Hospitalization, Female, medicine.symptom, Malnutrition, Mortality, medicine.medical_specialty, Waist, 030209 endocrinology & metabolism, NO, 03 medical and health sciences, Internal medicine, medicine, Humans, Obesity, Geriatric Assessment, Serum Albumin, Aged, Proportional Hazards Models, 030109 nutrition & dietetics, business.industry, medicine.disease, Nursing Homes, Logistic Models, Nutrition Assessment, business, Body mass index
Abstract: Summary Objectives This study aimed to investigate the association between different nutritional and anthropometric parameters with the risk of hospitalizations and death within 18 months from nursing home admission. Our hypothesis was that measures of malnutrition could be more strongly associated with worse clinical outcomes than measures of overweight/obesity. Methods This prospective study involved 144 older adults newly admitted in nursing home and followed up over 18 months. A multidimensional assessment focusing on clinical, functional and cognitive status was performed at baseline. Assessment also included body mass index (BMI), waist circumference, calf circumference, MNA Short-Form (MNA-SF), and serum albumin and lymphocytes levels. Anthropometric measurements were repeated at 6 months. Data on hospitalizations and mortality over the study period, with their respective causes, were obtained from administrative data. The associations between baseline nutritional parameters and the risk of hospitalizations or death were analyzed through multinomial logistic regressions and Cox regressions, respectively. Results During the follow-up, 64 individuals (44.4%) were hospitalized, and 52 (36.1%) died. Residents who reported low MNA-SF and calf circumference at nursing home admission had more than threefold-increased odds of hospitalizations compared with their healthier counterparts. Adults with low calf circumference also had the highest mortality (HR = 3.39, 95%CI:1.80–6.39), while more attenuated results were observed for low serum albumin, MNA-SF, and BMI (either when considering cut-offs of excess weight or malnutrition). When assessing the associations between 0 and 6 month changes in calf circumference and mortality in the following 12 months, we found that each 1 cm decrease in calf circumference increased the one-year mortality by 29% (95%CI 1.04–1.60). Conclusions Malnutrition, but not overweight/obesity, seems associated with a higher risk of hospitalization and mortality after nursing home admission. Monitoring calf circumference, in particular, may help in the early detection of individuals who are potentially vulnerable to adverse health-related outcomes after institutionalization.
Published: 2020

30. Longitudinal investigation of the role of cognitive reserve in the evolution of dementia in outpatients prescribed AChEI

Author: Alessandra Coin, A. Girardi, Alessandra Bordignon, Daniela Mapelli, Caterina Trevisan, Giuseppe Sergi, Enzo Manzato, and Maria Devita
Subjects: Gerontology, Male, cholinesterase inhibitors, Leisure time, 050105 experimental psychology, NO, 03 medical and health sciences, 0302 clinical medicine, Cognition, Brain reserve, Surveys and Questionnaires, Outpatients, medicine, Dementia, Humans, 0501 psychology and cognitive sciences, Cognitive reserve, Aged, cognitive reserve, dementia, leisure time, Aged, 80 and over, 05 social sciences, medicine.disease, Mental Status and Dementia Tests, Clinical Psychology, Neurology, Educational Status, Female, Neurology (clinical), Psychology, 030217 neurology & neurosurgery
Abstract: Aim: The role of cognitive reserve (CR) in modulating dementia has been broadly investigated. We aimed to evaluate the long-term effects of CR on cognitive functions in outpatients newly treated wi...
Published: 2020

31. The mutual association between dyspnea and depressive symptoms in older adults: a 4-year prospective study

Author: Andrea Vianello, Caterina Trevisan, Egle Perissinotto, Chiara Curreri, Enzo Manzato, Giuseppe Sergi, Bruno Micael Zanforlini, Marina De Rui, Stefania Maggi, Maria Chiara Corti, and Marianna Noale
Subjects: congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, depression, Dyspnea, older age, prospective study, Psychiatric Mental Health, Gerontology, Geriatrics and Gerontology, Psychiatry and Mental Health, NO, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, medicine, Humans, Daily living, Prospective Studies, Psychiatry, Association (psychology), Prospective cohort study, Depression (differential diagnoses), Depressive symptoms, Aged, 030214 geriatrics, business.industry, respiratory tract diseases, Dyspnea, depression, older age, prospective study, Independent Living, sense organs, Pshychiatric Mental Health, Older people, business, 030217 neurology & neurosurgery
Abstract: Objectives: dyspnea in daily living (DDL), night-time dyspnea (NTD) and depression are common symptoms in older people. However, how changes in dyspnea may influence and be influenced by modificati...
Published: 2020

32. The importance of cognitive reserve in comprehensive geriatric assessment for dementia

Author: Alessandra Coin, Enzo Manzato, Daniela Mapelli, A. Girardi, Giuseppe Sergi, Alessandra Bordignon, Sara Mondini, and Maria Devita
Subjects: Gerontology, Aging, Cognitive stimulation, Geriatrics gerontology, Cognitive reserve, Geriatric assessment, medicine.disease, Comprehensive geriatric assessment, Diagnosis, medicine, Dementia, Geriatrics and Gerontology, Psychology
Published: 2020

33. The Impact of Smoking on Bone Metabolism, Bone Mineral Density and Vertebral Fractures in Postmenopausal Women

Author: Enzo Manzato, Giuseppe Sergi, Francesca Zoccarato, Anna Bertocco, G. Girotti, Sandro Giannini, Caterina Trevisan, Mattia Mazzochin, Marta Dianin, Francesca Piovesan, Bruno Micael Zanforlini, and Agnese Alessi
Subjects: 0301 basic medicine, Endocrinology, Diabetes and Metabolism, Osteoporosis, Parathyroid hormone, Physiology, 030209 endocrinology & metabolism, vitamin D, NO, Cigarette Smoking, Bone remodeling, 03 medical and health sciences, 0302 clinical medicine, Lumbar, Bone Density, medicine, Vitamin D and neurology, Humans, Outpatient clinic, parathyroid hormone, Radiology, Nuclear Medicine and imaging, Orthopedics and Sports Medicine, Mass index, vertebral fractures, Femur, Smoking habits, Osteoporosis, Postmenopausal, Aged, Bone mineral, Smokers, business.industry, Non-Smokers, Tobacco Products, Middle Aged, medicine.disease, Postmenopause, Spinal Fractures, Female, 030101 anatomy & morphology, Ex-Smokers, business, Osteoporotic Fractures
Abstract: Smoking is recognized among the risk factors for osteoporosis, but only few studies have comprehensively explored its influence on bone metabolism and strength. We aimed to evaluate smoking effects on calcium-phosphate metabolism, bone mineral density (BMD) and fracture risk in postmenopausal women.Our sample included 1067 postmenopausal women who arrived to our osteoporosis outpatient clinic. Anamnestic data, smoking habits (categorized as never, former, and current; and by smoking intensity and duration), biochemical parameters, lumbar/femoral BMD, and presence of vertebral fractures were recorded. In a subsample of 357 women, the changes in BMD after a 2-yr follow-up period were also assessed.Current smokers had shorter reproductive age, lower body mass index, and higher prevalence of heavy alcohol consumption than former/never smokers. They also had lower PTH values and weaker linear association between serum vitamin D and parathyroid hormone (current β = -0.11[SE = 0.004]; former β = -0.14[SE = 0.01]; never β = -0.20[SE = 0.003]; p0.01 for all). Baseline BMD did not reflect differences based on smoking habits, duration or intensity. However, after 2 years, only current smokers significantly worsened in femural BMD. After adjustment for confounders, the chance of having sustained vertebral fractures at the first evaluation increased by 74% (95% confidence interval:1.07-2.83) in current compared with never smokers, especially among heavy smokers.Smoking may negatively affect bone by inhibiting vitamin D-parathyroid hormone axis, reducing estrogen exposure, promoting risky health behaviors, and accelerating bone loss, especially at the femur. No significant differences were observed in these outcomes among former smokers, suggesting that quitting smoking has beneficial effects on bone health.
Published: 2020

34. Gender differences in the impact of metabolic syndrome components on mortality in older people: A systematic review and meta-analysis

Author: Enzo Manzato, Caterina Trevisan, Mattia Mazzochin, Chiara Curreri, Anna Bertocco, Leon A. Simons, Giuseppe Sergi, Marta Dianin, and Bruno Micael Zanforlini
Subjects: Blood Glucose, Male, Time Factors, Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous), Blood Pressure, 030204 cardiovascular system & hematology, 0302 clinical medicine, Risk Factors, Cause of Death, Prospective cohort study, Abdominal obesity, Aged, 80 and over, Metabolic Syndrome, Nutrition and Dietetics, Age Factors, Prognosis, All-cause mortality, Lipids, Meta-analysis, Hypertension, Female, Sex, medicine.symptom, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Cardiovascular mortality, 030209 endocrinology & metabolism, Risk Assessment, NO, 03 medical and health sciences, Sex Factors, Internal medicine, medicine, Humans, Metabolic syndrome components, Older people, Aged, Dyslipidemias, business.industry, Health Status Disparities, medicine.disease, Confidence interval, Blood pressure, Relative risk, Hyperglycemia, All-cause mortality, Cardiovascular mortality, Metabolic syndrome components, Older people, Sex, Metabolic syndrome, business, Biomarkers
Abstract: Background and aims The influence of metabolic syndrome (MetS) on mortality may be influenced by age- and gender-related changes affecting the impact of individual MetS components. We investigated gender differences in the association between MetS components and mortality in community-dwelling older adults. Methods and results Prospective studies were identified through a systematic literature review up to June 2019. Random-effect meta-analyses were run to estimate the pooled relative risk (RR) and 95% confidence intervals (95% CI) of all-cause and cardiovascular (CV) mortality associated with the presence of MetS components (abdominal obesity, high triglycerides, low HDL cholesterol, high fasting glycemia, and high blood pressure) in older men and women. Meta-analyses considering all-cause (103,859 individuals, 48,830 men, 55,029 women; 10 studies) and CV mortality (94,965 individuals, 44,699 men, 50,266 women; 8 studies) did not reveal any significant association for abdominal obesity and high triglycerides in either gender. Low HDL was associated with increased all-cause (RR = 1.16, 95% CI: 1.02–1.32) and CV mortality (RR = 1.34, 95% CI: 1.03–1.74) among women, while weaker results were found for men. High fasting glycemia was associated with higher all-cause mortality in older women (RR = 1.35, 95% CI: 1.22–1.50) more than in older men (RR = 1.21, 95% CI: 1.13–1.30), and CV mortality only in the former (RR = 1.36, 95% CI: 1.04–1.78). Elevated blood pressure was associated with increased all-cause mortality (RR = 1.16, 95% CI: 1.03–1.32) and showed marginal significant results for CV death only among women. Conclusions The impact of MetS components on mortality in older people present some gender differences, with low HDL cholesterol, hyperglycemia, and elevated blood pressure being more strongly associated to all-cause and CV mortality in women.
Published: 2020

35. Are cytochrome P4502D6 and apolipoprotein E genotypes associated with long-term cognitive and functional changes in patients treated with donepezil?

Author: Alessandra Coin, Giuseppe Sergi, Caterina Trevisan, Sabrina Pigozzo, Maria Valentina Pamio, A. Girardi, Enzo Manzato, Marina De Rui, and Maria Devita
Subjects: Apolipoprotein E, medicine.medical_specialty, CYP2D6, Activities of daily living, Genotype, Apolipoprotein E4, Disease, functional status, digestive system, NO, 03 medical and health sciences, 0302 clinical medicine, Apolipoproteins E, Cognition, Piperidines, Alzheimer Disease, Internal medicine, Activities of Daily Living, medicine, Dementia, Humans, Donepezil, CYP2D6 genotype, skin and connective tissue diseases, Nootropic Agents, 030214 geriatrics, business.industry, medicine.disease, acetylcholinesterase inhibitors, apolipoprotein E genotype, cognitive status, dementia, Psychiatry and Mental health, Endocrinology, Cytochrome P-450 CYP2D6, Indans, Geriatrics and Gerontology, business, Gerontology, 030217 neurology & neurosurgery, medicine.drug
Abstract: Aim We investigated the associations of the single-nucleotide polymorphism rs1080985 of cytochrome P4502D6 (CYP2D6) and the apolipoprotein E (APOE) genotypes with cognitive and functional changes in patients treated with donepezil. Methods Sixty-five outpatients with Alzheimer's disease or mixed dementia being treated with donepezil were assessed at baseline and over 27 months. Changes in cognitive status, assessed with the Mini-Mental State Examination, and in functional status, assessed by the Activities of Daily Living Scale and the Instrumental Activities of Daily Living Scale, were evaluated as a function of CYP2D6 and APOE genotypes by using linear mixed models. Multiplicative interactions between the CYP2D6 and APOE genotypes and time were investigated. Results Individuals with the mutated CYP2D6 exhibited a slower decline in total Mini-Mental State Examination scores, orientation, registration, and functional status than those with the wild type. A significant interaction between CYP2D6, APOE, and time was found for changes in the Activities of Daily Living Scale; among the e4 carriers, those with the mutated CYP2D6 exhibited a slower decline on the Activities of Daily Living Scale than those with the wild type. Conclusion The CYP2D6 and APOE genotypes may modulate the effectiveness of donepezil on cognitive and functional status.
Published: 2019

36. Judgment Capacity, Fear of Falling, and the Risk of Falls in Community-Dwelling Older Adults: The Progetto Veneto Anziani Longitudinal Study

Author: Stefania Maggi, Giuseppe Sergi, Marina De Rui, Egle Perissinotto, Anna-Karin Welmer, Enzo Manzato, Maria Chiara Corti, Caterina Trevisan, Bruno Micael Zanforlini, Federica Limongi, and Marianna Noale
Subjects: 0301 basic medicine, Gerontology, Male, Aging, Longitudinal study, Recurrent falls, Fear of falling, 03 medical and health sciences, Judgment, 0302 clinical medicine, Risk Factors, medicine, Humans, Longitudinal Studies, Postural Balance, Aged, Aged, 80 and over, Fall risk, Fear, biochemical phenomena, metabolism, and nutrition, 030104 developmental biology, Italy, Accidental Falls, Female, Independent Living, Geriatrics and Gerontology, medicine.symptom, Psychology, 030217 neurology & neurosurgery
Abstract: Little is known of the factors that transform fear of falling (FOF) from a normal adaptive to a maladaptive response that could alter its impact on fall risk. Focusing on judgment capacity, we investigated whether it is associated with FOF and FOF-related activity restriction (AR), and whether it modifies the influence of FOF on fall risk. Data came from 2625 community-dwelling older adults enrolled in the Progetto Veneto Anziani. Baseline FOF and AR were assessed through personal interviews, and judgment capacity-high, moderate, or poor-through situational tests. At follow-up after 4.4 years, self-reported falls during the previous year were recorded. The associations between judgment and FOF/AR, and between FOF and the risk of at least one fall or recurrent falls (two or more falls), stratified by judgment capacity, were evaluated using multinomial logistic regressions. Compared with high-judgment participants, lower judgment participants were 20% more likely to report FOF; moderate judgment participants were 54% more likely and poor judgment participants twice as likely to report AR. After adjusting for potential confounders, including physical activity and physical performance, FOF increased the reporting of at least one fall only in the poor judgment group. The association between FOF and recurrent falls was stronger in individuals with poor (odds ratio [OR] = 3.66, 95% confidence interval [CI]: 2.10-6.36) than with moderate (OR = 2.81, 95% CI: 2.22-3.55) or high (OR = 1.65, 95% CI: 1.48-1.83) judgment. Poor judgment capacity increases the probability of FOF and AR in older adults, and may exacerbate the effect of FOF in increasing fall risk.
Published: 2019

37. Efficacy of an interdisciplinary pathway in a first level trauma center orthopaedic unit: A prospective study of a cohort of elderly patients with hip fractures

Author: Giulia Bano, Alessandra Bordignon, Marta Dianin, Giuseppe Sergi, Marco Bedogni, Carlo Biz, Agnese Alessi, Antonio Berizzi, Marianna Bizzotto, Pietro Ruggieri, and Enzo Manzato
Subjects: Male, Aging, medicine.medical_specialty, Health (social science), Activities of daily living, functional recovery, Unit (housing), Hip fracture, 03 medical and health sciences, 0302 clinical medicine, Trauma Centers, orthogeriatrics, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Geriatric Assessment, older adults, Aged, Retrospective Studies, Aged, 80 and over, 030214 geriatrics, business.industry, Hip Fractures, Trauma center, Recovery of Function, Functional recovery, medicine.disease, mortality, Orthopedics, Cohort, Physical therapy, Functional status, Female, Geriatrics and Gerontology, business, Gerontology
Abstract: Background hip fracture has negative consequences for elderly people. Alternative models of care, with respect to traditional model, were developed to minimize complications and improve functional outcomes. The interdisciplinary model in orthopaedic wards has less evidence of efficacy compared to orthogeriatric units. Objective to compare the efficacy (in–hospital outcomes, mortality, functional status at 6 months after discharge) of an interdisciplinary pathway, based on comprehensive geriatric assessment, compared to a traditional model of care, in hip-fractured elderly patients. Design prospective study with retrospective control group conducted in a first-level trauma center Orthopaedic Unit. Subjects 97 patients treated with the traditional model and 127 with an interdisciplinary pathway (mean age 83.9 ± 7.4 vs 84 ± 6.7 years, p = 0.89). Methods in all participants we assessed: clinical history, functional pre-fracture status utilising Activities of Daily Living (ADL), in-hospital details. At 6 months after discharge, we evaluated functional status, place of residence, hospital readmissions, mortality. Results during hospital stay, significant differences emerged in mortality and in external visits. A higher proportion of patients of the orthogeriatric group lived alone at home at 6 months and showed a lower functional decline. Comprehensive geriatric assessment was associated with the ADL score (partial R2: 0.08, p Conclusions an interdisciplinary pathway in hip-fractured elderly patients, could reduce in–hospital mortality, improve functional recovery and increase the probability of living alone at home, at 6 months.
Published: 2019

38. The impact of aging on pressure pain thresholds: are men less sensitive than women also in older age?

Author: Emine Meral Inelmen, Stefania Fratta, Giuseppe Sergi, Caterina Trevisan, Elena Debora Toffanello, Enzo Manzato, and G. Girotti
Subjects: Aging, 030214 geriatrics, Pressure pain, business.industry, Socio-culturale, Gender differences, Pain perception, Geriatric assessment, Anthropometry, 03 medical and health sciences, 0302 clinical medicine, Formal education, Threshold of pain, Medicine, Life course approach, 030212 general & internal medicine, Young adult, business, Demography
Abstract: Gender differences in pain perception change in advanced age, with men presenting a steeper reduction in pain threshold than women with aging. To evaluate whether the gender differences in pain perception change with aging. Female gender and older age were associated with lower pressure pain thresholds, but difference between genders reduced from young to middle to old adult. Men have generally demonstrated higher pressure pain thresholds (PPT) than women. However, the possible impact of aging on the gender differences in pain perception has not been fully evaluated. In this study, we aimed to investigate the gender differences in PPT over the life course, in young, middle-aged and older adults. This cross-sectional study involved 355 pain-free healthy individuals aged 19–95 years, divided into
Published: 2019

39. Elder abuse: are we turning a blind eye to a crucial issue?

Author: Emine Meral Inelmen, Enzo Manzato, and Giuseppe Sergi
Subjects: medicine.medical_specialty, business.industry, Internal Medicine, Emergency Medicine, Health Personnel, MEDLINE, Elder abuse, Elder Abuse, Hospitals, Health personnel, Family medicine, medicine, Humans, business, Aged
Published: 2019

40. Phase angle and metabolic equivalents as predictors of frailty transitions in advanced age

Author: Bruno Micael Zanforlini, Francesca Zoccarato, Enzo Manzato, Anna Bertocco, Giuseppe Sergi, Marta Dianin, Mattia Mazzochin, Caterina Trevisan, Agnese Alessi, and Francesca Piovesan
Subjects: 0301 basic medicine, Male, Frailty transition, Aging, medicine.medical_specialty, Sarcopenia, Physical examination, Biochemistry, Metabolic equivalent, NO, Odds, 03 medical and health sciences, Elderly, 0302 clinical medicine, Endocrinology, Absorptiometry, Photon, Bioimpedance analysis, Metabolic equivalents, Phase angle, Internal medicine, Metabolic Equivalent, Genetics, Electric Impedance, Medicine, Humans, Prospective Studies, Prospective cohort study, Molecular Biology, Geriatric Assessment, Bioimpedance analysis, Elderly, Frailty transition, Metabolic equivalents, Phase angle, Aged, medicine.diagnostic_test, Frailty, business.industry, Cell Biology, Odds ratio, medicine.disease, Confidence interval, 030104 developmental biology, Logistic Models, Linear Models, Female, business, Bioelectrical impedance analysis, 030217 neurology & neurosurgery
Abstract: Objectives The aim of this prospective study was to investigate whether two cellular and metabolic health indices, phase angle (PhA) and metabolic equivalents (METs), can predict changes in frailty states in fit community-dwelling older people. Methods A sample of 118 individuals aged ≥65 years who attended a twice-weekly mild fitness program of aerobic and/or resistance exercises was enrolled in the study. At baseline and after three years, individuals underwent a clinical examination, biochemical determinations, bioelectrical impedance analysis, body composition assessment with dual energy X-ray absorptiometry, physical performance tests, and frailty and sarcopenia assessment. In 78 participants was executed indirect calorimetry, too. Based on frailty transitions during the follow-up between non-frailty, pre-frailty and frailty, participants were categorized as improved, stable (non-frail or pre-frail), and worsened or remaining frail. The chances to experience different frailty changes by baseline PhA and METs were explored through multinomial regression analysis and expressed as odds ratios (OR) and 95% Confidence intervals (95%CI). Results During the follow-up, 8 participants improved in frailty status, 84 were stable and 26 worsened or remained frail. For each one-unit increase in PhA, the odds of improving in frailty increased by 4.53 times (95%CI:1.18–17.46); while for each one-unit increase in METs, the odds of worsening in frailty decreased by 65% (95%CI:0.16–0.79). Conclusions PhA and METs may be indirect measures of functional reserve, with lower values being potential biomarkers of evolving frailty.
Published: 2019

41. Prevalence of sarcopenia and associated factors in the healthy older adults of the Peruvian Andes

Author: Alessandra Tramontano, Valter Giantin, Francesca De Zaiacomo, Stefania Maggi, Giuseppe Sergi, Caterina Trevisan, Diana Rodríguez-Hurtado, Enzo Manzato, Nicola Veronese, Tramontano, A., Veronese, N., Sergi, G., Manzato, E., Rodriguez-Hurtado, D., Maggi, S., Trevisan, C., De Zaiacomo, F., and Giantin, V.
Subjects: Male, Gerontology, Sarcopenia, Aging, Health (social science), Activities of daily living, Sarcopenia/epidemiology, Population, Nutritional Status, Walk Test, 030209 endocrinology & metabolism, Motor activity, Body Mass Index, NO, Disability Evaluation, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Peru, Prevalence, Instrumental activities of daily living, Humans, Medicine, Activities of daily living, Body mass index, Instrumental activities of daily living, Motor activity, Sarcopenia, 030212 general & internal medicine, education, Exercise, Body mass index, Aged, education.field_of_study, business.industry, Confounding, Age Factors, Odds ratio, medicine.disease, Physical activity level, Confidence interval, Female, Geriatrics and Gerontology, purl.org/pe-repo/ocde/ford#3.02.26 [https], business, Peru/epidemiology, human activities
Abstract: Aim To assess the prevalence of sarcopenia and associated factors in a population of older people living in a rural area of the Peruvian Andes. Materials and methods The study concerned 222 people aged ≥65 years. Sarcopenia was diagnosed on the basis of skeletal muscle mass, measured using bioimpedance analysis, and gait speed, measured with the 4-m walking test, as recommended by the International Working Group on sarcopenia. Self-reported physical activity, the Short Physical Performance Battery, and the Six-Minute Walking Test also contributed information on participants’ physical performance status. Disabilities were investigated by assessing participants’ self-reported difficulties in performing one or more basic or instrumental activities of daily living. Results The prevalence of sarcopenia was 17.6%. Compared with participants without sarcopenia, individuals who were found sarcopenic were significantly older, female and were less frequently farmers, had fewer children, had a worse nutritional status, a significantly lower physical performance, and higher levels of disability in the instrumental activities of daily living. After adjusting for potential confounders, age, female sex, a low body mass index, a self-reported low physical activity level, a worse Six-Minute Walking Test scores, and a low number of children were significantly associated with sarcopenia. Conclusion The prevalence of sarcopenia seems to be quite high among community-dwelling older subjects in the Peruvian Andes. Age, female sex, a low body mass index, little physical activity, a poor Six-Minute Walking Test scores, and a low number of children could be associated with this condition. © 2016 Elsevier Ireland Ltd
Published: 2017
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42. Weight loss is associated with improvements in cognitive function among overweight and obese people: A systematic review and meta-analysis

Author: Nicola Veronese, Enzo Manzato, Brendon Stubbs, Giuseppe Sergi, Silvia Facchini, Stefania Maggi, Theodore D. Cosco, Claudio Luchini, Luigi Fontana, Marco Solmi, Veronese, N., Facchini, S., Stubbs, B., Luchini, C., Solmi, M., Manzato, E., Sergi, G., Maggi, S., Cosco, T., and Fontana, L.
Subjects: Weight loss, medicine.medical_specialty, Cognitive Neuroscience, Physical activity, 030209 endocrinology & metabolism, Overweight, law.invention, 03 medical and health sciences, Behavioral Neuroscience, Cognition, 0302 clinical medicine, Randomized controlled trial, Memory, law, medicine, Humans, Attention, Obesity, Exercise, Nutrition, Meta-analysis, Weight Loss, Cognition, Memory, Attention, Weight loss, Obesity, Meta-analysis, Physical activity, Nutrition, Executive functions, medicine.disease, Neuropsychology and Physiological Psychology, Physical therapy, medicine.symptom, Psychology, 030217 neurology & neurosurgery
Abstract: Whilst obesity is associated with a higher risk of cognitive impairment, the influence of weight loss on cognitive function in obese/overweight people is equivocal. We conducted a meta-analysis of randomized controlled trials (RCTs) and longitudinal studies evaluating the influence of voluntary weight loss on cognitive function in obese/overweight individuals. Articles were acquired from a systematic search of major databases from inception till 01/2016. A random effect meta-analysis of weight loss interventions (diet, physical activity, bariatric surgery) on different cognitive domains (memory, attention, executive functions, language and motor speed) was conducted. Twenty studies (13 longitudinal studies = 551 participants; 7 RCTs = 328 treated vs. 140 controls) were included. Weight loss was associated with a significant improvement in attention and memory in both longitudinal studies and RCTs, whereas executive function and language improved in longitudinal and RCT studies, respectively. In conclusion, intentional weight loss in obese/overweight people is associated with improvements in performance across various cognitive domains. Future adequately powered RCTs are required to confirm/refute these findings. © 2016 Elsevier Ltd
Published: 2017
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43. Sinonasal Polyposis in the Elderly

Author: Giuseppe Brescia, Gino Marioni, Umberto Barion, Alfonso Luca Pendolino, Filippo Marino, Alessandro Martini, Francesco Cinetto, Luciano Giacomelli, Enzo Manzato, and Barbara Pedruzzi
Subjects: Adult, Male, medicine.medical_specialty, Chronic rhinosinusitis, Young Adult, 03 medical and health sciences, Nasal Polyps, 0302 clinical medicine, Recurrence, Paranasal Sinuses, Hypersensitivity, Humans, Immunology and Allergy, Medicine, Nasal polyps, Sinusitis, 030223 otorhinolaryngology, Aged, Rhinitis, End point, business.industry, Endoscopy, General Medicine, medicine.disease, Dermatology, Asthma, Eosinophils, Treatment Outcome, 030228 respiratory system, Otorhinolaryngology, Chronic Disease, Female, business
Abstract: Background/Objective The main end point of this investigation was to review our experience gained from 2009 to 2015 of treating chronic rhinosinusitis with nasal polyps (CRSwNP) in elderly patients (≥65 years old) with functional endoscopic sinus surgery. Secondary aims were to analyze the prognostic variables for CRSwNP in elderly patients and to compare the demographic, clinical, laboratory, histologic, and prognostic characteristics of CRSwNP in elderly versus young adult patients (20-40 years old). Methods Forty-three consecutive elderly patients and 71 consecutive young adult patients with CRSwNP were enrolled. Results Significant associations were found in the elderly group between CRSwNP recurrence and allergy (p = 0.037), CRSwNP recurrence and asthma (p = 0.017), and CRSwNP recurrence and acetyl salicylic acid (ASA) intolerance (p = 0.032) but not between recurrence and eosinophilic/noneosinophilic CRSwNP histology. Significant associations emerged in the young adult group between CRSwNP recurrence and asthma (p = 0.009), and ASA intolerance (p = 0.016), and serum eosinophil count (p = 0.02). The recurrence rate was also significantly higher for young adult patients with eosinophilic-type CRSwNP (p = 0.001). CRSwNP recurred less often in the elderly than in the young adult patients (p = 0.05). Conclusion The present preliminary investigation found a lower recurrence rate after functional endoscopic sinus surgery for CRSwNP in elderly patients than in young adult patients. Further investigations on larger, prospective series are mandatory to support the hypothesis that, although eosinophilic-type CRSwNP is generally considered a variant at high risk of recurrence and that probably warrants stricter postoperative follow-up and adjuvant postoperative medical treatment, these considerations could not be applied to elderly patients.
Published: 2016
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44. Activity of myricetin and other plant-derived polyhydroxyl compounds in human LDL and human vascular endothelial cells against oxidative stress

Author: Guglielmina Froldi, Raffaella Marin, Zheng Chen, Angela Feltrinelli, Monica Montopoli, Enzo Manzato, Maddalena Donati, Sabina Zambon, and Riccardo Bertin
Subjects: 0301 basic medicine, Phytochemicals, Silibinin, 030204 cardiovascular system & hematology, medicine.disease_cause, Thiobarbituric Acid Reactive Substances, Antioxidants, Ox-LDL, 03 medical and health sciences, chemistry.chemical_compound, HUVEC, 0302 clinical medicine, Oleuropein, Human Umbilical Vein Endothelial Cells, medicine, TBARS, Humans, Flavonoids, Pharmacology, Myricetin, Plant-derived compounds, ROS, Free Radical Scavengers, Hydrogen Peroxide, General Medicine, Magnolol, Baicalein, Lipoproteins, LDL, Galangin, Kinetics, Oxidative Stress, 030104 developmental biology, chemistry, Biochemistry, Oxidative stress
Abstract: Studies indicate that oxidative modifications of endothelium and LDL play a preeminent role in atherogenesis; therefore, the preservation of the endothelial antioxidant capacity and the inhibition of LDL oxidation by use of plant-derived compounds are an appealing strategy against several vascular disorders. On this basis, baicalein, eupatorin, galangin, magnolol, myricetin, oleuropein, silibinin and bilobalide were studied against various oxidative conditions. The radical scavenging capacity was analysed using DPPH and ORAC assays. Furthermore, the LDL oxidation was detected by measuring the formation of thiobarbituric acid reactive substances (TBARS) and by monitoring the oxidation kinetics. Further, we used cultured HUVEC to investigate the activities of the polyhydroxyl compounds towards the oxidative stress induced by H2O2. The lowest levels of TBARS were observed in the presence of oleuropein and baicalein, while myricetin, magnolol and eupatorin inhibited these ones to a lesser extent. In addition, oleuropein and myricetin exhibited higher protection in copper-induced LDL oxidation kinetics. However, only myricetin and galangin showed significant protective effects against H2O2 oxidative injury in HUVEC cells. Taken all together the results indicate myricetin as the most active agent among the selected plant-derived polyhydroxyl compounds, with prominent capacities against ox-LDL and ROS production in HUVEC.
Published: 2016
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45. Extra-nodal extension of sentinel lymph node metastasis is a marker of poor prognosis in breast cancer patients: A systematic review and an exploratory meta-analysis

Author: Paola Capelli, Mehmet Akif Eryılmaz, Franco Bonetti, Audrey H. Choi, Antonio Pea, Mehmet Koç, Luisa Carbognin, Marco Solmi, Giuseppe Sergi, Fabio Bagante, Rudi M. H. Roumen, Emilio Bria, Mattia Barbareschi, Brendon Stubbs, Enzo Manzato, Maheswari Senthil, Alessia Nottegar, Matteo Fassan, Nicola Veronese, Marco Maruzzo, Claudio Luchini, N. C. Verheuvel, Nottegar, A., Veronese, N., Senthil, M., Roumen, R.M., Stubbs, B., Choi, A.H., Verheuvel, N.C., Solmi, M., Pea, A., Capelli, P., Fassan, M., Sergi, G., Manzato, E., Maruzzo, M., Bagante, F., Koç, M., Eryilmaz, M.A., Bria, E., Carbognin, L., Bonetti, F., Barbareschi, M., Luchini, C., RS: FHML non-thematic output, RS: GROW - School for Oncology and Reproduction, Surgery, Promovendi ODB, Interne Geneeskunde, and RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy
Subjects: Breast cancer, ENE, Extra-nodal, Extracapsular, Extranodal, Sentinel, Oncology, Surgery, 0301 basic medicine, Metastasis, 0302 clinical medicine, sentinel, Lymph node, extracapsular, medicine.diagnostic_test, extra-nodal, General Medicine, Prognosis, medicine.anatomical_structure, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Female, Sentinel Lymph Node, medicine.medical_specialty, Sentinel lymph node, Breast Neoplasms, Malignancy, Disease-Free Survival, 03 medical and health sciences, breast cancer, Internal medicine, Biopsy, medicine, Humans, Survival analysis, Neoplasm Staging, Sentinel Lymph Node Biopsy, business.industry, medicine.disease, Survival Analysis, Axilla, 030104 developmental biology, Lymph Node Excision, business, Follow-Up Studies
Abstract: Invasive breast cancer is the most common malignancy in women. Its most common site of metastasis is represented by the lymph nodes of axilla, and the sentinel lymph node (SLN) is the first station of nodal metastasis. Axillary SLN biopsy accurately predicts axillary lymph node status and has been accepted as standard of care for nodal staging in breast cancer. To date, the morphologic aspects of SLN metastasis have not been considered by the oncologic staging system. Extranodal extension (ENE) of nodal metastasis, defined as extension of neoplastic cells through the nodal capsule into the peri-nodal adipose tissue, has recently emerged as an important prognostic factor in several types of malignancies. It has also been considered as a possible predictor of non-sentinel node tumor burden in SLN-positive breast cancer patients. We sought out to clarify the prognostic role of ENE in SLN-positive breast cancer patients in terms of overall and disease-free survival by conducting a systematic review and meta-analysis. Among 172 screened articles, 5 were eligible for the meta-analysis; they globally include 624 patients (163 ENE+ and 461 ENE−) with a median follow-up of 58 months. ENE was associated with a higher risk of both mortality (RR=2.51; 95% CI: 1.66–3.79, p&nbsp
Published: 2016
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46. Factors influencing serum 25-hydroxivitamin D levels and other bone metabolism parameters in healthy older women

Author: Emine Meral Inelmen, Giuseppe Sergi, Alessandra Coin, Egle Perissinotto, Nicola Veronese, M. De Rui, Francesco Bolzetta, Enzo Manzato, Linda Berton, S. Carraro, F. Miotto, Caterina Trevisan, Trevisan, C., Veronese, N., Berton, L., Carraro, S., Bolzetta, F., de Rui, M., Miotto, F., Inelmen, E.M., Coin, A., Perissinotto, E., Manzato, E., and Sergi, G.
Subjects: 0301 basic medicine, medicine.medical_specialty, Bone density, Medicine (miscellaneous), 030209 endocrinology & metabolism, 25-hydroxyvitamin D, bone metabolism, dietary vitamin D intake, elderly, fat mass, Nutrition and Dietetics, Geriatrics and Gerontology, NO, Bone remodeling, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, medicine, Vitamin D and neurology, Femoral neck, Bone mineral, Hyperparathyroidism, 030109 nutrition & dietetics, business.industry, medicine.disease, medicine.anatomical_structure, Endocrinology, chemistry, 25-hydroxyvitamin D, dietary vitamin D intake, fat mass, bone metabolism, elderly, Calcifediol, Secondary hyperparathyroidism, business
Abstract: Objective: Older women have frequently low serum 25-hydroxivitamin D (25[OH]D) concentrations, high parathormone (PTH) levels and low bone mineral density (BMD) values. Endogenous synthesis, dietary habits, sunlight exposure and fat-mass-mediated storage may influence 25(OH)D levels and bone metabolism, but the relevance of these factors in the elderly has yet to be fully elucidated. We aimed to investigate the influence of dietary vitamin D intake and fat mass on serum 25(OH)D levels and bone metabolism in older women. Design: Cross-sectional. Setting: Community. Participants: 218 fit older women attending a biweekly mild fitness program. Measurements: Dietary habits was investigated through a 3-day record questionnaire. Serum 25(OH)D and intact parathormone (PTH) concentrations were measured by radioimmunoassay and by a 2-step immunoradiometric assay, respectively. BMD and body composition were estimated using dualenergy X-ray absorptiometry with fan-beam technology. Results: Only fat mass showed a significant negative association with 25(OH)D (β=-3.76, p
Published: 2016
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47. Serum Dehydroepiandrosterone Sulfate and Risk for Type 2 Diabetes in Older Men and Women: The Pro.V.A Study

Author: Giuseppe Sergi, Egle Perissinotto, Marina De Rui, Sabina Zambon, Maria Chiara Corti, Giovannella Baggio, Gaetano Crepaldi, Stefania Maggi, Caterina Trevisan, Nicola Veronese, Enzo Manzato, Francesco Bolzetta, Veronese, N., Trevisan, C., De Rui, M., Bolzetta, F., Maggi, S., Zambon, S., Corti, M.C., Baggio, G., Perissinotto, E., Crepaldi, G., Manzato, E., and Sergi, G.
Subjects: Blood Glucose, Male, 0301 basic medicine, medicine.medical_specialty, DHEAS, Endocrinology, Diabetes and Metabolism, Blood sugar, Physiology, 030209 endocrinology & metabolism, Type 2 diabetes, NO, sex hormones in the pathogenesis of diabete, Cohort Studies, 03 medical and health sciences, chemistry.chemical_compound, Elderly, 0302 clinical medicine, Endocrinology, Dehydroepiandrosterone sulfate, Risk Factors, Internal medicine, Diabetes mellitus, Internal Medicine, Humans, Medicine, Aged, Glycated Hemoglobin, Dehydroepiandrosterone Sulfate, business.industry, Incidence (epidemiology), General Medicine, Prognosis, medicine.disease, Community-dwelling adults, Diabetes and Metabolism, 030104 developmental biology, Diabetes Mellitus, Type 2, chemistry, dehydroepiandrosterone sulfate (DHEAS), Cohort, Female, Glycated hemoglobin, business, Biomarkers, Follow-Up Studies, Cohort study
Abstract: Objective: A large body of clinical data suggests the importance of endogenous sex hormones in the pathogenesis of diabetes, but very little is known about the possible relationship between dehydroepiandrosterone sulfate (DHEAS) and diabetes, particularly in the elderly. We aimed, therefore, to examine whether high serum levels of DHEAS have any protective effects on the incidence of type 2 diabetes and to elucidate the possible role of gender in a cohort of older subjects. Methods: We followed 1258 community-dwelling subjects aged ≥65 years without type 2 diabetes who belonged to the Progetto Veneto Anziani (Pro.V.A.) for 4.4±1.2 years. DHEAS were measured at baseline and categorized into gender-specific tertiles. The incidence of type 2 diabetes was diagnosed in cases of fasting plasma glucose above 7.0 nmol/L, glycated hemoglobin ≥6.5%, use of glucose-lowering drugs or a 2-hour postload blood sugar level ≥11.1 nmol/L during the follow-up period. Results: Although no significant differences in potential risk factors for diabetes were apparent across DHEAS tertiles at the baseline in either gender, when those with lower DHEAS were taken for reference, Cox regression analysis showed that males in the highest DHEAS tertile had lower risks for being diagnosed with diabetes during the follow up (HR = 0.23; 95% CI: 0.11-0.51; p < 0.0001), whereas no significant differences emerged across DHEAS tertiles for females or for the sample as a whole. Conclusions: Higher serum DHEAS levels revealed a significant protective effect against the onset of type 2 diabetes in older men but not in older women, confirming different sensitivities of type 2 diabetes to DHEAS between genders. Objectif: Méthodes: Résultats: Conclusions: © 2016 Canadian Diabetes Association.
Published: 2016
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48. Advanced dementia: opinions of physicians and nurses about antibiotic therapy, artificial hydration and nutrition in patients with different life expectancies

Author: Elisabetta Valentini, Enzo Manzato, Valter Giantin, Anna Zurlo, Francesca De Zaiacomo, Mario Iasevoli, Stefania Maggi, Alberto Voci, Valentina Pengo, Renzo Pegoraro, and Massimo Catarini
Subjects: Gerontology, medicine.medical_specialty, business.industry, media_common.quotation_subject, Alternative medicine, Logistic regression, 03 medical and health sciences, 0302 clinical medicine, Feeling, 030220 oncology & carcinogenesis, Antibiotic therapy, Advanced dementia, medicine, Life expectancy, In patient, 030212 general & internal medicine, Nursing homes, business, media_common
Abstract: Aim: The aim of the present study was to investigate the proportion of physicians and nurses who agree with the administration of antibiotic therapy (AT), artificial hydration (AH), and artificial nutrition (AN) in patients with advanced dementia and different life expectancies. Furthermore, we aimed at analyzing the correlates of the opinion according to which medical treatments should no longer be given to advanced dementia patients once their life expectancy falls. Methods: End-of-life decisions and opinions were measured with a questionnaire that was sent to geriatric units, hospices and nursing homes in three different regions of Italy. Multivariate logistic regressions were carried out to ascertain the correlates of the agreement with the administration of AH, AT or AN. Results: When the patient's life expectancy was 1–6 months, 83% of respondents agreed with AH, 79% with AT and 71% with AN. When the life expectancy was less than 1 month, a large proportion of respondents still agreed with AH and AT (73% and 61%), whereas less than one in two respondents (48%) agreed with AN. Conclusions: The findings of the present study showed that AN creates more ethical dilemmas in the clinical management of end of life than other treatments, such as AH or AT. Opinions on whether or not these practices are appropriate at the end of life were related with feelings, thoughts and ethical issues that played a different part for physicians and nurses. Geriatr Gerontol Int 2017; 17: 487–493.
Published: 2016
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49. Short article

Author: Enzo Manzato, Francesca Galeazzi, Florinda Petruzzellis, Claudia Mescoli, Anna Zurlo, Giovanni Nante, Elena Ruggiero, and Valter Giantin
Subjects: Abdominal pain, medicine.medical_specialty, Pathology, Malabsorption, Gastroenterology, Tropheryma whipplei, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Biopsy, medicine, 030212 general & internal medicine, Whipple's disease, Hepatology, medicine.diagnostic_test, biology, Esophagogastroduodenoscopy, business.industry, medicine.disease, biology.organism_classification, Diarrhea, medicine.anatomical_structure, Duodenum, 030211 gastroenterology & hepatology, medicine.symptom, business
Abstract: Whipple's disease is a rare infection caused by Tropheryma whipplei, a Gram-negative Bacillus usually found in macrophages of the lamina propria of the small intestine. The typical clinical manifestations of classic Whipple's disease are diarrhea, weight loss, malabsorption, abdominal pain, and arthralgia. The disease's laboratory diagnosis is currently based on duodenal biopsy. Treatment generally includes primary therapy for 2 weeks with intravenous antibiotics capable of reaching high levels in the cerebrospinal fluid, such as ceftriaxone, usually followed by treatment with oral cotrimoxazole for 1 year. Early diagnosis should enable appropriate treatment and improves the prognosis, and prolonged antibiotic treatment often leads to complete remission. Our case report focuses on a 72-year-old man who had been passing watery stools for 1-2 months, accompanied by low-grade fever. He reported profound asthenia, a weight loss of about 3 kg, and loss of appetite. Thirty years earlier (in 1984), he had been working as a horse keeper at a University Department of Agricultural and Veterinary Studies, where he had contracted Whipple's disease. Laboratory tests and microbiological studies led to a diagnosis of recurrent Whipple's disease. Esophagogastroduodenoscopy was performed under deep sedation. Biopsy samples obtained from the stomach and duodenum were stained with hematoxylin and eosin, Giemsa, and periodic acid-Schiff to identify any accumulation of typical periodic acid-Schiff-positive macrophages in the lamina propria. A specific quantitative real-time PCR assay using specific oligonucleotide probes for targeting repeated sequences of Tropheryma whipplei was also performed to detect its DNA in the duodenum samples.
Published: 2016
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50. Lipoprotein-X fifty years after its original discovery

Author: Renato Fellin and Enzo Manzato
Subjects: medicine.medical_specialty, History, Endocrinology, Diabetes and Metabolism, Hypercholesterolemia, Medicine (miscellaneous), Bile, Cholestasis, Cholesterol, Dyslipidemias, LDL, Lecithin cholesterol acyltransferase, Lipid and lipoprotein metabolism, Animals, Biological Transport, History, 20th Century, History, 21st Century, Humans, Lecithin Cholesterol Acyltransferase Deficiency, Lipoprotein-X, Liver, Prognosis, Risk Factors, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, Cholesterol 7 alpha-hydroxylase, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, medicine, Nutrition and Dietetics, Catabolism, ABCB4, medicine.disease, 21st Century, 20th Century, Endocrinology, chemistry, lipids (amino acids, peptides, and proteins), Liver function, Cardiology and Cardiovascular Medicine, Lipoprotein
Abstract: Aims To review the formation, catabolism, and the possible atherogenic properties of Lp-X. Data Synthesis The conversion of cholesterol to bile acids is regulated by several mechanisms including cholesterol 7 alpha hydroxylase, fibroblast growth factor 19, and farnesoid X receptors. During cholestasis these mechanisms are altered and there is an accumulation of bile acids and cholesterol in plasma. The hypercholesterolemia observed in cholestasis is due to the presence of an anomalous lipoprotein called lipoprotein-X (Lp-X). Lp-X is a lipoprotein rich in phospholipid and free cholesterol present in plasma of patients with cholestasis and, with some variations, in patients with lecithin-cholesterol-acyl-transferase deficiency (LCAT), and after lipid infusion. Lp-X is formed from a bile lipoprotein moving to the blood vessels where it incorporates small quantities of triglycerides, apo-C and esterified cholesterol and becomes a “mature” Lp-X. The activity of the phosphatidilcholine canalicular transporter Mdr2 P-glycoprotein (homologous to the human ABCB4) is essential for LpX appearance, since its suppression abolishes Lp-X formation. However, the concentration of Lp-X in plasma is determined also by the degree of the cholestasis, the residual liver function, and the LCAT deficiency. The Lp-X catabolism seems to be mediated by the reticuloendothelial system and possibly the kidney. Conclusions Lp-X might be considered a defense mechanism against the toxic effect of free cholesterol in cholestasis. The frequency of cardiovascular events in patients affected by primary biliary cholangitis, in whom the Lp-X is present in high concentration, are not increased. Further studies could now clarify the remaining open questions on the role of Lp-X in the dyslipidemia of cholestasis.
Published: 2019

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