Changes In Habits Research Articles

Cross-sectional study of partners’ tobacco consumption during their spouse’s pregnancy

Background A smoking partner is a major risk factor for passive smoking and continued maternal smoking. Objective To assess the smoking habits, knowledge, and information received to stop smoking of smoking partners during their spouse’s pregnancy. Method This was a cross-sectional study of partners who smoked at the start of pregnancy and whose spouses had just given birth. Recruitment was carried out in maternity hospitals in the Auvergne-Rhône-Alpes region from June 2021 to December 2021. Data were collected using a self-administered questionnaire. Results A total of 105 men using tobacco were recruited, average age 34 years (± 6.4). Of these, 46 (44%) had modified their consumption during pregnancy: 11 (10.5%) had stopped smoking until maternity hospital entry, 24 (23%) had cut down and 11 (10.5%) had relapsed after initial total cessation. A multivariate analysis revealed a statistically significant relationship between men’s change in smoking behaviour during pregnancy and a first pregnancy, an overweight participant, not living in a rural area, and information provided by the General Practitioner (GP). GPs are the first point of contact for participants looking for help to quit smoking. Among men who have not changed their smoking habits, 46% have not received any information from health professionals. Conclusions Intervention and medical information provided by GPs to smoking partners may be associated with changes in smoking habits during pregnancy. Additional prospective, comparative studies are needed to support a robust conclusion.

Beneficial microbiome and diet interplay in early-onset colorectal cancer.

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer-related deaths worldwide. Although the risk of developing CRC increases with age, approximately 10% of newly diagnosed cases occur in individuals under the age of 50. Significant changes in dietary habits in young adults since industrialization create a favorable microenvironment for colorectal carcinogenesis. We aim here to shed light on the complex interplay between diet and gut microbiome in the pathogenesis and prevention of early-onset CRC (EO-CRC). We provide an overview of dietary risk factors associated with EO-CRC and contrast them with the general trends for CRC. We delve into gut bacteria, fungi, and phages with potential benefits against CRC and discuss the underlying molecular mechanisms. Furthermore, based on recent findings from human studies, we offer insights into how dietary modifications could potentially enhance gut microbiome composition to mitigate CRC risk. All together, we outline the current research landscape in this area and propose directions for future investigations that could pave the way for novel preventive and therapeutic strategies.

Precipitating Factors of Hepatic Encephalopathy in Patients with Cirrhosis of Liver in a Tertiary Care Center of Nepal

Introduction: Chronic liver disease is a common disease presenting in hospitals in Nepal. A large number of cirrhotics present with hepatic encephalopathy. Various precipitating factors are present which precipitate hepatic encephalopathy. This study was intended to identify the precipitating factors of hepatic encephalopathy and to assess whether identifiable precipitating factors of encephalopathy are present. Materials and Methods: This was a hospital-based observational cross-sectional study conducted at the Department of Medicine, Manipal Teaching Hospital, Pokhara. A total of 80 patients were included. The precipitating factors for encephalopathy were documented along with grading. SPSS was used for data analysis. Results: The mean age of the patients was 54.725 ± 11.33 years. There were 55 males (68.8%) and 25 (31.3%) females in the study. All the patients (100%) had a significant amount of alcohol consumption. It was found that hepatic encephalopathy was more severe in the higher Child-Pugh class as compared to a lower one. At least 1 precipitating factor was identified in 81% of patients. The common precipitating factors were increased protein intake, bleeding, infection, diarrhea, and constipation. Conclusions: We conclude that there are different factors that play a key role in precipitating hepatic encephalopathy, with a high protein diet, constipation, bleeding, and infections being predominant. A minor change in dietary habits, regular follow up and timely visits to the health care facility may result in the identification of these common precipitating factors like infections, constipation, and diarrhea.

Protective Effects of Exogenous Melatonin Administration on White Fat Metabolism Disruption Induced by Aging and a High-Fat Diet in Mice

Obesity has emerged as a major risk factor for human health, exacerbated by aging and changes in dietary habits. It represents a significant health challenge, particularly for older people. While numerous studies have examined the effects of obesity and aging on fat metabolism independently, research on their combined effects is limited. In the present study, the protective action against white fat accumulation after a high-fat diet (HFD) exerted by exogenous melatonin, a circadian hormone endowed with antioxidant properties also involved in fat metabolism, was investigated in a mouse model. For this purpose, a battery of tests was applied before and after the dietary and melatonin treatments of the animals, including epididymal white adipose tissue (eWAT) histological evaluations, transcriptomic and lipidomic analyses, real-time PCR tests, immunofluorescence staining, Western blot, the appraisal of serum melatonin levels, and transmission electron microscopy. This study found that aged mice on a high-fat diet (HFD) showed increased lipid deposition, inflammation, and reduced antioxidant glutathione (GSH) levels compared to younger mice. Lipidomic and transcriptomic analyses revealed elevated triglycerides, diglycerides, ceramides, and cholesterol, along with decreased sphingomyelin and fatty acids in eWAT. The genes linked to inflammation, NF-κB signaling, autophagy, and lipid metabolism, particularly the melatonin and glutathione pathways, were significantly altered. The aged HFD mice also exhibited reduced melatonin levels in serum and eWAT. Melatonin supplementation reduced lipid deposition, increased melatonin and GSH levels, and upregulated AANAT and MTNR1A expression in eWAT, suggesting that melatonin alleviates eWAT damage via the MTNR1A pathway. It also suppressed inflammatory markers (e.g., TNF-α, NLRP3, NF-κB, IL-1β, and CEBPB) and preserved mitochondrial function through enhanced mitophagy. This study highlights how aging and HFD affect lipid metabolism and gene expression, offering potential intervention strategies. These findings provide important insights into the mechanisms of fat deposition associated with aging and a high-fat diet, suggesting potential intervention strategies.

Based on SICAS Model: Research on New Media Marketing Strategy of Cotti Coffee

With the development of people’s living standards and changes in habits, people’s demand for coffee continues to expand. And more and more coffee brands enter the market. In such a fierce market competition, Cotti Coffee quickly entered the market with its price advantage, and adopted some new media marketing strategies to expand its market share. Although its new media marketing strategy has achieved initial results, there are still some shortcomings. So this paper studies the current situation of new media marketing based on the SICAS model and puts forward corresponding optimization suggestions. Fristly, paper analyzes the background of the coffee consuming industry, and then analyzes the theory of SICAS model. Secondly, based on the SICAS model, a consumer questionaire was designed to investigate the new media marketing effect. Finally, according to the survey result, the SICAS model was built and targeted measures were proposed to solve the problems in the new media marketing process of Cotti Coffee. The purpose of paper is to provide improvement measures in new media marketing for Cotti Coffee, and further enrich the content of new media marketing.

Public Transport Demand Elasticities in Developing Agglomerations: The Case of Tunisian Regions

Abstract This paper examined the characteristics of public transport demand in some major Tunisian cities. It followed the research trend which calculated the public transport demand elasticities. The adopted procedure in this study consists in estimating a log linear dynamic panel model relating per capita bus patronage to bus fares, users’ income, and service quality. Two variants of the basic model were estimated for the most important Tunisian agglomerations for the period 2003-2020. In the first variant, this paper considered the same fare elasticity value for the different regions, whereas in the second it’s proceeded to the calculation of specific fare elasticity values for each region. The estimation results show interesting and different elasticities compared to those revealed by earlier studies for occidental agglomerations. This result can be explained by specifics users’ characteristics and networks’ configuration. Although these results may sometimes contradict the theoretical suggestions, they still highlight the specificities of the public transport demand in Tunisia and its users’ characteristics. The demand for public transport in large Tunisian agglomerations is not very sensitive to fares changes. Second, income does not have the same effect as that advocated by economic theories. Indeed, we have found a positive impact of income on demand for public transport. Finally, the quality of service has the most important effect on demand. Changes in travel habits and cultures, improvements in the quality of services and their differentiation can be more effective for public transport than fares changes.

Species differences of fatty liver diseases: Comparisons between human and feline.

Nonalcoholic fatty liver disease (NAFLD) has emerged as the most widespread chronic liver disease that poses significant threats to public health due to changes in dietary habits and lifestyle patterns. The transition from simple steatosis to nonalcoholic steatohepatitis (NASH) markedly increases the risk of developing cirrhosis, hepatocellular carcinoma, and liver failure in patients. However, there is only one FDA approved therapeutic drug in the world, and the clinical demand is huge. There is significant clinical heterogeneity among patients with NAFLD, and it is challenging to fully understand human NAFLD using only a single animal model. Interestingly, felines, like humans, are particularly prone to spontaneous fatty liver disease. This review summarized and compared etiology, clinical features, pathological characteristics, and molecular pathogenesis between human fatty liver and feline hepatic lipidosis (FHL). We analyzed the key similarities and differences of those two species, aiming to provide theoretical foundations for developing effective strategies for the treatment of NAFLD in clinic.

Factors Impacting the Adoption and Potential Reimbursement of a Virtual Reality Tool for Pain Management in Switzerland: Qualitative Case Study.

Pain and its adequate treatment are an issue in hospitals and emergency departments (EDs). A virtual reality (VR) tool to manage pain could act as a valuable complement to common pharmaceutical analgesics. While efficacy could be shown in previous studies, this does not assure clinical adoption in EDs. The main aim of this study was to investigate which factors affect the adoption and potential reimbursement of a VR tool for pain management in the ED of a Swiss university hospital. Key informant interviews were conducted using in-depth semistructured interviews with 11 participants reflecting the perspectives of all the relevant stakeholder groups, including physicians, nurses, patients, health technology providers, and health insurance and reimbursement experts. The interviews were recorded and transcribed, and the extracted data were systematically analyzed using a thematic analysis and narrative synthesis of emergent themes. A consolidated framework for eHealth adoption was used to enable a systematic investigation of the topic and help determine which adoption factors are considered as facilitators or barriers or as not particularly relevant for the tool subject of this study. According to the participants, the three key facilitators are (1) organizational environment; (2) tension for change, ease of use, and demonstrability; and (3) employee engagement. Further, the three key barriers to adoption are (1) workload, (2) changes in clinical workflow and habit, and (3) reimbursement. This study concludes that the adoption of a VR tool for pain management in the ED of the hospital subject of this study, although benefiting from a high tension for change in pain and workload management, is highly dependent on the respective organizational environment, engagement of the clinical staff, and reimbursement considerations. While tailored incentive structures and ambassador roles could benefit initial adoption, a change in the reimbursement landscape and further investigation of the positive effects on workflow effectiveness are required to drive long-term adoption.

Impact of Self-Reported Long-Term Mental Health Morbidity on Help-Seeking and Diagnostic Testing for Bowel-Related Cancer Symptoms: A Vignette Study.

To investigate if pre-existing mental health morbidity (MHM) might influence help-seeking and willingness to undergo diagnostic investigations for potential colorectal cancer (CRC) symptoms. An online vignette survey was completed by 1307 adults aged > 50 years recruited through Prolific, a UK panel provider. Participants self-reported any chronic physical or MHM. After having been presented with vignettes describing new onset symptoms (rectal bleeding or change in bowel habit), participants answered questions on symptom attribution and attitudes to investigations. Using multivariable logistic regression we examined the association between MHM and symptom attribution, intended help-seeking, and willingness to undergo investigations, controlling for socio-demographic factors and physical morbidities. Self-reported MHM (reported by 14% of participants) was not associated with cancer symptom attribution (29% of participants with or without MHM mentioned cancer as a possible reason for rectal bleeding and 14% for change in bowel habit). Individuals with self-reported MHM were less likely to contact a GP if experiencing a change in bowel habit (19% vs. 39%; adjusted (a)OR = 0.34, 95% CI 0.19-0.60) and to mention rectal bleeding to their GP (83% vs. 89%, aOR = 0.49, 95% CI 0.26-0.94). Although most participants would be willing to undergo a colonoscopy for these high-risk symptoms, those with depression/anxiety were less willing (90% vs. 96%; aOR: 0.37, 95% CI 0.16-0.87). Individuals with self-reported MHM are less likely to seek help and less willing to undergo investigations for high-risk symptoms. Targeted support, for example, through additional mental health nurses, might facilitate prompt cancer diagnosis for the large group of people with MHM.

Wastewater treatment plants circular performance models evaluation: Portugal case-study

Population growth, economic growth, and changes in societal habits have led to significant changes in resource consumption. Therefore, it's crucial to accelerate the “reduce, reuse, recycle, and recover” of resources to ensure the balance of ecosystems, and water is surely one of the most fundamental resources. The acceleration of this approach in the water cycle makes sense only if we combine a circular economy (CE) transition with a sustainable perspective. In this context, more rational usage of water resources (which are under pressure) and more sustainable wastewater practices are expected to be a way towards the CE in the water and wastewater sector. This study provides a description and evaluation of existing frameworks that can be used to measure and assess the level of circularity of the wastewater treatment plant (WWTP). The treatment of urban wastewater requires new concepts of management and operation for the adaptation of existing plants, which lack robustness and flexibility, to face these new challenges and requirements because we can no longer continue to look at the WWTP only as treatment units, but as wastewater resource recovery facilities. This transformation must be transposed according to a matrix that allows the assessment to describe the current situation, analyse the problem, identify vulnerabilities and opportunities, identify, and evaluate measures, and identify and evaluate strategies. Considering that decision-makers face profound uncertainties such as climate change, population growth, population needs, innovative technologies, economic developments, ecosystem preservation and the impacts of human and natural activities.

Analysis of diversity and an updated catalog of mosquito species (Diptera: Culicidae) in the Capivari-Monos Environmental Protection Area, São Paulo, Brazil.

The Capivari-Monos Environmental Protection Area (EPA) is located in the southern part of the São Paulo city Green Belt. Since the 1950s, this region has been affected by uncontrolled urban sprawl, resulting in a change in the ecological habits of some vector mosquitoes. Over the last two decades, cases of autochthonous bromeliad malaria associated with the presence of anopheline mosquitoes in the EPA have been recorded. Anopheles cruzii, the primary vector of plasmodia in the region, is abundant and found naturally infected with both Plasmodium vivax and Plasmodium malariae. In light of this, the present study sought to update the catalog of mosquito fauna in this EPA, analyze mosquito diversity among sites with different degrees of conservation and compare species using different collection techniques. Field collections were carried out from March, 2015 to April, 2017. A total of 20,755 specimens were collected, distributed in 106 different taxa representing 16 genera. Analysis of the diversity among the sites based on the Shannon and Simpson indices showed that the most preserved of them had the lowest indices because of the dominance of An. cruzii. The results highlight the increase in the number of different taxa collected as different mosquito collection techniques were included, confirming the importance of using several strategies to ensure adequate sampling of a local mosquito fauna when exploring a greater number of ecotopes. Furthermore, the survey produced the most recent and complete list of mosquito species in the Capivari-Monos EPA, a refuge and shelter for native and introduced mosquito species where new biocenoses, including pathogens, vertebrate hosts, and vectors can form, allowing zoonotic outbreaks in the local human population to occur.

Metabolic Syndrome Prevalence Change Before and After the COVID-19 Epidemic: Using Data from the National Health and Nutrition Examination Survey 2018-2021

Objectives: In this study, we aim to investigate changes in the prevalence and risk factors of metabolic syndrome before and after the COVID-19 epidemic. Methods: A cross-sectional survey was conducted using data from the 2018-2021 National Health and Nutrition Examination Survey, and 21,159 people were selected for analysis. SPSS version 29.0 program was used to analyze data, and frequency analysis and chi-square test were performed to determine the frequency and ratio of demographic and health behavioral factors before and after the COVID-19 epidemic, and the distribution of metabolic syndrome prevalence. The risk of occurrence by metabolic syndrome prevalence factor was analyzed through logistic regression. Results: As a result of the study, the prevalence of metabolic syndrome increased after the COVID-19 epidemic, and among the five diagnostic criteria, waist circumference, fasting blood sugar, triglycerides, and HDL-cholesterol, excluding blood pressure, increased significantly. In addition, the risk of metabolic syndrome was 1.16 times higher after the COVID-19 epidemic compared to before, and even after controlling for variables such as demographic factors, it was significantly higher at 1.14 times compared to before. Conclusions: Through this study, the prevalence of metabolic syndrome increased during the COVID-19 epidemic due to changes in lifestyle habits, such as decreased activity. If times like the COVID-19 epidemic repeat in the future, we recommend adding and promoting measures that can help manage chronic diseases such as metabolic syndrome when creating national action guidelines to prevent infectious diseases.

PENGARUH TRAINING OF TRAINER KESEHATAN GIGI DAN MULUT PADA GURU DAN ORANG TUA TERHADAP PERUBAHAN PERILAKU MENGGOSOK GIGI SISWA SISWI SDIT AL-USWAH

Oral and dental health is an essential aspect of general health that must be maintained from an early age. This study aims to evaluate the impact of the Training of Trainer (ToT) program on dental and oral health for teachers and parents on changing tooth brushing behavior among students at SDIT Al-Uswah Surabaya. The methods used include surveys, training, evaluations, and observations of a tooth-brushing calendar filled out over 21 days. The results showed an increase in knowledge among teachers and parents, as well as positive changes in students' habits of brushing their teeth twice daily. These results highlight the importance of the role of teachers and parents in supporting dental and oral health promotion for children, which is expected to reduce the risk of dental caries in the future.

UrologiQ: AI-based accurate detection, measurement and reporting of stones in CT-KUB scans.

Kidney stone disease is becoming increasingly common worldwide, with its prevalence increasing annually across all age groups, races, and geographic regions. This sharp increase may be due to significant changes in dietary habits. Early and accurate detection of kidney stones is crucial for timely intervention and prevention of complications. This article discusses the role of artificial intelligence (AI) in detecting kidney stones and managing surgical treatments. Recent advances in AI techniques have introduced new tools that improve the diagnosis and analysis of medical images. AI can use CT-KUB image data to accurately detect the location of kidney stones and measure their size more efficiently than manual methods. AI-based detection methods ensure greater precision and consistency in stone identification and measurement. These improvements can help doctors plan treatments more effectively, resulting in a higher success rate for patients. Integrating AI into kidney stone detection and analysis significantly improves treatment planning and patient management, leading to better patient outcomes and overall quality of healthcare.

An investigation into water consumption by university students: actions, beliefs and perceptions

Sustainable development requires water resources, and the supply of water is directly linked to economic growth, political and social issues. This article presents the findings of a research study conducted to identify actions, beliefs and perceptions regarding water consumption among students and the possible associations between actions related to water conservation and demographic, socioeconomic and cultural variables. In addition, we aimed at finding any changes in water use habits due to the COVID-19 pandemic. The study was carried out at a university in the city of Joinville (southern Brazil). Non-probabilistic quota sampling was implemented and a total of 246 responses were obtained. Exploratory data analysis was performed by means of descriptive and graphical measures. Classical statistical tests were applied to identify possible associations. The results provided information on the use of water for personal hygiene and cleaning, among others. Based on the understanding of the consumption habits, more targeted awareness-raising actions can be prioritized.

Colorectal Cancer in Elderly Patients: Insights into Presentations, Prognosis, and Patient Outcomes

Background and Objectives: Colorectal cancer (CRC) ranks as the third most prevalent cancer globally and is the third leading cause of cancer-related deaths. In 2020 alone, there were over 1.9 million new cases of CRC and nearly 0.9 million deaths worldwide. The incidence and outcomes of CRC exhibit significant geographical and temporal variations, largely influenced by diverse risk factors among populations. Recognizing the prognostic factors and the presenting symptoms of CRC, a leading global cancer with high mortality, can enhance early detection and thereby improve clinical outcomes. Materials and Methods: This retrospective, observational study analyzed 724 CRC elderly patients aged 70 and over (median age 80, 53.17% male), treated at a single center. Data on demographics, clinical characteristics, and outcomes were collected. Overall survival was analyzed using Kaplan–Meier curves, with stratification based on tumor location, disease staging, lymph node involvement, and family history. Results: Our study encompassed all CRC cases treated with surgery and systemic therapies (chemotherapy or biological agents) from July 2002 to September 2020. We focused on comparing prognosis between left-sided and right-sided CRC, as well as rectal cancer. We found that left-sided CRC demonstrated a superior prognosis compared to rectal cancer (p = 0.0022). Furthermore, among patients with CRC, tumors originating in the rectum were associated with worse outcomes compared to those arising in both the right and left colon, regardless of disease stage (p = 0.0049). Additionally, a family history of CRC was associated with poorer prognosis, impacting both metastatic (p = 0.0022) and localized disease (p = 0.035). The main symptoms prompting patients to start an investigation of CRC were abdominal pain (31.49%), anemia (18.08%), rectal bleeding (hematochezia) (17.82%), change in bowel habits (9.94%), and weight loss (7.60%). Conclusions: This study provides valuable insights into the symptoms prompting initial investigation and the prognostic factors associated with CRC in an elderly population with varied characteristics. It underscores the need for increased vigilance in recognizing key symptoms and the importance of personalized treatment strategies tailored to these prognostic factors.

Social Infrastructure During the COVID-19 Pandemic: Evaluating the Impact of Outdoor Recreation on Pandemic Dynamics in Europe

The COVID-19 pandemic has drastically affected mental and physical well-being, leading to significant changes in daily habits and preferences. Given that pandemics require the tear down of most social ties and interactions to limit their inevitable spread, this study delved into the extent to which social infrastructures have been affected, focusing on behavioral shifts in essential services such as retail, recreation, groceries, pharmacies, public transport, parks and open spaces, workplaces, and residential areas. Notably, while most social infrastructures saw a decline in public usage, parks and open spaces experienced increased visitation despite public health measures aimed at minimizing social interactions. This striking increase in park and open space visitations has captured the interest of this study to observe the impact it had on the trajectory of the COVID-19 pandemic, as well as the underlying causes behind this trend. Since Europe was heavily affected by the pandemic, this study focused specifically on European countries over a two-year period (March 2020 to March 2022), covering the severe period of the pandemic. While parks and open spaces initially showed no direct influence on the pandemic trajectory, when closely observing visitation trends, both increases and declines, opposing insights were revealed. This study found that attempts to reduce park and open space visitation were significantly unsuccessful, leading to substantial increases in both the magnitude and duration of visits once restrictions were eased. This surge in park and open space attendance corresponded to notable spikes in new infections during periods of peak visitation. Therefore, urban planning and public health authorities must prioritize safely accommodating the increased park and open space demand while effectively minimizing virus transmission. This involves considering park sizes and proximity, along with implementing a balanced set of crucial public health strategies to support community well-being and resilience.

Trends and Symptoms Among Increasing Proportion of African Americans with Early-Onset Colorectal Cancer over a 60-Year Period.

The proportion of early onset colorectal cancer (EOCRC) is alarming in adults, including in African Americans (AA). To investigate differences between EOCRC compared to late-onset colorectal cancer (LOCRC) among AA patients. This retrospective study reviewed demographic, clinical presentations, colonoscopy, and pathology reports of patients at Howard University Hospital from 1959 to 2023. The study included 176 EOCRC cases (< 45years) and 2034 LOCRC cases (> 45years). Both EOCRC and LOCRC groups were predominantly AA (> 80%) with slightly more females (53%) than males. The mean age was 38years for EOCRC and 66years for LOCRC cases. EOCRC cases increased as a proportion of total detected CRC cases since 2010 (over 13%) after several decades of just above 6%. Family history of CRC in first degree relatives was higher among EOCRC (15.5% vs.3.4% in LOCRC patients, p < 0.01). Symptoms at presentation were prevalent in both EOCRC (93.8%) and LOCRC (92.6%). EOCRC patients exhibited higher incidence of abdominal pain (23.3% vs. 17.2%, p = 0.05) and changes in bowel habits (24.4% vs. 14%, p < 0.01) compared to LOCRC patients. Other symptoms such as melena, hematochezia, and weight loss were less prevalent in EOCRC patients. Comorbidities like hypertension (HTN), diabetes mellitus (DM), and inflammatory bowel disease (IBD) were less frequent among EOCRC patients. EOCRC was primarily observed in the sigmoid and rectosigmoid regions (p = 0.02). Metastasis at index colonoscopy was more prevalent with EOCRC compared to LOCRC (p = 0.04), with a higher proportion of patients at stage 3 cancer (p < 0.05). Significant differences were noted in the timeline for undergoing surgery after the diagnosis of colorectal cancer, with EOCRC patients taking longer than LOCRC patients (p = 0.03). Presentation of EOCRC over LOCRC increased proportionally in our cohort since 2010 and is associated with family history, and symptoms such as abdominal pain and change in bowel habits. Likely because of age at presentation, there are less comorbidities among EOCRC patients who predominantly present in the outpatient setting, and more likely diagnosed with advanced stage lesions that are predominantly sigmoid or rectosigmoid. These findings are similar to observations seen in the general population with EOCRC, albeit African American patients have commonly had earlier age presentation of CRC than White American patients.

Cancer incidence and competing mortality risk following 15 presenting symptoms in primary care: a population-based cohort study using electronic healthcare records

·ObjectivesAssessment of age, sex and smoking-specific risk of cancer diagnosis and non-cancer mortality following primary care consultation for 15 new-onset symptoms.Methods and analysisData on patients aged 30–99 in 2007–2017 were...

Portuguese Lipid Study (e_LIPID).

Background/Objectives: Incidence of cardiovascular disease (CVD) is increasing in low- and middle-income countries because of changing lifestyles. Since dyslipidaemia is a major independent cardiovascular risk factor, its correct identification is critical to implement specific interventions for CVD prevention. This study aimed to characterise the lipid profile of the Portuguese population. Methods: Overall, 1688 individuals from the general population (e_COR study, 2012-2014) were included. Population-specific percentiles for ten lipid biomarkers were estimated by bootstrapping methods to ensure national representativity. Statistical analyses were performed using RStudio. Results: The 50th percentile estimated for total cholesterol (TC), LDL-C, and non-HDL-C are similar to scientific societies recommended values for the general (low or moderate risk) population. National prevalence of having lipid parameters above recommended values was 64.6%, 66.9%, 51.3%, 68.9%, 17.8%, and 21.1% for TC, LDL-C, apoB, non-HDL-C, triglycerides, and Lp(a), respectively; these values are generally higher in men and increasing with age, except for Lp(a). A high prevalence of severe dyslipidaemia (>90th percentile) was identified, highest for small dense LDL-C (31.3%), apoB (30.4%), and LDL-C (30.3%). The national prevalence of CVD events was 5%. Three individuals were genetically identified with familial hypercholesterolemia, a high CVD risk condition. Conclusions: We provide for the first-time lipid biomarker percentiles for the general Portuguese population. Our results highlight that hypercholesterolemia is a neglected cardiovascular risk factor with over half of the population with TC, LDL-C, and apoB above recommended values. Since hypercholesterolemia is a modifiable risk factor, strategies to increase adherence to changes in lifestyle habits and medication need to be urgently discussed.