Prevalence In Europe Research Articles

The EKiTE network (epidemiology in kidney transplantation - a European validated database): an initiative epidemiological and translational European collaborative research

BackgroundKidney transplantation is considered to be the treatment of choice for people with end-stage renal disease (ESRD). However, due to the shortage of available organs and the increase in the ESRD prevalence in Europe, it is essential to improve transplantation outcomes by studying the related prognostic factors. Today, there is no European registry collecting data to perform such clinical epidemiology studies.Main bodyEntitled EKiTE, for European cohort for Kidney Transplantation Epidemiology, this prospective and multicentric cohort includes patients from Spanish (Barcelona), Belgian (Leuven), Norwegian (Oslo) and French (Paris Necker, Lyon, Nantes, Nancy, Montpellier, Nice and Paris Saint Louis) transplantation centers and currently contains 13,394 adult recipients of kidney (only) transplantation from 2005 and updated annually. A large set of parameters collected from transplantation until graft failure or death with numbers of post-transplantation outcomes. The long-term follow-up and the collected data enable a wide range of possible survival and longitudinal analyses.ConclusionEKiTE is a multicentric cohort aiming to better assess the natural history of the ESRD in European kidney transplant recipients and perform benchmarking of clinical practices. The data are available for clinical epidemiology studies and open for external investigators upon request to the scientific council. Short-term perspectives are to extend EKITE network to other European countries and collect additional parameters in respect of the common thesaurus.

Are smokers "hardening" or rather "softening"? An ecological and multilevel analysis across 28 European Union countries.

Tobacco control policies can reduce smoking prevalence. These measures may be less effective where smoking prevalence has significantly declined, as the remaining smokers have "hardened". Our aim was to empirically evaluate the "hardening hypothesis" at the population level in the European Union (EU) and explore factors associated with hardcore smoking. We conducted two separate analyses in the EU using data on smoking from the Eurobarometer surveys (2009-2017, n=112 745). 1) A panel-data fixed-effects linear regression to investigate changes over time in the percentage of hardcore smokers in relation to standardised smoking prevalence at the country level. 2) A multilevel logistic regression analysis with hardcore (daily smokers, ≥15 cigarettes per day who have not attempted to quit in the last 12 months) or light (<5 cigarettes per day) smoking as the dependent variable and time as the main independent variable, controlling for individual and ecological variables. We studied 29 010 current smokers (43.8% hardcore smokers and 14.7% light smokers). The prevalence of hardcore smoking among adult smokers increased by 0.55 (95% CI 0.14-0.96) percentage points per each additional percentage point in the overall smoking prevalence. The odds of being a hardcore smoker increased over time and were higher in middle-aged males and people with financial difficulties, while the odds of being a light smoker significantly declined among females. This study does not support the "hardening hypothesis" in the EU between 2009 and 2017, but suggests a softening of the smoking population. Existing tobacco control policies are likely to be suitable to further decrease smoking prevalence in Europe.

2393-PUB: First Metabolic Control Results in Insulin-Treated Diabetes Patients from Republic of Macedonia Derived from National eHealth System

Republic of Macedonia (RoM) is estimated to have third highest diabetes prevalence in Europe. National eHealth System (NeHS) was introduced since 2015, enabling physicians to optionally record metabolic parameters. Our aim was to evaluate national metabolic control in insulin-treated pts, based on data derived from NeHS. NeHS was searched for all insulin-treated pts, as of 01-May-2017, with data in their Electronic Healthcare Records (EHR) for any of following parameters: HbA1c, BMI, Total Cholesterol (TC), LDL Cholesterol (LDL), Triglycerides (TG), Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP). Mean values were calculated and number of pts identified to pre-specified thresholds: HbA1c - 7% and 8%; BMI - 25 kg/m2 and 30 kg/m2; TC - 5 mmol/l; LDL - 2.6 mmol/l; TG - 1.7 mmol/l; SBP - 140 mmHg and DBP - 90 mmHg. Total number of insulin-treated pts in RoM was 37,011 out of 84,568 diagnosed pts (43.8%). Of those, 6.204 (16.8%), mean age 63.8 ± 11.7 years, 54.7% women, were identified as having data in EHR for any metabolic parameter. Mean HbA1c was 7.8 ± 1.8% (n=6,204); 2,346 pts (37.8%) ≤ 7%, 1,607 (25.9%) &amp;gt;7% and ≤ 8%; and 2,251 (36.3%) &amp;gt;8%. Mean BMI was 30.4 ± 5.2 kg/m2 (n=1,920); 273 pts (14.2%) ≤ 25 kg/m2, 739 (38.5%) &amp;gt;25 and ≤ 30 kg/m2, and 908 (47.3%) &amp;gt;30 kg/m2. Mean TC was 5.3 ± 1.4 mmol/l (n=1,838); 988 pts (53.8%) &amp;gt;5 mmol/l. Mean LDL was 3.2 ± 1.1 mmol/l (n=433); 290 pts (67.0%) &amp;gt;2.6 mmol/l. Mean TG was 2.3 ± 1.6 mmol/l (n=1,588); 938 pts (59.1%) &amp;gt;1.7 mmol/l. Mean SBP was 134.5 ± 17.3 mmHg (n=1,055); 232 pts (22.0%) &amp;gt;140 mmHg. Mean DBP was 81.1 ± 8.5 mmHg (n=1,055); 65 pts (6.2%) &amp;gt;90 mmHg. These are the first metabolic control results in insulin-treated pts from RoM, derived from NeHS. There is a need for improvement of glycemic control (36.3% of pts with HbA1c &amp;gt;8%), weight and lipid management. Since 16.8% of pts have any metabolic data in EHR, change from optional to mandatory recording is necessary to improve individual and national metabolic control. Disclosure I. Smokovski: Advisory Panel; Self; Sanofi. T. Milenkovic: None.

Health State Utility Data in Cystic Fibrosis: A Systematic Review.

IntroductionCystic fibrosis (CF) is a life-limiting, hereditable condition, with the highest prevalence in Europe. CF treatments have led to improvements in clinical symptoms, disease management and decelerated disease progression. However, little is known about the health state utility (HSU) associated with CF disease states, adverse events, and changes in disease severity. Although HSU data have contributed to existing health economic modelling studies, a lack of such data have been highlighted. This systematic review aims to provide a summary of HSU-related research in CF and highlight related research gaps.MethodsOnline searches were performed in six databases and studies in any of the following categories were included: (1) estimation of HSUs in CF; (2) mapping studies between patient-reported outcome measures (PROMs) and HSUs; (3) economic evaluations on the management of CF that report primary HSU data; and (4) any CF clinical trial that reported HSU as an outcome.ResultsA total of 17 studies were reviewed, of which 12 provided HSU values for specific CF populations. The remaining five articles provided HSU data that were broken down by CF relevant health states, including lung transplantations, pulmonary exacerbation (PEx) events and forced expiratory volume in 1 s (FEV1).ConclusionCurrent HSU data in CF are limited and there is considerable scope for further research, both in providing HSU values for CF and in investigating methods for HSU elicitation/evaluation in CF populations.Electronic supplementary materialThe online version of this article (10.1007/s41669-019-0144-1) contains supplementary material, which is available to authorized users.

Tobacco control: prevention and cessation in Europe

Reasons for high smoking prevalence in Europe compared to Australia and North America are low prices of tobacco adjusted for purchasing power and poor smoke-free legislation and enforcement in Central and Eastern Europe. High rates of passive smoking in Czechia, Slovakia, Poland and Austria are associated with weak implementation of smoke-free public rooms, especially in the hospitality industry. In 2018 Austria cancelled the smoking ban in all bars and restaurants and continued to allow access to minors, while Hungary since 2012 showed remarkable success by limiting supply of cigarettes and by banning access of minors to tobacco shops. Even more advanced are Western European countries because of lower affordability of cigarettes, ban of smoking rooms and tobacco advertising, plain packaging and public information campaigns. Smoking cessation services across Europe make use of quitlines, provide internet counseling and apps for self-help. Cooperation with physicians should be improved and could help oncologists to combine cancer screening with smoking cessation. Cancer therapy is more successful after smoking cessation.

Antibiotic resistance in European wastewater treatment plants mirrors the pattern of clinical antibiotic resistance prevalence.

Integrated antibiotic resistance (AR) surveillance is one of the objectives of the World Health Organization global action plan on antimicrobial resistance. Urban wastewater treatment plants (UWTPs) are among the most important receptors and sources of environmental AR. On the basis of the consistent observation of an increasing north-to-south clinical AR prevalence in Europe, this study compared the influent and final effluent of 12 UWTPs located in seven countries (Portugal, Spain, Ireland, Cyprus, Germany, Finland, and Norway). Using highly parallel quantitative polymerase chain reaction, we analyzed 229 resistance genes and 25 mobile genetic elements. This first trans-Europe surveillance showed that UWTP AR profiles mirror the AR gradient observed in clinics. Antibiotic use, environmental temperature, and UWTP size were important factors related with resistance persistence and spread in the environment. These results highlight the need to implement regular surveillance and control measures, which may need to be appropriate for the geographic regions.

Prevalence of frailty at population level in European ADVANTAGE Joint Action Member States: a systematic review and meta-analysis.

Although frailty is common among community-dwelling older adults, its prevalence in Europe and how this varies between countries is unclear. A systematic review and meta-analysis of literature on frailty prevalence in 22 European countries involved in the Joint Action ADVANTAGE was conducted. Sixty-two papers, representing 68 unique datasets were included. Meta-analysis showed an overall estimated frailty prevalence of 18% (95% confidence interval, CI, 15-21%). The prevalence in community (n = 53) vs non-community based studies (n = 15) was 12% (95% CI 10-15%) and 45% (95% CI 27-63%), respectively. Pooled prevalence in community studies adopting a physical phenotype was 12% (95% CI 10-14%, n = 45) vs 16% (95% CI 7-29%, n = 8) for all other definitions. Sub-analysis of a subgroup of studies assessed as high-quality (n = 47) gave a pooled estimate of 17% (95% CI 13-21%). The considerable and significant heterogeneity found warrants the development of common methodological approaches to provide accurate and comparable frailty prevalence estimates at population-level.

Do overweight and obesity prevalence rates converge in Europe?

We exploit recently published data to evaluate the long-run evolution of overweight and obesity rates among European economies between 1975 and 2016. We find that overweight rates for both females and males converge in Europe. In particular, the convergence is driven by the nations in the EU. This fact is consistent with food patterns as well as trade, agricultural, and health policies that are common among EU members. Across our model specifications, the steady-state average overweight rate ranges between 60% and 77% for European female individuals and lies above 82% for their male counterparts. Confidence intervals suggest that such gender differences are statistically significant. In the EU, the point estimates of these rates are 62% and 91%, respectively. Obesity prevalence in Europe would reach long-term rates of 39% and 45% for females and males respectively, whereas these rates would be similar in the EU (approximately 28%).

Global Prevalence of Asymptomatic Norovirus Infection: A Meta-analysis

BackgroundStudies about asymptomatic norovirus infections have been frequently reported. We aim to assess the global prevalence of asymptomatic infections. MethodWe identified publications that included the proportion of asymptomatic norovirus infections by searching in PubMed, Ovid, Scopus, and Web of Science and by screening references from the articles reviewed. The principal summary data were the prevalence of asymptomatic norovirus infection. Random-effect models for meta-analysis were fitted to generate estimates of overall and subgroup prevalence. FindingsOf 81 studies included, asymptomatic norovirus prevalence was estimated at 7% (95% CI: 6%–9%). Africa, Meso America and South America had higher prevalence (15%, 14%, 11%, respectively) while the prevalence in Europe and North America was lower (4%). Prevalence was similar between community and hospital (9%). Prevalence was higher in children (8%) than adults (4%). For food handlers, prevalence was estimated at 3%. In context of outbreaks, prevalence estimated from 15 studies was as high as 18% (95% CI: 10%–30%). InterpretationThis knowledge could have an impact on the development of transmission prevention strategies in the future. The high prevalence indicated asymptomatic individuals must not be overlooked. Outstanding questionsThe high prevalence indicated asymptomatic individuals must not be overlooked. Asymptomatic individuals may play an important role in norovirus transmission. This knowledge could have an impact on the development of transmission prevention strategies.

Prevalence of asthma among the adult general population of five Middle Eastern countries: results of the SNAPSHOT\xa0program

BackgroundAsthma is a common chronic respiratory disease leading to morbidity, mortality and impaired quality of life worldwide. Information on asthma prevalence in the Middle East is fragmented and relatively out-dated. The SNAPSHOT program was conducted to obtain updated information.MethodsSNAPSHOT is a cross-sectional epidemiological program carried out in five Middle Eastern countries (Egypt, Turkey, Kuwait, Saudi Arabia, and the United Arab Emirates, the latter three grouped into a Gulf cluster) to collect data on asthma, allergic rhinitis, benign prostatic hyperplasia and bipolar disorder. The survey was carried out by telephone in a random sample of the adult general population with quotas defined according to country demographics. The analysis presented in this paper focuses on asthma. Subjects were screened for asthma based on criteria from the global Asthma Insights and Reality studies. Current prevalence (last 12 months) was estimated. Multivariate logistic regression analyses were used to investigate risk factors related to asthma and the association with allergic rhinitis and other co-morbidities. Quality of life was assessed using the three-level EQ-5D questionnaire.Results2124 out of the 33,486 subjects enrolled in the SNAPSHOT program fulfilled the criteria for asthma. The adjusted prevalence of asthma ranged from 4.4% [95% CI: 4.0–4.8%] in Turkey, to 6.7% [95% CI: 6.2–7.2%] in Egypt and 7.6% [95% CI: 7.1–8.0%] in the Gulf cluster. Prevalence was higher (p < 0.0001) in women than men and increased with age (p < 0.0001). Co-morbidities occurred more frequently in asthma subjects compared to the non-asthma population (38% vs. 15% p < 0.0001). Subjects with asthma reported a lower (p < 0.0001) EQ-VAS score (68.2 ± 22.9) compared to the general population (78.1 ± 17.5). The risk factors associated with asthma were age, gender, country, and certain co-morbidities, namely respiratory, cardiovascular, gastrointestinal, nervous, and neurological diseases.ConclusionThe observed adjusted prevalence of asthma in the Middle East ranges from 4.4% to 7.6%, which is comparatively lower than the reported prevalence in Europe and North America. Asthma has a negative impact on quality of life, and is associated with high levels of co-morbid diseases, indicating a need for physicians to check for co-morbidities and ensure they are managed correctly in all asthma patients.

Il gioco problematico in Europa: una rassegna della letteratura empirica (2000-2016)

Problem gambling has been identified as an emergent public health issue, and there is a need to identify gambling trends and to regularly update worldwide gambling prevalence rates. This paper reviews recent research on adult gambling and problem gambling in Europe (2000-2016). A systematic literature search was carried out using some academic databases, Internet and governmental websites. Following this search and utilizing exclusion criteria, 46 studies on adult gambling prevalence in Europe were identified. These studies demonstrated that there are wide variations in past-year problem gambling rates across different countries in Europe (0.12% to 3.4%). However, it is difficult to directly compare studies due to different methodological procedures, instruments, cut-offs, and time frames. Despite the variability among instruments, some consistent results with regard to demographics were found. Findings highlight the need for continuing monitoring problem gambling prevalence rates in Europe in order to examine the influence of cultural context on gambling patterns, assess the effectiveness of policies on gambling related harms and establish priorities for future research.

Geographical distribution of COPD prevalence in Europe, estimated by an inverse distance weighting interpolation technique.

Existing data on COPD prevalence are limited or totally lacking in many regions of Europe. The geographic information system inverse distance weighted (IDW) interpolation technique has proved to be an effective tool in spatial distribution estimation of epidemiological variables, when real data are few and widely separated. Therefore, in order to represent cartographically the prevalence of COPD in Europe, an IDW interpolation mapping was performed. The point prevalence data provided by 62 studies from 19 countries (21 from 5 Northern European countries, 11 from 3 Western European countries, 14 from 5 Central European countries, and 16 from 6 Southern European countries) were identified using validated spirometric criteria. Despite the lack of data in many areas (including all regions of the eastern part of the continent), the IDW mapping predicted the COPD prevalence in the whole territory, even in extensive areas lacking real data. Although the quality of the data obtained from some studies may have some limitations related to different confounding factors, this methodology may be a suitable tool for obtaining epidemiological estimates that can enable us to better address this major public health problem.

Discrepancy in prevalence of Huntington's disease in two Swedish regions.

Huntington's disease (HD) is a neurodegenerative disease with an autosomal dominant pattern of inheritance. The prevalence varies between different geographical regions with an estimated average in Europe of about 6/100000. Parts of northern Sweden are known to have an accumulation of HD, but no prevalence studies have been undertaken for 50years. The aim of this study was to estimate the prevalence of HD in the two different Swedish counties of Jämtland and Uppsala and compare them with the reported prevalence in Europe. Patients registered with the diagnosis of HD were identified through medical records in each county. Presymptomatic patients were excluded. We also compared the annual number of individuals with HD registered in the database of the National Board of Health and Welfare in these regions, with all of Sweden. The prevalence of HD was found to be 22.1/100000 in Jämtland and 4.9/100000 in Uppsala county. The mean age was 62.2years and 61.8years, respectively. The annual average of patients with HD registered at inpatient care was 1.5/100000 in Jämtland, 0.44/100000 in Uppsala county, and 0.56/100000 in all of Sweden. The prevalence of patients with the diagnosis of HD is four times higher in the county of Jämtland than in the county of Uppsala, where the prevalence is more similar to the average in Europe. Our results support earlier findings of regional variations of HD prevalence with an accumulation in certain parts of northern Sweden.

Porphyria: Analysis of Register from Brazilian Association of Porphyria (ABRAPO)

1.1.Background:The porphyria is a group of rare metabolic disorders that arise from deficiencies in the heme biosynthetic pathway. The prevalence in Europe is 1-2:100,000 inhabitants. These disorders occur mostly due to mutations in the genes encoding enzymes involved in heme production. They are classified and divided into acute (ALA Dehydratase Deficiency [ALADP], Acute Intermittent Porphyria [AIP], Variegate Porphyria [VP], Hereditary Coproporphyria [HCP]), chronic (Congenital Erythropoietic Porphyria [CEP], Erythropoietic Porphyria [EPP], Porphyria Cutanea Tarda [PCT] and Hepato Erythropoietic Porphyria [HEP]). AIP is the most common form of hepatic porphyria and symptoms are often begin after puberty and consist of acute neurovisceral signs, abdominal pain, vomiting, constipation, tachycardia, fever, hypertension and alterations in the central nervous system. 1.2.Aim:To study the porphyria frequency in Brazil by Associacao Brasileira de Porfiria (ABRAPO- Brazilian Porphyria Association). 1.3.Methods:We study the frequency of porphyria in 439 cases of patients with porphyria diagnosis from ABRAPO from 2007 to 2015 and data were analyzed with Microsoft Excel® program. 1.4.Results:We analyzed 439 cases consisting of 74.2% female. 59% percent had been diagnosed with AIP, 22% PCT, 4% HCP, 4% EPP, 2.5% VP, 1.1% CEP, 0.9% HEP and 0.4% ALADP. 1.5.Conclusion:Our analysis revealed similar epidemiological characteristics as seen in the United States and United Kingdom. In Brazil, porphyria should be studied more carefully to assess, properly diagnosis and treatment.

Colonisation with extended-spectrum β-lactamase-producing Enterobacteriaceae and risk for infection among patients with solid or haematological malignancy: a systematic review and meta-analysis

Cancer patients are vulnerable to infections, including those with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE), and most of these infections are associated with colonisation of the gastrointestinal tract. The aim of this study was to estimate the prevalence of gastrointestinal colonisation with ESBL-PE cancer populations and to determine the risk for subsequent bloodstream infection (BSI) with these pathogens. PubMed and EMBASE databases were searched from 1 January 1991 to 1 March 2016 to identify studies regarding ESBL-PE colonisation among patients with malignancies. Ten studies (out of 561 non-duplicate articles) were included, providing data on 2211 patients. The pooled prevalence of ESBL-PE colonisation was 19% [95% confidence interval (CI) 8–32%]. Stratifying per region, the pooled prevalence in Europe was 15% (95% CI 10–21%), whereas in Asia the pooled prevalence was 31% (95% CI 4–69%). In addition, the pooled prevalence was 15% (95% CI 7–24%) among patients with haematological malignancy, whereas no studies were identified that included solely patients with solid tumours. Notably, cancer patients with ESBL-PE colonisation were 12.98 times (95% CI 3.91–43.06) more likely to develop a BSI with ESBL-PE during their hospitalisation compared with non-colonised patients. We found that, overall, one in five patients with cancer is colonised with ESBL-PE and the incidence can be as high as one in three in Asia. This is important because colonisation was associated with an almost 13 times higher risk for developing BSI with ESBL-PE. Screening measures should be evaluated to identify their clinical benefit in patients with malignancy.

Translation of clinical problems in osteoarthritis into pathophysiological research goals

Osteoarthritis (OA) accounts for more disability among the elderly than any other disease and is associated with an increased mortality rate. The prevalence in Europe will rise in the future...

The prevalence of actinic keratosis in patients visiting dermatologists in two hospitals in China.

Actinic keratosis (AK) is one of the most common conditions treated by dermatologists in western countries. Studies have shown that AK prevalence in Europe, the U.S.A. and Australia is 4·5-60%. No data of AK prevalence in China has been reported. This study aimed to explore the prevalence of AK in patients visiting dermatologists in two hospitals in China. This study was conducted in the dermatology departments of two teaching hospitals (Peking University First Hospital, Beijing, and Fourth Military Medical University, Xi'an). All records for 5 years between 2008 and 2012 with clinically or pathologically diagnosed AKs were collected from the pathological databases of both hospitals. Data from these records were used to calculate the prevalence of AKs among patients who were seen by dermatologists in these hospitals. To estimate the reliability of data from the previous database, a cross-sectional study was conducted simultaneously in the two hospitals from 15 October to 8 December in 2012 after all dermatologists in the two departments were retrained through intensive courses on recognizing AK clinically. The prevalence of total clinical AKs through 2008-2012 was 0·52% in 1 590 817 patient visits in the two hospitals. The yearly prevalence of clinical AKs was 0·30-1·20%. In the cross-sectional study, 72 437 clinical patients were screened and 76 patients (1·05%) were identified to have clinically recognized AK. The overall prevalence of AKs in patients visiting dermatologists in the two hospitals in China was 0·52%, which is much lower than the prevalence in western countries.

ADHD, one of the most challenging mental disorders in adult psychopathology

IntroductionIn 40 to 60% of children with ADHD, the disorder persists into adulthood. Nevertheless, diagnosis in adulthood sometimes becomes a challenge because, even the etiology is not very clear yet, ADHD shares several clinical features or may coexist with other psychiatric disorders. This issue leads to confusion and also to a delayed treatment or a wrong treatment, causing negative effects on patient outcomes.ObjectiveTo highlight the importance of making an accurate differential diagnosis and to consider the coexistence of other mental disorders, in the diagnosis of a patient with ADHD.MethodsSystematic review of the literature in English (Pubmed). Keywords: “adult ADHD”; “bipolar disorder”; “substance abuse”; “personality disorders”.ResultsAdult ADHD has a prevalence in Europe of 3,4% and it seems to appear more frequently in developed countries. In adults, the clinical presentation differs from children. There often are symptoms of impulsivity, attention deficit, restlessness, and emotional dysregulation and risk behavior, causing difficulties in everyday functioning. The coexistence of substance abuse and the similarity between bipolar disorder and personality disorders with ADHD, translate in a difficult diagnosis, especially for patients with mild presentations.ConclusionsSo far, the authors conclude that a detailed clinic history plus the validated scales for adult ADHD are the most reliable tools for diagnosis. Neuroimaging and EEG studies do not provide conclusive data to consider them as diagnostic methods.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Congenital anomalies of the kidney and the urinary tract: A murmansk county birth registry study.

Congenital anomalies of the kidney and the urinary tract (CAKUTs) are relatively common birth defects. The combined prevalence in Europe was 3.3 per 1000 in 2012. The risk factors for these anomalies are not clearly identified. The aims of our study were to calculate the birth prevalences of urinary malformations in Murmansk County during 2006 to 2011 and to investigate related prenatal risk factors. The Murmansk County Birth Registry was the primary source of information and our study included 50,936 singletons in the examination of structure, prevalence and proportional distribution of CAKUTs. The multivariate analyses of risk factors involved 39,322 newborns. The prevalence of CAKUTs was 4.0 per 1000 newborns (95% confidence interval [CI], 3.4-4.5) and did not change during the study period. The most prevalent malformation was congenital hydronephrosis (14.2% of all cases). Diabetes mellitus or gestational diabetes (odds ratio [OR] = 4.77; 95% CI, 1.16-19.65), acute infections while pregnant (OR = 1.83; 95% CI, 1.14-2.94), the use of medication during pregnancy (OR = 2.03; 95% CI, 1.44-2.82), and conception during the summer (OR = 1.75; 95% CI 1.15-2.66) were significantly associated with higher risk of CAKUTs. The overall fourfold enhancement of the occurrence of urinary malformations in Murmansk County for the 2006 to 2011 period showed little annual dependence. During pregnancy, use of medications, infections, pre-existing diabetes mellitus, or gestational diabetes were associated with increased risk of these anomalies, as was conception during summer. Our findings have direct applications in improving prenatal care in Murmansk County and establishing targets for prenatal screening and women's consultations.

Individual and contextual correlates of obesity-related behaviours and obesity: the SPOTLIGHT project.

Individual and contextual correlates of obesity-related behaviours and obesity: the SPOTLIGHT project.