Prospective Epidemiological Study Research Articles

Factors Determining the Three-Year Dynamics of Lipid Metabolism Indicators in Residents of a Large Industrial Region of Siberia

Aim. To assess the contribution of traditional and socio-economic factors to the development and dynamics of dyslipidemia based on the results of an epidemiological study in a large region of Siberia.Material and methods. Clinical and epidemiological prospective study of the population 35-70 years old was carried out. At the basic stage, 1600 participants were examined, including 1124 women and 476 men, the prospective stage included 807 respondents (the response was 84.1%). A survey was carried out to find out the state of health (presence of diseases, taking medications), socio-economic status (level of education and income, marital status) and the presence of behavioral risk factors (tobacco and alcohol use).Results. The proportion of people with hypercholesterolemia increased 1.2 times, low LDL – 1.1 times, and hypertriglyceridemia and low HDL – 1.7 times. In persons with hypertriglyceridemia, the frequency of detected obesity and hypertension decreased by 7.9% and 4.6%, respectively (p = 0.046). Obesity was associated with an increased risk of developing hypercholesterolemia (OR = 1.49, CI: 1.0-2.2), hypertriglyceridemia (OR = 2.14, CI: 1.5-3.0), high LDL cholesterol (OR = 2.16, CI: 1.3-3.6) and low HDL cholesterol (OR = 2.07, CI: 1.5-2.9). The presence of hypertension - with an increased risk of developing hypertriglyceridemia (OR = 2.19, CI: 1.5-3.1) and low HDL (OR = 2.49, CI: 1.8-3.5). Among people with low HDL levels, the number of smokers and drinkers decreased (by 7.0% and 5.7%, respectively), as well as those with obesity by 8.6%. The prevalence of dyslipidemia increased in all socioeconomic groups.Conclusion. Over 3 years of follow-up, there was a statistically significant increase in the proportion of persons with dyslipidemia in all socio-economic groups. There was a significant decrease in such risk factors as obesity, hypertension, smoking, alcohol consumption and an increase in the number of respondents taking lipid-lowering therapy.

Longitudinal study of SARS-CoV-2 infections in different employee groups of long distance train services from June 2020 until February 2021 in Germany.

Abstract This prospective longitudinal epidemiological study was aimed at investigating the occupational SARS-CoV-2 infection risk of long distance train services in Germany. Three different employee groups (train attendants, train drivers and maintenance workers) within the workforce of the German railway carrier Deutsche Bahn Fernverkehr AG were studied based on their contact frequency with passengers and colleagues. Approximately 1100 employees were tested by PCR for acute infections and by antibody detection for past infections in June 2020, October 2020 and February 2021. Cumulative incidence (acute and past infections) after the third (final) test series in February 2021 was 8.5% (95% interval CI 6.8–10.4): 8.5% (95% CI 6.2–11.2) for train attendants, 5.5% (95% CI 2.9–9.5) for train drivers and 11.8% (95% CI 7.6–17.2) for maintenance workers. Between June 2020 and October 2020, the incidence was 1.2% (95% CI 0.6–2.3): 1.2% (95% CI 0.4–2.7) for train attendants, 1.1% (95% CI 0.1–3.9) for train drivers and 1.4% (95% CI 0.17–5.10) for maintenance workers. Between October 2020 and February 2021, it was 5.1% (95% CI 3.6–6.8): 5.2% (95% CI 3.3–7.8) for train attendants, 1.6% (95% CI 0.3–4.5) for train drivers and 8.8% (95% CI 4.9–14.3) for maintenance workers. Thus, contrary to expectation our exploratory data did not show train attendants to be at the highest risk of SARS-CoV-2 infections among the employee groups. In line with expectations, train drivers, representing the low contact group, seemed at lowest occupational risk.

Факторы, предрасполагающие к прогрессированию атеросклероза каротидных артерий у пациентов с артериальной гипертензией

The aim of the research. To study clinical and genetic factors predisposing to progression of carotid artery atherosclerosis among the Shor people based on a 5-year dynamic follow-up of hypertensive patients. Material and methods. A prospective clinical and epidemiological study of the indigenous population of the Mountain Shoria was carried out including patients with arterial hypertension (367 subjects). The dynamics of the intima-media complex thickness and atherosclerotic plaque thickness was assessed 5 years later by repeat ultrasound examination of carotid arteries. Polymorphisms of ACE (I/D, rs 4340), AGT (c.803T>C, rs699), AGTR1 (A1166C, rs5186), ADRB1 (c.145A>G, Ser49Gly, rs1801252), ADRA2B (I/D, rs28365031), MTHFR (C677T, rs1801133) and eNOS (VNTR 4b/4a) genes were tested using polymerase chain reaction. Results. The 5-year observation of the indigenous population of the Mountain Shoria has shown that such factors as the age (p=0.011) and the course of arterial hypertension (3rd-degree AH, duration of the disease for over 10 years, failure to achieve the target level of arterial pressure during treatment) play a significant role in the frequent unfavourable dynamics of the intima-media complex thickness. Th e study has also established association between the development of the atherosclerotic process in carotid arteries and smoking (OR=1.52), abdominal obesity (OR=2.87) and impaired glucose tolerance (OR=2.94). The increased level of low-density lipoprotein cholesterol also determines the negative dynamics as manifested by the growth of the atherosclerotic plaque in brachiocephalic arteries (OR=1.93). A high risk of atherosclerosis in the Shor cohort is associated with carriership of the prognostically unfavourable D alleles of the ACE gene (OR=8.29), C of the AGTR1 gene (OR=7.04) and T of the MTHFR gene (OR=3.25). Conclusion. The 5-year prospective observation of the small indigenous population of the Shors has revealed certain clinical and genetic factors for patients with arterial hypertension that are associated with the carotid artery atherosclerosis. The polymorphism of certain candidate genes is an important strategic biomarker that can be used in the future for early diagnostics of diseases associated with atherosclerosis.

Abdominal obesity is an independent risk factor for the development of fatal and non-fatal cardiovascular events according to the prospective observational epidemiological study ESSE-RF2

Abdominal obesity is an independent risk factor for the development of fatal and non-fatal cardiovascular events according to the prospective observational epidemiological study ESSE-RF2

Reproductive performance of northern Australia beef herds. 5. Factors influencing risk of non-pregnancy

Context Sound reproductive efficiency is a key determinant for the overall productivity and profitability of a beef breeding business. Failure of a cow to conceive results in either culling or the cost of carrying non-pregnant animals. Aims This study aimed to determine and quantify the major factors associated with non-pregnancy in commercial beef breeding herds of northern Australia. Methods A prospective population-based epidemiological study of the likelihood of non-pregnancy in cows after an annual mating in northern Australian beef breeding cows used data from 73 herds from four broad country types and 62 323 animal years; approximately 80 property-, management-group- and cow-level risk factors were considered. A multivariable model building process was employed to scrutinise the resulting dataset, so as to identify what herd management practices, nutritional, environmental, and individual cow factors were associated with non-pregnancy and estimate their magnitude of effect. Key results Non-pregnancy was disproportionately high in the Northern Forest (32.1%), compared with the Northern Downs, Central Forest and Southern Forest where it was 17.1%, 16.0% and 13.2% respectively. Time of expected calving had the largest impact on occurrence of non-pregnancy. Parity also had a significant influence, with first-lactation cows typically having 5–12% higher non-pregnancy than did mature cows. Non-pregnancy decreased with an increasing body condition score at the branding/weaning muster for lactating cows. The difference in non-pregnancy when comparing availability of wet-season pasture phosphorus content and digestibility of pasture during the dry season was 13.2 and 10.2 percentage points respectively. Conclusions This study demonstrated the substantial impact environment, herd management practices, nutrition and disease factors can have on the reproductive performance of females. Implications To optimise the efficiency of females (through reducing the occurrence of non-pregnancy) under commercial conditions in northern Australia, production systems should support beef herds calving early in the production year, being in at least moderate body condition and having access to more digestible pastures that address the nutritional requirements for both protein and phosphorus. This indicates focus for management, especially in the Northern Forest where the likelihood of non-pregnancy was highest.

Enteric protists in wild western chimpanzees (Pan troglodytes verus) and humans in Comoé National Park, Côte d'Ivoire.

The western chimpanzee (Pan troglodytes verus), a subspecies of the common chimpanzee, is currently listed as Critically Endangered. Human-driven habitat loss and infectious diseases are causing dramatic chimpanzee population declines and range contractions that are bringing these primates to the brink of extinction. Little information is currently available on the occurrence of diarrhoea-causing enteric protist species in chimpanzees in general, and in western chimpanzees in particular, or on the role of humans as a potential source of these infections. In this prospective molecular epidemiological study, we investigated the presence, genetic variability, and zoonotic potential of enteric protists in faecal samples from western chimpanzees (n = 124) and humans (n = 9) in Comoé National Park, Côte d'Ivoire. Parasite detection and genotyping were conducted by using polymerase chain reaction (PCR) and Sanger sequencing. The protist species found in the chimpanzee samples were Entamoeba dispar (14.5%), Blastocystis sp. (11.3%), Giardia duodenalis (5.8%), Troglodytella abrassarti (2.5%) and Cryptosporidium hominis (0.8%). The protist species found in the human samples were G. duodenalis (22.2%) and Blastocystis sp. (11.1%). Entamoeba histolytica, Enterocytozoon bieneusi, and Balantioides coli were undetected in both chimpanzee and human samples. Sequence analyses revealed the presence of Blastocystis subtype (ST) 1 (alleles 4 and 8) and ST3 (allele 24) in chimpanzees, and ST3 (allele 52) in humans. ST1 allele 8 represents a chimpanzee-adapted Blastocystis genetic variant. Cross-species transmission of pathogenic enteric protists between chimpanzees and humans might be possible in Comoé National Park, although the frequency and extent of zoonotic events remain to be fully elucidated.

СОЧЕТАННОЕ ПОТРЕБЛЕНИЕ АЛКОГОЛЯ И ТАБАКА И ИХ СВЯЗЬ С ФАКТОРАМИ РИСКА СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ

Over the past few decades, heavy smoking and alcohol use have been shown to results in serious health consequences and are associated with the increased risk of death. Alcohol and tobacco have an individual effect on the human body, but in combination they act synergistically, and the neurochemical processes that occur during their use seem to reinforce each other. The combined impact of tobacco and alcohol consumption on public health is still poorly understood, despite the fact that these two behavioral risk factors for cardiovascular diseases (CVD) often complement each other. The purpose of the study is to analyze prevalence of traditional risk factors for diseases of the circulatory system (DCS) depending on the combination of the behavioral risk factors (smoking and alcohol consumption). Material and methods - 1124 females and 476 males were included in the clinical and epidemiological prospective cohort study. The average age equaled to 54.9 ± 9.75 and 52.6 ± 10.0 years, respectively, p <0.001. Statistical data processing was carried out using the Statistica 6.0 software package. Results - the group of people who never used alcohol and tobacco was associated with the development of significant DCS (OR = 2.2, CI: 1.2-4.1, p = 0.010) and DCS resulting in hospitalization (OR = 1.7 , CI: 1.1-2.7, p = 0.015). The group of people who “smoke but quitted alcohol” was associated with a lower risk of significant DCS resulting in hospitalization (OR = 0.1, CI: 0.01-1.0, p = 0.050) and higher risk of death from all causes (OR = 23.9, CI: 1.0-587.5, p = 0.049). The group of people who “do not use tobacco, but drink alcohol” was associated with a lower risk of significant DCS resulting in hospitalization (OR = 0.3, CI: 0.2-0.7, p = 0.002), significant DCS resulting in hospitalization (OR = 0.5, CI: 0.3-0.8, p = 0.007). The group of people who “quitted tobacco and alcohol” was associated with a higher risk of death from all causes (OR=28.0, CI:1.0-769.8, p=0.047). The group of people who “quitted tobacco but continued to drink alcohol” was also associated with higher risk of death from all causes (OR=7.9, CI: 1.4-43.9, p=0.017). Also, the respondents who smoked but never consumed alcohol had a risk of developing obesity (OR=6.0, CI:1.2-30.0, p=0.027). Conclusion - a complete absence of behavioral risk factors was associated with the risk of developing significant DCS, including those resulted in hospitalization. The risk of death from all causes was higher in individuals who “smoke but quitted alcohol,” “quitted tobacco and alcohol,” and “quitted tobacco, but drink alcohol”.

Production and performance of commercial beef breeding females in northern Australia. 4. Factors influencing the occurrence of lactating cows becoming pregnant within 4 months of calving

Context Sound reproductive efficiency is a key determinant for the overall productivity of a beef breeding business. For beef breeding herds to obtain high levels of reproductive productivity, breeding females need to efficiently become pregnant while lactating. Aims This study aimed to determine and quantify the major factors associated with lactating cows becoming pregnant within 4 months of calving (P4M) in commercial beef breeding herds of northern Australia. Methods A prospective epidemiological study was conducted using 78 commercial northern Australian beef breeding herds and involved 78 000 cattle that were monitored for 3–4 years. A multivariable model-building process was employed to scrutinise the resulting dataset to identify what herd-management practices, and nutritional, environmental and individual cow factors were major determinants of lactating cows becoming pregnant within 4 months of calving (P4M) and to estimate their magnitudes of effect. Key results Overall, 41.6% of cows per production year were successful for P4M. Country type was strongly associated with 65.4%, 57.5%, 61.8% and 16.4% P4M for the Southern Forest, Central Forest, Northern Downs, and Northern Forest respectively. Between-year variability ranged between 3.3 and 11.7 percentage points. Cows calving in December–January (61%) had a substantially higher occurrence of P4M than did cows calving between July and September (15%). The difference in P4M when comparing availability of wet-season pasture protein and phosphorus was 12.7 and 20.3 percentage points respectively. Modelling of the impact of group seroprevalence and management group prevalence of recent infection with several infectious diseases was estimated, with a large negative association between group bovine viral diarrhoea seroprevalence and P4M suggested. Conclusions This study further demonstrated the substantial impact that environment, herd management practices, nutrition and disease factors can have on the reproductive performance of females. Implications To optimise the performance of females (through increasing the occurrence of cows contributing calves in consecutive years) under commercial conditions in northern Australia, herd managers should focus on maximising the proportion of cows within a herd calving at the desired time of the year, ensuring that any nutritional deficiencies and herd health issues are managed, and that cows are managed such that they are of good body condition score at the time of calving.

Variations in the association of height with mortality, cardiovascular disease and cancer in low-, middle- and high-income countries.

Final adult height is a useful proxy measure of childhood nutrition and disease burden. Tall stature has been previously associated with decreased risk of all-cause mortality, decreased risk of major cardiovascular events and an increased risk of cancer. However, these associations have primarily been derived from people of European and East Asian backgrounds, and there are sparse data from other regions of the world. The Prospective Urban-Rural Epidemiology study is a large, longitudinal population study done in 21 countries of varying incomes and sociocultural settings. We enrolled an unbiased sample of households, which were eligible if at least one household member was aged 35-70 years. Height was measured in a standardized manner, without shoes, to the nearest 0.1 cm. During a median follow-up of 10.1 years (interquartile range 8.3-12.0), we assessed the risk of all-cause mortality, major cardiovascular events and cancer. A total of 154 610 participants, enrolled since January 2003, with known height and vital status, were included in this analysis. Follow-up event data until March 2021 were used; 11 487 (7.4%) participants died, whereas 9291 (6.0%) participants had a major cardiovascular event and 5873 (3.8%) participants had a new diagnosis of cancer. After adjustment, taller individuals had lower hazards of all-cause mortality [hazard ratio (HR) per 10-cm increase in height 0.93, 95% confidence interval (CI) 0.90-0.96] and major cardiovascular events (HR 0.97, 95% CI 0.94-1.00), whereas the hazard of cancer was higher in taller participants (HR 1.23, 95% CI 1.18-1.28). The interaction p-values between height and country-income level for all three outcomes were <0.001, suggesting that the association with height varied by country-income level for these outcomes. In low-income countries, height was inversely associated with all-cause mortality (HR 0.88, 95% CI 0.84-0.92) and major cardiovascular events (HR 0.87, 95% CI 0.82-0.93). There was no association of height with these outcomes in middle- and high-income countries. The respective HRs for cancer in low-, middle- and high-income countries were 1.14 (95% CI 0.99-1.32), 1.12 (95% CI 1.04-1.22) and 1.20 (95% CI 1.14-1.26). Unlike high- and middle-income countries, tall stature has a strong inverse association with all-cause mortality and major cardiovascular events in low-income countries. Improved childhood physical development and advances in population-wide cardiovascular treatments in high- and middle-income countries may contribute to this gap. From a life-course perspective, we hypothesize that optimizing maternal and child health in low-income countries may improve rates of premature mortality and cardiovascular events in these countries, at a population level.

Comparisons of musculoskeletal injuries among three different modalities of Taekwondo (Kyorugi, Poomsae, and Shibum): a one-year follow-up prospective epidemiologic study

ABSTRACT The purpose of the study was to report the injury rates and characteristics (body location, type, mechanism, and severity) of musculoskeletal injuries in Kyorugi, Poomsae, and Shibum. A total of 137 Korean collegiate Taekwondo players – Kyorugi (n = 44), Poomsae (n = 46), and Shibum (n = 47) – were prospectively studied in 2019. Injury rates per 1,000 athlete-exposures (AEs) and time-exposures (TEs) during training and competition were calculated. Additionally, body location, type, mechanism, and severity of injury were analysed. The highest injury rate was recorded in Poomsae (172.0/1,000 AEs and 79.5/1,000 TEs) followed by Kyorugi (47.1/1,000 AEs and 25.9/1,000 TEs) and Shibum (57.5/1,000 AEs and 17.0/1,000 TEs). The frequently injured body location was the thigh (Kyorugi = 17%; Poomsae = 25%; Shibum = 18%). The common injury types were muscle cramps/spasms in Kyorugi (33%) and Poomsae (59%), and sprain in Shibum (41%). The common injury mechanisms were gradual onset in Kyorugi (40%) and Shibum (49%), and non-contact trauma in Poomsae (91%). Regarding the severity, the number of days from the injury onset to recovery > 1 week were higher in the order of Kyorugi (78%), Shibum (54%), and Poomsae (28%). Our data provide preliminary evidence that different injury prevention strategies should be applied to each modality of Taekwondo.

1382. A Prospective Epidemiological Study BK Polyomavirus DNAuria and DNAemia within the First Year after Kidney Transplantation

Abstract Background Screening and early detection for the preceding BK polyomavirus (BKV) DNAuria and DNAemia to prevent the occurrence of BK polyomavirus BKV-associated nephropathy (BKPyVAN) among kidney transplant (KT) recipients has not been universally utilized and never assessed in a setting where the resource is limited. Therefore, we aimed to investigate this entity’s incidence, risk factors, and outcome with this intervention at our institution. Methods A prospective study of KT recipients at a tertiary care transplant center in Bangkok, Thailand, was conducted between January 2019 and March 2020. All patients underwent preemptive monitoring of urine and plasma BKV DNA load, measured by quantitative real-time PCR at 1, 2, 3, 6, 9, and 12 months post-KT. Low- and high-level BKV DNAuria was defined as urine BKV DNA load of &amp;lt; and &amp;gt; 7log10 copies/mL, respectively. Low- and high-level BKV DNAemia was defined as plasma BKV DNA load of &amp;lt; and &amp;gt; 4log10 copies/mL, respectively. The incidences were calculated by Kaplan-Meier analysis. The chi-square or student’s T-test compared clinical characteristics between those with and without high-level BKV DNAuria as appropriate. Risk factors of high-level BKV DNAuria were analyzed using Cox proportional hazard model. Results Among 99 evaluable KT recipients, a mean (SD) age was 42 (11) years, 64.6% were male, and 69.6% received an induction immunosuppressive therapy. Within 12 months post-KT, the incidences of low-level BKV DNAuria, high-level BKV DNAuria, low-level BKV DNAemia, and high-level BKV DNAemia were 22.63%, 13.14%, 9.49%, and 5.11%, respectively. High panel reactive antibody (PRA) was associated with high-level BKV DNAuria at 6 and 12 months, (HR 1.02 [95% CI (1.00-1.04)], P=0.019) and (HR 1.02 [95% CI (1.00-1.04)], P=0.023), respectively. Underlying diabetes mellitus was associated with high-level BKV DNAuria (HR 3.49 [95% CI (1.28-9.51)], P=0.015) at six months; however, not at 12 months. There was no allograft rejection directly related to a reduction of immunosuppression for BKV infection observed. Conclusion BKPyV infection is also prevalent among KT recipients in a resource-limited setting, however, without unfavorable consequence. Those with high-level PRA and underlying diabetes could be at risk of high-level BKV DNAuria after KT. Disclosures All Authors: No reported disclosures

Long-standing groin pain syndrome in athletic women: a multidisciplinary assessment in keeping with the Italian Consensus Agreement.

Long-standing groin pain syndrome (LSGPS) is a form of groin pain syndrome in which the cohort of symptoms reported by patients is experienced for a long period, typically for over 12 weeks, and is recalcitrant to any conservative therapy. The aim of this prospective epidemiological study was to describe the clinical causes of LSGPS in 37 female athletic subjects in Italy through the Groin Pain Syndrome Italian Consensus Conference on terminology, clinical evaluation and imaging assessment in groin pain in athletes' classification and guidelines. Thirty-seven female athletes affected by LSGPS were evaluated following the guidelines issued by the Groin Pain Syndrome Italian Consensus Conference on terminology, clinical evaluation and imaging assessment of groin pain in athletes. In the considered population, each patient presented only one pathological cause for LSGPS. The most frequent etiologies were inguinal pathologies (54.05% of the cases), acetabular labrum tear (18.92%) and pelvic floor disorders (8.11%). Adductor tendinopathy represented only 2.70% of cases. Female athletic patients affected by LSGPS show a similar incidence of inguinal and hip pathologies as in male populations. However, these clinical situations do not seem to be associated in women unlike in the male population. This difference is probably due to particular anatomical differences related to gender. For this reason, women affected by LSGPS represent an important subset of patients. Moreover, adductor tendinopathy is probably overrated as an etiopathogenetic source of LSGPS in women.

HIV indirectly accelerates coronary artery disease by promoting the effects of risk factors: longitudinal observational study

Our objective was to assess whether human immunodeficiency virus (HIV)-infection directly or indirectly promotes the progression of clinical characteristics of coronary artery disease (CAD). 300 African Americans with asymptomatic CAD (210 male; age: 48.0 ± 7.2 years; 226 HIV-infected) who underwent coronary CT angiography at two time points (mean follow-up: 4.0 ± 2.3 years) were randomly selected from 1429 participants of a prospective epidemiological study between May 2004 and August 2015. We calculated Agatston-scores, number of coronary plaques and segment stenosis score (SSS). Linear mixed models were used to assess the effects of HIV-infection, atherosclerotic cardiovascular disease (ASCVD) risk, years of cocaine use on CAD. There was no significant difference in annual progression rates between HIV-infected and—uninfected regarding Agatston-scores (10.8 ± 25.1/year vs. 7.2 ± 17.8/year, p = 0.17), the number of plaques (0.2 ± 0.3/year vs. 0.3 ± 0.5/year, p = 0.11) or SSS (0.5 ± 0.8/year vs. 0.5 ± 1.3/year, p = 0.96). Multivariately, HIV-infection was not associated with Agatston-scores (8.3, CI: [− 37.2–53.7], p = 0.72), the number of coronary plaques (− 0.1, CI: [− 0.5–0.4], p = 0.73) or SSS (− 0.1, CI: [− 1.0–0.8], p = 0.84). ASCVD risk scores and years of cocaine-use significantly increased all CAD outcomes among HIV-infected individuals, but not among HIV-uninfected. Importantly, none of the HIV-medications were associated with any of the CAD outcomes. HIV-infection is not directly associated with CAD and therefore HIV-infected are not destined to have worse CAD profiles. However, HIV-infection may indirectly promote CAD progression as risk factors may have a more prominent role in the acceleration of CAD in these patients.

Injuries in elite road cyclists during competition in one UCI WorldTour season: a prospective epidemiological study of incidence and injury burden

ABSTRACT To measure and evaluate the extent and characteristics of accidents and injuries in professional cycling competitions at the elite level (UCI WorldTour 2019) during one complete season. Methods Fifty-four male athletes from two different teams were involved. Accidents and injuries were recorded immediately after the incident by a team physician present at every race. Exposure, location, type and cause of injury have been recorded. Incidence was calculated. Severity was measured as a cumulative severity score and burden depicted in a risk matrix. Results Total time of exposure was 12537 hours over 3524 athlete days and 544002 kilometers of racing. 98 accidents were recorded, with 83 leading to injury. The total number of recorded injuries was 193. Injury incidence for all injuries was 54,8 (±SD 47,7–62,8) /1000 athlete days, 15,4 (±SD 13,4–17,7) /1000 athlete hours and 35,5 (±SD 30,8–40,8) /100.000 km raced. By far the most frequent types of injury were hematomas, contusions and bruising (n = 141, 73%) followed by lacerations (n = 22; 11,4%). Most injuries affected the arm and elbow (n = 34, 17,6%) followed by the shoulder and clavicle (n = 28, 14,5%) and occurred with contact (79%). Fractures pose a high injury burden due to long time loss, whereas hematomas, contusions and bruising showed the highest incidence numbers but comparably less time loss. Conclusion Road cyclists’ injuries have been underestimated in previous studies. Hematomas, contusions and bruising pose the highest number of injuries with a broad degree of severity and range of injury burden. Fractures are less common but show the highest injury burden. The upper extremities are involved the most.

The Influence of Infection and Colonization on Outcomes in Inpatients With COVID-19: Are We Forgetting Something?

The COVID-19 epidemic has been a great challenge to health systems and especially hospitals. A prospective observational epidemiological study was planned as of February 26, 2020 in a tertiary hospital in the Valencia region. The total number of patients followed up with complete information during the first year was 2,448. Among other variables, the comorbidities of the patients were collected (and grouped in the Charson index), the stay in the intensive care unit (ICU), the co-infections, and the colonizations. Data on nosocomial infections due to said virus were also collected. The median days from the onset of symptoms to diagnosis were 4 + 4.6, while an additional 4.4 days had to pass for the patients to be admitted to the ICU. The factors associated with a higher risk of death were those with coinfection, especially with Candida auris [odds ratio (OR): 4.6], a situation that also occurred in the ICU (OR: 3.18). Charlson Index comorbidity and C. auris colonization were also very important both in general hospitalization and in the ICU.

Prevalence, aetiology, and impact of paediatric feeding disorders in preterm infants admitted to a neonatal intensive care unit in Cyprus

BACKGROUND: Advancements in neonatal care have resulted in increased survival for preterm infants, with associated risk for paediatric feeding disorders (PFDs), the prevalence of which is relatively unexplored. Risk factors for developing PFDs in this population must be identified. OBJECTIVE: The aim of this study was to determine the epidemiology and risk factors for PFDs in preterm infants with Extremely Low Birth Weight (ELBW); Very Low Birth Weight (VLBW) and Low Birth weight (LBW) in the only neonatal intensive care unit (NICU) in Cyprus. METHODS: This study comprised 2 phases: Phase 1, a retrospective 2-year file audit, informing methodology for Phase 2, a prospective epidemiological study. Profiles of 1027 preterm infants were obtained in Phase 1. In Phase 2, clinical assessment data on 458 preterm infants (N = 224) were analyzed. RESULTS: The prevalence of PFDs was 36.5%. All preterm infants with ELBW and 69%with VLBW exhibited PFDs. Risk factors were birth weight (BW), gestational age (GA), bronchopulmonary dysplasia (BPD), neurological disorders, structural anomalies, and congenital heart disease (CHD). CONCLUSIONS: This unique epidemiological data for one country will inform NICU service provision and direct international research on PFDs in neonates.

Breast may not always be best: moderation of effects of postnatal depression by breastfeeding and infant sex

BackgroundThere is good evidence that female infants are particularly vulnerable to poor emotional outcomes following in utero glucocorticoid exposure. It is currently unclear whether such effects might persist into the postnatal period for breastfed infants, as maternal cortisol is expressed in breastmilk and is influenced by maternal psychological distress. We pre-registered hypotheses that maternal postnatal depression would be associated with infant negative emotionality, and that this effect would be moderated by breastfeeding status and infant sex.MethodsWe analysed data from the Wirral Child Health and Development Study (WCHADS), a prospective epidemiological study starting in pregnancy. Nine weeks after birth mothers self-reported depressive symptoms and breastfeeding status, and reported infant negative emotionality using the distress to limits subscale of the infant behaviour questionnaire (IBQ-R) when their infant was aged 9 weeks and 14 months. Maximum likelihood estimations made use of data from 857 mother-infant pairs.ResultsAt 9 weeks of age, maternal postnatal depressive symptoms were positively associated with infant distress to limits; however, this effect was not moderated by infant sex or breastfeeding. At age 14 months, the association between postnatal depression symptoms and distress to limits was greatest in the breastfed females, whereas the association was smaller, but still significant, in the non-breastfed females. For males, the association was non-significant in both the breastfed and non-breastfed groups. A test of sex difference between breastfed males and females was significant.ConclusionsWe provide evidence that effects of maternal postnatal depression on child emotional outcomes are moderated by breastfeeding status and differ by infant sex. Female vulnerability to elevated maternal breastmilk glucocorticoids may, at least in part, explain these effects.

Фармакоэпидемиологический анализ использования пероральных гипогликемических препаратов: факторы влияющие на эффективность фармакотерапии сахарного диабета 2 типа

As a result of the pharmacoepidemiological study, factors have been established that make it possible to increase the effectiveness of hypoglycemic therapy and the compliance of patients with diabetes mellitus in Kyrgyzstan. The structure of the prescribed oral hypoglycemic agents was investigated; the assessment, according to the results of the questionnaire of patients, was given of the effectiveness of the hypoglycemic therapy they received, as well as the level of its compliance with modern medical guidelines for the diagnosis and treatment of diabetes. At the time of filling out the questionnaire, only 44% of respondents had a target fasting glucose level (≤7 mmol/l). According to the data obtained, it can be concluded that in real clinical practice, the effectiveness of diabetes treatment remains low. We have obtained data that 47.8% of patients with diabetes are not adherent to treatment, which may also contribute to a rather low percentage of patients among the respondents who have reached the target blood glucose level. As for the use of drugs, the analysis of the data showed that the majority of patients (62.81%) receive monotherapy with oral hypoglycemic agents. According to the analysis, metformin is the most commonly used drug among the oral hypoglycemic agents. It is accepted by 60.1% of the respondents. Most diabetic patients spend 1000 som or more per month on oral hypoglycemic agents. Taking into account the cost of living in the country, it can be concluded that the acquisition of oral hypoglycemic agents significantly affects the budget of citizens and that there are problems with the economic availability of oral hypoglycemic agents. The results of our research indicate the insufficient effectiveness of the treatment and prophylactic measures for type 2 diabetes in our country, requiring more active work in this direction. The work was carried out in the design of a simple one-step prospective descriptive epidemiological study within the framework of a pharmacoepidemiological study.

P62.01 PREVALUNG: Evaluation of Lung Cancer Prevalence in Patients With Smocking-associated Atherosclerotic Cardiovascular Diseases

Lung cancer is the leading cause of cancer related death in France and Worldwide. Lung cancer screening based on low dose thoracic computed tomography (low dose CT) in patients selected on age and lifelong tobacco consumption has proven to improve lung cancer related mortality. However, the definition and identification of patients eligible for lung cancer screening is a challenge that may limit lung cancer screening program implementation. Epidemiological data shows that 30 to 40% of patients with lung cancer present a history of cardiovascular disease, mainly atheromatous diseases such as peripheral arterial diseases and coronary artery stenoses. We hypothesized that patients with history of smoking who developed atheromatous disease could represent a population at high risk to develop lung cancer. Our main objective was to evaluate the prevalence of lung cancer among patients with atherosclerotic disease and history of tobacco consumption. Our second objective was to evaluate the lung cancer screening program implemented to measure the prevalence. We implemented a monocentric prospective epidemiological study to evaluate the prevalence of lung cancer among 500 patients with inclusion criteria i.e age 45-75 years old, history of at least 10 years of daily tobacco consumption preceding the onset of an atherosclerotic disease. Principal exclusion criteria were history of active carcinoma < 5 years, symptoms of lung cancer, follow-up for lung nodules and grade IV dyspnea. Patients with inclusion criteria are referred for an inclusion visit (V0) with a thoracic surgeon by adult cardiologists, vascular surgeons and adult cardiac surgeons in charge of the patient. After information and inclusion, a low dose CT scan is scheduled within 7 months and a smoking cessation visit is proposed in case of active smoking. Blood and gut microbiota samples are harvested the day of the low dose CT. Positive low-dose CT are discussed weekly at the multidisciplinary thoracic oncologic staff meeting and managed accordingly to the current European and national recommendations. A clinical follow-up is scheduled by phone at 3, 6 and 12 months after the low-dose CT to evaluate oncologic and cardiovascular events. Between November 2019 and April 2021 we included 487 of the 500 patients scheduled, 330 low dose CT were completed, 7 localized primary lung cancer were resected by minimally invasive lobectomy, 1 patient was treated by radiation alone without pathological proof for a lung nodule, 1 patient was related with systemic therapy for a stage IV primary lung cancer and 2 patients are waiting for surgical resection for clinically localized lung cancers. The implementation of a lung cancer screening program dedicated to patients followed-up for tobacco related atherosclerotic diseases is feasible and will allow to evaluate both lung cancer prevalence and short-term benefits of lung cancer screening in this population.

Injuries in Quidditch: A Prospective Study from a Complete UK Season

BackgroundQuidditch is a mixed-gender, full-contact sport founded in the USA in 2005, played worldwide by an estimated 25,000 players. It is one of the few mixed-gender full-contact sports, yet there remain few published studies regarding injury rates and patterns. A previous study suggested that the overall rate of injury in quidditch is in line with other contact sports, however raised concerns that female players were sustaining a higher rate of concussion when compared to male players.PurposeTo examine injury rates and injury patterns in UK quidditch athletes over the course of a single season.Study designProspective epidemiological studyMethodsData were prospectively collected by professional first aid staff for the 2017-18 season spanning all major UK tournaments, involving 699 athletes. Anonymized player demographics were collected by an online survey. Time loss injury rates were measured per 1000 athletic exposures (AEs) and hours of play.ResultsThe overall time loss injury rate was 20.5 per 1000 hours or 8.0 per 1000 AEs. The combined rate of concussion was 7.3 per 1000 hours or 2.8 per 1000 AEs. There was no statistical difference between time loss injuries in males (20.9/1000 hours and 8.1/1000 AEs) and females (13.9/1000 hours and 5.4/1000 AEs) (p=0.30) and no statistical difference between concussion rates in males (n=7) and females (n=4) (p=0.60).ConclusionsTotal time loss injury rates in quidditch appear to be comparable with other full-contact sports such as football. The rate of concussions for both males and females appear higher when compared to other contact sports.Level of evidence3