Predictive Medicine and Public Health

Medicine Lodge, United States

Predictive Medicine and Public Health

Medicine Lodge, United States
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De Lauzon-Guillain B.,Center for Research in Epidemiology and Population Health | De Lauzon-Guillain B.,University Paris - Sud | De Lauzon-Guillain B.,French Institute of Health and Medical Research | Jones L.,University of Bristol | And 13 more authors.
American Journal of Clinical Nutrition | Year: 2013

Background: Fruit and vegetable intake in children remains below recommendations in many countries. The long-term effects of early parental feeding practices on fruit and vegetable intake are not clearly established. Objective: The purpose of the current study was to examine whether early feeding practices influence later fruit and vegetable intake in preschool children. Design: The study used data from 4 European cohorts: the British Avon Longitudinal Study of Parents and Children (ALSPAC), the French Etude des Déterminants pre et postnatals de la santé et du développement de l'Enfant study, the Portuguese Generation XXI Birth Cohort, and the Greek EuroPrevall study. Fruit and vegetable intake was assessed in each cohort by food-frequency questionnaire. Associations between early feeding practices, such as breastfeeding and timing of complementary feeding, and fruit and/or vegetable intake in 2-4-y-old children were tested by using logistic regressions, separately in each cohort, after adjustment for infant's age and sex and maternal age, educational level, smoking during pregnancy, and maternal fruit and vegetable intake. Results: Large differences in early feeding practices were highlighted across the 4 European cohorts with longer breastfeeding duration in the Generation XXI Birth Cohort and earlier introduction to complementary foods in ALSPAC. Longer breastfeeding duration was consistently related to higher fruit and vegetable intake in young children, whereas the associations with age of introduction to fruit and vegetable intake were weaker and less consistent across the cohorts. Mothers' fruit and vegetable intake (available in 3 of the cohorts) did not substantially attenuate the relation with breastfeeding duration. Conclusion: The concordant positive association between breastfeeding duration and fruit and vegetable intake in different cultural contexts favors an independent specific effect. © 2013 American Society for Nutrition.

Carvalho H.N.,University of Porto | Campos Costa I.M.,University of Porto | Botelho F.,Predictive Medicine and Public Health | Botelho F.,Hospital of Braga | And 2 more authors.
Aging Male | Year: 2013

Aims: Analyze the capacity of ICO, the ratio of waist circumference (WC) and height, in predicting hemodynamic impairment in Erectile Dysfunction (ED) patients, independently and integrated in Metabolic Syndrome (MetS) definitions. Methods: Four hundred and eighty-five ED patients followed in Urology consult from January 2008 until March 2012 were evaluated by a standardized protocol: health questionnaire, anthropometric measurements (AM), blood pressure and analysis, and Penile Duplex Doppler Ultrasound (PDDU) exam. Associations between AM and MetS definitions, including ATPIII, IDF and a new definition replacing WC by ICO in ATPIII MetS definition (ModATPIII), and PDDU were calculated. Results: ICO was the measure of obesity more strongly correlated with diminished mean Peak Systolic Velocity (mPSV) (r=-0.189, p<0.001). A positive association remained when replacing WC by ICO0.60 (a nationally obtained ratio) in ATPIII MetS definition (ModATPIII). Patients with ModATPIII had lower mPSV when compared to non-MetS patients (30.8 versus 37.1, p<0.001). Only the IDF definition had a significant association with AD (OR=1853; 95%CI, 1.202-2.857). Conclusions: ICO revealed potential value to predict PDDU changes in a MetS context. However, IDF definition presented a stronger correlation with arteriogenic ED. Although longitudinal studies are necessary to confirm this hypothesis, our study highlights the importance of different MetS definitions for ED assessment. © 2013 Informa UK Ltd.

Lunet N.,University of Porto | Lunet N.,Predictive Medicine and Public Health | Peleteiro B.,University of Porto | Peleteiro B.,Predictive Medicine and Public Health | And 11 more authors.
European Journal of Cancer Prevention | Year: 2014

Helicobacter pylori infection is the most important risk factor for gastric cancer. It is acquired predominantly during childhood, and understanding the determinants of infection in early life may translate into identifying preventive measures. However, the independent role of child day-care attendance remains to be understood. The aim of the study was to evaluate the association between child day-care attendance and H. pylori infection in early life. The study was nested within Geração XXI, a birth cohort assembled in Portugal. Serum anti-H. pylori IgG was quantified using ELISA in 1047 children between the ages of 4 and 5 years, and information on child day-care attendance since birth was collected. Odds ratios and 95% confidence intervals (95% CIs), adjusted for the child's age and number of siblings, as well as maternal education and infection status, were computed using unconditional logistic regression. The prevalence of H. pylori infection was 30.6% (95% CI 27.9-33.6), and it increased significantly with the cumulative time of attendance in day-care centers/homes (from 13.2% among never attendees to 40.2% among those attending for >36 months; P for trend<0.001). The odds ratio was 4.88 (95% CI 2.55-9.35) among those attending these institutions for more than 3 years, in comparison with never attendees. H. pylori infection remains a frequent and early event in Portugal. Child day-care attendance increases the risk of infection, making this setting a target for preventive measures. © 2014 Wolters Kluwer Health Lippincott Williams & Wilkins.

Araujo J.,Predictive Medicine and Public Health | Araujo J.,University of Porto | Teixeira J.,Predictive Medicine and Public Health | Teixeira J.,University of Porto | And 5 more authors.
Nutrition | Year: 2015

Objective: The aim of this study was to identify dietary patterns in 13-y-old adolescents and to evaluate their association with socioeconomic and behavioral factors. Methods: Data from 1489 adolescents born in 1990 and enrolled in schools of Porto, Portugal, in 2003-2004 (EPITeen study) were analyzed, after excluding those without information on the food frequency questionnaire and the outliers. The questionnaire items were grouped into 14 food groups and dietary patterns were identified by cluster analysis (k-means). Their association with participants' characteristics was computed using multinomial logistic regression. Results: Four dietary patterns were identified. The pattern healthier (16.1%) was characterized by the highest consumption of seafood, soup, vegetables/legumes, fruit, and added fats. The dairy products pattern (29.7%) showed the highest consumption of dairies. The pattern fast food and sweets (14.2%) presented the highest intake of fast food, sweets and pastry, soft drinks and coffee or tea. The lower intake pattern (40%) was characterized by a lower consumption of the majority of food groups. A higher odds of belonging to the fast food and sweets pattern, compared with the lower intake pattern was found among adolescents spending more time watching TV on the weekends (>360min: odds ratio [OR], 2.09; 95% confidence interval [CI], 1.23-3.57) and among those consuming four to seven fried meals per week (OR, 3.96; 95% CI, 2.27-6.90). Adolescents with highly educated parents were less likely to belong to the fast food and sweets group. Conclusion: Unhealthier behaviors and lower socioeconomic position were the main factors associated with the unhealthier dietary pattern (fast food and sweets). This information should be considered in the development of health-promotion interventions. © 2015 Elsevier Inc.

Goncalves J.-P.,University of Porto | Goncalves J.-P.,Predictive Medicine and Public Health | Severo M.,University of Porto | Severo M.,Predictive Medicine and Public Health | And 6 more authors.
Clinical Laboratory | Year: 2013

Background: Studies on SUA temporal profile in relation to acute myocardial infarction (AMI) are controversial. The aim of this study was to evaluate the SUA level variations following myocardial infarction. Methods: We studied 222 patients more than 18 years old diagnosed with AMI. SUA was measured at baseline and on day 2 to 4 and day 5 to 8 after AMI. Within and between person variability of SUA following an AMI was estimated using intraclass correlation coefficients (ICC). The change in SUA between each assessment point was analyzed by repeated measures one-way analysis of variance. To evaluated SUA variation post-myocardial infarction and its predictors we used generalized linear mixed-effects models. Results: The mean plasma concentration of SUA was lower at baseline (58.5 ± 18.9 mg/L). The ICC across the three time points was 0.75 (95% CI 0.70 - 0.80). SUA levels increased 1.33 mg/L per day after AMI (2.3 mg/L/day in women and 1.0 mg/L/day in men). Normouricemic patients had a 1.6 fold increase risk to change to hyperuricemic: status per day after AMI (OR = 1.60, 95% CI: 1.27 - 2.00). Conclusions: Serum uric acid concentration is relatively stable over an eight-day post-myocardial infarction period. However, even a small increase of SUA per day after AMI is associated with a high probability of changing the classification of hyperuricemic status.

Morais A.,University of Porto | Beltrao M.,University of Porto | Sokhatska O.,University of Porto | Costa D.,Predictive Medicine and Public Health | And 5 more authors.
Respiratory Medicine | Year: 2015

Introduction Accurate diagnosis of idiopathic pulmonary fibrosis (IPF) has important therapeutic and prognostic implications and would be greatly aided by reliable diagnostic biomarkers as IPF has sometimes overlapping features with other interstitial lung diseases (ILD). Objectives To explore the value of serum metalloproteinases (MMP) 1 and 7 levels in the differential diagnosis of IPF with other ILD. Methods MMP-1/7 serum levels were measured using Luminex xMAP technology in 139 patients- 47 IPF, 36 non-IPF Usual Interstitial Pneumonia (UIP), 14 idiopathic Nonspecific Interstitial Pneumonia (iNSIP), 29 secondary NSIP (secNSIP), 13 stage IV sarcoidosis- and 20 healthy controls, and compared using the Mann-Whitney U test. Results MMP-1 was significantly higher in IPF than non-IPF UIP (P =.042) and sarcoidosis (P =.027). MMP-7 was significantly higher in IPF than controls (P <.001), non-IPF UIP (P =.003), secNSIP (P <.001), and sarcoidosis (P <.001). The Area Under the Curve for IPF versus other ILD was 0.63 (95%CI, 0.53-0.73) for MMP-1, 0.73 (95%CI, 0.65-0.81) for MMP-7, and 0.74 (95%CI, 0.66-0.82) for MMP-1/MMP-7 combined. Sensitivity and specificity for MMP-7 cutoff = 3.91 ng/mL was 72.3% and 66.3%, respectively, Positive Predictive Values = 52.3% and Negative Predictive Values = 82.4%. Conclusions MMP-1 and particularly MMP-7 serum levels were significantly higher in IPF than in non-IPF UIP, the main entity in differential diagnosis. The value of these biomarkers as additional tools in a multidisciplinary approach to IPF diagnosis needs to be considered and further explored. © 2015 Elsevier Ltd. All rights reserved.

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