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Pisinger C.,Research Center for Prevention and Health
BMC Medicine | Year: 2014

haracterized by severe methodological problems, severe conflicts of interest, relatively few and often small studies, inconsistencies and contradictions in results, and a lack of long-term follow-up. Therefore, no firm conclusions can be drawn on the harm of e-cigarettes, but they can hardly be called safe. Experimental studies indicate negative health effects and, amongst others, the major ingredient propylene glycol warrants concern. Growing evidence raises doubt about the efficacy of e-cigarettes as a smoking cessation aid. Unfortunately, it seems that many smokers use e-cigarettes with the intention to quit but switch to long-term use of e-cigarettes or dual use. Use is spreading rapidly to minors, ex-smokers, and never-smokers. It is questionable whether the potential health benefits obtained by some smokers outweigh the potential harm by use of non-smokers, of undermining of complete cessation, smokers' dual use, and of eventual re-normalization of smoking. Even if e-cigarettes are significantly less harmful than conventional cigarettes, the product may have a very negative impact on public health if its use is spread to a large part of the population. © 2014 Pisinger.. Source

Munch I.C.,Roskilde Hospital | Munch I.C.,Copenhagen University | Linneberg A.,Copenhagen University | Linneberg A.,Research Center for Prevention and Health | Larsen M.,Copenhagen University
Investigative Ophthalmology and Visual Science | Year: 2013

PURPOSE. To investigate associations of small, hard macular drusen and larger macular drusen with obesity-related risk factors. METHODS. Cross-sectional study of 888 subjects aged 30 to 60 years characterized using anthropometric measurements and blood sample analyses. Physical activity was assessed by questionnaire. Digital grayscale fundus photographs were recorded in red-free illumination and graded for the presence of macular drusen > 63 lm in either eye and the presence of 20 or more small, hard macular drusen as a mean of both eyes. RESULTS. Macular drusen > 63 lm were associated with the level of physical activity, the ageand sex-adjusted odds ratio being 0.33 (95% confidence interval 0.13-0.82, P 1/4 0.016) for participants who were physically active more than 7 hours/week compared with participants active 0 to 2 hours/week. In women, macular drusen > 63 lm were associated with higher serum triglycerides (P 1/4 0.0005). A waist circumference in the top quartile increased the odds for drusen > 63 lm in men whereas in women, having a waist circumference in the middle quartiles reduced these odds. The presence of 20 or more small, hard macular drusen was associated with lower levels of serum high-density lipoprotein cholesterol (HDL; P 1/4 0.029) and with moderately elevated triglycerides. CONCLUSIONS. Precursors of AMD were associated with modifiable obesity-related risk factors; notably low physical activity with drusen > 63 lm; and lower serum HDL and moderately elevated serum triglycerides with 20 or more small, hard macular drusen per eye. These findings support that a physically active, heart-healthy lifestyle prevents the earliest manifestation of AMD. © 2013 The Association for Research in Vision and Ophthalmology, Inc. Source

Bertelsen C.A.,Copenhagen University | Andreasen A.H.,Research Center for Prevention and Health | Jorgensen T.,Copenhagen University | Harling H.,Copenhagen University
Colorectal Disease | Year: 2010

Objective: The study aimed to identify risk factors for clinical anastomotic leakage (AL) after anterior resection for rectal cancer in a consecutive national cohort. Method: All patients with an initial first diagnosis of colorectal adenocarcinoma were prospectively registered in a national database. The register included 1495 patients who had had a curative anterior resection between May 2001 and December 2004. The association of a number of patient- and procedure-related factors with clinical AL after anterior resection was analysed in a cohort design. Results: Anastomotic leakages occurred in 163 (11%) patients. In a multivariate analysis, the risk of AL was significantly increased in patients with tumours located below 10 cm from the anal verge if no faecal diversion was undertaken (OR 5.37 5 cm (tumour level from anal verge), 95% CI 2.10-13.7, OR 3.57 7 cm, CI 1.81-7.07 and OR 1.96 10 cm, CI 1.22-3.10), in male patients (OR 2.36, CI 1.18-4.71), in smokers (OR 1.88, CI 1.02-3.46), and perioperative bleeding (OR 1.05 for intervals of 100 ml blood loss, CI 1.02-1.07). Conclusion: Anastomotic leakage after anterior resection for low rectal tumours is related to the level, male gender, smoking and perioperative bleeding. Faecal diversion is advisable after total mesorectal excision of low rectal tumours in order to prevent AL. © 2009 The Authors. Journal Compilation. Source

Krarup P.-M.,Copenhagen University | Jorgensen L.N.,Copenhagen University | Andreasen A.H.,Research Center for Prevention and Health | Harling H.,Copenhagen University
Colorectal Disease | Year: 2012

Aim Anastomotic leakage (AL) is a major challenge in colorectal cancer surgery due to increased morbidity and mortality. Possible risk factors should be investigated differentially, distinguishing between rectal and colonic surgery in large-scale studies to avoid selection bias and confounding. Method The incidence and risk factors associated with AL were analysed in an unselected nationwide prospective cohort of patient subjected to curative colonic cancer surgery with primary anastomosis and entered into The Danish Colorectal Cancer Group database between May 2001 and December 2008. Results AL occurred in 593 (6.4%) of 9333 patients. Laparoscopic surgery [odds ratio (OR) 1.34; 95% confidence interval (CI) 1.05-1.70; P=0.03); left hemicolectomy (OR 2.02; 95% CI 1.50-2.72; P=0.01) or sigmoid colectomy (OR 1.69; 95% CI 1.32-2.17; P=0.01); intra-operative blood loss (OR 1.04; 95% CI 1.01-1.07; P=0.03); blood transfusion (OR 10.27; 95% CI 6.82-15.45; P<0.001) and male gender (OR 1.41; 95% CI 1.12-1.75; P=0.02) were associated with AL in the multivariate analysis. Conclusion The main finding that a laparoscopic approach was associated with an increased risk of AL should prompt close future monitoring. There was no evidence that centralization of surgery to high-volume hospitals reduced the rate of AL. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland. Source

Pisinger C.,Research Center for Prevention and Health | Dossing M.,Medicinsk Afdeling
Preventive Medicine | Year: 2014

Objective: To provide a systematic review of the existing literature on health consequences of vaporing of electronic cigarettes (ECs). Methods: Search in: PubMed, EMBASE and CINAHL. Inclusion criteria: Original publications describing a health-related topic, published before 14 August 2014. PRISMA recommendations were followed. We identified 1101 studies; 271 relevant after screening; 94 eligible. Results: We included 76 studies investigating content of fluid/vapor of ECs, reports on adverse events and human and animal experimental studies. Serious methodological problems were identified. In 34% of the articles the authors had a conflict of interest. Studies found fine/ultrafine particles, harmful metals, carcinogenic tobacco-specific nitrosamines, volatile organic compounds, carcinogenic carbonyls (some in high but most in low/trace concentrations), cytotoxicity and changed gene expression. Of special concern are compounds not found in conventional cigarettes, e.g. propylene glycol. Experimental studies found increased airway resistance after short-term exposure. Reports on short-term adverse events were often flawed by selection bias. Conclusions: Due to many methodological problems, severe conflicts of interest, the relatively few and often small studies, the inconsistencies and contradictions in results, and the lack of long-term follow-up no firm conclusions can be drawn on the safety of ECs. However, they can hardly be considered harmless. © 2014 Published by Elsevier Inc. Source

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