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Prevalence, incidence, and mortality of Myasthenia Gravis and myasthenic syndromes: a systematic review. 重症肌无力和肌无力综合征的患病率、发病率和死亡率:系统综述。
IF 3.2 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-09 DOI: 10.1159/000539577
Francesco Sciancalepore, Niccolò Lombardi, Giulia Valdiserra, Marco Bonaso, Emiliano Cappello, Giulia Hyeraci, Giada Crescioli, Maria Grazia Celani, Teresa Anna Cantisani, Paola Brunori, Simona Vecchi, Ilaria Bacigalupo, Nicoletta Locuratolo, Eleonora Lacorte, Nicola Vanacore, Ursula Kirchmayer

Introduction: No systematic reviews were published in the last years investigating epidemiological data, involving Myasthenia Gravis (MG) and related myasthenic syndromes. The aim of this systematic review was to estimate the prevalence, incidence, and mortality of all MG types and myasthenic syndromes worldwide.

Methods: All literature published up to February 2024 was retrieved by searching the databases "Medline", "Embase", "ISI Web of Science" and "CINAHL" using the following search terms: (epidemiolog* OR frequency OR prevalence OR incidence OR mortality) AND (myasth* OR "anti-acetylcholine receptor antibody" OR "AChR" OR "MuSK" OR "anti-muscle specific kinase antibody" OR "LRP4" OR "seronegative MG").

Results: A total of 94 studies, performed between 1952 and 2022, were included. Prevalence of MG ranged from 20 to 475 cases per million, with a mean prevalence of 173.3 (95% CI: 129.7-215.5) cases per million and a median prevalence of 129.6 cases per million. Incidence rates ranged from 2.3 to 61.3 cases per million person-years, with a mean incidence of 15.7 (95% CI: 11.5-19.9) and a median of 13.3 cases. Mortality rates showed a mean of 1.4 (95% CI: 0.8-2.1) cases per million person-years. AChR-MG was the clinical subtype more frequent in terms of prevalence and incidence.

Discussion: The prevalence and incidence of MG have significantly increased over the last years worldwide, probably due to the improvement of epidemiological methodologies and current advances in diagnosis. However, we observed a significant variation in frequencies of MG between and within countries because of methodological biases and complex heterogeneity of the disease characterized by several phenotypes and different clinical responses.

导言:在过去几年中,没有发表过关于肌无力(MG)和相关肌无力综合征流行病学数据的系统性综述。本系统综述旨在估算全球所有类型的肌萎缩症和肌无力综合征的患病率、发病率和死亡率:使用以下检索词:(epidemiolog* OR frequency OR prevalence OR incidence OR mortality)和(myasth* OR "anti-acetylcholine receptor antibody" OR "AChR" OR "MuSK" OR "anti-muscle specific kinase antibody" OR "LRP4" OR "seronegative MG"),检索了截至 2024 年 2 月发表的所有文献:"Medline"、"Embase"、"ISI Web of Science "和 "CINAHL":结果:共纳入了 94 项研究,这些研究在 1952 年至 2022 年间进行。MG患病率从每百万人中20例到475例不等,平均患病率为每百万人中173.3例(95% CI:129.7-215.5),中位患病率为每百万人中129.6例。发病率从每百万人年 2.3 例到 61.3 例不等,平均发病率为 15.7 例(95% CI:11.5-19.9),中位数为 13.3 例。死亡率为每百万人年平均 1.4 例(95% CI:0.8-2.1)。就患病率和发病率而言,AChR-MG 是更常见的临床亚型:讨论:可能是由于流行病学方法的改进和当前诊断技术的进步,过去几年中,MG 的患病率和发病率在全球范围内显著上升。然而,我们观察到,由于方法上的偏差,以及该疾病具有多种表型和不同临床反应的复杂异质性,各国之间和各国内部的 MG 发病率存在显著差异。
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引用次数: 0
Strength of Association between Coronavirus Disease 2019 and Neurological Disorders in Children: A Case-Control Study. 2019 年冠状病毒疾病与儿童神经系统疾病之间的关联强度:病例对照研究
IF 5.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-12 DOI: 10.1159/000541303
Utcharee Intusoma,Wisarut Srisintorn,Titaporn Thamcharoenvipas,Kemmapon Chumchuen
Evidence suggests potential neurological complications of Coronavirus Disease 2019 (COVID-19), particularly in adults. While case series have hinted at associations between COVID-19 and neurological disorders (NDs) in children, the extent of this link remains unclear. This study investigates temporal trends in NDs during the pandemic and assesses their potential association with COVID-19 infection in children. We analyzed national Thai hospitalization data (2017-2022) for children under 18 with specific NDs (acute transverse myelitis, central nervous system demyelination, neuromyelitis optica, optic neuritis, polyneuropathy, stroke). An interrupted time series analysis was employed to identify changes in the incidence trends of NDs following the declaration of the COVID-19 pandemic. A matched case-control analysis was conducted using data specific to the Thai COVID-19 outbreak period. This analysis aimed to estimate the association between recent/concurrent COVID-19 infection and NDs in children. A propensity score matching on age group, sex, and month of admission was performed before conducting logistic regression. From 2017-2022, 1,721 children admitted with NDs (2,474 admissions), with a male predominance (55%) and average age of 10.6 years. Significant slope change was observed in optical neuritis trends coinciding with the third COVID-19 wave. The case-control analysis included 468 cases and 2,340 controls. Children with NDs had a significantly higher prevalence of recent/concurrent COVID-19 (matched odds ratio: 1.95, 95% confidence interval: 1.21-3.16). Subgroup analysis revealed an association between stroke and recent/concurrent COVID-19 (matched odds ratio: 3.05, 95% confidence interval: 1.3-7.16). Thus, this study suggests an association between recent/concurrent COVID-19 and NDs, especially pediatric stroke.
有证据表明,冠状病毒病 2019(COVID-19)可能会引起神经系统并发症,尤其是在成人中。虽然系列病例暗示COVID-19与儿童神经系统疾病(NDs)有关联,但这种关联的程度仍不清楚。本研究调查了大流行期间 NDs 的时间趋势,并评估了其与儿童感染 COVID-19 的潜在关联。我们分析了泰国全国 18 岁以下儿童因特定 ND(急性横贯性脊髓炎、中枢神经系统脱髓鞘、神经性视脊髓炎、视神经炎、多发性神经病、中风)而住院治疗的数据(2017-2022 年)。我们采用了间断时间序列分析,以确定 COVID-19 大流行后非传染性疾病发病趋势的变化。利用泰国 COVID-19 爆发期间的特定数据进行了匹配病例对照分析。该分析旨在估计儿童近期/经常感染 COVID-19 与 ND 之间的关系。在进行逻辑回归之前,对年龄组、性别和入院月份进行了倾向得分匹配。从2017年至2022年,共有1721名儿童因NDs入院(2474人次),其中男性占多数(55%),平均年龄为10.6岁。在光学神经炎趋势中观察到显著的斜率变化,与 COVID-19 第三波相吻合。病例对照分析包括 468 例病例和 2,340 例对照。患有 ND 的儿童近期/复发 COVID-19 的发病率明显更高(匹配几率比:1.95,95% 置信区间:1.21-3.16)。亚组分析显示,中风与近期/复发性 COVID-19 之间存在关联(匹配几率比:3.05,95% 置信区间:1.3-7.16)。因此,本研究表明近期/复发的 COVID-19 与玖玖病,尤其是小儿中风之间存在关联。
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引用次数: 0
Low sun exposure is associated with both progressive-onset and relapse-onset multiple sclerosis risk: a case-control study. 少晒太阳与进展期发病和复发期发病的多发性硬化症风险有关:一项病例对照研究。
IF 5.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-11 DOI: 10.1159/000540921
Ying Li,Alice Saul,Bruce Taylor,Anne-Louise Ponsonby,Steve Simpson-Yap,Leigh Blizzard,Simon Broadley,Jeannette Lechner-Scott,,Ingrid van der Mei
BACKGROUNDSun exposure has consistently been associated with Multiple Sclerosis (MS) onset, but case samples are predominantly relapse-onset MS (ROMS), and risk estimates have rarely been reported separately for ROMS and progressive-onset MS (POMS). We aimed to determine whether sun exposure prior to disease onset was associated with POMS, and whether the effect differed between POMS and ROMS.METHODSThis nationwide case-control study included 153 POMS cases, 204 incident ROMS cases, and 558 community controls with data from two separate datasets: the PPMS Study (2015-2019) and the Ausimmune Study (2003-2006). Information on time spent in the sun before first MS symptom, skin phenotype, sun protection behavior was collected. Satellite data on ambient ultraviolet radiation (UVR) was used to calculate cumulative UVR dose. Unconditional logistic regression was used with adjustment for covariates.RESULTSThere were consistent dose-response associations, with higher levels of UVR exposure associated with a reduced risk of POMS, both for leisure-time and occupational UVR from age 6 to symptom onset. Associations were overall stronger for POMS than ROMS. For example, cumulative leisure-time UVR dose (per 100 kJ/m2 increment) was associated with POMS (aOR 0.93, 95% CI 0.91-0.95) and the association was slightly weaker for ROMS (aOR 0.96, 95% CI 0.94-0.99) for age 6 to symptom onset (test for interaction p<0.001).CONCLUSIONSLow levels of sun exposure, throughout the whole life span, are associated with increased risk of POMS and ROMS onset. The sun effects are usually stronger for POMS than ROMS.
背景日光照射一直与多发性硬化症(MS)的发病有关,但病例样本主要是复发型多发性硬化症(ROMS),而且很少单独报告复发型多发性硬化症和进展型多发性硬化症(POMS)的风险估计值。这项全国性病例对照研究纳入了153例POMS病例、204例ROMS病例和558例社区对照,其数据分别来自两个数据集:PPMS研究(2015-2019年)和Ausimmune研究(2003-2006年)。研究人员收集了首次出现多发性硬化症症状前在阳光下活动的时间、皮肤表型、防晒行为等信息。环境紫外线辐射(UVR)卫星数据用于计算累积紫外线辐射剂量。结果紫外线辐射暴露水平越高,POMS发病风险越低,这与从6岁到发病前的闲暇时间和职业性紫外线辐射都存在一致的剂量-反应关系。总体而言,POMS的相关性强于ROMS。例如,从 6 岁到症状出现,休闲时间的累积紫外线辐射剂量(每 100 kJ/m2 增量)与 POMS(aOR 0.93,95% CI 0.91-0.95)相关,而与 ROMS(aOR 0.96,95% CI 0.94-0.99)的相关性稍弱(交互作用检验 p<0.001)。阳光对POMS的影响通常强于对ROMS的影响。
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引用次数: 0
Insights from ARCOS-V's Transition to Remote Data Collection During the COVID-19 Pandemic: A Descriptive Study. COVID-19 大流行期间 ARCOS-V 向远程数据收集过渡的启示:描述性研究。
IF 5.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-09 DOI: 10.1159/000541368
Nathan I N Henry,Balakrishnan Nair,Anna Ranta,Rita Krishnamurthi,Anjali Bhatia,Valery Feigin
INTRODUCTIONThe ARCOS-V study, an epidemiological study on stroke and transient ischemic attack (TIA), faced the challenge of continuing data collection amidst the COVID-19 pandemic. This study aims to describe the methodological changes and challenges encountered during the transition from paper-based methods to digital data collection for the ARCOS-V study, and to provide insights into the potential of using digital tools to transform epidemiological research.METHODSThe study adapted to remote data collection using REDCap and Zoom, involving daily health record reviews, direct data entry by trained researchers, and remote follow-up assessments. The process was secured with encryption and role-based access controls. The transition period was analyzed to evaluate the effectiveness and challenges of the new approach.RESULTSThe digital transition allowed for uninterrupted monitoring of stroke and TIA cases during lockdowns. Using REDCap and Zoom improved data reach, accuracy, and security. However, it also revealed issues such as the potential for systematic data entry errors and the need for robust security measures to protect sensitive health information.CONCLUSIONThe ARCOS-V study's digital transformation exemplifies the resilience of epidemiological research in the face of a global crisis. The successful adaptation to digital data collection methods highlights the potential benefits of such tools, particularly as we enter a new age of Artificial Intelligence (AI).
简介:ARCOS-V 研究是一项关于中风和短暂性脑缺血发作(TIA)的流行病学研究,它面临着在 COVID-19 大流行期间继续收集数据的挑战。本研究旨在描述 ARCOS-V 研究从纸质方法过渡到数字数据收集过程中方法的变化和遇到的挑战,并深入探讨使用数字工具改变流行病学研究的潜力。方法该研究采用 REDCap 和 Zoom 进行远程数据收集,包括每日健康记录审查、由训练有素的研究人员直接输入数据以及远程随访评估。该过程采用了加密和基于角色的访问控制。结果数字化过渡使中风和 TIA 病例在封锁期间得到了不间断的监测。使用 REDCap 和 Zoom 提高了数据的覆盖范围、准确性和安全性。然而,它也暴露出了一些问题,如可能出现系统性数据输入错误,以及需要采取强有力的安全措施来保护敏感的健康信息。对数字数据收集方法的成功适应凸显了此类工具的潜在优势,尤其是在我们进入人工智能(AI)新时代的时候。
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引用次数: 0
Changing Epidemiology of Neurological Diseases in Africa. 非洲不断变化的神经系统疾病流行病学。
IF 5.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-09 DOI: 10.1159/000539654
G Logroscino,R Kalaria,P M Preux
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引用次数: 0
Low Intake of Total Antioxidant Nutrients as a Risk Factor for Incident Dementia in Older Adults: The Shanghai Aging Study. 总抗氧化营养素摄入量低是老年人痴呆症发病的风险因素:上海老龄化研究。
IF 3.2 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-05 DOI: 10.1159/000541231
Su Liu, Jianfeng Luo, Zhenxu Xiao, Wanqing Wu, Xiaoniu Liang, Qianhua Zhao, Xianfeng Zhao, Yi Wang, Wenhuan Fu, Ding Ding

Introduction: Previous longitudinal studies reported the impact of antioxidant nutrients (ANs) on cognitive impairment in the older population, but the conclusions were inconsistent. This study aimed to verify the hypothesis that dietary intake of total AN was associated with incident dementia among older individuals.

Methods: Community residents without dementia aged ≥60 years were prospectively followed up for an average of 5.2 years in the Shanghai Aging Study. At baseline, daily intakes of total dietary AN (the sum of carotene, vitamin C, vitamin E, lutein, and flavonoids) and energy were calculated based on an interviewer-administered food frequency questionnaire measuring the dietary intake over the past 1 year for each participant. A battery of neuropsychological tests was used to evaluate cognitive function, and a consensus diagnosis of dementia was made according to the DSM-IV criteria at baseline and follow-up.

Results: Among 1,550 dementia-free participants, 135 (8.7%) incident dementia cases were identified during the average of 5.2 years of follow-up. Participants with low AN intake (<112 mg/day) had a significantly higher risk of incident dementia than those with high AN intake (≥112 mg/day) (hazard ratio 1.87, 95% confidence interval 1.26-2.77) after adjusting for age, gender, education, obesity, APOE-ε4, hypertension, diabetes, depression, baseline Mini-Mental State Examination score, and total energy intake. The significant association of total AN intake with incident dementia was only found in individuals ≥70 years.

Conclusion: Low total AN intake may be a risk factor for incident dementia among older adults. Maintaining sufficient AN intake may be beneficial against age-related cognitive decline.

导言:以往的纵向研究报告了抗氧化营养素(AN)对老年人认知障碍的影响,但结论并不一致。本研究旨在验证膳食中总抗氧化营养素摄入量与老年人痴呆症发病率相关的假设:方法:上海老龄化研究对年龄≥60岁、无痴呆症的社区居民进行了平均为期5.2年的前瞻性随访。基线时,根据访谈者发放的食物频率调查问卷,计算每位受试者过去一年的膳食总摄入量(胡萝卜素、维生素 C、维生素 E、叶黄素和类黄酮的总和)和能量。对认知功能进行了一系列神经心理测试,并根据 DSM-IV 标准在基线和随访期间对痴呆症进行了一致诊断:在平均 5.2 年的随访期间,1550 名未患痴呆症的参与者中发现了 135 例(8.7%)痴呆症病例。在对年龄、性别、教育程度、肥胖、APOE-ε4、高血压、糖尿病、抑郁症、基线迷你精神状态检查评分和总能量摄入进行调整后,AN摄入量低(<112毫克/天)的参与者发生痴呆症的风险明显高于AN摄入量高(≥112毫克/天)的参与者(危险比[HR]1.87,95%置信区间[CI]1.26 - 2.77)。只有在年龄≥70岁的人群中才发现总AN摄入量与痴呆症的发生有明显关系:结论:总氨摄入量低可能是老年人患痴呆症的一个风险因素。保持足够的 AN 摄入量可能有利于防止与年龄相关的认知能力下降。
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引用次数: 0
Prevalence of Traumatic Brain Injury in the General Adult Population of the USA: A Meta-Analysis. 美国普通成年人群中的创伤性脑损伤患病率:荟萃分析。
IF 3.2 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-22 DOI: 10.1159/000540676
Armin Karamian, Brandon Lucke-Wold, Ali Seifi

Background: Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. It has been estimated that 64-74 million individuals experience TBI from all causes each year. Due to these variations in reporting TBI prevalence in the general population, we decided to perform a meta-analysis of published studies to better understand the prevalence of TBI in the general adult population of the USA which can help health decision-makers in determining general policies to reduce TBI cases and their costs and burden on the healthcare system.

Methods: Our meta-analysis was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. The study protocol was registered with PROSPERO (CRD42024534598). A comprehensive literature search of PubMed from the National Library of Medicine and Google Scholar was performed from database inception to April 2024. Sixteen studies that evaluated the US general population met our inclusion criteria. A meta-analysis using a random-effects model was performed to estimate the prevalence of TBI in the general adult population of the USA.

Results: The total sample consisted of 27,491 individuals, of whom 4,453 reported a lifetime history of TBI with loss of consciousness (LOC) (18.2%, 95% CI 14.4-22.7%). Some studies did not report relevant information based on gender, but based on available data, among males, 1,843 individuals out of 8,854 reported a lifetime history of TBI with LOC (20.8%). Among females, 1,363 individuals out of 11,943 reported a lifetime history of TBI with LOC (11.4%). The odds of sustaining TBI in males were higher than in females with moderate heterogeneity between studies (OR = 2.09, 95% CI 1.85-2.36, p < 0.01, I2 = 40%).

Conclusion: The prevalence of TBI in the US general population is 18.2%, making it a major public health concern. In addition, males were more than twice as likely as females to sustain TBI with LOC. Considering the irreparable long-term adverse effects of TBI on survivors, their families, and the healthcare system, prevention strategies can facilitate substantial reductions in TBI-related permanent disabilities and medical care costs.

背景:创伤性脑损伤(TBI)是导致全球死亡和残疾的主要原因。据估计,每年有 6,400 万至 7,400 万人因各种原因遭受创伤性脑损伤。由于在报告普通人群中的 TBI 患病率方面存在这些差异,我们决定对已发表的研究进行荟萃分析,以更好地了解美国普通成年人群中的 TBI 患病率,这将有助于卫生决策者确定一般性政策,以减少 TBI 病例及其对医疗系统造成的成本和负担:我们的荟萃分析采用系统综述和荟萃分析首选报告项目(PRISMA)清单进行。研究方案已在 PROSPERO 注册(CRD42024534598)。对美国国家医学图书馆的 PubMed 和谷歌学术进行了全面的文献检索,检索期从数据库开始至 2024 年 4 月。16项评估美国普通人群的研究符合我们的纳入标准。我们使用随机效应模型进行了荟萃分析,以估算美国普通成年人群中创伤性脑损伤的患病率:样本总数为 27,491 人,其中 4,453 人报告了终生 TBI 病史,并伴有 LOC(18.2%,95% CI 14.4-22.7%)。一些研究没有报告基于性别的相关信息,但根据现有数据,在 8,854 名男性中,有 1,843 人报告终生有过伴有 LOC 的创伤性脑损伤病史(20.8%)。在 11,943 名女性中,有 1,363 人(11.4%)报告终生有过伴有 LOC 的创伤性脑损伤病史。男性遭受创伤性脑损伤的几率高于女性,不同研究之间存在中度异质性(OR = 2.09, 95% CI 1.85-2.36, p < 0.01, I2 = 40%):结论:创伤性脑损伤在美国总人口中的发病率为 18.2%,是一个重大的公共卫生问题。此外,男性发生创伤性脑损伤并伴有LOC的几率是女性的两倍多。考虑到创伤性脑损伤对幸存者、其家庭和医疗保健系统造成的不可挽回的长期不利影响,预防策略可以大大减少创伤性脑损伤相关的永久性残疾和医疗费用。
{"title":"Prevalence of Traumatic Brain Injury in the General Adult Population of the USA: A Meta-Analysis.","authors":"Armin Karamian, Brandon Lucke-Wold, Ali Seifi","doi":"10.1159/000540676","DOIUrl":"10.1159/000540676","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. It has been estimated that 64-74 million individuals experience TBI from all causes each year. Due to these variations in reporting TBI prevalence in the general population, we decided to perform a meta-analysis of published studies to better understand the prevalence of TBI in the general adult population of the USA which can help health decision-makers in determining general policies to reduce TBI cases and their costs and burden on the healthcare system.</p><p><strong>Methods: </strong>Our meta-analysis was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. The study protocol was registered with PROSPERO (CRD42024534598). A comprehensive literature search of PubMed from the National Library of Medicine and Google Scholar was performed from database inception to April 2024. Sixteen studies that evaluated the US general population met our inclusion criteria. A meta-analysis using a random-effects model was performed to estimate the prevalence of TBI in the general adult population of the USA.</p><p><strong>Results: </strong>The total sample consisted of 27,491 individuals, of whom 4,453 reported a lifetime history of TBI with loss of consciousness (LOC) (18.2%, 95% CI 14.4-22.7%). Some studies did not report relevant information based on gender, but based on available data, among males, 1,843 individuals out of 8,854 reported a lifetime history of TBI with LOC (20.8%). Among females, 1,363 individuals out of 11,943 reported a lifetime history of TBI with LOC (11.4%). The odds of sustaining TBI in males were higher than in females with moderate heterogeneity between studies (OR = 2.09, 95% CI 1.85-2.36, p &lt; 0.01, I2 = 40%).</p><p><strong>Conclusion: </strong>The prevalence of TBI in the US general population is 18.2%, making it a major public health concern. In addition, males were more than twice as likely as females to sustain TBI with LOC. Considering the irreparable long-term adverse effects of TBI on survivors, their families, and the healthcare system, prevention strategies can facilitate substantial reductions in TBI-related permanent disabilities and medical care costs.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gender Disparities in Neurological Symptoms of Long COVID: A Systematic Review and Meta-Analysis. Long-COVID 神经系统症状的性别差异:系统回顾与荟萃分析。
IF 3.2 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-19 DOI: 10.1159/000540919
Alon Gorenshtein, Liron Leibovitch, Tom Liba, Shai Stern, Yael Stern

Background: Female gender is a known risk factor for long COVID. With the increasing number of COVID-19 cases, the corresponding number of survivors is also expected to rise. To the best of our knowledge, no systematic review has specifically addressed the gender differences in neurological symptoms of long COVID.

Methods: We included studies on female individuals who presented with specific neurological symptoms at least 12 weeks after confirmed COVID-19 diagnosis from PubMed, Central, Scopus, and Web of Science. The search limit was put for after January 2020 until June 15, 2024. We excluded studies that did not provide sex-specific outcome data, those not in English, case reports, case series, and review articles Results: A total of 5,632 eligible articles were identified. This article provides relevant information from 12 studies involving 6,849 patients, of which 3,414 were female. The sample size ranged from 70 to 2,856, with a maximum follow-up period of 18 months. The earliest publication date was September 16, 2021, while the latest was June 11, 2024. The following neurological symptoms had a significant difference in the risk ratio (RR) for female gender: fatigue RR 1.40 (95% confidence interval [CI]: 1.22-1.60, p < 0.001), headache RR 1.37 (95% CI: 1.12-1.67, p = 0.002), brain-fog RR 1.38 (95% CI 1.08-1.76, p = 0.011) depression RR 1.49 (95% CI: 1.2-1.86, p < 0.001), and anosmia RR 1.61 (95% CI: 1.36-1.90, p < 0.001). High heterogenicity was found for fatigue, brain fog, and anxiety due to the diverse methodologies employed in the studies.

Conclusion: Our findings suggest that women are at a higher risk for long-COVID neurological symptoms, including fatigue, headaches, brain fog, depression, and anosmia, compared to men. The prevalence of these symptoms decreases after 1 year, based on limited data from the small number of studies available beyond this period.

背景--女性性别是已知的长COVID风险因素。随着 COVID-19 病例的增加,预计幸存者的人数也会相应增加。据我们所知,还没有系统性综述专门讨论过长COVID神经症状的性别差异。研究方法我们从 PubMed、Central、Scopus 和 Web of Science 中纳入了有关确诊 COVID-19 至少 12 周后出现特定神经症状的女性患者的研究。搜索限制为 2020 年 1 月 1 日之后至 2024 年 6 月 15 日。我们排除了未提供性别特异性结果数据的研究、非英语研究、病例报告、系列病例和综述文章。结果:共找到 5632 篇符合条件的文章。本文提供了 12 项研究的相关信息,涉及 6849 名患者,其中 3414 人为女性。样本量从 70 个到 2856 个不等,随访时间最长为 18 个月。最早发表日期为 2021 年 9 月 16 日,最晚发表日期为 2024 年 6 月 11 日。以下神经症状的风险比(RR)与女性有显著差异:疲劳 RR 1.40(95% 置信区间(CI):1.22 - 1.60,p<0.001),头痛 RR 1.37(95% CI:1.12 - 1.67,p=0.002),脑雾 RR 1.38(95% CI 1.由于研究采用的方法不同,疲劳、脑雾和焦虑的异质性很高。结论-- 我们的研究结果表明,与男性相比,女性出现长期 COVID 神经症状(包括疲劳、头痛、脑雾、抑郁和嗅觉障碍)的风险更高。一年后,这些症状的发生率会有所下降,但这是基于一年后的少数研究中的有限数据。
{"title":"Gender Disparities in Neurological Symptoms of Long COVID: A Systematic Review and Meta-Analysis.","authors":"Alon Gorenshtein, Liron Leibovitch, Tom Liba, Shai Stern, Yael Stern","doi":"10.1159/000540919","DOIUrl":"10.1159/000540919","url":null,"abstract":"<p><strong>Background: </strong>Female gender is a known risk factor for long COVID. With the increasing number of COVID-19 cases, the corresponding number of survivors is also expected to rise. To the best of our knowledge, no systematic review has specifically addressed the gender differences in neurological symptoms of long COVID.</p><p><strong>Methods: </strong>We included studies on female individuals who presented with specific neurological symptoms at least 12 weeks after confirmed COVID-19 diagnosis from PubMed, Central, Scopus, and Web of Science. The search limit was put for after January 2020 until June 15, 2024. We excluded studies that did not provide sex-specific outcome data, those not in English, case reports, case series, and review articles Results: A total of 5,632 eligible articles were identified. This article provides relevant information from 12 studies involving 6,849 patients, of which 3,414 were female. The sample size ranged from 70 to 2,856, with a maximum follow-up period of 18 months. The earliest publication date was September 16, 2021, while the latest was June 11, 2024. The following neurological symptoms had a significant difference in the risk ratio (RR) for female gender: fatigue RR 1.40 (95% confidence interval [CI]: 1.22-1.60, p &lt; 0.001), headache RR 1.37 (95% CI: 1.12-1.67, p = 0.002), brain-fog RR 1.38 (95% CI 1.08-1.76, p = 0.011) depression RR 1.49 (95% CI: 1.2-1.86, p &lt; 0.001), and anosmia RR 1.61 (95% CI: 1.36-1.90, p &lt; 0.001). High heterogenicity was found for fatigue, brain fog, and anxiety due to the diverse methodologies employed in the studies.</p><p><strong>Conclusion: </strong>Our findings suggest that women are at a higher risk for long-COVID neurological symptoms, including fatigue, headaches, brain fog, depression, and anosmia, compared to men. The prevalence of these symptoms decreases after 1 year, based on limited data from the small number of studies available beyond this period.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between Constipation and the Risk of Parkinson's Disease among Participants in the UK Biobank. 英国生物库参与者中便秘与帕金森病风险之间的关系。
IF 3.2 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-19 DOI: 10.1159/000540955
Jing Zhang, Mengyao Shi, Qilu Zhang, Yi Chen, Xiangyan Yin, Xiaoxiao Wang, Yonghong Zhang

Introduction: Constipation is common in patients with Parkinson's disease (PD), but its impact on incident PD remains uncertain. We aimed to prospectively investigate constipation symptoms and the risk of PD.

Methods: Participants without PD at baseline from the UK Biobank were included in the study. Information on the regular use of laxatives, bowel movement frequency, and the frequency of hard or lumpy stools was collected. Incident PD was defined by the ICD-10 code. Cox proportional hazards models were used to assess the association between constipation symptoms and incident PD.

Results: In the analysis of regular laxative use and PD, 490,797 participants were included and 2,735 incident PD were detected. The multivariable adjusted HR of PD in participants who regularly used laxatives was 1.99 (95% confidence interval [CI], 1.70-2.33) compared with those who did not. In the analysis of bowel movement frequency and hard or lumpy stools and PD, 170,017 participants were included and 519 incident PD were detected. The multivariable adjusted HRs were 2.16 (95% CI, 1.74-2.68) and 2.57 (95% CI, 2.00-3.31) for participants with a bowel movement frequency of 3-6 times/week and <3 times/week, respectively, compared with those with a bowel movement frequency of ≥7 times/week; compared with participants who never had hard or lumpy stools, multivariable adjusted HRs were 1.31 (95% CI, 1.07-1.60), 2.32 (95% CI, 1.77-3.05), and 2.94 (95% CI, 2.14-4.05) for those who sometimes had hard or lumpy stools, often had hard or lumpy stools, and most of time/always had hard or lumpy stools, respectively.

Conclusions: Constipation measured by the regular use of laxatives, bowel movement frequency, and the frequency of hard or lumpy stools was significantly associated with an increased risk of incident PD.

简介:便秘在帕金森病(PD)患者中很常见,但其对帕金森病发病的影响仍不确定。我们旨在对便秘症状和帕金森病发病风险进行前瞻性调查:研究纳入了英国生物库中基线无帕金森病的参与者。我们收集了有关定期使用泻药、排便频率、硬便或块状便频率的信息。根据ICD-10代码定义发病的腹泻症。研究采用Cox比例危险模型评估便秘症状与发病前列腺增生之间的关系:结果:在对经常使用泻药和腹泻进行的分析中,共纳入了 490,797 名参与者,发现了 2,735 例腹泻事件。与不经常使用泻药的参与者相比,经常使用泻药的参与者出现腹泻病的多变量调整HR为1.99(95%置信区间[CI],1.70-2.33)。在对排便频率、硬便或块状便与腹泻进行的分析中,共纳入了 170,017 名参与者,发现了 519 例腹泻事件。与排便次数≥7次/周的参与者相比,排便次数为3-6次/周和<3次/周的参与者的多变量调整HR分别为2.16(95% CI,1.74-2.68)和2.57(95% CI,2.00-3.31);与从未有过硬便或块状便的参与者相比,多变量调整HR为1.与从未有过硬结或块状粪便的参与者相比,有时有硬结或块状粪便、经常有硬结或块状粪便以及大部分时间/总是有硬结或块状粪便的参与者的多变量调整HR分别为1.31(95% CI,1.07-1.60)、2.32(95% CI,1.77-3.05)和2.94(95% CI,2.14-4.05):以经常使用泻药、排便次数以及大便变硬或结块的频率来衡量的便秘与罹患前列腺增生症的风险增加显著相关。
{"title":"Association between Constipation and the Risk of Parkinson's Disease among Participants in the UK Biobank.","authors":"Jing Zhang, Mengyao Shi, Qilu Zhang, Yi Chen, Xiangyan Yin, Xiaoxiao Wang, Yonghong Zhang","doi":"10.1159/000540955","DOIUrl":"10.1159/000540955","url":null,"abstract":"<p><strong>Introduction: </strong>Constipation is common in patients with Parkinson's disease (PD), but its impact on incident PD remains uncertain. We aimed to prospectively investigate constipation symptoms and the risk of PD.</p><p><strong>Methods: </strong>Participants without PD at baseline from the UK Biobank were included in the study. Information on the regular use of laxatives, bowel movement frequency, and the frequency of hard or lumpy stools was collected. Incident PD was defined by the ICD-10 code. Cox proportional hazards models were used to assess the association between constipation symptoms and incident PD.</p><p><strong>Results: </strong>In the analysis of regular laxative use and PD, 490,797 participants were included and 2,735 incident PD were detected. The multivariable adjusted HR of PD in participants who regularly used laxatives was 1.99 (95% confidence interval [CI], 1.70-2.33) compared with those who did not. In the analysis of bowel movement frequency and hard or lumpy stools and PD, 170,017 participants were included and 519 incident PD were detected. The multivariable adjusted HRs were 2.16 (95% CI, 1.74-2.68) and 2.57 (95% CI, 2.00-3.31) for participants with a bowel movement frequency of 3-6 times/week and &lt;3 times/week, respectively, compared with those with a bowel movement frequency of ≥7 times/week; compared with participants who never had hard or lumpy stools, multivariable adjusted HRs were 1.31 (95% CI, 1.07-1.60), 2.32 (95% CI, 1.77-3.05), and 2.94 (95% CI, 2.14-4.05) for those who sometimes had hard or lumpy stools, often had hard or lumpy stools, and most of time/always had hard or lumpy stools, respectively.</p><p><strong>Conclusions: </strong>Constipation measured by the regular use of laxatives, bowel movement frequency, and the frequency of hard or lumpy stools was significantly associated with an increased risk of incident PD.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Associations of Diet and Lifestyle with Mortality and Stroke: The China Cardiometabolic Disease and Cancer Cohort (4C) Study. 饮食和生活方式与死亡率和中风的关系:中国心脏代谢疾病和癌症队列(4C)研究》。
IF 3.2 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-14 DOI: 10.1159/000540922
Yue-Yang Zhang, Xin Yang, Ying Miu, Bing-Xue Chen, Qin Wan

Objective: This study aimed to examine the individual and combined associations between dietary habits and lifestyle factors concerning all-cause mortality and stroke in Chinese adults.

Method: We conducted a nationwide, multicenter, prospective cohort study involving 10,008 participants, gathering baseline data on lifestyle, metabolic status, dietary habits, and living behaviors. Subsequently, a 10-year follow-up was performed, resulting in the inclusion of 7,612 participants in this study. We employed Spearman correlation analysis, restricted cubic spline regression, and Cox regression analysis to evaluate the connections between outcome events, dietary habits, and lifestyle.

Result: For each additional serving of pulses consumed per week, there was a slight decrease in the risk of all-cause mortality (HR: 0.91, 95% CI: 0.83-0.99). The hazard ratios for stroke were 2.24 (1.48, 3.37) for current smokers, in comparison to individuals who had never smoked. Appropriate intake of specific dietary factors and certain lifestyle habits were associated with reduced stroke: fruit drinks at 0.51 (0.34, 0.87), and animal viscera at 0.58 (0.32, 1.04). Weekly consumption of at least 21 servings of vegetables (0.72, 0.53-0.98), 0-1 serving of fried food (0.58, 0.38-0.90), and at least 1 serving of carbonated beverages (0.51, 0.28-0.92) was associated with a reduced risk of stroke.

Conclusion: Smoking was found to be linked to an increased risk of stroke. A higher intake of fruit drinks and animal viscera was associated with a reduced risk of stroke. In contrast, a higher intake of beans was associated with a decreased risk of overall mortality. Consuming an appropriate amount of vegetables, fried foods, and carbonated drinks was found to potentially lower the risk of stroke. Collectively, these findings underscore the importance of developing tailored dietary interventions conducive to the Chinese populace's health.

研究目的本研究旨在探讨中国成年人饮食习惯和生活方式因素与全因死亡率和脑卒中之间的个体和综合关联:我们在全国范围内开展了一项多中心前瞻性队列研究,共纳入 10,008 名参与者,收集了有关生活方式、代谢状况、饮食习惯和生活行为的基线数据。随后,我们进行了为期 10 年的随访,最终将 7612 名参与者纳入本研究。我们采用了斯皮尔曼相关分析、限制性三次样条回归和考克斯回归分析来评估结果事件、饮食习惯和生活方式之间的联系:结果:每周每多摄入一份豆类,全因死亡风险略有降低(HR:0.91,95% CI:0.83-0.99)。与从未吸烟者相比,目前吸烟者的中风危险比为 2.24(1.48, 3.37)。适当摄入特定的饮食因素和某些生活习惯与减少中风有关:水果饮料为 0.51(0.34, 0.87),动物内脏为 0.58(0.32, 1.04)。每周至少食用 21 份蔬菜(0.72,0.53-0.98)、0-1 份油炸食品(0.58,0.38-0.90)和至少 1 份碳酸饮料(0.51,0.28-0.92)与中风风险降低有关:结论:吸烟与中风风险增加有关。结论:吸烟与中风风险增加有关,而水果饮料和动物内脏摄入量越高,中风风险越低。相反,豆类摄入量越高,总体死亡风险越低。适量摄入蔬菜、油炸食品和碳酸饮料有可能降低中风风险。总之,这些发现强调了制定有利于中国人健康的针对性膳食干预措施的重要性。
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引用次数: 0
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Neuroepidemiology
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