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  • 1
    In: Digestion, S. Karger AG, Vol. 75, No. 1 ( 2007), p. 46-52
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Situations where practical therapeutic decisions differ from guidelines in the management of patients with Crohn’s disease (CD) have been described through opinion surveys. The feasibility of actually documenting these situations using an explicit approach has not been examined. 〈 i 〉 Objective: 〈 /i 〉 The aim of this study was to evaluate the feasibility of a retrospective application of appropriateness criteria to a population of CD patients. 〈 i 〉 Methods: 〈 /i 〉 Medical records of a cohort of patients diagnosed with CD were systematically reviewed. We used appropriateness criteria for treatment of CD that had been developed by the European Panel on the Appropriateness of Crohn’s Disease Therapy (EPACT). First we evaluated the level of precision of the elements abstracted from medical records needed in order to be able to apply these criteria. We then assessed the appropriateness of treatment for different CD categories. Only participants with at least one physician encounter during the preceding 6 months were included. 〈 i 〉 Results: 〈 /i 〉 260 patient medical records were reviewed on site at 22 gastroenterologists’ offices over a 2-month period in 2005. 116 (44%) patients were excluded because they had not had at least one medical visit at their referred gastroenterologist during the preceding 6 months. Medical records for 8 additional patients (3%) were not accessible. 136 (53%) medical records including 148 encounters were available for analysis. Overall, elements necessary to determine the appropriateness of treatment were available in 94% (139/148) of encounters. These elements were available in more than 90% of cases for all CD categories except for mild-moderate luminal active CD where 66% were available. Among those with all necessary elements available, 18% of treatments were judged as appropriate, 29% inappropriate, 38% uncertain according to the EPACT criteria, and for the other 15%, appropriateness had not been rated by the EPACT panel. 〈 i 〉 Conclusions: 〈 /i 〉 The information necessary to assess the appropriateness of treatment of major types of CD was generally both present and precise in medical records. Therefore, in addition to the intended prospective use of these criteria, retrospective evaluation of the appropriateness of CD treatment using medical records is also feasible with the EPACT criteria.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    RVK:
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    Language: English
    Publisher: S. Karger AG
    Publication Date: 2007
    detail.hit.zdb_id: 1482218-0
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  • 2
    In: Gastrointestinal Tumors, S. Karger AG, Vol. 8, No. 2 ( 2021), p. 63-70
    Abstract: 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 Fecal blood testing is a noninvasive alternative to colonoscopy for colorectal cancer (CRC) screening and is preferred by a substantial proportion of individuals. However, participant-related determinants of the choice of screening method, particularly up-to-date screening status, remain less studied. We aimed to determine if up-to-date screening status was related to choosing a fecal blood test over colonoscopy. 〈 b 〉 〈 i 〉 Setting: 〈 /i 〉 〈 /b 〉 Participants in the population-based cross-sectional survey study Bus Santé in Geneva, Switzerland – aged 50–69 years. 〈 b 〉 〈 i 〉 Design: 〈 /i 〉 〈 /b 〉 Cross-sectional survey study using mailed questionnaires inquiring about CRC screening method of choice after providing information on advantages and disadvantages of both screening methods. We used multivariable logistic regression models to determine the association between up-to-date CRC screening status and choosing fecal blood testing. 〈 b 〉 〈 i 〉 Key results: 〈 /i 〉 〈 /b 〉 We included 1,227 participants. Thirty-eight percent of participants did not have up-to-date CRC screening. Overall, colonoscopy (54.9%) was preferred to fecal blood testing (45.1%) ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) as screening method of choice. However, screening method choices differed between those with (65.6% colonoscopy and 34.4% fecal blood testing) and without up-to-date CRC screening (36.5% colonoscopy and 63.5% fecal blood testing). Not having up-to-date CRC screening was associated with a higher probability of choosing fecal blood testing as screening method (odds ratio = 2.6 [1.9; 3.7] , 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) after adjustment for the aforementioned confounders. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Not having up-to-date screening was independently associated with fecal blood testing as the preferred method for CRC screening. Proposing this method to this subpopulation, in a context of shared decision, could potentially increase screening uptake in settings where it is already high.
    Type of Medium: Online Resource
    ISSN: 2296-3774 , 2296-3766
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 2735769-7
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  • 3
    In: Gerontology, S. Karger AG, Vol. 65, No. 5 ( 2019), p. 474-484
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Muscle weakness – a biomarker of health – may have its origins in early life and be related to factors such as adverse childhood experiences (ACE), which refer to a set of early-life traumatic and stressful psychosocial events out of the child’s control. To date, evidence of an association between ACE and muscle strength in older age is lacking. ­ 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 Here, we assessed the associations between ACE during the first 15 years of life and the risk of low muscle strength (LMS) later in life. We also examined whether adult-life socioeconomic circumstances (i.e., educational attainment, main occupational position, and satisfaction with household financial situation) and unhealthy behaviors (i.e., physical inactivity, unhealthy eating, smoking, and high level of alcohol consumption) explained this association. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We used data from the Survey of Health, Ageing, and Retirement in Europe, a 12-year cohort study with 6 ­repeated measurements between 2004 and 2015. Muscle strength was measured using a handheld dynamometer. Confounder-adjusted logistic mixed-effect models were used to examine the associations between ACE (child in care, parental death, parental mental illness, parental drinking, period of hunger, or property taken away) and the risk of LMS in older age. ­ 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 24,179 participants (96,372 observations; 13,477 women; aged 50–96 years) living in 14 countries were included. LMS increased with age for both genders. For women, there was a gradual increase in the risk of LMS with the number of experienced ACE (ORs = 1.22 for 1 ACE, 1.74 for ≥2 ACE compared to no ACE). However, there was no significant association among men. This association was only slightly attenuated when adjusting for socioeconomic circumstances and unhealthy behaviors in adulthood. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 ACE are associated with later-life muscle weakness among women. These associations were not compensated by the adoption of healthy behaviors or an improvement in socioeconomic circumstances in adulthood. These results suggest that tackling these early-life risk factors in women could promote long-term grip strength, a biomarker of aging.
    Type of Medium: Online Resource
    ISSN: 0304-324X , 1423-0003
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2019
    detail.hit.zdb_id: 1482689-6
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  • 4
    Online Resource
    Online Resource
    S. Karger AG ; 2015
    In:  Annals of Nutrition and Metabolism Vol. 67, No. 2 ( 2015), p. 87-95
    In: Annals of Nutrition and Metabolism, S. Karger AG, Vol. 67, No. 2 ( 2015), p. 87-95
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 The determinants of a healthy diet have not been studied in Switzerland. This study aimed at assessing the individual and behavioural factors associated with a healthy diet in a Swiss city. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Cross-sectional, population-based study conducted between 2009 and 2013 (n = 4,439, 2,383 women, mean age 57.5 ± 10.3 years) in Lausanne. Food consumption was assessed using a validated food frequency questionnaire. Two Mediterranean diet scores (classic score and specific for Switzerland) and the Harvard School of Public Health alternate healthy eating index were computed. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 For all three dietary scores considered, living in couple or having a high education were associated with a healthier diet. An unhealthy lifestyle (smoking, sedentary behaviour) or a high body mass index were associated with an unhealthier diet. Participants born in Italy, Portugal and Spain had healthier diets than participants born in France or Switzerland. Women and elderly participants had healthier diets than men and young participants according to 2 scores, while no differences were found for the Swiss-specific Mediterranean score. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 In Switzerland, healthy eating is associated with high education, a healthy lifestyle, marital status and country of origin. The associations with gender and age depend on the dietary score considered.
    Type of Medium: Online Resource
    ISSN: 0250-6807 , 1421-9697
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 1481977-6
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  • 5
    Online Resource
    Online Resource
    S. Karger AG ; 2011
    In:  Kidney and Blood Pressure Research Vol. 34, No. 6 ( 2011), p. 404-417
    In: Kidney and Blood Pressure Research, S. Karger AG, Vol. 34, No. 6 ( 2011), p. 404-417
    Abstract: The relationship between calcium and cardiovascular diseases (CVD) has been explored for a long time. Studies exploring the effect of calcium intake or calcium supplementation on cardiovascular risk suggest that systolic blood pressure increases under low calcium intake and decreases with calcium supplementation. A lower calcium intake has been associated with an increased risk of stroke. However, the impact of calcium supplementation on stroke risk remains unclear. Calcium supplementation may increase the risk of myocardial infarction. The relationship between vitamin D and CVD has been explored more recently. Negative correlations between vitamin D levels and the risk of hypertension, myocardial infarction, and stroke have been reported in several observational studies. The effect of vitamin D supplementation on blood pressure is still unclear and no effect of vitamin D supplementation on coronary heart disease or stroke has been clearly demonstrated. There is a lack of randomized clinical trials primarily addressing the effect of these parameters on CVD. Therefore, the real impact of calcium and vitamin D on cardiovascular outcomes remains to be documented by appropriate experimental data.
    Type of Medium: Online Resource
    ISSN: 1420-4096 , 1423-0143
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1482922-8
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  • 6
    In: Kidney and Blood Pressure Research, S. Karger AG, Vol. 39, No. 1 ( 2014), p. 74-85
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 Prospective studies on factors associated with adverse kidney outcomes in European general populations are scant. Also, few studies consider the potential confounding effect of baseline kidney function. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We used baseline (2003-2006) and 5-year follow-up data of adults from the general population to evaluate the effect of baseline kidney function and proteinuria on the association of clinical, biological (e.g. uric acid, homocysteine, cytokines), and socioeconomic factors with change in kidney function, rapid decline in kidney function, and incidence of chronic kidney disease (CKD). Estimated glomerular filtration rate (eGFR) and urinary albuminuria-to-creatinine ratio (UACR) were collected. Kidney outcomes were modeled using multivariable regressions. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 4,441 subjects were included in the analysis. Among participants without CKD at baseline, 11.4% presented rapid decline in eGFR and/or incident CKD. After adjustment for baseline eGFR and log UACR, only age (Odds Ratio; 1.25 [95%CI 1.18-1.33]), diabetes (OR 1.48 [1.03-2.13] ), education (OR middle 〈 i 〉 vs 〈 /i 〉 . high 1.51 [1.08-2.11]) and log ultrasensitive CRP (OR 1.16 [1.05-1.22] ) were associated with rapid decline in eGFR or incident CKD. Baseline log UACR (OR 1.18 [1.06-1.32]) but not eGFR was associated with rapid decline in eGFR and/or incident CKD. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 In addition to age and diabetes, education and CRP levels are associated with adverse kidney outcomes independently of baseline kidney function.
    Type of Medium: Online Resource
    ISSN: 1420-4096 , 1423-0143
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 1482922-8
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