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    A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial.
    BMC Med 2018 Feb 23;16(1):28. Epub 2018 Feb 23.
    Distrito de AtenciónPrimariaMálaga-Guadalhorce, Unidad de Investigación, C/Sevilla, 23, 3a Planta, 29009, Málaga, Spain.
    Background: Depression is viewed as a major and increasing public health issue, as it causes high distress in the people experiencing it and considerable financial costs to society. Efforts are being made to reduce this burden by preventing depression. A critical component of this strategy is the ability to assess the individual level and profile of risk for the development of major depression. Read More

    Multidrug-resistant tuberculosis treatment adherence in migrants: a systematic review and meta-analysis.
    BMC Med 2018 Feb 22;16(1):27. Epub 2018 Feb 22.
    Infectious Diseases & Immunity, Department of Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 ONN, UK.
    Background: Multidrug-resistant tuberculosis (MDR-TB) is a growing concern in meeting global targets for TB control. In high-income low-TB-incidence countries, a disproportionate number of MDR-TB cases occur in migrant (foreign-born) populations, with concerns about low adherence rates in these patients compared to the host non-migrant population. Tackling MDR-TB in this context may, therefore, require unique approaches. Read More

    Reproducibility of clinical research in critical care: a scoping review.
    BMC Med 2018 Feb 21;16(1):26. Epub 2018 Feb 21.
    Department of Critical Care Medicine, University of Calgary, 3134 Hospital Drive NW, Calgary, AB, T2N 2T9, Canada.
    Background: The ability to reproduce experiments is a defining principle of science. Reproducibility of clinical research has received relatively little scientific attention. However, it is important as it may inform clinical practice, research agendas, and the design of future studies. Read More

    Genomic screening for monogenic forms of diabetes.
    BMC Med 2018 Feb 20;16(1):25. Epub 2018 Feb 20.
    Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
    Adult-onset, or type II diabetes mellitus (T2DM) has a complex genetic architecture, from hundreds of genes with low penetrance, common susceptibility variants (e.g., TCF7L2), to a set of more than ten genes that, when mutated, can cause a single-gene or Mendelian form of T2DM (e. Read More

    Circadian pathway genetic variation and cancer risk: evidence from genome-wide association studies.
    BMC Med 2018 Feb 19;16(1):20. Epub 2018 Feb 19.
    Department of Surgery Oncology and Gastroenterology, University of Padova, Via Giustiniani 2, 35128, Padova, Italy.
    Background: Dysfunction of the circadian clock and single polymorphisms of some circadian genes have been linked to cancer susceptibility, although data are scarce and findings inconsistent. We aimed to investigate the association between circadian pathway genetic variation and risk of developing common cancers based on the findings of genome-wide association studies (GWASs).

    Methods: Single nucleotide polymorphisms (SNPs) of 17 circadian genes reported by three GWAS meta-analyses dedicated to breast (Discovery, Biology, and Risk of Inherited Variants in Breast Cancer (DRIVE) Consortium; cases, n = 15,748; controls, n = 18,084), prostate (Elucidating Loci Involved in Prostate Cancer Susceptibility (ELLIPSE) Consortium; cases, n = 14,160; controls, n = 12,724) and lung carcinoma (Transdisciplinary Research In Cancer of the Lung (TRICL) Consortium; cases, n = 12,160; controls, n = 16,838) in patients of European ancestry were utilized to perform pathway analysis by means of the adaptive rank truncated product (ARTP) method. Read More

    Second-line treatment for advanced NSCLC without actionable mutations: is immunotherapy the 'panacea' for all patients?
    BMC Med 2018 02 16;16(1):24. Epub 2018 Feb 16.
    The Medical Oncology Unit, Thoracic-Pulmonary Department, Istituto Nazionale Tumori, "Fondazione G. Pascale" - IRCCS, Via Mariano Semola, 80131, Naples, Italy.
    The therapeutic approach for the second-line treatment of patients with advanced non-small cell lung cancer (NSCLC) without actionable mutations has been revolutionized by the recent approval of new effective drugs with various mechanisms of action, including nintedanib, ramucirumab, nivolumab, pembrolizumab, atezolizumab, and afatinib. The recent network meta-analysis of Créquit et al. (BMC Medicine, 15:193, 2017) compared the effectiveness and tolerability of the second-line treatments for advanced NSCLC with wild-type or unknown status for EGFR. Read More

    Chronic morbidity, deprivation and primary medical care spending in England in 2015-16: a cross-sectional spatial analysis.
    BMC Med 2018 02 14;16(1):19. Epub 2018 Feb 14.
    Department of Health Sciences, University of York, Yorkshire, UK.
    Background: Primary care provides the foundation for most modern health-care systems, and in the interests of equity, it should be resourced according to local need. We aimed to describe spatially the burden of chronic conditions and primary medical care funding in England at a low geographical level, and to measure how much variation in funding is explained by chronic condition prevalence and other patient and regional factors.

    Methods: We used multiple administrative data sets including chronic condition prevalence and management data (2014/15), funding for primary-care practices (2015-16), and geographical and area deprivation data (2015). Read More

    International core outcome set for clinical trials of medication review in multi-morbid older patients with polypharmacy.
    BMC Med 2018 02 13;16(1):21. Epub 2018 Feb 13.
    Louvain Drug Research Institute (LDRI), Clinical pharmacy research group, Université catholique de Louvain, Brussels, Belgium.
    Background: Comparisons of clinical trial findings in systematic reviews can be hindered by the heterogeneity of the outcomes reported. Moreover, the outcomes that matter most to patients might be underreported. A core outcome set can address these issues, as it defines a minimum set of outcomes that should be reported in all clinical trials in a particular area of research. Read More

    The human fetal adrenal produces cortisol but no detectable aldosterone throughout the second trimester.
    BMC Med 2018 02 12;16(1):23. Epub 2018 Feb 12.
    Institute of Medical Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK.
    Background: Human fetal adrenal glands are highly active and, with the placenta, regulate circulating progesterone, estrogen and corticosteroids in the fetus. At birth the adrenals are essential for neonate salt retention through secretion of aldosterone, while adequate glucocorticoids are required to prevent adrenal insufficiency. The objective of this study was to carry out the first comprehensive analysis of adrenal steroid levels and steroidogenic enzyme expression in normal second trimester human fetuses. Read More

    Geographic variation in sexual behavior can explain geospatial heterogeneity in the severity of the HIV epidemic in Malawi.
    BMC Med 2018 02 9;16(1):22. Epub 2018 Feb 9.
    Center for Biomedical Modeling, Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, 760 Westwood Plaza, Office 27-423, Los Angeles, California, 90095, USA.
    Background: In sub-Saharan Africa, where ~ 25 million individuals are infected with HIV and transmission is predominantly heterosexual, there is substantial geographic variation in the severity of epidemics. This variation has yet to be explained. Here, we propose that it is due to geographic variation in the size of the high-risk group (HRG): the group with a high number of sex partners. Read More

    Elucidating the impact of the pneumococcal conjugate vaccine programme on pneumonia, sepsis and otitis media hospital admissions in England using a composite control.
    BMC Med 2018 02 8;16(1):13. Epub 2018 Feb 8.
    Public Health England, London, UK.
    Background: The seven-valent pneumococcal conjugate vaccine (PCV) was introduced in England in September 2006, changing to the 13-valent vaccine in April 2010. PCV impact on invasive pneumococcal disease (IPD) has been extensively reported, but less described is its impact on the burden of pneumonia, sepsis and otitis media in the hospital.

    Methods: Using details on all admissions to hospitals in England, we compared the incidence of pneumococcal-specific and syndromic disease endpoints in a 24-month pre-PCV period beginning April 2004 to the 24-month period ending March 2015 to derive incidence rate ratios (IRRs). Read More

    Metabolic characterization of menopause: cross-sectional and longitudinal evidence.
    BMC Med 2018 02 6;16(1):17. Epub 2018 Feb 6.
    MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
    Background: Women who experience menopause are at higher cardiometabolic risk and often display adverse changes in metabolic biomarkers compared with pre-menopausal women. It remains elusive whether the changes in cardiometabolic biomarkers during the menopausal transition are due to ovarian aging or chronological aging. Well-conducted longitudinal studies are required to determine this. Read More

    Melatonin and health: an umbrella review of health outcomes and biological mechanisms of action.
    BMC Med 2018 02 5;16(1):18. Epub 2018 Feb 5.
    Centre for Population Health Sciences, 11 Mandalay Road, Level 18 Clinical Sciences Building, Lee Kong Chian School of Medicine, Novena Campus, Nanyang Technological University , Singapore, 308232, Singapore.
    Background: Our aims were to evaluate critically the evidence from systematic reviews as well as narrative reviews of the effects of melatonin (MLT) on health and to identify the potential mechanisms of action involved.

    Methods: An umbrella review of the evidence across systematic reviews and narrative reviews of endogenous and exogenous (supplementation) MLT was undertaken. The Oxman checklist for assessing the methodological quality of the included systematic reviews was utilised. Read More

    Near-death experiences, attacks by family members, and absence of health care in their home countries affect the quality of life of refugee women in Germany: a multi-region, cross-sectional, gender-sensitive study.
    BMC Med 2018 02 1;16(1):15. Epub 2018 Feb 1.
    Psychiatric University Clinic of Charité at St. Hedwig Hospital, Große Hamburger Straße 5 - 11, 10115, Berlin, Germany.
    Background: The year 2016 has marked the highest number of displaced people worldwide on record. A large number of these refugees are women, yet little is known about their specific situation and the hurdles they have to face during their journey. Herein, we investigated whether sociodemographic characteristics and traumatic experiences in the home country and during the flight affected the quality of life of refugee women arriving in Germany in 2015-2016. Read More

    Built environmental characteristics and diabetes: a systematic review and meta-analysis.
    BMC Med 2018 01 31;16(1):12. Epub 2018 Jan 31.
    Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081HV, Amsterdam, The Netherlands.
    Background: The built environment influences behaviour, like physical activity, diet and sleep, which affects the risk of type 2 diabetes mellitus (T2DM). This study systematically reviewed and meta-analysed evidence on the association between built environmental characteristics related to lifestyle behaviour and T2DM risk/prevalence, worldwide.

    Methods: We systematically searched PubMed, EMBASE. Read More

    Economic evaluation of type 2 diabetes prevention programmes: Markov model of low- and high-intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia.
    BMC Med 2018 01 30;16(1):16. Epub 2018 Jan 30.
    Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
    Background: National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate categories of hyperglycaemia defined in terms of impaired fasting glucose (IFG) or 'at-risk' levels of HbA1c. In a recent systematic review of economic evaluations of such interventions, most studies had evaluated intensive trial-based lifestyle programmes in participants with impaired glucose tolerance (IGT). This study examines the costs and effects of different intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia. Read More

    Rotavirus vaccine impact and socioeconomic deprivation: an interrupted time-series analysis of gastrointestinal disease outcomes across primary and secondary care in the UK.
    BMC Med 2018 01 29;16(1):10. Epub 2018 Jan 29.
    The Centre for Global Vaccine Research, Institute of Infection and Global Health, University of Liverpool, L69 7BE, Liverpool, UK.
    Background: Rotavirus causes severe gastroenteritis in infants and young children worldwide. The UK introduced the monovalent rotavirus vaccine (Rotarix®) in July 2013. Vaccination is free of charge to parents, with two doses delivered at 8 and 12 weeks of age. Read More

    Rethinking Disability.
    BMC Med 2018 01 26;16(1):14. Epub 2018 Jan 26.
    Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland.
    Disability as a health outcome deserves more attention than it has so far received. With people living longer and the epidemiological transition from infectious to noncommunicable diseases as the major cause of health burden, we need to focus attention on disability - the non-fatal impact of heath conditions - over and above our concern for causes of mortality.With the first Global Burden of Disease study, WHO provided a metric that enabled the comparison of the impact of diseases, drawing on a model of disability that focused on decrements of health. Read More

    Vaginal dysbiosis increases risk of preterm fetal membrane rupture, neonatal sepsis and is exacerbated by erythromycin.
    BMC Med 2018 01 24;16(1). Epub 2018 Jan 24.
    Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, W12 0NN, UK.
    Background: Preterm prelabour rupture of the fetal membranes (PPROM) precedes 30% of preterm births and is a risk factor for early onset neonatal sepsis. As PPROM is strongly associated with ascending vaginal infection, prophylactic antibiotics are widely used. The evolution of vaginal microbiota compositions associated with PPROM and the impact of antibiotics on bacterial compositions are unknown. Read More

    Micronutrient powders to combat anaemia in young children: do they work?
    BMC Med 2018 01 22;16(1). Epub 2018 Jan 22.
    MRC Unit The Gambia, Atlantic Boulevard, Fajara, Gambia.
    In 2016, the World Health Organization (WHO) recommended point-of-use fortification of complementary foods with iron-containing micronutrient powders to improve iron status and reduce anaemia in children at risk of anaemia. This recommendation continues to be debated. In a recent trial among Kenyan children aged 12-36 months, we found no evidence that daily point-of-use fortification was efficacious in improving haemoglobin concentration or plasma iron markers. Read More

    Efficacy of melatonin for sleep disturbance following traumatic brain injury: a randomised controlled trial.
    BMC Med 2018 01 19;16(1). Epub 2018 Jan 19.
    School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Wellington Road, Melbourne, Victoria, 3800, Australia.
    Background: The study aimed to determine the efficacy of melatonin supplementation for sleep disturbances in patients with traumatic brain injury (TBI).

    Methods: This is a randomised double-blind placebo-controlled two-period two-treatment (melatonin and placebo) crossover study. Outpatients were recruited from Epworth and Austin Hospitals Melbourne, Australia. Read More

    Single low-dose primaquine for blocking transmission of Plasmodium falciparum malaria - a proposed model-derived age-based regimen for sub-Saharan Africa.
    BMC Med 2018 01 18;16(1):11. Epub 2018 Jan 18.
    Mahidol Oxford Tropical Medicine Research Unit (MORU), Mahidol University, 420/6 Rajvithi Road, Rajthevee, Bangkok, 10400, Thailand.
    Background: In 2012, the World Health Organization recommended blocking the transmission of Plasmodium falciparum with single low-dose primaquine (SLDPQ, target dose 0.25 mg base/kg body weight), without testing for glucose-6-phosphate dehydrogenase deficiency (G6PDd), when treating patients with uncomplicated falciparum malaria. We sought to develop an age-based SLDPQ regimen that would be suitable for sub-Saharan Africa. Read More

    Antidepressant use during pregnancy and risk of autism spectrum disorder and attention deficit hyperactivity disorder: systematic review of observational studies and methodological considerations.
    BMC Med 2018 01 15;16(1). Epub 2018 Jan 15.
    Pharmacovigilance and Epidemiology Department, European Medicines Agency, 30 Churchill Place, Canary Wharf, London, E14 5EU, UK.
    Background: Antidepressant exposure during pregnancy has been associated with an increased risk of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) in several observational studies. We performed a systematic review of these studies to highlight the effect that important methodological limitations have on such analyses and to consider approaches to the conduct, reporting and interpretation of future studies.

    Methods: A review of MEDLINE and EMBASE identified case-control, cohort and sibling studies assessing the risk of ASD and ADHD with antidepressant use during pregnancy. Read More

    Identifying older adults at risk of harm following elective surgery: a systematic review and meta-analysis.
    BMC Med 2018 01 12;16(1). Epub 2018 Jan 12.
    Division of Geriatric Medicine, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S 1A1, Canada.
    Background: Elective surgeries can be associated with significant harm to older adults. The present study aimed to identify the prognostic factors associated with the development of postoperative complications among older adults undergoing elective surgery.

    Methods: Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and AgeLine were searched for articles published between inception and April 21, 2016. Read More

    Deprescribing preventive cardiovascular medication in patients with predicted low cardiovascular disease risk in general practice - the ECSTATIC study: a cluster randomised non-inferiority trial.
    BMC Med 2018 01 11;16(1). Epub 2018 Jan 11.
    Department of Public Health and Primary Care, Leiden University Medical Centre, PO Box 9600, 2300 RC, Leiden, The Netherlands.
    Background: The use of cardiovascular medication for the primary prevention of cardiovascular disease (CVD) is potentially inappropriate when potential risks outweigh the potential benefits. It is unknown whether deprescribing preventive cardiovascular medication in patients without a strict indication for such medication is safe and cost-effective in general practice.

    Methods: In this pragmatic cluster randomised controlled non-inferiority trial, we recruited 46 general practices in the Netherlands. Read More

    Risk of fracture among patients with polymyalgia rheumatica and giant cell arteritis: a population-based study.
    BMC Med 2018 01 10;16(1). Epub 2018 Jan 10.
    Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, ST5 5BG, UK.
    Background: Glucocorticoids are associated with increased fracture risk and are the mainstay of treatment in polymyalgia rheumatica (PMR) and giant cell arteritis (GCA). However, fracture risk in these conditions has not been previously quantified. The aim of this study was to quantify the risk of fracture among patients with PMR and GCA. Read More

    Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany - a mathematical modelling study.
    BMC Med 2018 01 9;16(1). Epub 2018 Jan 9.
    ESME - Epidemiological and Statistical Methods Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany.
    Background: Epidemiological studies suggest that reduced exposure to varicella might lead to an increased risk for herpes zoster (HZ). Reduction of exposure to varicella is a consequence of varicella vaccination but also of demographic changes. We analyzed how the combination of vaccination programs and demographic dynamics will affect the epidemiology of varicella and HZ in Germany over the next 50 years. Read More

    The health impacts of climate-related migration.
    BMC Med 2017 12 11;16(1). Epub 2017 Dec 11.
    The School of Geography, The University of Melbourne, Parkville, VIC, 3010, Australia.
    Background: Changes in climate, in conjunction with other drivers of mobility, shape human migration. While there is an increasing focus on the adaptive potential of migration, the health impacts of climate-related migration, including planned relocation and forced displacement, have not been thoroughly examined. The Intergovernmental Panel on Climate Change stated that migration is currently, and will increasingly be, influenced by environmental degradation and climate change, and that it needs to be addressed in a focused and coordinated manner. Read More

    Simulations for designing and interpreting intervention trials in infectious diseases.
    BMC Med 2017 12 29;15(1):223. Epub 2017 Dec 29.
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
    Background: Interventions in infectious diseases can have both direct effects on individuals who receive the intervention as well as indirect effects in the population. In addition, intervention combinations can have complex interactions at the population level, which are often difficult to adequately assess with standard study designs and analytical methods.

    Discussion: Herein, we urge the adoption of a new paradigm for the design and interpretation of intervention trials in infectious diseases, particularly with regard to emerging infectious diseases, one that more accurately reflects the dynamics of the transmission process. Read More

    Factors associated with junior doctors' decisions to apply for general practice training programmes in the UK: secondary analysis of data from the UKMED project.
    BMC Med 2017 12 21;15(1):220. Epub 2017 Dec 21.
    Collaboration for the Advancement of Medical Education Research and Assessment (CAMERA), Plymouth University Peninsula Schools of Medicine and Dentistry, John Bull Building, Plymouth Science Park, Plymouth, PL6 8BU, UK.
    Background: The UK, like many high-income countries, is experiencing a worsening shortfall of general practitioners (GPs) alongside an increasing demand for their services. At the same time, factors influencing junior doctors' decisions to apply for GP training are only partially understood and research in this area has been hampered by the difficulties in connecting the datasets that map the journey from student to qualified GP. The UK Medical Education Database (UKMED) has been established to ameliorate this problem by linking institutional data across the spectrum of medical education from school to specialty training. Read More

    Models and analyses to understand threats to polio eradication.
    BMC Med 2017 12 22;15(1):221. Epub 2017 Dec 22.
    Deparment of Epidemiology, 1415 E. Washington Heights, Ann Arbor, MI, 48109, USA.
    To achieve complete polio eradication, the live oral poliovirus vaccine (OPV) currently used must be phased out after the end of wild poliovirus transmission. However, poorly understood threats may arise when OPV use is stopped. To counter these threats, better models than those currently available are needed. Read More

    Bringing patient-centered tuberculosis diagnosis into the light of day.
    BMC Med 2017 Dec 20;15(1):219. Epub 2017 Dec 20.
    Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College Street, Room 620, New Haven, Connecticut, 06520-8034, USA.
    In 2015, the WHO End TB Strategy laid out ambitious goals to dramatically reduce tuberculosis (TB) deaths, incidence, and catastrophic costs through research, bold new strategies, and patient-centered care. In this commentary, recent evidence on sputum collection strategies for smear microscopy is reviewed, and the argument is made that redesigning smear microscopy as a patient-centered service offers the only realistic and widely available strategy to advance TB diagnostic care towards the initial End TB Strategy goals laid out for 2025. Finally, the successful adoption of same-day sputum smear microscopy as a model for patient-centered TB care is suggested to be synergistic with and to form part of the scale-up of new TB diagnostic tools. Read More

    Blood lipids and lipoproteins in relation to incidence and mortality risks for CVD and cancer in the prospective EPIC-Heidelberg cohort.
    BMC Med 2017 Dec 19;15(1):218. Epub 2017 Dec 19.
    Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
    Background: Circulating concentrations of lipid biomarkers are associated with risk of cardiovascular diseases (CVD). The evidence for a relationship with cancer risk, however, is not entirely consistent. This study aims to assess the relationships of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), apolipoprotein (a) (apo(a)), apoB-100, and lipoprotein(a) (Lp(a)) with risk of common cancer forms and total cancer mortality in comparison to incidence and mortality of CVD. Read More

    Modeling HIV-HCV coinfection epidemiology in the direct-acting antiviral era: the road to elimination.
    BMC Med 2017 Dec 18;15(1):217. Epub 2017 Dec 18.
    Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de Recherche en Cancérologie de Lyon, F-69008, Lyon, France.
    Background: HCV treatment uptake has drastically increased in HIV-HCV coinfected patients in France since direct-acting antiviral (DAA) treatment approval, resulting in HCV cure in 63% of all HIV-HCV patients by the end of 2015. We investigated the impact of scaling-up DAA on HCV prevalence in the whole HIV population and in various risk groups over the next 10 years in France using a transmission dynamic compartmental model.

    Methods: The model was based on epidemiological data from the French Dat'AIDS cohort. Read More

    Reconsidering the prognosis of major depressive disorder across diagnostic boundaries: full recovery is the exception rather than the rule.
    BMC Med 2017 Dec 12;15(1):215. Epub 2017 Dec 12.
    Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, PO Box 74077, 1070 BB, Amsterdam, The Netherlands.
    Background: Major depressive disorder (MDD) is often handled as an episodic and isolated disorder, resulting in an optimistic view about its prognosis. Herein, we test the idea that the prognosis of MDD changes if we vary the perspective in terms of (1) a longer time frame and (2) a broader diagnostic conceptualisation including dysthymia, (hypo)mania and anxiety disorders as relevant outcomes.

    Methods: Patients with current MDD at baseline (n = 903) and available 2-, 4-, and/or 6-year follow-up assessments were selected from the Netherlands Study of Depression and Anxiety, a psychiatric cohort study. Read More

    Individual, collective, and transgenerational traumatization in the Yazidi.
    BMC Med 2017 Dec 11;15(1):198. Epub 2017 Dec 11.
    Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Albert-Einstein-Allee 23, D-89081, Ulm, Germany.
    In recent years, Islamic terrorism has manifested itself with an unexpectedly destructive force. Despite the fact that Islamic terrorism commences locally in most cases, it has spread its terror worldwide. In August 2014, when troops of the self-proclaimed 'Islamic State' conquered areas of northern Iraq, they turned on the long-established religious minorities in the area with tremendous brutality, especially towards the Yazidis. Read More

    Mapping the evidence on pharmacological interventions for non-affective psychosis in humanitarian non-specialised settings: a UNHCR clinical guidance.
    BMC Med 2017 Dec 11;15(1):197. Epub 2017 Dec 11.
    Public Health Section, United Nations High Commissioner for Refugees, Geneva, Switzerland.
    Background: Populations exposed to humanitarian emergencies are particularly vulnerable to mental health problems, including new onset, relapse and deterioration of psychotic disorders. Inadequate care for this group may lead to human rights abuses and even premature death. The WHO Mental Health Gap Action Programme Intervention Guide (mhGAP-IG), and its adaptation for humanitarian settings (mhGAP-HIG), provides guidance for management of mental health conditions by non-specialised healthcare professionals. Read More

    Humanitarian and primary healthcare needs of refugee women and children in Afghanistan.
    BMC Med 2017 Dec 11;15(1):196. Epub 2017 Dec 11.
    UNICEF Afghanistan Country Office, Kabul, Afghanistan.
    This Commentary describes the situation and healthcare needs of Afghans returning to their country of origin. With more than 600,000 Afghans returned from Pakistan and approximately 450,000 Afghans returned from Iran in 2016, the movement of people, which has been continuing in 2017, presents additional burden on the weak health system and confounds new health vulnerabilities especially for women and children. Stewardship and response is required at all levels: the central Ministry of Public Health, Provincial Health Departments and community leaders all have important roles, while continued support from development partners and technical experts is needed to assist the health sector to address the emergency and primary healthcare needs of returnee and internally displaced women, children and families. Read More

    The extra cost of comorbidity: multiple illnesses and the economic burden of non-communicable diseases.
    BMC Med 2017 Dec 8;15(1):216. Epub 2017 Dec 8.
    ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
    Background: The literature offers competing estimates of disease costs, with each study having its own data and methods. In 2007, the Dutch Center for Public Health Forecasting of the National Institute for Public Health and the Environment provided guidelines that can be used to set up cost-of-illness (COI) studies, emphasising that most COI analyses have trouble accounting for comorbidity in their cost estimations. When a patient has more than one chronic condition, the conditions may interact such that the patient's healthcare costs are greater than the sum of the costs for the individual diseases. Read More

    A pilot systematic genomic comparison of recurrence risks of hepatitis B virus-associated hepatocellular carcinoma with low- and high-degree liver fibrosis.
    BMC Med 2017 Dec 7;15(1):214. Epub 2017 Dec 7.
    Department of Genetics and Genomic Sciences, Icahn Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
    Background: Chronic hepatitis B virus (HBV) infection leads to liver fibrosis, which is a major risk factor in hepatocellular carcinoma (HCC) and an independent risk factor of recurrence after HCC tumor resection. The HBV genome can be inserted into the human genome, and chronic inflammation may trigger somatic mutations. However, how HBV integration and other genomic changes contribute to the risk of tumor recurrence with regards to the different degree of liver fibrosis is not clearly understood. Read More

    Spectrum of mutations in monogenic diabetes genes identified from high-throughput DNA sequencing of 6888 individuals.
    BMC Med 2017 Dec 6;15(1):213. Epub 2017 Dec 6.
    Department of Internal Medicine I, Ulm University Medical Centre, Ulm, Germany.
    Background: Diagnosis of monogenic as well as atypical forms of diabetes mellitus has important clinical implications for their specific diagnosis, prognosis, and targeted treatment. Single gene mutations that affect beta-cell function represent 1-2% of all cases of diabetes. However, phenotypic heterogeneity and lack of family history of diabetes can limit the diagnosis of monogenic forms of diabetes. Read More

    Choice of surrogate tissue influences neonatal EWAS findings.
    BMC Med 2017 Dec 5;15(1):211. Epub 2017 Dec 5.
    Singapore Institute for Clinical Sciences, A*STAR, Singapore, 117609, Singapore.
    Background: Epigenomes are tissue specific and thus the choice of surrogate tissue can play a critical role in interpreting neonatal epigenome-wide association studies (EWAS) and in their extrapolation to target tissue. To develop a better understanding of the link between tissue specificity and neonatal EWAS, and the contributions of genotype and prenatal factors, we compared genome-wide DNA methylation of cord tissue and cord blood, two of the most accessible surrogate tissues at birth.

    Methods: In 295 neonates, DNA methylation was profiled using Infinium HumanMethylation450 beadchip arrays. Read More

    Comprehensive metabolic profiling of chronic low-grade inflammation among generally healthy individuals.
    BMC Med 2017 Nov 30;15(1):210. Epub 2017 Nov 30.
    Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Str. NK, 17475, Greifswald, Germany.
    Background: Inflammation occurs as an immediate protective response of the immune system to a harmful stimulus, whether locally confined or systemic. In contrast, a persisting, i.e. Read More

    Depression comorbid with tuberculosis and its impact on health status: cross-sectional analysis of community-based data from 48 low- and middle-income countries.
    BMC Med 2017 Nov 28;15(1):209. Epub 2017 Nov 28.
    Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK.
    Background: Depression in tuberculosis increases the risk for adverse health outcomes. However, little is known about comorbid depression and tuberculosis in the general population. Thus, we assessed the association between depression and tuberculosis, and the decrements in health status associated with this comorbidity in 48 low- and middle-income countries. Read More

    The potential impact of food taxes and subsidies on cardiovascular disease and diabetes burden and disparities in the United States.
    BMC Med 2017 Nov 27;15(1):208. Epub 2017 Nov 27.
    Friedman School of Nutrition Science & Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA.
    Background: Fiscal interventions are promising strategies to improve diets, reduce cardiovascular disease and diabetes (cardiometabolic diseases; CMD), and address health disparities. The aim of this study is to estimate the impact of specific dietary taxes and subsidies on CMD deaths and disparities in the US.

    Methods: Using nationally representative data, we used a comparative risk assessment to model the potential effects on total CMD deaths and disparities of price subsidies (10%, 30%) on fruits, vegetables, whole grains, and nuts/seeds and taxes (10%, 30%) on processed meat, unprocessed red meats, and sugar-sweetened beverages. Read More

    A comparison of liquid and solid culture for determining relapse and durable cure in phase III TB trials for new regimens.
    BMC Med 2017 Nov 24;15(1):207. Epub 2017 Nov 24.
    School of Medicine, University of St Andrews, St Andrews, UK.
    Background: Tuberculosis kills more people than any other infectious disease, and new regimens are essential. The primary endpoint for confirmatory phase III trials for new regimens is a composite outcome that includes bacteriological treatment failure and relapse. Culture methodology is critical to the primary trial outcome. Read More

    Effects of long-term weekly iron and folic acid supplementation on lower genital tract infection - a double blind, randomised controlled trial in Burkina Faso.
    BMC Med 2017 Nov 23;15(1):206. Epub 2017 Nov 23.
    Liverpool School of Tropical Medicine and Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.
    Background: Provision of routine iron supplements to prevent anaemia could increase the risk for lower genital tract infections as virulence of some pathogens depends on iron availability. This trial in Burkina Faso assessed whether weekly periconceptional iron supplementation increased the risk of lower genital tract infection in young non-pregnant and pregnant women.

    Methods: Genital tract infections were assessed within a double blind, controlled, non-inferiority trial of malaria risk among nulliparous women, randomised to receive either iron and folic acid or folic acid alone, weekly, under direct observation for 18 months. Read More

    Telomere tracking from birth to adulthood and residential traffic exposure.
    BMC Med 2017 Nov 21;15(1):205. Epub 2017 Nov 21.
    Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium.
    Background: Telomere attrition is extremely rapid during the first years of life, while lifestyle during adulthood exerts a minor impact. This suggests that early life is an important period in the determination of telomere length. We investigated the importance of the early-life environment on both telomere tracking and adult telomere length. Read More

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