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Cognitive deficits may often be found among patients with APS, independent of any history of central nervous system involvement. Livedo reticularis and the presence of white matter lesions on brain magnetic resonance imaging are associated with an increased risk for cognitive dysfunction in APS.
There is strong evidence that the intake of vegetables and fruits reduces the risk of cardiovascular disease (CVD) and is inversely associated with several forms of cancer. In contrast, information concerning specific macro- or micronutrients in relation to chronic diseases is limited and largely inconclusive. The beneficial role of vegetable and fruit consumption can also be inferred by considering the health effects of two dietary patterns, the Mediterranean and Japanese ones, in both of which the consumption of plant foods holds a prominent position. Time-trend data, retrieved from the DAFNE databank on the vegetable and fruit availability in four European countries (Greece, Ireland, Italy and Norway) indicate that, during the last decade, fruit availability decreased in Greece and Italy and increased in Ireland and Norway, whereas vegetable availability decreased only in Italy. In Greece, Italy and Norway, the daily fruit availability was higher than that of vegetables, a dietary pattern not in accordance to recommendations for higher vegetable consumption. This information, which is crucial for nutrition policies and health education, also demonstrates the value of the DAFNE surveillance system.
Background
The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context.
Methods
We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient’s age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score.
Results
The median age in the sample of 7487 consecutive patients was 84 years (IQR 81–87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0.001). The relationship between the CFS score and mortality was nonlinear (p < 0.01).
Conclusion
Knowledge about a patient’s frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided.
Trial registration NCT03134807 (VIP1), NCT03370692 (VIP2)
We estimate that almost 1 in 6 subjects on HAART interrupts treatment by 2 years. Further research is needed to investigate the reasons why TI is higher in women. We have identified characteristics of subjects with the greatest risk for CD4 loss in whom TI may have greater risks.
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