Tobiasen Nicolaisen (kendospoon08)

BACKGROUND There is increasing recognition that heart failure (HF) and cancer are conditions with a number of shared characteristics. OBJECTIVES To explore the association between tumour biomarkers and HF outcomes. Inflammation inhibitor METHODS In 2,079 patients of BIOSTAT-CHF cohort, we measured six established tumour biomarkers CA125, CA15-3, CA19-9, CEA, CYFRA 21-1 and AFP. RESULTS During a median follow-up of 21 months, 555 (27%) patients reached the primary end-point of all-cause mortality. CA125, CYFRA 21-1, CEA and CA19-9 levels were positively correlated with NT-proBNP quartiles (all P  less then  0.001, P for trend  less then  0.001) and were, respectively, associated with a hazard ratio of 1.17 (95% CI 1.12-1.23; P  less then  0.0001), 1.45 (95% CI 1.30-1.61; P  less then  0.0001), 1.19 (95% CI 1.09-1.30; P = 0.006) and 1.10 (95% CI 1.05-1.16; P  less then  0.001) for all-cause mortality after correction for BIOSTAT risk model (age, BUN, NT-proBNP, haemoglobin and beta blocker). All tumour biomarkers (except AFP) had significant associations with secondary end-points (composite of all-cause mortality and HF hospitalization, HF hospitalization, cardiovascular (CV) mortality and non-CV mortality). ROC curves showed the AUC of CYFRA 21-1 (0.64) had a noninferior AUC compared with NT-proBNP (0.68) for all-cause mortality (P = 0.08). A combination of CYFRA 21-1 and NT-proBNP (AUC = 0.71) improved the predictive value of the model for all-cause mortality (P = 0.0002 compared with NT-proBNP). CONCLUSIONS Several established tumour biomarkers showed independent associations with indices of severity of HF and independent prognostic value for HF outcomes. This demonstrates that pathophysiological pathways sensed by these tumour biomarkers are also dysregulated in HF. © 2020 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.BACKGROUND Although evidence about skeletal muscle mass loss and type 2 diabetes risk has accumulated, little information is available on the combined effect of skeletal muscle mass and abdominal obesity on type 2 diabetes. We examined whether skeletal muscle mass and abdominal obesity were synergistically associated with the prevalence of type 2 diabetes. METHODS Skeletal muscle mass and waist circumference (WC) were measured in 1515 Japanese aged 40-69 years. Relative muscle mass was calculated as percentage of total skeletal muscle mass in body weight (SMM%). Type 2 diabetes was identified as fasting serum glucose ≥7.0 mmol/L (126 mg/dL), non-fasting serum glucose ≥11.1 mmol/L (200 mg/dL), hemoglobin A1c ≥ 6.5%, and/or diabetes medication use. RESULTS The multivariable-adjusted odds ratio (OR) of prevalent diabetes from the lowest to third quartiles of SMM% compared to the highest quartile was gradually higher in both sexes. The association between a high WC and prevalent diabetes was similar. The multivariable-adjusted OR (95% confidence intervals) for the prevalence of type 2 diabetes in the low skeletal muscle mass/high WC group was 3.19 (1.78-5.71) for men and 4.46 (2.09-9.51) for women compared with the high skeletal muscle mass/low WC group. The relative excess risk due to interaction was 2.2 (0.5-3.9) in men and 2.8 (0.2-5.3) in women for an excess burden of type 2 diabetes for low skeletal muscle mass and high WC. CONCLUSIONS Low skeletal muscle mass and abdominal obesity were synergistically associated with presence of type 2 diabetes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.AIMS AND OBJECTIVES To synthesise literature regarding PTSD among nurses. Two objectives guided this review (a) describe the prevalence of PTSD in registered nurses and (b) identify factors associated with nursing work-related PTSD. BACKGROUN