From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (F.R., S.V.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 and CNRS UMR 5292, Lyon; Eugene Devic EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), Bron; Service de Biostatistique-Bioinformatique (M.F., Z.U., N.B., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (M.F., N.B., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Direction des Maladies Nontransmissibles et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; REPERES-EA 7449 (E.L.), Univ Rennes/EHESP; and CIC-P 1414 (E.L.), CHU Rennes, France.
Published: July 2021
AI Article Synopsis
Article Abstract
Objective: To determine the effects of current age and disease duration on excess mortality in multiple sclerosis (MS), we describe the dynamics of excess death rates over these 2 time scales and study the effect of age at MS clinical onset on these dynamics, separately in each initial phenotype.
Methods: We used data from 18 French MS expert centers participating in the Observatoire Français de la Sclérose en Plaques. Patients with MS living in metropolitan France and having a clinical onset between 1960 and 2014 were included. Vital status was updated on January 1, 2016. For each MS phenotype separately (relapsing onset [RMS] or primary progressive [PPMS]), we used an innovative statistical method to model the logarithm of excess death rates by a multidimensional penalized spline of age and disease duration.
Results: Among 37,524 patients (71% women, mean age at MS onset ± SD 33.0 ± 10.6 years), 2,883 (7.7%) deaths were observed and 7.8% of patients were lost to follow-up. For patients with RMS, there was no excess mortality during the first 10 years after disease onset; afterwards, whatever the age at onset, excess death rates increased with current age. From current age 70, the excess death rate values converged and became identical whatever the age at disease onset, which means that disease duration had no more effect. Excess death rates were higher in men, with an excess hazard ratio of 1.46 (95% confidence interval 1.25-1.70). In contrast, in patients with PPMS, excess death rates rapidly increased from disease onset, and were associated with age at onset, but not with sex.
Conclusions: In RMS, current age has a stronger effect on MS mortality than disease duration, while their respective effects are not clear in PPMS.
Background: Aortic valve stenosis (AVS) is a progressive disease characterized by fibrosis, inflammation, calcification, and stiffening of the aortic valve leaflets, leading to disrupted blood flow. If untreated, AVS can progress to heart failure and death within 2 to 5 years. Uncovering the molecular mechanisms behind AVS is key for developing effective noninvasive therapies.
College of Animal Science and Technology, Jiangxi Agricultural University, No. 1101 Zhimin Avenue, Economic and Technological Development District, Nanchang 330045, Jiangxi, PR China. Electronic address:
Excessive molybdenum (Mo) and cadmium (Cd) are environmental pollutants with serious nephrotoxicity. B-cell lymphoma 2 (Bcl-2) plays a critical role in modulating mitochondrial ROS (Mito-ROS). Ferroptosis is a form of cell death dependent on lipid peroxidation.
Liver fibrosis represents a reversible pathophysiological process, caused by chronic inflammation stemming from hepatocyte damage. It delineates the initial stage in the progression of chronic liver disease. This pathological progression is characterized by the excessive accumulation of the extracellular matrix (ECM), which leads to significant structural disruption and ultimately impairs liver function.
Miami-Dade is an HIV epicenter where Black populations experience excess AIDS-related deaths due to poor medication adherence, which prevents achieving an undetectable HIV viral load (VL). A promising approach to improving HIV outcomes in Black populations has been the use of community health workers (CHWs). Evidence shows CHWs trained in motivational interviewing (MI) may further improve outcomes, however little data exists about Black CHWs trained in MI who support Black patients with HIV.
