Substantial decrease of PFAS with anion exchange resin treatment - A clinical cross-over trial.

BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) are heat and stain resisting chemicals. They are persistent, bioaccumulating and spread ubiquitously. Many hotspots where humans are exposed to high levels of PFAS have been reported. A few small observational studies in humans suggest that treatment with an Anion Exchange Resin (AER) decreases serum PFAS. This first clinical controlled crossover study aimed to assess whether AER decreases perfluorooctanesulfonic acid (PFOS) in highly exposed adults. METHODS: An open label 1:1 randomized treatment sequence crossover study with allocation to oral AER (cholestyramine 4 g three times daily) or observation for 12 weeks was conducted among citizens from a PFAS hotspot. Main inclusion criteria was serum PFOS > 21 ng/mL. Primary endpoint was change in serum PFOS levels between treatment and observational period. RESULTS: In total, 45 participants were included with a mean age of 50 years (SD 13). Serum PFOS baseline median was 191 ng/mL (IQR: 129-229) and decreased with a mean of 115 ng/mL (95 % CI: 89-140) on treatment, and 4.3 ng/mL in observation period corresponding to a decrease of 60 % (95 % CI: 53-67; p < 0.0001). PFHxS, PFOA, PFNA and PFDA decreased during treatment between 15 and 44 %. No serious adverse events were reported. CONCLUSIONS: Oral treatment with AER significantly lowered serum PFOS concentrations suggesting a possible treatment for enhancing elimination of PFOS in highly exposed adults.

The Mental Vulnerability Questionnaire: a psychometric evaluation.

The Mental Vulnerability Questionnaire was originally a 22 item scale, later reduced to a 12 item scale. In population studies the 12 item scale has been a significant predictor of health and illness. The scale has not been psychometrically evaluated for more than 30 years, and the aim of the present study was both to evaluate the psychometric properties of the 22 and 12 item scales and of three new scales. The main study sample was a community sample comprising more than 6,000 men and women. In this sample the coefficients of homogeneity were all over 0.30 for the three new scales, but below 0.30 for the 12 and the 22 item scales. All five Mental Vulnerability scales had positively skewed score distributions which were associated significantly with both SCL-90-R symptom scores and NEO-PI-R personality scales (primarily Neuroticism and Extraversion). Coefficient alpha was highest for the 22 and 12 item scales, and the two scales also showed the highest long-term stability. The three new scales reflect relatively independent dimensions of Psychosomatic Symptoms, Mental Symptoms, and Interpersonal Problems, but because of reliability problems it remains an open question whether they will prove useful as predictors of health and morbidity.

Prognosis of migraine and tension-type headache: a population-based follow-up study.

OBJECTIVE: To determine the prognosis of migraine and tension-type headache and to identify prognostic factors. METHODS: Of 740 persons (aged 25 to 64 years) examined in a 1989 Danish cross-sectional headache study, 673 were eligible for follow-up in 2001. All interviews at baseline and at follow-up were conducted by medical doctors and based on the 1988 IHS-criteria. RESULTS: A total of 549 persons (81.6%) participated in the follow-up study. Of 64 migraineurs at baseline, 42% had experienced remission, 38% had low migraine frequency, and 20% had more than 14 migraine days per year (poor outcome) at follow-up. Poor outcome was associated with high migraine frequency at baseline and age at onset younger than 20 years. Among 146 subjects with frequent episodic tension-type headache and 15 with chronic tension-type headache at baseline, 45% experienced infrequent or no tension-type headache (remission), 39% had frequent episodic tension-type headache, and 16% experienced chronic tension-type headache (poor outcome) at follow-up. Poor outcome was associated with baseline chronic tension-type headache, coexisting migraine, not being married, and sleeping problems. CONCLUSIONS: The prognosis of migraine, frequent episodic tension-type headache, and chronic tension-type headache was favorable.

Has the prevalence of migraine and tension-type headache changed over a 12-year period? A Danish population survey.

OBJECTIVE: The present study aims to compare the prevalence of primary headaches in Denmark in two periods as only few replicate studies have re-evaluated the prevalence of primary headaches. STUDY DESIGN AND SETTING: The 2001 study is a replicate of a cross-sectional survey of primary headaches in 1989, and compares 297 subjects aged 25-36 years from the general population, with the 294 comparable subjects invited in 1989. Medical doctors diagnosed all headaches using IHS-classification. RESULTS: The participation rate was 75% in 1989 and 70% in 2001. The prevalence of migraine did not change significantly (11-15%), while the prevalence of tension-type headache (79-87%), especially of frequent tension-type headache (29-37%) increased significantly. The prevalence of chronic tension-type headache (2-5%) tended to increase. The proportion of the migraineurs with migraine 14 days or more per year increased (12-38%). Female gender was a risk factor for both primary headaches. The majority of migraineurs (92-94%) also reported coexistent tension-type headache. CONCLUSION: The prevalence of tension-type headache but not of migraine increased. The increase in migraine and tension-type headache frequency suggests a higher individual and societal impact of primary headaches now, than 12 years ago.