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Sample records for based cohort study

  1. Brain-Science Based Cohort Studies

    Science.gov (United States)

    Koizumi, Hideaki

    2011-01-01

    This article describes a number of human cohort studies based on the concept of brain-science and education. These studies assess the potential effects of new technologies on babies, children and adolescents, and test hypotheses drawn from animal and genetic case studies to see if they apply to people. A flood of information, virtual media,…

  2. Screening and cervical cancer cure: population based cohort study

    OpenAIRE

    Andrae, B.; Andersson, T. M.-L.; Lambert, P C; Kemetli, L.; Silfverdal, L.; Strander, B.; Ryd, W; Dillner, J; Tornberg, S; Sparen, P

    2012-01-01

    Objective To determine whether detection of invasive cervical cancer by screening results in better prognosis or merely increases the lead time until death. Design Nationwide population based cohort study. Setting Sweden. Participants All 1230 women with cervical cancer diagnosed during 1999-2001 in Sweden prospectively followed up for an average of 8.5 years. Main outcome measures Cure proportions and five year relative survival ratios, stratified by screening history, mode of detection, age...

  3. Internet-Based Birth-Cohort Studies: Is This the Future for Epidemiology?

    OpenAIRE

    Firestone, Ridvan; Cheng, Soo; Pearce, Neil; Douwes, Jeroen; Merletti, Franco; Pizzi, Costanza; Pivetta, Emanuele; Rusconi, Franca; Richiardi, Lorenzo

    2015-01-01

    Background International collaborative cohorts the NINFEA and the ELF studies are mother-child cohorts that use the internet for recruitment and follow-up of their members. The cohorts investigated the association of early life exposures and a wide range of non-communicable diseases. Objective The objective is to report the research methodology, with emphasis on the advantages and limitations offered by an Internet-based design. These studies were conducted in Turin, Italy and Wellington, New...

  4. Sensor, a population-based cohort study on gastroenteritis in the Netherlands: incidence and etiology.

    NARCIS (Netherlands)

    Wit, M.A.S. de; Koopmans, M.P.G.; Kortbeek, L.M.; Wannet, W.J.B.; Vinje, J; Leusden, F. van; Bartelds, A.I.M.; Duynhoven, Y.T.H.P. van

    2001-01-01

    A prospective population-based cohort study with a nested case- control study was conducted to estimate the incidence of gastroenteritis and the associated pathogens in the general Dutch population. Follow-up of two consecutive cohorts was performed by weekly reporting cards from december 1998 to de

  5. Birth order and mortality: a population-based cohort study.

    Science.gov (United States)

    Barclay, Kieron; Kolk, Martin

    2015-04-01

    This study uses Swedish population register data to investigate the relationship between birth order and mortality at ages 30 to 69 for Swedish cohorts born between 1938 and 1960, using a within-family comparison. The main analyses are conducted with discrete-time survival analysis using a within-family comparison, and the estimates are adjusted for age, mother's age at the time of birth, and cohort. Focusing on sibships ranging in size from two to six, we find that mortality risk in adulthood increases with later birth order. The results show that the relative effect of birth order is greater among women than among men. This pattern is consistent for all the major causes of death but is particularly pronounced for mortality attributable to cancers of the respiratory system and to external causes. Further analyses in which we adjust for adult socioeconomic status and adult educational attainment suggest that social pathways only mediate the relationship between birth order and mortality risk in adulthood to a limited degree. PMID:25777302

  6. Rosacea and gastrointestinal disorders - a population-based cohort study

    DEFF Research Database (Denmark)

    Egeberg, A; Weinstock, L B; Thyssen, E P;

    2016-01-01

    BACKGROUND: Rosacea is a common inflammatory facial skin condition. Recent genetic and epidemiologic studies have suggested pathogenic links between rosacea and gastrointestinal disorders, but data are limited. OBJECTIVES: The objective was to investigate the association between rosacea and celiac...... disease (CeD), Crohn's disease (CD), ulcerative colitis (UC), Helicobactor pylori (HP) infection, small intestinal bacterial overgrowth (SIBO), and irritable bowel syndrome (IBS), respectively. METHODS: We performed a nationwide cohort study. A total of 49,475 patients with rosacea, and 4,312,213 general...... population controls were identified using nationwide administrative registers. We established the prevalence of the aforementioned disorders, and used Cox regression to obtain hazard ratios (HRs) of the risk of new-onset CeD, CD, UC, HP infection, SIBO, and IBS, respectively, in patients with rosacea...

  7. Sensor, a population-based cohort study on gastroenteritis in the Netherlands: incidence and etiology.

    OpenAIRE

    Wit, M.A.S. de; Koopmans, M. P. G.; Kortbeek, L. M.; Wannet, W. J. B.; Vinje, J.; Leusden, F. van; Bartelds, A.I.M.; Duynhoven, Y.T.H.P. van

    2001-01-01

    A prospective population-based cohort study with a nested case- control study was conducted to estimate the incidence of gastroenteritis and the associated pathogens in the general Dutch population. Follow-up of two consecutive cohorts was performed by weekly reporting cards from december 1998 to december 1999. Cases and controls in the case-control study supplied a questionnaire and stool samples. The standardized gastroenteritis incidence was 283 per 1,000 person-years. The incidence rose w...

  8. Vegetarianism, low meat consumption and the risk of colorectal cancer in a population based cohort study

    OpenAIRE

    Anne M. J. Gilsing; Schouten, Leo J.; R. Alexandra Goldbohm; Dagnelie, Pieter C.; van den Brandt, Piet A.; Weijenberg, Matty P.

    2015-01-01

    To study how a vegetarian or low meat diet influences the risk of colorectal cancer compared to a high meat diet, and to assess the explanatory role of factors associated with these diets. In the Netherlands Cohort Study – Meat Investigation Cohort (NLCS-MIC) (cohort of 10,210 individuals including 1040 self-defined vegetarians), subjects completed a baseline questionnaire in 1986, based on which they were classified into vegetarians (n = 635), pescetarians (n = 360), 1 day/week- (n = 1259), ...

  9. A population-based cohort study of oral health in South Brazil: The Porto Alegre Study.

    Science.gov (United States)

    Haas, Alex Nogueira; Gaio, Eduardo José; Wagner, Marcius Comparsi; Rios, Fernando Silva; Costa, Ricardo dos Santos Araujo; Rösing, Cassiano Kuchenbecker; Oppermann, Rui Vicente; Albandar, Jasim; Susin, Cristiano

    2015-01-01

    Few population-based cohort studies have been established in Dentistry and this is especially true for Latin America. We conducted a population-based prospective study focusing on oral health in Porto Alegre, south Brazil, and herein we describe its methodology and discuss directions for further research. The cohort was established in 2001 using a multistage probability sample of 1,465 toothed and 121 edentulous subjects. A 5-year follow-up was performed in 2006 that included 755 individuals. The main aim of this study was to determine the pattern and risk factors for periodontal disease progression and tooth loss incidence. A full-mouth protocol was used including periodontal assessments at six sites per tooth. Primary outcomes were periodontal attachment loss and tooth loss. Oral mucosal lesions, dental plaque, gingivitis, supragingival calculus, probing depths, gingival recession, and dental caries were also assessed. This is the first population-based cohort study to focus on periodontal disease in Latin America. Findings will contribute to our understanding of the epidemiology of periodontal disease and provide valuable data for the planning and implementation of preventive and therapeutic strategies. PMID:26083520

  10. A population-based cohort study of oral health in South Brazil: The Porto Alegre Study

    Directory of Open Access Journals (Sweden)

    Alex Nogueira Haas

    2015-06-01

    Full Text Available Few population-based cohort studies have been established in Dentistry and this is especially true for Latin America. We conducted a population-based prospective study focusing on oral health in Porto Alegre, south Brazil, and herein we describe its methodology and discuss directions for further research. The cohort was established in 2001 using a multistage probability sample of 1,465 toothed and 121 edentulous subjects. A 5-year follow-up was performed in 2006 that included 755 individuals. The main aim of this study was to determine the pattern and risk factors for periodontal disease progression and tooth loss incidence. A full-mouth protocol was used including periodontal assessments at six sites per tooth. Primary outcomes were periodontal attachment loss and tooth loss. Oral mucosal lesions, dental plaque, gingivitis, supragingival calculus, probing depths, gingival recession, and dental caries were also assessed. This is the first population-based cohort study to focus on periodontal disease in Latin America. Findings will contribute to our understanding of the epidemiology of periodontal disease and provide valuable data for the planning and implementation of preventive and therapeutic strategies.

  11. Gastrointestinal Events with Clopidogrel: A Nationwide Population-Based Cohort Study

    DEFF Research Database (Denmark)

    Grove, Erik; Würtz, Morten; Schwarz, Peter;

    2012-01-01

    -based cohort study based on linkage of three administrative registries in Denmark. PARTICIPANTS: All individuals who redeemed at least one prescription of clopidogrel from 1996 to 2008 were included as exposed subjects (n = 77,503). For each exposed subject, three matched controls were randomly selected from...

  12. Predictors of Childhood Anxiety: A Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Dawn Kingston

    Full Text Available Few studies have explored predictors of early childhood anxiety.To determine the prenatal, postnatal, and early life predictors of childhood anxiety by age 5.Population-based, provincial administrative data (N = 19,316 from Manitoba, Canada were used to determine the association between demographic, obstetrical, psychosocial, medical, behavioral, and infant factors on childhood anxiety.Risk factors for childhood anxiety by age 5 included maternal psychological distress from birth to 12 months and 13 months to 5 years post-delivery and an infant 5-minute Apgar score of ≤7. Factors associated with decreased risk included maternal age < 20 years, multiparity, and preterm birth.Identifying predictors of childhood anxiety is a key step to early detection and prevention. Maternal psychological distress is an early, modifiable risk factor. Future research should aim to disentangle early life influences on childhood anxiety occurring in the prenatal, postnatal, and early childhood periods.

  13. Asthma and Attention-Deficit/Hyperactivity Disorder: A Nationwide Population-Based Prospective Cohort Study

    Science.gov (United States)

    Chen, Mu-Hong; Su, Tung-Ping; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

    2013-01-01

    Background: Previous cross-sectional studies have suggested an association between asthma and attention-deficit/hyperactivity disorder (ADHD), but the temporal relationship was not determined. Using a nationwide population-based prospective case-control cohort study (1:4, age-/gender-matched), we hypothesized that asthma in infanthood or early…

  14. Term perinatal mortality audit in the Netherlands 2010-2012 : a population-based cohort study

    NARCIS (Netherlands)

    Eskes, Martine; Waelput, Adja J. M.; Erwich, Jan Jaap H. M.; Brouwers, Hens A. A.; Ravelli, Anita C. J.; Achterberg, Peter W.; Merkus, Hans (J) M. W. M.; Bruinse, Hein W.

    2014-01-01

    Objective: To assess the implementation and first results of a term perinatal internal audit by a standardised method. Design: Population-based cohort study. Setting: All 90 Dutch hospitals with obstetric/ paediatric departments linked to community practices of midwives, general practitioners in the

  15. Risk of developing diabetes is inversely related to lung function: a population-based cohort study.

    OpenAIRE

    Engström, Gunnar; Janzon, Lars

    2002-01-01

    AimTo investigate whether reduced lung function is a risk factor for developing diabetes. MethodsNon-diabetic men (n = 382) from the population-based cohort 'Men Born in 1914' were examined with spirometry at age 55 years. The cohort was re-examined at 68 years. Diabetes and fasting plasma glucose at follow-up were studied in relation to vital capacity (VC) and forced expiratory volume (FEV1.0) at baseline. ResultsFifteen men developed diabetes during the follow-up. The ...

  16. Maternal death audit in Rwanda 2009–2013: a nationwide facility-based retrospective cohort study

    OpenAIRE

    Sayinzoga, Felix; Bijlmakers, Leon; van Dillen, Jeroen; Mivumbi, Victor; Ngabo, Fidèle; van der Velden, Koos

    2016-01-01

    Objective Presenting the results of 5 years of implementing health facility-based maternal death audits in Rwanda, showing maternal death classification, identification of substandard (care) factors that have contributed to death, and conclusive recommendations for quality improvements in maternal and obstetric care. Design Nationwide facility-based retrospective cohort study. Settings All cases of maternal death audited by district hospital-based audit teams between January 2009 and December...

  17. Use of fertility drugs and risk of ovarian cancer: Danish Population Based Cohort Study

    DEFF Research Database (Denmark)

    Jensen, Allan; Sharif, Heidi; Frederiksen, Kirsten;

    2009-01-01

    OBJECTIVE: To examine the effects of fertility drugs on overall risk of ovarian cancer using data from a large cohort of infertile women. DESIGN: Population based cohort study. SETTING: Danish hospitals and private fertility clinics. PARTICIPANTS: 54,362 women with infertility problems referred to...... confounding factors. RESULTS: Analyses within cohort showed no overall increased risk of ovarian cancer after any use of gonadotrophins (rate ratio 0.83, 95% confidence interval 0.50 to 1.37), clomifene (1.14, 0.79 to 1.64), human chorionic gonadotrophin (0.89, 0.62 to 1.29), or gonadotrophin releasing...... all Danish fertility clinics during 1963-98. The median age at first evaluation of infertility was 30 years (range 16-55 years), and the median age at the end of follow-up was 47 (range 18-81) years. Included in the analysis were 156 women with invasive epithelial ovarian cancer (cases) and 1241...

  18. Vegetarianism, low meat consumption and the risk of colorectal cancer in a population based cohort study

    NARCIS (Netherlands)

    Gilsing, A.M.J.; Schouten, L.J.; Goldbohm, R.A.; Dagnelie, P.C.; Brandt, P.A. van den; Weijenberg, M.P.

    2015-01-01

    To study how a vegetarian or low meat diet influences the risk of colorectal cancer compared to a high meat diet, and to assess the explanatory role of factors associated with these diets. In the Netherlands Cohort Study – Meat Investigation Cohort (NLCS-MIC) (cohort of 10,210 individuals including

  19. General practitioner characteristics and delay in cancer diagnosis. a population-based cohort study

    OpenAIRE

    Vedsted Peter; Hansen Rikke P; Sokolowski Ineta; Søndergaard Jens; Olesen Frede

    2011-01-01

    Abstract Background Delay in cancer diagnosis may have serious prognostic consequences, and some patients experience delays lasting several months. However, we have no knowledge whether such delays are associated with general practitioner (GP) characteristics. The aim of the present study was to analyse whether GP and practice characteristics are associated with the length of delay in cancer diagnosis. Methods The study was designed as a population-based cohort study. The setting was the Coun...

  20. Cancer Risk in Children and Adolescents with Birth Defects: A Population-Based Cohort Study

    OpenAIRE

    Botto, Lorenzo D.; Flood, Timothy; Little, Julian; Fluchel, Mark N.; Krikov, Sergey; Feldkamp, Marcia L.; Wu, Yuan; Goedken, Rhinda; Puzhankara, Soman; Romitti, Paul A.

    2013-01-01

    Objective Birth defects are an increasing health priority worldwide, and the subject of a major 2010 World Health Assembly Resolution. Excess cancer risk may be an added burden in this vulnerable group of children, but studies to date have provided inconsistent findings. This study assessed the risk for cancer in children and young adolescents with major birth defects. Methods and Findings This retrospective, statewide, population-based, cohort study was conducted in three US states (Utah, Ar...

  1. Fertility treatment and risk of childhood and adolescent mental disorders: register based cohort study

    OpenAIRE

    Bay, Bjørn; Mortensen, Erik Lykke; Hvidtjørn, Dorte; Kesmodel, Ulrik Schiøler

    2013-01-01

    Objective To assess the mental health of children born after fertility treatment by comparing their risk of mental disorders with that of spontaneously conceived children. Design Prospective register based cohort study. Setting Nationwide register based information from Danish National Health Registers cross linked by a unique personal identification number assigned to all citizens in Denmark. Participants All children born in Denmark in 1995-2003 with follow-up in 2012 when the children were...

  2. Suicide in recently released prisoners: a population-based cohort study.

    OpenAIRE

    Pratt D, Piper M, Appleby L, Webb RT, Shaw J.

    2006-01-01

    BACKGROUND: Several studies have been undertaken on suicide in custody, but few on suicide after the release from prison. We undertook a population-based cohort study to investigate suicide rates in recently released prisoners in England and Wales. METHODS: We used the database of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness for England and Wales to identify all individuals who died by suicide or who received an open verdict at the coroner's inques...

  3. Profiling postgraduate workplace-based assessment implementation in Ireland: a retrospective cohort study

    OpenAIRE

    Barrett, Aileen; Galvin, Rose; Steinert, Yvonne; Scherpbier, Albert; O’Shaughnessy, Ann; Walsh, Gillian; Horgan, Mary

    2016-01-01

    In 2010, workplace-based assessment (WBA) was formally integrated as a method of formative trainee assessment into 29 basic and higher specialist medical training (BST/HST) programmes in six postgraduate training bodies in Ireland. The aim of this study is to explore how WBA is being implemented and to examine if WBA is being used formatively as originally intended. A retrospective cohort study was conducted and approved by the institution’s Research Ethics Committee. A profile of WBA require...

  4. Reproducibility in echocardiographic assessment of diastolic function in a population based study (the STANISLAS Cohort study.

    Directory of Open Access Journals (Sweden)

    Zied Frikha

    Full Text Available There is limited evidence regarding intra-observer and inter-observer variations in echocardiographic measurements of diastolic function. This study aimed to assess this reproducibly within a population-based cohort study.Sixty subjects in sinus rhythm were randomly selected among 4th visit participants of the STANISLAS Cohort (Lorraine region, France. This 4th examination systematically included M-mode, 2-dimensional, DTI and pulsed-wave Doppler echocardiograms. Reproducibility of variables was studied by intra-class correlation coefficients (ICC and Bland Altman plots.Our population was on average middle-aged (50 ± 14 y, overweight (BMI = 26 ± 6 kg/m2 and non-smoking (87% with a quarter of the participants having self-declared hypertension or treated with anti-hypertensive medication(s. Intra-observer ICC were > 0.90 for all analyzed parameters except for left ventricular ejection fraction (LVEF which was 0.89 (0.81-0.93. The mean relative intra-observer differences were small and limits of agreement of relative differences were narrow for all considered parameters ( 0.90 for all analyzed parameters except for LVEF (ICC = 0.87 and both mitral and pulmonary A wave duration (0.83 and 0.73 respectively. The mean relative inter-observer differences were <5% for all parameters except for pulmonary A wave duration (mean difference = 6.5%. Limits of agreement of relative differences were narrow (<15%, except for mitral A wave duration and velocity (both <20% as well as left ventricular mass and pulmonary A wave duration (both <30%. Intra-observer agreements with regard to the presence and severity of diastolic dysfunction were excellent (Kappa = 0.93 (0.83-1.00 and 0.88 (0.75-0.99, respectively.In this validation study within the STANISLAS cohort, diastolic function echocardiographic parameters were found to be highly reproducible. Diastolic dysfunction consequently appears as a highly effective clinical and research tool.

  5. Methodology Series Module 1: Cohort Studies

    OpenAIRE

    Maninder Singh Setia

    2016-01-01

    Cohort design is a type of nonexperimental or observational study design. In a cohort study, the participants do not have the outcome of interest to begin with. They are selected based on the exposure status of the individual. They are then followed over time to evaluate for the occurrence of the outcome of interest. Some examples of cohort studies are (1) Framingham Cohort study, (2) Swiss HIV Cohort study, and (3) The Danish Cohort study of psoriasis and depression. These studies may be pro...

  6. Residents' awareness and attitudes about an ongoing community-based genome cohort study in Nagahama, Japan.

    Science.gov (United States)

    Miyamoto, Keiko; Iwakuma, Miho; Nakayama, Takeo

    2015-11-01

    This study's objective was to examine residents' attitudes toward and factors associated with an ongoing, real genome cohort study based on a community in Japan. After the genome cohort study's launch in 2007, in November and December 2009, a self-administered questionnaire survey was conducted with 2500 randomly sampled residents aged 30-74 years, living in Nagahama, Japan. Responses were received from 1363 people (response rate = 54.5%), of whom 187 respondents had already participated in the study. Although the local government and researchers disseminated information through leaflets and citizen-information papers to every household, sent notices by personalized letter, and held symposia and other meetings, 65.7% of males and 47.2% of females first became aware of the study when they received our questionnaire. Among all respondents, 81.2% of those who knew that the genome cohort study had begun and 68.6% of those who did not know had a positive attitude toward the study. Their attitudes were significantly associated with high health consciousness and the desire for an extensive health check-up. Although for males there were no particular negative aspects of the genome study, for females, positive aspects were associated with participating in community activities and desiring an extensive health check-up. Although promoting a community-based genome cohort study requires huge effort, it is essential to popularize it. Actions are vital both for monitoring public awareness and attitudes at a community level and for keeping communication channels open. PMID:25767212

  7. Birth weight and cognitive function in the British 1946 birth cohort: longitudinal population based study

    OpenAIRE

    M. Richards; HARDY, R.; Kuh, D.; Wadsworth, M E J

    2001-01-01

    Objective To examine the association between birth weight and cognitive function in the normal population.Design A longitudinal, population based, birth cohort study.Participants 3900 males and females born in 1946.Main outcome measures Cognitive function from childhood to middle life (measured at ages 8, 11, 15, 26, and 43 years).Results Birth weight was significantly and positively associated with cognitive ability at age 8 (with an estimated standard deviation score of 0.44 (95%, confidenc...

  8. Excess risk of adverse pregnancy outcomes in women with porphyria: a population-based cohort study

    OpenAIRE

    Tollånes, Mette Christophersen; Aarsand, Aasne Karine; Sandberg, Sverre

    2010-01-01

    The porphyrias comprise a heterogeneous group of rare, primarily hereditary, metabolic diseases caused by a partial deficiency in one of the eight enzymes involved in the heme biosynthesis. Our aim was to assess whether acute or cutaneous porphyria has been associated with excess risks of adverse pregnancy outcomes. A population-based cohort study was designed by record linkage between the Norwegian Porphyria Register, covering 70% of all known porphyria patients in Norway, and the Medical Bi...

  9. Childhood cancer and nuclear power plants in Switzerland: a census-based cohort study

    OpenAIRE

    Spycher, Ben D.; Feller, Martin; Zwahlen, Marcel; Röösli, Martin; von der Weid, Nicolas X.; Hengartner, Heinz; Egger, Matthias; Kuehni, Claudia E.

    2011-01-01

    BACKGROUND: Previous studies on childhood cancer and nuclear power plants (NPPs) produced conflicting results. We used a cohort approach to examine whether residence near NPPs was associated with leukaemia or any childhood cancer in Switzerland. METHODS: We computed person-years at risk for children aged 0-15 years born in Switzerland from 1985 to 2009, based on the Swiss censuses 1990 and 2000 and identified cancer cases from the Swiss Childhood Cancer Registry. We geo-coded place...

  10. Diabetes and pancreatic cancer survival: a prospective cohort-based study

    OpenAIRE

    Toriola, A T; Stolzenberg-Solomon, R; Dalidowitz, L; Linehan, D; Colditz, G

    2014-01-01

    Background: Diabetes is a risk factor for pancreatic cancer but its association with survival from pancreatic cancer is poorly understood. Our objective was to investigate the association of diabetes with survival among pancreatic cancer patients in a prospective cohort-based study where diabetes history was ascertained before pancreatic cancer diagnosis. Methods: We evaluated survival by baseline (1993–2001) self-reported diabetes history (n=62) among 504 participants that developed exocrine...

  11. Benzodiazepine discontinuation among community-dwelling older people: a population-based cohort study

    OpenAIRE

    Bell, J Simon; Lavikainen, Piia; Korhonen, Mikko; Hartikainen, Sirpa

    2010-01-01

    Benzodiazepine discontinuation among community-dwelling older people: a population-based cohort study fax: +358-171-62424 (Bell, J. Simon) (Bell, J. Simon) Kuopio Research Centre of Geriatric Care, University of Eastern Finland - P.O. Box 1627 - 70211 - Kuopio - FINLAND (Bell, J. Simon) Clinical Pharmacology and Geriatric Pharmacotherapy Unit, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland - Kuopio - FINLAND (Bell, J. Simon) ...

  12. The Brady Bunch? New evidence for nominative determinism in patients’ health: retrospective, population based cohort study

    OpenAIRE

    Keaney, John J; Groarke, John D; Galvin, Zita; McGorrian, Catherine; McCann, Hugh A; Sugrue, Declan; Keelan, Edward; Galvin, Joseph; Blake, Gavin; Mahon, Niall G.; O’Neill, James

    2013-01-01

    Objective To ascertain whether a name can influence a person’s health, by assessing whether people with the surname “Brady” have an increased prevalence of bradycardia. Design Retrospective, population based cohort study. Setting One university teaching hospital in Dublin, Ireland. Participants People with the surname “Brady” in Dublin, determined through use of an online telephone directory. Main outcome measure Prevalence of participants who had pacemakers inserted for bradycardia between 1...

  13. 1970 British Cohort Study

    Directory of Open Access Journals (Sweden)

    Matt Brown

    2014-10-01

    Full Text Available The 1970 British Cohort Study (BCS70 is one of Britain’s world famous national longitudinal birth cohort studies, three of which are run by the Centre for Longitudinal Studies at the Institute of Education, University of London. BCS70 follows the lives of more than 17,000 people born in England, Scotland and Wales in a single week of 1970. Over the course of cohort members lives, the BCS70 has collected information on health, physical, educational and social development, and economic circumstances among other factors. Since the birth survey in 1970, there have been nine ‘sweeps’ of all cohort members at ages 5, 10, 16, 26, 30, 34, 38 and most recently at 42. Data has been collected from a number of different sources (the midwife present at birth, parents of the cohort members, head and class teachers, school health service personnel and the cohort members themselves. The data has been collected in a variety of ways including via paper and electronic questionnaires, clinical records, medical examinations, physical measurements, tests of ability, educational assessments and diaries. The majority of can be accessed by bona fide researchers through the a href="http://discover.ukdataservice.ac.uk/series/?sn=200001" UK Data Service at the University of Essex.

  14. 1970 British Cohort Study

    Directory of Open Access Journals (Sweden)

    Matt Brown

    2014-10-01

    Full Text Available The 1970 British Cohort Study (BCS70 is one of Britain’s world famous national longitudinal birth cohort studies, three of which are run by the Centre for Longitudinal Studies at the Institute of Education, University of London.  BCS70 follows the lives of more than 17,000 people born in England, Scotland and Wales in a single week of 1970. Over the course of cohort members lives, the BCS70 has collected information on health, physical, educational and social development, and economic circumstances among other factors. Since the birth survey in 1970, there have been nine ‘sweeps’ of all cohort members at ages 5, 10, 16, 26, 30, 34, 38 and most recently at 42. Data has been collected from a number of different sources (the midwife present at birth, parents of the cohort members, head and class teachers, school health service personnel and the cohort members themselves. The data has been collected in a variety of ways including via paper and electronic questionnaires, clinical records, medical examinations, physical measurements, tests of ability, educational assessments and diaries. The majority of BCS70 survey data can be accessed by bona fide researchers through the UK Data Service at the University of Essex.

  15. Operative Complications During Pregnancy After Gastric Bypass—a Register-Based Cohort Study

    DEFF Research Database (Denmark)

    Andreasen, Lisbeth A; Nilas, Lisbeth; Kjær, Mette M

    2014-01-01

    BACKGROUND: Late complications to bariatric surgery during pregnancy have become an area of concern. Expansion of the uterus and the following displacement of the small intestine may increase the risk of internal herniation. We wanted to estimate the risk and consequences of surgical complications...... during pregnancy in a national cohort of women with a history of gastric bypass surgery. METHODS: A national, register-based cohort study of all Danish women with a history of gastric bypass surgery who had given birth from 2004 to 2010 was conducted. Surgical codes registered during pregnancy and until...... puerperium. CONCLUSIONS: The incidence of internal herniation during pregnancy was 1 % in our study. Internal herniation may be a serious complication in pregnant women, and both the diagnosis and treatment requires handling by experienced obstetrical, radiological, and surgical staff....

  16. RAPID HOME-BASED HIV TESTING TO REDUCE COSTS IN A LARGE TUBERCULOSIS COHORT STUDY

    OpenAIRE

    Galea, Jerome T.; Contreras, Carmen; Lecca, Leonid; Shin, Sonya; Lobatón, Raúl; Zhang, Zibiao; Calderón, Roger; Murray, Megan; Becerra, Mercedes C.

    2013-01-01

    To reduce costs in a large tuberculosis household contact cohort study in Lima, Peru, we replaced laboratory-based HIV testing with home-based rapid testing. We developed a protocol and training course to prepare staff for the new strategy; these included role playing for home-based deployment of the Determine® HIV 1/2 Ag/Ac Combo HIV test. Though the rapid HIV test produced more false-positives, the overall cost per participant tested, refusal rate and time to confirmatory HIV testing were l...

  17. Risk of schizophrenia in second-generation immigrants: a Danish population-based cohort study

    DEFF Research Database (Denmark)

    Cantor-Graae, Elizabeth; Pedersen, Carsten Bøcker

    2007-01-01

    Background. Urban birth, a risk factor for schizophrenia, is more frequent among second-generation immigrants. The aim of the current study was to determine whether the increased risk for schizophrenia found in second-generation immigrants is explained by the degree of urbanization of birthplace...... and/or factors related to parentage, such as geographic origin or history of residence abroad during upbringing.Method. Using data from the Danish Civil Registration System (CRS), we established a population-based cohort of 2.0 million Danes (persons born in Denmark). Schizophrenia in cohort members....... Adjustment for urbanization of birthplace and parental characteristics reduced these risks slightly. However, urbanization had a lesser effect in second-generation immigrants than in Danes. History of residence abroad was a risk factor for schizophrenia, regardless of whether parents were foreign-born or...

  18. Association between adult otitis media and nasopharyngeal cancer: A nationwide population-based cohort study

    International Nuclear Information System (INIS)

    Purpose: To determine whether the diagnosis of otitis media (OM) in adults is associated with an increased risk for the subsequent development of nasopharyngeal cancer (NPC) using a nationwide population-based retrospective study. Methods and materials: We selected 13,513 adult patients that had been previously diagnosed with OM between 2000 and 2005 from the Taiwan Longitudinal Health Insurance Database 2000 as the study cohort, and randomly extracted the data of 135,130 participants matched by sex, age, and baseline year for the comparison cohort. The follow-up period was terminated upon developing NPC, withdrawal from the national health insurance system, or the end of 2009. Cumulative incidences and hazard ratios (HRs) of NPC development were determined. Results: The subsequent NPC incidence rates in the OM and comparison cohorts were 6.41 and 0.58 per 10 000 person-years, respectively (adjusted HR, 11.04; 95% CI, 7.68–5.87; P < 0.0001). The NPC risk for males was significantly higher than that for females (adjusted HR = 3.24; 95% CI, 2.16–4.85). In both female and male patients, the diagnosis of OM was associated with a significantly increased risk for NPC (adjusted HR, 11.91 vs. 10.78, respectively). Among the OM cohort, 62 participants were subsequently diagnosed with NPC, with 71% of them occurring within 1 year following the diagnosis of OM. However, even after 5-year follow-up, the OM cohort still displayed a higher risk for NPC (adjusted HR = 2.50). Stratified by the frequency of OM episodes, more than one episode per year had a significantly greater risk of developing NPC, compared with the comparison cohort (HR = 29.22; 95% CI, 20.19–42.27). Conclusion: We found that adult OM is a warning sign for the development of NPC in Taiwan, with approximately an 11-fold higher risk for adult OM patients. We recommend that OM patients undergo follow-up examinations for at least 5 years. To extrapolate our findings, further studies are warranted in other

  19. Weekly miscarriage rates in a community-based prospective cohort study in rural western Kenya

    Science.gov (United States)

    Dellicour, Stephanie; Aol, George; Ouma, Peter; Yan, Nicole; Bigogo, Godfrey; Hamel, Mary J; Burton, Deron C; Oneko, Martina; Breiman, Robert F; Slutsker, Laurence; Feikin, Daniel; Kariuki, Simon; Odhiambo, Frank; Stergachis, Andreas; Laserson, Kayla F; ter Kuile, Feiko O; Desai, Meghna

    2016-01-01

    Objective Information on adverse pregnancy outcomes is important to monitor the impact of public health interventions. Miscarriage is a challenging end point to ascertain and there is scarce information on its rate in low-income countries. The objective was to estimate the background rate and cumulative probability of miscarriage in rural western Kenya. Design This was a population-based prospective cohort. Participants and setting Women of childbearing age were followed prospectively to identify pregnancies and ascertain their outcomes in Siaya County, western Kenya. The cohort study was carried out in 33 adjacent villages under health and demographic surveillance. Outcome measure Miscarriage. Results Between 2011 and 2013, among 5536 women of childbearing age, 1453 pregnancies were detected and 1134 were included in the analysis. The cumulative probability was 18.9%. The weekly miscarriage rate declined steadily with increasing gestation until approximately 20 weeks. Known risk factors for miscarriage such as maternal age, gravidity, occupation, household wealth and HIV infection were confirmed. Conclusions This is the first report of weekly miscarriage rates in a rural African setting in the context of high HIV and malaria prevalence. Future studies should consider the involvement of community health workers to identify the pregnancy cohort of early gestation for better data on the actual number of pregnancies and the assessment of miscarriage. PMID:27084287

  20. Cesarean Section and Rate of Subsequent Stillbirth, Miscarriage, and Ectopic Pregnancy: A Danish Register-Based Cohort Study

    OpenAIRE

    ,

    2014-01-01

    Louise Kenny and colleagues conduct a population-based cohort study in Denmark to assess the likelihood of stillbirth, miscarriage, and ectopic pregnancy following cesarean section compared to women who gave birth by vaginal delivery.

  1. Air Pollution and Newly Diagnostic Autism Spectrum Disorders: A Population-Based Cohort Study in Taiwan

    OpenAIRE

    Jung, Chau-Ren; Lin, Yu-Ting; Hwang, Bing-Fang

    2013-01-01

    There is limited evidence that long-term exposure to ambient air pollution increases the risk of childhood autism spectrum disorder (ASD). The objective of the study was to investigate the associations between long-term exposure to air pollution and newly diagnostic ASD in Taiwan. We conducted a population-based cohort of 49,073 children age less than 3 years in 2000 that were retrieved from Taiwan National Insurance Research Database and followed up from 2000 through 2010. Inverse distance w...

  2. Ambient Fine Particulate Matter and Mortality among Survivors of Myocardial Infarction: Population-Based Cohort Study

    Science.gov (United States)

    Chen, Hong; Burnett, Richard T.; Copes, Ray; Kwong, Jeffrey C.; Villeneuve, Paul J.; Goldberg, Mark S.; Brook, Robert D.; van Donkelaar, Aaron; Jerrett, Michael; Martin, Randall V.; Brook, Jeffrey R.; Kopp, Alexander; Tu, Jack V.

    2016-01-01

    Background: Survivors of acute myocardial infarction (AMI) are at increased risk of dying within several hours to days following exposure to elevated levels of ambient air pollution. Little is known, however, about the influence of long-term (months to years) air pollution exposure on survival after AMI. Objective: We conducted a population-based cohort study to determine the impact of long-term exposure to fine particulate matter ≤ 2.5 μm in diameter (PM2.5) on post-AMI survival. Methods: We assembled a cohort of 8,873 AMI patients who were admitted to 1 of 86 hospital corporations across Ontario, Canada in 1999–2001. Mortality follow-up for this cohort extended through 2011. Cumulative time-weighted exposures to PM2.5 were derived from satellite observations based on participants’ annual residences during follow-up. We used standard and multilevel spatial random-effects Cox proportional hazards models and adjusted for potential confounders. Results: Between 1999 and 2011, we identified 4,016 nonaccidental deaths, of which 2,147 were from any cardiovascular disease, 1,650 from ischemic heart disease, and 675 from AMI. For each 10-μg/m3 increase in PM2.5, the adjusted hazard ratio (HR10) of nonaccidental mortality was 1.22 [95% confidence interval (CI): 1.03, 1.45]. The association with PM2.5 was robust to sensitivity analyses and appeared stronger for cardiovascular-related mortality: ischemic heart (HR10 = 1.43; 95% CI: 1.12, 1.83) and AMI (HR10 = 1.64; 95% CI: 1.13, 2.40). We estimated that 12.4% of nonaccidental deaths (or 497 deaths) could have been averted if the lowest measured concentration in an urban area (4 μg/m3) had been achieved at all locations over the course of the study. Conclusions: Long-term air pollution exposure adversely affects the survival of AMI patients. Citation: Chen H, Burnett RT, Copes R, Kwong JC, Villeneuve PJ, Goldberg MS, Brook RD, van Donkelaar A, Jerrett M, Martin RV, Brook JR, Kopp A, Tu JV. 2016. Ambient fine

  3. Higher migraine risk in healthcare professionals than in general population: a nationwide population-based cohort study in Taiwan

    OpenAIRE

    Kuo, Wan-Yin; Huang, Chien-Cheng; Weng, Shih-Feng; Lin, Hung-Jung; Su, Shih-Bin; Wang, Jhi-Joung; Guo, How-Ran; Hsu, Chien-Chin

    2015-01-01

    Background High stress levels and shift work probably trigger migraine in healthcare professionals (HCPs). However, the migraine risk differences between HCPs and the general population is unknown. Methods This nationwide population-based cohort study used Taiwan’s National Health Insurance Research Database. Physicians (50,226), nurses (122,357), and other HCPs (pharmacists, technicians, dietitians, rehabilitation therapists, social workers, etc.) (45,736) were enrolled for the study cohort,...

  4. Pneumoconiosis increases the risk of congestive heart failure: A nationwide population-based cohort study.

    Science.gov (United States)

    Yen, Chia-Ming; Lin, Cheng-Li; Lin, Ming-Chia; Chen, Huei-Yong; Lu, Nan-Han; Kao, Chia-Hung

    2016-06-01

    The purpose of the study was to determine the relationship between pneumoconiosis and congestive heart failure (CHF).We collected data from the National Health Insurance Research Database in Taiwan. The study sample comprised 8923 patients with pneumoconiosis and 35,692 nonpneumoconiosis controls enrolled from 2000 to 2011. Patients were followed up until the end of 2011 to evaluate the incidence of CHF. The risk of CHF was analyzed using Cox proportional hazard regression models, and the analysis accounted for factors such as sex, age, comorbidities, and air pollutants (μg/m).The overall incidence of CHF was higher in the pneumoconiosis cohort (15.7 per 1000 person-y) than in the nonpneumoconiosis cohort (11.2 per 1000 person-y), with a crude hazard ratio (HR) of 1.40 (P pneumoconiosis cohort than in the nonpneumoconiosis cohort (P pneumoconiosis cohort compared with the nonpneumoconiosis cohort was significant for men (adjusted HR = 1.40, 95% confidence interval = 1.21-1.62, P pneumoconiosis patients had a higher relative risk of CHF for all age group.Patients with pneumoconiosis were at higher risk for developing CHF than patients in the nonpneumoconiosis cohort, particularly in cases with coexisting coronary artery disease, hypertension, and chronic obstructive pulmonary disease. PMID:27336897

  5. Vegetarianism, low meat consumption and the risk of colorectal cancer in a population based cohort study.

    Science.gov (United States)

    Gilsing, Anne M J; Schouten, Leo J; Goldbohm, R Alexandra; Dagnelie, Pieter C; van den Brandt, Piet A; Weijenberg, Matty P

    2015-01-01

    To study how a vegetarian or low meat diet influences the risk of colorectal cancer compared to a high meat diet, and to assess the explanatory role of factors associated with these diets. In the Netherlands Cohort Study - Meat Investigation Cohort (NLCS-MIC) (cohort of 10,210 individuals including 1040 self-defined vegetarians), subjects completed a baseline questionnaire in 1986, based on which they were classified into vegetarians (n = 635), pescetarians (n = 360), 1 day/week- (n = 1259), 2-5 day/week- (n = 2703), and 6-7 day/week meat consumers (n = 5253). After 20.3 years of follow-up, 437 colorectal cancer cases (307 colon, 92 rectal) were available. A non-significantly decreased risk of CRC for vegetarians, pescetarians, and 1 day/week compared to 6-7 day/week meat consumers was observed (age/sex adjusted Hazard Ratios (HR): 0.73(0.47-1.13), 0.80(0.47-1.39), and 0.72(0.52-1.00), respectively). Most of the differences in HR between these groups could be explained by intake of dietary fiber and soy products. Other (non-)dietary factors characteristic for a vegetarian or low meat diet had negligible individual effects, but attenuated the HRs towards the null when combined. Vegetarians, pescetarians, and 1 day/week meat eaters showed a non-significantly decreased risk of colorectal cancer compared to 6-7 day/week meat consumers, mainly due to differences in dietary pattern other than meat intake. PMID:26316135

  6. Assessment of Allergy to Milk, Egg, Cod, and Wheat in Swedish Schoolchildren: A Population Based Cohort Study

    OpenAIRE

    Winberg, Anna; Christina E West; Strinnholm, Åsa; Nordström, Lisbeth; Hedman, Linnea; Rönmark, Eva

    2015-01-01

    Objectives Knowledge about the prevalence of allergies to foods in childhood and adolescence is incomplete. The purpose of this study was to investigate the prevalence of allergies to milk, egg, cod, and wheat using reported data, clinical examinations, and double-blind placebo-controlled food challenges, and to describe the phenotypes of reported food hypersensitivity in a cohort of Swedish schoolchildren. Methods In a population-based cohort of 12-year-old children, the parents of 2612 (96%...

  7. Patients with chronic kidney disease are at an elevated risk of dementia: A population-based cohort study in Taiwan

    OpenAIRE

    Cheng Kao-Chi; Chen Yu-Lung; Lai Shih-Wei; Mou Chih-Hsin; Tsai Pang-Yao; Sung Fung-Chang

    2012-01-01

    Abstract Background Chronic kidney disease (CKD) is more prevalent in Taiwan than in most countries. This population-based cohort study evaluated the dementia risk associated with CKD. Methods Using claims data of 1,000,000 insured residents covered in the universal health insurance of Taiwan, we selected 37049 adults with CKD newly diagnosed from 2000–2006 as the CKD cohort. We also randomly selected 74098 persons free from CKD and other kidney diseases, frequency matched with age, sex and t...

  8. SLE disease patterns in a Danish population-based lupus cohort: an 8-year prospective study

    DEFF Research Database (Denmark)

    Laustrup, H; Voss, A; Green, A;

    2009-01-01

    In 1995 all systemic lupus erythematosus (SLE) patients in the county of Funen were retrieved from four separate and independent sources as part of an 8-year prospective study to determine the pattern of disease activity and damage accumulation in a community based lupus cohort of predominantly...... Scandinavian ancestry. Incident cases were subsequently identified by surveillance of these sources. Established and new cases underwent annual, structured interviews, clinical examination and blood sampling. The Systemic Lupus Erythematosus Diseases Activity Index SLEDAI and Systemic Lupus International...... Collaborating Clinics SLICC scores were calculated. Flares were defined as modified - SLEDAI >/= 4.The annual flare rate in definite SLE (D-SLE) was 0.21 (95%CI 0.18-0.24) versus 0.03 (95%CI 0.01-0.07) in incomplete SLE (I-SLE). Forty-three per cent of the entire study population had no disease exacerbations...

  9. Pneumococcal serotypes and mortality following invasive pneumococcal disease: a population-based cohort study

    DEFF Research Database (Denmark)

    Harboe, Zitta B; Thomsen, Reimar W; Riis, Anders;

    2009-01-01

    BACKGROUND: Pneumococcal disease is a leading cause of morbidity and mortality worldwide. The aim of this study was to investigate the association between specific pneumococcal serotypes and mortality from invasive pneumococcal disease (IPD). METHODS AND FINDINGS: In a nationwide population......-based cohort study of IPD in Denmark during 1977-2007, 30-d mortality associated with pneumococcal serotypes was examined by multivariate logistic regression analysis after controlling for potential confounders. A total of 18,858 IPD patients were included. Overall 30-d mortality was 18%, and 3% in children...... compared with serotype 1 (all: adjusted odds ratio >or=3, p<0.001). In children younger than 5 y, associations between serotypes and mortality were different than in adults but statistical precision was limited because of low overall childhood-related mortality. CONCLUSIONS: Specific pneumococcal serotypes...

  10. Comorbidity Acquired before HIV Diagnosis and Mortality in HIV-infected and Uninfected Persons: A Danish population-based cohort study

    DEFF Research Database (Denmark)

    Lohse, Nicolai; Gerstoft, Jan; Kronborg, Gitte;

    2011-01-01

    BACKGROUND:: We aimed to estimate the impact of comorbidity acquired before HIV diagnosis on mortality in HIV-infected individuals METHODS:: This cohort study compared two different cohorts. The prospective population-based nationwide observational Danish HIV Cohort Study was used to compare all ...

  11. A population-based, incidence cohort study of mid-back pain after traffic collisions

    DEFF Research Database (Denmark)

    Johansson, M S; Boyle, E; Hartvigsen, Jan;

    2015-01-01

    BACKGROUND: Traffic collisions often result in a wide range of symptoms included in the umbrella term whiplash-associated disorders. Mid-back pain (MBP) is one of these symptoms. The incidence and prognosis of different traffic injuries and their related conditions (e.g. neck pain, low back pain......, depression or others) has been investigated previously; however, knowledge about traffic collision-related MBP is lacking. The study objectives were to describe the incidence, course of recovery and prognosis of MBP after traffic collisions, in terms of global self-reported recovery. METHODS: Longitudinal...... data from a population-based inception cohort of all traffic injuries occurring in Saskatchewan, Canada, during a 2-year period were used. Annual overall and age-sex-specific incidence rates were calculated, the course of recovery was described using the Kaplan-Meier technique, and associations between...

  12. Elevated plasma vitamin B12 levels and cancer prognosis: A population-based cohort study

    DEFF Research Database (Denmark)

    Arendt, Johan Frederik Håkonsen; Farkas, Dora Kormendine; Pedersen, Lars;

    2015-01-01

    BACKGROUND: Elevated plasma vitamin B12 levels (cobalamin, Cbl) are associated with increased short-term cancer risk among patients referred for this laboratory measurement. We aimed to assess prognosis in cancer patients with elevated plasma Cbl. METHODS: We conducted a population-based cohort...

  13. Determinants of Disability in Rheumatoid Arthritis: A Community-Based Cohort Study

    OpenAIRE

    Krause, Megan L.; Crowson, Cynthia S.; Bongartz, Tim; Matteson, Eric L.; Michet, Clement J; Mason, Thomas G.; Persellin, Scott T.; Gabriel, Sherine E.; Davis, John M.

    2015-01-01

    Longitudinal care of a community-based cohort of patients with rheumatoid arthritis (RA) was evaluated retrospectively. Candidate determinants of disability included visual analog scales (VAS) for patient global assessment and pain, comorbidities, and medications. The outcome was the ‘patient-acceptable symptom state’ for disability as defined by the Health Assessment Questionnaire (HAQ) disability index, using a cutoff of

  14. The Use of Hypnotics and Mortality--A Population-Based Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Tzuo-Yun Lan

    Full Text Available Sleep disorders, especially chronic insomnia, have become major health problem worldwide and, as a result, the use of hypnotics is steadily increasing. However, few studies with a large sample size and long-term observation have been conducted to investigate the relationship between specific hypnotics and mortality.We conducted this retrospective cohort study using data from the National Health Insurance Research Database in Taiwan. Information from claims data including basic characteristics, the use of hypnotics, and survival from 2000 to 2009 for 1,320,322 individuals were included. The use of hypnotics was divided into groups using the defined daily dose and the cumulative length of use. Hazard ratios (HRs were calculated from a Cox proportional hazards model, with two different matching techniques to examine the associations.Compared to the non-users, both users of benzodiazepines (HR = 1.81; 95% confidence interval [CI] = 1.78-1.85 and mixed users (HR = 1.44; 95% CI = 1.42-1.47 had a higher risk of death, whereas the users of other non-benzodiazepines users showed no differences. Zolpidem users (HR = 0.73; 95% CI = 0.71-0.75 exhibited a lower risk of mortality in the adjusted models. This pattern remained similar in both matching techniques. Secondary analysis indicated that zolpidem users had a reduced risk of major cause-specific mortality except cancer, and that this protective effect was dose-responsive, with those using for more than 1 year having the lowest risk.The effects of different types of hypnotics on mortality were diverse in this large cohort with long-term follow-up based on representative claims data in Taiwan. The use of zolpidem was associated with a reduced risk of mortality.

  15. Risk of Peripheral Artery Disease in Patients With Carbon Monoxide Poisoning: A Population-Based Retrospective Cohort Study.

    Science.gov (United States)

    Chen, Yu-Guang; Lin, Te-Yu; Dai, Ming-Shen; Lin, Cheng-Li; Hung, Yuan; Huang, Wen-Sheng; Kao, Chia-Hung

    2015-10-01

    Carbon monoxide (CO) poisoning can cause several life-threatening complications, particularly in cardiovascular and neurological systems. However, no studies have been performed to investigate the association between peripheral artery disease (PAD) and CO poisoning. We constructed a population-based retrospective cohort study to clarify the risks between PAD and CO poisoning. This population-based cohort study involved analyzing data from 1998 to 2010 obtained from the Taiwanese National Health Insurance Research Database, with a follow-up period extending to the end of 2011. We identified patients with CO poisoning and selected a comparison cohort that was frequency matched according to age, sex, and year of diagnosis of CO poisoning at a ratio of 1 patient to 4 control patients. We analyzed the risks for patients with CO poisoning and PAD by using Cox proportional hazards regression models. In this study, 9046 patients with CO poisoning and 36,183 controls were included. The overall risks for developing PAD were 1.85-fold in the patients with CO poisoning compared with the comparison cohort after adjusting for age, sex, and comorbidities. Our long-term cohort study results showed a higher risk for PAD development among patients with CO poisoning. PMID:26448007

  16. Prognostic factors in breast-conserving therapy : a prospective population-based cohort study

    NARCIS (Netherlands)

    Jobsen, Jan Jacobus

    2010-01-01

    A large cohort study on breast cancer was started that included patients treated with breastconserving therapy, from the early start of this treatment in the Twente – Achterhoek region, till today, with more than 3.800 breast-conserving treatments. Recruitment is still continuing. In chapter 2, on f

  17. The Netherlands Cohort Study – Meat Investigation Cohort; a population-based cohort over-represented with vegetarians, pescetarians and low meat consumers

    OpenAIRE

    Gilsing, Anne MJ; Weijenberg, Matty P.; Goldbohm, R. Alexandra; Dagnelie, Pieter C.; van den Brandt, Piet A.; Schouten, Leo J.

    2013-01-01

    Background Vegetarian diets have been associated with lower risk of chronic disease, but little is known about the health effects of low meat diets and the reliability of self-reported vegetarian status. We aimed to establish an analytical cohort over-represented with vegetarians, pescetarians and 1 day/week meat consumers, and to describe their lifestyle and dietary characteristics. In addition, we were able to compare self-reported vegetarians with vegetarians whose status has been confirme...

  18. Maternal death audit in Rwanda 2009–2013: a nationwide facility-based retrospective cohort study

    Science.gov (United States)

    Sayinzoga, Felix; Bijlmakers, Leon; van Dillen, Jeroen; Mivumbi, Victor; Ngabo, Fidèle; van der Velden, Koos

    2016-01-01

    Objective Presenting the results of 5 years of implementing health facility-based maternal death audits in Rwanda, showing maternal death classification, identification of substandard (care) factors that have contributed to death, and conclusive recommendations for quality improvements in maternal and obstetric care. Design Nationwide facility-based retrospective cohort study. Settings All cases of maternal death audited by district hospital-based audit teams between January 2009 and December 2013 were reviewed. Maternal deaths that were not subjected to a local audit are not part of the cohort. Population 987 audited cases of maternal death. Main outcome measures Characteristics of deceased women, timing of onset of complications, place of death, parity, gravida, antenatal clinic attendance, reported cause of death, service factors and individual factors identified by committees as having contributed to death, and recommendations made by audit teams. Results 987 cases were audited, representing 93.1% of all maternal deaths reported through the national health management information system over the 5-year period. Almost 3 quarters of the deaths (71.6%) occurred at district hospitals. In 44.9% of these cases, death occurred in the post-partum period. Seventy per cent were due to direct causes, with post-partum haemorrhage as the leading cause (22.7%), followed by obstructed labour (12.3%). Indirect causes accounted for 25.7% of maternal deaths, with malaria as the leading cause (7.5%). Health system failures were identified as the main responsible factor for the majority of cases (61.0%); in 30.3% of the cases, the main factor was patient or community related. Conclusions The facility-based maternal death audit approach has helped hospital teams to identify direct and indirect causes of death, and their contributing factors, and to make recommendations for actions that would reduce the risk of reoccurrence. Rwanda can complement maternal death audits with other

  19. Parental concerns based general developmental screening tool and autism risk: the Taiwan National Birth cohort study.

    Science.gov (United States)

    Lung, For-Wey; Shu, Bih-Ching; Chiang, Tung-Liang; Lin, Shio-Jean

    2010-02-01

    Early detection of developmental delay and childhood disorders are important for early intervention. This study aimed to describe the distribution of responses in a large population-based survey, identify cutoff points for the parent concern checklist (PCC) suitable for the Chinese language and culture, and explore how many children were identified as having evidence of problems at age 18 mo different from those at age 6 mo. Using a national randomly selected sample, the overall development of 21,248 children was investigated using the Taiwan Birth Cohort study instrument, and the PCC, a problem-oriented screening instrument. The Newton-Raphson iteration showed that the PCC should be separated into three groups, those scoring 1-2 in the first group, 3- 6 in the second group, and 7- 8 in the third group.Structural equation models showed that 6-mo development was predictive of 18-mo development; additionally, 18-mo development and the PCC showed good concurrent validity. This study identified three groups with distinct developmental trajectories and two cutoff points of 2/3 and 6/7. Thus, the PCC can be used as a first-stage screening instrument in a two-stage window screening procedure. Further studies are needed to investigate the factors, which contribute to the differences among these groups;follow-up on the typical and atypical development of these children is necessary. PMID:20091940

  20. Risk of psychiatric disorders following polycystic ovary syndrome: a nationwide population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Jeng-Hsiu Hung

    Full Text Available BACKGROUND: Polycystic ovary syndrome (PCOS is one of the most common endocrine disorders among women of reproductive age. A higher prevalence of psychiatric comorbidities, including depressive disorder, anxiety disorder, and bipolar disorder has been proved in patients with PCOS. However, a clear temporal causal relationship between PCOS and psychiatric disorders has not been well established. OBJECTIVE: We explored the relationship between PCOS and the subsequent development of psychiatric disorders including schizophrenia, bipolar disorder, depressive disorder, anxiety disorder, and sleep disorder. METHODS: We identified patients who were diagnosed with PCOS by an obstetrician-gynecologist in the Taiwan National Health Insurance Research Database. A comparison cohort was constructed of patients without PCOS who were matched according to age and sex. The occurrence of subsequent new-onset psychiatric disorders was evaluated in both cohorts based on diagnoses made by psychiatrists. RESULTS: The PCOS cohort consisted of 5431 patients, and the comparison cohort consisted of 21,724 matched control patients without PCOS. The incidence of depressive disorder (hazard ratio [HR] 1.296, 95% confidence interval [CI] 1.084-.550, anxiety disorder (HR 1.392, 95% CI 1.121-1.729, and sleep disorder (HR 1.495, 95% CI 1.176-1.899 were higher among the PCOS patients than among the patients in the comparison cohort. In addition, a higher incidence of newly diagnosed depressive disorder, anxiety disorder, and sleep disorder remained significantly increased in all of the stratified follow-up durations (0-1, 1-5, ≥5 y. CONCLUSIONS: PCOS might increase the risk of subsequent newly diagnosed depressive disorder, anxiety disorder, and sleep disorder. The risk of newly diagnosed bipolar disorder, which has often been reported in the literature to be comorbid with PCOS, was not significantly elevated.

  1. The association between fracture site and obesity in men: a population-based cohort study.

    Science.gov (United States)

    Premaor, Melissa O; Compston, Juliet E; Fina Avilés, Francesc; Pagès-Castellà, Aina; Nogués, Xavier; Díez-Pérez, Adolfo; Prieto-Alhambra, Daniel

    2013-08-01

    A site-dependent association between obesity and fracture has been reported in postmenopausal women. In this study we investigated the relationship between body mass index (BMI) and fracture at different skeletal sites in older men (≥65 years). We carried out a population-based cohort study using data from the Sistema d'Informació per al Desenvolupament de l'Investigació en Atenció Primària (SIDIAP(Q) ) database. SIDIAP(Q) contains the primary care and hospital admission computerized medical records of >1300 general practitioners (GPs) in Catalonia (Northeast Spain), with information on a representative 30% of the population (>2 million people). In 2007, 186,171 men ≥65 years were eligible, of whom 139,419 (74.9%) had an available BMI measurement. For this analysis men were categorized as underweight/normal (BMI < 25 kg/m(2) , n = 26,298), overweight (25 ≤ BMI < 30 kg/m(2) , n = 70,851), and obese (BMI ≥ 30 kg/m(2) , n = 42,270). Incident fractures in the period 2007 to 2009 were ascertained using International Classification of Diseases, 10th edition (ICD-10) codes. A statistically significant reduction in clinical spine and hip fractures was observed in obese (relative risk [RR], 0.65; 95% confidence interval [CI], 0.53-0.80 and RR, 0.63; 95% CI, 0.54-0.74, respectively), and overweight men (RR, 0.77; 95% CI, 0.64-0.92 and RR, 0.63; 95% CI 0.55-0.72, respectively) when compared with underweight/normal men. Additionally, obese men had significantly fewer wrist/forearm (RR, 0.77; 95% CI, 0.61-0.97) and pelvic (RR, 0.44; 95% CI, 0.28-0.70) fractures than underweight/normal men. Conversely, multiple rib fractures were more frequent in overweight (RR, 3.42; 95% CI, 1.03-11.37) and obese (RR, 3.96; 95% CI, 1.16-13.52) men. In this population-based cohort of older men, obesity was associated with a reduced risk of clinical spine, hip, pelvis, and wrist/forearm fracture and increased risk of multiple rib fractures when compared

  2. Ischemic heart disease in HIV-infected and HIV-uninfected individuals: a population-based cohort study

    DEFF Research Database (Denmark)

    Obel, Niels; Thomsen, Henrik F; Kronborg, Gitte; Larsen, Carsten S; Hildebrandt, Per R; Sørensen, Henrik T; Gerstoft, Jan

    2007-01-01

    BACKGROUND: There are concerns about highly active antiretroviral therapy (HAART) causing a progressive increase in the risk of ischemic heart disease. We examined this issue in a nationwide cohort study of patients with human immunodeficiency virus (HIV) infection and a population-based control ...

  3. Risk of cryptorchidism and hypospadias among boys of maternal hairdressers - a Danish population-based cohort study

    DEFF Research Database (Denmark)

    Jørgensen, Kristian Tore; Jensen, Morten Søndergaard; Toft, Gunnar;

    2013-01-01

    fetal development. This study assessed the risk of cryptorchidism and hypospadias among boys of maternal hairdressers. METHODS: National population-based registers were used to determine maternal occupation and identify cases of cryptorchidism and hypospadias. The cohort comprised all children born in...

  4. Post-transplant lymphoproliferative disorder following kidney transplantation: a population-based cohort study.

    Science.gov (United States)

    Maksten, Eva Futtrup; Vase, Maja Ølholm; Kampmann, Jan; d'Amore, Francesco; Møller, Michael Boe; Strandhave, Charlotte; Bendix, Knud; Bistrup, Claus; Thiesson, Helle Charlotte; Søndergaard, Esben; Hamilton-Dutoit, Stephen; Jespersen, Bente

    2016-04-01

    Post-transplant lymphoproliferative disorder (PTLD) incidence is difficult to determine, mainly because both early and other lesions may go unrecognized and unregistered. Few studies have included systematic pathology review to maximize case identification and decide more accurately PTLD frequency after long-term post-transplantation follow-up. A retrospective population-based cohort study including all kidney transplant recipients at two Danish centres (1990-2011; population covered 3.1 million; 2175 transplantations in 1906 patients). Pathology reports were reviewed for all patient biopsies to identify possible PTLDs. Candidate PTLDs underwent histopathological review and classification. Seventy PTLD cases were identified in 2175 transplantations (3.2%). The incidence rate (IR) after first transplantation was 5.4 cases per 1000 patient-years (95% CI: 4.0-7.3). Most PTLDs were monomorphic (58.5%), or early lesions (21.5%). Excluding early lesions and patients <18 years, IR was 3.7 (95% CI: 2.9-5.5). Ten patients with PTLD were retransplanted, 2 developing further PTLDs. Post-transplant patient survival was inferior in patients with PTLD, while death-censored graft survival was not. Using registry data together with extensive pathological review and long follow-up, a rather high incidence of PTLD was found. PMID:26749337

  5. Asthma and Risk of Prostate Cancer: A Population-Based Case-Cohort Study in Taiwan.

    Science.gov (United States)

    Su, Yu-Li; Chou, Ching-Lan; Rau, Kun-Ming; Lee, Charles Tzu-Chi

    2015-09-01

    Several epidemiologic studies in Western countries have examined the association between asthma and prostate cancer risk, but the results have been inconclusive. We investigated this association in a large, nationwide, population-based case-cohort study. Using the Taiwan National Health Insurance Research Database from 1997 to 2008, we collected data from 12,372 men, including 4124 with asthma and 8248 age-, residence-, and insurance premium-matched control subjects, who were never diagnosed with asthma. Competing risk-adjusted Cox proportional hazards regression was used to calculate the hazard ratios (HRs) and 95% confidence interval (CI) for determining the association between prostate cancer and asthma. During a mean follow-up of 5.05 years (standard deviation, 2.10), there were 74 cases of prostate cancer. The incidence of prostate cancer was 163.0/100,000 person-years (95% CI: 113.0-228.0) in the asthma patients. Asthma was significantly associated with prostate cancer (HR: 2.36; 95% CI: 1.22-4.57; P = 0.011) after adjusting for age, residential area, insurance premium, hypertriglyceridemia, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, duration of hospitalization, and mortality. In the subgroup analysis, independent risk factors for prostate cancer among men with asthma were age (HR: 1.09; 95% CI: 1.05-1.21; P risk of prostate cancer. PMID:26356691

  6. A Canadian naturalistic study of a community-based cohort treated for bipolar disorder

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    Chandresena Ranjith

    2010-03-01

    Full Text Available Abstract Background Bipolar illness is associated with significant psychosocial morbidity and health resource utilization. Second generation antipsychotics, used alone or in combination with mood stabilizers are effective in treating acute mania in community settings. This study was designed to compare the change in clinical parameters and resource utilization at one month in a group of patients who required treatment intervention for exacerbation of mania. The clinical response at one year was also evaluated. Methods 496 patients were enrolled at 75 psychiatric practices across Canada. The Olanzapine cohort (n = 287 included patients who had olanzapine added to their medication regimen or the dose of olanzapine increased. The Other cohort (n = 209 had a medication other than olanzapine added or the dose adjusted. Changes from baseline in the Young Mania Rating Scale (YMRS, Montgomery Asberg Depression Rating Scale, Beck Anxiety Inventory and SF-12 Health Survey were compared at one month using ANCOVA. Categorical variables at one month for health resource utilization, employment status, abuse/dependency, and the number of suicide attempts were compared using Fisher's Exact test. Patients were followed for one year and a subgroup was evaluated. Results At one month, patients in the Olanzapine cohort recorded a mean reduction in the YMRS of 11.5, significantly greater than the mean reduction in the Other cohort of 9.7 (ANCOVA P = 0.002. The Olanzapine cohort was significantly improved compared to the Other cohort on the scales for depression and anxiety and did not experience the deterioration in physical functioning seen in the Other cohort. No significant differences were detected in health-related quality-of-life measures, employment status, drug abuse/dependency, number of suicide attempts, mental functioning, emergency room visits or inpatient psychiatric hospitalizations. In a subgroup treated for 12 months with a single second generation

  7. Recurrence of Preeclampsia in Northern Tanzania: A Registry-Based Cohort Study

    OpenAIRE

    Mahande, Michael Johnson; Daltveit, Anne Kjersti; Mmbaga, Blandina T; Masenga, Gileard; Obure, Joseph; Manongi, Rachel; Lie, Rolv Terje

    2013-01-01

    Objective: Preeclampsia occurs in about 4 per cent of pregnancies worldwide, and may have particularly serious consequences for women in Africa. Studies in western countries have shown that women with preeclampsia in one pregnancy have a substantially increased risk of preeclampsia in subsequent pregnancies. We estimate the recurrence risks of preeclampsia in data from Northern Tanzania.Methods: A prospective cohort study was designed using 19,811 women who delivered singleton infant...

  8. Surgery or consultation: a population-based cohort study of use of orthopaedic surgeon services.

    Directory of Open Access Journals (Sweden)

    Elizabeth M Badley

    Full Text Available BACKGROUND: This population-based cohort study has the objective to understand the sociodemographic characteristics and health conditions of patients who do not receive surgery within 18 months following an ambulatory visit to an orthopaedic surgeon. METHODS: Administrative healthcare databases in Ontario, Canada were linked to identify all patients making an initial ambulatory visit to orthopaedic surgeons between October 1(st, 2004 and September 30(th, 2005. Logistic regression was used to examine predictors of not receiving surgery within 18 months. RESULTS: Of the 477,945 patients in the cohort 49% visited orthopaedic surgeons for injury, and 24% for arthritis. Overall, 79.3% did not receive surgery within 18 months of the initial visit, which varied somewhat by diagnosis at first visit (84.5% for injury and 73.0% for arthritis with highest proportions in the 0-24 and 25-44 age groups. The distribution by income quintile of patients visiting was skewed towards higher incomes. Regression analysis for each diagnostic group showed that younger patients were significantly more likely to be non-surgical than those aged 65+ years (age 0-24: OR 3.45 95%CI 3.33-3.57; age 25-44: OR 1.30 95%CI 1.27-1.33. The odds of not getting surgery were significantly higher for women than men for injury and other conditions; the opposite was true for arthritis and bone conditions. CONCLUSION: A substantial proportion of referrals were for expert diagnosis or advice on management and treatment. The findings also suggest socioeconomic inequalities in access to orthopaedic care. Further research is needed to investigate whether the high caseload of non-surgical cases affects waiting times to see a surgeon. This paper contributes to the development of evidence-based strategies to streamline access to surgery, and to develop models of care for non-surgical patients to optimize the use of scarce orthopaedic surgeon resources and to enhance the management of

  9. Nutritionists’ Health Study cohort: a web-based approach of life events, habits and health outcomes

    Science.gov (United States)

    da Silva, Isis Tande; de Almeida-Pititto, Bianca; Ferreira, Sandra Roberta G

    2016-01-01

    Introduction Non-communicable chronic diseases (NCCDs) represent a burden for public health. Alongside the established cardiometabolic risk factors such as high blood pressure and disorders of glucose and lipid metabolism, living habits and nutritional status at different stages of life are seen as contributors to this scenario. Gut microbiota composition and subclinical inflammation have been pointed out as underlying mechanisms of NCCDs. Studies involving health professionals have brought relevant contributions to the knowledge about risk factors. Technological advances facilitate data collection and analysis for big samples. A web-based survey addressed to collect data from a cohort study, which is able to identify NCCDs risk factors, is highly desirable. The objective of the Brazilian Nutritionists’ Health Study (NutriHS) is to gather online information on early life events, daily habits, emergent cardiometabolic risk factors and health outcomes of a specific subset of the Brazilian population. Methods and analysis NutriHS, developed at the School of Public Health—University of Sao Paulo, Brazil, is a research initiative that enrols undergraduates of nutrition courses from Brazilian universities and graduated volunteers. A web-based self-administered system was designed to collect health-related data. After fulfilling online questionnaires (socioeconomic, early life events and lifestyle data), participants are invited to a clinical visit for physical examination and laboratory procedures (blood sampling, faeces collection and body composition). At a 3-year interval, they will be invited to repeat similar procedures. Ethics and dissemination The NutriHS research protocol was approved by the Institutional Ethics Committee and is providing promising data which contribute to the understanding of pathophysiological links between early life events, body composition, gut microbiota, and inflammatory and metabolic risk profile. The combination of a friendly tool

  10. Mobilising community-based research on zoonotic infections: A case study of longitudinal cohorts in Vietnam

    OpenAIRE

    Karen Saylors; Tue Ngo Tri; Toan Tran Khanh; Kiet Bach Tuan; Heiman FL Wertheim; Stephen Baker; Hoa Ngo Thi; Bryant, Juliet E

    2015-01-01

    We initiated the Vietnam Initiative on Zoonotic Infections (VIZIONS) research program to better understand the epidemiology of disease transmission at the human–animal interface in Vietnamese rural communities and to integrate One Health approaches to disease surveillance. We established a longitudinal community cohort study of individuals with occupational exposure to animals, which involves concurrent targeted sampling from domestic livestock species and follow-up monitoring of human clinic...

  11. Different angiotensin receptor blockers and incidence of diabetes: a nationwide population-based cohort study

    OpenAIRE

    Chang, Chia-Hsuin; Chang, Yi-Cheng; Wu, Li-Chiu; Lin, Jou-Wei; Chuang, Lee-Ming; Lai, Mei-Shu

    2014-01-01

    Background Angiotensin receptor blockers (ARBs) have been shown to exert various peroxisome proliferator-activated receptor gamma (PPARγ) binding activities and insulin-sensitizing effects. The objective of this study was to investigate the association of different ARBs with new-onset diabetes mellitus. Methods In the respective cohort, a total of 492,530 subjects who initiated ARB treatment between January 2004 and December 2009 were identified from Taiwan National Health Insurance Database....

  12. The Risk of Chronic Pancreatitis in Patients with Psoriasis: A Population-Based Cohort Study

    Science.gov (United States)

    Chiang, Yi-Ting; Huang, Weng-Foung; Tsai, Tsen-Fang

    2016-01-01

    Background Psoriasis is a chronic systemic inflammatory disorder, and studies have revealed its association with a variety of comorbidities. However, the risk of chronic pancreatitis (CP) in psoriasis has not been studied. This study aimed to investigate the risk of CP among patients with psoriasis. Methods Using the Taiwan National Health Insurance Research Database, this population-based cohort study enrolled 48430 patients with psoriasis and 193720 subjects without psoriasis. Stratified Cox proportional hazards models were used to compare the risks of CP between the patients with and without psoriasis. Results The incidence of CP was 0.61 per 1000 person-years in patients with psoriasis and 0.34 per 1000 person-years in controls during a mean 6.6-year follow-up period. Before adjustment, patients with psoriasis had a significantly higher risk of CP (crude hazard ratio (HR) = 1.81; 95% confidence interval (CI) = 1.53–2.15), and the risk remained significantly higher after adjustments for gender, age group, medications, and comorbidities (adjusted HR (aHR) = 1.76; 95% CI = 1.47–2.10). All psoriasis patient subgroups other than those with arthritis, including those with mild and severe psoriasis and those without arthritis, had significantly increased aHRs for CP, and the risk increased with increasing psoriasis severity. Psoriasis patients taking nonsteroidal anti-inflammatory drugs (aHR = 0.33; 95% CI = 0.22–0.49) and methotrexate (aHR = 0.28; 95% CI = 0.12–0.64) had a lower risk of developing CP after adjustments. Conclusions Psoriasis is associated with a significantly increased risk of CP. The results of our study call for more research to provide additional insight into the relationship between psoriasis and CP. PMID:27467265

  13. Incidence of anogenital warts in Germany: a population-based cohort study

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    Mikolajczyk Rafael T

    2010-12-01

    Full Text Available Abstract Background Human papilloma virus (HPV types 6 and 11 account for 90 percent of anogenital warts (AGW. Assessment of a potential reduction of the incidence of AGW following introduction of HPV vaccines requires population-based incidence rates. The aim of this study was to estimate incidence rates of AGW in Germany, stratified by age, sex, and region. Additionally, the medical practitioner (gynaecologist, dermatologist, urologist etc. who made the initial diagnosis of AGW was assessed. Methods Retrospective cohort study in a population aged 10 to 79 years in a population-based healthcare insurance database. The database included more than 14 million insurance members from all over Germany during the years 2004-2006. A case of AGW was considered incident if a disease-free period of twelve months preceded the diagnosis. To assess regional variation, analyses were performed by federal state. Results The estimated incidence rate was 169.5/100,000 person-years for the German population aged 10 to 79 years. Most cases occurred in the 15 to 40 years age group. The incidence rate was higher and showed a peak at younger ages in females than in males. The highest incidence rates for both sexes were observed in the city-states Berlin, Hamburg and Bremen. In females, initial diagnosis of AGW was most frequently made by a gynaecologist (71.7%, whereas in males, AGW were most frequently diagnosed by a dermatologist (44.8% or urologist (25.1%. Conclusions Incidence of AGW in Germany is comparable with findings for other countries. As expected, most cases occurred in the younger age groups. The frequency of diagnoses of AGW differs between sexes and women and men receive treatment by doctors of different specialties.

  14. Suicide after release from prison - a population-based cohort study from Sweden

    Science.gov (United States)

    Haglund, Axel; Tidemalm, Dag; Jokinen, Jussi; Långström, Niklas; Liechtenstein, Paul; Fazel, Seena; Runeson, Bo

    2015-01-01

    Objective Released prisoners have high suicide rates compared with the general population, but little is known about risk factors and possible causal pathways. We conducted a population-based cohort study to investigate rates and risk factors for suicide in people previously imprisoned. Methods We identified individuals released from prison in Sweden between January 1, 2005 and December 31, 2009 through linkage of national population-based registers. Released prisoners were followed from the day of release until death, emigration, new incarceration, or December 31, 2009. Survival analyses were conducted to compare incidence rates and psychiatric morbidity with non-convicted population controls matched on gender and year of birth. Results We identified 38,995 releases among 26,953 prisoners (7.6% females) during 2005-2009. Overall, 127 suicides occurred, accounting for 14% of all deaths after release (n=920). The mean suicide rate was 204 per 100,000 person years yielding an incidence rate ratio of 18.2 (95% CI 13.9-23.8) compared with general population controls. Previous substance use disorder (Hazard Ratio [HR]=2.1, 1.4-3.2), suicide attempt (HR=2.5, 1.7-3.7), and being born in Sweden vs. abroad (HR=2.1, 1.2-3.6) were independent risk factors for suicide after release. Conclusions Released prisoners are at high suicide risk and with a slightly different pattern of psychiatric risk factors for suicide compared with the general population. Results suggest appropriate allocation of resources to facilitate transition to life outside prison and increased attention to prisoners with both a previous suicide attempt and substance use disorder. PMID:25373114

  15. The Clinical Research Center for Depression Study: Baseline Characteristics of a Korean Long-Term Hospital-Based Observational Collaborative Prospective Cohort Study

    OpenAIRE

    Kim, Tae-Suk; Jeong, Seung Hee; Kim, Jung-Bum; Lee, Min-Soo; Kim, Jae-Min; Yim, Hyeon-Woo; Jun, Tae-Youn

    2010-01-01

    Objective The Clinical Research Center for Depression (CRESCEND) study is a 9-year observational collaborative prospective cohort study for the clinical outcomes in participants with depressive disorders in Korea. In this study, we examined the baseline characteristics of the depressive participants as the hospital-based cohort. Methods Participants were assessed using various instruments including the Clinical Global Impression scale, 17-item Hamilton Depression Rating Scale (HDRS-17), Hamil...

  16. Risk of Parkinson Disease in Diabetes Mellitus: An Updated Meta-Analysis of Population-Based Cohort Studies

    Science.gov (United States)

    Yue, Xuejing; Li, Hehua; Yan, Haiqing; Zhang, Ping; Chang, Li; Li, Tong

    2016-01-01

    Abstract Previous meta-analysis has identified the associations between diabetes mellitus (DM) and the risk of Parkinson disease (PD). However, the results are still debatable. The purpose of this study is to perform an updated meta-analysis to investigate the up-to-date pooling evidence based on published population-based cohort studies and assess the association between DM and the risk of PD. Electronic database including Pubmed and Embase were searched to identify cohort studies published before October, 2015. Studies were selected if they reported the risk estimates for PD associated with DM. We pooled the adjusted effect estimates using random-effects meta-analysis. Funnel plot, Begg, or Egger test as well as Duval and Tweedie trim-and-fill approach were applied to assess publication bias. A total of 7 population-based cohort studies, representing 1,761,632 individuals were included in the meta-analysis. The pooled adjusted relative risk (RR) of PD associated with DM was 1.38 (95% CI 1.18–1.62, P < 0.001). An effect was consistent in female (RR 1.50 95% CI 1.07–2.11, P = 0.019) and in male (RR 1.40, 95% CI 1.17–1.67). The association was similar when stratified by study quality, research region, study design, sample size, published year, diabetes duration, and baseline age. The trim-and-fill approach confirmed the robutness of the result (RR 1.31, 95% CI 1.09–1.57, P = 0.015). Our findings based on population-based cohort studies indicate that diabetes is associated with increased PD risk by about 38%. More large-scale prospective studies are warranted to further clarify this association and its mechanism. PMID:27149468

  17. Long-term cancer risk after hysterectomy on benign indications: Population-based cohort study.

    Science.gov (United States)

    Altman, Daniel; Yin, Li; Falconer, Henrik

    2016-06-01

    Hysterectomy on benign indications is associated with an increased risk for adverse health effects. However, little is known about the association between hysterectomy and subsequent cancer occurrence later in life. The purpose of this study was to assess the effect of hysterectomy on the incidence of cancer. In this population-based cohort study, we used data on 111,595 hysterectomized and 537,9843 nonhysterectomized women from nationwide Swedish Health Care registers including the Inpatient Register, the Cancer Register and the Cause of Death Register between 1973 and 2009. Hysterectomy with or without concomitant bilateral salpingo-ophorectomy (BSO) performed on benign indications was considered as exposure and incidence of primary cancers was used as outcome measure. Rare primary cancers (cancer was observed for women with previous hysterectomy and for those with hysterectomy and concurrent BSO (HR 0.93, 95% CI 0.91-0.95 and HR 0.92, 95% CI 0.87-0.96, respectively). Compared to nonhysterectomized women, significant risks were observed for thyroid cancer (HR 1.76, 95% CI 1.45-2.14). For both hysterectomy and hysterectomy with BSO, an association with brain cancer was observed (HR 1.48, 95% CI 1.32-1.65 and HR 1.45, 95% CI 1.15-1.83, respectively). Hysterectomy, with or without BSO, was not associated with breast, lung or gastrointestinal cancer. We conclude that hysterectomy on benign indications is associated with an increased risk for thyroid and brain cancer later in life. Further research efforts are needed to identify patient groups at risk of malignancy following hysterectomy. PMID:26800386

  18. Predictors of death among patients who completed tuberculosis treatment: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Juan-Pablo Millet

    Full Text Available BACKGROUND: Mortality among patients who complete tuberculosis (TB treatment is still high among vulnerable populations. The objective of the study was to identify the probability of death and its predictive factors in a cohort of successfully treated TB patients. METHODS: A population-based retrospective longitudinal study was performed in Barcelona, Spain. All patients who successfully completed TB treatment with culture-confirmation and available drug susceptibility testing between 1995-1997 were retrospectively followed-up until December 31, 2005 by the Barcelona TB Control Program. Socio-demographic, clinical, microbiological and treatment variables were examined. Mortality, TB Program and AIDS registries were reviewed. Kaplan-Meier and a Cox regression methods with time-dependent covariates were used for the survival analysis, calculating the hazard ratio (HR with 95% confidence intervals (CI. RESULTS: Among the 762 included patients, the median age was 36 years, 520 (68.2% were male, 178 (23.4% HIV-infected, and 208 (27.3% were alcohol abusers. Of the 134 (17.6% injecting drug users (IDU, 123 (91.8% were HIV-infected. A total of 30 (3.9% recurrences and 173 deaths (22.7% occurred (mortality rate: 3.4/100 person-years of follow-up. The predictors of death were: age between 41-60 years old (HR: 3.5; CI:2.1-5.7, age greater than 60 years (HR: 14.6; CI:8.9-24, alcohol abuse (HR: 1.7; CI:1.2-2.4 and HIV-infected IDU (HR: 7.9; CI:4.7-13.3. CONCLUSIONS: The mortality rate among TB patients who completed treatment is associated with vulnerable populations such as the elderly, alcohol abusers, and HIV-infected IDU. We therefore need to fight against poverty, and promote and develop interventions and social policies directed towards these populations to improve their survival.

  19. Birth by Caesarean Section and the Risk of Adult Psychosis: A Population-Based Cohort Study.

    Science.gov (United States)

    O'Neill, Sinéad M; Curran, Eileen A; Dalman, Christina; Kenny, Louise C; Kearney, Patricia M; Clarke, Gerard; Cryan, John F; Dinan, Timothy G; Khashan, Ali S

    2016-05-01

    Despite the biological plausibility of an association between obstetric mode of delivery and psychosis in later life, studies to date have been inconclusive. We assessed the association between mode of delivery and later onset of psychosis in the offspring. A population-based cohort including data from the Swedish National Registers was used. All singleton live births between 1982 and 1995 were identified (n= 1,345,210) and followed-up to diagnosis at age 16 or later. Mode of delivery was categorized as: unassisted vaginal delivery (VD), assisted VD, elective Caesarean section (CS) (before onset of labor), and emergency CS (after onset of labor). Outcomes included any psychosis; nonaffective psychoses (including schizophrenia only) and affective psychoses (including bipolar disorder only and depression with psychosis only). Cox regression analysis was used reporting partially and fully adjusted hazard ratios (HR) with 95% confidence intervals (CI). Sibling-matched Cox regression was performed to adjust for familial confounding factors. In the fully adjusted analyses, elective CS was significantly associated with any psychosis (HR 1.13, 95% CI 1.03, 1.24). Similar findings were found for nonaffective psychoses (HR 1.13, 95% CI 0.99, 1.29) and affective psychoses (HR 1.17, 95% CI 1.05, 1.31) (χ(2)for heterogeneityP= .69). In the sibling-matched Cox regression, this association disappeared (HR 1.03, 95% CI 0.78, 1.37). No association was found between assisted VD or emergency CS and psychosis. This study found that elective CS is associated with an increase in offspring psychosis. However, the association did not persist in the sibling-matched analysis, implying the association is likely due to familial confounding by unmeasured factors such as genetics or environment. PMID:26615187

  20. Risk of Obstructive Sleep Apnea in Adult Patients with Asthma: A Population-Based Cohort Study in Taiwan.

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    Te-Chun Shen

    Full Text Available There are several publications reported that obstructive sleep apnea (OSA was associated with asthma. However, large-scaled, population-based cohort study has been limited. We aimed to examine the risk of OSA among adult patients with asthma in an Asian population.We conducted a retrospective cohort study using data from the National Health Insurance (NHI of Taiwan. The asthma cohort included 38,840 newly diagnosed patients between 2000 and 2010. The date of diagnosis was defined as the index date. Each patient was randomly matched with four people without asthma according to gender, age, and the index year as the comparison cohort. The occurrence of OSA was followed up until the end of 2011. The risk of OSA was estimated using the Cox proportional hazard model after adjusting for gender, age, and comorbidities.The overall incidence of OSA was 2.51-fold greater in the asthma cohort than in the comparison cohort (12.1 versus 4.84 per 1000 person-years. Compared to non-asthma subjects, the adjusted hazard ratio (aHR of OSA increased to 1.78 for asthma patients with one or less annual emergency room (ER visit, and 23.8 for those who visited ER more than once per year. In addition, aHR in patients with inhaled steroid treatment compared to those without steroid treatment was 1.33 (95% CI = 1.01-1.76.Patients with asthma have a significantly higher risk of developing OSA than the general population. The results suggest that the risk of OSA is proportional to asthma control and patients with inhaled steroid treatment have a higher risk for OSA than those without steroid treatment.

  1. Air pollution and newly diagnostic autism spectrum disorders: a population-based cohort study in Taiwan.

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    Chau-Ren Jung

    Full Text Available There is limited evidence that long-term exposure to ambient air pollution increases the risk of childhood autism spectrum disorder (ASD. The objective of the study was to investigate the associations between long-term exposure to air pollution and newly diagnostic ASD in Taiwan. We conducted a population-based cohort of 49,073 children age less than 3 years in 2000 that were retrieved from Taiwan National Insurance Research Database and followed up from 2000 through 2010. Inverse distance weighting method was used to form exposure parameter for ozone (O3, carbon monoxide (CO, nitrogen dioxide (NO2, sulfur dioxide (SO2, and particles with aerodynamic diameter less than 10 µm (PM10. Time-dependent Cox proportional hazards (PH model was performed to evaluate the relationship between yearly average exposure air pollutants of preceding years and newly diagnostic ASD. The risk of newly diagnostic ASD increased according to increasing O3, CO, NO2, and SO2 levels. The effect estimate indicating an approximately 59% risk increase per 10 ppb increase in O3 level (95% CI 1.42-1.79, 37% risk increase per 10 ppb in CO (95% CI 1.31-1.44, 340% risk increase per 10 ppb increase in NO2 level (95% CI 3.31-5.85, and 17% risk increase per 1 ppb in SO2 level (95% CI 1.09-1.27 was stable with different combinations of air pollutants in the multi-pollutant models. Our results provide evident that children exposure to O3, CO, NO2, and SO2 in the preceding 1 year to 4 years may increase the risk of ASD diagnosis.

  2. Air pollution and newly diagnostic autism spectrum disorders: a population-based cohort study in Taiwan.

    Science.gov (United States)

    Jung, Chau-Ren; Lin, Yu-Ting; Hwang, Bing-Fang

    2013-01-01

    There is limited evidence that long-term exposure to ambient air pollution increases the risk of childhood autism spectrum disorder (ASD). The objective of the study was to investigate the associations between long-term exposure to air pollution and newly diagnostic ASD in Taiwan. We conducted a population-based cohort of 49,073 children age less than 3 years in 2000 that were retrieved from Taiwan National Insurance Research Database and followed up from 2000 through 2010. Inverse distance weighting method was used to form exposure parameter for ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and particles with aerodynamic diameter less than 10 µm (PM10). Time-dependent Cox proportional hazards (PH) model was performed to evaluate the relationship between yearly average exposure air pollutants of preceding years and newly diagnostic ASD. The risk of newly diagnostic ASD increased according to increasing O3, CO, NO2, and SO2 levels. The effect estimate indicating an approximately 59% risk increase per 10 ppb increase in O3 level (95% CI 1.42-1.79), 37% risk increase per 10 ppb in CO (95% CI 1.31-1.44), 340% risk increase per 10 ppb increase in NO2 level (95% CI 3.31-5.85), and 17% risk increase per 1 ppb in SO2 level (95% CI 1.09-1.27) was stable with different combinations of air pollutants in the multi-pollutant models. Our results provide evident that children exposure to O3, CO, NO2, and SO2 in the preceding 1 year to 4 years may increase the risk of ASD diagnosis. PMID:24086549

  3. Occupational activity during pregnancy based on the Polish Mother and Child Cohort Study

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    Kinga Polańska

    2014-02-01

    Full Text Available Background: In Poland conditions related to or aggravated by the pregnancy, childbirth or the puerperium are one of the most common causes of sickness absence. The aim of the study was to analyze the occupational activity pattern during pregnancy and to evaluate the determinants of pregnancy-related temporary work disability confirmed by medical certificate. Materials and Methods: The presented analysis is based on data collected under the Polish Mother and Child Cohort Study. The study population consisted of 954 women who reported occupational activity during pregnancy. All women participating in the study were interviewed 3 times during pregnancy. Detail information on occupational activity during pregnancy and occupational stress, based on the Subjective Work Characteristics Questionnaire, was collected from all women. Results: The pregnant women had been issued medical certificate of temporary work disability because of conditions related to or aggravated by the pregnancy, childbirth or by the puerperium at 16 week of gestation on average and did not continue their activities until the end of pregnancy. The statistically significant determinants of receiving such medical certificate in the first trimester of pregnancy (≤ 12 weeks of pregnancy comprised poor health condition and complications during pregnancy (OR = 1.4; p = 0.01, lower education (OR = 2.4; p < 0.001, socio-economic status (OR = 9.6; p = 0.03, use of public transport to commute to work (OR = 2.7; p < 0.001, a longer work commute (OR = 1.4; p = 0.008 and a higher level of occupational stress (OR = 3.0; p < 0.01. Waitresses, nurses and saleswomen received medical certificate of temporary work disability in the first trimester of pregnancy more frequently than office workers (OR = 4.2; p = 0.005; OR = 3.3; p = 0.02; OR = 2.3; p < 0.001 respectively. Conclusions: It is crucial to develop the model of cooperation between occupational medicine physicians and gynecologists and a

  4. Use of Framingham risk score and new biomarkers to predict cardiovascular mortality in older people: population based observational cohort study

    OpenAIRE

    de Ruijter, Wouter; Westendorp, Rudi G. J.; Assendelft, Willem J J; Wendy P J den Elzen; Anton J M de Craen; le Cessie, Saskia; Gussekloo, Jacobijn

    2009-01-01

    Objectives To investigate the performance of classic risk factors, and of some new biomarkers, in predicting cardiovascular mortality in very old people from the general population with no history of cardiovascular disease. Design The Leiden 85-plus Study (1997-2004) is an observational prospective cohort study with 5 years of follow-up. Setting General population of the city of Leiden, the Netherlands. Participants Population based sample of participants aged 85 years (215 women and 87 men) ...

  5. Effects of Statins on Incident Dementia in Patients with Type 2 DM: A Population-Based Retrospective Cohort Study in Taiwan

    OpenAIRE

    Chen, Jui-Ming; Chang, Cheng-Wei; Chang, Tzu-Hao; Hsu, Chi-Chang; Horng, Jorng-Tzong; Sheu, Wayne H-H

    2014-01-01

    Background Patients with Type 2 diabetes (T2DM) are prone to develop dementia. Results from a recent study indicated that statin users had lower chance of developing incident dementia. However there is little information on the potential benefits of statin use on dementia in patients with T2DM cohort. Method A population-based retrospective study using a nationwide cohort of National Health Insurance Research Database in Taiwan was performed. T2DM cohort with regular use of statins was follow...

  6. Recurrence risk for offspring of twins discordant for oral cleft: a population-based cohort study of the Danish 1936-2004 cleft twin cohort

    DEFF Research Database (Denmark)

    Grosen, Dorthe; Bille, Camilla; Pedersen, Jacob Krabbe; Skytthe, Axel; Murray, Jeffrey C; Christensen, Kaare

    Our objective in this Danish population-based cohort study was to estimate the recurrence risk of isolated oral cleft (OC) for offspring of the unaffected co-twins of OC discordant twin pairs and to compare this risk to the recurrence risk in the offspring of the affected co-twin as well as to the...... risk in the background population. During 1936-2004, 207 twin pairs were ascertained, among whom at least one twin had an OC. The index persons were twins discordant for OC who had children (N=117), and their offspring (N=239). The participants were ascertained by linkage between The Danish Facial...... Cleft Database, The Danish Twin Registry and The Danish Civil Registration System. In the study OC recurrence risk for offspring of the affected and unaffected twin and relative risk were compared to the background prevalence. We found that among 110 children of the 54 OC affected twins, two (1...

  7. Profiling postgraduate workplace-based assessment implementation in Ireland: a retrospective cohort study.

    Science.gov (United States)

    Barrett, Aileen; Galvin, Rose; Steinert, Yvonne; Scherpbier, Albert; O'Shaughnessy, Ann; Walsh, Gillian; Horgan, Mary

    2016-01-01

    In 2010, workplace-based assessment (WBA) was formally integrated as a method of formative trainee assessment into 29 basic and higher specialist medical training (BST/HST) programmes in six postgraduate training bodies in Ireland. The aim of this study is to explore how WBA is being implemented and to examine if WBA is being used formatively as originally intended. A retrospective cohort study was conducted and approved by the institution's Research Ethics Committee. A profile of WBA requirements was obtained from 29 training programme curricula. A data extraction tool was developed to extract anonymous data, including written feedback and timing of assessments, from Year 1 and 2 trainee ePortfolios in 2012-2013. Data were independently quality assessed and compared to the reference standard number of assessments mandated annually where relevant. All 29 training programmes mandated the inclusion of at least one case-based discussion (max = 5; range 1-5). All except two non-clinical programmes (93 %) required at least two mini-Clinical Evaluation Exercise assessments per year and Direct Observation of Procedural Skills assessments were mandated in 27 training programmes over the course of the programme. WBA data were extracted from 50 % of randomly selected BST ePortfolios in four programmes (n = 142) and 70 % of HST ePortfolios (n = 115) in 21 programmes registered for 2012-2013. Four programmes did not have an eligible trainee for that academic year. In total, 1142 WBAs were analysed. A total of 164 trainees (63.8 %) had completed at least one WBA. The average number of WBAs completed by HST trainees was 7.75 (SD 5.8; 95 % CI 6.5-8.9; range 1-34). BST trainees completed an average of 6.1 assessments (SD 9.3; 95 % CI 4.01-8.19; range 1-76). Feedback-of varied length and quality-was provided on 44.9 % of assessments. The majority of WBAs were completed in the second half of the year. There is significant heterogeneity with respect to the frequency and

  8. Chronic myeloproliferative neoplasms and subsequent cancer risk: a Danish population-based cohort study

    DEFF Research Database (Denmark)

    Frederiksen, Henrik Kronholm; Farkas, Dóra Körmendiné; Christiansen, Christian Fynbo;

    2011-01-01

    Patients with chronic myeloproliferative neoplasms, including essential thrombocythemia (ET), polycythemia vera (PV), and chronic myeloid leukemia (CML), are at increased risk of new hematologic malignancies, but their risk of nonhematologic malignancies remains unknown. In the present study, we...... diagnosed with a chronic myeloproliferative neoplasm during 1977-2008. We compared the incidence of subsequent cancer in this cohort with that expected on the basis of cancer incidence in the general population (standardized incidence ratio). Overall, ET, PV, and CML patients were at increased risk of...... conclude that patients with chronic myeloproliferative neoplasms are at increased risk of developing a new malignant disease. © 2011 by The American Society of Hematology....

  9. Patients With Carbon Monoxide Poisoning and Subsequent Dementia: A Population-Based Cohort Study.

    Science.gov (United States)

    Lai, Ching-Yuan; Huang, Yu-Wei; Tseng, Chun-Hung; Lin, Cheng-Li; Sung, Fung-Chang; Kao, Chia-Hung

    2016-01-01

    The present study evaluated the dementia risk after carbon monoxide poisoning (CO poisoning). Using the National Health Insurance Research Database of Taiwan, a total of 9041 adults newly diagnosed with CO poisoning from 2000 to 2011 were identified as the CO poisoning cohort. Four-fold (N = 36,160) of non-CO poisoning insured people were randomly selected as controls, frequency-matched by age, sex, and hospitalization year. Incidence and hazard ratio (HR) of dementia were measured by the end 2011. The dementia incidence was 1.6-fold higher in the CO exposed cohort than in the non-exposed cohort (15.2 vs 9.76 per 10,000 person-years; n = 62 vs 174) with an adjusted HR of 1.50 (95% CI = 1.11-2.04). The sex- and age-specific hazards were higher in male patients (adjusted HR = 1.74, 95% CI = 1.20-2.54), and those aged <= 49 years (adjusted HR = 2.62, 95% CI = 1.38-4.99). CO exposed patients with 7-day or longer hospital stay had an adjusted HR of 2.18 (95% CI = 1.42, 3.36). The CO poisoning patients on hyperbaric oxygen (HBO2) therapy had an adjusted HR of 1.80 (95% CI = 0.96-3.37). This study suggests that CO poisoning may have association with the risk of developing dementia, which is significant for severe cases. The effectiveness of HBO2 therapy remains unclear in preventing dementia. Patients with CO poisoning are more prevalent with depression. PMID:26735545

  10. Evidence-based practice profiles of physiotherapists transitioning into the workforce: a study of two cohorts

    Directory of Open Access Journals (Sweden)

    McEvoy Maureen P

    2011-11-01

    Full Text Available Abstract Background Training in the five steps of evidence-based practice (EBP has been recommended for inclusion in entry-level health professional training. The effectiveness of EBP education has been explored predominantly in the medical and nursing professions and more commonly in post-graduate than entry-level students. Few studies have investigated longitudinal changes in EBP attitudes and behaviours. This study aimed to assess the changes in EBP knowledge, attitudes and behaviours in entry-level physiotherapy students transitioning into the workforce. Methods A prospective, observational, longitudinal design was used, with two cohorts. From 2008, 29 participants were tested in their final year in a physiotherapy program, and after the first and second workforce years. From 2009, 76 participants were tested in their final entry-level and first workforce years. Participants completed an Evidence-Based Practice Profile questionnaire (EBP2, which includes self-report EBP domains [Relevance, Terminology (knowledge of EBP concepts, Confidence, Practice (EBP implementation, Sympathy (disposition towards EBP]. Mixed model analysis with sequential Bonferroni adjustment was used to analyse the matched data. Effect sizes (ES (95% CI were calculated for all changes. Results Effect sizes of the changes in EBP domains were small (ES range 0.02 to 0.42. While most changes were not significant there was a consistent pattern of decline in scores for Relevance in the first workforce year (ES -0.42 to -0.29 followed by an improvement in the second year (ES +0.27. Scores in Terminology improved (ES +0.19 to +0.26 in each of the first two workforce years, while Practice scores declined (ES -0.23 to -0.19 in the first year and improved minimally in the second year (ES +0.04. Confidence scores improved during the second workforce year (ES +0.27. Scores for Sympathy showed little change. Conclusions During the first two years in the workforce, there was a

  11. Cholesterol-lowering drugs and incident open-angle glaucoma: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Michael W Marcus

    Full Text Available BACKGROUND: Open-angle glaucoma (OAG is a progressive neurodegenerative disease that may lead to blindness. An elevated intraocular pressure (IOP is its major risk factor. OAG treatment is currently exclusively directed towards the lowering of the IOP. IOP lowering does not prevent disease progression in all patients and thus other treatment modalities are needed. Earlier studies reported cholesterol-lowering drugs to have neuroprotective properties. The aim of this study was to determine the associations between the use of cholesterol-lowering drugs and incident OAG. METHODOLOGY/PRINCIPAL FINDINGS: Participants in a prospective population-based cohort study underwent ophthalmic examinations, including IOP measurements and perimetry, at baseline and follow-up. The use of statins and non-statin cholesterol-lowering drugs was monitored continuously during the study. Associations between the use of cholesterol-lowering drugs and incident OAG were analyzed with Cox regression; associations between cholesterol-lowering drugs and IOP at follow-up were analyzed with multiple linear regression. During a mean follow-up of 9.8 years, 108 of 3939 eligible participants (2.7% developed OAG. The hazard ratio for statin use was 0.54 (95% confidence interval 0.31-0.96; P = 0.034 and for non-statin cholesterol-lowering drugs 2.07 (0.81-5.33; P = 0.13. The effect of statins was more pronounced with prolonged use (hazard ratio 0.89 [0.41-1.94; P = 0.77] for use two years or less; 0.46 [0.23-0.94; P = 0.033] for use more than two years; P-value for trend 0.10. The analyzes were adjusted for age and gender, baseline IOP and IOP-lowering treatment, the family history of glaucoma, and myopia. There was no effect of statins on the IOP. CONCLUSIONS/SIGNIFICANCE: Long-term use of statins appears to be associated with a reduced risk of OAG. The observed effect was independent of the IOP. These findings are in line with the idea that statins have

  12. Family history of psychiatric illness as a risk factor for schizoaffective disorder: a Danish register-based cohort study

    DEFF Research Database (Denmark)

    Laursen, Thomas Munk; Labouriau, Rodrigo; Licht, Rasmus W;

    2005-01-01

    BACKGROUND: Schizoaffective disorder may be related to both schizophrenia and bipolar disorders, but no population-based studies, to our knowledge, have investigated this association in families. OBJECTIVES: To determine whether a psychiatric history of schizoaffective disorder, bipolar disorder......, or schizophrenia among parents and siblings is a risk factor for developing a schizoaffective disorder, and whether a specific pattern of family history of psychiatric illness exists in persons with schizoaffective disorder compared with persons with bipolar disorder or schizophrenia. DESIGN......: Register-based cohort study. SETTING: Denmark. COHORT: The 2.4 million persons born in Denmark after 1952. MAIN OUTCOME MEASURES: Relative risks of the 3 illnesses estimated by Poisson regression. RESULTS: In total, 1925 persons had a schizoaffective disorder, 3721 had a bipolar disorder, and 12 501 had...

  13. General practitioner characteristics and delay in cancer diagnosis. a population-based cohort study

    Directory of Open Access Journals (Sweden)

    Vedsted Peter

    2011-09-01

    Full Text Available Abstract Background Delay in cancer diagnosis may have serious prognostic consequences, and some patients experience delays lasting several months. However, we have no knowledge whether such delays are associated with general practitioner (GP characteristics. The aim of the present study was to analyse whether GP and practice characteristics are associated with the length of delay in cancer diagnosis. Methods The study was designed as a population-based cohort study. The setting was the County of Aarhus, Denmark (640,000 inhabitants. Participants include 334 GPs and their 1,525 consecutive, newly diagnosed cancer patients. During one year (September 2004 to August 2005, patients with incident cancer were enrolled from administrative registries. GPs completed questionnaires on the patients' diagnostic pathways and on GP and practice characteristics. Delay was categorised as patient-related (more than 60 days, doctor-related (more than 30 days and system-related (more than 90 days. The associations between delay and characteristics were assessed in a logistic regression model using odds ratios (ORs. Results No GP characteristics (seniority, practice organization, list size, participation in continuing medical education, job satisfaction and level of burnout were associated with doctor delay. Patients of female GPs more often had a short patient delay than patients of male GPs (OR 0.44, 95% confidence interval (95%CI 0.28 to 0.71. Patients whose GPs provided many services (OR 0.66, 95%CI 0.44 to 0.95 and patients attending GPs with little former knowledge of their patients (OR 0.68, 95%CI 0.47 to 0.99 more often experienced a short system delay than patients attending GPs with less activity and more knowledge of their patients. Patients listed with a female GP more often experienced a long system delay than patients of male GPs (OR 1.50, 95%CI 1.02 to 2.21. Finally, patients with low GP-reported compliance more often experienced a long system delay

  14. Preeclampsia as a risk factor for diabetes: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Denice S Feig

    Full Text Available BACKGROUND: Women with preeclampsia (PEC and gestational hypertension (GH exhibit insulin resistance during pregnancy, independent of obesity and glucose intolerance. Our aim was to determine whether women with PEC or GH during pregnancy have an increased risk of developing diabetes after pregnancy, and whether the presence of PEC/GH in addition to gestational diabetes (GDM increases the risk of future (postpartum diabetes. METHODS AND FINDINGS: We performed a population-based, retrospective cohort study for 1,010,068 pregnant women who delivered in Ontario, Canada between April 1994 and March 2008. Women were categorized as having PEC alone (n=22,933, GH alone (n=27,605, GDM alone (n=30,852, GDM+PEC (n=1,476, GDM+GH (n=2,100, or none of these conditions (n=925,102. Our main outcome was a new diagnosis of diabetes postpartum in the following years, up until March 2011, based on new records in the Ontario Diabetes Database. The incidence rate of diabetes per 1,000 person-years was 6.47 for women with PEC and 5.26 for GH compared with 2.81 in women with neither of these conditions. In the multivariable analysis, both PEC alone (hazard ratio [HR]=2.08; 95% CI 1.97-2.19 and GH alone (HR=1.95; 95% CI 1.83-2.07 were risk factors for subsequent diabetes. Women with GDM alone were at elevated risk of developing diabetes postpartum (HR=12.77; 95% CI 12.44-13.10; however, the co-presence of PEC or GH in addition to GDM further elevated this risk (HR=15.75; 95% CI 14.52-17.07, and HR=18.49; 95% CI 17.12-19.96, respectively. Data on obesity were not available. CONCLUSIONS: Women with PEC/GH have a 2-fold increased risk of developing diabetes when followed up to 16.5 years after pregnancy, even in the absence of GDM. The presence of PEC/GH in the setting of GDM also raised the risk of diabetes significantly beyond that seen with GDM alone. A history of PEC/GH during pregnancy should alert clinicians to the need for preventative counseling and more vigilant

  15. Burn injury, gender and cancer risk: population-based cohort study using data from Scotland and Western Australia

    OpenAIRE

    Duke, Janine M; Bauer, Jacqui; Fear, Mark W.; Rea, Suzanne; Wood, Fiona M; Boyd, James

    2014-01-01

    Objective To investigate the risk of cancer and potential gender effects in persons hospitalised with burn injury. Design Population-based retrospective cohort study using record-linkage systems in Scotland and Western Australia. Participants Records of 37 890 and 23 450 persons admitted with a burn injury in Scotland and Western Australia, respectively, from 1983 to 2008. Deidentified extraction of all linked hospital morbidity records, mortality and cancer records were provided by the Infor...

  16. The prognostic role of HER2 expression in ductal breast carcinoma in situ (DCIS); a population-based cohort study

    OpenAIRE

    Borgquist, Signe; Zhou, Wenjing; Jirström, Karin; Amini, Rose-Marie; Sollie, Thomas; Sørlie, Therese; Blomqvist, Carl; Butt, Salma; Wärnberg, Fredrik

    2015-01-01

    Abstract Background HER2 is a well-established prognostic and predictive factor in invasive breast cancer. The role of HER2 in ductal breast carcinoma in situ (DCIS) is debated and recent data have suggested that HER2 is mainly related to in situ recurrences. Our aim was to study HER2 as a prognostic factor in a large population based cohort of DCIS with long-term follow-up. Methods ...

  17. Variations of care quality for infectious pulmonary tuberculosis in Taiwan: a population based cohort study

    Directory of Open Access Journals (Sweden)

    Chang Ray-E

    2007-06-01

    Full Text Available Abstract Background Effective and efficient care is required to prevent the spread of infectious pulmonary tuberculosis (PTB. We attempted to compare care quality among different healthcare institutions in Southern Taiwan. Methods This study conducted population-based retrospective cohort design. One tuberculosis sanatorium, 2 medical centers, 11 regional hospitals, and 15 district hospitals and primary practitioners in the study area had reported tuberculosis cases, registered from January 1 to June 30 2003. Those cases with sputum positive PTB were followed 15 months after anti-tuberculosis treatment initiation. Meanwhile, Level of conformance with diagnostic guidelines, efficiency of diagnostic and treatment process, and treatment were measured as main outcome. Association was investigated using Chi-square tests, Kruskal Wallis tests, Mann-Whiteney U tests, and multiple logistic regression analysis to evaluate outcome differences among different levels of institutions. Results The analyses included 421 patients. In comparison with patients receiving treatment at medical centers, regional hospitals, and district hospitals/primary practitioners, patients at the Chest Specialty Hospital were more likely to provide at least three sputum specimens (74.1% vs. 48.2%, 36.8%, and 50.0%, shorter workdays examining sputum smears (2.4 ± 2.4 days vs. 2.6 ± 2.1, 4.5 ± 3.1, and 3.5 ± 2.6 days, shorter interval between the first consultation and treatment (10.1 ± 18.3 days vs. 31.0 ± 53.6, 31.2 ± 70.4, and 25.4 ± 37.6 days, and a higher successful treatment rate (92.6% vs. 65.2%, 63.9%, and 68.0%. Furthermore, after adjusting age and gender, the patients treated by the pulmonologists and treated at Chest Specialty Hospital had significantly more successful treatment rate, of which odds ratios were 1.74 and 4.58 respectively. Conclusion Differences in care quality exist among different types of healthcare institutions and among individual physicians

  18. Stress and survival after cancer: A prospective study of a Finnish population-based cohort

    DEFF Research Database (Denmark)

    Saito-Nakaya, K.; Bidstrup, P. E.; Nakaya, N.;

    2012-01-01

    Stress has been suggested to reduce survival after cancer, but the results of previous studies have been contradictory. We investigated the hypothesis in a national cohort of adults in Finland. Of those who completed the Stressful Life Events scale and the Stress of Daily Activities scale, 1470 and...... score was 0.99 (95% CI, 0.95-1.03). Further, the HR was 0.92 (95% CI, 0.69-1.22) for severe daily stress. Overall, the results of the current study do not support the hypothesis that stress reduces cancer survival. (C) 2011 Elsevier Ltd. All rights reserved....... 1882, respectively, later had cancer and were included in the analysis, covering 23 years of follow-up between 1982 and 2004. In Cox regression analysis, the multivariate hazard ratio (HR) was 0.99 (95% confidence interval [CI], 0.96-1.01) for total number of life events and the HR for the life change...

  19. Physical activity and influenza-coded outpatient visits, a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Eric Siu

    Full Text Available BACKGROUND: Although the benefits of physical activity in preventing chronic medical conditions are well established, its impacts on infectious diseases, and seasonal influenza in particular, are less clearly defined. We examined the association between physical activity and influenza-coded outpatient visits, as a proxy for influenza infection. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a cohort study of Ontario respondents to Statistics Canada's population health surveys over 12 influenza seasons. We assessed physical activity levels through survey responses, and influenza-coded physician office and emergency department visits through physician billing claims. We used logistic regression to estimate the risk of influenza-coded outpatient visits during influenza seasons. The cohort comprised 114,364 survey respondents who contributed 357,466 person-influenza seasons of observation. Compared to inactive individuals, moderately active (OR 0.83; 95% CI 0.74-0.94 and active (OR 0.87; 95% CI 0.77-0.98 individuals were less likely to experience an influenza-coded visit. Stratifying by age, the protective effect of physical activity remained significant for individuals <65 years (active OR 0.86; 95% CI 0.75-0.98, moderately active: OR 0.85; 95% CI 0.74-0.97 but not for individuals ≥ 65 years. The main limitations of this study were the use of influenza-coded outpatient visits rather than laboratory-confirmed influenza as the outcome measure, the reliance on self-report for assessing physical activity and various covariates, and the observational study design. CONCLUSION/SIGNIFICANCE: Moderate to high amounts of physical activity may be associated with reduced risk of influenza for individuals <65 years. Future research should use laboratory-confirmed influenza outcomes to confirm the association between physical activity and influenza.

  20. Cancer incidence in patients with type 2 diabetes mellitus: a population-based cohort study in Shanghai

    OpenAIRE

    Xu, Hui-Lin; Fang, Hong; Xu, Wang-Hong; Qin, Guo-You; Yan, Yu-Jie; Yao, Bao-Dong; Zhao, Nai-Qing; Liu, Yi-Nan; Zhang, Fen; Li, Wei-Xi; Wang, Na; Zhou, Jie; Zhang, Jin-Ling; Zhao, Li-Yun; Li, Lun-Qiang

    2015-01-01

    Background Type 2 diabetes mellitus (T2DM) has been suggested to increase the risk of cancers. The aim of this study was to investigate the risk of common cancers in Chinese patients with T2DM. Methods A population-based retrospective cohort study including 36,379 T2DM patients was conducted in Minhang District of Shanghai, China, during 2004 to 2010. All T2DM patients were enrolled from the standardized management system based on local electronic information system. Newly-diagnosed cancer ca...

  1. The case for launch of an international DNA based birth cohort study

    Directory of Open Access Journals (Sweden)

    Igor Rudan

    2011-06-01

    Full Text Available The global health agenda beyond 2015 will inevitably need to broaden its focus from mortality reduction to the social determinants of deaths, growing inequities among children and mothers, and ensuring the sustainability of the progress made against the infectious diseases. New research tools, including technologies that enable high-throughput genetic and ‘-omics’ research, could be deployed for better understanding of the aetiology of maternal and child health problems. The research needed to address those challenges will require conceptually different studies than those used in the past. It should be guided by stringent ethical frameworks related to the emerging collections of biological specimens and other health related information. We will aim to establish an international birth cohort which should assist low- and middle-income countries to use emerging genomic research technologies to address the main problems in maternal and child health, which are still major contributors to the burden of disease globally.

  2. Family history of psychiatric illness as a risk factor for schizoaffective disorder: a Danish register-based cohort study

    DEFF Research Database (Denmark)

    Laursen, Thomas Munk; Labouriau, Rodrigo; Licht, Rasmus Wentzer;

    2005-01-01

    , or schizophrenia among parents and siblings is a risk factor for developing a schizoaffective disorder, and whether a specific pattern of family history of psychiatric illness exists in persons with schizoaffective disorder compared with persons with bipolar disorder or schizophrenia. DESIGN...... significantly strongest risk factor. When schizophrenia was the outcome, the significantly strongest risk factor was schizophrenia among first-degree relatives. CONCLUSION: Schizoaffective disorder is not simply a subgroup of either bipolar disorder or schizophrenia but may be genetically linked to both, with......: Register-based cohort study. SETTING: Denmark. COHORT: The 2.4 million persons born in Denmark after 1952. MAIN OUTCOME MEASURES: Relative risks of the 3 illnesses estimated by Poisson regression. RESULTS: In total, 1925 persons had a schizoaffective disorder, 3721 had a bipolar disorder, and 12 501 had...

  3. Health impact of US military service in a large population-based military cohort: findings of the Millennium Cohort Study, 2001-2008

    Directory of Open Access Journals (Sweden)

    Amoroso Paul J

    2011-01-01

    Full Text Available Abstract Background Combat-intense, lengthy, and multiple deployments in Iraq and Afghanistan have characterized the new millennium. The US military's all-volunteer force has never been better trained and technologically equipped to engage enemy combatants in multiple theaters of operations. Nonetheless, concerns over potential lasting effects of deployment on long-term health continue to mount and are yet to be elucidated. This report outlines how findings from the first 7 years of the Millennium Cohort Study have helped to address health concerns related to military service including deployments. Methods The Millennium Cohort Study was designed in the late 1990s to address veteran and public concerns for the first time using prospectively collected health and behavioral data. Results Over 150 000 active-duty, reserve, and National Guard personnel from all service branches have enrolled, and more than 70% of the first 2 enrollment panels submitted at least 1 follow-up survey. Approximately half of the Cohort has deployed in support of operations in Iraq and Afghanistan. Conclusion The Millennium Cohort Study is providing prospective data that will guide public health policymakers for years to come by exploring associations between military exposures and important health outcomes. Strategic studies aim to identify, reduce, and prevent adverse health outcomes that may be associated with military service, including those related to deployment.

  4. Multiple births and maternal mental health from pregnancy to 5 years after birth: a longitudinal population-based cohort study

    OpenAIRE

    Eivind Ystrom; Ted Reichborn-Kjennerud; Kristian Tambs; Per Magnus; Anne Mari Torgersen; Kristin Gustavson

    2014-01-01

    Background: There is a lack of population-based studies on multiple births and maternal mental health. Having a high-risk pregnancy by bearing two or more children is a stressful life event, and the challenges of parenting two or more children probably also lead to a high level of parental stress. There are a few results on multiple births and maternal mental health from studies on in vitro fertilization samples. The only previous cohort study on multiple birth and maternal mental health incl...

  5. Social Conditions for People With Down Syndrome: A Register-Based Cohort Study in Denmark

    OpenAIRE

    Zhu, Jin Liang; Obel, Carsten; Hasle, Henrik; Rasmussen, Sonja A.; Li, Jiong; Olsen, Jørn

    2014-01-01

    Today, most persons with Down syndrome (DS) survive into middle age, but information on their social conditions as adults is limited. We addressed this knowledge gap using data from national registers in Denmark. We identified a national cohort of 1,998 persons with DS who were born between 1968 and 2007 (1,852 with standard trisomy 21, 80 with Robertsonian translocations and 66 with mosaicism) using the Danish Cytogenetic Register. We followed this cohort from 1980 to 2007. Information on so...

  6. The Danish National Cohort Study (DANCOS)

    DEFF Research Database (Denmark)

    Davidsen, Michael; Kjøller, Mette; Helweg-Larsen, Karin

    2011-01-01

    INTRODUCTION: The Danish National Cohort Study (DANCOS) is a nationally representative public health survey based on linkage of information in the repeated Danish Health Interview surveys, 1986-2005, to the national Danish registers on health and welfare. It facilitates studies of self-reported h......INTRODUCTION: The Danish National Cohort Study (DANCOS) is a nationally representative public health survey based on linkage of information in the repeated Danish Health Interview surveys, 1986-2005, to the national Danish registers on health and welfare. It facilitates studies of self...

  7. Ischemic heart disease in HIV-infected and HIV-uninfected individuals: a population-based cohort study

    DEFF Research Database (Denmark)

    Obel, Niels; Thomsen, Henrik F; Kronborg, Gitte; Larsen, Carsten S; Hildebrandt, Per R; Sørensen, Henrik T; Gerstoft, Jan

    2007-01-01

    BACKGROUND: There are concerns about highly active antiretroviral therapy (HAART) causing a progressive increase in the risk of ischemic heart disease. We examined this issue in a nationwide cohort study of patients with human immunodeficiency virus (HIV) infection and a population-based control...... hospitalization for ischemic heart disease and comorbidity were obtained from the Danish National Hospital Registry for all study participants. We used Cox's regression to compute the hospitalization rate ratio as an estimate of relative risk, adjusting for comorbidity. RESULTS: Although the difference was not...

  8. Secondhand smoke and incidence of dental caries in deciduous teeth among children in Japan: population based retrospective cohort study

    OpenAIRE

    Tanaka, Shiro; Shinzawa, Maki; Tokumasu, Hironobu; Seto, Kahori; Tanaka, Sachiko; Kawakami, Koji

    2015-01-01

    Study question Does maternal smoking during pregnancy and exposure of infants to tobacco smoke at age 4 months increase the risk of caries in deciduous teeth? Methods Population based retrospective cohort study of 76 920 children born between 2004 and 2010 in Kobe City, Japan who received municipal health check-ups at birth, 4, 9, and 18 months, and 3 years and had information on household smoking status at age 4 months and records of dental examinations at age 18 months and 3 years. Smoking ...

  9. Long-Term Health Outcomes in Children Born to Mothers with Diabetes: A Population-Based Cohort Study

    OpenAIRE

    Wu, Chun S.; Nohr, Ellen A; Bech, Bodil H.; Vestergaard, Mogens; Olsen, Jørn

    2012-01-01

    Background To examine whether prenatal exposure to parental type 1 diabetes, type 2 diabetes, or gestational diabetes is associated with an increased risk of malignant neoplasm or diseases of the circulatory system in the offspring. Methods/Principal Findings We conducted a population-based cohort study of 1,781,576 singletons born in Denmark from 1977 to 2008. Children were followed for up to 30 years from the day of birth until the onset of the outcomes under study, death, emigration, or De...

  10. Neck circumference predicts renal function decline in overweight women: A community-based prospective cohort study.

    Science.gov (United States)

    Yoon, Chang-Yun; Park, Jung Tak; Jhee, Jong Hyun; Kee, Youn Kyung; Seo, Changhwan; Lee, Misol; Cha, Min-Uk; Jung, Su-Young; Park, Seohyun; Yun, Hae-Ryong; Kwon, Young Eun; Oh, Hyung Jung; Han, Seung Hyeok; Yoo, Tae-Hyun; Kang, Shin-Wook

    2016-09-01

    Chronic kidney disease (CKD) is characterized by increased risks of morbidity and mortality. Upper-body subcutaneous fat, which is commonly estimated from the neck circumference (NC), was revealed to be the main reservoir of circulating nonesterified fatty acids in overweight patients. Despite a close association between NC and metabolic complications, the relationship of NC with renal function has not been fully investigated. In this study, the impact of NC on the development of incident CKD was elucidated.The data were retrieved from the Korean Genome and Epidemiology Study cohort. The subjects were followed at 2-year intervals from 2003 to 2011. Overweight was defined as a body mass index of ≥23 kg/m. A total of 4298 cohort subjects were screened. After exclusion, 2268 overweight subjects were included for the final analysis. The primary end point was incident CKD, which was defined as a composite of estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m or the development of proteinuria.The mean patient age was 36.3 ± 3.0 years, and 1285 (56.7%) were men. They were divided into 2 groups according to the median NC in male and female subjects, separately. In both sexes, hypertension (men, P < 0.001; women, P = 0.009) and diabetes (men, P = 0.002; women, P < 0.001) were significantly more prevalent in the big NC group than in the small NC group. In contrast, eGFR was significantly lower only in male subjects of the big NC group (P < 0.001), whereas it was comparable between the small and big NC groups (P = 0.167). In multivariate Cox proportional hazards regression analysis, NC values were independently associated with incident CKD development in female subjects after adjusting for multiple confounding factors (per 1 cm increase, hazard ratio [95% confidence interval] = 1.159 [1.024-1.310], P = 0.019) but not in male subjects.NC is independently associated with the development of CKD in overweight female subjects, suggesting

  11. Course of bereavement over 8-10 years in first degree relatives and spouses of people who committed suicide : longitudinal community based cohort study

    NARCIS (Netherlands)

    de Groot, Marieke; Kollen, Boudewijn J.

    2013-01-01

    Objective To identify factors predicting the long term course of complicated grief, depression, and suicide ideation in a community based sample of relatives bereaved through suicide. Design Longitudinal cohort study. Included in the multilevel regression models were sociodemographic and personality

  12. Academic Achievement in Primary School in Offspring Born to Mothers With Type 1 Diabetes (the EPICOM Study): A Register-Based Prospective Cohort Study

    DEFF Research Database (Denmark)

    Knorr, Sine; Clausen, Tine D; Vlachová, Zuzana;

    2015-01-01

    OBJECTIVE: This study examined the effect of maternal pregestational type 1 diabetes on offspring primary school performance. RESEARCH DESIGN AND METHODS: We performed a prospective combined clinical and register-based cohort study comparing primary school performance in offspring (n = 707) of wo...

  13. Hospital contacts for chronic diseases among danish seafarers and fishermen: a population-based cohort study

    DEFF Research Database (Denmark)

    Kaerlev, Linda; Dahl, Søren; Nielsen, Per Sabro;

    2007-01-01

    and the SHCR for chronic heart diseases was statistically significantly higher in the 1999 than in the 1994 cohort. For both time periods high SHCR values were found for bronchitis, emphysema, cancer of the lung, alcohol-related liver diseases, and diabetes among male non-officers, and lung cancer......, from 1 January 1994 and 1 January 1999, respectively, using rates specific for age and calendar time for the entire Danish workforce as a reference. RESULTS: The SHCRs for lung and cardiovascular diseases were high for non-officers. Among male officers, the SHCR for diabetes was high in the 1999 cohort...... among male officers. Among female non-officers, a high SHCR for skin melanomas was seen. Among fishermen high SHCRs for bronchitis, emphysema, lung cancer, and Raynaud's syndrome were found in both cohorts. No duration-response pattern was observed in any of the analyses, which may reflect health- and...

  14. Perinatal mortality in rural Burkina Faso: a prospective community-based cohort study

    Directory of Open Access Journals (Sweden)

    Diallo Abdoulaye

    2010-08-01

    Full Text Available Abstract Background There is a scarcity of reliable data on perinatal mortality (PNM in Sub-Saharan Africa. The PROMISE-EBF trial, during which we promoted exclusive breastfeeding, gave us the opportunity to describe the epidemiology of PNM in Banfora Health District, South-West in Burkina Faso. Study objectives To measure the perinatal mortality rate (PNMR in the PROMISE-EBF cohort in Banfora Health District and to identify potential risk factors for perinatal death. Methods We used data collected prospectively during the PROMISE-EBF-trial to estimate the stillbirth rate (SBR and early neonatal mortality rate (ENMR. We used binomial regression with generalized estimating equations to identify potential risk factors for perinatal death. Results 895 pregnant women were enrolled for data collection in the EBF trial and followed-up to 7 days after birth. The PNMR, the SBR and the ENMR, were 79 per 1000 (95% CI: 59-99, 54 per 1000 (95% CI: 38-69 and 27 per 1000 (95% CI: 9-44, respectively. In a multivariable analysis, nulliparous women (RR = 2.90, 95% CI: 1.6-5.0, primiparae mothers (RR = 2.20, 95% CI: 1.2-3.9, twins (RR = 4.0, 95% CI: 2.3-6.9 and giving birth during the dry season (RR = 2.1 95% CI: 1.3-3.3 were factors associated with increased risk of perinatal death. There was no evidence that risk of perinatal death differed between deliveries at home and at a health centre Conclusion Our study observed the highest PNMR ever reported in Burkina. There is an urgent need for sustainable interventions to improve maternal and newborn health in the country.

  15. Malignancy in scleroderma patients from south west England: a population-based cohort study.

    LENUS (Irish Health Repository)

    Siau, Keith

    2010-01-08

    The pathophysiological relationship between scleroderma and malignancy remains poorly understood. Although some previous studies have demonstrated an increased malignancy risk in patients with scleroderma, others have been inconclusive. We aimed to determine if patients with scleroderma had an increased risk of malignancy compared to an age- and sex-matched local South West England population, and if there were any important differences between scleroderma patients with and without malignancy. Methods of this study are as follows. Notes were obtained on all local scleroderma patients (n = 68) locally, and those diagnosed with malignancy verified by contacting each patient\\'s general practitioner. Expected malignancy figures were obtained from age- and sex-stratified regional prevalence data provided by the South West Cancer Intelligence Service registry. Among the patients, 22.1% with scleroderma were identified with concurrent malignancy. Affected sites were of the breast (n = 5), haematological system (n = 5), skin (n = 4), and unknown primary (n = 1). Overall, malignancy risk was found to be increased in scleroderma (RR = 3.15, 95% CI 1.77-5.20, p = 0.01). In particular, this risk was the highest for haematological malignancies (RR = 18.5, 95% CI 6-43, p = 0.03), especially for non-Hodgkin\\'s lymphoma (RR = 25.8, 95% CI 5-75, p = 0.10). The majority of patients (86.7%) developed malignancy after the onset of scleroderma (mean = 6.9 years). Age of >70 and patients with limited scleroderma were significant risk factors for a patient with scleroderma to have a concurrent malignancy; however, no increased risk was found in patients with any particular pattern of organ involvement, cytotoxic usage or serology. To conclude, in this small patient cohort, we have found that scleroderma is associated with an increased risk of malignancy. This risk is statistically significant in patients with limited scleroderma. Patients who are elderly and those with limited disease

  16. Risk and Prognosis of Bloodstream Infections among Patients on Chronic Hemodialysis: A Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Lars Skov Dalgaard

    Full Text Available Infections are common complications among patients on chronic hemodialysis. This population-based cohort study aims to estimate risk and case fatality of bloodstream infection among chronic hemodialysis patients.In this population-based cohort study we identified residents with end-stage renal disease in Central and North Jutland, Denmark who had hemodialysis as first renal replacement therapy (hemodialysis patients during 1995-2010. For each hemodialysis patient, we sampled 19 persons from the general population matched on age, gender, and municipality. Information on positive blood cultures was obtained from regional microbiology databases. All persons were observed from cohort entry until first episode of bloodstream infection, emigration, death, or end of hemodialysis treatment, whichever came first. Incidence-rates and incidence-rate ratios were computed and risk factors for bloodstream infection assessed by Poisson regression. Case fatality was compared by Cox regression.Among 1792 hemodialysis patients and 33 618 matched population controls, we identified 461 and 1126 first episodes of bloodstream infection, respectively. Incidence rates of first episode of bloodstream infection were 13.7 (95% confidence interval (CI, 12.5-15.0 per 100 person-years among hemodialysis patients and 0.53 (95% CI, 0.50-0.56 per 100 person-years among population controls. In hemodialysis patients, the most common causative microorganisms were Staphylococcus aureus (43.8% and Escherichia coli (12.6%. The 30-day case fatality was similar among hemodialysis patients and population controls 16% (95% CI, 13%-20% vs. 18% (95% CI, 15%-20%.Hemodialysis patients have extraordinary high risk of bloodstream infection while short-term case fatality following is similar to that of population controls.

  17. Risk and Prognosis of Bloodstream Infections among Patients on Chronic Hemodialysis: A Population-Based Cohort Study

    Science.gov (United States)

    Skov Dalgaard, Lars; Nørgaard, Mette; Jespersen, Bente; Jensen-Fangel, Søren; Østergaard, Lars Jørgen; Schønheyder, Henrik Carl; Søgaard, Ole Schmeltz

    2015-01-01

    Background and Objectives Infections are common complications among patients on chronic hemodialysis. This population-based cohort study aims to estimate risk and case fatality of bloodstream infection among chronic hemodialysis patients. Methods In this population-based cohort study we identified residents with end-stage renal disease in Central and North Jutland, Denmark who had hemodialysis as first renal replacement therapy (hemodialysis patients) during 1995–2010. For each hemodialysis patient, we sampled 19 persons from the general population matched on age, gender, and municipality. Information on positive blood cultures was obtained from regional microbiology databases. All persons were observed from cohort entry until first episode of bloodstream infection, emigration, death, or end of hemodialysis treatment, whichever came first. Incidence-rates and incidence-rate ratios were computed and risk factors for bloodstream infection assessed by Poisson regression. Case fatality was compared by Cox regression. Results Among 1792 hemodialysis patients and 33 618 matched population controls, we identified 461 and 1126 first episodes of bloodstream infection, respectively. Incidence rates of first episode of bloodstream infection were 13.7 (95% confidence interval (CI), 12.5–15.0) per 100 person-years among hemodialysis patients and 0.53 (95% CI, 0.50–0.56) per 100 person-years among population controls. In hemodialysis patients, the most common causative microorganisms were Staphylococcus aureus (43.8%) and Escherichia coli (12.6%). The 30-day case fatality was similar among hemodialysis patients and population controls 16% (95% CI, 13%–20%) vs. 18% (95% CI, 15%–20%). Conclusions Hemodialysis patients have extraordinary high risk of bloodstream infection while short-term case fatality following is similar to that of population controls. PMID:25910221

  18. Predictors of fracture while on treatment with oral bisphosphonates: a population-based cohort study.

    Science.gov (United States)

    Prieto-Alhambra, Daniel; Pagès-Castellà, Aina; Wallace, Gemma; Javaid, M Kassim; Judge, Andrew; Nogués, Xavier; Arden, Nigel K; Cooper, Cyrus; Diez-Perez, Adolfo

    2014-01-01

    Although oral bisphosphonates (BPs) are highly effective in preventing fractures, some patients will fracture while on treatment. We identified predictors of such fractures in a population-based cohort of incident users of oral BPs. We screened the Sistema d'Informació per al Desenvolupament de l'Investigació en Atenció Primària (SIDIAP) database to identify new users of oral BPs in 2006-2007. SIDIAP includes pharmacy invoice data and primary care electronic medical records for a representative 5 million people in Catalonia (Spain). Exclusion criteria were the following: Paget disease; medications. Fractures were considered if they appeared at least 6 months after treatment initiation. "Fractures while on treatment" were defined as those occurring among participants persisting for at least 6 months and with an overall high compliance (medication possession ratio ≥80%). Fine and Gray survival models accounting for competing risk with therapy discontinuation were fitted to identify key predictors. Only 7449 of 21,385 (34.8%) participants completed >6 months of therapy. Incidence of fracture while on treatment was 3.4/100 person-years (95% confidence interval [CI], 3.1-3.7). Predictors of these among patients persisting and adhering to treatment included: older age (subhazard ratio [SHR] for 60 to <80 years, 2.18 [95% CI, 1.70-2.80]; for ≥80 years, 2.5 [95% CI, 1.82-3.43]); previous fracture (1.75 [95% CI, 1.39-2.20] and 2.49 [95% CI, 1.98-3.13], in the last 6 months and longer, respectively); underweight, 2.11 (95% CI, 1.14-3.92); inflammatory arthritis, 1.46 (95% CI, 1.02-2.10); use of proton pump inhibitors (PPIs), 1.22 (95% CI, 1.02-1.46); and vitamin D deficiency, 2.69 (95% CI, 1.27-5.72). Even among high compliers, 3.4% of oral BP users will fracture every year. Older age, underweight, vitamin D deficiency, PPI use, previous fracture, and inflammatory arthritides increase risk. Monitoring strategies and/or alternative therapies should be considered for

  19. Estimating the inbreeding depression on cognitive behavior: a population based study of child cohort.

    Directory of Open Access Journals (Sweden)

    Mohd Fareed

    Full Text Available BACKGROUND: Cognitive ability tests are widely assumed to measure maximal intellectual performance and predictive associations between intelligence quotient (IQ scores and later mental health problems. Very few epidemiologic studies have been done to demonstrate the relationship between familial inbreeding and modest cognitive impairments in children. OBJECTIVE: We aimed to estimate the effect of inbreeding on children's cognitive behavior in comparison with non-inbred children. METHODOLOGY: A cohort of 408 children (6 to 15 years of age was selected from inbred and non-inbred families of five Muslim populations of Jammu region. The Wechsler Intelligence Scales for Children (WISC was used to measure the verbal IQ (VIQ, performance IQ (PIQ and full scale IQ (FSIQ. Family pedigrees were drawn to access the family history and children's inbred status in terms of coefficient of inbreeding (F. RESULTS: We found significant decline in child cognitive abilities due to inbreeding and high frequency of mental retardation among offspring from inbred families. The mean differences (95% C.I. were reported for the VIQ, being -22.00 (-24.82, -19.17, PIQ -26.92 (-29.96, -23.87 and FSIQ -24.47 (-27.35,-21.59 for inbred as compared to non-inbred children (p<0.001 [corrected].The higher risk of being mentally retarded was found to be more obvious among inbred categories corresponding to the degree of inbreeding and the same accounts least for non-inbred children (p<0.0001. We observed an increase in the difference in mean values for VIQ, PIQ and FSIQ with the increase of inbreeding coefficient and these were found to be statistically significant (p<0.05. The regression analysis showed a fitness decline (depression for VIQ (R2 = 0.436, PIQ (R2 = 0.468 and FSIQ (R2 = 0.464 with increasing inbreeding coefficients (p<0.01. CONCLUSIONS: Our comprehensive assessment provides the evidence for inbreeding depression on cognitive abilities among children.

  20. Assessment of Allergy to Milk, Egg, Cod, and Wheat in Swedish Schoolchildren: A Population Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Anna Winberg

    Full Text Available Knowledge about the prevalence of allergies to foods in childhood and adolescence is incomplete. The purpose of this study was to investigate the prevalence of allergies to milk, egg, cod, and wheat using reported data, clinical examinations, and double-blind placebo-controlled food challenges, and to describe the phenotypes of reported food hypersensitivity in a cohort of Swedish schoolchildren.In a population-based cohort of 12-year-old children, the parents of 2612 (96% of invited completed a questionnaire. Specific IgE antibodies to foods were analyzed in a random sample (n=695. Children reporting complete avoidance of milk, egg, cod, or wheat due to perceived hypersensitivity and without physician-diagnosed celiac disease were invited to undergo clinical examination that included specific IgE testing, a celiac screening test, and categorization into phenotypes of food hypersensitivity according to preset criteria. Children with possible food allergy were further evaluated with double-blind challenges.In this cohort, the prevalence of reported food allergy to milk, egg, cod, or wheat was 4.8%. Food allergy was diagnosed in 1.4% of the children after clinical evaluation and in 0.6% following double-blind placebo-controlled food challenge. After clinical examination, children who completely avoided one or more essential foods due to perceived food hypersensitivity were categorized with the following phenotypes: allergy (29%, outgrown allergy (19%, lactose intolerance (40%, and unclear (12%.There was a high discrepancy in the prevalence of allergy to milk, egg, cod and wheat as assessed by reported data, clinical evaluation, and double-blind food challenges. Food hypersensitivity phenotyping according to preset criteria was helpful for identifying children with food allergy.

  1. Cohort Profile : LifeLines, a three-generation cohort study and biobank

    NARCIS (Netherlands)

    Scholtens, Salome; Smidt, Nynke; Swertz, Morris A.; Bakker, Stephan J. L.; Dotinga, Aafje; Vonk, Judith M.; van Dijk, Freerk; van Zon, Sander K. R.; Wijmenga, Cisca; Wolffenbuttel, Bruce H. R.; Stolk, Ronald P.

    2015-01-01

    The LifeLines Cohort Study is a large population-based cohort study and biobank that was established as a resource for research on complex interactions between environmental, phenotypic and genomic factors in the development of chronic diseases and healthy ageing. Between 2006 and 2013, inhabitants

  2. Cohort Profile Update: The China Jintan Child Cohort Study.

    Science.gov (United States)

    Liu, Jianghong; Cao, Siyuan; Chen, Zehang; Raine, Adrian; Hanlon, Alexandra; Ai, Yuexian; Zhou, Guoping; Yan, Chonghuai; Leung, Patrick W; McCauley, Linda; Pinto-Martin, Jennifer

    2015-10-01

    The China Jintan Child Cohort study began in 2004 with 1656 pre-school participants and a research focus on studying the impact of environmental exposures, such as lead, on children's neurobehavioural outcomes. This population cohort now includes around 1000 of the original participants, who have been assessed three times over a period of 10 years. Since the original IJE cohort profile publication in 2010, participants have experienced a critical developmental transition from pre-school to school age and then adolescence. The study has also witnessed an increase in breadth and depth of data collection from the original aim of risk assessment. This cohort has added new directions to investigate the mechanisms and protective factors for the relationship between early health factors and child physical and mental health outcomes, with an emphasis on neurobehavioural consequences. The study now encompasses 11 domains, composed of repeated measures of the original variables and new domains of biomarkers, sleep, psychophysiology, neurocognition, personality, peer relationship, mindfulness and family dynamics. Depth of evaluation has increased from parent/teacher report to self/peer report and intergenerational family report. Consequently, the cohort has additional directions to include: (i) classmates of the original cohort participants for peer relationship assessment; and (ii) parental and grandparental measures to assess personality and dynamics within families. We welcome interest in our study and ask investigators to contact the corresponding author for additional information on data acquisition. PMID:26323725

  3. Non-participation in breast cancer screening for persons with chronic diseases and multimorbidity: a population-based cohort study

    DEFF Research Database (Denmark)

    Andersen, Berit

    2015-01-01

    Background Chronic diseases and multimorbidity are common in western countries and associated with increased breast cancer mortality. This study aims to investigate non-participation in breast cancer screening among women with chronic diseases and multimorbidity and the role of time in this...... association. Method This population-based cohort study used regional and national registries. Women who were invited to the first breast cancer screening round in the Central Denmark Region in 2008–09 were included (n = 149,234). Selected chronic diseases and multimorbidity were assessed up to 10 years before...... the screening date. Prevalence ratios (PR) were used as an association measure. Results The results indicated that women with at least one chronic condition were significantly more likely not to participate in breast cancer screening. In adjusted analysis, a significantly higher likelihood of non...

  4. The high burden of infant deaths in rural Burkina Faso: a prospective community-based cohort study

    Directory of Open Access Journals (Sweden)

    Diallo Abdoulaye

    2012-09-01

    Full Text Available Abstract Background Infant mortality rates (IMR remain high in many sub-Saharan African countries, especially in rural settings where access to health services may be limited. Studies in such communities can provide relevant data on the burden of and risk factors for infant death. We measured IMR and explored risk factors for infant death in a cohort of children born in Banfora Health District, a rural area in South-West Burkina Faso. Methods A prospective community-based cohort study was nested within the PROMISE-EBF trial (NCT00397150 in 24 villages of the study area. Maternal and infant baseline characteristics were collected at recruitment and after birth, respectively. Home visits were conducted at weeks 3, 6, 12, 24 and 52 after birth. Descriptive statistics were calculated using robust standard errors to account for cluster sampling. Cox multivariable regression was used to investigate potential risk factors for infant death. Results Among the 866 live born children included in the study there were 98 infant deaths, yielding an IMR of 113 per 1000 live births (95% CI: 89–143. Over 75% of infant deaths had occurred by 6 months of age and the post neonatal infant mortality rate was 67 per 1000 live births (95% CI: 51–88. Infections (35% and preterm births complications (23% were the most common probable causes of death by 6 months. Multivariable analyses identified maternal history of child death, polygyny, twin births and poor anthropometric z-scores at week-3 as factors associated with increased risk of infant death. Conclusions We observed a very high IMR in a rural area of Burkina Faso, a country where 75% of the population lives in rural settings. Community-based health interventions targeting mothers and children at high risk are urgently needed to reduce the high burden of infant deaths in these areas.

  5. A population-based cohort study on chronic pain: the role of opioids

    DEFF Research Database (Denmark)

    Sjøgren, Per; Grønbæk, Morten; Peuckmann, Vera;

    2010-01-01

    Interview Survey in 2000, which were linked on the individual level with register-based follow-up data. The survey was based on a county-stratified random sample of 16,684 individuals, out of which 10,434 individuals (62.5%) completed a face-to-face interview and returned a self-administered questionnaire......OBJECTIVES: The aims of this study were 2-fold: (1) to investigate the consequences of opioid use in individuals with chronic pain in the Danish population, and (2) to investigate the development of and recovery from chronic pain from 2000 to 2005. METHODS: Data derived from the Danish Health...

  6. Cancer risk and key components of metabolic syndrome:a population-based prospective cohort study in Chinese

    Institute of Scientific and Technical Information of China (English)

    CHEN Wei; SHEN Hong-bing; LU Feng; LIU Si-jun; DU Jiang-bo; WANG Jian-ming; QIAN Yun; SHEN Chong; JIN Guang-fu; HU Zhi-bin

    2012-01-01

    Background The key components of metabolic syndrome (MS) are waist circumference,blood pressure,fast blood glucose,high density lipoprotein cholesterol (HDL-c) and triglycerides (TG).These components have,separately and jointly,been associated with an increased risk of cardiovascular diseases.In this study,we aimed to explore the association between MS components and cancer risk in a population-based cohort in China.Methods We established a population-based cohort with 17 779 individuals aged 35 and above at baseline in 2004 and 2005 in Changzhou,Jiangsu Province,China.All participants were face-to-face interviewed to complete a questionnaire and were accepted physical examinations including blood tests for glucose and lipids and physical measurements for obesity and blood pressure.In 2009,a total of 16 284 subjects (6886 men and 9398 women,91.6%) attended the flow-up interviews and the participants or their family members reported all the hospitalizations and diseases including cancer occurred during the follow-up period.Multivariate Cox regression was used to estimate the hazard ratios (HRs) of metabolic syndrome components and cancer incidence.Results There was a dose-response association between cancer risk and the number of MS components presented at baseline (P for trend=0.012) and the HR (95% confidence interval (CI)) was 2.63 (1.27-5.45) for subjects carrying 3 or more metabolic syndrome components after adjustment for possible confounding factors.Specifically,the multivariate-adjusted HRs (95% CIs) for cancer risk in subjects with central obesity,high fasting glucose,low HDL-c were 1.94 (1.01-3.74),2.04 (1.10-3.77) and 2.05 (1.09-3.88),respectively.Conclusions In this population-based,prospective cohort study in China,we found MS components,e.g.,central obesity,high fasting glucose,low HDL-c were risk factors for cancer development.Early intervention of MS components may be also beneficial to reduce cancer burden.

  7. Studying variability in human brain aging in a population-based German cohort – Rationale and design of 1000BRAINS

    Directory of Open Access Journals (Sweden)

    Svenja eCaspers

    2014-07-01

    Full Text Available The ongoing 1000 brains study (1000BRAINS is an epidemiological and neuroscientific investigation of structural and functional variability in the human brain during aging. The two recruitment sources are the 10-year follow-up cohort of the German Heinz Nixdorf Recall (HNR Study, and the HNR MultiGeneration Study cohort, which comprises spouses and offspring of HNR subjects. The HNR is a longitudinal epidemiological investigation of cardiovascular risk factors, with a comprehensive collection of clinical, laboratory, socioeconomic, and environmental data from population-based subjects aged 45-75 years on inclusion. HNR subjects underwent detailed assessments in 2000, 2006, and 2011, and completed annual postal questionnaires on health status. 1000BRAINS accesses these HNR data and applies a separate protocol comprising: neuropsychological tests of attention, memory, executive functions & language; examination of motor skills; ratings of personality, life quality, mood & daily activities; analysis of laboratory and genetic data; and state-of-the-art magnetic resonance imaging (MRI, 3 Tesla of the brain. The latter includes (i 3D-T1- and 3D-T2-weighted scans for structural analyses and myelin mapping; (ii three diffusion imaging sequences optimized for diffusion tensor imaging, high-angular resolution diffusion imaging for detailed fibre tracking and for diffusion kurtosis imaging; (iii resting-state and task-based functional MRI; and (iv fluid-attenuated inversion recovery and MR angiography for the detection of vascular lesions and the mapping of white matter lesions. The unique design of 1000BRAINS allows: (i comprehensive investigation of various influences including genetics, environment and health status on variability in brain structure and function during aging; and (ii identification of the impact of selected influencing factors on specific cognitive subsystems and their anatomical correlates.

  8. Studying variability in human brain aging in a population-based German cohort-rationale and design of 1000BRAINS.

    Science.gov (United States)

    Caspers, Svenja; Moebus, Susanne; Lux, Silke; Pundt, Noreen; Schütz, Holger; Mühleisen, Thomas W; Gras, Vincent; Eickhoff, Simon B; Romanzetti, Sandro; Stöcker, Tony; Stirnberg, Rüdiger; Kirlangic, Mehmet E; Minnerop, Martina; Pieperhoff, Peter; Mödder, Ulrich; Das, Samir; Evans, Alan C; Jöckel, Karl-Heinz; Erbel, Raimund; Cichon, Sven; Nöthen, Markus M; Sturma, Dieter; Bauer, Andreas; Jon Shah, N; Zilles, Karl; Amunts, Katrin

    2014-01-01

    The ongoing 1000 brains study (1000BRAINS) is an epidemiological and neuroscientific investigation of structural and functional variability in the human brain during aging. The two recruitment sources are the 10-year follow-up cohort of the German Heinz Nixdorf Recall (HNR) Study, and the HNR MultiGeneration Study cohort, which comprises spouses and offspring of HNR subjects. The HNR is a longitudinal epidemiological investigation of cardiovascular risk factors, with a comprehensive collection of clinical, laboratory, socioeconomic, and environmental data from population-based subjects aged 45-75 years on inclusion. HNR subjects underwent detailed assessments in 2000, 2006, and 2011, and completed annual postal questionnaires on health status. 1000BRAINS accesses these HNR data and applies a separate protocol comprising: neuropsychological tests of attention, memory, executive functions and language; examination of motor skills; ratings of personality, life quality, mood and daily activities; analysis of laboratory and genetic data; and state-of-the-art magnetic resonance imaging (MRI, 3 Tesla) of the brain. The latter includes (i) 3D-T1- and 3D-T2-weighted scans for structural analyses and myelin mapping; (ii) three diffusion imaging sequences optimized for diffusion tensor imaging, high-angular resolution diffusion imaging for detailed fiber tracking and for diffusion kurtosis imaging; (iii) resting-state and task-based functional MRI; and (iv) fluid-attenuated inversion recovery and MR angiography for the detection of vascular lesions and the mapping of white matter lesions. The unique design of 1000BRAINS allows: (i) comprehensive investigation of various influences including genetics, environment and health status on variability in brain structure and function during aging; and (ii) identification of the impact of selected influencing factors on specific cognitive subsystems and their anatomical correlates. PMID:25071558

  9. Osteoporosis increases subsequent risk of gallstone: a nationwide population-based cohort study in Taiwan

    OpenAIRE

    Klahan, Sukhontip; Kuo, Chun-Nan; Chien, Shu-Chen; Lin, Yea-Wen; Lin, Chun-Yi; Lin, Chia-Hsien; Chang, Wei-Chiao; Lin, Ching-I; Hung, Kuo-Sheng; Chang, Wei-Pin

    2014-01-01

    Background Osteopontin (OPN) is a pro-inflammatory cytokine which is expressed in various tissues. It participates in the bone remodeling process and stimulates bone resorption by osteoclasts. It is also a core protein of cholesterol gallstones. We hypothesized osteoporotic patients might have higher risk in developing gallstones and conducted a population-based study to examine the risk of developing gallstone in osteoporotic patients in Taiwan. Methods A total of 1,638 patients diagnosed wi...

  10. Low dose ionizing radiation exposure and cardiovascular disease mortality: cohort study based on Canadian national dose registry of radiation workers

    International Nuclear Information System (INIS)

    The purpose of our study was to assess the risk of cardiovascular disease (CVD) mortality in a Canadian cohort of 337 397 individuals (169 256 men and 168 141 women) occupationally exposed to ionizing radiation and included in the National Dose Registry (NDR) of Canada. Material and Methods: Exposure to high doses of ionizing radiation, such as those received during radiotherapy, leads to increased risk of cardiovascular diseases. The emerging evidence of excess risk of CVDs after exposure to doses well below those previously considered as safe warrants epidemiological studies of populations exposed to low levels of ionizing radiation. In the present study, the cohort consisted of employees at nuclear power stations (nuclear workers) as well as medical, dental and industrial workers. The mean whole body radiation dose was 8.6 mSv for men and 1.2 mSv for women. Results: During the study period (1951 - 1995), as many as 3 533 deaths from cardiovascular diseases have been identified (3 018 among men and 515 among women). In the cohort, CVD mortality was significantly lower than in the general population of Canada. The cohort showed a significant dose response both among men and women. Risk estimates of CVD mortality in the NDR cohort, when expressed as excess relative risk per unit dose, were higher than those in most other occupational cohorts and higher than in the studies of Japanese atomic bomb survivors. Conclusions: The study has demonstrated a strong positive association between radiation dose and the risk of CVD mortality. Caution needs to be exercised when interpreting these results, due to the potential bias introduced by dosimetry uncertainties, the possible record linkage errors, and especially by the lack of adjustment for non-radiation risk factors. (authors)

  11. Metabolic changes in urine during and after pregnancy in a large, multiethnic population-based cohort study of gestational diabetes.

    Directory of Open Access Journals (Sweden)

    Daniel Sachse

    Full Text Available This study aims to identify novel markers for gestational diabetes (GDM in the biochemical profile of maternal urine using NMR metabolomics. It also catalogs the general effects of pregnancy and delivery on the urine profile. Urine samples were collected at three time points (visit V1: gestational week 8-20; V2: week 28±2; V3 10-16 weeks post partum from participants in the STORK Groruddalen program, a prospective, multiethnic cohort study of 823 healthy, pregnant women in Oslo, Norway, and analyzed using (1H-NMR spectroscopy. Metabolites were identified and quantified where possible. PCA, PLS-DA and univariate statistics were applied and found substantial differences between the time points, dominated by a steady increase of urinary lactose concentrations, and an increase during pregnancy and subsequent dramatic reduction of several unidentified NMR signals between 0.5 and 1.1 ppm. Multivariate methods could not reliably identify GDM cases based on the WHO or graded criteria based on IADPSG definitions, indicating that the pattern of urinary metabolites above micromolar concentrations is not influenced strongly and consistently enough by the disease. However, univariate analysis suggests elevated mean citrate concentrations with increasing hyperglycemia. Multivariate classification with respect to ethnic background produced weak but statistically significant models. These results suggest that although NMR-based metabolomics can monitor changes in the urinary excretion profile of pregnant women, it may not be a prudent choice for the study of GDM.

  12. Weight Change in a Commercial Web-Based Weight Loss Program and its Association With Website Use: Cohort Study

    OpenAIRE

    Neve, Melinda; Morgan, Philip J; Clare E. Collins

    2011-01-01

    Background There is a paucity of information in the scientific literature on the effectiveness of commercial weight loss programs, including Web-based programs. The potential of Web-based weight loss programs has been acknowledged, but their ability to achieve significant weight loss has not been proven. Objective The objectives were to evaluate the weight change achieved within a large cohort of individuals enrolled in a commercial Web-based weight loss program for 12 or 52 weeks and to desc...

  13. Hip Fracture in People with Erectile Dysfunction: A Nationwide Population-Based Cohort Study

    Science.gov (United States)

    Wu, Chieh-Hsin; Tung, Yi-Ching; Lin, Tzu-Kang; Chai, Chee-Yin; Su, Yu-Feng; Tsai, Tai-Hsin; Tsai, Cheng-Yu; Lu, Ying-Yi; Lin, Chih-Lung

    2016-01-01

    The aims of this study were to investigate the risk of hip fracture and contributing factors in patients with erectile dysfunction(ED). This population-based study was performed using the Taiwan National Health Insurance Research Database. The analysis included4636 patients aged ≥ 40 years who had been diagnosed with ED (International Classification of Diseases, Ninth Revision, Clinical Modification codes 302.72, 607.84) during 1996–2010. The control group included 18,544 randomly selected age-matched patients without ED (1:4 ratio). The association between ED and hip fracture risk was estimated using a Cox proportional hazard regression model. During the follow-up period, 59 (1.27%) patients in the ED group and 140 (0.75%) patients in the non-ED group developed hip fracture. After adjusting for covariates, the overall incidence of hip fracture was 3.74-times higher in the ED group than in the non-ED group (2.03 vs. 0.50 per 1000 person-years, respectively). The difference in the overall incidence of hip fracture was largest during the 3-year follow-up period (hazard ratio = 7.85; 95% confidence interval = 2.94–20.96; P <0.0001). To the best of our knowledge, this nationwide population-based study is the first to investigate the relationship between ED and subsequent hip fracture in an Asian population. The results showed that ED patients had a higher risk of developing hip fracture. Patients with ED, particularly those aged 40–59 years, should undergo bone mineral density examinations as early as possible and should take measures to reduce the risk of falls. PMID:27078254

  14. Increased risk of systemic lupus erythematosus in pregnancy-induced hypertension: A nationwide population-based retrospective cohort study.

    Science.gov (United States)

    Lin, Li-Te; Wang, Peng-Hui; Tsui, Kuan-Hao; Cheng, Jiin-Tsuey; Cheng, Jin-Shiung; Huang, Wei-Chun; Tang, Pei-Ling; Hu, Li-Yu

    2016-07-01

    Dysregulation of the immune system plays a role in the pathogenesis of both, pregnancy-induced hypertension (PIH) and systemic lupus erythematosus (SLE). It is well known that SLE predisposes to be complicated with PIH. However, few studies have attempted to investigate whether PIH increased subsequent SLE risk.The objectives of this study were to assess the association between PIH and subsequent SLE risk and identify predictive risk factors.Patients with newly diagnosed PIH were selected from the Taiwan National Health Insurance Research Database (NHIRD) and compared with a matched cohort without PIH based on age and the year of delivery. The incidence of new-onset SLE was evaluated in both cohorts. The overall observational period was from January 1, 2000 to December 31, 2013.Among the 23.3 million individuals registered in the NHIRD, 29,091 patients with PIH and 116,364 matched controls were identified. The incidence of SLE was higher among patients with PIH than in the matched controls (incidence rate ratio [IRR] = 4.02, 95% confidence interval [CI] 3.98-4.05, P order to identify the possible risk factors for subsequent SLE in the population with PIH.Patients with PIH may have higher risk of developing newly diagnosed SLE than those without PIH. In addition, among individuals who have experienced PIH, those younger than 30 years, having experienced preeclampsia/eclampsia, single parity, preterm birth, or chronic kidney disease, may display an increased subsequent risk of SLE. PMID:27472738

  15. Dairy Intake and Coronary Heart Disease or Stroke – a population-based cohort study in the Netherlands

    NARCIS (Netherlands)

    Dalmeijer, G.W.; Struijk, E.A.; Schouw, van der Y.T.; Soedamah-Muthu, S.S.; Verschuren, W.M.M.; Geleijnse, J.M.

    2013-01-01

    AIM: This study aimed to investigate the relationship between total dairy intake and dairy subtypes (high-fat dairy, low-fat dairy, milk and milk products, cheese and fermented dairy) with incident coronary heart disease (CHD) and stroke. METHODS: EPIC-NL is a prospective cohort study among 33,625 D

  16. Pivmecillinam and adverse birth and neonatal outcomes: a population-based cohort study.

    Science.gov (United States)

    Vinther Skriver, Mette; Nørgaard, Mette; Pedersen, Lars; Carl Schønheyder, Henrik; Sørensen, Henrik Toft

    2004-01-01

    A previous study unexpectedly showed an increased, statistically imprecise, risk of low Apgar score in children of women redeeming prescriptions for pivmecillinam in late pregnancy. To improve statistical precision we extended the previous dataset with data for 5 more y, and in addition added more neonatal outcomes. We thus examined the risk of adverse birth and neonatal outcomes among pregnant users of pivmecillinam based on population-based registries in North Jutland County, Denmark. We included 63,659 women with a live birth, or stillbirth after the 28th week of gestation. 2031 had redeemed prescriptions for pivmecillinam any time during pregnancy, 559 in the first trimester and 371 within 28 d before delivery. Adjusted odds ratios were: birth defects 0.83 (95% confidence interval (95% CI) 0.53-1.32) for exposure during first trimester, preterm delivery 0.96 (95% CI 0.79-1.18) and low birth weight 0.79 (95% CI 0.52-1.20) for exposure any time during pregnancy, and stillbirth 1.19 (95% CI 0.30-4.80), low Apgar score 1.17 (95% CI 0.37-3.66), hypoglycaemia 1.03 (95% CI 0.53-2.00), and respiratory distress syndrome 0.79 (95% CI 0.38-1.68) for exposure within 28 d before delivery. Use of pivmecillinam during pregnancy did not appear to increase the risk of adverse birth and neonatal outcomes; however, statistical precision is still low. PMID:15513399

  17. Twin-singleton differences in intelligence: a register-based birth cohort study of Norwegian males.

    Science.gov (United States)

    Eriksen, Willy; Sundet, Jon M; Tambs, Kristian

    2012-10-01

    The aim was to determine the difference in intelligence between singletons and twins in young adulthood. Data from the Medical Birth Register of Norway were linked with register data from the Norwegian National Conscript Service. The study base consisted of data on the 445,463 males who were born alive in either single or twin births in Norway during 1967-1984 and who were examined at the time of the mandatory military conscription (age 18-20). Within this study base, there were data on 1,653 sibships of full brothers that included at least one man born in single birth and at least one man born in twin birth (4,307 persons, including 2,378 twins and 1,929 singletons). The intelligence scores of the singletons were 11% (95% confidence interval [CI]: 9-14%) of a standard deviation higher than those of the twins, after adjustment for birth year, birth order, parental ages at delivery, parental education levels, and other factors. The adjusted within-family difference was also 11% (95 % CI: 6-16%) of a standard deviation, indicating that unmeasured factors shared by siblings (e.g., maternal body height) have not influenced the estimate in important ways. When gestational age at birth was added to the model, the estimate for the difference in intelligence score was approximately the same. Including birth weight in the model strongly reduced the estimate. In conclusion, twins born in Norway during 1967-1984 had slightly lower intelligence in early adulthood compared with the singletons. PMID:22877999

  18. Predicting mortality with biomarkers: a population-based prospective cohort study for elderly Costa Ricans

    Directory of Open Access Journals (Sweden)

    Rosero-Bixby Luis

    2012-06-01

    Full Text Available Abstract Background Little is known about adult health and mortality relationships outside high-income nations, partly because few datasets have contained biomarker data in representative populations. Our objective is to determine the prognostic value of biomarkers with respect to total and cardiovascular mortality in an elderly population of a middle-income country, as well as the extent to which they mediate the effects of age and sex on mortality. Methods This is a prospective population-based study in a nationally representative sample of elderly Costa Ricans. Baseline interviews occurred mostly in 2005 and mortality follow-up went through December 2010. Sample size after excluding observations with missing values: 2,313 individuals and 564 deaths. Main outcome: prospective death rate ratios for 22 baseline biomarkers, which were estimated with hazard regression models. Results Biomarkers significantly predict future death above and beyond demographic and self-reported health conditions. The studied biomarkers account for almost half of the effect of age on mortality. However, the sex gap in mortality became several times wider after controlling for biomarkers. The most powerful predictors were simple physical tests: handgrip strength, pulmonary peak flow, and walking speed. Three blood tests also predicted prospective mortality: C-reactive protein (CRP, glycated hemoglobin (HbA1c, and dehydroepiandrosterone sulfate (DHEAS. Strikingly, high blood pressure (BP and high total cholesterol showed little or no predictive power. Anthropometric measures also failed to show significant mortality effects. Conclusions This study adds to the growing evidence that blood markers for CRP, HbA1c, and DHEAS, along with organ-specific functional reserve indicators (handgrip, walking speed, and pulmonary peak flow, are valuable tools for identifying vulnerable elderly. The results also highlight the need to better understand an anomaly noted previously in

  19. Cancer among patients with type 2 diabetes mellitus: A population-based cohort study in northeastern Italy.

    Science.gov (United States)

    Gini, Andrea; Bidoli, Ettore; Zanier, Loris; Clagnan, Elena; Zanette, Giorgio; Gobbato, Michele; De Paoli, Paolo; Serraino, Diego

    2016-04-01

    Diabetes mellitus (DM) is associated with an elevated risk of cancer. The aim of this study was to assess cancer risk and survival in individuals with type 2 DM (T2DM) in Friuli Venezia Giulia, Italy. A retrospective population-based cohort study of 32,247 T2DM patients aged 40-84 years was conducted through a record linkage of local healthcare databases and cancer registry for the period 2002-2009. Standardized incidence ratios (SIRs) with 95% confidence intervals (95%CIs) and 5-year survival probabilities after T2DM and cancer diagnosis were computed. The SIRs for all cancers (n=2069) was 1.28 (95%CI: 1.23-1.34). The highest SIRs were observed for cancers of the liver, female genital organs, small intestine, and pancreas. After 3 years from T2DM diagnosis, a reduced risk of prostate cancer (SIR=0.73, 95%CI: 0.54-0.96) was found in men aged 65-74 years, and a higher risk for breast cancer (SIR=1.24, 95%CI: 1.00-1.52) was found among T2DM female patients. The overall 5-year survival after T2DM was 88.7%. Furthermore, T2DM appeared to have a negative effect on survival of women with breast cancer. This population-based study confirmed that T2DM patients are at increased risk of several cancers, and of premature death in women with breast cancer. PMID:26851751

  20. Statin therapy and mortality in HIV-infected individuals; a Danish nationwide population-based cohort study

    DEFF Research Database (Denmark)

    Rasmussen, Line; Kronborg, Gitte; Larsen, Carsten S;

    2013-01-01

    Recent studies have suggested that statins possess diverse immune modulatory and anti-inflammatory properties. As statins might attenuate inflammation, statin therapy has been hypothesized to reduce mortality in HIV-infected individuals. We therefore used a Danish nationwide cohort of HIV...

  1. Swedish snuff and incidence of cardiovascular disease. A population-based cohort study

    Directory of Open Access Journals (Sweden)

    Hedblad Bo

    2009-05-01

    Full Text Available Abstract Background The relationship between smoking and an increased incidence of cardiovascular diseases is well known. Whether smokeless tobacco (snuff is related to myocardial infarction (MI or stroke is still controversial. Aim of this study was to explore whether snuff users have an increased incidence of MI or stroke. Methods A total of 16 754 women and 10 473 men (aged 45–73 years, without history of cardiovascular disease (CVD, belonging to the population-based "Malmö Diet and Cancer" study were examined. Incidence of MI and stroke were monitored over 10.3 years. Results Snuff was used by 737 (7.0% men and 75 (0.4% women, respectively. Among men, snuff was significantly associated with low occupation level, single civil status, high BMI and with current and former smoking. In women, snuff was associated with lower systolic blood pressure. A total of 964 individuals (3.5%, i.e.544 men (5.3% and 420 (2.5% women suffered a MI during the follow-up period. The corresponding numbers of incident stroke cases were 1048, i.e. 553 men (5.3% and 495 (3.0% women, respectively. Snuff was not associated with any statistically significant increased risk of MI or stroke in men or women. The relative risks (RR in male snuff users compared to non-users were 1.05 (95% confidence interval (CI: 0.8–1.4, p = 0.740 for incident MI and 0.97 (0.7–1.4, p = 0.878 for stroke, after taking age and potential confounders into account. In women none of the 420 (2.5% women who were snuff users had a MI and only one suffered a stroke during the follow-up. Conclusion Several life-style risk factors were more prevalent in snuff-users than in non-users. However, the present study does not support any relationship between snuff and incidence of cardiovascular disease in men.

  2. What Matters Most for Predicting Survival? A Multinational Population-Based Cohort Study

    Science.gov (United States)

    Goldman, Noreen; Glei, Dana A; Weinstein, Maxine

    2016-01-01

    Despite myriad efforts among social scientists, epidemiologists, and clinicians to identify variables with strong linkages to mortality, few researchers have evaluated statistically the relative strength of a comprehensive set of predictors of survival. Here, we determine the strongest predictors of five-year mortality in four national, prospective studies of older adults. We analyze nationally representative surveys of older adults in four countries with similar levels of life expectancy: England (n = 6113, ages 52+), the US (n = 2023, ages 50+), Costa Rica (n = 2694, ages 60+), and Taiwan (n = 1032, ages 53+). Each survey includes a broad set of demographic, social, health, and biological variables that have been shown previously to predict mortality. We rank 57 predictors, 25 of which are available in all four countries, net of age and sex. We use the area under the receiver operating characteristic curve and assess robustness with additional discrimination measures. We demonstrate consistent findings across four countries with different cultural traditions, levels of economic development, and epidemiological transitions. Self-reported measures of instrumental activities of daily living limitations, mobility limitations, and overall self-assessed health are among the top predictors in all four samples. C-reactive protein, additional inflammatory markers, homocysteine, serum albumin, three performance assessments (gait speed, grip strength, and chair stands), and exercise frequency also discriminate well between decedents and survivors when these measures are available. We identify several promising candidates that could improve mortality prediction for both population-based and clinical populations. Better prognostic tools are likely to provide researchers with new insights into the behavioral and biological pathways that underlie social stratification in health and may allow physicians to have more informed discussions with patients about end-of-life treatment

  3. Multiple births and maternal mental health from pregnancy to 5 years after birth: A longitudinal population-based cohort study

    Directory of Open Access Journals (Sweden)

    Eivind Ystrom

    2014-12-01

    Full Text Available Background: There is a lack of population-based studies on multiple births and maternal mental health. Having a high-risk pregnancy by bearing two or more children is a stressful life event, and the challenges of parenting two or more children probably also lead to a high level of parental stress. There are a few results on multiple births and maternal mental health from studies on in vitro fertilization samples. The only previous cohort study on multiple birth and maternal mental health included a single measure of depressive symptoms at 9 months postpartum. We aim to estimate the relative risk for depression and anxiety after multiple birth in a population-based prospective cohort study while adjusting for factors prior and subsequent to fertilization.Methods: We used data from 87,807 pregnancies included in the Norwegian Mother and Child Cohort study. Information on multiple birth was retrieved from the Norwegian Medical Birth Registry, and maternal mental health was assessed at 17th and 30th week of gestation and 0.5, 1.5, 3, and 5 years postpartum. There were 1,842 plural births included in the study (i.e. 1,821 twin births and 21 higher order births. We predicted maternal mental health at each time point, subsequently adjusting for 1 factors prior to fertilization (e.g. maternal age and in vitro fertilization; 2 factors during pregnancy (e.g. hypertensive states; 3 factors at delivery (e.g. cesarean section; 4 child-related postnatal complications (e.g. intracranial hemorrhage; and 5 concurrent depression or anxiety after pregnancy.Results: Adjusted for antecedents of plural birth, mothers expecting a plural birth had a normal risk for anxiety (RR=1.05; 95% CI 0.92-1.20 and depression (RR=1.02; 95% CI 0.89-1.16 at 17th week of gestation. However, plural birth was associated with maternal depression at 1.5, 3, and 5 years postpartum and maternal anxiety at 3 years postpartum. The trend was for the association to increase across time, and

  4. A sensitivity analysis of secular trends in risk factors and mortality based on cohort studies

    DEFF Research Database (Denmark)

    Prescott, Eva; Andersen, Per Kragh; Osler, Merete; Lange, Peter; Vestbo, Jørgen

    Nonparticipation, healthy responder, tobacco, smoking, mortality, epidemiologic methods, population study......Nonparticipation, healthy responder, tobacco, smoking, mortality, epidemiologic methods, population study...

  5. Poor survival in rheumatoid arthritis associated with bronchiectasis: a family-based cohort study.

    Directory of Open Access Journals (Sweden)

    Xavier Puéchal

    Full Text Available BACKGROUND: Diffuse bronchiectasis (DB may occur in rheumatoid arthritis (RA. CFTR (cystic fibrosis transmembrane conductance regulator mutations predispose RA patients to DB, but the prognosis of RA-associated DB (RA-DB is unclear. METHODS: We report long-term mortality data from a nationwide family-based association study of patients with RA only, DB only or RA-DB. We assessed mortality as a function of clinical characteristics and CF/CFTR-RD (CFTR-related disorders mutations in 137 subjects from 24 kindreds. Potential risk factors were investigated by Cox proportional-hazard analysis with shared Gaussian random effects to account for within-family correlations. RESULTS: During a median follow-up of 11 years after inclusion, 18 patients died, mostly from cardiorespiratory causes. Survival was significantly lower for RA-DB patients than for unaffected relatives and for patients with RA or DB only. RA patients with DB had also a poorer prognosis in terms of survival after RA diagnosis (HR, 8.6; 95% CI, 1.5-48.2; P = 0.014 and from birth (HR, 9.6; 95% CI, 1.1-81.7; P = 0.039. Early onset of DB (HR, 15.4; 95% CI, 2.1-113.2; P = 0.007 and CF/CFTR-RD mutation (HR, 7.2; 95% CI, 1.4-37.1; P = 0.018 were associated with poorer survival in patients with RA-DB. Thus, CF/CFTR-RD mutations in RA patients with early-onset DB defined a subgroup of high-risk patients with higher mortality rates (log-rank test P = 1.28×10(-5. CONCLUSION: DB is associated with poorer survival in patients with RA. Early-onset DB and CFTR mutations are two markers that identify RA patients at a high risk of death, for whom future therapeutic interventions should be designed and evaluated.

  6. Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Brouwer, Annemieke J.; Groenendaal, Floris; Koopman, Corine; Vries, Linda S. de [University Medical Center Utrecht, Department of Neonatology, Wilhelmina Children' s Hospital, PO Box 85090, Utrecht (Netherlands); Nievelstein, Rutger-Jan A. [University Medical Center Utrecht, Department of Radiology, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Han, Sen K. [University Medical Center Utrecht, Department of Neurosurgery, Wilhelmina Children' s Hospital, Utrecht (Netherlands)

    2010-06-15

    In recent years, intracranial hemorrhage (ICH) with parenchymal involvement has been diagnosed more often in full-term neonates due to improved neuroimaging techniques. The aim of this study is to describe clinical and neuroimaging data in the neonatal period and relate imaging findings to outcome in a hospital-based population admitted to a level 3 neonatal intensive care unit (NICU). From our neuroimaging database, we retrospectively retrieved records and images of 53 term infants (1991-2008) in whom an imaging diagnosis of ICH with parenchymal involvement was made. Clinical data, including mode of delivery, clinical manifestations, neurological symptoms, extent and site of hemorrhage, neurosurgical intervention, and neurodevelopmental outcomes, were recorded. Seventeen of the 53 term infants had infratentorial ICH, 20 had supratentorial ICH, and 16 had a combination of the two. Seizures were the most common presenting symptom (71.7%), another ten infants (18.9%) presented with apneic seizures, and five infants had no clinical signs but were admitted to our NICU because of perinatal asphyxia (n = 2), respiratory distress (n = 2), and development of posthemorrhagic ventricular dilatation (n = 1). Continuous amplitude-integrated electroencephalography recordings were performed in all infants. Clinical or subclinical seizures were seen in 48/53 (90.6%) infants; all received anti-epileptic drugs. Thirteen of all 53 (24.5%) infants died. The lowest mortality rate was seen in infants with supratentorial ICH (10%). Three infants with a midline shift required craniotomy, six infants needed a subcutaneous reservoir due to outflow obstruction, and three subsequently required a ventriculoperitoneal shunt. The group with poor outcome (death or developmental quotient (DQ) <85) had a significantly lower 5-min Apgar score (p =.006). Follow-up data were available for 37/40 survivors aged at least 15 months. Patients were assessed with the Griffiths Mental Developmental Scales

  7. Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

    International Nuclear Information System (INIS)

    In recent years, intracranial hemorrhage (ICH) with parenchymal involvement has been diagnosed more often in full-term neonates due to improved neuroimaging techniques. The aim of this study is to describe clinical and neuroimaging data in the neonatal period and relate imaging findings to outcome in a hospital-based population admitted to a level 3 neonatal intensive care unit (NICU). From our neuroimaging database, we retrospectively retrieved records and images of 53 term infants (1991-2008) in whom an imaging diagnosis of ICH with parenchymal involvement was made. Clinical data, including mode of delivery, clinical manifestations, neurological symptoms, extent and site of hemorrhage, neurosurgical intervention, and neurodevelopmental outcomes, were recorded. Seventeen of the 53 term infants had infratentorial ICH, 20 had supratentorial ICH, and 16 had a combination of the two. Seizures were the most common presenting symptom (71.7%), another ten infants (18.9%) presented with apneic seizures, and five infants had no clinical signs but were admitted to our NICU because of perinatal asphyxia (n = 2), respiratory distress (n = 2), and development of posthemorrhagic ventricular dilatation (n = 1). Continuous amplitude-integrated electroencephalography recordings were performed in all infants. Clinical or subclinical seizures were seen in 48/53 (90.6%) infants; all received anti-epileptic drugs. Thirteen of all 53 (24.5%) infants died. The lowest mortality rate was seen in infants with supratentorial ICH (10%). Three infants with a midline shift required craniotomy, six infants needed a subcutaneous reservoir due to outflow obstruction, and three subsequently required a ventriculoperitoneal shunt. The group with poor outcome (death or developmental quotient (DQ) <85) had a significantly lower 5-min Apgar score (p =.006). Follow-up data were available for 37/40 survivors aged at least 15 months. Patients were assessed with the Griffiths Mental Developmental Scales

  8. Post-Stroke Mortality, Stroke Severity, and Preadmission Antipsychotic Medicine Use – A Population-Based Cohort Study

    DEFF Research Database (Denmark)

    Prior, Anders; Laursen, Thomas Munk; Larsen, Karen Kjær; Johnsen, Søren Paaske; Christensen, Jakob; Andersen, Grethe; Vestergaard, Mogens

    2014-01-01

    Background and Purpose: It has been suggested that antipsychotic medication may be neuroprotective and may reduce post-stroke mortality, but studies are few and ambiguous. We aimed to investigate the post-stroke effects of preadmission antipsychotic use. Methods: We conducted a nationwide, popula...... mortality, even after adjustment for known confounders. Antipsychotics play an important role in the treatment of many psychiatric conditions, but our findings do not support the hypothesis that they reduce stroke severity or post-stroke mortality.......Background and Purpose: It has been suggested that antipsychotic medication may be neuroprotective and may reduce post-stroke mortality, but studies are few and ambiguous. We aimed to investigate the post-stroke effects of preadmission antipsychotic use. Methods: We conducted a nationwide......, population-based cohort study of 81,143 persons admitted with stroke in Denmark from 2003–2010. Using Danish health care databases, we extracted data on preadmission use of antipsychotics and confounding factors. We examined the association between current, former, and never use of antipsychotics and stroke...

  9. Adult physical, sexual, and emotional abuse and postpartum depression, a population based, prospective study of 53,065 women in the Norwegian Mother and Child Cohort Study

    OpenAIRE

    Sørbø, Marie Flem; Grimstad, Hilde; Bjørngaard, Johan Håkon; Lukasse, Mirjam; Schei, Berit

    2014-01-01

    Background Postpartum depression (PPD) has detrimental consequences to the women, their infants and families. The aim of the present study was to assess the association between adult abuse and PPD. Methods This study was based on data from 53,065 pregnant women in the Norwegian Mother and Child Cohort Study (MoBa), conducted by the Norwegian Institute of Public Health. Women were recruited through a postal invitation in relation to a routine ultra-sound invitation at week 18 of gestation. Exp...

  10. Cancer incidence and specific occupational exposures in the Swedish leather tanning industry: a cohort based case-control study.

    OpenAIRE

    Mikoczy, Z; Schütz, A; Strömberg, U; Hagmar, L

    1996-01-01

    OBJECTIVE--To study the effect on the incidence of cancer of exposure to chemicals handled in the leather tanning industry. MATERIALS AND METHODS--A case-control study was performed within a cohort of 2487 workers employed for at least six months during the period 1900-89 in three Swedish leather tanneries. 68 cancer cases (lung, stomach, bladder, kidney, nasal, and pancreatic cancers and soft tissue sarcomas) and 178 matched controls were studied. Effects of chemical exposures on cancer inci...

  11. Preterm birth by vacuum extraction and neonatal outcome: a population-based cohort study

    OpenAIRE

    Åberg, Katarina; Norman, Mikael; Ekéus, Cecilia

    2014-01-01

    Background Very few studies have investigated the neonatal outcomes after vacuum extraction delivery (VE) in the preterm period and the results of these studies are inconclusive. The objective of this study was to describe the use of VE for preterm delivery in Sweden and to compare rates of neonatal complications after preterm delivery by VE to those found after cesarean section during labor (CS) or unassisted vaginal delivery (VD). Methods Data was obtained from Swedish national registers. I...

  12. A population-based cohort study of chest x-ray screening in smokers: lung cancer detection findings and follow-up

    International Nuclear Information System (INIS)

    Case-control studies of mass screening for lung cancer (LC) by chest x-rays (CXR) performed in the 1990s in scarcely defined Japanese target populations indicated significant mortality reductions, but these results are yet to be confirmed in western countries. To ascertain whether CXR screening decreases LC mortality at community level, we studied a clearly defined population-based cohort of smokers invited to screening. We present here the LC detection results and the 10-year survival rates. The cohort of all smokers of > 10 pack-years resident in 50 communities of Varese, screening-eligible (n = 5,815), in July 1997 was invited to nonrandomized CXR screening. Self-selected participants (21% of cohort) underwent screening in addition to usual care; nonparticipants received usual care. The cohort was followed-up until December 2010. Kaplan-Meier LC-specific survival was estimated in participants, in nonparticipants, in the whole cohort, and in an uninvited, unscreened population (control group). Over the initial 9.5 years of study, 67 LCs were diagnosed in screening participants (51% were screen-detected) and 178 in nonparticipants. The rates of stage I LC, resectability and 5-year survival were nearly twice as high in participants (32% stage I; 48% resected; 30.5% 5-year survival) as in nonparticipants (17% stage I; 27% resected; 13.5% 5-year survival). There were no bronchioloalveolar carcinomas among screen-detected cancers, and median volume doubling time of incidence screen-detected LCs was 80 days (range, 44-318), suggesting that screening overdiagnosis was minimal. The 10-year LC-specific survival was greater in screening participants than in nonparticipants (log-rank, p = 0.005), and greater in the whole cohort invited to screening than in the control group (log-rank, p = 0.001). This favourable long-term effect was independently related to CXR screening exposure. In the setting of CXR screening offered to a population-based cohort of smokers, screening

  13. Association between bilirubin and risk of Non-Alcoholic Fatty Liver Disease based on a prospective cohort study

    Science.gov (United States)

    Tian, Jianbo; Zhong, Rong; Liu, Cheng; Tang, Yuhan; Gong, Jing; Chang, Jiang; Lou, Jiao; Ke, Juntao; Li, Jiaoyuan; Zhang, Yi; Yang, Yang; Zhu, Ying; Gong, Yajie; Xu, Yanyan; Liu, Peiyi; Yu, Xiao; Xiao, Lin; Du, Min; Yang, Ling; Yuan, Jing; Wang, Youjie; Chen, Weihong; Wei, Sheng; Liang, Yuan; Zhang, Xiaomin; He, Meian; Wu, Tangchun; Yao, Ping; Miao, Xiaoping

    2016-01-01

    The study aimed to assess the association between total, direct, and indirect bilirubin and nonalcoholic fatty live disease (NAFLD) risk given its high prevalence and serious clinical prognosis. Among 27,009 subjects who participated in a healthy screening program from the Dongfeng-Tongji cohort study in 2008, 8189 eligible subjects (aged 35–86 years; males, 43.95%) were ultimately enrolled. The incidence rates of NAFLD in 2013 were compared with respect to baseline bilirubin levels among subjects free of NAFLD, and the effect sizes were estimated by logistic regression analysis. During 5 years follow-up, we observed 1956 cases of newly developed NAFLD with the overall incidence of 23.88%. Direct bilirubin was presented to inversely associate with NAFLD risk. Compared with quartile 1 of direct bilirubin, the multivariable-adjusted ORs (95% CIs) for NAFLD of quartile 2 to 4 were 1.104 (0.867–1.187), 0.843 (0.719–0.989), and 0.768 (0.652–0.905), respectively, P for trend 0.002). Similarly, inverse effects of direct bilirubin on NAFLD incidence were also observed when stratified by sex and BMI. However, no significant associations were found between total, and indirect bilirubin and NAFLD risk. Direct bilirubin reduced NAFLD risk independent of possible confounders among middle-aged and elderly Chinese population, probably based on the endogenous antioxidation of bilirubin. PMID:27484402

  14. Association between bilirubin and risk of Non-Alcoholic Fatty Liver Disease based on a prospective cohort study.

    Science.gov (United States)

    Tian, Jianbo; Zhong, Rong; Liu, Cheng; Tang, Yuhan; Gong, Jing; Chang, Jiang; Lou, Jiao; Ke, Juntao; Li, Jiaoyuan; Zhang, Yi; Yang, Yang; Zhu, Ying; Gong, Yajie; Xu, Yanyan; Liu, Peiyi; Yu, Xiao; Xiao, Lin; Du, Min; Yang, Ling; Yuan, Jing; Wang, Youjie; Chen, Weihong; Wei, Sheng; Liang, Yuan; Zhang, Xiaomin; He, Meian; Wu, Tangchun; Yao, Ping; Miao, Xiaoping

    2016-01-01

    The study aimed to assess the association between total, direct, and indirect bilirubin and nonalcoholic fatty live disease (NAFLD) risk given its high prevalence and serious clinical prognosis. Among 27,009 subjects who participated in a healthy screening program from the Dongfeng-Tongji cohort study in 2008, 8189 eligible subjects (aged 35-86 years; males, 43.95%) were ultimately enrolled. The incidence rates of NAFLD in 2013 were compared with respect to baseline bilirubin levels among subjects free of NAFLD, and the effect sizes were estimated by logistic regression analysis. During 5 years follow-up, we observed 1956 cases of newly developed NAFLD with the overall incidence of 23.88%. Direct bilirubin was presented to inversely associate with NAFLD risk. Compared with quartile 1 of direct bilirubin, the multivariable-adjusted ORs (95% CIs) for NAFLD of quartile 2 to 4 were 1.104 (0.867-1.187), 0.843 (0.719-0.989), and 0.768 (0.652-0.905), respectively, P for trend 0.002). Similarly, inverse effects of direct bilirubin on NAFLD incidence were also observed when stratified by sex and BMI. However, no significant associations were found between total, and indirect bilirubin and NAFLD risk. Direct bilirubin reduced NAFLD risk independent of possible confounders among middle-aged and elderly Chinese population, probably based on the endogenous antioxidation of bilirubin. PMID:27484402

  15. Risk of pancreatitis according to alcohol drinking habits: a population-based cohort study

    DEFF Research Database (Denmark)

    Kristiansen, L.; Gronbaek, M.; Tolstrup, J.S.;

    2008-01-01

    The association between alcohol intake and pancreatitis has been examined previously in case-control studies, mostly consisting of men. The significance of beverage type and drinking pattern is unknown. The objective of this study was to assess the association between amount, type, and frequency of...... alcohol intake and risk of pancreatitis. For this purpose, the authors used data on 17,905 men and women who participated in the Copenhagen City Heart Study in 1976-1978, 1981-1983, 1991-1994, and 2001-2003 in Copenhagen, Denmark. Alcohol intake and covariates were assessed by questionnaire. Information...

  16. Atypical antipsychotic medications and hyponatremia in older adults: a population-based cohort study

    OpenAIRE

    Gandhi, Sonja; McArthur, Eric; Reiss, Jeffrey P.; Mamdani, Muhammad M.; Hackam, Daniel G.; Weir, Matthew A.; Garg, Amit X

    2016-01-01

    Background A number of case reports have suggested a possible association between atypical antipsychotic medications and hyponatremia. Currently, there are no reliable estimates of hyponatremia risk from atypical antipsychotic drugs. Objective The objective of this study was to examine the 30-day risk of hospitalization with hyponatremia in older adults dispensed an atypical antipsychotic drug relative to no antipsychotic use. Design The design of this study was a retrospective, population-ba...

  17. Sarcopenic Obesity and Risk of Cardiovascular Disease and Mortality: A Population-Based Cohort Study of Older Men

    OpenAIRE

    Atkins, J. L.; Morris, R W; Lennon, L T; Papacosta, O; Wannamethee, S. G.; Whincup, P H

    2014-01-01

    Objectives To examine associations between sarcopenia, obesity, and sarcopenic obesity and risk of cardiovascular disease (CVD) and all-cause mortality in older men. Design Prospective cohort study. Setting British Regional Heart Study. Participants Men aged 60-79 years (n = 4,252). Measurements Baseline waist circumference (WC) and midarm muscle circumference (MAMC) measurements were used to classify participants into four groups: sarcopenic, obese, sarcopenic obese, or optimal WC and MAMC. ...

  18. Radiotherapy waiting times for women with breast cancer: a population-based cohort study

    Directory of Open Access Journals (Sweden)

    Sainsbury Richard

    2007-05-01

    Full Text Available Abstract Background Waiting times for cancer patients are a national priority in the UK. Previous studies have shown variation between cancer networks in the time between diagnosis and start of radiotherapy for all cancer patients. Studies of the relationship between delay in receiving treatment and survival of breast cancer patients have been inconsistent. This study aimed to examine factors associated with waiting times for radiotherapy for breast cancer patients. Methods 35,354 women resident in South East England and diagnosed with breast cancer between 1992 and 2001 who received radiotherapy within six months of diagnosis were identified from the Thames Cancer Registry. Time to radiotherapy was measured from either the date of diagnosis or the start of the previous treatment, whichever was shorter. Unadjusted and adjusted logistic regression models were fitted to examine whether patients received radiotherapy within 60 days of their diagnosis or previous treatment. Results The adjusted proportions of patients receiving radiotherapy within 60 days varied significantly between different cancer networks (range: 43% to 81%, and decreased from 68% in 1992 to 33% in 2001. After adjustment there was no association between deprivation of area of residence, age or stage and radiotherapy wait. Median time waited to radiotherapy increased over the study period whether measured from the start of chemotherapy, hormone therapy, surgery or the date of diagnosis. Conclusion This study covered a period of time before the investment following the Cancer Plan of 2000. Results are consistent with other findings suggesting variation between cancer networks and increasing waits over time. Further studies should examine different methods of measuring waiting time, the causes and consequences of waits for radiotherapy and the effect of current initiatives and investments.

  19. Radiotherapy waiting times for women with breast cancer: a population-based cohort study

    International Nuclear Information System (INIS)

    Waiting times for cancer patients are a national priority in the UK. Previous studies have shown variation between cancer networks in the time between diagnosis and start of radiotherapy for all cancer patients. Studies of the relationship between delay in receiving treatment and survival of breast cancer patients have been inconsistent. This study aimed to examine factors associated with waiting times for radiotherapy for breast cancer patients. 35,354 women resident in South East England and diagnosed with breast cancer between 1992 and 2001 who received radiotherapy within six months of diagnosis were identified from the Thames Cancer Registry. Time to radiotherapy was measured from either the date of diagnosis or the start of the previous treatment, whichever was shorter. Unadjusted and adjusted logistic regression models were fitted to examine whether patients received radiotherapy within 60 days of their diagnosis or previous treatment. The adjusted proportions of patients receiving radiotherapy within 60 days varied significantly between different cancer networks (range: 43% to 81%), and decreased from 68% in 1992 to 33% in 2001. After adjustment there was no association between deprivation of area of residence, age or stage and radiotherapy wait. Median time waited to radiotherapy increased over the study period whether measured from the start of chemotherapy, hormone therapy, surgery or the date of diagnosis. This study covered a period of time before the investment following the Cancer Plan of 2000. Results are consistent with other findings suggesting variation between cancer networks and increasing waits over time. Further studies should examine different methods of measuring waiting time, the causes and consequences of waits for radiotherapy and the effect of current initiatives and investments

  20. Risk of pancreatitis according to alcohol drinking habits: a population-based cohort study

    DEFF Research Database (Denmark)

    Kristiansen, Louise; Grønbaek, Morten; Becker, Ulrik;

    2008-01-01

    alcohol intake and risk of pancreatitis. For this purpose, the authors used data on 17,905 men and women who participated in the Copenhagen City Heart Study in 1976-1978, 1981-1983, 1991-1994, and 2001-2003 in Copenhagen, Denmark. Alcohol intake and covariates were assessed by questionnaire. Information...

  1. Corticosteroids and Open-Angle Glaucoma in the Elderly A Population-Based Cohort Study

    NARCIS (Netherlands)

    Marcus, Michael W.; Muskens, Rogier P. H. M.; Ramdas, Wishal D.; Wolfs, Roger C. W.; De Jong, Paulus T. V. M.; Vingerling, Johannes R.; Hofman, Albert; Stricker, Bruno H. C.; Jansonius, Nomdo M.

    2012-01-01

    Background It is largely unknown if corticosteroid-induced open-angle glaucoma (OAG) is an entity that is limited to a few susceptible individuals or whether it contributes significantly to the overall population burden of OAG. Objective The aim of this study was to determine whether there is an ass

  2. Stressful life events and leukocyte telomere attrition in adulthood : a prospective population-based cohort study

    NARCIS (Netherlands)

    van Ockenburg, S. L.; Bos, E. H.; de Jonge, P.; van der Harst, P.; Gans, R. O. B.; Rosmalen, J. G. M.

    2015-01-01

    Background. Telomere attrition might be one of the mechanisms through which psychosocial stress leads to somatic disease. To date it is unknown if exposure to adverse life events in adulthood is associated with telomere shortening prospectively. In the current study we investigated whether life even

  3. Risk for schizophrenia and schizophrenia-like psychosis among patients with epilepsy: population based cohort study

    DEFF Research Database (Denmark)

    Qin, Ping; Xu, Huylan; Laursen, Thomas Munk;

    2005-01-01

    OBJECTIVES: To investigate whether age at onset of epilepsy, type of epilepsy, family history of psychosis, or family history of epilepsy affect the risk of schizophrenia or schizophrenia-like psychosis among patients with epilepsy. DESIGN: Comparison of population based data. SETTING: Danish...... people with a history of epilepsy. The effect of epilepsy was the same in men and in women and increased with age. Family history of psychosis and a family history of epilepsy were significant risk factors for schizophrenia and schizophrenia-like psychosis, and the effect of epilepsy, both in cases and...... families, was greater among people with no family history of psychosis. In addition, the increased risk for schizophrenia or schizophrenia-like psychosis did not differ by type of epilepsy but increased with increasing number of admissions to hospital and, particularly, was significantly greater for people...

  4. Multisystem Morbidity and Mortality in Offspring of Women With Type 1 Diabetes (The EPICOM Study): A Register-Based Prospective Cohort Study

    DEFF Research Database (Denmark)

    Knorr, Sine; Krag, Kirstine Stochholm; Vlachová, Zuzana; Bytoft, Birgitte; Clausen, Tine D; Jensen, Rikke Beck; Juul, Svend; Ovesen, Per; Damm, Peter; Beck-Nielsen, Henning; Jensen, Dorte M; Gravholt, Claus Højbjerg

    2015-01-01

    OBJECTIVE: This study examined the long-term consequences for offspring born to mothers with pregestational type 1 diabetes regarding mortality, hospital admissions, and medication. We also examined the association between HbA1c levels during pregnancy and mortality and incidence of hospital...... admissions. RESEARCH DESIGN AND METHODS: We performed a prospective combined clinical and register-based cohort study comparing mortality, hospital admissions, and use of medication in offspring (n = 1,326) of women with pregestational type 1 diabetes (index children) with matched control subjects (n = 131...

  5. A sensitivity analysis of secular trends in risk factors and mortality based on cohort studies

    DEFF Research Database (Denmark)

    Prescott, E; Andersen, P K; Osler, M; Lange, P; Vestbo, J

    1999-01-01

    study for several years. The result may be an artificial increase in mortality, which impedes analyzing the effect of secular trends in risk factors on mortality. The objective of this paper is to suggest a solution by using data on nonresponders and applying a sensitivity analysis. We illustrate this...... biased. In a sensitivity analysis, the observed person-years of nonresponders were distributed among six categories of persons with respect to smoking behavior (never-smokers; ex-smokers; noninhaling current smokers; and current smokers of 1-14, 15-24, and > or =25 gm tobacco per day) according to preset...... assumptions regarding smoking habits. The observed deaths among nonresponders were then distributed on the six smoking categories according to relative risks derived from a Poisson regression analysis among responders. This procedure allowed us to study the effect of adjustment for smoking on the unbiased...

  6. Nutrition and cardiometabolic risk: a prospective population-based cohort study

    OpenAIRE

    Funtikova, Anna N.

    2015-01-01

    Cardiovascular diseases (CVD) are the principal cause of mortality worldwide. Lifestyle plays a crucial role in preventing the development of CVD, and one of its key elements is diet, which directly affects cardiometabolic health and cardiovascular risk. Given the complexity of diet and also of cardiovascular disease etiology, a lot of recent research into the association between diet and disease have focused on dietary patterns, as this is currently the most holistic way to study dietary hab...

  7. Timing of Pregnancy After Gastric Bypass—a National Register-Based Cohort Study

    DEFF Research Database (Denmark)

    Kjær, Mette Karie Mandrup; Nilas, Lisbeth

    2013-01-01

    Current recommendations suggest postponing pregnancy by at least 1 year after gastric bypass. During the first postoperative year, women are in a catabolic phase with a rapid weight loss which may increase the risk of adverse pregnancy and neonatal outcomes. This study tested the hypothesis that...... the risk of adverse pregnancy and neonatal outcomes is increased in women who conceive during the first year after gastric bypass surgery....

  8. A Canadian naturalistic study of a community-based cohort treated for bipolar disorder

    OpenAIRE

    Chandresena Ranjith; Lee Bobbie; Sagman Doron; Jones Barry; Brunner Elizabeth

    2010-01-01

    Abstract Background Bipolar illness is associated with significant psychosocial morbidity and health resource utilization. Second generation antipsychotics, used alone or in combination with mood stabilizers are effective in treating acute mania in community settings. This study was designed to compare the change in clinical parameters and resource utilization at one month in a group of patients who required treatment intervention for exacerbation of mania. The clinical response at one year w...

  9. The Impact of Diagnosis on Job Retention: A Danish Registry-Based Cohort Study

    Directory of Open Access Journals (Sweden)

    Rasmus Espersen

    2015-01-01

    Full Text Available Background. In 1998, Denmark introduced the flex job scheme to ensure employment of people with a permanent reduced work capacity. This study investigated the association between select diagnoses and the risk of disability pension among persons eligible for the scheme. Methods. Using the national DREAM database we identified all persons eligible for the flex job scheme from 2001 to 2008. This information piece was linked to the hospital discharge registry. Selected participants were followed for 5 years. Results. From the 72,629 persons identified, our study included 329 patients with rheumatoid arthritis, 10,120 patients with spine disorders, 2179 patients with ischemic heart disease, and 1765 patients with functional disorders. A reduced risk of disability pension was found in the group with rheumatoid arthritis (hazard ratio = 0.69 (0.53–0.90 compared to the group with spine disorders. No differences were found when comparing ischemic heart disease and functional disorders. Employment during the first 3 months of the flex job scheme increased the degree of employment for all groups. Conclusion. Differences in the risk of disability pension were identified only in patients with rheumatoid arthritis. This study demonstrates the importance of obtaining employment immediately after allocation to the flex job scheme, regardless of diagnosis.

  10. Early-Life Factors and Risk of Parkinson's Disease: A Register-Based Cohort Study.

    Science.gov (United States)

    Liu, Bojing; Chen, Honglei; Fang, Fang; Tillander, Annika; Wirdefeldt, Karin

    2016-01-01

    Parkinson's disease (PD) may take decades to develop and early life exposures such as infection may be important. However, few epidemiological studies have evaluated early life risk factors in relation to PD risk. We therefore examined such associations in a prospective analysis of 3 545 612 individuals born in Sweden between 1932 and 1970 without PD on January 1, 2002. Incident PD cases were identified using the Swedish Patient Register during 2002-2010. Information on sibship size, number of older and younger siblings, multiple births, parental age, birth month and season was obtained from the Swedish Multi-Generation Register. Monthly data on national burden of influenza-like illness during 1932-1970 were obtained from the Swedish Public Health Agency. Hazard ratios with 95% confidence intervals (CI) were estimated using Cox proportional hazards regression. During the follow-up, 8779 incident PD cases were identified. As expected, older age, male sex, parental occupation as farmers, and family history of PD were associated with higher PD risk. Overall, early life factors, including flu burden in the year of birth, were not associated with PD risk, although we did find a lower PD risk among participants with older siblings than those without (HR = 0.93, 95%CI: 0.89, 0.98). Our study therefore provided little support for important etiological contributions of early life factors to the PD risk late in life. The finding of a lower PD risk among individuals with older siblings will need confirmation and further investigation. PMID:27082111

  11. A prospective cohort study: probe based confocal laser endomicroscopy for peripheral pulmonary lesions (Conference Presentation)

    Science.gov (United States)

    Matsumoto, Yuji; Izumo, Takehiro; Hiraishi, Yoshihisa; Tsuchida, Takaaki

    2016-03-01

    Introduction: The diagnostic value of bronchoscopy for peripheral pulmonary lesions (PPLs) has improved since the application of radial endobronchial ultrasound (R-EBUS). Though R-EBUS indicates the position of the PPL, there is often a discrepancy between the obtained R-EBUS image and the diagnostic outcome. Meanwhile, probe based confocal laser endomicroscopy (pCLE) is a novel technique which provides in vivo real-time image of the contacted surface structures. However, its findings have not been established yet. Methods: Consecutive patients who have underwent bronchoscopy for PPLs were prospectively enrolled. R-EBUS with a guide sheath (GS) was inserted to the target PPL under X-ray fluoroscopic guidance. When an adequate R-EBUS image (within or adjacent to) was obtained, pCLE was sequentially inserted through the GS. Then pCLE image was scanned and biopsy was performed where an abnormal finding was estimated. The pCLE findings of PPLs and the background were recorded and analyzed exploratorily. Results: We analyzed 19 cases that we could get appropriate tissues. In all cases, bronchial walls showed longitudinal elastic fibers whereas alveolar walls formed grid-like elastic fiber networks. Conversely, discontinuous, crushed or aggregated alveolar structures accompanied by thickened and distorted fibers were detected in PPLs. Some cases showed dark hollow with fragmented or granular fluorescence. On the other hand, 11 cases (57.9%) indicated normal elastic fibers and needed the position change (3 cases; approached other bronchus, 6 cases; adjusted the position, 2 cases; penetrated the covered bronchial wall). Conclusion: The pCLE has a potential to improve the efficacy of diagnostic bronchoscopy for PPLs.

  12. Retinitis pigmentosa reduces the risk of proliferative diabetic retinopathy: a nationwide population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Yuh-Fang Chen

    Full Text Available PURPOSE: To study the association between retinitis pigmentosa (RP and the progression of diabetic retinopathy (DR. METHODS: Using the Longitudinal Health Insurance Database 2000 of Taiwan, we identified individuals with an initial diagnosis for RP during the period of 1997-2008. A non-RP comparison group, 10-fold frequency matched by sex, age, index year and the year of diabetes diagnosed, were randomly selected from the same database. The occurrence of DR was observed for all subjects until the end of 2009. The Kaplan-Meier curves were used to illustrate the cumulative probability of developing DR for the RP group and comparison groups. The hazard ratio (HR of DR for the RP group relative to the comparison group was estimated using Cox proportional hazards model after adjusting for potential confounders. RESULTS: The Kaplan-Meier curves were not statistically significant different between the RP group and the comparison group. However, the RP group had a higher cumulative probability of developing DR during the first six to seven years. The cumulative probability kept increasing and became higher in the comparison group but remained unchanged in the RP group. The HR for the RP patients comparing with the comparison group was 0.96 (95% confidence interval (CI = 0.43-2.14. Stratified by severity, RP was associated with a non-statistically significant reduced risk of proliferative DR (PDR (HR = 0.70, 95% CI = 0.16-3.14. The HR for non-proliferative DR (NPDR was 1.08 (95% CI = 0.40-2.86. CONCLUSION: In this study, RP was not statistically significant associated with the incidence of DR.

  13. Predictors of Adherence to Oral Bisphosphonate Therapy: A Register-based National Open Cohort Study

    DEFF Research Database (Denmark)

    Hansen, Carrinna; Pedersen, B D; Konradsen, Hanne;

    ≥ 80% for the first two years on treatment, group A), as patients who persisted with treatment for longer than 6 mo but had low refill compliance (MPR < 80%, group B) or as patients who stopped therapy early (≤ 84 defined daily doses in the first 6 mo and no prescriptions filled in the remaining period......, group C). Results: The study population consisted of 2962 men and 18,236 women, mean age 68.6 y. By multiple logistic regression, poor adherence (groups B + C vs group A) was significantly, albeit weakly, predicted by the number of co-medications (p < 0.001), use of proton pump inhibitors (p < 0.05) or...... H2-antagonists (p < 0.01) and younger age (p < 0.01) but not by gender (p = 0.23), comorbidity index (p = 0.28) or the use of prednisolone (p = 0.52). In the patients with poor adherence, early cessation of treatment (group C) was weakly associated with higher age (p < 0.01), use of proton pump...

  14. Resource allocation of in vitro fertilization: a nationwide register-based cohort study

    Directory of Open Access Journals (Sweden)

    Sevón Tiina

    2007-12-01

    Full Text Available Abstract Background Infertility is common and in vitro fertilization (IVF is a widely used treatment. In IVF the need increases and the effectiveness and appropriateness decrease by age. The purpose of this study was to describe allocation of resources for IVF by women's age, socioeconomic position, area of residence and treatment sector (public vs. private and to discuss how fairly the IVF resources are allocated in Finland. Methods Women who received IVF between 1996 and 1998 (N = 9175 were identified from the reimbursement records of the Social Insurance Institution (SII. Information on IVF women's background characteristics came from the Central Population Register and the SII, on treatment costs from IVF clinics and the SII, and on births from the Medical Birth Register. The main outcome measures were success of IVF by number of cycles and treated women, expenditures per IVF cycles, per women, per live-birth, and per treatment sector, and private and public expenditures. Expenditures were estimated from health care visits and costs. Results During a mean period of 1.5 years, older women (women aged 40 or older received 1.4 times more IVF treatment cycles than younger women (women aged below 30. The success rate decreased by age: from 22 live births per 100 cycles among younger women to 6 per 100 among older women. The mean cost of a live birth increased by age: compared to younger women, costs per born live birth of older women were 3-fold. Calculated by population, public expenditure was allocated most to young women and women from the highest socioeconomic position. Regional differences were not remarkable. Conclusion Children of older infertile women involve more expense due to the lower success rates of IVF. Socioeconomic differences suggest unfair resource allocation in Finland.

  15. OBAYA (obesity and adverse health outcomes in young adults: feasibility of a population-based multiethnic cohort study using electronic medical records

    Directory of Open Access Journals (Sweden)

    Koebnick Corinna

    2012-08-01

    Full Text Available Abstract Background Although obesity is a risk factor for many chronic diseases, we have only limited knowledge of the magnitude of these associations in young adults. A multiethnic cohort of young adults was established to close current knowledge gaps; cohort demographics, cohort retention, and the potential influence of migration bias were investigated. Methods For this population-based cross-sectional study, demographics, and measured weight and height were extracted from electronic medical records of 1,929,470 patients aged 20 to 39 years enrolled in two integrated health plans in California from 2007 to 2009. Results The cohort included about 84.4% of Kaiser Permanente California members in this age group who had a medical encounter during the study period and represented about 18.2% of the underlying population in the same age group in California. The age distribution of the cohort was relatively comparable to the underlying population in California Census 2010 population, but the proportion of women and ethnic/racial minorities was slightly higher. The three-year retention rate was 68.4%. Conclusion These data suggest the feasibility of our study for medium-term follow-up based on sufficient membership retention rates. While nationwide 6% of young adults are extremely obese, we know little to adequately quantify the health burden attributable to obesity, especially extreme obesity, in this age group. This cohort of young adults provides a unique opportunity to investigate associations of obesity-related factors and risk of cancer in a large multiethnic population.

  16. Short term adherence tool predicts failure on second line protease inhibitor-based antiretroviral therapy: an observational cohort study

    OpenAIRE

    Court, Richard; Leisegang, Rory; Stewart, Annemie; Sunpath, Henry; Murphy, Richard; Winternheimer, Philip; Ally, Mashuda; Maartens, Gary

    2014-01-01

    Background Most patients who experience virologic failure (VF) on second line antiretroviral therapy (ART) in low-middle income countries fail due to poor adherence rather than antiretroviral resistance. A simple adherence tool designed to detect VF would conserve resources by rationally limiting need for viral load (VL) testing and, in those countries with access to third line ART, the need for resistance testing. Methods We conducted an observational cohort study of patients who initiated s...

  17. Relative Risk of Acute Myocardial Infarction in People with Schizophrenia and Bipolar Disorder: A Population-Based Cohort Study

    OpenAIRE

    Shu-I Wu; Su-Chiu Chen; Shen-Ing Liu; Fang-Ju Sun; Jimmy J M Juang; Hsin-Chien Lee; Kai-Liang Kao; Dewey, Michael E; Martin Prince; Robert Stewart

    2015-01-01

    Objective Despite high mortality associated with serious mental illness, risk of acute myocardial infarction (AMI) remains unclear, especially for patients with bipolar disorder. The main objective was to investigate the relative risk of AMI associated with schizophrenia and bipolar disorders in a national sample. Method Using nationwide administrative data, an 11-year historic cohort study was assembled, comprised of cases aged 18 and above who had received a diagnosis of schizophrenia or bi...

  18. Does IQ explain socioeconomic inequalities in health? Evidence from a population based cohort study in the west of Scotland

    OpenAIRE

    Batty, G D; Der, Geoff; MacIntyre, S; Deary, Ian

    2006-01-01

    Objective: To test the hypothesis that IQ is a fundamental cause of socioeconomic inequalities in health. Design: Cross sectional and prospective cohort study, in which indicators of IQ were assessed by written test and socioeconomic position by self report. Setting: West of Scotland. Participants: 1347 people (739 women) aged 56 in 1987. Main outcome measures: Total mortality and coronary heart disease mortality (ascertained between 1987 and 2004); respiratory function, self ...

  19. Hospital contacts for injuries and musculoskeletal diseases among seamen and fishermen: A population-based cohort study

    OpenAIRE

    Olsen Jørn; Nielsen Per; Jensen Anker; Kaerlev Linda; Hannerz Harald; Tüchsen Finn

    2008-01-01

    Abstract Background We studied musculoskeletal diseases (MSD) and injuries among fishermen and seamen with focus on low back disorders, carpal tunnel syndrome (CTS), rotator cuff syndrome and arthrosis. Methods Cohorts of all male Danish seamen (officers and non-officers) and fishermen employed 1994 and 1999 with at least six months employment history were linked to the Occupational Hospitalisation Register. We calculated standardised incidence ratios (SIR) for the two time periods, using rat...

  20. Domestic Violence as a Risk Factor for Maternal Depression and Neonatal Outcomes: A Hospital-Based Cohort Study

    OpenAIRE

    Rida Nongrum; Elsy Thomas; Jessie Lionel; Kuruthukulangara S Jacob

    2014-01-01

    Objectives: This study attempted to follow up a cohort of women who presented to a tertiary hospital to investigate the effect of domestic violence on maternal and neonatal outcomes. Materials and Methods: Women, between 26-34 weeks of gestation, attending the obstetrics outpatient department, were recruited and followed up until delivery. They were assessed at recruitment and after delivery using the Edinburgh Postnatal Depression Scale, the Abuse Assessment Screen, and a pro forma to assess...

  1. Hypertensive disorders of pregnancy and the recent increase in obstetric acute renal failure in Canada: population based retrospective cohort study

    OpenAIRE

    Mehrabadi, Azar; Liu, Shiliang; Bartholomew, Sharon; Hutcheon, Jennifer A; Magee, Laura A.; Kramer, Michael S; Liston, Robert M; Joseph, K. S.

    2014-01-01

    Objective To examine whether changes in postpartum haemorrhage, hypertensive disorders of pregnancy, or other risk factors explain the increase in obstetric acute renal failure in Canada. Design Retrospective cohort study. Setting Canada (excluding the province of Quebec). Participants All hospital deliveries from 2003 to 2010 (n=2 193 425). Main outcome measures Obstetric acute renal failure identified by ICD-10 diagnostic codes. Methods Information on all hospital deliveries in Canada (excl...

  2. A longitudinal cohort based association study between uric acid level and metabolic syndrome in Chinese Han urban male population

    Directory of Open Access Journals (Sweden)

    Zhang Qian

    2012-06-01

    Full Text Available Abstract Background It has been recently demonstrated that serum uric acid (UA is associated with metabolic syndrome (MetS or its related clinical indications based on cross-sectional or prospective cohort studies. Nonetheless, due to the fact that UA level constantly fluctuates from time to time even for the person, using a single measure of UA level at baseline of those studies may not be sufficient for estimating the UA-Mets association. Methods To further estimate this time-dependent association, we fitted a generalized estimating equation (GEE regression model with data from a large-scale 6-year longitudinal study, which included 2222 participants aged > =25 years with an average of 3.5 repeated measures of UA per person in the Health Management Center of Shandong Provincial Hospital, Shandong, China. Results After adjusting for other potential confounding factors (i.e., total cholesterol, low-density lipoprotein, it was verified that time-dependent UA level was an independent risk factor for MetS (OR = 1.6920, p  Conclusions Serum UA level may serve as an important risk factor of MetS. Additionally, our study suggested that UA level be an independent risk factor to obesity, hypertension and dyslipidemia, but a protective factor to hyperglycemia. These findings are concordant with results from other studies on Asian populations, and jointly provide a basis to further develop a risk assessment model for predicting MetS using UA levels and other factors in China.

  3. Ischemic heart disease among subjects with and without chronic obstructive pulmonary disease – ECG-findings in a population-based cohort study

    OpenAIRE

    Nilsson, Ulf; Johansson, Bengt; Eriksson, Berne; Blomberg, Anders; Lundbäck, Bo; Lindberg, Anne

    2015-01-01

    Background Cardiovascular comorbidity in COPD is common and contributes to increased mortality. A few population-based studies indicate that ischemic electrocardiogram (ECG)-changes are more prevalent in COPD, while others do not. The aim of the present study was to estimate the presence of ischemic heart disease (IHD) in a population-based COPD-cohort in comparison with subjects without COPD. Methods All subjects with obstructive lung function (COPD, n = 993) were identified together with ag...

  4. A population-based cohort study of symptomatic gallstone disease in diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Chi-Ming Liu; Chung-Te Hsu; Chung-Yi Li; Chu-Chieh Chen; Meng-Lun Liu; Jorn-Hon Liu

    2012-01-01

    AIM:To investigate the prevalence of gallstone disease (GSD) and to evaluate the risk of symptomatic GSD among diabetic patients.METHODS:The study was conducted by analyzing the National Health Research Institutes (NHRI) dataset of ambulatory care patients,inpatient claims,and the updated registry of beneficiaries from 2000 to 2008.A total of 615 532 diabetic patients without a prior history of hospital treatment or ambulatory care visits for symptomatic GSD were identified in the year 2000.Age-and gender-matched control individuals free from both GSD and diabetes from 1997 to 1999 were randomly selected from the NHIR database (n =614 871).The incidence densities of symptomatic GSD were estimated according to the subjects' diabetic status.The distributions of age,gender,occupation,income,and residential area urbanization were compared between diabetic patients and control subjects using Cox proportion hazards models.Differences between the rates of selected comorbidities were also assessed in the two groups.RESULTS:Overall,60 734 diabetic patients and 48 116control patients developed symptomatic GSD and underwent operations,resulting in cumulative operation rates of 9.87% and 7.83%,respectively.The age and gender distributions of both groups were similar,with a mean age of 60 years and a predominance of females.The diabetic group had a significantly higher prevalence of all comorbidities of interest.A higher incidence of symptomatic GSD was observed in females than in males in both groups.In the control group,females under the age of 64 had a significantly higher incidence of GSD than the corresponding males,but this difference was reduced with increasing age.The cumulative incidences of operations for symptomatic GSD in the diabetic and control groups were 13.06 and 9.52 cases per 1000 person-years,respectively.Diabetic men exhibited a higher incidence of operations for symptomatic GSD than did their counterparts in the control group (12.35vs 8.75 cases per

  5. COBA-Cohort: a prospective cohort of HIV-negative men who have sex with men, attending community-based HIV testing services in five European countries (a study protocol)

    Science.gov (United States)

    Fernàndez-López, Laura; Fuertes, Ricardo; Rojas Castro, Daniela; Pichon, François; Cigan, Bojan; Chanos, Sophocles; Meireles, Paula; Morel, Stéphane; Slaaen Kaye, Per; Agustí, Cristina; Klavs, Irena; Casabona, Jordi

    2016-01-01

    Introduction Community-based voluntary counselling and testing (CBVCT) services for men who have sex with men (MSM) can reach those most-at-risk and provide an environment for gay men that is likely to be non-stigmatising. Longitudinal data on the behaviour of HIV-negative MSM are scarce in Europe. The aim of this protocol, developed during the Euro HIV Early Diagnosis And Treatment (EDAT) project, is to implement a multicentre community-based cohort of HIV-negative MSM attending 15 CBVCT services in 5 European countries. Research objectives (1) To describe the patterns of CBVCT use, (2) to estimate HIV incidence, and to identify determinants of (3) HIV seroconversion and (4) HIV and/or sexually transmitted infection (STI) test-seeking behaviour. Methods and analysis All MSM aged 18 years or over and who had a negative HIV test result are invited to participate in the COmmunity-BAsed Cohort (COBA-Cohort). Study enrolment started in February 2015, and is due to continue for at least 12 months at each study site. Follow-up frequency depends on the testing recommendations in each country (at least 1 test per year). Sociodemographic data are collected at baseline; baseline and follow-up questionnaires both gather data on attitudes and perceptions, discrimination, HIV/STI testing history, sexual behaviour, condom use, and pre- and post-exposure prophylaxis. Descriptive, exploratory and multivariate analyses will be performed to address the main research objectives of this study, using appropriate statistical tests and models. These analyses will be performed on the whole cohort data and stratified by study site or country. Ethics and dissemination The study was approved by the Public Health authorities of each country where the study is being implemented. Findings from the COBA-Cohort study will be summarised in a report to the European Commission, and in leaflets to be distributed to study participants. Articles and conference abstracts will be submitted to peer

  6. Fetal alcohol exposure and IQ at age 8: evidence from a population-based birth-cohort study.

    Directory of Open Access Journals (Sweden)

    Sarah J Lewis

    Full Text Available Observational studies have generated conflicting evidence on the effects of moderate maternal alcohol consumption during pregnancy on offspring cognition mainly reflecting problems of confounding. Among mothers who drink during pregnancy fetal alcohol exposure is influenced not only by mother's intake but also by genetic variants carried by both the mother and the fetus. Associations between children's cognitive function and both maternal and child genotype at these loci can shed light on the effects of maternal alcohol consumption on offspring cognitive development.We used a large population based study of women recruited during pregnancy to determine whether genetic variants in alcohol metabolising genes in this cohort of women and their children were related to the child's cognitive score (measured by the Weschler Intelligence Scale at age 8.We found that four genetic variants in alcohol metabolising genes in 4167 children were strongly related to lower IQ at age 8, as was a risk allele score based on these 4 variants. This effect was only seen amongst the offspring of mothers who were moderate drinkers (1-6 units alcohol per week during pregnancy (per allele effect estimates were -1.80 (95% CI= -2.63 to -0.97 p=0.00002, with no effect among children whose mothers abstained during pregnancy (0.16 (95%CI= -1.05 to 1.36 p=0.80, p-value for interaction  =0.009. A further genetic variant associated with alcohol metabolism in mothers was associated with their child's IQ, but again only among mothers who drank during pregnancy.

  7. Comparative Outcome Analysis of Penicillin-Based Versus Fluoroquinolone-Based Antibiotic Therapy for Community-Acquired Pneumonia: A Nationwide Population-Based Cohort Study.

    Science.gov (United States)

    Wang, Chi-Chuan; Lin, Chia-Hui; Lin, Kuan-Yin; Chuang, Yu-Chung; Sheng, Wang-Huei

    2016-02-01

    Community-acquired pneumonia (CAP) is a common but potentially life-threatening condition, but limited information exists on the effectiveness of fluoroquinolones compared to β-lactams in outpatient settings. We aimed to compare the effectiveness and outcomes of penicillins versus respiratory fluoroquinolones for CAP at outpatient clinics.This was a claim-based retrospective cohort study. Patients aged 20 years or older with at least 1 new pneumonia treatment episode were included, and the index penicillin or respiratory fluoroquinolone therapies for a pneumonia episode were at least 5 days in duration. The 2 groups were matched by propensity scores. Cox proportional hazard models were used to compare the rates of hospitalizations/emergence service visits and 30-day mortality. A logistic model was used to compare the likelihood of treatment failure between the 2 groups.After propensity score matching, 2622 matched pairs were included in the final model. The likelihood of treatment failure of fluoroquinolone-based therapy was lower than that of penicillin-based therapy (adjusted odds ratio [AOR], 0.88; 95% confidence interval [95%CI], 0.77-0.99), but no differences were found in hospitalization/emergence service (ES) visits (adjusted hazard ratio [HR], 1.27; 95% CI, 0.92-1.74) and 30-day mortality (adjusted HR, 0.69; 95% CI, 0.30-1.62) between the 2 groups.The likelihood of treatment failure of fluoroquinolone-based therapy was lower than that of penicillin-based therapy for CAP on an outpatient clinic basis. However, this effect may be marginal. Further investigation into the comparative effectiveness of these 2 treatment options is warranted. PMID:26871827

  8. The risk of cancer in patients with congenital heart disease: a nationwide population-based cohort study in Taiwan.

    Directory of Open Access Journals (Sweden)

    Yu-Sheng Lee

    Full Text Available The relationship between congenital heart disease (CHD and malignancies has not been determined. This study aimed to explore the association of CHD with malignancies and examine the risk factors for the development of cancer after a diagnosis of CHD.This nationwide, population-based cohort study on cancer risk evaluated 31,961 patients with newly diagnosed CHD using the Taiwan National Health Insurance Research Database (NHIRD between 1998 and 2006. The standardized incidence ratios (SIRs for all and specific cancer types were analyzed, while the Cox proportional hazard model was used to evaluate risk factors of cancer occurrence.Among patients with newly diagnosed CHD regardless of ages, 187 (0.6% subsequently developed cancers after a diagnosis of CHD. Patients with CHD had increased risk of cancer (SIR, 1.45; 95% CI, 1.25-1.67, as well as significantly elevated risks of hematologic (SIR, 4.04; 95% CI, 2.76-5.70, central nervous system (CNS (SIR, 3.51; 95% CI, 1.92-5.89, and head and neck (SIR, 1.81; 95% CI, 1.03-2.94 malignancies. Age (HR, 1.06; 95% CI, 1.05-1.06 and co-morbid chronic liver disease (HR, 1.91; 95% CI, 1.27-2.87 were independent risk factors for cancer occurrence among CHD patients.Patients with CHD have significantly increased cancer risk, particularly hematologic, CNS, and head and neck malignancies. Physicians who care for patients with CHD should be aware of their predisposition to malignancy after the diagnosis of CHD. Further studies are warranted to clarify the association between CHD and malignancies.

  9. The impact of maternal celiac disease on birthweight and preterm birth: a Danish population-based cohort study.

    LENUS (Irish Health Repository)

    Khashan, A S

    2012-01-31

    BACKGROUND: Adverse pregnancy outcomes have been associated with maternal celiac disease (CD). In this study, we investigate the effect of treated and untreated maternal CD on infant birthweight and preterm birth. METHODS: A population-based cohort study consisted of all singleton live births in Denmark between 1 January 1979 and 31 December 2004 was used. A total of 1,504,342 babies were born to 836,241 mothers during the study period. Of those, 1105 babies were born to women with diagnosed CD and 346 were born to women with undiagnosed CD. Women with diagnosed CD were considered as treated with a gluten free diet while women with undiagnosed CD were considered as untreated. The outcome measures were: birthweight, small for gestational age (SGA: birthweight <10th centile), very small for gestational age (VSGA: birthweight <5th centile) and preterm birth. We compared these measures in treated and untreated women with those of a reference group (no history of CD). RESULTS: Women with untreated CD delivered smaller babies [difference = -98 g (95% CI: -130, -67)], with a higher risk of SGA infants [OR = 1.31 (95% CI: 1.06, 1.63)], VSGA infants [OR = 1.54 (95% CI: 1.17, 2.03)] and preterm birth [OR = 1.33 (95% CI: 1.02, 1.72)] compared with women without CD. Women with treated CD had no increased risk of reduced mean birthweight, risk of delivering SGA and VSGA infants or preterm birth compared with women without CD. CONCLUSION: Untreated maternal CD increases the risk of reduced birthweight, the risk of delivering SGA and VSGA infants and preterm birth. Diagnosis and presumed treatment of maternal CD with a gluten-free diet appeared to result in a birthweight and preterm birth rate similar to those in women without CD.

  10. Psychosocial functioning and intelligence both partly explain socioeconomic inequalities in premature death. A population-based male cohort study.

    Directory of Open Access Journals (Sweden)

    Daniel Falkstedt

    Full Text Available OBJECTIVE: The possible contributions of psychosocial functioning and intelligence differences to socioeconomic status (SES-related inequalities in premature death were investigated. None of the previous studies focusing on inequalities in mortality has included measures of both psychosocial functioning and intelligence. METHODS: The study was based on a cohort of 49 321 men born 1949-1951 from the general community in Sweden. Data on psychosocial functioning and intelligence from military conscription at ∼18 years of age were linked with register data on education, occupational class, and income at 35-39 years of age. Psychosocial functioning was rated by psychologists as a summary measure of differences in level of activity, power of initiative, independence, and emotional stability. Intelligence was measured through a multidimensional test. Causes of death between 40 and 57 years of age were followed in registers. RESULTS: The estimated inequalities in all-cause mortality by education and occupational class were attenuated with 32% (95% confidence interval: 20-45% and 41% (29-52% after adjustments for individual psychological differences; both psychosocial functioning and intelligence contributed to account for the inequalities. The inequalities in cardiovascular and injury mortality were attenuated by as much as 51% (24-76% and 52% (35-68% after the same adjustments, and the inequalities in alcohol-related mortality were attenuated by up to 33% (8-59%. Less of the inequalities were accounted for when those were measured by level of income, with which intelligence had a weaker correlation. The small SES-related inequalities in cancer mortality were not attenuated by adjustment for intelligence. CONCLUSIONS: Differences in psychosocial functioning and intelligence might both contribute to the explanation of observed SES-related inequalities in premature death, but the magnitude of their contributions likely varies with measure of

  11. Efficacy and safety of rilpivirine-based regimens in treatment-experienced HIV-1 infected patients: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Sandrine Gazaignes

    2014-11-01

    Full Text Available Introduction: Rilpivirine (RPV is a new once-daily, non-nucleoside, reverse transcriptase inhibitor (NNRTI. In treatment-naïve patients, RPV has shown non-inferior antiviral activity to efavirenz but data in treatment-experienced patients are more limited. We assessed the efficacy and safety of RPV in treatment-experienced patients switching to a RPV-based regimen. Methods: Between September 2012 and June 2013, all antiretroviral therapy (ART experienced HIV-1 infected patients with a plasma HIV-RNA level <50 cp/mL, and switching to a RPV-based regimen, were enrolled in this prospective monocentric cohort study. Clinical and laboratory data were collected every 3 months to assess safety and efficacy. The primary endpoint was the proportion of patients with virologic success (HIV-RNA load <50 cp/mL at 12 months using the FDA snapshot algorithm. Results: A total of 281 patients (76% male, median age: 47 years, 56% MSM were enrolled in this study. Median lymphocyte CD4 count at baseline was 640/mm3. Patients have received ART for a median of 7 years and viral replication was fully suppressed for a median of 3 years. Before the switch, 39% patients were treated with NNRTI, 52% with protease inhibitor and 7% with integrase inhibitor-based regimens. Reasons for switch were simplification (176 cases, adverse events (AEs (93 cases and others (12 cases. At month 12 (database frozen on June 2014 in the snapshot analysis, 56% of patients met virologic success, 5% experienced virologic failure (n=14 and 39% had no data in the window period. In the LOCF analysis (using data from the previous available visit before month 12, 89% patients were suppressed, 5% had virologic failure and 6% had no data. Genotypic resistance analysis was performed in 7/14 patients at the time of virologic failure (3 of whom had previous NRTI/NNRTI resistance-associated mutations (RAMs, and new NNRTI and NRTI RAMs emerged in 4 patients. RPV-based regimen was generally well

  12. Risk of affective disorders following prenatal exposure to severe life events: a Danish population-based cohort study.

    LENUS (Irish Health Repository)

    Khashan, Ali S

    2012-01-31

    OBJECTIVE: To examine the effect of prenatal exposure to severe life events on risk of affective disorders in the offspring. METHODS: In a cohort of 1.1 million Danish births from May 1978 until December 1997, mothers were considered exposed if one (or more) of their close relatives died or was diagnosed with serious illness up to 6 months before conception or during pregnancy. Offspring were followed up from their 10th birthday until their death, migration, onset of affective disorder or 31 December 2007; hospital admissions were identified by linkage to the Central Psychiatric Register. Log-linear Poisson regression was used for data analysis. RESULTS: The risk of affective disorders was increased in male offspring whose mothers were exposed to severe life events during the second trimester (adjusted RR 1.55 [95% CI 1.05-2.28]). There was an increased risk of male offspring affective disorders in relation to maternal exposure to death of a relative in the second trimester (adjusted RR 1.74 [95% CI 1.06-2.84]) or serious illness in a relative before pregnancy (adjusted RR 1.44 [95% CI 1.02-2.05]). There was no evidence for an association between prenatal exposure to severe life events and risk of female offspring affective disorders. CONCLUSIONS: Our population-based study suggests that prenatal maternal exposure to severe life events may increase the risk of affective disorders in male offspring. These findings are consistent with studies of populations exposed to famine and earthquake disasters which indicate that prenatal environment may influence the neurodevelopment of the unborn child.

  13. Extent of ductal carcinoma in situ according to breast cancer subtypes: a population-based cohort study.

    Science.gov (United States)

    Doebar, Shusma C; van den Broek, Esther C; Koppert, Linetta B; Jager, Agnes; Baaijens, Margreet H A; Obdeijn, Inge-Marie A M; van Deurzen, Carolien H M

    2016-07-01

    Ductal carcinoma in situ (DCIS) is a precursor of invasive breast carcinoma (IBC). The DCIS component is often more extensive than the invasive component, which affects local control. The aim of our study was to analyze features of DCIS within different IBC subtypes, which may contribute to the optimization of personalized approaches for patients with IBC. Patients with IBC reported according to the synoptic reporting module in the Netherlands between 2009 and 2015 were included. Data extraction included characteristics of the invasive component and, if present, several features of the DCIS component. Resection margin status analyses were restricted to patients undergoing breast-conserving surgery (BCS). Differences between subtypes were tested by a Chi-square test, spearman's Rho test or a one-way ANOVA test. Overall, 36.937 cases of IBC were included. About half of the IBCs (n = 16.014; 43.4 %) were associated with DCIS. Her2+ IBC (irrespective of ER status) was associated with a higher prevalence of adjacent DCIS, a larger extent of DCIS and a higher rate of irradicality of the DCIS component as compared to ER+/Her2- and triple-negative subtypes (P IBC on the other hand was lowest. In this large population-based cohort study, we showed significant differences between the prevalence and extent of DCIS according to IBC subtypes, which is also reflected in the resection margin status in patients treated with BCS. Our data provide important information regarding the optimization of local therapy according to IBC subtypes. PMID:27318854

  14. Gastrointestinal and liver disease in Adult Life After Childhood Cancer in Scandinavia: A population-based cohort study.

    Science.gov (United States)

    Asdahl, Peter Haubjerg; Winther, Jeanette Falck; Bonnesen, Trine Gade; De Fine Licht, Sofie; Gudmundsdottir, Thorgerdur; Holmqvist, Anna Sällfors; Malila, Nea; Tryggvadottir, Laufey; Wesenberg, Finn; Dahlerup, Jens Frederik; Olsen, Jørgen Helge; Hasle, Henrik

    2016-10-01

    Survival after childhood cancer diagnosis has remarkably improved, but emerging evidence suggests that cancer-directed therapy may have adverse gastrointestinal late effects. We aimed to comprehensively assess the frequency of gastrointestinal and liver late effects among childhood cancer survivors and compare this frequency with the general population. Our population-based cohort study included all 1-year survivors of childhood and adolescent cancer in Denmark, Finland, Iceland, Norway and Sweden diagnosed from the 1940s and 1950s. Our outcomes of interest were hospitalization rates for gastrointestinal and liver diseases, which were ascertained from national patient registries. We calculated standardized hospitalization rate ratios (RRs) and absolute excess rates comparing hospitalizations of any gastrointestinal or liver disease and for specific disease entities between survivors and the general population. The study included 31,132 survivors and 207,041 comparison subjects. The median follow-up in the hospital registries were 10 years (range: 0-42) with 23% of the survivors being followed at least to the age of 40 years. Overall, survivors had a 60% relative excess of gastrointestinal or liver diseases [RR: 1.6, 95% confidence interval (CI): 1.6-1.7], which corresponds to an absolute excess of 360 (95% CI: 330-390) hospitalizations per 100,000 person-years. Survivors of hepatic tumors, neuroblastoma and leukemia had the highest excess of gastrointestinal and liver diseases. In addition, we observed a relative excess of several specific diseases such as esophageal stricture (RR: 13; 95% CI: 9.2-20) and liver cirrhosis (RR: 2.9; 95% CI: 2.0-4.1). Our findings provide useful information about the breadth and magnitude of late complications among childhood cancer survivors and can be used for generating hypotheses about potential exposures related to these gastrointestinal and liver late effects. PMID:27194488

  15. The effect of optic disc diameter on vertical cup to disc ratio percentiles in a population based cohort: the Blue Mountains Eye Study

    OpenAIRE

    Crowston, J G; Hopley, C R; Healey, P R; Lee, A.; Mitchell, P

    2004-01-01

    Objective: The 97.5th percentile for vertical cup to disc ratio (VCDR) has been proposed as a useful tool to assist in the diagnosis of glaucoma in population studies. Previous reports of VCDR percentiles have either not been adjusted for disc size or have been calculated by regression analysis from small hospital based cohorts. The authors’ aim was to generate VCDR percentiles in a large, population based sample.

  16. Cognitive and educational outcomes of being born small-for-gestational-age : A longitudinal study based on Stockholm Birth Cohort

    OpenAIRE

    Yu, Bing

    2016-01-01

    The aim of this study is to examine the long-term cognitive effects and educational outcomes of being born small-for-gestational-age (SGA). It also assesses whether the family’s attitude towards education modifies the effect of SGA on cognitive performance. A total of 9598 children born in 1953 and living in the Stockholm metropolitan area in 1963 were included in this study. Data were obtained from the Stockholm Birth Cohort. Multiple ordinary least square regressions analyses suggest that S...

  17. Pioglitazone and risk of bladder cancer among diabetic patients in France: a population-based cohort study

    OpenAIRE

    Neumann, A.; Weill, A.; Ricordeau, P.; Fagot, J. P.; Alla, F.; Allemand, H.

    2012-01-01

    Aims/hypothesis Previous studies have suggested an increased risk of bladder cancer with pioglitazone exposure. We aimed to investigate the association between pioglitazone exposure and bladder cancer in France. Methods This cohort study involved use of data from the French national health insurance information system (Système National d'Information Inter-régimes de l'Assurance Maladie; SNIIRAM) linked with the French hospital discharge database (Programme de Médicalisation des Systèmes d'Inf...

  18. Dairy Intake and Coronary Heart Disease or Stroke – a population-based cohort study in the Netherlands

    OpenAIRE

    Dalmeijer, G.W.; Struijk, E.A.; van, der Schouw, Yvonne T.; Soedamah-Muthu, S. S.; W M M Verschuren; Geleijnse, J M

    2013-01-01

    AIM: This study aimed to investigate the relationship between total dairy intake and dairy subtypes (high-fat dairy, low-fat dairy, milk and milk products, cheese and fermented dairy) with incident coronary heart disease (CHD) and stroke. METHODS: EPIC-NL is a prospective cohort study among 33,625 Dutch men and women. At baseline (1993-1997), dairy intake was measured with a validated food frequency questionnaire (FFQ). The incidence of both fatal and non-fatal CHD and stroke was obtained by ...

  19. Hospital contacts for injuries and musculoskeletal diseases among seamen and fishermen: A population-based cohort study

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    Olsen Jørn

    2008-01-01

    Full Text Available Abstract Background We studied musculoskeletal diseases (MSD and injuries among fishermen and seamen with focus on low back disorders, carpal tunnel syndrome (CTS, rotator cuff syndrome and arthrosis. Methods Cohorts of all male Danish seamen (officers and non-officers and fishermen employed 1994 and 1999 with at least six months employment history were linked to the Occupational Hospitalisation Register. We calculated standardised incidence ratios (SIR for the two time periods, using rates for the entire Danish workforce as a reference. Results Among fishermen, we found high SIRs for knee arthrosis, thoraco-lumbar disc disorders, injuries and statistically significant SIRs above 200 were seen for both rotator cuff syndrome and CTS. The SIR was augmented for injuries and reduced for hip arthrosis between the two time periods. The SIRs for injuries and CTS were high for non-officers. A sub-analysis revealed that the highest risk for CTS was found among male non-officers working as deck crew, SIR 233 (95% CI: 166–317 based on 40 cases. Among officers, the SIRs for injuries and MSDs were low. The number of employed Danish fishermen declined with 25% 1994–1999 to 3470. Short-term employments were common. None of the SIRs increased with increasing length of employment. Conclusion Both fishermen and non-officers have high SIRs for injuries and fishermen also for MSD. Only the SIR for injuries among fishermen was augmented between 1994 and 1999. Our findings suggest an association between the incidence of rotator cuff syndrome and CTS and work within fishery. Long-term cumulative effects of employment were not shown for any of the disease outcomes. Other conditions may play a role.

  20. Association of Diabetes in Pregnancy with Child Weight at Birth, Age 12 Months and 5 Years – A Population-Based Electronic Cohort Study

    OpenAIRE

    Morgan, Kelly; Rahman, Mohammed; Atkinson, Mark; Zhou, Shang-Ming; Hill, Rebecca; Khanom, Ashrafunnesa; Paranjothy, Shantini; Brophy, Sinead

    2013-01-01

    Background This study examines the effect of diabetes in pregnancy on offspring weight at birth and ages 1 and 5 years. Methods A population-based electronic cohort study using routinely collected linked healthcare data. Electronic medical records provided maternal diabetes status and offspring weight at birth and ages 1 and 5 years (n = 147,773 mother child pairs). Logistic regression models were used to obtain odds ratios to describe the association between maternal diabetes status and offs...

  1. International travel and the risk of hospitalization with non-typhoidal Salmonella bacteremia. A Danish population-based cohort study, 1999-2008

    OpenAIRE

    Mølbak Kåre; Ethelberg Steen; Holt Hanne M; Kristensen Brian; Koch Kristoffer; Schønheyder Henrik C

    2011-01-01

    Abstract Background Information is sparse regarding the association between international travel and hospitalization with non-typhoidal Salmonella bacteremia. The aim of this study was to determine the proportion, risk factors and outcomes of travel-related non-typhoidal Salmonella bacteremia. Methods We conducted a 10-year population-based cohort study of all patients hospitalized with non-typhoidal Salmonella bacteremia in three Danish counties (population 1.6 million). We used denominator ...

  2. Maternal eating disorder and infant diet. A latent class analysis based on the Norwegian Mother and Child Cohort Study (MoBa)

    OpenAIRE

    Torgersen, Leila; Ystrom, Eivind; Siega-Riz, Anna Maria; Berg, Cecilie Knoph; Zerwas, Stephanie; Reichborn-Kjennerud, Ted; Bulik, Cynthia M.

    2014-01-01

    Knowledge of infant diet and feeding practices among children of mothers with eating disorders is essential to promote healthy eating in these children. This study compared the dietary patterns of 6-month-old children of mothers with anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified - purging subtype, to the diet of children of mothers with no eating disorders. The study was based on 53,879 mothers in the Norwegian Mother and Child Cohort St...

  3. Economic Impact of Adverse Drug Events – A Retrospective Population-Based Cohort Study of 4970 Adults

    Science.gov (United States)

    Gyllensten, Hanna; Hakkarainen, Katja M.; Hägg, Staffan; Carlsten, Anders; Petzold, Max; Rehnberg, Clas; Jönsson, Anna K.

    2014-01-01

    Background The aim was to estimate the direct costs caused by ADEs, including costs for dispensed drugs, primary care, other outpatient care, and inpatient care, and to relate the direct costs caused by ADEs to the societal COI (direct and indirect costs), for patients with ADEs and for the entire study population. Methods We conducted a population-based observational retrospective cohort study of ADEs identified from medical records. From a random sample of 5025 adults in a Swedish county council, 4970 were included in the analyses. During a three-month study period in 2008, direct and indirect costs were estimated from resource use identified in the medical records and from register data on costs for resource use. Results Among 596 patients with ADEs, the average direct costs per patient caused by ADEs were USD 444.9 [95% CI: 264.4 to 625.3], corresponding to USD 21 million per 100 000 adult inhabitants per year. Inpatient care accounted for 53.9% of all direct costs caused by ADEs. For patients with ADEs, the average societal cost of illness was USD 6235.0 [5442.8 to 7027.2], of which direct costs were USD 2830.1 [2260.7 to 3399.4] (45%), and indirect costs USD 3404.9 [2899.3 to 3910.4] (55%). The societal cost of illness was higher for patients with ADEs compared to other patients. ADEs caused 9.5% of all direct healthcare costs in the study population. Conclusions Healthcare costs for patients with ADEs are substantial across different settings; in primary care, other outpatient care and inpatient care. Hence the economic impact of ADEs will be underestimated in studies focusing on inpatient ADEs alone. Moreover, the high proportion of indirect costs in the societal COI for patients with ADEs suggests that the observed costs caused by ADEs would be even higher if including indirect costs. Additional studies are needed to identify interventions to prevent and manage ADEs. PMID:24637879

  4. Cohort Profile: Golestan Hepatitis B Cohort Study- A Prospective Long Term Study in Northern Iran ​

    OpenAIRE

    Poustchi, Hossein; Katoonizadeh, Aezam; Ostovaneh, Mohammad Reza; Moossavi, Shirin; Sharafkhah, Maryam; Esmaili, Saeed; Pourshams, Akram; Mohamadkhani, Ashraf; Besharat, Sima; Merat, Shahin; Mohamadnejad, Mehdi; George, Jacob; Malekzadeh, Reza

    2014-01-01

    Hepatitis B virus (HBV) infection is the most common cause of end stage liver disease in Iran and in Golestan province. Large-scale population-based prospective cohort studies with long term follow-up are the method of choice to accurately understand the natural course of HBV infection. To date, several studies of HBV epidemiology, natural history, progression to cirrhosis and association with HCC have been reported from other countries. However, few of these are prospective and fewer still a...

  5. Riyadh Mother and Baby Multicenter Cohort Study: The Cohort Profile

    Science.gov (United States)

    Esmaeil, Samia; Alzeidan, Rasmieh; Elawad, Mamoun; Tabassum, Rabeena; Hansoti, Shehnaz; Magzoup, Mohie Edein; Al-Kadri, Hanan; Elsherif, Elham; Al-Mandil, Hazim; Al-Shaikh, Ghadeer; Zakaria, Nasria

    2016-01-01

    Objectives To assess the effects of non-communicable diseases, such as diabetes, hypertension and obesity, on the mother and the infant. Methods A multicentre cohort study was conducted in three hospitals in the city of Riyadh in Saudi Arabia. All Saudi women and their babies who delivered in participating hospitals were eligible for recruitment. Data on socio-demographic characteristics in addition to the maternal and neonatal outcomes of pregnancy were collected. The cohort demographic profile was recorded and the prevalence of maternal conditions including gestational diabetes, pre-gestational diabetes, hypertensive disorders in pregnancy and obesity were estimated. Findings The total number of women who delivered in participating hospitals during the study period was 16,012 of which 14,568 women participated in the study. The mean age of the participants was 29 ± 5.9 years and over 40% were university graduates. Most of the participants were housewives, 70% were high or middle income and 22% were exposed to secondhand smoke. Of the total cohort, 24% were married to a first cousin. More than 68% of the participants were either overweight or obese. The preterm delivery rate was 9%, while 1.5% of the deliveries were postdate. The stillbirth rate was 13/1000 live birth. The prevalence of gestational diabetes was 24% and that of pre-gestational diabetes was 4.3%. The preeclampsia prevalence was 1.1%. The labour induction rate was 15.5% and the cesarean section rate was 25%. Conclusion Pregnant women in Saudi Arabia have a unique demographic profile. The prevalence of obesity and diabetes in pregnancy are among the highest in the world. PMID:26937965

  6. Riyadh Mother and Baby Multicenter Cohort Study: The Cohort Profile.

    Directory of Open Access Journals (Sweden)

    Hayfaa Wahabi

    Full Text Available To assess the effects of non-communicable diseases, such as diabetes, hypertension and obesity, on the mother and the infant.A multicentre cohort study was conducted in three hospitals in the city of Riyadh in Saudi Arabia. All Saudi women and their babies who delivered in participating hospitals were eligible for recruitment. Data on socio-demographic characteristics in addition to the maternal and neonatal outcomes of pregnancy were collected. The cohort demographic profile was recorded and the prevalence of maternal conditions including gestational diabetes, pre-gestational diabetes, hypertensive disorders in pregnancy and obesity were estimated.The total number of women who delivered in participating hospitals during the study period was 16,012 of which 14,568 women participated in the study. The mean age of the participants was 29 ± 5.9 years and over 40% were university graduates. Most of the participants were housewives, 70% were high or middle income and 22% were exposed to secondhand smoke. Of the total cohort, 24% were married to a first cousin. More than 68% of the participants were either overweight or obese. The preterm delivery rate was 9%, while 1.5% of the deliveries were postdate. The stillbirth rate was 13/1000 live birth. The prevalence of gestational diabetes was 24% and that of pre-gestational diabetes was 4.3%. The preeclampsia prevalence was 1.1%. The labour induction rate was 15.5% and the cesarean section rate was 25%.Pregnant women in Saudi Arabia have a unique demographic profile. The prevalence of obesity and diabetes in pregnancy are among the highest in the world.

  7. The Effects of Anti-Dementia and Nootropic Treatments on the Mortality of Patients with Dementia: A Population-Based Cohort Study in Taiwan

    OpenAIRE

    Chen-Yi Wu; Hsiao-Yun Hu; Lok-Hi Chow; Yiing-Jenq Chou; Nicole Huang; Pei-Ning Wang; Chung-Pin Li

    2015-01-01

    Background Few studies have examined the contribution of treatment on the mortality of dementia based on a population-based study. Objective To investigate the effects of anti-dementia and nootropic treatments on the mortality of dementia using a population-based cohort study. Methods 12,193 incident dementia patients were found from 2000 to 2010. Their data were compared with 12,193 age- and sex-matched non-dementia controls that were randomly selected from the same database. Dementia was cl...

  8. Adverse outcomes after major surgery in patients with pressure ulcer: a nationwide population-based retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Chia-Lun Chou

    Full Text Available Postoperative adverse outcomes in patients with pressure ulcer are not completely understood. This study evaluated the association between preoperative pressure ulcer and adverse events after major surgeries.Using reimbursement claims from Taiwan's National Health Insurance Research Database, we conducted a nationwide retrospective cohort study of 17391 patients with preoperative pressure ulcer receiving major surgery in 2008-2010. With a propensity score matching procedure, 17391 surgical patients without pressure ulcer were selected for comparison. Eight major surgical postoperative complications and 30-day postoperative mortality were evaluated among patients with pressure ulcer of varying severity.Patients with preoperative pressure ulcer had significantly higher risk than controls for postoperative adverse outcomes, including septicemia, pneumonia, stroke, urinary tract infection, and acute renal failure. Surgical patients with pressure ulcer had approximately 1.83-fold risk (95% confidence interval 1.54-2.18 of 30-day postoperative mortality compared with control group. The most significant postoperative mortality was found in those with serious pressure ulcer, such as pressure ulcer with local infection, cellulitis, wound or treatment by change dressing, hospitalized care, debridement or antibiotics. Prolonged hospital or intensive care unit stay and increased medical expenditures were also associated with preoperative pressure ulcer.This nationwide propensity score-matched retrospective cohort study showed increased postoperative complications and mortality in patients with preoperative pressure ulcer. Our findings suggest the urgency of preventing and managing preoperative pressure ulcer by a multidisciplinary medical team for this specific population.

  9. Short- and Long-Term Major Cardiovascular Adverse Events in Carotid Artery Interventions: A Nationwide Population-Based Cohort Study in Taiwan

    OpenAIRE

    Ming-Lung Tsai; Chun-Tai Mao; Dong-Yi Chen; I-Chang Hsieh; Ming-Shien Wen; Tien-Hsing Chen

    2015-01-01

    Introduction Carotid artery stenosis is one of the leading causes of ischemic stroke. Carotid artery stenting has become well-established as an effective treatment option for carotid artery stenosis. For this study, we aimed to determine the efficacy and safety of carotid stenting in a population-based large cohort of patients by analyzing the Taiwan National Healthcare Insurance (NHI) database. Methods 2,849 patients who received carotid artery stents in the NHI database from 2004 to 2010 we...

  10. Improved Survival in Patients with Viral Hepatitis-Induced Hepatocellular Carcinoma Undergoing Recommended Abdominal Ultrasound Surveillance in Ontario: A Population-Based Retrospective Cohort Study

    OpenAIRE

    Thein, Hla-Hla; Campitelli, Michael A.; Yeung, Latifa T.; Zaheen, Ahmad; Yoshida, Eric M; Earle, Craig C

    2015-01-01

    The optimal schedule for ultrasonographic surveillance of patients with viral hepatitis for the detection of hepatocellular carcinoma (HCC) remains unclear owing to a lack of reliable studies. We examined the timing of ultrasonography in patients with viral hepatitis-induced HCC and its impact on survival and mortality risk while determining predictors of receiving surveillance before HCC diagnosis. A population-based retrospective cohort analysis of patients with viral hepatitis-induced HCC ...

  11. Sitagliptin and risk of heart failure hospitalization in patients with type 2 diabetes on dialysis: A population-based cohort study.

    Science.gov (United States)

    Hung, Yi-Chih; Lin, Che-Chen; Huang, Wei-Lun; Chang, Man-Ping; Chen, Ching-Chu

    2016-01-01

    The incidence of heart failure hospitalization (HHF) after taking sitagliptin in type 2 diabetes (T2DM) patients with end stage renal disease (ESRD) on dialysis is unclear. In this population-based cohort study, we identified individuals with T2DM and ESRD on dialysis who were treated with sitagliptin between 2009 and 2011 and randomly selected a control cohort matched by age, sex, duration of T2DM, hypertension medications, use of statin and aspirin, sulfonylureas, glinides, and insulin usage, atherosclerotic heart disease, congestive heart failure and chronic obstructive pulmonary disease at a 1:4 ratio. Multivariable Cox proportional hazards regression analysis was used to evaluate HHF risk. The overall incidence of HHF was higher in the sitagliptin cohort than in the control cohort (1130 vs. 754 per 10000 person-years; adjusted hazard ratio (HR): 1.52, 95% CI = 1.21-1.90). There was a significant trend towards increased HHF risk associated with increased sitagliptin dose (p for trend ACE inhibitors treatment, with history of heart failure or receiving hemodialysis rather than peritoneal dialysis. In conclusion, use of sitagliptin was associated with an increased risk of HHF in patients with T2DM on dialysis. PMID:27460913

  12. Sitagliptin and risk of heart failure hospitalization in patients with type 2 diabetes on dialysis: A population-based cohort study

    Science.gov (United States)

    Hung, Yi-Chih; Lin, Che-Chen; Huang, Wei-Lun; Chang, Man-Ping; Chen, Ching-Chu

    2016-01-01

    The incidence of heart failure hospitalization (HHF) after taking sitagliptin in type 2 diabetes (T2DM) patients with end stage renal disease (ESRD) on dialysis is unclear. In this population-based cohort study, we identified individuals with T2DM and ESRD on dialysis who were treated with sitagliptin between 2009 and 2011 and randomly selected a control cohort matched by age, sex, duration of T2DM, hypertension medications, use of statin and aspirin, sulfonylureas, glinides, and insulin usage, atherosclerotic heart disease, congestive heart failure and chronic obstructive pulmonary disease at a 1:4 ratio. Multivariable Cox proportional hazards regression analysis was used to evaluate HHF risk. The overall incidence of HHF was higher in the sitagliptin cohort than in the control cohort (1130 vs. 754 per 10000 person-years; adjusted hazard ratio (HR): 1.52, 95% CI = 1.21–1.90). There was a significant trend towards increased HHF risk associated with increased sitagliptin dose (p for trend < 0.01). Subjects at greater risk of HHF after taking sitagliptin were those without severe hypoglycemia, without ACE inhibitors treatment, with history of heart failure or receiving hemodialysis rather than peritoneal dialysis. In conclusion, use of sitagliptin was associated with an increased risk of HHF in patients with T2DM on dialysis. PMID:27460913

  13. Does Sitagliptin Affect the Rate of Osteoporotic Fractures in Type 2 Diabetes? Population-Based Cohort Study

    Science.gov (United States)

    Josse, Robert G.; Lin, Mu; Eurich, Dean T.

    2016-01-01

    Context: Type 2 diabetes and osteoporosis are both common, chronic, and increase with age, whereas type 2 diabetes is also a risk factor for major osteoporotic fractures (MOFs). However, different treatments for type 2 diabetes can affect fracture risk differently, with metaanalyses showing some agents increase risk (eg, thiazolidinediones) and some reduce risk (eg, sitagliptin). Objective: To determine the independent association between new use of sitagliptin and MOF in a large population-based cohort study. Design, Setting, and Subjects: A sitagliptin new user study design employing a nationally representative Unites States claims database of 72 738 insured patients with type 2 diabetes. We used 90-day time-varying sitagliptin exposure windows and controlled confounding by using multivariable analyses that adjusted for clinical data, comorbidities, and time-updated propensity scores. Main Outcomes: We compared the incidence of MOF (hip, clinical spine, proximal humerus, distal radius) in new users of sitagliptin vs nonusers over a median 2.2 years follow-up. Results: At baseline, the median age was 52 years, 54% were men, and median A1c was 7.5%. There were 8894 new users of sitagliptin and 63 834 nonusers with a total 181 139 person-years of follow-up. There were 741 MOF (79 hip fractures), with 53 fractures (4.8 per 1000 person-years) among new users of sitagliptin vs 688 fractures (4.0 per 1000 person-years) among nonusers (P = .3 for difference). In multivariable analyses, sitagliptin was not associated with fracture (adjusted hazard ratio 1.1, 95% confidence interval 0.8–1.4; P = .7), although insulin (P < .001), sulfonylureas (P < .008), and thiazolidinedione (P = .019) were each independently associated with increased fracture risk. Conclusions: Even in a young population with type 2 diabetes, osteoporotic fractures were not uncommon. New use of sitagliptin was not associated with fracture, but other commonly used second-line agents for type 2 diabetes

  14. A Study of Group Dynamics in Educational Leadership Cohort and Non-Cohort Groups

    Science.gov (United States)

    Greenlee, Bobbie J.; Karanxha, Zorka

    2010-01-01

    The purpose of this study was to examine group dynamics of educational leadership students in cohorts and make comparisons with the group dynamics characteristics of non-cohort students. Cohorts have emerged as dynamic and adaptive entities with attendant group dynamic processes that shape collective learning and action. Cohort (n=42) and…

  15. Differences in late fetal death rates in association with determinants of small for gestational age fetuses: population based cohort study

    Science.gov (United States)

    Cnattingius, Sven; Haglund, Bengt; Kramer, Michael S

    1998-01-01

    Objective: To examine differences in late fetal death rates in association with determinants of small for gestational age fetuses. Design: Population based cohort study. Subjects: 1 026 249 pregnancies without congenital malformations. Setting: Sweden 1983-92. Main outcome measure: Late fetal death rate. Results: Depending on underlying determinants late fetal death rates were greatly increased in extremely small for gestational age fetuses (range 16 to 45 per 1000) compared with non-small for gestational age fetuses (1.4 to 4.6). In extremely small for gestational age fetuses late fetal death rates were increased from 31 per 1000 in mothers aged less than 35 years to 45 per 1000 in older mothers, and from 22 per 1000 in women <155 cm in height to 33 per 1000 in women ⩾175 cm tall. Late fetal death rates were also higher in extremely small for gestational age fetuses in singleton compared with twin pregnancies and in non-hypertensive pregnancies compared with pregnancies complicated by severe pre-eclampsia or other hypertensive disorders. Slightly higher late fetal death rates were observed in nulliparous compared with parous women and in non-smokers compared with smokers. Conclusions: Although the risk of late fetal death is greatly increased in fetuses that are extremely small for gestational age the risk is strongly modified by underlying determinants—for example, there is a lower risk of late fetal death in a small for gestational age fetus if the mother is of short stature, has a twin pregnancy, or has hypertension. Key messages Small for gestational age fetuses are at increased risk of late fetal death regardless of the underlying determinants The effect of birthweight ratio on risk of late fetal death is modified by underlying determinants, except maternal age Regardless of birthweight ratio the rates of late fetal death are higher among women aged 35 years or older compared with younger women In pregnancies of extremely small for gestational age

  16. Risk of myocardial infarction in parents of HIV-infected individuals: a population-based cohort study

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Omland, Lars H; Pedersen, Court;

    2010-01-01

    controls and their parents were identified. Cumulative incidence functions were constructed to illustrate time to first MI of the parents as registered in the Danish National Hospital Registry. Incidence rate ratios (IRR) were estimated by Cox's regression analyses. Due to the confidential type...... of MI in parents of HIV-infected individuals METHODS: From the Danish HIV Cohort Study and the Danish Civil Registration System we identified the parents of all HIV-infected patients born in Denmark after 1952 in whom a Danish born mother was identifiable. For each HIV patient, 4 matched population...... of the analysed data the study was approved by the Danish Data Protection Agency. RESULTS: 2,269 mothers and 2,022 fathers of HIV patients as well as 9,076 mothers and 8,460 fathers of control subjects were identified. We observed an increased risk of MI in mothers of HIV patients (adjusted IRR, 1.31; 95% CI: 1...

  17. Prelabor Cesarean Section and Risk of Childhood Type 1 Diabetes A Nationwide Register-based Cohort Study

    DEFF Research Database (Denmark)

    Clausen, Tine Dalsgaard; Bergholt, Thomas; Eriksson, Frank;

    2016-01-01

    BACKGROUND: Unfavorable conditions associated with cesarean section may influence the risk of type 1 diabetes in offspring, but results from studies are conflicting. We aimed to evaluate the association between prelabor cesarean section and risk of childhood type 1 diabetes. METHODS: A Danish...... nationwide cohort study followed all singletons born during 1982-2010. Five national registers provided information on mode of delivery, outcome, and confounders. The risk of childhood type 1 diabetes with onset before the age of 15 years was assessed by Cox regression. A total of 1,760,336 singletons...... contributed 20,436,684 person-years, during which 4,400 were diagnosed with childhood type 1 diabetes. RESULTS: The hazard ratio for childhood type 1 diabetes was increased in children delivered by prelabor cesarean section compared with vaginal delivery when adjusted for year of birth, parity, sex, parental...

  18. Association Between Prepartum Maternal Iron Deficiency and Offspring Risk of Schizophrenia: Population-Based Cohort Study With Linkage of Danish National Registers

    DEFF Research Database (Denmark)

    2010-01-01

    a diagnosis of anemia at any time during the pregnancy. Cohort members were followed from their 10th birthday until onset of schizophrenia, death, or December 31, 2008, whichever came first. Adjusted for relevant confounders, cohort members whose mothers had received a diagnosis of anemia during......Recent findings suggest that maternal iron deficiency may increase the risk of schizophrenia-spectrum disorder in offspring. We initiated this study to determine whether maternal prepartum anemia influences offspring risk of schizophrenia. We conducted a population-based study with individual...... pregnancy had a 1.60-fold (95% confidence interval = 1.16-2.15) increased risk of schizophrenia. Although the underlying mechanisms are unknown and independent replication is needed, our findings suggest that maternal iron deficiency increases offspring risk of schizophrenia....

  19. Association Between Prepartum Maternal Iron Deficiency and Offspring Risk of Schizophrenia: Population-Based Cohort Study With Linkage of Danish National Registers

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Nielsen, Philip R; Pedersen, Carsten B;

    2011-01-01

    a diagnosis of anemia at any time during the pregnancy. Cohort members were followed from their 10th birthday until onset of schizophrenia, death, or December 31, 2008, whichever came first. Adjusted for relevant confounders, cohort members whose mothers had received a diagnosis of anemia during......Recent findings suggest that maternal iron deficiency may increase the risk of schizophrenia-spectrum disorder in offspring. We initiated this study to determine whether maternal prepartum anemia influences offspring risk of schizophrenia. We conducted a population-based study with individual...... pregnancy had a 1.60-fold (95% confidence interval = 1.16-2.15) increased risk of schizophrenia. Although the underlying mechanisms are unknown and independent replication is needed, our findings suggest that maternal iron deficiency increases offspring risk of schizophrenia....

  20. The short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Nandini Sreenivasan

    Full Text Available BACKGROUND AND OBJECTIVE: Varicella zoster virus (VZV is known to cause VZV vasculopathy, which may be associated with stroke. A recent study found an increased risk of stroke within one year of herpes zoster. We aimed to investigate the short and long-term effects of herpes zoster on the risk of stroke. METHODS: Using Danish national registers, we constructed a cohort consisting of all Danish adults ≥18 years old between 1995 and 2008 (n = 4.6 million; person-years of follow-up = 52.9 million. Individual-level information on prescriptions for herpes zoster antiviral treatment and diagnoses of stroke was obtained from national registers. We compared the risk of stroke in persons who had received the specific dosage of acyclovir for herpes zoster with persons who had never received antiviral treatment by Poisson regression. RESULTS: During follow-up, 2.5% received treatment for herpes zoster and 5.0% were diagnosed with stroke. Individuals who had received medication had a 127% (95% CI 83-182% increased risk the first two weeks, 17% (CI 9-24% between two weeks and one year, and 5% (2-9% after the first year. The increased risk was greatest in the youngest age group (<40. To control for healthcare-seeking behaviour, we conducted parallel analyses investigating the risk of selected fractures after herpes zoster and found no similar increased risks. CONCLUSIONS: This large nationwide cohort study found an increased risk of stroke after treatment for herpes zoster. Although the short-term risk was particularly high, we cannot rule out the possibility of a small but important long-term risk.

  1. Cohort profile: golestan hepatitis B cohort study- a prospective long term study in northern iran ​.

    Science.gov (United States)

    Poustchi, Hossein; Katoonizadeh, Aezam; Ostovaneh, Mohammad Reza; Moossavi, Shirin; Sharafkhah, Maryam; Esmaili, Saeed; Pourshams, Akram; Mohamadkhani, Ashraf; Besharat, Sima; Merat, Shahin; Mohamadnejad, Mehdi; George, Jacob; Malekzadeh, Reza

    2014-10-01

    Hepatitis B virus (HBV) infection is the most common cause of end stage liver disease in Iran and in Golestan province. Large-scale population-based prospective cohort studies with long term follow-up are the method of choice to accurately understand the natural course of HBV infection. To date, several studies of HBV epidemiology, natural history, progression to cirrhosis and association with HCC have been reported from other countries. However, few of these are prospective and fewer still are population-based. Moreover, the underlying molecular mechanisms and immunogenetic determinants of the outcome of HBV infection especially in low and middle income countries remains largely unknown. Therefore, the hepatitis B cohort study (HBCS), nested as part of the Golestan Cohort Study (GCS), Golestan, Iran was established in 2008 with the objective to prospectively investigate the natural course of chronic hepatitis B with reference to its epidemiology, viral/host genetic interactions, clinical features and outcome in the Middle East where genotype D HBV accounts for >90% of infections. In 2008, a baseline measurement of HBV surface antigen (HBsAg) was performed on stored serum samples of all GCS participants. A sub-cohort of 3,505 individuals were found to be HBsAg positive and were enrolled in the Golestan HBCS. In 2011, all first degree relatives of HBsAg positive subjects including their children and spouses were invited for HBV serology screening and those who were positive for HBsAg were also included in the Golestan HBCS. PMID:25349681

  2. Hospitalization for pneumonia among individuals with and without HIV infection, 1995-2007: a Danish population-based, nationwide cohort study

    DEFF Research Database (Denmark)

    Sogaard, O.S.; Lohse, N.; Gerstoft, J.; Kronborg, G.; Ostergaard, L.; Pedersen, C.; Pedersen, G.; Sorensen, H.T.; Obel, N.; Sogaard, Ole S; Lohse, Nicolai; Gerstoft, Jan; Kronborg, Gitte; Ostergaard, Lars; Pedersen, Court; Pedersen, Gitte; Sørensen, Henrik Toft; Obel, Niels

    2008-01-01

    population. METHODS: This was an observational cohort study conducted during 1995-2007. Each member of a Danish population-based nationwide cohort of HIV-infected individuals was matched with up to 99 control individuals from the general population. Data on age, mortality, emigration, and hospital discharge......BACKGROUND: Human immunodeficiency virus (HIV)-infected individuals with high CD4(+) cell counts may have increased susceptibility to other infections. We compared incidence rates of pneumonia among individuals with and without HIV infection and explored risk factors for pneumonia in the HIV-infected...... diagnoses from 1977 onward were obtained from nationwide administrative databases. Individuals without previous hospitalization for pneumonia were observed from the date of HIV diagnosis until the first hospitalization to treat pneumonia (excluding pneumonia attributable to Pneumocystis jiroveci). Risk...

  3. Maternal use of fertility drugs and risk of cancer in children--a nationwide population-based cohort study in Denmark

    DEFF Research Database (Denmark)

    Hargreave, Marie; Jensen, Allan; Nielsen, Thor Schütt Svane;

    2015-01-01

    and follicle-stimulating hormone], gonadotropin-releasing hormone analogs, human chorionic gonadotropins, progesterone and other fertility drugs). We found no statistically significant association between maternal use of fertility drugs and risk for overall cancer in childhood or young adulthood......Large population-based studies are needed to examine the effect of maternal use of fertility drugs on the risk of cancer in children, while taking into account the effect of the underlying infertility. A cohort of 123,322 children born in Denmark between 1964 and 2006 to 68,255 women who had been...... evaluated for infertility was established. We used a case-cohort design and calculated hazard ratios (HRs) for cancer in childhood (0-19 years) and in young adulthood (20-29 years) associated with maternal use of six groups of fertility drugs (clomiphene, gonadotropins [i.e., human menopausal gonadotropins...

  4. The Participation of HPV-Vaccinated Women in a National Cervical Screening Program: Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Eva Herweijer

    Full Text Available Concerns have been raised that HPV-vaccination might affect women's cervical screening behavior. We therefore investigated the association between opportunistic HPV-vaccination and attendance after invitation to cervical screening.A cohort of all women resident in Sweden, born 1977-1987 (N=629,703, and invited to cervical screening, was followed October 2006 - December 2012. Invitations to screening were identified via the National Quality Register for Cervical Cancer Prevention, as was the primary outcome of a registered smear. Vaccination status was obtained from two nationwide health data registers. Hazard ratios (HR were estimated using Cox regression adjusted for age, education level and income (HRadj. Women were individually followed for up to 6 years, of which the first and second screening rounds were analyzed separately.Screening attendance after three years of follow-up was 86% in vaccinated women (N=4,897 and 75% in unvaccinated women (N=625,804. The crude HR of screening attendance in vaccinated vs. unvaccinated women was 1.31 (95% CI 1.27-1.35 in the first screening round. Adjustment for education and income reduced but did not erase this difference (HRadj=1.09, 95% CI 1.05-1.13. In the second screening round, attendance was likewise higher in HPV-vaccinated women (crude HR=1.26, 95% CI 1.21-1.32; HRadj=1.15, 95% CI 1.10-1.20.HPV-vaccination is so far associated with equal or higher attendance to cervical screening in Sweden in a cohort of opportunistically vaccinated young women. Most but not all of the difference in attendance was explained by socioeconomic differences between vaccinated and unvaccinated women. HPV vaccine effectiveness studies should consider screening attendance of HPV-vaccinated women when assessing incidence of screen-detected cervical lesions.

  5. Cohort profile: Lifelines DEEP, a prospective, general population cohort study in the northern Netherlands: study design and baseline characteristics

    OpenAIRE

    Tigchelaar, E.F.; Zhernakova, A; Dekens, J.A.M.; Hermes, G.D.A.; Baranska, A.; Mujagic, Z.; M.A. Swertz; Munoz, A.M.; Deelen, P.; Cenit, M. C.; Franke, L; Scholtens, S.; Stolk, R.P.; Wijmenga, C; Feskens, E.J.M.

    2015-01-01

    Purpose: There is a critical need for population-based prospective cohort studies because they follow individuals before the onset of disease, allowing for studies that can identify biomarkers and disease-modifying effects, and thereby contributing to systems epidemiology. Participants: This paper describes the design and baseline characteristics of an intensively examined subpopulation of the LifeLines cohort in the Netherlands. In this unique subcohort, LifeLines DEEP, we included 1539 part...

  6. The MANGUA Project: A Population-Based HIV Cohort in Guatemala

    OpenAIRE

    Juan Ignacio García; Blanca Samayoa; Meritxell Sabidó; Luis Alberto Prieto; Mikhail Nikiforov; Rodolfo Pinzón; Luis Roberto Santa Marina de León; José Fernando Ortiz; Ernesto Ponce; Carlos Rodolfo Mejía; Eduardo Arathoon; Jordi Casabona; The Mangua Cohort Study Group

    2015-01-01

    Introduction. The MANGUA cohort is an ongoing multicenter, observational study of people living with HIV/AIDS in Guatemala. The cohort is based on the MANGUA application which is an electronic database to capture essential data from the medical records of HIV patients in care. Methods. The cohort enrolls HIV-positive adults ≥16 years of age. A predefined set of sociodemographic, behavioral, clinical, and laboratory data are registered at entry to the cohort study. Results. As of October 1st, ...

  7. Dysthymia increases the risk of temporomandibular disorder: A population-based cohort study (A STROBE-Compliant Article).

    Science.gov (United States)

    Lin, Shang-Lun; Wu, Shang-Liang; Ko, Shun-Yao; Lu, Ching-Hsiang; Wang, Diew-Wei; Ben, Ren-Jy; Horng, Chi-Ting; Yang, Jung-Wu

    2016-07-01

    Numerous studies have investigated the relationship between depression and temporomandibular disorders (TMD), but the conclusions remain vague. The aim of this study was to examine the causal effect between depression and TMD.The reporting of this study conforms to the STROBE statement. In this retrospective cohort study, all samples were recruited from a representative subdataset of 1 million insured persons for the year 2005 Longitudinal Health Insurance Database, who were randomly selected from all beneficiaries enrolled in the National Health Insurance program of Taiwan. We used a propensity score and stratified 926,560 patients into 2 groups (propensity1 = 588,429 and propensity2 = 338,131) and 4 cohorts (propensity1 with depression = 18,038, propensity1 without depression = 570,391, propensity2 with depression = 38,656, propensity2 without depression = 299,475) to detect the development of TMD among the depressive and nondepressive patients between 2004 and 2013.The positive correlative factors of TMD included female, total number of times seeking medical advice (TTSMA) for anxiety state, TTSMA for generalized anxiety disorder, TTSMA for mandible fracture, and TTSMA for unspecified anomaly of jaw size. The propensity2 group was represented by elder and female-predominant patients who used more psychiatric health resources. Among 3 types of depression, only dysthymia (so-called chronic depression) had a causal impact on TMD in the propensity 2 group. In the propensity 2 group, the hazard ratio of dysthymia for TMD measured by Cox's regression was 1.64 (95% confidence interval 1.28-2.09), after adjusting for demographic factors, psychiatric comorbidities, and maxillofacial confounders. The first-onset mean time of TMD as the consequence of dysthymia was 3.56 years (sd = 2.74, min = 0.08, median = 2.99, max = 9.73).This study demonstrates that dysthymia increases the risk of TMD in elderly and female-predominant patients

  8. Fracture Risk Is Decreased in Women With Polycystic Ovary Syndrome: A Register-Based and Population-Based Cohort Study.

    Science.gov (United States)

    Rubin, Katrine Hass; Glintborg, Dorte; Nybo, Mads; Andersen, Marianne; Abrahamsen, Bo

    2016-04-01

    Hyperandrogenism, obesity, and hyperinsulinemia may protect against osteoporosis, whereas amenorrhea, increased cortisol, and low growth hormone may be associated with higher fracture risk in polycystic ovary syndrome (PCOS). The objective of this study was to investigate fracture risk in PCOS. In the PCOS Denmark study, women with PCOS and/or hirsutism were identified in the Danish National Patient Register (1995-2012). Each patient was assigned three age-matched controls on the index date of PCOS diagnosis. Individuals with a previous endocrine diagnosis were excluded. Within PCOS Denmark, we embedded a well-characterized subcohort of patients, PCOS OUH, diagnosed with PCOS at Odense University Hospital (n = 1217). We identified incident fractures by International Classification of Diseases, 10th Revision (ICD-10) codes and used conditional Cox regression analyses to compare fracture risk. In the PCOS Denmark study, there were 19,199 women with PCOS and 57,483 controls were included, mean age 30.6 years (range, 12-60 years). Fracture rates were decreased in PCOS Denmark (10.3/1000 patient years) versus controls (13.6/1000 patient years). The adjusted ORs were 0.76 (95% CI, 0.71 to 0.80) for all fractures, 0.82 (95% CI, 0.74 to 0.92) for major osteoporotic fractures, and 0.57 (95% CI, 0.47 to 0.70) for fractures of head and face. The risk reduction was more pronounced below the age of 30 years at diagnosis. Women with PCOS had significant more hospital contacts due to strains and sprains. In the PCOS OUH subcohort, the risk reduction of fractures did not differ between PCOS women with elevated versus normal testosterone levels and the risk reduction was nominally smaller in overweight versus normal weight PCOS women. Women with PCOS had reduced risk of fractures, in particular of the appendicular skeleton. The risk reduction was greater in women with younger age at diagnosis suggesting that the skeletal effects of PCOS may be greater in women who have not yet

  9. Does Low Participation in Cohort Studies Induce Bias?

    DEFF Research Database (Denmark)

    Nøhr, Ellen Aagaard; Frydenberg, Morten; Henriksen, Tine Brink; Olsen, Jørn

    2006-01-01

    confidence intervals gave very similar results and a small simulation study showed that the coverage probabilities were close to the 95% nominal level Conclusion: For the three chosen associations the odds ratios were not biased by non-participation. The results are reassuring for studies based on the Danish...... cohort and similar cohorts of pregnant women. The methodology used to compute confidence intervals for the relative odds ratios performed well in the scenarios considered.......Background: Participation rates in large cohort studies have dropped during the last two decades. The consequences of this trend for relative risk estimation are unknown. Methods: The impact of a low participation rate (30%) on the Danish National Birth Cohort was examined among 49,751 women from...

  10. Maternal Pre-Pregnancy BMI and Intelligence Quotient (IQ) in 5-Year-Old Children: A Cohort Based Study

    OpenAIRE

    Bliddal, Mette; Olsen, Jørn; Støvring, Henrik; Eriksen, Hanne-Lise F.; Kesmodel, Ulrik S.; Sørensen, Thorkild I A; Nøhr, Ellen A.

    2014-01-01

    Background An association between maternal pre-pregnancy BMI and childhood intelligence quotient (IQ) has repeatedly been found but it is unknown if this association is causal or due to confounding caused by genetic or social factors. Methods We used a cohort of 1,783 mothers and their 5-year-old children sampled from the Danish National Birth Cohort. The children participated between 2003 and 2008 in a neuropsychological assessment of cognitive ability including IQ tests taken by both the mo...

  11. A population-based cohort study of late mortality in adult autologous hematopoietic stem cell transplant recipients in Australia.

    Science.gov (United States)

    Ashton, Lesley J; Le Marsney, Renate E; Dodds, Anthony J; Nivison-Smith, Ian; Wilcox, Leonie; O'Brien, Tracey A; Vajdic, Claire M

    2014-07-01

    We assessed overall and cause-specific mortality and risk factors for late mortality in a nation-wide population-based cohort of 4547 adult cancer patients who survived 2 or more years after receiving an autologous hematopoietic stem cell transplantation (HSCT) in Australia between 1992 and 2005. Deaths after HSCT were identified from the Australasian Bone Marrow Transplant Recipient Registry and through data linkage with the National Death Index. Overall, the survival probability was 56% at 10 years from HSCT, ranging from 34% for patients with multiple myeloma to 90% for patients with testicular cancer. Mortality rates moved closer to rates observed in the age- and sex-matched Australian general population over time but remained significantly increased 11 or more years from HSCT (standardized mortality ratio, 5.9). Although the proportion of deaths from nonrelapse causes increased over time, relapse remained the most frequent cause of death for all diagnoses, 10 or more years after autologous HSCT. Our findings show that prevention of disease recurrence remains 1 of the greatest challenges for autologous HSCT recipients, while the increasing rates of nonrelapse deaths due to the emergence of second cancers, circulatory diseases, and respiratory diseases highlight the long-term health issues faced by adult survivors of autologous HSCT. PMID:24631736

  12. Review of Cohort Studies for Mood Disorders.

    Science.gov (United States)

    Jeon, Hong Jin; Baek, Ji Hyun; Ahn, Yong-Min; Kim, Se Joo; Ha, Tae Hyun; Cha, Boseok; Moon, Eunsoo; Kang, Hee-Ju; Ryu, Vin; Cho, Chul-Hyun; Heo, Jung-Yoon; Kim, Kiwon; Lee, Heon-Jeong

    2016-05-01

    This paper aimed to review currently available cohort studies of subjects with mood disorders such as major depressive disorder (MDD) and bipolar disorder (BD). Using the PubMed and KoreaMed databases, we reviewed eight major cohort studies. Most studies recruited participants with MDD and BD separately, so direct comparison of factors associated with diagnostic changes was difficult. Regular and frequent follow-up evaluations utilizing objective mood ratings and standardized evaluation methods in a naturalistic fashion are necessary to determine detailed clinical courses of mood disorders. Further, biological samples should also be collected to incorporate clinical findings in the development of new diagnostic and therapeutic approaches. An innovative cohort study that can serve as a platform for translational research for treatment and prevention of mood disorders is critical in determining clinical, psychosocial, neurobiological and genetic factors associated with long-term courses and consequences of mood disorders in Korean patients. PMID:27247592

  13. Stress and epilepsy: a population-based cohort study of epilepsy in parents who lost a child

    DEFF Research Database (Denmark)

    Christensen, Jakob; Li, Jiong; Vestergaard, Mogens;

    2007-01-01

    OBJECTIVE: The goal of the study described here was to study the risk for epilepsy in parents exposed to severe stress caused by loss of a child. METHODS: The risk of being diagnosed with epilepsy (Danish National Hospital Register) in a cohort of parents who had lost a child under the age of 18...... was compared with the risk among parents who had not lost a child. RESULTS: The adjusted relative risk (RR) of epilepsy in parents who had lost a child was 1.50 (95% CI: 1.21-1.86). The RR was modified by time since bereavement and was 2.46 (95% CI: 1.49-4.07) in mothers and 1.92 (95% CI: 1.09-3.36) in fathers...... within the first 3 years of loss of a child, and 2.10 (95% CI: 1.53-2.88) in mothers and 0.66 (95% CI: 0.41-1.06) in fathers 4 to 18 years after loss. CONCLUSIONS: Stress was associated with a moderately increased risk of being diagnosed with epilepsy. Udgivelsesdato: 2007-Nov...

  14. Incidence and Predictors of Multiple Fractures Despite High Adherence to Oral Bisphosphonates: A Binational Population-Based Cohort Study.

    Science.gov (United States)

    Hawley, Samuel; Javaid, M Kassim; Rubin, Katrine H; Judge, Andrew; Arden, Nigel K; Vestergaard, Peter; Eastell, Richard; Diez-Perez, Adolfo; Cooper, Cyrus; Abrahamsen, Bo; Prieto-Alhambra, Daniel

    2016-01-01

    Oral bisphosphonates (BPs) are highly effective in preventing fractures and are recommended first-line therapies for patients with osteoporosis. We identified the incidence and predictors of oral BP treatment failure, defined as the incidence of two or more fractures while on treatment (≥2 FWOT) among users with high adherence. Fractures were considered from 6 months after treatment initiation and up to 6 months after discontinuation. Data from computerized records and pharmacy invoices were obtained from Sistema d'Informació per al Desenvolupament de l'Investigació en Atenció Primària (SIDIAP; Catalonia, Spain) and Danish Health Registries (Denmark) for all incident users of oral BPs in 2006-2007 and 2000-2001, respectively. Fine and Gray survival models using backward-stepwise selection (p-entry 0.049; p- exit 0.10) and accounting for the competing risk of therapy cessation were used to identify predictors of ≥2 FWOT among patients having persisted with treatment ≥6 months with overall medication possession ratio (MPR) ≥80%. Incidence of ≥2 FWOT was 2.4 (95% confidence interval [CI], 1.8 to 3.2) and 1.7 (95% CI, 1.2 to 2.2) per 1000 patient-years (PYs) within Catalonia and Denmark, respectively. Older age was predictive of ≥2 FWOT in both Catalonian and Danish cohorts: subhazard ratio (SHR) = 2.28 (95% CI, 1.11 to 4.68) and SHR = 2.61 (95% CI, 0.98 to 6.95), respectively, for 65 to <80 years; and SHR = 3.19 (95% CI, 1.33 to 7.69) and SHR = 4.88 (95% CI, 1.74 to 13.7), respectively, for ≥80 years. Further significant predictors of ≥2 FWOT identified within only one cohort were dementia, SHR = 4.46 (95% CI, 1.02 to 19.4) (SIDIAP); and history of recent or older fracture, SHR = 3.40 (95% CI, 1.50 to 7.68) and SHR = 2.08 (95% CI: 1.04-4.15), respectively (Denmark). Even among highly adherent users of oral BP therapy, a minority sustain multiple fractures while on treatment. Older age was predictive of increased risk

  15. Domestic violence as a risk factor for maternal depression and neonatal outcomes: A hospital-based cohort study

    Directory of Open Access Journals (Sweden)

    Rida Nongrum

    2014-01-01

    Full Text Available Objectives: This study attempted to follow up a cohort of women who presented to a tertiary hospital to investigate the effect of domestic violence on maternal and neonatal outcomes. Materials and Methods: Women, between 26-34 weeks of gestation, attending the obstetrics outpatient department, were recruited and followed up until delivery. They were assessed at recruitment and after delivery using the Edinburgh Postnatal Depression Scale, the Abuse Assessment Screen, and a pro forma to assess socio-demographic and clinical characteristics. Bivariate and multivariate statistics were employed to assess statistical significance. Results: One hundred and fifty women were recruited, 132 delivered in the hospital and were followed up. Domestic violence was associated with antenatal and postnatal depression, spouse′s insistence of a boy baby, medical complications during pregnancy, preterm delivery, and lower birth-weight. Conclusion: Domestic violence has a significant impact on maternal and neonatal outcomes. Screening for domestic violence and interventions should be part of all antenatal programs. India should also employ public health approaches to change its patriarchal culture.

  16. Association between perinatal depression in mothers and the risk of childhood infections in offspring: a population-based cohort study

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    West Joe

    2010-12-01

    Full Text Available Abstract Background Previous studies have suggested that children of mothers who experience depression during the perinatal period may have more infections, but such studies are few in number and none have been carried out in the United Kingdom (UK population. The aim of this study was to investigate the association between perinatal depression in mothers and the risk of childhood infections in offspring in the UK general population. Methods We used data from The Health Improvement Network (THIN, a large database of electronic primary care medical records to conduct a cohort study among all first-born singleton children born and enrolled in THIN between 1988 and 2004. We used Poisson regression to compare the incidence of gastrointestinal infections and lower respiratory tract infections reported between birth and age 4 years among children of mothers with a record of perinatal depression with those born to mothers with no such history. Results Children of mothers with perinatal depression had a 40% increased risk of gastrointestinal infections and a 27% increased risk of lower respiratory tract infections compared with children of mothers without perinatal depression (incidence rate ratios = 1.40 and 1.27; 95% confidence intervals 1.37-1.42 and 1.22-1.32, respectively. On restricting to antibiotic-treated infections there was a slight increase in the magnitude of association with gastrointestinal infections but a decrease in that with lower respiratory tract infections (incidence rate ratios = 1.47 and 1.19; 95% confidence intervals 1.34-1.61 and 1.11-1.27, respectively. Conclusions Maternal perinatal depression is associated with increased rates of childhood gastrointestinal infections, particularly more severe infections, and lower respiratory tract infections in the UK. Preventing maternal perinatal depression may avoid substantial morbidity among offspring, although further work is also needed to investigate the detailed reasons for these

  17. Clarithromycin in early pregnancy and the risk of miscarriage and malformation: a register based nationwide cohort study.

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    Jon Trærup Andersen

    Full Text Available BACKGROUND: The antibiotic clarithromycin has been associated with fetal loss in animals and a study has found a doubling in the frequency of miscarriages among women using clarithromycin in pregnancy. The aim of the study was to investigate whether clarithromycin use in early pregnancy was associated with an increased risk for miscarriages and major malformations. METHODS: We conducted a nationwide cohort study including all women in Denmark with a known conception between 1997 and 2007. The Fertility Database was used to identify all women giving birth and the National Hospital Register was used to identify all women with a record of miscarriage or induced abortion. Prescription data was obtained from the National Prescription Register. The primary outcome was the number of miscarriages and offspring with major congenital malformations among users of clarithromycin compared to non-users. RESULTS: We identified 931 504 pregnancies (705 837 live births, 77 553 miscarriages, and 148 114 induced abortions. 401 women redeemed a prescription of clarithromycin in the first trimester of which 40 (10.0% experienced a miscarriage and among the live born nine (3.6% had offspring with malformations. The hazard ratio (HR of having a miscarriage after exposure to clarithromycin was 1.56 (CI95% 1.14-2.13. There was no increased hazard of having a miscarriage when being exposed to penicillin or erythromycin. There was no increased prevalence (OR = 1.03 (CI95% 0.52-2.00 of having offspring with malformations after exposure to clarithromycin. CONCLUSIONS: We found an increased hazard of miscarriage but no increased prevalance of having offspring with malformations among women redeeming a prescription of clarithromycin in early pregnancy. This is supported by previous studies in animals and humans. However, further research is required to explore the possible effect of treatment indication on the associations found.

  18. Gestational Age at Birth and 'Body-Mind' Health at 5 Years of Age: A Population Based Cohort Study.

    Science.gov (United States)

    Cronin, Frances M; Segurado, Ricardo; McAuliffe, Fionnuala M; Kelleher, Cecily C; Tremblay, Richard E

    2016-01-01

    Numerous studies have identified the effects of prematurity on the neonate's physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000-2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children's general health and severity of behavior problems. The association between parent's general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32-36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%-6.2%), compared to 1% (0.2-2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies. PMID:26975048

  19. Gestational Age at Birth and ‘Body-Mind’ Health at 5 Years of Age: A Population Based Cohort Study

    Science.gov (United States)

    Segurado, Ricardo; McAuliffe, Fionnuala M.; Kelleher, Cecily C.

    2016-01-01

    Numerous studies have identified the effects of prematurity on the neonate’s physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000–2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children’s general health and severity of behavior problems. The association between parent’s general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32–36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%–6.2%), compared to 1% (0.2–2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies. PMID:26975048

  20. Long-term survival of women with basal-like ductal carcinoma in situ of the breast: a population-based cohort study

    OpenAIRE

    Zhou, Wenjing; Jirström, Karin; Johansson, Christine; Amini, Rose-Marie; Blomqvist, Carl; Agbaje, Olorunsola; Wärnberg, Fredrik

    2010-01-01

    Background Microarray gene-profiling of invasive breast cancer has identified different subtypes including luminal A, luminal B, HER2-overexpressing and basal-like groups. Basal-like invasive breast cancer is associated with a worse prognosis. However, the prognosis of basal-like ductal carcinoma in situ (DCIS) is still unknown. Our aim was to study the prognosis of basal-like DCIS in a large population-based cohort. Methods All 458 women with a primary DCIS diagnosed between 1986 and 2004, i...

  1. Implications of Type1/2 Diabetes Mellitus in Breast Cancer Development: A General Female Population-based Cohort Study

    Science.gov (United States)

    Liaw, Yung-Po; Ko, Pei-Chieh; Jan, Shiou-Rung; Huang, Jing-Yang; Nfor, Oswald Ndi; Lung, Chia-Chi; Chiang, Yi-Chen; Yeh, Liang-Tsai; Chou, Ming-Chih; Tsai, Horng-Der; Hsiao, Yi-Hsuan

    2015-01-01

    significantly associated with diabetes and breast cancer risk (p<0.0001). Conclusion: Our results demonstrated different implications of diabetes type for the risk of breast cancer with type 2 posing a higher risk than type 1. This is the largest cohort study that assesses the possible correlation between both type 1 and 2 diabetes with breast cancer, and also is the largest cohort study showing that diabetes are associated with age, insurance, and region, which further suggest that living condition and life style may significantly associated with diabetes and breast cancer. PMID:26185535

  2. Impact of integrated PET/CT in the staging of oesophageal cancer-a UK population-based cohort study

    International Nuclear Information System (INIS)

    Aim: To document the impact of integrated positron-emission tomography and computed tomography (PET/CT) on the management of a cohort of UK patients undergoing PET/CT as part of their staging investigations for potentially curable oesophageal cancer. Materials and methods: A multicentre, prospective study of newly diagnosed patients with oesophageal cancer undergoing PET/CT was set up across five cancer networks covering a total population of 6.6 million. Data were prospectively collected for cases diagnosed between 1 November 2006 and 31 October 2007. Results: One hundred and ninety-one patients underwent PET/CT, with 31 (16%) positive for possible metastatic disease. Amongst the 31 positive examinations, 18 (9.4%) were confirmed to have metastatic disease, and 13 (6.5%) patients had no subsequent evidence of metastatic disease, although in three (1.6%) of these a second previously unsuspected pathology was diagnosed. Two patients had false-negative PET/CT and were found to have metastatic disease. The results of the PET/CT examination down-staged 10 (5%) patients thought to have coeliac/M1a node involvement on CT. Fifteen of 110 (13%) patients with stage 3 or 4 disease at CT and endoscopic ultrasound (EUS) had confirmed metastatic disease at PET/CT, compared with none of 18 with stage 2b, three of 52 (6%) with stage 2a, and none of 10 with stage 1 disease. Conclusion: This study confirms the role of PET/CT in a multicentre UK setting in the management of patients with potentially curable carcinoma of the oesophagus, improving the accuracy of pre-treatment staging compared with CT and EUS alone. Early tumours infrequently show evidence of metastasis on PET/CT, although further data are required to confidently determine the stage of tumours where PET/CT has no additional value.

  3. Neutrophil to Lymphocyte Ratio and Cardiovascular Disease Incidence in HIV-Infected Patients: A Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Eugenia Quiros-Roldan

    Full Text Available Neutrophil to lymphocyte ratio (NLR has been shown to predict occurrence of cardiovascular events in the general population. The aim of our study was to evaluate the role of NLR to predict major cardiovascular disease (CVD events in HIV-infected subjects. We performed a retrospective cohort study of HIV-infected patients residing in the Local Health Authority (LHA of Brescia, northern Italy, from 2000 to 2012. The incidence of CVD events in HIV-positive patients was compared with that expected in the general population living in the same area, computing standardized incidence ratios (SIRs. To evaluate the predictive role of NLR, univariate and multivariate Cox regression models were applied, computing hazard ratios (HRs. A total of 3766 HIV-infected patients (mean age 38.1 years, 71.3% males were included (person-years 28768.6. A total of 134 CVD events occurred in 119 HIV-infected patients. A 2-fold increased risk (SIR 2.02 of CVD was found in HIV-infected patients compared to the general population. NLR levels measured at baseline and during follow-up were independently associated with CVD incidence, when also adjusting for both traditional CVD risk factors and HIV-related factors (HR 3.05 for NLR≥ 1.2. The area under the receiver operating characteristics (ROC curve showed a modest, not statistically significant, increase, from 0.81 to 0.83, with addition of NLR to Framingham risk score model covariates. In conclusion an elevated NLR is a predictor of risk CVD in HIV-infected patients, independently from the traditional CVD risk factors.

  4. Genome-wide association studies of asthma in population-based cohorts confirm known and suggested loci and identify an additional association near HLA.

    Directory of Open Access Journals (Sweden)

    Adaikalavan Ramasamy

    Full Text Available RATIONALE: Asthma has substantial morbidity and mortality and a strong genetic component, but identification of genetic risk factors is limited by availability of suitable studies. OBJECTIVES: To test if population-based cohorts with self-reported physician-diagnosed asthma and genome-wide association (GWA data could be used to validate known associations with asthma and identify novel associations. METHODS: The APCAT (Analysis in Population-based Cohorts of Asthma Traits consortium consists of 1,716 individuals with asthma and 16,888 healthy controls from six European-descent population-based cohorts. We examined associations in APCAT of thirteen variants previously reported as genome-wide significant (P<5 x 10(-8 and three variants reported as suggestive (P<5× 10(-7. We also searched for novel associations in APCAT (Stage 1 and followed-up the most promising variants in 4,035 asthmatics and 11,251 healthy controls (Stage 2. Finally, we conducted the first genome-wide screen for interactions with smoking or hay fever. MAIN RESULTS: We observed association in the same direction for all thirteen previously reported variants and nominally replicated ten of them. One variant that was previously suggestive, rs11071559 in RORA, now reaches genome-wide significance when combined with our data (P = 2.4 × 10(-9. We also identified two genome-wide significant associations: rs13408661 near IL1RL1/IL18R1 (P(Stage1+Stage2 = 1.1x10(-9, which is correlated with a variant recently shown to be associated with asthma (rs3771180, and rs9268516 in the HLA region (P(Stage1+Stage2 = 1.1x10(-8, which appears to be independent of previously reported associations in this locus. Finally, we found no strong evidence for gene-environment interactions with smoking or hay fever status. CONCLUSIONS: Population-based cohorts with simple asthma phenotypes represent a valuable and largely untapped resource for genetic studies of asthma.

  5. Risk of cerebrovascular events in persons with and without HIV: A Danish nationwide population-based cohort study

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Engsig, Frederik Neess; Christensen, Hanne;

    2011-01-01

    , stratifying the analyses on IDU. Impact of immunodeficiency, HAART, protease-inhibitors, indinavir, didanosin, tenofovir and abacavir on risk of CVE was analyzed using time-dependent Cox regression analyses. RESULTS:: HIV-infected individuals had an increased risk of CVE compared with the comparison cohorts...

  6. Distribution of energy intake throughout the day and weight gain: a population-based cohort study in Spain.

    Science.gov (United States)

    Hermengildo, Ygor; López-García, Esther; García-Esquinas, Esther; Pérez-Tasigchana, Raúl F; Rodríguez-Artalejo, Fernando; Guallar-Castillón, Pilar

    2016-06-01

    Experimental research suggests that food timing is associated with weight regulation. However, the association between the distribution of energy intake (EI) throughout the day and weight gain in the population is uncertain. A cohort of 4243 individuals (49·9 % men, 50·1 % women) aged ≥18 years was selected in 2008-2010 and followed-up through 2012. At baseline, food consumption for a typical week in the previous year was collected with a validated dietary history, and EI was assessed at six eating occasions: breakfast, mid-morning meal, lunch, mid-afternoon meal, dinner and snacking (at any other moment). Individuals were classified into sex-specific quartiles of %EI for each eating occasion. The cut-off points for increasing quartiles of %EI at lunch were 34·4, 40·8 and 47·7 % in men and 33·2, 39·4 and 46·1 % in women. Weight was self-reported at baseline and at the end of follow-up. During a 3·5-year follow-up, 16·3 % of study participants gained >3 kg. Compared with those in the lowest quartile of %EI at lunch, the multivariate OR of gaining >3 kg was 0·79 (95 % CI 0·63, 0·99) in the second quartile, 0·82 (95 % CI 0·64, 1·04) in the third quartile and 0·62 (95 % CI 0·47, 0·80) in the highest quartile (P trend: 0·001). The association was stronger among women and those with overweight or obesity. No association was found between the %EI at the rest of the eating occasions and weight gain. In conclusion, a higher %EI at lunch was associated with a lower risk of weight gain; this may help weight control through the appropriate distribution of daily EI. PMID:27044416

  7. Relative Risk of Acute Myocardial Infarction in People with Schizophrenia and Bipolar Disorder: A Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Shu-I Wu

    Full Text Available Despite high mortality associated with serious mental illness, risk of acute myocardial infarction (AMI remains unclear, especially for patients with bipolar disorder. The main objective was to investigate the relative risk of AMI associated with schizophrenia and bipolar disorders in a national sample.Using nationwide administrative data, an 11-year historic cohort study was assembled, comprised of cases aged 18 and above who had received a diagnosis of schizophrenia or bipolar disorder, compared to a random sample of all other adults excluding those with diagnoses of serious mental illness. Incident AMI as a primary diagnosis was ascertained. Hazard ratios stratified by age and gender were calculated and Cox regression models were used to adjust for other covariates.A total of 70,225 people with schizophrenia or bipolar disorder and 207,592 people without serious mental illness were compared. Hazard ratios in men adjusted for age, income and urbanization were 1.15 (95% CI 1.01~1.32 for schizophrenia and 1.37 (1.08~1.73for bipolar disorder, and in women, 1.85 (1.58~2.18 and 1.88(1.47~2.41 respectively. Further adjustment for treated hypertension, diabetes and hyperlipidaemia attenuated the hazard ratio for men with schizophrenia but not the other comparison groups. Hazard ratios were significantly stronger in women than men and were stronger in younger compared to older age groups for both disorders; however, gender modification was only significant in people with schizophrenia, and age modification only significant in people with bipolar disorder.In this large national sample, schizophrenia and bipolar disorder were associated with raised risk of AMI in women and in the younger age groups although showed differences in potential confounding and modifying factors.

  8. Care needs and clinical outcomes of older people with dementia: a population-based propensity score-matched cohort study.

    Directory of Open Access Journals (Sweden)

    Fei-Yuan Hsiao

    Full Text Available To explore the healthcare resource utilization, psychotropic drug use and mortality of older people with dementia.A nationwide propensity score-matched cohort study.National Health Insurance Research database.A total of 32,649 elderly people with dementia and their propensity-score matched controls (n=32,649.Outpatient visits, inpatient care, psychotropic drug use, in-hospital mortality and all-cause mortality at 90 and 365 days.Compared to the non-dementia group, a higher proportion of patients with dementia used inpatient services (1 year after index date: 20.91% vs. 9.55%, and the dementia group had more outpatient visits (median [standard deviation]: 7.00 [8.87] vs. 3.00 [8.30]. Furthermore, dementia cases with acute admission had the highest psychotropic drug utilization both at baseline and at the post-index dates (difference-in-differences: all <0.001. Dementia was associated with an increased risk of all-cause mortality (90 days, Odds ratio (OR=1.85 [95%CI 1.67-2.05], p<0.001; 365 days, OR=1.59 [1.50-1.69], p<0.001 and in-hospital mortality (90 days, OR=1.97 [1.71-2.27], p<0.001; 365 days, OR=1.82 [1.61-2.05], p<0.001 compared to matched controls.When older people with dementia are admitted for acute illnesses, they may increase their use of psychotropic agents and their risk of death, particularly in-hospital mortality.

  9. Does a healthy lifestyle behaviour influence the prognosis of low back pain among men and women in a general population? A population-based cohort study

    OpenAIRE

    Bohman, Tony; Alfredsson, Lars; Jensen, Irene; Hallqvist, Johan; Vingård, Eva; Skillgate, Eva

    2014-01-01

    OBJECTIVES: To study the influence of healthy lifestyle behaviour on the prognosis of occasional low back pain among men and women in a general population. DESIGN: Cohort study with a 4-year follow-up. SETTINGS: General population in Stockholm County, Sweden. PARTICIPANTS: The study sample comprised 3938 men and 5056 women aged 18-84 from the Stockholm Public Health Cohort reporting occasional low back pain in the baseline questionnaire 2006. MEASURES: Lifestyle factors and potential confound...

  10. Exposure to radio-frequency electromagnetic fields from broadcast transmitters and risk of childhood cancer: a census-based cohort study.

    Science.gov (United States)

    Hauri, Dimitri D; Spycher, Ben; Huss, Anke; Zimmermann, Frank; Grotzer, Michael; von der Weid, Nicolas; Spoerri, Adrian; Kuehni, Claudia E; Röösli, Martin

    2014-04-01

    We investigated the association between exposure to radio-frequency electromagnetic fields (RF-EMFs) from broadcast transmitters and childhood cancer. First, we conducted a time-to-event analysis including children under age 16 years living in Switzerland on December 5, 2000. Follow-up lasted until December 31, 2008. Second, all children living in Switzerland for some time between 1985 and 2008 were included in an incidence density cohort. RF-EMF exposure from broadcast transmitters was modeled. Based on 997 cancer cases, adjusted hazard ratios in the time-to-event analysis for the highest exposure category (>0.2 V/m) as compared with the reference category (<0.05 V/m) were 1.03 (95% confidence interval (CI): 0.74, 1.43) for all cancers, 0.55 (95% CI: 0.26, 1.19) for childhood leukemia, and 1.68 (95% CI: 0.98, 2.91) for childhood central nervous system (CNS) tumors. Results of the incidence density analysis, based on 4,246 cancer cases, were similar for all types of cancer and leukemia but did not indicate a CNS tumor risk (incidence rate ratio = 1.03, 95% CI: 0.73, 1.46). This large census-based cohort study did not suggest an association between predicted RF-EMF exposure from broadcasting and childhood leukemia. Results for CNS tumors were less consistent, but the most comprehensive analysis did not suggest an association. PMID:24651167

  11. Maternal Pre-Pregnancy BMI and Intelligence Quotient (IQ) in 5-Year-Old Children: A Cohort Based Study

    DEFF Research Database (Denmark)

    Bliddal, Mette; Olsen, Jørn; Støvring, Henrik;

    2014-01-01

    -old children sampled from the Danish National Birth Cohort. The children participated between 2003 and 2008 in a neuropsychological assessment of cognitive ability including IQ tests taken by both the mother and the child. Linear regression analyses were used to estimate the associations between parental BMI......BACKGROUND: An association between maternal pre-pregnancy BMI and childhood intelligence quotient (IQ) has repeatedly been found but it is unknown if this association is causal or due to confounding caused by genetic or social factors. METHODS: We used a cohort of 1,783 mothers and their 5-year...... and child IQ adjusted for a comprehensive set of potential confounders. Child IQ was assessed with the Wechsler Primary and Preschool Scales of Intelligence--Revised (WPPSI-R). RESULTS: The crude association between maternal BMI and child IQ showed that BMI was adversely associated with child IQ with...

  12. Introducing evidence based medicine to the journal club, using a structured pre and post test: a cohort study

    OpenAIRE

    Mahoney Martin C; Cramer J Steven

    2001-01-01

    Abstract Background Journal Club at a University-based residency program was restructured to introduce, reinforce and evaluate residents understanding of the concepts of Evidence Based Medicine. Methods Over the course of a year structured pre and post-tests were developed for use during each Journal Club. Questions were derived from the articles being reviewed. Performance with the key concepts of Evidence Based Medicine was assessed. Study subjects were 35 PGY2 and PGY3 residents in a Unive...

  13. Risk of breast cancer recurrence in patients receiving manual lymphatic drainage: a hospital-based cohort study

    Directory of Open Access Journals (Sweden)

    Hsiao PC

    2015-02-01

    Full Text Available Pei-Chi Hsiao,1,2 Jung-Tai Liu,3 Chien-Liang Lin,4 Willy Chou,1,2 Shiang-Ru Lu5 1Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, Taiwan; 2Department of Recreation and Health Care Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; 3Departments of Physical Medicine and Rehabilitation, Chi-Mei Medical Center Liouying Campus, Tainan, Taiwan; 4Department of Hematology and Oncology, Chi-Mei Medical Center Liouying Campus, Tainan, Taiwan; 5Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Background: This retrospective cohort study evaluated whether manual lymphatic drainage (MLD therapy increases the risk of recurrence of breast cancer. Methods: We analyzed 1,106 women who were diagnosed with stage 0­–3 breast cancer between 2007 and 2011 and experienced remission after surgery and adjuvant therapy. The patients were divided into two groups: group A (n=996, in which patients did not participate in any MLD therapy, regardless of whether they developed breast cancer-related lymphedema (BCRL after cancer treatment; and group B (n=110, in which patients participated in MLD therapy for BCRL. All patients were monitored until October 2013 to determine whether breast cancer recurrence developed, including local or regional recurrence and distant metastasis. Patients who developed cancer recurrence prior to MLD therapy were excluded from analysis. Risk factors associated with cancer recurrence were evaluated using Cox proportional hazards models. Results: During the monitoring period, 166 patients (15.0% developed cancer recurrence, including 154 (15.5% in group A and 12 (10.9% in group B. The median period from surgery to cancer recurrence was 1.85 (interquartile range 1.18–2.93 years. Independent risk factors for cancer recurrence were tumor histological grading of grade 3, high number (≥3 of axillary lymph node invasion, and a large tumor size (>5 cm. Factors

  14. Psychiatric Diagnoses in Individuals with Non-Syndromic Oral Clefts: A Danish Population-Based Cohort Study

    Science.gov (United States)

    Pedersen, Dorthe Almind; Wehby, George L.; Murray, Jeffrey C.; Christensen, Kaare

    2016-01-01

    Background The aim of this study was to investigate the risk of psychiatric diagnoses in individuals with non-syndromic oral clefts (OC) compared with individuals without OC, including ages from 1 to 76 years. Methods Linking four Danish nationwide registers, we investigated the risk of psychiatric diagnoses at Danish psychiatric hospitals during the period 1969–2012 for individuals born with non-syndromic OC in Denmark 1936–2009 compared with a cohort of 10 individuals without OC per individual with OC, matched by sex and birth year. The sample included 8,568 individuals with OC, observed for 247,821 person-years, and 85,653 individuals without OC followed for 2,501,129 person-years. Results A total of 953 (11.1%) of the individuals with OC (9.6% for cleft lip (CL), 10.8% for cleft lip and palate (CLP) and 13.1% for cleft palate (CP)) and 8,117 (9.5%) in the comparison group had at least one psychiatric diagnosis. Cox proportional hazard regression model revealed that individuals with OC had significantly higher risk of a psychiatric diagnosis (hazard ratio (HR) = 1.19, 95% CI: 1.12–1.28). When examining cleft type, no difference was found for CL (HR = 1.03, 95% CI: 0.90–1.17), but CLP was associated with a small increased risk (HR = 1.13, 95% CI: 1.01–1.26), whereas individuals with CP had the largest increased risk (HR = 1.45, 95% CI: 1.30–1.62). The largest differences were found in schizophrenia-like disorders, mental retardation and pervasive developmental disorders, but we found no increased risk of mood disorders and anxiety-related disorders. Conclusion Individuals with non-syndromic OC had significantly higher risk of psychiatric diagnoses compared with individuals without OC. However, the elevated risk was observed for individuals with CLP and CP but not for individuals with CL and the absolute risk increase was modest. PMID:27223812

  15. Statin therapy and mortality in HIV-infected individuals; a Danish nationwide population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Line D Rasmussen

    Full Text Available BACKGROUND: Recent studies have suggested that statins possess diverse immune modulatory and anti-inflammatory properties. As statins might attenuate inflammation, statin therapy has been hypothesized to reduce mortality in HIV-infected individuals. We therefore used a Danish nationwide cohort of HIV-infected individuals to estimate the impact of statin use on mortality before and after a diagnosis of cardiovascular disease, chronic kidney disease or diabetes. METHODS: We identified all Danish HIV-infected individuals (1,738 who initiated HAART after 1 January 1998, and achieved virological suppression within 180 days. Date of first redemption of a prescription of statin was obtained from the Danish National Prescription Registry. We used Poisson regression analysis to assess adjusted mortality rate ratios (aMRR. First, time was censored at date of virological failure (VL >500 copies/ml. Second, time was not censored at virological failure. All analyses were adjusted for potential confounders. RESULTS: In the analyses confined to observation time without virological failure (+ censoring statin therapy was associated with a non-statistically significant reduced rate of death (aMRR 0.75; 95% CI: 0.33-1.68. No difference was observed in the analysis with no censoring (aMRR 1.17; 95% CI: 0.66-2.07. Use of statin seemed to reduce mortality in individuals after a diagnosis of comorbidity {(+ censoring: aMRR: 0.34; 95% CI: 0.11-1.04, (-censoring: aMRR: 0.64; 95% CI: 0.32-1.29}. No difference in rate of death could be detected before first date of diagnosis of comorbidity {(+ censoring: aMRR: 1.12; 95% CI: 0.34-3.62, (-censoring: aMRR: 0.90; 95% CI: 0.28-2.88}. CONCLUSION: Statin therapy might reduce all-cause mortality in HIV-infected individuals, but the impact on individuals with no comorbidity seems small or absent. An unambiguous proof of a causal relation can only be obtained in a randomized controlled trial, but the sample size predicted may be

  16. Anthropometric markers and their association with incident type 2 diabetes mellitus: which marker is best for prediction? Pooled analysis of four German population-based cohort studies and comparison with a nationwide cohort study

    Science.gov (United States)

    Hartwig, Saskia; Kluttig, Alexander; Tiller, Daniel; Fricke, Julia; Müller, Grit; Schipf, Sabine; Völzke, Henry; Schunk, Michaela; Meisinger, Christa; Schienkiewitz, Anja; Heidemann, Christin; Moebus, Susanne; Pechlivanis, Sonali; Werdan, Karl; Kuss, Oliver; Tamayo, Teresa; Haerting, Johannes; Greiser, Karin Halina

    2016-01-01

    Objective To compare the association between different anthropometric measurements and incident type 2 diabetes mellitus (T2DM) and to assess their predictive ability in different regions of Germany. Methods Data of 10 258 participants from 4 prospective population-based cohorts were pooled to assess the association of body weight, body mass index (BMI), waist circumference (WC), waist-to-hip-ratio (WHR) and waist-to-height-ratio (WHtR) with incident T2DM by calculating HRs of the crude, adjusted and standardised markers, as well as providing receiver operator characteristic (ROC) curves. Differences between HRs and ROCs for the different anthropometric markers were calculated to compare their predictive ability. In addition, data of 3105 participants from the nationwide survey were analysed separately using the same methods to provide a nationally representative comparison. Results Strong associations were found for each anthropometric marker and incidence of T2DM. Among the standardised anthropometric measures, we found the strongest effect on incident T2DM for WC and WHtR in the pooled sample (HR for 1 SD difference in WC 1.97, 95% CI 1.75 to 2.22, HR for WHtR 1.93, 95% CI 1.71 to 2.17 in women) and in female DEGS participants (HR for WC 2.24, 95% CI 1.91 to 2.63, HR for WHtR 2.10, 95% CI 1.81 to 2.44), whereas the strongest association in men was found for WHR among DEGS participants (HR 2.29, 95% CI 1.89 to 2.78). ROC analysis showed WHtR to be the strongest predictor for incident T2DM. Differences in HR and ROCs between the different markers confirmed WC and WHtR to be the best predictors of incident T2DM. Findings were consistent across study regions and age groups (<65 vs ≥65 years). Conclusions We found stronger associations between anthropometric markers that reflect abdominal obesity (ie, WC and WHtR) and incident T2DM than for BMI and weight. The use of these measurements in risk prediction should be encouraged. PMID:26792214

  17. Recurrent differentiated thyroid cancer: towards personalized treatment based on evaluation of tumor characteristics with PET (THYROPET Study): study protocol of a multicenter observational cohort study

    International Nuclear Information System (INIS)

    After initial treatment of differentiated thyroid carcinoma (DTC) patients are followed with thyroglobulin (Tg) measurements to detect recurrences. In case of elevated levels of Tg and negative neck ultrasonography, patients are treated 'blindly' with Iodine-131 (131I). However, in up to 50% of patients, the post-therapy scan reveals no 131I-targeting of tumor lesions. Such patients derive no benefit from the blind therapy but are exposed to its toxicity. Alternatively, iodine-124 (124I) Positron Emission Tomography/Computed Tomography (PET/CT) has become available to visualize DTC lesions and without toxicity. In addition to this, 18F-fluorodeoxyglucose (18F-FDG) PET/CT detects the recurrent DTC phenotype, which lost the capacity to accumulate iodine. Taken together, the combination of 124I and 18F-FDG PET/CT has potential to stratify patients for treatment with 131I. In a multicenter prospective observational cohort study the hypothesis that the combination of 124I and 18F-FDG PET/CT can avoid futile 131I treatments in patients planned for ‘blind’ therapy with 131I, is tested. One hundred patients planned for 131I undergo both 124I and 18F-FDG PET/CT after rhTSH stimulation. Independent of the outcome of the scans, all patients will subsequently receive, after thyroid hormone withdrawal, the 131I therapy. The post 131I therapeutic scintigraphy is compared with the outcome of the 124I and 18F-FDG PET/CT in order to evaluate the diagnostic value of the combined PET modalities. This study primary aims to reduce the number of futile 131I therapies. Secondary aims are the nationwide introduction of 124I PET/CT by a quality assurance and quality control (QA/QC) program, to correlate imaging outcome with histopathological features, to compare 124I PET/CT after rhTSH and after withdrawal of thyroid hormone, and to compare 124I and 131I dosimetry. This study aims to evaluate the potential value of the combination of 124I and 18F-FDG PET/CT in the prevention

  18. Prevalence of Tourette Syndrome and Chronic Tics in the Population-Based Avon Longitudinal Study of Parents and Children Cohort

    Science.gov (United States)

    Scharf, Jeremiah M.; Miller, Laura L.; Mathews, Carol A.; Ben-Shlomo, Yoav

    2012-01-01

    Objective: Recent epidemiologic studies have demonstrated that Tourette syndrome (TS) and chronic tic disorder (CT) are more common than previously recognized. However, few population-based studies have examined the prevalence of co-occurring neuropsychiatric conditions such as obsessive-compulsive disorder (OCD) and…

  19. Risk set sampling in epidemiologic cohort studies

    OpenAIRE

    Langholz, Bryan; Goldstein, Larry

    1996-01-01

    Recent work has extended the methods for the analysis of nested case-control studies to accomodate a broad variety of risk set sampling designs. These results have implications for the design of sampled epidemiologic cohort studies. We describe a model which is a natural extension of the Cox proportional hazards model and may be used to estimate parameters from sampled risk set data. We illustrate how these techniques may be used to solve three diverse design and analysis problems from epidem...

  20. Risk of Dementia in Patients with Insomnia and Long-term Use of Hypnotics: A Population-based Retrospective Cohort Study

    OpenAIRE

    Pin-Liang Chen; Wei-Ju Lee; Wei-Zen Sun; Yen-Jen Oyang; Jong-Ling Fuh

    2012-01-01

    BACKGROUND: Hypnotics have been reported to be associated with dementia. However, the relationship between insomnia, hypnotics and dementia is still controversial. We sought to examine the risk of dementia in patients with long-term insomnia and the contribution of hypnotics. METHODS: Data was collected from Taiwan's Longitudinal Health Insurance Database. The study cohort comprised all patients aged 50 years or older with a first diagnosis of insomnia from 2002 to 2007. The comparison cohort...

  1. Direct Medical Costs for Patients with Type 2 Diabetes and Related Complications: A Prospective Cohort Study Based on the Korean National Diabetes Program

    OpenAIRE

    Kim, Tae Ho; Chun, Ki Hong; Kim, Hae Jin; Han, Seung Jin; Kim, Dae Jung; Kwak, Jiyeong; Kim, Young Seol; Woo, Jeong Taek; Park, Yongsoo; Nam, Moonsuk; Baik, Sei Hyun; Ahn, Kyu Jeung; Lee, Kwan Woo

    2012-01-01

    We analyzed the direct medical costs for Korean patients with type 2 diabetes according to the type of complications and the number of microvascular complications. We analyzed costs for type 2 diabetes and associated complications in 3,125 patients. These data were obtained from the Korean National Diabetes Program (KNDP), a large, ongoing, prospective cohort study that began in 2005. The cost data were prospectively collected, using an electronic database, for the KNDP cohort at six hospital...

  2. Introducing evidence based medicine to the journal club, using a structured pre and post test: a cohort study

    Directory of Open Access Journals (Sweden)

    Mahoney Martin C

    2001-11-01

    Full Text Available Abstract Background Journal Club at a University-based residency program was restructured to introduce, reinforce and evaluate residents understanding of the concepts of Evidence Based Medicine. Methods Over the course of a year structured pre and post-tests were developed for use during each Journal Club. Questions were derived from the articles being reviewed. Performance with the key concepts of Evidence Based Medicine was assessed. Study subjects were 35 PGY2 and PGY3 residents in a University based Family Practice Program. Results Performance on the pre-test demonstrated a significant improvement from a median of 54.5 % to 78.9 % over the course of the year (F 89.17, p Conclusions Following organizational revision, the introduction of a pre-test/post-test instrument supported achievement of the learning objectives with a better understanding and utilization of the concepts of Evidence Based Medicine.

  3. Reduced colon cancer incidence and mortality in postmenopausal women treated with an oral bisphosphonate-Danish National Register Based Cohort Study

    DEFF Research Database (Denmark)

    Pazianas, M; Abrahamsen, B; Eiken, Pia Agnete; Eastell, R; Russell, R Graham G

    2012-01-01

    whether alendronate acts as chemopreventive. INTRODUCTION: When bisphosphonates are given by mouth, around 99% remains non-absorbed in the intestine. Based on their biochemical actions, we predicted that oral bisphosphonates might prevent colon cancers. METHODS: This is a Danish national register...... incidence and post-diagnosis survival in patients taking oral alendronate for osteoporosis. RESULTS: Cox proportional hazards analysis of death due to colon cancer showed lower risk in alendronate users, crude hazard ratio (HR) 0.69 (95% CI 0.59-0.81) with an adjusted HR of 0.62 (95% CI 0.52-0.72). The......In this Danish national register-based cohort study, we examined the effects of alendronate on the development of colon cancers and survival. The incidence of colon cancer and mortality rate, once colon cancer had been diagnosed, were lower in patients treated with alendronate, posing the question...

  4. Stroke and Risks of Development and Progression of Kidney Diseases and End-Stage Renal Disease: A Nationwide Population-Based Cohort Study

    Science.gov (United States)

    Wu, Chia-Lin; Tsai, Chun-Chieh; Kor, Chew-Teng; Tarng, Der-Cherng; Lian, Ie-Bin; Yang, Tao-Hsiang; Chiu, Ping-Fang; Chang, Chia-Chu

    2016-01-01

    Background There is little information about the association between stroke and kidney diseases. We aimed to investigate the impact of stroke on long-term renal outcomes. Methods In this large population-based retrospective cohort study, we identified 100,353 subjects registered in the National Health Insurance Research Database of Taiwan from January 1, 2000, through December 31, 2012, including 33,451 stroke patients and 66,902 age-, sex- and Charlson’s comorbidity index score-matched controls. Results The incidence rate of chronic kidney disease (CKD) was higher in the stroke than in the control cohort (17.5 vs. 9.06 per 1000 person-years). After multivariate adjustment, the risk of developing CKD was significantly higher in patients with stroke (adjusted hazard ratio [aHR] 1.43, 95% confidence interval [CI] 1.36–1.50, Psex, comorbidities and long-term medications. Conclusions Stroke is associated with higher risks for incident CKD, decline in renal function and ESRD. Younger stroke patients, as well as those with concomitant diabetes mellitus, hyperlipidemia or gout are at greater risk for kidney diseases. PMID:27355475

  5. Development and validation of a nomogram for prediction of survival and local control in laryngeal carcinoma patients treated with radiotherapy alone: A cohort study based on 994 patients

    International Nuclear Information System (INIS)

    Introduction: To advise laryngeal carcinoma patients on the most appropriate form of treatment, a tool to predict survival and local control is needed. Materials and methods: We performed a population-based cohort study on 994 laryngeal carcinoma patients, treated with RT from 1977 until 2008. Two nomograms were developed and validated. Performance of the models is expressed as the Area Under the Curve (AUC). Results: Unfavorable prognostic factors for overall survival were low hemoglobin level, male sex, high T-status, nodal involvement, older age, lower EQD2T (total radiation dose corrected for fraction dose and overall treatment time), and non-glottic tumor. All factors except tumor location were prognostic for local control. The AUCs were 0.73 for overall survival and 0.67 for local control. External validation of the survival model yielded AUCs of 0.68, 0.74, 0.76 and 0.71 for the Leuven (n = 109), the VU Amsterdam (n = 178), the Manchester (n = 403) and the NKI cohort (n = 205), respectively, while the validation procedure for the local control model resulted in AUCs of 0.70, 0.71, 0.72 and 0.62. The resulting nomograms were made available on the website (www.predictcancer.org). Conclusions: For patients with a laryngeal carcinoma treated with RT alone, we have developed visual, easy-to-use nomograms for the prediction of overall survival and primary local control. These models have been successfully validated in four external centers.

  6. Observational cohort study of HIV-infected African children.

    NARCIS (Netherlands)

    Laufer, M.K.; Oosterhout, J.J. van; Perez, M.A.; Kanyanganlika, J.; Taylor, T.E.; Plowe, C.V.; Graham, S.M.

    2006-01-01

    BACKGROUND: Most information about children living with HIV is based on follow up from children identified through mother-to-child transmission studies. Children identified through voluntary counseling and testing (VCT) represent a unique cohort that has not been previously described in the literatu

  7. Increased risk and related factors of depression among patients with COPD: a population-based cohort study

    OpenAIRE

    Tsai, Tzung-Yi; Livneh, Hanoch; Lu, Ming-Chi; Tsai, Pang-Yau; Chen, Pei-Chun; Sung, Fung-Chang

    2013-01-01

    Background Depression is a common and mostly undertreated problem in patients with chronic diseases. However, population-based studies on the association between chronic obstructive pulmonary disease (COPD) and subsequent depression are limited in Asian populations. This study evaluated the incidence and risk factors of depression for patients with COPD in Taiwan. Methods Using the claims data from the National Health Insurance of Taiwan, we identified 38,010 COPD patients newly diagnosed in ...

  8. Epilepsy in Individuals with a History of Asperger's Syndrome: A Danish Nationwide Register-Based Cohort Study

    Science.gov (United States)

    Mouridsen, Svend Erik; Rich, Bente; Isager, Torben

    2013-01-01

    We performed a nationwide, register-based retrospective follow-up study of epilepsy in all people who were born between January 1, 1980 and June 29, 2006 and registered in the Danish Psychiatric Central Register with Asperger's syndrome on February 7, 2011. All 4,180 identified cases with AS (3,431 males and 749 females) were screened through the…

  9. Patient characteristics in low back pain subgroups based on an existing classification system. A descriptive cohort study in chiropractic practice

    DEFF Research Database (Denmark)

    Eirikstoft, Heidi; Kongsted, Alice

    2014-01-01

    Sub-grouping of low back pain (LBP) is believed to improve prediction of prognosis and treatment effects. The objectives of this study were: (1) to examine whether chiropractic patients could be sub-grouped according to an existing pathoanatomically-based classification system, (2) to describe...

  10. The Danish National Cohort Study (DANCOS)

    DEFF Research Database (Denmark)

    Helweg-Larsen, Karin; Kjøller, Mette; Davidsen, Michael;

    2003-01-01

    -interview survey. As part of the national health interview survey programme, three nation-wide surveys were conducted in 1986/1987, 1991 and 1994. The samples in the three cohorts consisted of 23,096 adult Danes ages 16 years and older, and 18,296 (79.2%) were personally interviewed on socio-economic status...... Service Register recorded 980,043 contacts with general practitioners and specialist physicians. For 1943-1996, the Danish cancer Registry contained information about one or more cancer diseases among 1,432 people. A total of 4,334 people in the 1994 cohort were re-interview in 2000. DANCOS allows...... for a wide range of analysis in a historical prospective design of determinants of morbidity and mortality, of health care utilization and of the social effects of ill health. DANCOS also allows studies of methodological issues, including analyzing the characteristics of non-respondents. Udgivelsesdato: 2003...

  11. Validation of the pooled cohort risk score in an Asian population – a retrospective cohort study

    OpenAIRE

    Chia, Yook Chin; Lim, Hooi Min; Ching, Siew Mooi

    2014-01-01

    Background The Pooled Cohort Risk Equation was introduced by the American College of Cardiology (ACC) and American Heart Association (AHA) 2013 in their Blood Cholesterol Guideline to estimate the 10-year atherosclerotic cardiovascular disease (ASCVD) risk. However, absence of Asian ethnicity in the contemporary cohorts and limited studies to examine the use of the risk score limit the applicability of the equation in an Asian population. This study examines the validity of the pooled cohort ...

  12. Raw and processed fruit and vegetable consumption and 10-year coronary heart disease incidence in a population-based cohort study in the Netherlands.

    Directory of Open Access Journals (Sweden)

    Linda M Oude Griep

    Full Text Available BACKGROUND: Prospective cohort studies have shown that high fruit and vegetable consumption is inversely associated with coronary heart disease (CHD. Whether food processing affects this association is unknown. Therefore, we quantified the association of fruit and vegetable consumption with 10-year CHD incidence in a population-based study in the Netherlands and the effect of processing on these associations. METHODS: Prospective population-based cohort study, including 20,069 men and women aged 20 to 65 years, enrolled between 1993 and 1997 and free of cardiovascular disease at baseline. Diet was assessed using a validated 178-item food frequency questionnaire. Hazard ratios (HR were calculated for CHD incidence using multivariable Cox proportional hazards models. RESULTS: During a mean follow-up time of 10.5y, 245 incident cases of CHD were documented, which comprised 211 non-fatal acute myocardial infarctions and 34 fatal CHD events. The risk of CHD incidence was 34% lower for participants with a high intake of total fruit and vegetables (>475 g/d; HR: 0.66; 95% CI: 0.45-0.99 compared to participants with a low total fruit and vegetable consumption (≤241 g/d. Intake of raw fruit and vegetables (>262 g/d vs ≤92 g/d; HR: 0.70; 95% CI: 0.47-1.04 as well as processed fruit and vegetables (>234 g/d vs ≤113 g/d; HR: 0.79; 95% CI: 0.54-1.16 were inversely related with CHD incidence. CONCLUSION: Higher consumption of fruit and vegetables, whether consumed raw or processed, may protect against CHD incidence.

  13. Maternal pre-pregnancy BMI and intelligence quotient (IQ in 5-year-old children: a cohort based study.

    Directory of Open Access Journals (Sweden)

    Mette Bliddal

    Full Text Available BACKGROUND: An association between maternal pre-pregnancy BMI and childhood intelligence quotient (IQ has repeatedly been found but it is unknown if this association is causal or due to confounding caused by genetic or social factors. METHODS: We used a cohort of 1,783 mothers and their 5-year-old children sampled from the Danish National Birth Cohort. The children participated between 2003 and 2008 in a neuropsychological assessment of cognitive ability including IQ tests taken by both the mother and the child. Linear regression analyses were used to estimate the associations between parental BMI and child IQ adjusted for a comprehensive set of potential confounders. Child IQ was assessed with the Wechsler Primary and Preschool Scales of Intelligence--Revised (WPPSI-R. RESULTS: The crude association between maternal BMI and child IQ showed that BMI was adversely associated with child IQ with a reduction in IQ of -0.40 point for each one unit increase in BMI. This association was attenuated after adjustment for social factors and maternal IQ to a value of -0.27 (-0.50 to -0.03. After mutual adjustment for the father's BMI and all other factors except maternal IQ, the association between paternal BMI and child IQ yielded a regression coefficient of -0.26 (-0.59 to 0.07, which was comparable to that seen for maternal BMI (-0.20 (-0.44 to 0.04. CONCLUSION: Although maternal pre-pregnancy BMI was inversely associated with the IQ of her child, the similar association with paternal BMI suggests that it is not a specific pregnancy related adiposity effect.

  14. CKD classification based on estimated GFR over three years and subsequent cardiac and mortality outcomes: a cohort study

    Directory of Open Access Journals (Sweden)

    Salem Deeb N

    2009-09-01

    Full Text Available Abstract Background It is unknown whether defining chronic kidney disease (CKD based on one versus two estimated glomerular filtration rate (eGFR assessments changes the prognostic importance of reduced eGFR in a community-based population. Methods Participants in the Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study were classified into 4 groups based on two eGFR assessments separated by 35.3 ± 2.5 months: sustained eGFR 2 (1 mL/sec per 1.73 m2; eGFR increase (change from below to above 60; eGFR decline (change from above to below 60; and eGFR persistently ≥60. Outcomes assessed in stratified multivariable Cox models included cardiac events and a composite of cardiac events, stroke, and mortality. Results There were 891 (4.9% participants with sustained eGFR 60. Participants with eGFR sustained Conclusion Individuals with persistently reduced eGFR are at highest risk of cardiovascular outcomes and mortality, while individuals with an eGFR 2 at any time are at intermediate risk. Use of even a single measurement of eGFR to classify CKD in a community population appears to have prognostic value.

  15. Reliance on social security benefits by Swedish patients with ill-health attributed to dental fillings: a register-based cohort study

    Directory of Open Access Journals (Sweden)

    Naimi-Akbar Aron

    2012-08-01

    Full Text Available Abstract Background Some people attribute their ill health to dental filling materials, experiencing a variety of symptoms. Yet, it is not known if they continue to financially support themselves by work or become reliant on different types of social security benefits. The aim of this study was to analyse reliance on different forms of social security benefits by patients who attribute their poor health to dental filling materials. Methods A longitudinal cohort study with a 13-year follow up. The subjects included were 505 patients attributing their ill health to dental restorative materials, who applied for subsidised filling replacement. They were compared to a cohort of matched controls representing the general population (three controls per patient. Annual individual data on disability pension, sick leave, unemployment benefits, and socio-demographic factors was obtained from Statistics Sweden. Generalized estimating equations were used to test for differences between cohorts in number of days on different types of social security benefits. Results The cohort of dental filling patients had a significantly higher number of days on sick leave and disability pension than the general population. The test of an overall interaction effect between time and cohort showed a significant difference between the two cohorts regarding both sick leave and disability pension. In the replacement cohort, the highest number of sick-leave days was recorded in the year they applied for subsidised replacement of fillings. While sick leave decreased following the year of application, the number of days on disability pension increased and peaked at the end of follow-up. Conclusions Ill health related to dental materials is likely to be associated with dependence on social security benefits. Dental filling replacement does not seem to improve workforce participation.

  16. Cyclin D1 expression in colorectal cancer is a favorable prognostic factor in men but not in women in a prospective, population-based cohort study

    Directory of Open Access Journals (Sweden)

    Wangefjord Sakarias

    2011-09-01

    Full Text Available Abstract Background Although colorectal cancer (CRC is generally not considered to be a hormone-dependent malignancy, several sex-related differences in incidence, molecular characteristics and survival have been reported. Epidemiological studies have consistently shown that increased exposure to female sex hormones is associated with a lower risk of CRC in women, and cyclin D1, an important downstream effector in estrogen-mediated signaling, is commonly activated in CRC. In this study, we analyzed the prognostic significance of cyclin D1 expression in CRC, with particular reference to sex-related differences, in tumors from a large, prospective, population-based cohort. Methods Using tissue microarrays and immunohistochemistry, the fraction and intensity of cyclin D1 expression was evaluated in 527 incident CRC cases from the Malmö Diet and Cancer Study. The χ2 and Spearman's rho (ρ tests were used for comparison of cyclin D1 expression and relevant clinicopathological characteristics. Kaplan-Meier analysis and Cox proportional hazards modeling were used to assess the effect of cyclin D1 expression on cancer-specific survival (CSS in univariate and multivariate analysis, adjusted for established prognostic factors. Results Cyclin D1 intensity was significantly lower in male compared with female CRC (P = 0.018. In the full cohort, cyclin D1 expression was associated with a significantly prolonged CSS (hazard ratio (HR = 0.69; 95% CI 0.49 to 0.96, P = 0.026 but subgroup analysis according to gender revealed a strongly accentuated prognostic effect of cyclin D1 in male CRC (HR = 0.48; 95% CI 0.31 to 0.74, P P = 0.864 (Pinteraction = 0.024. The prognostic value of cyclin D1 was not retained in multivariate analysis, either in the full cohort or in male CRC. Conclusions Cyclin D1 expression is strongly associated with prolonged survival in male CRC. These findings not only support an important role for cyclin D1 in colorectal carcinogenesis, but

  17. Childhood ADHD Is Strongly Associated with a Broad Range of Psychiatric Disorders during Adolescence: A Population-Based Birth Cohort Study

    Science.gov (United States)

    Yoshimasu, Kouichi; Barbaresi, William J.; Colligan, Robert C.; Voigt, Robert G.; Killian, Jill M.; Weaver, Amy L.; Katusic, Slavica K.

    2012-01-01

    Background: To evaluate associations between attention-deficit/hyperactivity disorder (ADHD) and comorbid psychiatric disorders using research-identified incident cases of ADHD and population-based controls. Methods: Subjects included a birth cohort of all children born 1976-1982 remaining in Rochester, MN after age five (n = 5,718). Among them we…

  18. Increased subsequent risk of erectile dysfunction among middle and old age males with chronic osteomyelitis: a nationwide population-based cohort study.

    Science.gov (United States)

    Wang, H-Y; Chao, C-H; Lin, C-L; Tseng, C-H; Kao, C-H

    2016-07-01

    Chronic inflammation may cause endothelial dysfunction and atherosclerosis, resulting in subsequent erectile dysfunction (ED). We examined the relationship between chronic osteomyelitis, which is a chronic inflammatory disease, and ED. A retrospective cohort study was conducted using data from the National Health Insurance Research Database. After excluding patients osteomyelitis (COM) from 1 January 2000 to 31 December 2011 were identified for the study. The non-osteomyelitis comparison cohort consisted of 2706 male participants. The incidence of ED was 2.66-fold higher in the COM cohort than in the non-osteomyelitis cohort (4.01 vs 1.51 per 10 000 person-years). After adjusting for age and comorbidities of coronary heart disease, hypertension, hyperlipidemia, depression, stroke, diabetes, peripheral vascular disease, chronic kidney disease, chronic obstructive pulmonary disease and asthma, the patients with COM had a 2.82-fold risk of ED (95% confidence interval=1.44-5.56). The incidence of ED increased with that of comorbidities in both cohorts. The highest hazard ratio was in patients between 40 and 59 years of age who had COM. Our data showed, for the first time, that COM is a possible risk factor for the development of ED. PMID:27169492

  19. Prognostic significance of systemic inflammation-based lymphocyte- monocyte ratio in patients with lung cancer: based on a large cohort study.

    Directory of Open Access Journals (Sweden)

    Pingping Hu

    Full Text Available Increasing evidence indicates cancer-related inflammatory biomarkers show great promise for predicting the outcome of cancer patients. The lymphocyte- monocyte ratio (LMR was demonstrated to be independent prognostic factor mainly in hematologic tumor. The aim of the present study was to investigate the prognostic value of LMR in operable lung cancer. We retrospectively enrolled a large cohort of patients with primary lung cancer who underwent complete resection at our institution from 2006 to 2011. Inflammatory biomarkers including lymphocyte count and monocyte count were collected from routinely performed preoperative blood tests and the LMR was calculated. Survival analyses were calculated for overall survival (OS and disease-free survival (DFS. A total of 1453 patients were enrolled in the study. The LMR was significantly associated with OS and DFS in multivariate analyses of the whole cohort (HR = 1.522, 95% CI: 1.275-1.816 for OS, and HR = 1.338, 95% CI: 1.152-1.556 for DFS. Univariate subgroup analyses disclosed that the prognostic value was limited to patients with non-small-cell lung cancer (NSCLC (HR: 1.824, 95% CI: 1.520-2.190, in contrast to patients with small cell lung cancer (HR: 1.718, 95% CI: 0.946-3.122. Multivariate analyses demonstrated that LMR was still an independent prognostic factor in NSCLC. LMR can be considered as a useful independent prognostic marker in patients with NSCLC after complete resection. This will provide a reliable and convenient biomarker to stratify high risk of death in patients with operable NSCLC.

  20. Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study

    DEFF Research Database (Denmark)

    Garcia-Aymerich, J; Lange, Peter; Benet, M; Schnohr, P; Antó, J M

    2006-01-01

    BACKGROUND: Information about the influence of regular physical activity on the course of chronic obstructive pulmonary disease (COPD) is scarce. A study was undertaken to examine the association between regular physical activity and both hospital admissions for COPD and all-cause and specific...... mortality in COPD subjects. METHODS: From a population-based sample recruited in Copenhagen in 1981-3 and 1991-4, 2386 individuals with COPD (according to lung function tests) were identified and followed until 2000. Self-reported regular physical activity at baseline was classified into four categories....... RESULTS: After adjustment for relevant confounders, subjects reporting low, moderate or high physical activity had a lower risk of hospital admission for COPD during the follow up period than those who reported very low physical activity (incidence rate ratio 0.72, 95% confidence interval (CI) 0.53 to 0...

  1. Activities and sources of income after a period of long-term sick leave - a population-based prospective cohort study

    Directory of Open Access Journals (Sweden)

    Wikman Anders

    2012-09-01

    Full Text Available Abstract Background There is limited knowledge about what happens to people after long-term sick leave. The aim of this report was to conduct a prospective study of individuals who were on prolonged sick leave during a particular year, considering their activities and sources of income during subsequent years. To enable comparison of different time periods, we used three cohorts of individuals with different starting years. Methods Using data from national registers, three separate cohorts were constructed that included all people living in Sweden who were 20-64 years of age (>5 million in the years 1995, 2000 and 2005, respectively. The individual members of the cohorts were classified into the following groups based on their main source of income and activity in 1995-2008: on long-term sick leave, employed, old-age pensioner, long-term unemployed, disability pensioner, on parental leave, social assistance recipient, student allowance recipient, deceased, or emigrated. Results Most individuals on long-term (> 6 months sick leave in 1995 were not employed 13 years later. Only 11% of the women and 13% of the men were primarily in employment after 13 years. Instead, a wide range of alternatives existed, for example, many had been granted disability pension, and about 10% of the women and 17% of the men had died during the follow-up period. A larger proportion of those with long-term sick leave were back in employment when 2005 was the starting year for the follow-up. Conclusions The low future employment rates for people on long-term sick leave may seem surprising. There are several possible explanations for the finding: The disorders these people may have, might have entailed longstanding difficulties on the labor market. Besides, long-term absence from work, no matter what its causes were, might have worsen the chances of further employment. The economic cycles may also have been of importance. The improving labor market during later years seems

  2. Typology of eaters based on conventional and organic food consumption: results from the NutriNet-Santé cohort study.

    Science.gov (United States)

    Baudry, Julia; Touvier, Mathilde; Allès, Benjamin; Péneau, Sandrine; Méjean, Caroline; Galan, Pilar; Hercberg, Serge; Lairon, Denis; Kesse-Guyot, Emmanuelle

    2016-08-01

    Limited information is available on large-scale populations regarding the socio-demographic and nutrient profiles and eating behaviour of consumers, taking into account both organic and conventional foods. The aims of this study were to draw up a typology of consumers according to their eating habits, based both on their dietary patterns and the mode of food production, and to outline their socio-demographic, behavioural and nutritional characteristics. Data were collected from 28 245 participants of the NutriNet-Santé study. Dietary information was obtained using a 264-item, semi-quantitative, organic FFQ. To identify clusters of consumers, principal component analysis was applied on sixteen conventional and sixteen organic food groups followed by a clustering procedure. The following five clusters of consumers were identified: (1) a cluster characterised by low energy intake, low consumption of organic food and high prevalence of inadequate nutrient intakes; (2) a cluster of big eaters of conventional foods with high intakes of SFA and cholesterol; (3) a cluster with high consumption of organic food and relatively adequate nutritional diet quality; (4) a group with a high percentage of organic food consumers, 14 % of which were either vegetarians or vegans, who exhibited a high nutritional diet quality and a low prevalence of inadequate intakes of most vitamins except B12; and (5) a group of moderate organic food consumers with a particularly high intake of proteins and alcohol and a poor nutritional diet quality. These findings may have implications for future aetiological studies investigating the potential impact of organic food consumption. PMID:27311793

  3. Cohort study of atypical pressure ulcers development.

    Science.gov (United States)

    Jaul, Efraim

    2014-12-01

    Atypical pressure ulcers (APU) are distinguished from common pressure ulcers (PU) with both unusual location and different aetiology. The occurrence and attempts to characterise APU remain unrecognised. The purpose of this cohort study was to analyse the occurrence of atypical location and the circumstances of the causation, and draw attention to the prevention and treatment by a multidisciplinary team. The cohort study spanned three and a half years totalling 174 patients. The unit incorporates two weekly combined staff meetings. One concentrates on wound assessment with treatment decisions made by the physician and nurse, and the other, a multidisciplinary team reviewing all patients and coordinating treatment. The main finding of this study identified APU occurrence rate of 21% within acquired PU over a three and a half year period. Severe spasticity constituted the largest group in this study and the most difficult to cure wounds, located in medial aspects of knees, elbows and palms. Medical devices caused the second largest occurrence of atypical wounds, located in the nape of the neck, penis and nostrils. Bony deformities were the third recognisable atypical wound group located in shoulder blades and upper spine. These three categories are definable and time observable. APU are important to be recognisable, and can be healed as well as being prevented. The prominent role of the multidisciplinary team is primary in identification, prevention and treatment. PMID:23374746

  4. Stroke and Risks of Development and Progression of Kidney Diseases and End-Stage Renal Disease: A Nationwide Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Chia-Lin Wu

    Full Text Available There is little information about the association between stroke and kidney diseases. We aimed to investigate the impact of stroke on long-term renal outcomes.In this large population-based retrospective cohort study, we identified 100,353 subjects registered in the National Health Insurance Research Database of Taiwan from January 1, 2000, through December 31, 2012, including 33,451 stroke patients and 66,902 age-, sex- and Charlson's comorbidity index score-matched controls.The incidence rate of chronic kidney disease (CKD was higher in the stroke than in the control cohort (17.5 vs. 9.06 per 1000 person-years. After multivariate adjustment, the risk of developing CKD was significantly higher in patients with stroke (adjusted hazard ratio [aHR] 1.43, 95% confidence interval [CI] 1.36-1.50, P<0.001. Subgroup analysis showed that stroke patients <50 years (aHR 1.61, P<0.001 and those with concomitant diabetes mellitus (aHR 2.12, P<0.001, hyperlipidemia (aHR 1.53, P<0.001 or gout (aHR 1.84, P<0.001 were at higher risk of incident CKD. Additionally, the risks of progression to advanced CKD and end-stage renal disease (ESRD were significantly higher for stroke patients (aHRs, 1.22 and 1.30; P = 0.04 and P = 0.008, respectively, independent of age, sex, comorbidities and long-term medications.Stroke is associated with higher risks for incident CKD, decline in renal function and ESRD. Younger stroke patients, as well as those with concomitant diabetes mellitus, hyperlipidemia or gout are at greater risk for kidney diseases.

  5. Can we monitor heart attack in the troponin era: evidence from a population-based cohort study

    Directory of Open Access Journals (Sweden)

    Rankin Jamie M

    2011-06-01

    Full Text Available Abstract Background Troponins (highly sensitive biomarkers of myocardial damage increase counts of myocardial infarction (MI in clinical practice, but their impact on trends in admission rates for MI in National statistics is uncertain. Methods Cases coded as MI or other cardiac diagnoses in the Hospital Morbidity Data Collection (MI-HMDC in Western Australia in 1998 and 2003 were classified using revised criteria for MI developed by an International panel convened by the American Heart Association (AHA criteria using information on symptoms, ECGs and cardiac biomarkers abstracted from samples of medical notes. Age-sex standardized rates of MI-HMDC were compared with rates of MI based on AHA criteria including troponins (MI-AHA or traditional biomarkers only (MI-AHAck. Results Between 1998 and 2003, rates of MI-HMDC decreased by 3.5% whereas rates of MI-AHA increased by 17%, a difference largely due to increased false-negative cases in the HMDC associated with marked increased use of troponin tests in cardiac admissions generally, and progressively lower test thresholds. In contrast, rates of MI-AHAck declined by 18%. Conclusions Increasing misclassification of MI-AHA by the HMDC may be due to reluctance by clinicians to diagnose MI based on relatively small increases in troponin levels. These influences are likely to continue. Monitoring MI using AHA criteria will require calibration of commercially available troponin tests and agreement on lower diagnostic thresholds for epidemiological studies. Declining rates of MI-AHAck are consistent with long-standing trends in MI in Western Australia, suggesting that neither MI-HMDC nor MI-AHA reflect the true underlying population trends in MI.

  6. All-cause mortality and serious cardiovascular events in people with hip and knee osteoarthritis: a population based cohort study.

    Directory of Open Access Journals (Sweden)

    Gillian A Hawker

    Full Text Available BACKGROUND: Because individuals with osteoarthritis (OA avoid physical activities that exacerbate symptoms, potentially increasing risk for cardiovascular disease (CVD and death, we assessed the relationship between OA disability and these outcomes. METHODS: In a population cohort aged 55+ years with at least moderately severe symptomatic hip and/or knee OA, OA disability (Western Ontario McMaster Universities (WOMAC OA scores; Health Assessment Questionnaire (HAQ walking score; use of walking aids and other covariates were assessed by questionnaire. Survey data were linked to health administrative data to determine the relationship between baseline OA symptom severity to all-cause mortality and occurrence of a composite CVD outcome (acute myocardial infarction, coronary revascularization, heart failure, stroke or transient ischemic attack over a median follow-up of 13.2 and 9.2 years, respectively. RESULTS: Of 2156 participants, 1,236 (57.3% died and 822 (38.1% experienced a CVD outcome during follow-up. Higher (worse baseline WOMAC function scores and walking disability were independently associated with a higher all-cause mortality (adjusted hazard ratio, aHR, per 10-point increase in WOMAC function score 1.04, 95% confidence interval, CI 1.01-1.07, p = 0.004; aHR per unit increase in HAQ walking score 1.30, 95% CI 1.22-1.39, p<0.001; and aHR for those using versus not using a walking aid 1.51, 95% CI 1.34-1.70, p<0.001. In survival analysis, censoring on death, risk of our composite CVD outcome was also significantly and independently associated with greater baseline walking disability ((aHR for use of a walking aid = 1.27, 95% CI 1.10-1.47, p = 0.001; aHR per unit increase in HAQ walking score = 1.17, 95% CI 1.08-1.27, p<0.001. CONCLUSIONS: Among individuals with hip and/or knee OA, severity of OA disability was associated with a significant increase in all-cause mortality and serious CVD events after controlling for multiple confounders

  7. Red cell distribution width in relation to incidence of stroke and carotid atherosclerosis: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Martin Söderholm

    Full Text Available Increased red cell distribution width (RDW has been related to poor prognosis in patients with cardiovascular disease, and is a predictor of cardiovascular mortality in the general population. The purpose of the present study was to investigate if RDW is associated with increased incidence of stroke and its subtypes in individuals from the general population.Red cell distribution width was measured in 26,879 participants (16,561 women and 10,318 men aged 45-73 years without history of coronary events or stroke, from the population-based Malmö Diet and Cancer Study. Incidences of total stroke and stroke subtypes over a mean follow-up of 15.2 years were calculated in relation to sex-specific quartiles of RDW. The presence of carotid plaque and intima-media thickness, as assessed by ultrasound, was studied in relation to RDW in a randomly selected subcohort (n = 5,309.Incidences of total stroke (n = 1,869 and cerebral infarction (n = 1,544 were both increased in individuals with high RDW. Hazard ratios (HRs in the highest compared to the lowest quartile were 1.31 for total stroke (95% confidence interval [CI]: 1.11-1.54, p for trend = 0.004 and 1.32 for cerebral infarction (95% CI: 1.10-1.58, p for trend = 0.004 after adjustment for stroke risk factors and hematological parameters. The adjusted HR for intracerebral hemorrhage (n = 230 was 1.44 (95% CI: 0.90-2.30 and the HR for subarachnoid hemorrhage (n = 75 was 0.94 (95% CI: 0.43-2.07, in the highest compared to the lowest quartile of RDW. Red cell distribution width was positively associated with intima-media thickness of the common carotid artery (p for trend = 0.011.Red cell distribution width in the highest quartile was associated with increased incidence of total stroke and cerebral infarction. There was no significant association between RDW and incidence of intracerebral or subarachnoid hemorrhage.

  8. Use of certainty-based marking in a second-year medical student cohort: a pilot study

    Directory of Open Access Journals (Sweden)

    Schoendorfer N

    2012-12-01

    , even though these did not count toward their final grades.Conclusion: Utilizing such practices at the beginning of an educational program may minimize apparent resistance and alter learning practices to become conducive to deeper levels of learning. This has been corroborated in other studies aiming to encourage similar higher order cognitive processes.Keywords: assessment, medical education, certainty-based marking

  9. Reduced Stroke Risk After Parathyroidectomy in End-Stage Renal Disease: A 13-Year Population-Based Cohort Study.

    Science.gov (United States)

    Hsu, Yueh-Han; Chen, Hsuan-Ju; Shen, Szu-Ching; Tsai, Wen-Chen; Hsu, Chih-Cheng; Kao, Chia-Hung

    2015-06-01

    Research information on the risk of stroke in patients with dialysis-dependent end-stage renal disease (ESRD) who have undergone parathyroidectomy (PTX) is scant. We used a nationwide health insurance claims database to select all patients with dialysis-dependent ESRD age 18 years and older for the study population. Of the patients with ESRD, we selected 1083 patients who had undergone PTX between 1998 and 2006 as the PTX group and frequency-matched 1083 patients with ESRD by sex, age, years since the disease diagnosis, and the year of undergoing PTX as the non-PTX group. We used a multivariate Cox proportional hazards regression analysis to measure the risk of stroke for the PTX group compared with the non-PTX group after adjusting for sex, age, premium-based income, urbanization, and comorbidity. The mean follow-up periods were 6.08 and 5.38 years for the PTX and non-PTX groups, respectively. After adjusting for previously mentioned variables, significant risk reductions of stroke (adjusted hazard ratio = 0.57, 95% confidence interval = 0.41-0.79), particularly those of hemorrhagic stroke (adjusted hazard ratio = 0.34, 95% confidence interval = 0.20-0.57), with PTX were observed. Chronologically, the risk of stroke in the PTX group decreased in the second year after PTX and persisted for >3 years. PTX reduces the risk of stroke, particularly that of hemorrhagic stroke, in patients with dialysis-dependent ESRD. Other factors for risk reduction include sex (females), an age <65 years, and the presence of comorbidity. PMID:26061321

  10. Subclinical Hyperthyroidism-A Cohort Study

    International Nuclear Information System (INIS)

    Objective: To compare the development of overt hyperthyroidism in a cohort of patients of subclinical hyperthyroidism (SCR) and in subjects with normal thyroid function tests. Study Design: A cohort study. Place and Duration of study: The study was conducted in the department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, Rawalpindi from Sept 2006 to Sept 2007. Patients and Methods: Fifty patients of SCR and almost equal number of age and sex-matched subjects with normal Thyroid function test (TFT) were included in the study as controls. Subclinical hyperthyroid patients and controls were followed for a period of one year on a six monthly basis. The patients were examined for signs and symptoms of hyperthyroidism and serum TSH, total T3 and free T4 were estimated. The clinical history, physical examination and TFT results were recorded. Five ml of blood was collected for serum thyroid profile in plain tube. Hormonal analysis(TSH, T4 and T3) was done for the patients and the controls enrolled in the study. The TFTs was analyzed using Chemiluminescence Immunoassay technique on Immulite 2000 an automated, random access, immunoassay analyzer. Results: Six (12%) out of 50 cases of the SCR patients and 2 (4%) out of 50 controls developed overt hyperthyroidism. SCR had no significant risk for conversion to overt hyperthyroidism as compared to healthy controls in this study. In addition to initial levels of serum TSH were one of important predictor for conversion of SCR to overt hyperthyroidism. Conclusion: Patients with SCR have no significant risk but showed an increase in frequency of conversion to overt hyperthyroidism (12% in this study) as compared to controls. (author)

  11. A multi-stage approach to maximizing geocoding success in a large population-based cohort study through automated and interactive processes

    Directory of Open Access Journals (Sweden)

    Jennifer S. Sonderman

    2012-05-01

    Full Text Available To enable spatial analyses within a large, prospective cohort study of nearly 86,000 adults enrolled in a 12-state area in the southeastern United States of America from 2002-2009, a multi-stage geocoding protocol was developed to efficiently maximize the proportion of participants assigned an address level geographic coordinate. Addresses were parsed, cleaned and standardized before applying a combination of automated and interactive geocoding tools. Our full protocol increased the non-Post Office (PO Box match rate from 74.5% to 97.6%. Overall, we geocoded 99.96% of participant addresses, with only 5.2% at the ZIP code centroid level (2.8% PO Box and 2.3% non-PO Box addresses. One key to reducing the need for interactive geocoding was the use of multiple base maps. Still, addresses in areas with population density 920 persons/km2 (odds ratio (OR = 5.24; 95% confidence interval (CI = 4.23, 6.49, as were addresses collected from participants during in-person interviews compared with mailed questionnaires (OR = 1.83; 95% CI = 1.59, 2.11. This study demonstrates that population density and address ascertainment method can influence automated geocoding results and that high success in address level geocoding is achievable for large-scale studies covering wide geographical areas.

  12. Low Birth Weight and Risk of Progression to End Stage Renal Disease in IgA Nephropathy-A Retrospective Registry-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Paschal Ruggajo

    Full Text Available Low Birth Weight (LBW is a surrogate for fetal undernutrition and is associated with impaired nephron development in utero. In this study, we investigate whether having been born LBW and/or small for gestational age (SGA predict progression to ESRD in IgA nephropathy (IgAN patients.Retrospective registry-based cohort study.The Medical Birth Registry has recorded all births since 1967 and the Norwegian Renal Registry has recorded all patients with ESRD since 1980. Based on data from the Norwegian Kidney Biopsy Registry we included all patients diagnosed with IgAN in Norway from 1988-2013. These registries were linked and we analysed risk of progression to ESRD associated with LBW (defined as birth weight less than the 10th percentile and/or SGA (defined as birth weight less than the 10th percentile for gestational week by Cox regression statistics.We included 471 patients, of whom 74 developed ESRD. As compared to patients without LBW, patients with LBW had a hazard ratio (HR of 2.0 (95% confidence interval 1.1-3.7 for the total cohort, 2.2 (1.1-4.4 for males and 1.3 (0.30-5.8 for females. Corresponding HRs for SGA were 2.2 (1.1-4.2, 2.7 (1.4-5.5 and 0.8 (0.10-5.9. Further analyses showed that as compared to patients with neither LBW nor SGA, patients with either SGA or LBW did not have significantly increased risks (HRs of 1.3-1.4 but patients who were both LBW and SGA had an increased risk (HR 3.2 (1.5-6.8.Mean duration of follow-up only 10 years and maximum age only 46 years.Among IgAN patients, LBW and/or SGA was associated with increased risk for progression to ESRD, the association was stronger in males.

  13. A Cross-Sectional Cohort Study of a Large, Statewide Medicaid Home and Community-Based Services Autism Waiver Program

    Science.gov (United States)

    Eskow, Karen Goldrich; Chasson, Gregory S.; Summers, Jean Ann

    2015-01-01

    State-specific 1915(c) Medicaid Home and Community-Based Services waiver programs have become central in the provision of services specifically tailored to children with autism spectrum disorders (ASD). Using propensity score matching, 130 families receiving waiver services for a child with ASD were matched with and compared to 130 families…

  14. Fractionated stereotactic radiation therapy improves cranial neuropathies in patients with skull base meningiomas: a retrospective cohort study

    International Nuclear Information System (INIS)

    Skull base meningiomas commonly present with cranial neuropathies. Fractionated stereotactic radiation therapy (FSRT) has been used to treat these tumors with excellent local control, but rates of improvement in cranial neuropathies have not been well defined. We review the experience at Thomas Jefferson University using FSRT in the management of these patients with a focus on symptom outcomes. We identified 225 cases of skull base meningiomas treated with FSRT at Thomas Jefferson University from 1994 through 2009. The target volume was the enhancing tumor, treated to a standard prescription dose of 54 Gy. Symptoms at the time of RT were classified based on the cranial nerve affected. Logistic regression was performed to determine predictors of symptom improvement after FSRT. The median follow-up time was 4.4 years. In 92% of cases, patients were symptomatic at the time of RT; the most common were impaired visual field/acuity (58%) or extraocular movements (34%). After FSRT, durable improvement of at least one symptom occurred in 57% of cases, including 40% of visual acuity/visual field deficits, and 40% of diplopia/ptosis deficits. Of all symptomatic patients, 27% experienced improvement of at least one symptom within 2 months of the end of RT. FSRT is very effective in achieving improvement of cranial neuropathies from skull base meningiomas, particularly visual symptoms. Over half of treated patients experience a durable improvement of at least one symptom, frequently within 2 months from the end of RT

  15. Counselling for burnout in Norwegian doctors: one year cohort study

    OpenAIRE

    Rø, Karin E Isaksson; Gude, Tore; Tyssen, Reidar; Aasland, Olaf G

    2008-01-01

    Objective To investigate levels and predictors of change in dimensions of burnout after an intervention for stressed doctors. Design Cohort study followed by self reported assessment at one year. Setting Norwegian resource centre. Participants 227 doctors participating in counselling intervention, 2003-5. Interventions Counselling (lasting one day (individual) or one week (group based)) aimed at motivating reflection on and acknowledgement of the doctors’ situation and personal needs. Main ou...

  16. Kidney stones and kidney function loss: a cohort study

    OpenAIRE

    Alexander, R Todd; Hemmelgarn, Brenda R; Wiebe, Natasha; Bello, Aminu; Morgan, Catherine; Samuel, Susan; Klarenbach, Scott W; Curhan, Gary C.; Tonelli, Marcello

    2012-01-01

    Objective To investigate whether the presence of kidney stones increase the risk of end stage renal disease (ESRD) or other adverse renal outcomes. Design A registry cohort study using validated algorithms based on claims and facility utilisation data. Median follow-up of 11 years. Setting Alberta, Canada, between 1997 and 2009. Participants 3 089 194 adult patients without ESRD at baseline or a history of pyelonephritis. Of these, 1 954 836 had outpatient serum creatinine measurements and we...

  17. Oropharyngeal Dysphagia in a Community-Based Elderly Cohort: the Korean Longitudinal Study on Health and Aging

    OpenAIRE

    Yang, Eun Joo; Kim, Mi Hyun; LIM, JAE-YOUNG; Paik, Nam-Jong

    2013-01-01

    This study was conducted to investigate the prevalence of dysphagia and evaluated the association of dysphagia and activities of daily living in a geriatric population residing in an independent-living facility in Korea. Korean men and women 65-yr and older living in a single, typical South Korean city (n=415) were enrolled in the Korean Longitudinal Study on Health and Aging study. Dysphagia was assessed using the Standardized Swallowing Assessment. Data were collected on activities of daily...

  18. Serum uric acid levels and cancer mortality risk among males in a large general population-based cohort study

    NARCIS (Netherlands)

    Taghizadeh, N.; Vonk, J. M.; Boezen, H. M.

    2014-01-01

    Serum uric acid (SUA) has antioxidant capacities and therefore may protect against the development of cancer. Few epidemiological studies have tested this hypothesis, and findings were inconsistent. We studied the association between SUA levels and mortality due to any type of cancer, and three comm

  19. Risk factors for patellar tendinopathy in volleyball and basketball players: : A survey-based prospective cohort study

    NARCIS (Netherlands)

    de Vries, A.J.; van der Worp, H.; Diercks, R.L.; van den Akker-Scheek, I.; Zwerver, J.

    2015-01-01

    Patellar tendinopathy (PT) is a common overuse injury of the patellar tendon in jumping athletes. In a recent large cross-sectional study from 2008 several factors were identified that may be associated with the etiology of PT. However, because of the study design no conclusions could be drawn about

  20. A Cross-Sectional Cohort Study of a Large, Statewide Medicaid Home and Community-Based Services Autism Waiver Program

    OpenAIRE

    Eskow, Karen Goldrich; Chasson, Gregory S.; Summers, Jean Ann

    2014-01-01

    State-specific 1915(c) Medicaid Home and Community-Based Services waiver programs have become central in the provision of services specifically tailored to children with autism spectrum disorders (ASD). Using propensity score matching, 130 families receiving waiver services for a child with ASD were matched with and compared to 130 families waiting on the registry (i.e., control group). Results indicate that participants in the waiver group reported more improvement in independent living skil...

  1. Iatrogenic immunosuppression and risk of non-Hodgkin lymphoma in solid organ transplantation: A population-based cohort study in Australia.

    Science.gov (United States)

    Na, Renhua; Laaksonen, Maarit A; Grulich, Andrew E; Meagher, Nicola S; McCaughan, Geoffrey W; Keogh, Anne M; Vajdic, Claire M

    2016-08-01

    Iatrogenic immunosuppression is a strong risk factor for non-Hodgkin lymphoma (NHL) but the dose-related association between individual immunosuppressive agents and NHL risk is unknown. We conducted a population-based cohort study of 4131 adult Australian liver, heart and lung transplant recipients (1984-2006). We ascertained NHL incidence by probabilistic record linkage between transplant registries and the Australian Cancer Database, and abstracted risk factor data at transplantation and at regular intervals thereafter from medical records. We estimated adjusted hazard ratios (HR) for early (immunosuppression, the risk of both early and late NHL did not significantly differ by organ type. In final models, higher mean daily doses of azathioprine were associated with increased risk of both early [HR 2·20, 95% confidence interval (CI): 1·21-4·01] and late NHL (HR 1·78, 95% CI: 1·12-2·84). There was no association between any other maintenance immunosuppressive agent and NHL risk. This study provides evidence that differences in immunosuppression may explain variation in NHL incidence by organ type, and high doses of azathioprine may independently predict NHL risk. PMID:27136044

  2. ADHD Candidate Gene Study in a Population-Based Birth Cohort: Association with DBH and DRD2

    Science.gov (United States)

    Nyman, Emma S.; Ogdie, Matthew N.; Loukola, Anu; Varilo, Teppo; Taanila, Anja; Hurtig, Tuula; Moilanen, Irma K.; Loo, Sandra K.; McGough, James J.; Jarvelin, Marjo-Riitta; Smalley, Susan L.

    2007-01-01

    A study aims to examine the genetic contribution if any to attention-deficit/hyperactivity disorder (ADHD). The results confirm the hypothesis and the association of dopamine [beta]-hydroxylase and dopamine receptor D2 genes with ADHD.

  3. Non-response and information bias in population-based psychiatric research:the Northern Finland 1966 Birth Cohort study

    OpenAIRE

    Haapea, M. (Marianne)

    2010-01-01

    Abstract Study samples in medical research are selected according to the objectives of the studies. Researchers seek to collect data as extensively and reliably as possible. In practice, however, data are often missing or may be incorrect. This thesis covers some of the problems concerning missing data and data collection in psychiatric research. Methods for adjusting for missing data and for evaluating the reliability of data are presented. The data originate from the Northern Finla...

  4. Early Parkinson’s Disease. Incidence, clinical features and quality of life in a population-based cohort study.

    OpenAIRE

    Müller, Bernd

    2014-01-01

    Background: The prevalence of Parkinson’s Disease (PD) in Norway is about 100/100 000 inhabitants. For planning of health care needs and for research purposes, incidence figures are considered the more valuable information, but have in Norway not been available for PD. Earlier incidence studies have shown variable results, likely due to methodological differences. To improve comparability, research criteria for high quality incidence studies of PD have been proposed in 2003.PD ...

  5. Incident somatic comorbidity after psychosis: Results from a retrospective cohort study based on Flemish general practice data

    OpenAIRE

    Truyers Carla; Buntinx Frank; De Lepeleire Jan; De Hert Marc; Van Winkel Ruud; Aertgeerts Bert; Bartholomeeusen Stefaan; Lesaffre Emmanuel

    2011-01-01

    Abstract Background Psychotic conditions and especially schizophrenia, have been associated with increased morbidity and mortality. Many studies are performed in specialized settings with a strong focus on schizophrenia. Somatic comorbidity after psychosis is studied, using a general practice comorbidity registration network. Methods Hazard ratios are presented resulting from frailty models to assess the risk of subsequent somatic disease after a diagnosis of psychosis compared to people with...

  6. Delirium is a strong risk factor for dementia in the oldest-old: a population-based cohort study

    OpenAIRE

    Davis, Daniel H. J.; Terrera, Graciela Muniz; Keage, Hannah; Rahkonen, Terhi; Oinas, Minna; Matthews, Fiona E; CUNNINGHAM, COLM; Polvikoski, Tuomo; Sulkava, Raimo; MacLullich, Alasdair M.J.; Brayne, Carol

    2012-01-01

    Recent studies suggest that delirium is associated with risk of dementia and also acceleration of decline in existing dementia. However, previous studies may have been confounded by incomplete ascertainment of cognitive status at baseline. Herein, we used a true population sample to determine if delirium is a risk factor for incident dementia and cognitive decline. We also examined the effect of delirium at the pathological level by determining associations between dementia and neuropathologi...

  7. Delirium is a strong risk factor for dementia in the oldest-old: a population-based cohort study.

    OpenAIRE

    CUNNINGHAM, COLM

    2012-01-01

    Recent studies suggest that delirium is associated with risk of dementia and also acceleration of decline in existing dementia. However, previous studies may have been confounded by incomplete ascertainment of cognitive status at baseline. Herein, we used a true population sample to determine if delirium is a risk factor for incident dementia and cognitive decline. We also examined the effect of delirium at the pathological level by determining associations between dementia and neuropathologi...

  8. Maternal serum cadmium level during pregnancy and its association with small for gestational age infants: a population-based birth cohort study

    OpenAIRE

    Hua Wang; Lu Liu; Yong-Fang Hu; Jia-Hu Hao; Yuan-Hua Chen; Pu-Yu Su; Lin Fu; Zhen Yu; Gui-Bin Zhang; Lei Wang; Fang-Biao Tao; De-Xiang Xu

    2016-01-01

    The association between maternal cadmium (Cd) exposure during pregnancy and the increased risk of fetal growth restriction (FGR) remains controversial. The present study evaluated the association between maternal serum Cd level and risk of small for gestational age (SGA) infants in a Chinese population. The present study analyzed a subsample of the C-ABCS cohort that recruited 3254 eligible mother-and-singleton-offspring pairs. Maternal serum Cd level during pregnancy was measured by graphite...

  9. Effectiveness of seasonal influenza vaccine in preventing medically attended influenza infection in England and Wales during the 2010/2011 season: a primary care‐based cohort study

    OpenAIRE

    Kafatos, George; Pebody, Richard; Andrews, Nick; Durnall, Hayley; Barley, Michele; Fleming, Douglas

    2013-01-01

    Background Estimates of seasonal influenza vaccine effectiveness (VE) are affected by factors such as the strain of the current circulating influenza virus and characteristics of the host. Objective The objective of this study was to provide VE estimates for the 2010/2011 seasonal trivalent influenza vaccine (TIV) in preventing medically attended influenza in England and Wales for the season 2010/2011. Methods A cohort study design was employed using electronic health records extracted from 1...

  10. Risk factors for patellar tendinopathy in volleyball and basketball players: A survey-based prospective cohort study.

    Science.gov (United States)

    de Vries, A J; van der Worp, H; Diercks, R L; van den Akker-Scheek, I; Zwerver, J

    2015-10-01

    Patellar tendinopathy (PT) is a common overuse injury of the patellar tendon in jumping athletes. In a recent large cross-sectional study from 2008 several factors were identified that may be associated with the etiology of PT. However, because of the study design no conclusions could be drawn about causal relations. The primary aim of the current study is to investigate whether the factors identified in the previous 2008 study can also be prospectively recognized as predictors of symptomatic PT in 2011. Nine hundred twenty-six Dutch elite and non-elite basketball and volleyball players from the previous study were invited again to complete an online survey about knee complaints and risk factors for PT in 2011. The logistic regression included 385 athletes of which 51 (13%) developed PT since 2008. Male gender [odds ratio (OR) 2.0, 95% confidence interval (CI) 1.1-3.5] was found to be a risk factor for developing PT. No sports-related variables could be identified to increase the risk of developing PT, but some evidence was found for performing heavy physically demanding work, like being a nurse or a physical education teacher (OR 2.3, 95% CI 0.9-6.3). These findings indicate that, when considering preventive measures, it is important to take into account the total tendon load. PMID:25091500

  11. Risk Factors for Full- and Partial-Syndrome Early Adolescent Eating Disorders: A Population-Based Pregnancy Cohort Study

    Science.gov (United States)

    Allen, Karina L.; Byrne, Susan M.; Forbes, David; Oddy, Wendy H.

    2009-01-01

    A sample of 14-year-old boys and girls were studied using previously collected biomedical, familial, antenatal, demographic, and social data to identify prospective predictors of eating disorders. Findings suggest that parents' perceptions on their child's weight were more powerful predictors of the development of eating disorders compared to…

  12. Acute respiratory symptoms and general illness during the first year of life: a population-based birth cohort study

    DEFF Research Database (Denmark)

    von Linstow, Marie-Louise; Holst, Klaus Kähler; Larsen, Karina; Koch, Anders; Andersen, Per Kragh; Høgh, Birthe

    2008-01-01

    . Determinants for respiratory symptoms were increasing age, winter season, household size, size of residence, day-care attendance, and having siblings aged 1-3 years attending a day nursery. In conclusion, the present study provides detailed data on the occurrence of disease symptoms during the first year of...

  13. Risk of extra-intestinal cancer in inflammatory bowel disease: meta-analysis of population-based cohort studies

    DEFF Research Database (Denmark)

    Pedersen, Eva Natalia G.; Duricova, Dana; Elkjaer, Margarita;

    2010-01-01

    Extra-intestinal manifestations of inflammatory bowel disease (IBD) are relatively common, whereas the risk of extra-intestinal cancer (EIC) remains uncertain. The aim of this study was to obtain a reliable estimate of the risk of EIC in Crohn's disease (CD) and ulcerative colitis (UC) by perform...

  14. Relevance of New Definitions to Incidence and Prognosis of Acute Kidney Injury in Hospitalized Patients with Cirrhosis: A Retrospective Population-Based Cohort Study

    Science.gov (United States)

    Tandon, Puneeta; James, Matthew T.; Abraldes, Juan G.; Karvellas, Constantine J.; Ye, Feng; Pannu, Neesh

    2016-01-01

    Background The implementation of new serum creatinine (SCr)-based criteria for acute kidney injury (AKI) has brought to light several areas of uncertainty in patients with cirrhosis. Study Design Population-based cohort study. Setting & Participants Adults with cirrhosis hospitalized between 2002–2012. Predictor We aimed to address the prognostic implications of the new AKI criteria in cirrhosis. Outcomes Baseline kidney function was defined from all outpatient SCr within 3 months before hospitalization. Cox proportional hazards models were fit to examine associations between AKI, renal recovery and all-cause mortality. Results 4,733 patients were studied. The 30-day mortality was higher for participants with AKI (43.9% vs 8.5%; p-valueSCr within the three months prior to admission was used to define baseline. The hazard ratio for mortality using the lowest SCr within 3 months and the closest pre-admission SCr (definition suggested by the recent consensus guideline) were similar, validating the use of the latter measure. As compared to patients without AKI, stage 1 AKI with maximum SCr ≤132 mmol/L remained associated with a 3.5-fold increased hazard of death at 30 days (95% CI 2.6 to 4.7). Limitations As an observational study, the results were vulnerable to residual confounding and ascertainment bias in the use of laboratory data to identify AKI. We did not have access to liver function or disease etiology variables and were unable to adjust for these in our analyses. Conclusions These results confirm the graded relationship between AKI severity, renal recovery, and mortality and further clarify previously discordant reports about the prognostic relevance of new AKI criteria in patients with cirrhosis. PMID:27504876

  15. Cohort profile: the Spanish WORKing life Social Security (WORKss) cohort study

    Science.gov (United States)

    López Gómez, María Andrée; Durán, Xavier; Zaballa, Elena; Sanchez-Niubo, Albert; Delclos, George L; Benavides, Fernando G

    2016-01-01

    Purpose The global economy is changing the labour market and social protection systems in Europe. The effect of both changes on health needs to be monitored in view of an ageing population and the resulting increase in prevalence of chronic health conditions. The Spanish WORKing life Social Security (WORKss) cohort study provides unique longitudinal data to study the impact of labour trajectories and employment conditions on health, in terms of sickness absence, permanent disability and death. Participants The WORKss cohort originated from the Continuous Working Life Sample (CWLS) generated by the General Directorate for the Organization of the Social Security in Spain. The CWLS contains a 4% representative sample of all individuals in contact with the Social Security system. The WORKss cohort exclusively includes individuals with a labour trajectory from 1981 or later. In 2004, the cohort was initiated with 1 022 779 Social Security members: 840 770 (82.2%) contributors and 182 009 (17.8%) beneficiaries aged 16 and older. Findings to date The WORKss cohort includes demographic characteristics, chronological data about employment history, retirement, permanent disability and death. These data make possible the measurement of incidence of permanent disability, the number of potential years of working life lost, and the number of contracts and inactive periods with the Social Security system. The WORKss cohort was linked to temporary sickness absence registries to study medical diagnoses that lead to permanent disability and consequently to an earlier exit from the labour market in unhealthy conditions. Future plans Thanks to its administrative source, the WORKss cohort study will continue follow-up in the coming years, keeping the representativeness of the Spanish population affiliated to the Social Security system. The linkage between the WORKss cohort and temporary sickness absence registries is envisioned to continue. Future plans include the linkage of

  16. Risk of breast cancer following fertility treatment – A registry based cohort study of parous women in Norway

    Science.gov (United States)

    Reigstad, Marte Myhre; Larsen, Inger Kristin; Myklebust, Tor Åge; Robsahm, Trude Eid; Oldereid, Nan Birgitte; Omland, Anne Katerine; Vangen, Siri; Brinton, Louise Annette; Storeng, Ritsa

    2014-01-01

    Despite increasing numbers of women availing themselves of assisted reproductive technology (ART), effects on cancer risk remain unresolved. Given hormonal exposures, breast cancer risk is of particular concern. The aim of this study is to investigate breast cancer risk amongst women giving birth following ART as compared to that amongst women who gave birth without ART. Data on all women who gave birth in Norway with or without ART, between 1984 and 2010 was obtained from the Medical Birth Registry of Norway (MBRN). 808 834 women eligible for study were linked to the Cancer Registry of Norway. Cox proportional hazards model computed relative risk of breast cancer between the two groups, adjusting for age, parity, age at first birth, calendar period and region of residence. A total of 8037 women were diagnosed with breast cancer during the study period, 138 ART women and 7899 unexposed. Total follow-up time was 12 401 121 person-years (median 16.0), median age at entry was 32.5 years (range18.6-49.9) for ART women and 26.3 (range 10.5-54.6) for women without ART. Women exposed to ART had an elevated risk of breast cancer (adjusted HR 1.20, 95% CI 1.01-1.42). Subgroup analyses resulted in an HR of 1.30 (95% CI 1.07-1.57) for women treated with IVF and 1.35 (95 % CI 1.07-1.71) for women with follow-up >10 years, compared with controls. Our findings of increased risk in the study population, warrant continued monitoring of women treated with ART as this population advances into more typical cancer age ranges. PMID:25042052

  17. Lower Urinary Tract Symptoms, Depression, Anxiety and Systemic Inflammatory Factors in Men: A Population-Based Cohort Study

    OpenAIRE

    Sean Martin; Andrew Vincent; Taylor, Anne W; Evan Atlantis; Alicia Jenkins; Andrzej Januszewski; Peter O'Loughlin; Gary Wittert

    2015-01-01

    Background The relationship between lower urinary tract symptoms (LUTS) and common mental health disorders such as depression and anxiety in men remains unclear. Inflammation has recently been identified as an independent risk factor for LUTS and depression. This study aimed to assess the association between depression, anxiety and LUTS, and the moderating influence of systemic inflammation, in the presence of other biopsychosocial confounders. Methods Participants were randomly-selected from...

  18. Mild hyponatremia, hypernatremia and incident cardiovascular disease and mortality in older men: A population-based cohort study

    OpenAIRE

    Wannamethee, S.G.; Shaper, A. G.; LENNON, L; Papacosta, O.; Whincup, P

    2016-01-01

    AIM: To examine the association between serum sodium concentration and incident major cardiovascular disease (CVD) outcomes and total mortality in older men. METHODS AND RESULTS: A prospective study of 3099 men aged 60-79 years without a history of cardiovascular disease followed up for an average 11 years during which there were 528 major CVD events (fatal coronary heart disease [CHD] and non-fatal MI, stroke and CVD death) and 873 total deaths. A U shaped relationship was seen between serum...

  19. Risk prediction for breast, endometrial, and ovarian cancer in white women aged 50 y or older: derivation and validation from population-based cohort studies.

    Directory of Open Access Journals (Sweden)

    Ruth M Pfeiffer

    Full Text Available BACKGROUND: Breast, endometrial, and ovarian cancers share some hormonal and epidemiologic risk factors. While several models predict absolute risk of breast cancer, there are few models for ovarian cancer in the general population, and none for endometrial cancer. METHODS AND FINDINGS: Using data on white, non-Hispanic women aged 50+ y from two large population-based cohorts (the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial [PLCO] and the National Institutes of Health-AARP Diet and Health Study [NIH-AARP], we estimated relative and attributable risks and combined them with age-specific US-population incidence and competing mortality rates. All models included parity. The breast cancer model additionally included estrogen and progestin menopausal hormone therapy (MHT use, other MHT use, age at first live birth, menopausal status, age at menopause, family history of breast or ovarian cancer, benign breast disease/biopsies, alcohol consumption, and body mass index (BMI; the endometrial model included menopausal status, age at menopause, BMI, smoking, oral contraceptive use, MHT use, and an interaction term between BMI and MHT use; the ovarian model included oral contraceptive use, MHT use, and family history or breast or ovarian cancer. In independent validation data (Nurses' Health Study cohort the breast and ovarian cancer models were well calibrated; expected to observed cancer ratios were 1.00 (95% confidence interval [CI]: 0.96-1.04 for breast cancer and 1.08 (95% CI: 0.97-1.19 for ovarian cancer. The number of endometrial cancers was significantly overestimated, expected/observed = 1.20 (95% CI: 1.11-1.29. The areas under the receiver operating characteristic curves (AUCs; discriminatory power were 0.58 (95% CI: 0.57-0.59, 0.59 (95% CI: 0.56-0.63, and 0.68 (95% CI: 0.66-0.70 for the breast, ovarian, and endometrial models, respectively. CONCLUSIONS: These models predict absolute risks for breast, endometrial, and ovarian

  20. Overweight, resting heart rate, and prediabetes/diabetes: A population-based prospective cohort study among Inner Mongolians in China.

    Science.gov (United States)

    Zhang, Shao Yan; Wu, Jia Hui; Zhou, Jing Wen; Liang, Zhu; Qiu, Qiao Yan; Xu, Tian; Zhang, Ming Zhi; Zhong, Chong Ke; Jiang, Wei; Zhang, Yong Hong

    2016-01-01

    We aimed to investigate the cumulative effect of overweight and resting heart rate on prediabetes/diabetes incidence in an 10-year follow-up study in Inner Mongolians. Among 1729 participants who were free from prediabetes and diabetes at baseline, 503 and 155 subjects developed prediabetes and diabetes, respectively. We categorized the participants into 4 subgroups according to overweight and resting heart rate status. The multivariate-adjusted OR (95% CI) in normal weight with heart rate ≥80 bpm, overweight with heart rate <80 bpm, and overweight with heart rate ≥80 bpm were 1.24 (0.95-1.61), 1.83 (1.29-2.61), 2.20 (1.41-3.45) for prediabetes and 1.52 (0.97-2.40), 3.64 (2.21-6.01), 4.61 (2.47-8.61) for diabetes, respectively, compared with normal weight with heart rate <80 bpm. The area under ROC curve (AUC) for the prediction of diabetes incidence for a model containing overweight and resting heart rate, along with conventional factors (AUC = 0.751), was significantly (P = 0.003) larger than the one containing only conventional factors (AUC = 0.707). Our study indicated that overweight was an independent risk factor of prediabetes and diabetes, and overweight with faster resting heart rate might further increase the risk of prediabetes and diabetes. PMID:27029423

  1. Maternal smoking during pregnancy predicts adult offspring cardiovascular risk factors - evidence from a community-based large birth cohort study.

    Directory of Open Access Journals (Sweden)

    Abdullah A Mamun

    Full Text Available BACKGROUND: Maternal smoking during pregnancy is associated with offspring obesity. However, little is known about whether maternal smoking in pregnancy predicts other offspring cardiovascular risk factors including waist circumference (WC, waist-hip-ratio (WHR, pulse rate (PR, systolic (SBP, and diastolic blood pressure (DBP. METHODS: We studied a sub-sample of 2038 (50% males young adults who were born in Brisbane, Australia to investigate the prospective association of maternal smoking during pregnancy with young adult cardiovascular risk factors. We compared offspring mean BMI, WC, WHR, SBP, DBP and PR and the risk of being overweight and obese at 21 years by three mutually exclusive categories of maternal smoking status defined as never smoked, smoked before and/or after pregnancy but not in pregnancy or smoked during pregnancy and other times. RESULTS: Offspring of mothers who smoked during pregnancy had greater mean BMI, WC, WHR and PR and they were at greater risk of being obese at 21 years compared to offspring of those mothers who never smoked. The mean of these risk factors among those adult offspring whose mothers stopped smoking during pregnancy, but who then smoked at other times in the child's life, were similar to those mothers who never smoked. These results were independent of a range of potential confounding factors. CONCLUSION: The findings of this study suggest a prospective association of maternal smoking during pregnancy and offspring obesity as well as PR in adulthood, and reinforce the need to persuade pregnant women not to smoke.

  2. Association between Gastroenterological Malignancy and Diabetes Mellitus and Anti-Diabetic Therapy: A Nationwide, Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Chien-Ming Lin

    Full Text Available The relationship between diabetes mellitus (DM and cancer incidence has been evaluated in limited kinds of cancer. The effect of anti-diabetic therapy (ADT on carcinogenesis among diabetic patients is also unclear.Using population-based representative insurance claims data in Taiwan, 36,270 DM patients and 145,080 comparison subjects without DM were identified from claims from 2005 to 2010. The association between the top ten leading causes of cancer-related death in Taiwan and DM was evaluated. Whether ADT altered the risk of developing cancer was also investigated.Incidence of cancer at any site was significantly higher in patients with DM than in those without (p<0.001. The risk of carcinogenesis imparted by DM was greatest in gastroenterological malignancies (liver, pancreas, and colorectal cancer as well as lung, breast and oral cancer (p<0.001. Among the oral types of ADT, metformin decreased the risk of lung and liver cancer, but had less effect on reducing the risk of colorectal cancer. α-glucosidase inhibitor decreased the risk of developing liver, colorectal, and breast cancer. Apart from intermediate-acting insulin, rapid-acting, long-acting, and combination insulin treatment significantly reduced the overall cancer risk among all DM patients. In subgroup analysis, long-acting insulin treatment significantly decreased the risk of lung, liver, and colorectal cancer.Our results supported the notion that pre-existing DM increases the incidence of gastroenterological cancer. ADT, especially metformin, α-glucosidase inhibitor, and long-acting insulin treatment, may protect patients with DM against these malignancies. It is crucial that oncologists should closely collaborate with endocrinologists to provide an optimal cancer-specific therapy and diabetic treatment to patients simultaneously with cancer and DM.

  3. Minimum incidence of adult invasive pneumococcal disease in Blantyre, Malawi an urban african setting: a hospital based prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Naor Bar-Zeev

    Full Text Available Invasive pneumococcal disease causes substantial morbidity and mortality in Africa. Evaluating population level indirect impact on adult disease of pneumococcal conjugate vaccine (PCV programmes in infants requires baseline population incidence rates but these are often lacking in areas with limited disease surveillance. We used hospital based blood culture and cerebrospinal fluid surveillance to calculate minimal incidence of invasive pneumococcal disease in the adult (≥15 years old population of Blantyre, a rapidly growing urban centre in southern Malawi, in the period preceding vaccine introduction. Invasive pneumococcal disease incidence in Blantyre district was high, mean 58.1 (95% confidence interval (CI: 53.7, 62.7 per 100,000 person years and peaking among 35 to 40 year olds at 108.8 (95%CI: 89.0, 131.7 mirroring the population age prevalence of HIV infection. For pneumococcal bacteraemia in urban Blantyre, mean incidence was 60.6 (95% CI: 55.2, 66.5 per 100,000 person years, peaking among 35 to 40 year olds at 114.8 (95%CI: 90.3, 143.9. We suspected that our surveillance may under-ascertain the true burden of disease, so we used location data from bacteraemic subjects and projected population estimates to calculate local sub-district incidence, then examined the impact of community level socio-demographic covariates as possible predictors of local sub-district incidence of pneumococcal and non-pneumococcal pathogenic bacteraemia. Geographic heterogeneity in incidence was marked with localised hotspots but ward level covariates apart from prison were not associated with pneumococcal bacteraemia incidence. Modelling suggests that the current sentinel surveillance system under-ascertains the true burden of disease. We outline a number of challenges to surveillance for pneumococcal disease in our low-resource setting. Subsequent surveillance in the vaccine era will have to account for geographic heterogeneity when evaluating population

  4. Minimum incidence of adult invasive pneumococcal disease in Blantyre, Malawi an urban african setting: a hospital based prospective cohort study.

    Science.gov (United States)

    Bar-Zeev, Naor; Mtunthama, Neema; Gordon, Stephen B; Mwafulirwa, Gershom; French, Neil

    2015-01-01

    Invasive pneumococcal disease causes substantial morbidity and mortality in Africa. Evaluating population level indirect impact on adult disease of pneumococcal conjugate vaccine (PCV) programmes in infants requires baseline population incidence rates but these are often lacking in areas with limited disease surveillance. We used hospital based blood culture and cerebrospinal fluid surveillance to calculate minimal incidence of invasive pneumococcal disease in the adult (≥15 years old) population of Blantyre, a rapidly growing urban centre in southern Malawi, in the period preceding vaccine introduction. Invasive pneumococcal disease incidence in Blantyre district was high, mean 58.1 (95% confidence interval (CI): 53.7, 62.7) per 100,000 person years and peaking among 35 to 40 year olds at 108.8 (95%CI: 89.0, 131.7) mirroring the population age prevalence of HIV infection. For pneumococcal bacteraemia in urban Blantyre, mean incidence was 60.6 (95% CI: 55.2, 66.5) per 100,000 person years, peaking among 35 to 40 year olds at 114.8 (95%CI: 90.3, 143.9). We suspected that our surveillance may under-ascertain the true burden of disease, so we used location data from bacteraemic subjects and projected population estimates to calculate local sub-district incidence, then examined the impact of community level socio-demographic covariates as possible predictors of local sub-district incidence of pneumococcal and non-pneumococcal pathogenic bacteraemia. Geographic heterogeneity in incidence was marked with localised hotspots but ward level covariates apart from prison were not associated with pneumococcal bacteraemia incidence. Modelling suggests that the current sentinel surveillance system under-ascertains the true burden of disease. We outline a number of challenges to surveillance for pneumococcal disease in our low-resource setting. Subsequent surveillance in the vaccine era will have to account for geographic heterogeneity when evaluating population level indirect

  5. Survival of invasive bladder cancer patients, 1998–2009; a central and northern Denmark population-based cohort study

    Directory of Open Access Journals (Sweden)

    Lund L

    2011-07-01

    Full Text Available Lars Lund1,2, R Erichsen1, M Nørgaard1, E H Larsen3, M Borre4, J Jacobsen11Department of Clinical Epidemiology, Aarhus University Hospital, Denmark; 2Department of Urology, Viborg Hospital, Denmark; 3Department of Urology, Aarhus University Hospital, Aalborg, Denmark; 4Department of Urology, Aarhus University Hospital, Skejby, DenmarkObjective: Invasive bladder cancer (IBC is a common urological malignancy accounting for 4%–5% of all cancers in Denmark. Our aim was to examine possible changes in short- and long-term survival of patients with IBC during 1998–2009.Study design and setting: Data on all patients (N = 4032 with an incident diagnosis of IBC within a population of 1.8 million were retrieved from the Danish National Registry of Patients from 1998 to 2009. We computed survival after 1, 3, and 5 years, stratified by age and gender, and estimated mortality rate ratios (MRR using Cox proportional hazard regression to compare mortality over time, controlling for age and gender. Data on tumor stage or histology were not included.Results: During the study period, the annual numbers of incident IBC patients remained stable. The median age was 74 years in each of the four 3-year periods in the study. The survival was relatively stable during the first three periods, whilst data from the last period showed modest improvement. The overall 1-year survival increased from 68% in 1998–2000 to 70% in 2007–2009, corresponding to an age and gender adjusted MRR of 0.89 (95% confidence interval [CI] 0.76–1.03. The 3- and 5-year survival was predicted to increase from 44% to 49% and from 35% to 40% respectively. This corresponded to a 3-year age and gender adjusted MRR of 0.87 (95% CI 0.77–0.98 and a 5-year MRR of 0.88 (95% CI 0.79–0.99. The 1-, 3-, and 5-year survival increased for men in all age groups (<70 years, 70–79 years, ≥80 years and in women only in the 70–79-year age group. Conclusion: The survival of IBC patients increased

  6. Smoking and risk of acute and chronic pancreatitis among women and men: a population-based cohort study

    DEFF Research Database (Denmark)

    Tolstrup, Janne Schurmann; Kristiansen, Louise; Becker, Ulrik;

    2009-01-01

    . Information on incident cases of acute and chronic pancreatitis were obtained by record linkage with the Danish national registries. RESULTS: A total of 235 cases of pancreatitis occurred during follow-up. A dose-response association between smoking and risk of acute and chronic pancreatitis was observed in......BACKGROUND: Alcohol and gallstone disease are the most established risk factors for pancreatitis. Smoking is rarely considered to be a cause despite the fact that a few studies have indicated the opposite. We aimed to assess the independent effects of smoking on the risk of pancreatitis. METHODS...... both men and women. For example, the hazard ratio of developing pancreatitis was 2.6 (95% confidence interval [CI], 1.5-4.7) among women and 2.6 (95% CI, 1.1-6.2) among men who smoked 15 to 24 grams of tobacco per day. Alcohol intake was associated with an increased risk of pancreatitis (hazard ratio...

  7. Systematic age-related differences in chronic disease management in a population-based cohort study: a new paradigm of primary care is required.

    Directory of Open Access Journals (Sweden)

    Alessandra Buja

    Full Text Available BACKGROUND: Our interest in chronic conditions is due to the fact that, worldwide, chronic diseases have overtaken infectious diseases as the leading cause of death and disability, so their management represents an important challenge for health systems. The aim of this study was to compare the performance of primary health care services in managing diabetes, congestive heart failure (CHF and coronary heart disease (CHD, by age group. METHODS: This population-based retrospective cohort study was conducted in Italy, enrolling 1,948,622 residents ≥ 16 years old. A multilevel regression model was applied to analyze compliance to care processes with explanatory variables at both patient and district level, using age group as an independent variable, and adjusting for sex, citizenship, disease duration, and Charlson index on the first level, and for District Health Unit on the second level. RESULTS: The quality of chronic disease management showed an inverted U-shaped relationship with age. In particular, our findings indicate lower levels for young adults (16-44 year-olds, adults (45-64, and oldest old (+85 than for patients aged 65-74 in almost all quality indicators of CHD, CHF and diabetes management. Young adults (16-44 y, adults (45-64 y, the very old (75-84 y and the oldest old (+85 y patients with CHD, CHF and diabetes are less likely than 65-74 year-old patients to be monitored and treated using evidence-based therapies, with the exceptions of echocardiographic monitoring for CHF in young adult patients, and renal monitoring for CHF and diabetes in the very old. CONCLUSION: Our study shows that more effort is needed to ensure that primary health care systems are sensitive to chronic conditions in the young and in the very elderly.

  8. Maternal eating disorder and infant diet. A latent class analysis based on the Norwegian Mother and Child Cohort Study (MoBa).

    Science.gov (United States)

    Torgersen, Leila; Ystrom, Eivind; Siega-Riz, Anna Maria; Berg, Cecilie Knoph; Zerwas, Stephanie C; Reichborn-Kjennerud, Ted; Bulik, Cynthia M

    2015-01-01

    Knowledge of infant diet and feeding practices among children of mothers with eating disorders is essential to promote healthy eating in these children. This study compared the dietary patterns of 6-month-old children of mothers with anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified-purging subtype, to the diet of children of mothers with no eating disorders (reference group). The study was based on 53,879 mothers in the Norwegian Mother and Child Cohort Study (MoBa). Latent class analysis (LCA) was used to identify discrete latent classes of infant diet based on the mothers' responses to questions about 16 food items. LCA identified five classes, characterized by primarily homemade vegetarian food (4% of infants), homemade traditional food (8%), commercial cereals (35%), commercial jarred baby food (39%), and a mix of all food groups (11%). The association between latent dietary classes and maternal eating disorders were estimated by multinomial logistic regression. Infants of mothers with bulimia nervosa had a lower probability of being in the homemade traditional food class compared to the commercial jarred baby food class, than the referent (O.R. 0.59; 95% CI 0.36-0.99). Infants of mothers with binge eating disorder had a lower probability of being in the homemade vegetarian class compared to the commercial jarred baby food class (O.R. 0.77; 95% CI 0.60-0.99), but only before adjusting for relevant confounders. Anorexia nervosa and eating disorder not otherwise specified-purging subtype were not statistically significantly associated with any of the dietary classes. These results suggest that maternal eating disorders may to some extent influence the child's diet at 6 months; however, the extent to which these differences influence child health and development remains an area for further inquiry. PMID:25453594

  9. Risk of Acute Kidney Injury and Long-Term Outcome in Patients With Acetaminophen Intoxication: A Nationwide Population-Based Retrospective Cohort Study.

    Science.gov (United States)

    Chen, Yu-Guang; Lin, Cheng-Li; Dai, Ming-Shen; Chang, Ping-Ying; Chen, Jia-Hong; Huang, Tzu-Chuan; Wu, Yi-Ying; Kao, Chia-Hung

    2015-11-01

    Acetaminophen (APAP) intoxication is a common cause of hepatic toxicity and life-threatening hepatic failure. However, few studies have investigated the possible association between APAP intoxication and acute kidney injury (AKI). We constructed a retrospective cohort study to clarify the relationship between APAP intoxication and the risk of AKI.We identified patients with APAP intoxication and selected a comparison cohort that was 1:4 frequency matched according to age, sex, and year of APAP intoxication diagnosis from the Taiwan National Health Insurance Research Database from 1998 to 2010. We analyzed the risks of AKI for patients with APAP intoxication by using Cox proportional hazards regression models.In this study, 2914 patients with APAP intoxication and 11,656 controls were included. The overall risks of developing AKI were 2.41-fold in the patients with APAP intoxication compared with the comparison cohort. After we excluded APAP intoxication patients with coexisting AKI and hepatic failure/hepatitis, the overall risks of developing AKI were still 2.22-fold in the patients with APAP intoxication. There were 2 patients who had end-stage renal disease (ESRD) following APAP intoxication-related AKI. Limitations include retrospective review, selection bias, and absence of data on detail medications used, laboratory investigations and dosage of APAP intoxication.Our long-term cohort study results showed that AKI is a possible adverse effect among patients with APAP intoxication, regardless of whether patients have presented with hepatic toxicity. However, additional studies are necessary to clarify whether such patients can progress to ESRD. PMID:26579812

  10. Preterm birth and reduced birthweight in first and second teenage pregnancies: a register-based cohort study.

    LENUS (Irish Health Repository)

    Khashan, Ali S

    2010-01-01

    BACKGROUND: Higher risks of preterm birth and small for gestational age babies have been reported in teenagers. The aim of this study was to investigate the relationship between first and second teenage pregnancies and preterm birth, birthweight and small for gestational age (SGA). METHODS: All women aged 14 to 29 yrs who gave birth to live singletons in the North Western Region of England between January 1st 2004 and December 31st 2006 were identified. Women were classified in three groups; 14-17 yrs, 18-19 yrs and 20-29 yrs (reference group). The outcome measures were preterm birth, very preterm birth, birthweight, SGA (< 5th percentile), very SGA (VSGA< 3rd percentile). We compared these outcome measures in teenagers\\' first and second pregnancies with those of mothers aged 20 to 29 yrs. RESULTS: The risk of preterm birth was increased in first (OR = 1.21, [95% CI: 1.01-1.45]) and second (OR = 1.93, [95% CI: 1.38-2.69]) time mothers aged 14-17 yrs compared to the reference group. Birthweight was reduced in the first (mean difference = -24 g; [95% CI: -40, -7]) and second (mean difference = -80 g; [95% CI: -115, -46]) time mothers aged 14-17 yrs compared to the reference group. There was some evidence of a protective effect against VSGA in 14-17 yr old first time mothers (OR = 0.79, [95% CI: 0.63-0.99]). CONCLUSIONS: Teenage mothers are at increased risk of preterm birth compared to adult mothers and this risk is further increased in second time teen pregnancies. This study highlights the importance of ensuring pregnant teenagers have appropriate antenatal care. A first pregnancy may be the first and only time a pregnant teenager interacts with health services and this opportunity for health education and the promotion of contraception should not be overlooked.

  11. Sick Leave within 5 Years of Whiplash Trauma Predicts Recovery: A Prospective Cohort and Register-Based Study

    Science.gov (United States)

    Carstensen, Tina Birgitte Wisbech; Fink, Per; Oernboel, Eva; Kasch, Helge; Jensen, Troels Staehelin; Frostholm, Lisbeth

    2015-01-01

    Background 10–22% of individuals sustaining whiplash trauma develop persistent symptoms resulting in reduced working ability and decreased quality of life, but it is poorly understood why some people do not recover. Various collision and post-collision risk factors have been studied, but little is known about pre-collision risk factors. In particular, the impact of sickness and socioeconomic factors before the collision on recovery is sparsely explored. The aim of this study was to examine if welfare payments received within five years pre-collision predict neck pain and negative change in provisional situation one year post-collision. Methods and Findings 719 individuals with acute whiplash trauma consecutively recruited from emergency departments or primary care after car accidents in Denmark completed questionnaires on socio-demographic and health factors immediately after the collision. After 12 months, a visual analogue scale on neck pain intensity was completed. 3595 matched controls in the general population were sampled, and national public register data on social benefits and any other welfare payments were obtained for participants with acute whiplash trauma and controls from five years pre-collision to 15 months after. Participants with acute whiplash trauma who had received sickness benefit for more than 12 weeks pre-collision had increased odds for negative change in future provisional situation (Odds Ratio (OR) (95% Confidence Interval (CI) = 3.8 (2.1;7.1)) and future neck pain (OR (95%CI) = 3.3 (1.8;6.3)), controlling for other known risk factors. Participants with acute whiplash trauma had weaker attachment to labour market (more weeks of sick leave (χ2(2) = 36.7, p < 0.001) and unemployment (χ2(2) = 12.5, p = 0.002)) pre-collision compared with controls. Experiencing a whiplash trauma raised the odds for future negative change in provisional situation (OR (95%CI) = 3.1 (2.3;4.4)) compared with controls. Conclusions Sick leave before the

  12. Sick Leave within 5 Years of Whiplash Trauma Predicts Recovery: A Prospective Cohort and Register-Based Study.

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    Tina Birgitte Wisbech Carstensen

    Full Text Available 10-22% of individuals sustaining whiplash trauma develop persistent symptoms resulting in reduced working ability and decreased quality of life, but it is poorly understood why some people do not recover. Various collision and post-collision risk factors have been studied, but little is known about pre-collision risk factors. In particular, the impact of sickness and socioeconomic factors before the collision on recovery is sparsely explored. The aim of this study was to examine if welfare payments received within five years pre-collision predict neck pain and negative change in provisional situation one year post-collision.719 individuals with acute whiplash trauma consecutively recruited from emergency departments or primary care after car accidents in Denmark completed questionnaires on socio-demographic and health factors immediately after the collision. After 12 months, a visual analogue scale on neck pain intensity was completed. 3595 matched controls in the general population were sampled, and national public register data on social benefits and any other welfare payments were obtained for participants with acute whiplash trauma and controls from five years pre-collision to 15 months after. Participants with acute whiplash trauma who had received sickness benefit for more than 12 weeks pre-collision had increased odds for negative change in future provisional situation (Odds Ratio (OR (95% Confidence Interval (CI = 3.8 (2.1;7.1 and future neck pain (OR (95%CI = 3.3 (1.8;6.3, controlling for other known risk factors. Participants with acute whiplash trauma had weaker attachment to labour market (more weeks of sick leave (χ2(2 = 36.7, p < 0.001 and unemployment (χ2(2 = 12.5, p = 0.002 pre-collision compared with controls. Experiencing a whiplash trauma raised the odds for future negative change in provisional situation (OR (95%CI = 3.1 (2.3;4.4 compared with controls.Sick leave before the collision strongly predicted prolonged recovery

  13. Risk of Second Cancers in Merkel Cell Carcinoma: A Meta-Analysis of Population Based Cohort Studies

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    Anshul Saxena

    2014-01-01

    Full Text Available The risk of second cancers in Merkel cell carcinoma (MCC remains uncertain since risk estimates vary worldwide. The global MCC population is growing and there is a demand for better knowledge of prognosis of this disease. The Cochrane Database of Systematic Reviews, MEDLINE, and EMBASE search engines were searched for the relevant literature between January 1999 and September 2014 by use of explicit search criteria. The main outcome was second malignancies associated with MCC patients measured by standardized incidence ratios (SIRs or other estimates of risks. Five papers fulfilled the inclusion criteria and reported SIRs of second cancer in MCC which varied from 1.07 to 2.80. Performing meta-analysis using random effects model revealed that there was an increased risk for second malignancies due to MCC (SIR, 1.52; 95% CI, 1.10–2.11. There was a significant increase in risk for malignant melanoma (SIR, 3.09; 95% CI, 2.02–4.73 as compared to all common second malignancies among the studies. Updated knowledge about risk of second malignancies in MCC will help in better assessment of the disease prognosis and will help in optimizing the medical and surgical treatment, radiotherapy, follow-up, and surveillance procedures.

  14. Transmission of genital human papillomavirus infection in couples: a population-based cohort study in rural China

    Science.gov (United States)

    Liu, Mengfei; He, Zhonghu; Zhang, Chanyuan; Liu, Fangfang; Liu, Ying; Li, Jingjing; Xu, Zhongyao; Wang, Qiyan; Hang, Dong; Shen, Na; Pan, Yaqi; Guo, Chuanhai; Cai, Hong; Ke, Yang

    2015-01-01

    HPV transmission dynamics have rarely been studied in the general population, especially in China. We followed the genital HPV infection status of both partners in 874 couples aged 25-65 years from rural China for up to 7 bi-annual visits during 2009-2013. The positive HPV concordance and transmission rate for partners in a couple were evaluated and relevant risk factors were assessed. The concordance of any, oncogenic, and non-oncogenic HPV was 15.52%, 16.18% and 10.41%, respectively. Male-to-female transmission rate was 7.11, 12.13 and 4.77/1000 person months for any, oncogenic and non-oncogenic HPV respectively. The female-to-male transmission rate was 5.56, 2.37, and 17.01/1000 person months for any, oncogenic and non-oncogenic HPV respectively. The risk of male-to-female transmission was significantly higher than that of female-to-male transmission for oncogenic types. However, for non-oncogenic types, the risk of male-to-female transmission was significantly lower than that of female-to-male transmission. Younger couples, persistent infection with HPV, higher numbers of sexual partners and higher frequency of sexual intercourse were positively associated with HPV transmission in couples. Our results indicate that men in rural China play a more important role than men in western populations as a source of cervical oncogenic HPV infection in women. PMID:26204471

  15. Human Cytomegalovirus Infection in Women of Childbearing Age Throughout Fars Province - Iran: A Population-based Cohort Study

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    Arabpour, M.

    2007-01-01

    Full Text Available Human cytomegalovirus (hCMV has been described as an important etiological agent of intrauterine infection in women of childbearing age that causes congenital malformation. In the present study we examined 844 serum samples from women of child-bearing age for the presence of IgM and IgG antibodies against hCMV by Elisa technique. 764 out of 844 (93% of the cases were seropositive for hCMV-IgG and 45 (5.4% cases were seropositive for hCMV-IgM. An increase in the rate of IgG seroprevalance was associated with an increase in age and parity. The IgG seroprevalance rate was inversely proportional to increasing abortions. Intrestingly seasonal variation affected IgG seroprevalance. There was an increasing trend in IgM positivity rate with age in women less than 29 years. hCMV seroprevalence rate was higher in women from rural as compared to those of urban areas. Finally hCMV primary infections occured in 2.4 % of all pregnancis and it is estimated that up to 0.3% of all congenital disorders, through out Fars province, were due to hCMV. We suggest a role of child to mother hCMV transmission and sexual maturity as the most probable epidemiological factors of hCMV seroprevalence among women of child bearing age.

  16. A population-based case-cohort study of the risk of myocardial infarction following radiation therapy for breast cancer

    International Nuclear Information System (INIS)

    Objective: To describe the risk of acute myocardial infarction (AMI) after radiation therapy (RT) for breast cancer (BrCa) in an exposed population. Methods: We identified and validated cases of AMI (vAMI), by electrocardiographic or enzyme criteria, among all 6680 women who received post-operative RT following lumpectomy or mastectomy, within 12 months following diagnosis of BrCa between 1982 and 1988 in Ontario, Canada. We identified women without vAMI whose death certification was ascribed to AMI (dAMI). We abstracted risk factors and treatment exposures for a random sample of women from the 6680, and for all with vAMI or dAMI. The hazards of vAMI and of dAMI were estimated using multivariate Cox proportional hazards models, corrected for study design. Results: We validated 121 cases of vAMI and identified 92 cases of dAMI. The risk of vAMI associated with RT to the left breast HR = 1.96 (1.09, 3.54) among women at age ≥ 60 at time of RT, adjusted for history of smoking and prior MI. The adjusted HR dAMI = 1.90 (1.08, 3.35) for exposure to anterior internal mammary node (IMC) RT. Among women who received anterior left breast boost RT, increasing area of the boost is associated with adjusted HR vAMI = 1.02 (1.00, 1.03)/cm2, and adjusted HR dAMI = 1.02 (1.01, 1.03)/cm2. Conclusion: The risks of vAMI and dAMI following RT for BrCa are related to anatomic sites of RT (left breast, area of anterior left breast boost field, and anterior IMC field)

  17. Work situation and self-perceived economic situation as predictors of change in burnout - a prospective general population-based cohort study

    OpenAIRE

    Norlund, Sofia; Reuterwall, Christina; Höög, Jonas; Janlert, Urban; Slunga-Järvholm, Lisbeth

    2015-01-01

    Background: Sick leave rates due to mental and behavioural disorders have increased in Sweden during the last decades. The aim of this prospective study was to investigate changes in the level of burnout in a working subset of the general population and to identify how such changes relate to changes in work situation and self-perceived economic situation. Methods: A cohort of 1000 persons from a subset of the 2004 northern Sweden MONICA (Multinational Monitoring of Trends and Determinants in ...

  18. Impact of hyperkalaemia definition on incidence assessment: implications for epidemiological research based on a large cohort study in newly diagnosed heart failure patients in primary care

    OpenAIRE

    Martín-Pérez, Mar; Ruigómez, Ana; Michel, Alexander; García Rodríguez, Luis A.

    2016-01-01

    Background Various definitions of hyperkalaemia have been used in clinical research, and data from routine clinical practice on its incidence are sparse. We aimed to establish the incidence of hyperkalaemia in patients with newly diagnosed heart failure in the UK general population using different definitions for the condition. Methods We conducted a large retrospective cohort study using data from The Health Improvement Network primary care database. Patients with newly diagnosed heart failu...

  19. Population-based incidence, mortality and quality of life in critically ill patients treated with renal replacement therapy: a nationwide retrospective cohort study in finnish intensive care units

    OpenAIRE

    Vaara, Suvi T; Pettilä, Ville; Reinikainen, Matti; Kaukonen, Kirsi-Maija

    2012-01-01

    Introduction Acute kidney injury (AKI) increases mortality and morbidity of critically ill patients. Mortality of patients treated with renal replacement therapy (RRT) is high. We aimed to evaluate the nationwide incidence of RRT-treated AKI in Finland, hospital and six-month mortality, and health-related quality of life (HRQoL) of these patients. Methods We performed a retrospective cohort study including all general intensive care unit (ICU) admissions in Finland in 2007 through 2008. We id...

  20. Dementia incidence and mortality in middle-income countries, and associations with indicators of cognitive reserve: a 10/66 Dementia Research Group population-based cohort study

    OpenAIRE

    Prince, Martin; Acosta, Daisy; Ferri, Cleusa P; Guerra, Mariella; Huang, Yueqin; Rodriguez, Juan J Llibre; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph D.; Dewey, Michael E; Acosta, Isaac; Jotheeswaran, Amuthavalli T; Liu, Zhaorui

    2012-01-01

    Summary Background Results of the few cohort studies from countries with low incomes or middle incomes suggest a lower incidence of dementia than in high-income countries. We assessed incidence of dementia according to criteria from the 10/66 Dementia Research Group and Diagnostic and Statistical Manual of Mental Disorders (DSM) IV, the effect of dementia at baseline on mortality, and the independent effects of age, sex, socioeconomic position, and indicators of cognitive reserve. Methods We ...

  1. Missed Opportunities: barriers to HIV testing during pregnancy from a population based cohort study in rural Uganda.

    Science.gov (United States)

    Larsson, Elin C; Thorson, Anna Ekéus; Pariyo, George; Waiswa, Peter; Kadobera, Daniel; Marrone, Gaetano; Ekström, Anna Mia

    2012-01-01

    The aim was to assess population-level HIV-testing uptake among pregnant women, key for access to prevention-of mother to child transmission (PMTCT) services, and to identify risk factors for not being HIV tested,The study was conducted May 2008-May 2010 in the Iganga/Mayuge Health and Demographic Surveillance Site (HDSS), Eastern Uganda, during regular surveillance of 68,000 individuals. All women identified to be pregnant May-July 2008 (n=881) were interviewed about pregnancy-related issues and linked to the HDSS database for socio-demographic data. Women were followed-up via antenatal care (ANC) register reviews at the health facilities to collect data related to ANC services received, including HIV testing. Adjusted relative risk (aRR), and 95% confidence intervals (CI) for not being HIV tested were calculated using multivariable binomial regression among the 544 women who remained after record review.Despite high ANC attendance (96%), the coverage of HIV testing was 64%. Only 6% of pregnant women who sought ANC at a facility without HIV testing services were referred for testing and only 20% received counseling regarding HIV. At ANC facilities with HIV testing services, 85% were tested. Only 4% of the women tested had been couple tested for HIV. Living more than three kilometers away from a health facility with HIV testing services was associated with not being tested both among the poorest (aRR,CI; 1.44,1.02-2.04) and the least poor women (aRR,CI;1.72,1.12-2.63).The lack of on site HIV testing services and distant ANC facilities lead to missed opportunities for PMTCT, especially for the poorest women. Referral systems for HIV testing need to be improved and testing should be expanded to lower level health facilities. This is in order to ensure that the policy of HIV testing during pregnancy is implemented more effectively and that testing is accessible for all. PMID:22916089

  2. Risk of Chronic Low Back Pain Among Parturients Who Undergo Cesarean Delivery With Neuraxial Anesthesia: A Nationwide Population-Based Retrospective Cohort Study.

    Science.gov (United States)

    Chia, Yuan-Yi; Lo, Yuan; Chen, Yan-Bo; Liu, Chun-Peng; Huang, Wei-Chun; Wen, Chun-Hsien

    2016-04-01

    To investigate the risk of chronic low back pain (LBP) in parturients undergoing cesarean delivery (CD) with neuraxial anesthesia (NA).LBP is common during pregnancy and also after delivery, but its etiology is poorly understood. Previous studies that investigated the correlation between epidural labor analgesia and chronic low back pain were inconclusive. These studies lacked objective diagnostic criteria for LBP and did not exclude possible confounders. We performed this nationwide population-based retrospective cohort study to explore the relationship between CD with NA and subsequent LBP.From the Taiwan National Health Insurance Research Database (NHIRD), we identified all primiparas who had given birth between January 1, 2000 and December 31, 2013. Using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes, we identified the women who had vaginal delivery (VD) and those who had CD. The mode of anesthesia was ascertained by the NHI codes. Multivariable logistic regression was used to estimate the odds of postpartum LBP in women undergoing CD with NA compared with those having VD. The outcome was a diagnosis of LBP according to the first ICD-9-CM diagnosis code. The patients were observed for 3 years after delivery or until diagnosis of postpartum LBP, withdrawal from the NHI system, death, or December 31, 2013.Of the 61,027 primiparas who underwent delivery during the observation period, 40,057 were eligible for inclusion in the study. Of these women, 27,097 (67.6%) received VD, 8662 (21.6%) received CD with spinal anesthesia, and 4298 (10.7%) received CD with epidural anesthesia (EA). Women who received CD with EA were found to have higher risk of LBP than did women who received VD, with the adjusted OR being 1.26 (95% CI: 1.17-1.34).CD with EA might increase the risk of subsequent chronic LBP. PMID:27100449

  3. The Anyang Esophageal Cancer Cohort Study: Study Design, Implementation of Fieldwork, and Use of Computer-Aided Survey System

    OpenAIRE

    Liu, Fangfang; Guo, Fangcen; Zhou, Yue; He, Zhonghu; Tian, Xiuyun; Guo, Chuanhai; Ning, Tao; Pan, Yaqi; Cai, Hong; Ke, Yang

    2012-01-01

    Background Human papillomavirus (HPV) has been observed repeatedly in esophageal squamous cell carcinoma (ESCC) tissues. However, the causal relationship between HPV infection and the onset of ESCC remains unknown. A large cohort study focusing on this topic is being carried out in rural Anyang, China. Methodology/Principal Findings The Anyang Esophageal Cancer Cohort Study (AECCS) is a population-based prospective endoscopic cohort study designed to investigate the association of HPV infecti...

  4. Association of Cytomegalovirus End-Organ Disease with Stroke in People Living with HIV/AIDS: A Nationwide Population-Based Cohort Study.

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    Yung-Feng Yen

    Full Text Available Cytomegalovirus (CMV infection might increase the risk of cardiovascular event. However, data on the link between incident stroke and co-infections of CMV and human immunodeficiency virus (HIV are limited and inconsistent. This nationwide population-based cohort study analyzed the association of CMV end-organ disease and stroke among people living with HIV/AIDS (PLWHA.From January 1, 1998, this study identified adult HIV individuals with and without CMV end-organ disease in the Taiwan National Health Insurance Research Database. All patients were observed for incident stroke and were followed until December 31, 2012. Time-dependent analysis was used to evaluate associations of CMV end-organ disease with stroke.Of the 22,581 PLWHA identified (439 with CMV end-organ disease and 22,142 without CMV end-organ disease, 228 (1.01% had all-cause stroke during a mean follow-up period of 4.85 years, including 169 (0.75% with ischemic stroke and 59 (0.26% with hemorrhagic stroke. After adjusting for age, sex, comorbidities, opportunistic infections after HIV diagnosis, and antiretroviral treatment, CMV end-organ disease was found to be an independent risk factor for incident all-cause stroke (adjusted hazard ratio [AHR], 3.07; 95% confidence interval [CI], 1.70 to 5.55. When stroke type was considered, CMV end-organ disease was significantly positively associated with the risk of ischemic stroke (AHR, 3.14; 95% CI, 1.49 to 6.62 but not hemorrhagic stroke (AHR, 2.52; 95% CI, 0.64 to 9.91.This study suggested that CMV end-organ disease was an independent predictor of ischemic stroke among PLWHA.

  5. Type 2 diabetes and the risk of non-Hodgkin's lymphoma: a report from two population-based cohort studies in China.

    Science.gov (United States)

    Yang, Wan-Shui; Li, Hong-Lan; Xu, Hong-Li; Yang, Gong; Gao, Yu-Tang; Zheng, Wei; Shu, Xiao-Ou; Xiang, Yong-Bing

    2016-03-01

    Coinciding with the increased incidence of non-Hodgkin's lymphoma (NHL) during the past decades, there has been a significant increase in the prevalence of diabetes mellitus in mainland China. We therefore evaluated whether type 2 diabetes (T2D) is associated with the risk of NHL using data from the Shanghai Men's Health Study (SMHS) and the Shanghai Women's Health Study (SWHS). The SMHS and SWHS are two on-going, prospective, population-based cohorts of more than 130 000 Chinese adults in urban Shanghai. Self-reported diabetes was recorded on the baseline questionnaire and updated in follow-up surveys. Cox regression models with T2D as a time-varying exposure were used to estimate hazard ratios and 95% confidence intervals, adjusting for covariates. After a median follow-up of 12.9 years for SWHS and 7.4 years for SMHS, 172 NHL cases were identified. Patients with T2D have a higher risk of incident NHL with a hazard ratio of 2.00 (95% confidence interval: 1.32-3.03) compared with those without diabetes. This positive association remained when the analysis was restricted to untreated diabetes or after excluding NHL cases that occurred within 3 years after the onset of diabetes. No interaction effect was found in the development of NHL between T2D and other potential risk factors. A linear inverse association was found between T2D duration and the risk of NHL in both men and women (Pfor linearity<0.01), with a highest risk of incident NHL in the first 5 years after the diagnosis of diabetes. Our study suggested that T2D might be associated with an increased risk of NHL. PMID:25793918

  6. Multiplicative synergistic risk of hepatocellular carcinoma development among hepatitis B and C co-infected subjects in HBV endemic area: a community-based cohort study

    International Nuclear Information System (INIS)

    There has been limited study on the effect of infection with different hepatitis C virus (HCV) genotypes on the risk of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV) endemic regions of Asia. Hazard ratios of HCC development were estimated for HBV and HCV co-infected subjects among a community-based prospective cohort. HCV genotype was determined in HCV RNA-positive samples. Incident HCC cases were identified through linkage to the cancer registry. HCC incidence was 79 per 100,000 person-years in the study population (50 incident cases among 6,694 individuals within 63,170 person-years with an average of 9.4 years of follow-up); seroprevalence of HBsAg and anti-HCV was 5.2% and 5.6%. Adjusted hazard ratios of HCC by HBsAg positivity and anti-HCV positivity were 13.3 (CI: 7.3-24.4) and 6.7 (CI: 3.6-12.6). HRs of HBV and HCV monoinfection, and HBV/HCV coinfection were 17.1 (CI: 8.4-34.8), 10.4 (CI: 4.9-22.1) and 115.0 (CI: 32.5-407.3). Multiplicative synergistic effect of HBV/HCV coinfection on HCC risk was also observed (synergy index: 4.5, CI: 1.3-15.5). Infection with HCV genotype 1 (HR: 29.7, CI: 13.6-46.8) and mixed infection with genotype 1 and 2 (HR: 68.7, CI: 16.4-288.4) significantly elevated HCC risk, much higher than HBV infection. The effect of differences in HCV genotype and the multiplicative synergistic effect of HBV/HCV coinfection on HCC risk shown in the present study underline the need for comprehensive identification of hepatitis infection status in order to prevent and control HCC in this HBV endemic area

  7. Relationship between distal radius fracture malunion and arm-related disability: A prospective population-based cohort study with 1-year follow-up

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    Dahlin Lars B

    2011-01-01

    Full Text Available Abstract Background Distal radius fracture is a common injury and may result in substantial dysfunction and pain. The purpose was to investigate the relationship between distal radius fracture malunion and arm-related disability. Methods The prospective population-based cohort study included 143 consecutive patients above 18 years with an acute distal radius fracture treated with closed reduction and either cast (55 patients or external and/or percutaneous pin fixation (88 patients. The patients were evaluated with the disabilities of the arm, shoulder and hand (DASH questionnaire at baseline (concerning disabilities before fracture and one year after fracture. The 1-year follow-up included the SF-12 health status questionnaire and clinical and radiographic examinations. Patients were classified into three hypothesized severity categories based on fracture malunion; no malunion, malunion involving either dorsal tilt (>10 degrees or ulnar variance (≥1 mm, and combined malunion involving both dorsal tilt and ulnar variance. Multivariate regression analyses were performed to determine the relationship between the 1-year DASH score and malunion and the relative risk (RR of obtaining DASH score ≥15 and the number needed to harm (NNH were calculated. Results The mean DASH score at one year after fracture was significantly higher by a minimum of 10 points with each malunion severity category. The RR for persistent disability was 2.5 if the fracture healed with malunion involving either dorsal tilt or ulnar variance and 3.7 if the fracture healed with combined malunion. The NNH was 2.5 (95% CI 1.8-5.4. Malunion had a statistically significant relationship with worse SF-12 score (physical health and grip strength. Conclusion Malunion after distal radius fracture was associated with higher arm-related disability regardless of age.

  8. Does chronic obstructive pulmonary disease with or without type 2 diabetes mellitus influence the risk of lung cancer? Result from a population-based cohort study.

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    Te-Chun Shen

    Full Text Available BACKGROUND: Previous studies have suggested that chronic obstructive pulmonary disease (COPD is an independent risk factor for lung cancer. There are some evidence that people with diabetes are at a risk of developing many forms of cancer, but inconclusive with regard to lung cancer. The aim of this study was to evaluate whether COPD with or without type 2 diabetes mellitus (T2DM influences the risk of developing lung cancer. METHODS: This is a retrospective cohort study consisting of 20,730 subjects newly diagnosed with COPD ("cases". Their data was collected from the National Health Insurance system of Taiwan from 1998 to 2010. Among these patients, 5,820 patients had T2DM and 14,910 patients did not have T2DM. The retrospective matched control group consisted of 20,729 subjects without either COPD or T2DM. The control group was matched with the cases for sex, age, and index year (the year that the patient was diagnosed with COPD. The subjects were followed until the end of 2011. RESULTS: The findings of our study showed that the risk of lung cancer was higher in the COPD group than in the non-COPD group, with adjusted hazard ratio (HR of 5.02 [95% confidence interval (CI = 4.23-5.94] among total case group, adjusted HR was 5.38 (95% CI = 4.52-6.40 in the cohort without T2DM and adjusted HR was 4.05 (95% CI = 3.26-5.03 in the cohort with T2DM. We observed a significantly protective effect from lung cancer (adjusted HR = 0.75, 95% CI = 0.63-0.90 of diabetic cohort than non-diabetic cohort among patients with COPD. CONCLUSION: Patients with COPD had a significantly higher risk of developing lung cancer than healthy people. However, there was a protective effect of T2DM for lung cancer among patients with COPD. Further investigation may be needed to corroborate the mechanism or bring up reliable reasons.

  9. Is nephrolithiasis an unrecognized extra-articular manifestation in ankylosing spondylitis? A prospective population-based Swedish national cohort study with matched general population comparator subjects.

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    Ane Krag Jakobsen

    Full Text Available BACKGROUND: Ankylosing spondylitis (AS is associated with several extra-articular manifestations. Nephrolithiasis (NL has not been recognized as one of those, however, several factors known to increase the risk of NL are at play in AS patients. The objective was to estimate rates and predictors of NL in Swedish patients with AS compared to the general population. METHODS AND FINDINGS: We performed a prospective population-based nationwide cohort study based on linkage of data from Swedish registries. 8,572 AS patients were followed for 49,258 person-years (py and 39,639 matched general population comparators were followed for 223,985 py. Patients were followed prospectively together with comparator subjects from January 2001 through December 2009. The first occurrence of NL during follow-up was the primary outcome. Hazard Ratios (HR were used to compare these rates adjusting for comorbidities and treatment, and to assess predictors for NL. Mean age at study entry was 46 years (inter quartile range 36-56 years, 65% were males. Based on 250 vs. 466 NL events, the adjusted HR of NL in AS patients was 2.1 (95%CI 1.8 to 2.4. Predictors of NL within the AS group included prior diagnosis of inflammatory bowel disease (IBD (HR 2.3; 95%CI 1.7 to 3.3, prior diagnosis of NL (HR 16.4; 95%CI 11.5 to 23.4, and patients receiving anti-TNF treatment (HR 1.6; 95%CI 1.2 to 2.1. Male sex was a risk factor for NL both in AS patients and in the general population. LIMITATIONS: The risk for residual confounding and inability to study the chemical nature of NL were considered the main limitations of the study. CONCLUSIONS: Patients with AS are at increased risk of NL, which may be considered a novel extra-articular manifestation. Previous history of NL, IBD, AS disease severity and male sex were identified as predictors of NL in AS.

  10. The impact of acid-suppressing drugs to the patients with chronic obstructive pulmonary disease: A nationwide, population-based, cohort study

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    Shou-Wu Lee

    2015-01-01

    Full Text Available Background: A high prevalence of gastroesophageal reflux disease symptoms has observed among chronic obstructive pulmonary disease (COPD patients, and proton-pump inhibitors (PPIs are the main medication in clinical practices. The aim of this study is to analyze the impact of PPIs to the risk of pneumonia in the cases with COPD. Materials and Methods: This was a nationwide, population-based, cohort study using National Health Insurance Program in Taiwan. The enrolled cases were newly-diagnosed COPD, older than 30 years, between 2001 and 2005. Patients′ prescriptions with PPIs and histamine receptor 2 antagonists (HR2As, >2 months, were identified. The appearance of pneumonia and mortality of these enrolled patients was recorded. Multivariate Cox′s regression was used to examine the influence of acid-suppressing drugs to pneumonia on individuals with COPD. Results: A total of 17,498 patients were included, of whom 109 (0.6% and 526 (3% cases had used PPIs and HR2As respectively. The risk of pneumonia existed when patients had used concurrent PPIs (adjusted hazard ratio [HR] = 1.76; 95% confidence interval [CI] = 1.33-2.34 or HR2As (adjusted HR = 1.25; 95% CI = 1.07-1.47. The positive association was lost in the cases over 70 years. The ratio of mortality also increased in those with PPIs or HR2As. Conclusion: Acid-suppressing drugs, especially PPIs, are attributed to more pneumonia happening in COPD patients compare with nonusers. The association was lost in elderly cases. Use acid-suppressing drugs should be careful about a higher possibility of pneumonia in younger individuals with COPD.

  11. Influence of interpersonal violence on maternal anxiety, depression, stress and parenting morale in the early postpartum: a community based pregnancy cohort study

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    Malta Lise A

    2012-12-01

    Full Text Available Abstract Background Research has shown that exposure to interpersonal violence is associated with poorer mental health outcomes. Understanding the impact of interpersonal violence on mental health in the early postpartum period has important implications for parenting, child development, and delivery of health services. The objective of the present study was to determine the impact of interpersonal violence on depression, anxiety, stress, and parenting morale in the early postpartum. Methods Women participating in a community-based prospective cohort study (n = 1319 completed questionnaires prior to 25 weeks gestation, between 34–36 weeks gestation, and at 4 months postpartum. Women were asked about current and past abuse at the late pregnancy data collection time point. Postpartum depression, anxiety, stress, and parenting morale were assessed at 4 months postpartum using the Edinburgh Postnatal Depression Scale, the Spielberger State Anxiety Index, the Cohen Perceived Stress Scale, and the Parenting Morale Index, respectively. The relationship between interpersonal violence and postpartum psychosocial health status was examined using Chi-square analysis (p  Results Approximately 30% of women reported one or more experience of interpersonal violence. Sixteen percent of women reported exposure to child maltreatment, 12% reported intimate partner violence, and 12% reported other abuse. Multivariable logistic regression analysis found that a history of child maltreatment had an independent effect on depression in the postpartum, while both child maltreatment and intimate partner violence were associated with low parenting morale. Interpersonal violence did not have an independent effect on anxiety or stress in the postpartum. Conclusion The most robust relationships were seen for the influence of child maltreatment on postpartum depression and low parenting morale. By identifying women at risk for depression and low parenting morale

  12. The influence of maternal and paternal factors on time to pregnancy--a Dutch population-based birth-cohort study : the GECKO Drenthe study

    NARCIS (Netherlands)

    Mutsaerts, M. A. Q.; Groen, H.; Huiting, H. G.; Kuchenbecker, W. K. H.; Sauer, P. J. J.; Land, J. A.; Stolk, R. P.; Hoek, A.

    2012-01-01

    BACKGROUND: Both maternal and paternal factors have been suggested to influence a couple's fecundity. To investigate this, we examined the role of several maternal and paternal lifestyle and socio-demographic factors as determinants of time to pregnancy (TTP) in a Dutch birth-cohort. METHODS: Gronin

  13. Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes in US Men and Women: Results from Three Prospective Cohort Studies.

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    Ambika Satija

    2016-06-01

    Full Text Available Plant-based diets have been recommended to reduce the risk of type 2 diabetes (T2D. However, not all plant foods are necessarily beneficial. We examined the association of an overall plant-based diet and hypothesized healthful and unhealthful versions of a plant-based diet with T2D incidence in three prospective cohort studies in the US.We included 69,949 women from the Nurses' Health Study (1984-2012, 90,239 women from the Nurses' Health Study 2 (1991-2011, and 40,539 men from the Health Professionals Follow-Up Study (1986-2010, free of chronic diseases at baseline. Dietary data were collected every 2-4 y using a semi-quantitative food frequency questionnaire. Using these data, we created an overall plant-based diet index (PDI, where plant foods received positive scores, while animal foods (animal fats, dairy, eggs, fish/seafood, poultry/red meat, miscellaneous animal-based foods received reverse scores. We also created a healthful plant-based diet index (hPDI, where healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils, tea/coffee received positive scores, while less healthy plant foods (fruit juices, sweetened beverages, refined grains, potatoes, sweets/desserts and animal foods received reverse scores. Lastly, we created an unhealthful plant-based diet index (uPDI by assigning positive scores to less healthy plant foods and reverse scores to healthy plant foods and animal foods. We documented 16,162 incident T2D cases during 4,102,369 person-years of follow-up. In pooled multivariable-adjusted analysis, both PDI and hPDI were inversely associated with T2D (PDI: hazard ratio [HR] for extreme deciles 0.51, 95% CI 0.47-0.55, p trend < 0.001; hPDI: HR for extreme deciles 0.55, 95% CI 0.51-0.59, p trend < 0.001. The association of T2D with PDI was considerably attenuated when we additionally adjusted for body mass index (BMI categories (HR 0.80, 95% CI 0.74-0.87, p trend < 0.001, while that with hPDI remained

  14. Cohort profile: the Young Lives study.

    Science.gov (United States)

    Barnett, Inka; Ariana, Proochista; Petrou, Stavros; Penny, Mary E; Duc, Le Thuc; Galab, S; Woldehanna, Tassew; Escobal, Javier A; Plugge, Emma; Boyden, Jo

    2013-06-01

    Young Lives is an international longitudinal study investigating the changing nature of childhood poverty in four low-income countries [Ethiopia, India (Andhra Pradesh), Peru and Vietnam] over a 15-year period. In each country, the cohort is comprised of ≈ 2000 children aged between 6 and 18 months and up to 1000 children aged between 7 and 8 years, recruited in 2002 and sampled from 20 sentinel sites. The first survey data collection from primary caregivers and older children took place in 2002, the second in 2006-07 and the third in 2009-10. Data on the community contexts were collected to complement the household surveys. To elaborate and extend the quantitative data, longitudinal qualitative research with a subgroup of the children was carried out in 2007, 2008 and 2010-11. Topic areas covered included nutrition, health and well-being, cognitive and physical development, health behaviours and education, as well as the social, demographic and economic status of the household. Survey data from the study are archived in the International Section of the UK Public Data Archive. PMID:22617687

  15. Epidemiological features and specificities of HCV infection: a hospital-based cohort study in a university medical center of Calabria region

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    Liberto MC

    2012-11-01

    Full Text Available Abstract The epidemiological status of HCV in Europe, and in particular in Mediterranean countries, is continuously evolving. The genotype distribution is related to improvement of healthcare conditions, expansion of intravenous drug use and immigration. We review and characterize the epidemiology of the distribution of HCV genotypes within Calabria, an area of Southern Italy. We focus on the pattern of distinct HCV genotype changes over the last 16 years; particularly subtype 1b and genotype 4. We collected data by evaluating a hospital-based cohort of chronic hepatitis C patients; in addition, we report an update including new patients enrolled during last eight months.

  16. The Effects of Anti-Dementia and Nootropic Treatments on the Mortality of Patients with Dementia: A Population-Based Cohort Study in Taiwan.

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    Chen-Yi Wu

    Full Text Available Few studies have examined the contribution of treatment on the mortality of dementia based on a population-based study.To investigate the effects of anti-dementia and nootropic treatments on the mortality of dementia using a population-based cohort study.12,193 incident dementia patients were found from 2000 to 2010. Their data were compared with 12,193 age- and sex-matched non-dementia controls that were randomly selected from the same database. Dementia was classified into vascular (VaD and degenerative dementia. Mortality incidence and hazard ratios (HRs were calculated.The median survival time was 3.39 years (95% confidence interval [CI]: 2.88-3.79 for VaD without medication, 6.62 years (95% CI: 6.24-7.21 for VaD with nootropics, 3.01 years (95% CI: 2.85-3.21 for degenerative dementia without medication, 8.11 years (95% CI: 6.30-8.55 for degenerative dementia with anti-dementia medication, 6.00 years (95% CI: 5.73-6.17 for degenerative dementia with nootropics, and 9.03 years (95% CI: 8.02-9.87 for degenerative dementia with both anti-dementia and nootropic medications. Compared to the non-dementia group, the HRs among individuals with degenerative dementia were 2.69 (95% CI: 2.55-2.83 without medication, 1.46 (95% CI: 1.39-1.54 with nootropics, 1.05 (95% CI: 0.82-1.34 with anti-dementia medication, and 0.92 (95% CI: 0.80-1.05 with both nootropic and anti-dementia medications. VaD with nootropics had a lower mortality (HR: 1.25, 95% CI: 1.15-1.37 than VaD without medication (HR: 2.46, 95% CI: 2.22-2.72.Pharmacological treatments have beneficial effects for patients with dementia in prolonging their survival.

  17. The Effects of Anti-Dementia and Nootropic Treatments on the Mortality of Patients with Dementia: A Population-Based Cohort Study in Taiwan

    Science.gov (United States)

    Wu, Chen-Yi; Hu, Hsiao-Yun; Chow, Lok-Hi; Chou, Yiing-Jenq; Huang, Nicole; Wang, Pei-Ning; Li, Chung-Pin

    2015-01-01

    Background Few studies have examined the contribution of treatment on the mortality of dementia based on a population-based study. Objective To investigate the effects of anti-dementia and nootropic treatments on the mortality of dementia using a population-based cohort study. Methods 12,193 incident dementia patients were found from 2000 to 2010. Their data were compared with 12,193 age- and sex-matched non-dementia controls that were randomly selected from the same database. Dementia was classified into vascular (VaD) and degenerative dementia. Mortality incidence and hazard ratios (HRs) were calculated. Results The median survival time was 3.39 years (95% confidence interval [CI]: 2.88–3.79) for VaD without medication, 6.62 years (95% CI: 6.24–7.21) for VaD with nootropics, 3.01 years (95% CI: 2.85–3.21) for degenerative dementia without medication, 8.11 years (95% CI: 6.30–8.55) for degenerative dementia with anti-dementia medication, 6.00 years (95% CI: 5.73–6.17) for degenerative dementia with nootropics, and 9.03 years (95% CI: 8.02–9.87) for degenerative dementia with both anti-dementia and nootropic medications. Compared to the non-dementia group, the HRs among individuals with degenerative dementia were 2.69 (95% CI: 2.55–2.83) without medication, 1.46 (95% CI: 1.39–1.54) with nootropics, 1.05 (95% CI: 0.82–1.34) with anti-dementia medication, and 0.92 (95% CI: 0.80–1.05) with both nootropic and anti-dementia medications. VaD with nootropics had a lower mortality (HR: 1.25, 95% CI: 1.15–1.37) than VaD without medication (HR: 2.46, 95% CI: 2.22–2.72). Conclusion Pharmacological treatments have beneficial effects for patients with dementia in prolonging their survival. PMID:26098910

  18. Short- and long-term major cardiovascular adverse events in carotid artery interventions: a nationwide population-based cohort study in Taiwan.

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    Ming-Lung Tsai

    Full Text Available Carotid artery stenosis is one of the leading causes of ischemic stroke. Carotid artery stenting has become well-established as an effective treatment option for carotid artery stenosis. For this study, we aimed to determine the efficacy and safety of carotid stenting in a population-based large cohort of patients by analyzing the Taiwan National Healthcare Insurance (NHI database.2,849 patients who received carotid artery stents in the NHI database from 2004 to 2010 were identified. We analyzed the risk factors of outcomes including major adverse cardiovascular events including death, acute myocardial infarction, and cerebral vascular accidents at 30 days, 1 year, and overall period and further evaluated cause of death after carotid artery stenting.The periprocedural stroke rate was 2.7% and the recurrent stroke rate for the overall follow-up period was 20.3%. Male, diabetes mellitus, and heart failure were significant risk factors for overall recurrent stroke (Hazard Ratio (HR = 1.35, p = 0.006; HR = 1.23, p = 0.014; HR = 1.61, p < 0.001, respectively. The periprocedural acute myocardial infarction rate was 0.3%. Age and Diabetes mellitus were the significant factors to predict periprocedural myocardial infarction (HR = 3.06, p = 0.019; HR = 1.68, p < 0.001, respectively. Periprocedural and overall mortality rates were 1.9% and 17.3%, respectively. The most significant periprocedural mortality risk factor was acute renal failure. Age, diabetes mellitus, acute or chronic renal failure, heart failure, liver disease, and malignancy were factors correlated to the overall period mortality.Periprocedural acute renal failure significantly increased the mortality rate and the number of major adverse cardiovascular events, and the predict power persisted more than one year after the procedure. Age and diabetes mellitus were significant risk factors to predict acute myocardial infarction after carotid artery stenting.

  19. Ethnic differences in neonatal body composition in a multi-ethnic population and the impact of parental factors: a population-based cohort study.

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    Line Sletner

    Full Text Available BACKGROUND: Neonates from low and middle income countries (LAMIC tend to have lower birth weight compared with Western European (WE neonates. Parental height, BMI and maternal parity, age and educational level often differ according to ethnic background, and are associated with offspring birth weight. Less is known about how these factors affect ethnic differences in neonatal body composition. OBJECTIVES: To explore differences in neonatal body composition in a multi-ethnic population, and the impact of key parental factors on these differences. METHODS: A population-based cohort study of pregnant mothers, fathers and their offspring, living in Oslo, Norway. Gender- and gestational-specific z-scores were calculated for several anthropometric measurements, with the neonates of WE ethnic origin as reference. Mean z-scores for neonates with LAMIC origin, and their parents, are presented as outcome variables. RESULTS: 537 singleton, term neonates and their parents were included. All anthropometric measurements were smaller in neonates with LAMIC origin. Abdominal circumference and ponderal index differed the most from WE (mean z-score: -0.57 (95% CI:-0.69 to -0.44 and -0.54 (-0.66 to -0.44, and remained so after adjusting for parental size. Head circumference and skin folds differed less, and length the least (-0.21 (-0.35 to -0.07. These measures became comparable to WEs when adjusted for parental factors. CONCLUSIONS: LAMIC origin neonates were relatively "thin-fat", as indicated by reduced AC and ponderal index and relatively preserved length and skin folds, compared with neonates with WE origin. This phenotype may predispose to type 2 diabetes.

  20. Use of Fibrates Monotherapy in People with Diabetes and High Cardiovascular Risk in Primary Care: A French Nationwide Cohort Study Based on National Administrative Databases.

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    Ronan Roussel

    Full Text Available According to guidelines, diabetic patients with high cardiovascular risk should receive a statin. Despite this consensus, fibrate monotherapy is commonly used in this population. We assessed the frequency and clinical consequences of the use of fibrates for primary prevention in patients with diabetes and high cardiovascular risk.Retrospective cohort study based on nationwide data from the medical and administrative databases of French national health insurance systems (07/01/08-12/31/09 with a follow-up of up to 30 months.Lipid-lowering drug-naive diabetic patients initiating fibrate or statin monotherapy were identified. Patients at high cardiovascular risk were then selected: patients with a diagnosis of diabetes and hypertension, and > 50 (men or 60 (women, but with no history of cardiovascular events. The composite endpoint comprised myocardial infarction, stroke, amputation, or death.Of the 31,652 patients enrolled, 4,058 (12.8% received a fibrate. Age- and gender-adjusted annual event rates were 2.42% (fibrates and 2.21% (statins. The proportionality assumption required for the Cox model was not met for the fibrate/statin variable. A multivariate model including all predictors was therefore calculated by dividing data into two time periods, allowing Hazard Ratios to be calculated before (HR 540 of follow-up. Multivariate analyses showed that fibrates were associated with an increased risk for the endpoint after 540 days: HR 540 = 1.73 (1.28-2.32.Fibrate monotherapy is commonly prescribed in diabetic patients with high cardiovascular risk and is associated with poorer outcomes compared to statin therapy.

  1. Symptoms of Insomnia and Sleep Duration and Their Association with Incident Strokes: Findings from the Population-Based MONICA/KORA Augsburg Cohort Study.

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    A Katharina Helbig

    Full Text Available To examine the relationship between symptoms of insomnia and sleep duration and incident total (non-fatal plus fatal strokes, non-fatal strokes, and fatal strokes in a large cohort of men and women from the general population in Germany.In four population-based MONICA (monitoring trends and determinants in cardiovascular disease/KORA (Cooperative Health Research in the Region of Augsburg surveys conducted between 1984 and 2001, 17,604 men and women (aged 25 to 74 years were asked about issues like sleep, health behavior, and medical history. In subsequent surveys and mortality follow-ups, incident stroke cases (cerebral hemorrhage, ischemic stroke, transient ischemic attack, unknown stroke type were gathered prospectively until 2009. Sex-specific hazard ratios (HR and their 95% confidence intervals (CI were estimated using sequential Cox proportional hazards regression models.During a mean follow-up of 14 years, 917 strokes (710 non-fatal strokes and 207 fatal strokes were observed. Trouble falling asleep and difficulty staying asleep were not significantly related to any incident stroke outcome in either sex in the multivariable models. Among men, the HR for the association between short (≤5 hours and long (≥10 hours daily sleep duration and total strokes were 1.44 (95% CI: 1.01-2.06 and 1.63 (95% CI: 1.16-2.29, after adjustment for basic confounding variables. As for non-fatal strokes and fatal strokes, in the analyses adjusted for age, survey, education, physical activity, alcohol consumption, smoking habits, body mass index, hypertension, diabetes, and dyslipidemia, the increased risks persisted, albeit somewhat attenuated, but no longer remained significant. Among women, in the multivariable analyses the quantity of sleep was also not related to any stroke outcome.In the present study, symptoms of insomnia and exceptional sleep duration were not significantly predictive of incident total strokes, non-fatal strokes, and fatal strokes in

  2. Excess body weight and cancer risk in patients with type 2 diabetes who were registered in Swedish National Diabetes Register--register-based cohort study in Sweden.

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    Junmei Miao Jonasson

    Full Text Available AIM: To assess the association between excess body weight and cancer risk in patients with type 2 diabetes (T2D who were registered in the Swedish National Diabetes Register (NDR. METHODS: This is a cohort study based on 25,268 patients with T2D and baseline BMI≥18.5 kg/m(2 from NDR 1997-1999. Subjects were grouped according to BMI into normal weight (18.5 to 24.9, overweight (25 to 29.9 or obesity (30 or more. All subjects were followed until the first occurrence of cancer, or death, or the end of follow-up (December 31, 2009. Adjusted hazard ratios (HRs and 95% confidence interval (CI for cancer risks were estimated by Cox regression. RESULTS: In men with T2D, overweight was associated with increased risks of all cancer [1.13 (1.02-1.27], gastrointestinal cancer [1.34 (1.07-1.72] and colorectal cancer [1.59 (1.18-2.13]; obesity was related to higher risks of all cancer [1.17 (1.04-1.33], gastrointestinal cancer [1.40 (1.08-1.82] and colorectal cancer [1.62 (1.17-2.24]. In women with T2D, obesity was associated with increased risk of all cancer [1.30 (1.12-1.51], gastrointestinal cancer [1.40 (1.03-1.91] and postmenopausal breast cancer [1.39 (1.00-1.91]. CONCLUSIONS: Excess body weight was associated with increased risks of all cancer, gastrointestinal cancer and colorectal cancer in men with T2D. Obesity was related with elevated risks of all cancer, gestational cancer and postmenopausal breast cancer in women with T2D.

  3. Loneliness and the rate of motor decline in old age: the rush memory and aging project, a community-based cohort study

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    Arnold Steven E

    2010-10-01

    Full Text Available Abstract Background Being alone, as measured by less frequent social interactions, has been reported to be associated with a more rapid rate of motor decline in older persons. We tested the hypothesis that feeling alone is associated with the rate of motor decline in community-dwelling older persons. Methods At baseline, loneliness was assessed with a 5-item scale in 985 persons without dementia participating in the Rush Memory and Aging Project, a longitudinal community-based cohort study. Annual detailed assessment of 9 measures of muscle strength and 9 motor performances were summarized in a composite measure of global motor function. Results Linear mixed-effects models which controlled for age, sex and education, showed that the level of loneliness at baseline was associated with the rate of motor decline (Estimate, -0.016; S.E. 0.006, p = 0.005. For each 1-point higher level of loneliness at baseline, motor decline was 40% more rapid; this effect was similar to the rate of motor decline observed in an average participant 4 years older at baseline. Furthermore, this amount of motor decline per year was associated with about a 50% increased risk of death. When terms for both feeling alone (loneliness and being alone were considered together in a single model, both were relatively independent predictors of motor decline. The association between loneliness and motor decline persisted even after controlling for depressive symptoms, cognition, physical and cognitive activities, chronic conditions, as well as baseline disability or a history of stroke or Parkinson's disease. Conclusions Among community-dwelling older persons, both feeling alone and being alone are associated with more rapid motor decline, underscoring the importance of psychosocial factors and motor decline in old age.

  4. Long-term survival of women with basal-like ductal carcinoma in situ of the breast: a population-based cohort study

    International Nuclear Information System (INIS)

    Microarray gene-profiling of invasive breast cancer has identified different subtypes including luminal A, luminal B, HER2-overexpressing and basal-like groups. Basal-like invasive breast cancer is associated with a worse prognosis. However, the prognosis of basal-like ductal carcinoma in situ (DCIS) is still unknown. Our aim was to study the prognosis of basal-like DCIS in a large population-based cohort. All 458 women with a primary DCIS diagnosed between 1986 and 2004, in Uppland and Västmanland, Sweden were included. TMA blocks were constructed. To classify the DCIS tumors, we used immunohistochemical (IHC) markers (estrogen-, progesterone-, HER2, cytokeratin 5/6 and epidermal growth factor receptor) as a surrogate for the gene expression profiling. The association with prognosis was examined for basal-like DCIS and other subtypes using Kaplan-Meier survival analyses and Cox proportional hazards regression models. IHC data were complete for 392 women. Thirty-two were basal-like (8.2%), 351 were luminal or HER2-positive (89.5%) and 9 unclassified (2.3%). Seventy-six women had a local recurrence of which 34 were invasive. Another 3 women had general metastases as first event. Basal-like DCIS showed a higher risk of local recurrence and invasive recurrence 1.8 (Confidence interval (CI) 95%, 0.8-4.2) and 1.9 (0.7-5.1), respectively. However, the difference was not statistically significant. Also, no statistically significant increased risk was seen for triple-negative or high grade DCIS. Basal-like DCIS showed about a doubled, however not statistically significant risk for local recurrence and developing invasive cancer compared with the other molecular subtypes. Molecular subtyping was a better prognostic parameter than histopathological grade

  5. Evidence for lower variability of coronary artery calcium mineral mass measurements by multi-detector computed tomography in a community-based cohort-Consequences for progression studies

    International Nuclear Information System (INIS)

    Purpose: To compare the measurement variability for coronary artery calcium (CAC) measurements using mineral mass compared with a modified Agatston score (AS) or volume score (VS) with multi-detector CT (MDCT) scanning, and to estimate the potential impact of these methods on the design of CAC progression studies. Materials and methods: We studied 162 consecutive subjects (83 women, 79 men, mean age 51 ± 11 years) from a general Caucasian community-based cohort (Framingham Heart Study) with duplicate runs of prospective electrocardiographically-triggered MDCT scanning. Each scan was independently evaluated for the presence of CAC by four experienced observers who determined a 'modified' AS, VS and mineral mass. Results: Of the 162 subjects, CAC was detected in both scans in 69 (42%) and no CAC was detected in either scan in 72 (45%). Calcium scores were low in the 21/162 subjects (12%) for whom CAC was present in one but not the other scan (modified AS 0.96). However, the mean interscan variability was significantly different between mineral mass, modified AS, and VS (coefficient of variation 26 ± 19%, 41 ± 28% and 34 ± 25%, respectively; p < 0.04), with significantly smaller mean differences in pair-wise comparisons for mineral mass compared with modified AS (p < 0.002) or with VS (p < 0.03). The amount of CAC but not heart rate was an independent predictor of interscan variability (r = -0.638, -0.614 and -0.577 for AS, VS, and mineral mass, respectively; all p < 0.0001). The decreased interscan variability of mineral mass would allow a sample size reduction of 5.5% compared with modified AS for observational studies of CAC progression and for randomized clinical trials. Conclusion: There is significantly reduced interscan variability of CAC measurements with mineral mass compared with the modified AS or VS. However, the measurement variability of all quantification methods is predicted by the amount of CAC and is inversely correlated to the extent of partial

  6. What Drives Teacher Engagement: A Study of Different Age Cohorts

    Science.gov (United States)

    Guglielmi, Dina; Bruni, Ilaria; Simbula, Silvia; Fraccaroli, Franco; Depolo, Marco

    2016-01-01

    Despite the growing body of research on work engagement, little is known about what drives work engagement among different age cohorts. This study aims to investigate whether engagement varies across age cohorts and examines the job resources that foster teacher engagement. A questionnaire was distributed to 537 teachers who were employed in…

  7. 131I treatment for thyroid cancer and the risk of developing salivary and lacrimal gland dysfunction and a second primary malignancy: a nationwide population-based cohort study

    International Nuclear Information System (INIS)

    The aim of this study was to determine the prevalence of salivary and lacrimal gland dysfunction and a second primary malignancy in patients from Taiwan with thyroid cancer after radioiodine therapy. This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database from 2000 to 2011. A total of 1,834 thyroid cancer patients treated with 131I therapy and 1,834 controls (thyroid cancer without 131I therapy) selected by 1:1 matching on a propensity score were enrolled. The cumulative 131I dose in each patient was calculated. A Cox proportional hazards model was applied to estimate the effect of radiation from the 131I therapy on the risk of salivary and lacrimal gland impairment as well as second primary malignancies in terms of hazard ratios (HRs) and 95 % confidence intervals (CIs). In patients treated with 131I therapy and in controls, the incidence rates of salivary gland dysfunction were 6.76 and 1.01 per 10,000 person-years, respectively (HR 6.81, 95 % CI 0.74 - 55.3), the incidence rates of keratoconjunctivitis sicca (KCS) were 13.6 and 16.3 per 10,000 person-years, respectively (HR 0.84, 95 % CI 0.41 - 1.73), and the incidence rates of second primary malignancy were 76.7 and 62.4 per 10,000 person-years, respectively (HR 1.23, 95 % CI 0.88 - 1.72). The risk of salivary secretion impairment significantly increased with increasing administered doses (HR 14.3, 95 % CI 1.73 - 119.0). However, there was no increase in the incidence of KCS or secondary cancer in patients treated with higher doses. 131I therapy insignificantly increased the risk of salivary gland dysfunction and second primary malignancy. In patients with higher cumulative doses, an increase in the incidence of salivary gland dysfunction was observed. By contrast, we did not find an association between 131I treatment and KCS development. (orig.)

  8. Familial aggregation of hypospadias: a cohort study

    DEFF Research Database (Denmark)

    Schnack, Tine H; Zdravkovic, Slobodan; Myrup, Charlotte;

    2008-01-01

    hypospadias in a cohort of 1,201,790 boys born in 1973-2005. Using binomial log-linear regression, they estimated recurrence risk ratios of hypospadias for male twin pairs and first-, second-, and third-degree relatives of a hypospadias case, which were 50.8 (95% confidence interval [CI]: 34.2, 75.5), 11...

  9. Familial risk of venous thromboembolism: a nationwide cohort study

    DEFF Research Database (Denmark)

    Sørensen, H T; Riis, A H; Diaz, L J;

    2011-01-01

    Background: Venous thromboembolism has genetic determinants, but population-based data on familial risks are limited. Objectives: To examine the familial risk of venous thromboembolism. Methods: We undertook a nationwide study of a cohort of patients with deep venous thrombosis or pulmonary...... expected number of venous thromboembolism cases among siblings, using population-specific, gender-specific and age-specific incidence rates. Results: We identified 30 179 siblings of 19 599 cases of venous thromboembolism. The incidence among siblings was 2.2 cases per 1000 person-years, representing a...... with pulmonary embolism. Conclusion: Venous thromboembolism has a strong familial component....

  10. HbA1C and cancer risk in patients with type 2 diabetes--a nationwide population-based prospective cohort study in Sweden.

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    Junmei Miao Jonasson

    Full Text Available BACKGROUND: Diabetes is associated with increased cancer risk. The underlying mechanisms remain unclear. Hyperglycemia might be one risk factor. HbA1c is an indicator of the blood glucose level over the latest 1 to 3 months. This study aimed to investigate association between HbA1c level and cancer risks in patients with type 2 diabetes based on real life situations. METHODS: This is a cohort study on 25,476 patients with type 2 diabetes registered in the Swedish National Diabetes Register from 1997-1999 and followed until 2009. Follow-up for cancer was accomplished through register linkage. We calculated incidences of and hazard ratios (HR for cancer in groups categorized by HbA1c ≤ 58 mmol/mol (7.5% versus >58 mmol/mol, by quartiles of HbA1c, and by HbA1c continuously at Cox regression, with covariance adjustment for age, sex, diabetes duration, smoking and insulin treatment, or adjusting with a propensity score. RESULTS: Comparing HbA1c >58 mmol/mol with ≤ 58 mmol/mol, adjusted HR for all cancer was 1.02 [95% CI 0.95-1.10] using baseline HbA1c, and 1.04 [95% CI 0.97-1.12] using updated mean HbA1c, and HRs were all non-significant for specific cancers of gastrointestinal, kidney and urinary organs, respiratory organs, female genital organs, breast or prostate. Similarly, no increased risks of all cancer or the specific types of cancer were found with higher quartiles of baseline or updated mean HbA1c, compared to the lowest quartile. HR for all cancer was 1.01 [0.98-1.04] per 1%-unit increase in HbA1c used as a continuous variable, with non-significant HRs also for the specific types of cancer per unit increase in HbA1c. CONCLUSIONS: In this study there were no associations between HbA1c and risks for all cancers or specific types of cancer in patients with type 2 diabetes.

  11. Dose-dependent relationship between prenatal exposure to fine particulates and exhaled carbon monoxide in non-asthmatic children. A population-based birth cohort study

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    Wiesław A. Jędrychowski

    2013-02-01

    Full Text Available Objectives: The main goal of the study was to assess possible association between fetal exposure to fi ne particulate matter (PM2.5 and exhaled carbon monoxide (eCO measured in non-asthmatic children. Material and Methods: The subjects include 118 children taking part in an ongoing population-based birth cohort study in Kraków. Personal samplers of PM2.5 were used to measure fi ne particle mass in the fetal period and carbon monoxide (CO in exhaled breath from a single exhalation effort at the age of 7. In the statistical analysis of the effect of prenatal PM2.5 exposure on eCO, a set of potential confounders, such as environmental tobacco smoke (ETS, city residence area, sensitization to house dust allergens and the occurrence of respiratory symptoms monitored over the seven-year follow-up was considered. Results: The level of eCO did not correlate with the self-reported ETS exposure recorded over the follow-up, however, there was a positive signifi cant relationship with the prenatal PM2.5 exposure (non-parametric trend p = 0.042. The eCO mean level was higher in atopic children (geometric mean = 2.06 ppm, 95% CI: 1.58–2.66 ppm than in non-atopic ones (geometric mean = 1.57 ppm, 95% CI: 1.47–1.73 ppm and the difference was statistically signifi cant (p = 0.036. As for the respiratory symptoms, eCO values were associated positively only with the cough severity score recorded in the follow-up (nonparametric trend p = 0.057. In the nested multivariable linear regression model, only the effects of prenatal PM2.5 and cough severity recorded in the follow-up were related to eCO level. The prenatal PM2.5 exposure represented 5.1%, while children’s cough represented only 2.6% of the eCO variability. Conclusion: Our study suggests that elevated eCO in non-asthmatic children may result from oxidative stress experienced in the fetal period and that heme oxygenase (HO activity in body tissues may be programmed in the fetal period by the exposure to

  12. "GOLD or lower limit of normal definition? a comparison with expert-based diagnosis of chronic obstructive pulmonary disease in a prospective cohort-study"

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    Güder Gülmisal

    2012-02-01

    Full Text Available Abstract Background The Global initiative for chronic Obstructive Lung Disease (GOLD defines COPD as a fixed post-bronchodilator ratio of forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC below 0.7. Age-dependent cut-off values below the lower fifth percentile (LLN of this ratio derived from the general population have been proposed as an alternative. We wanted to assess the diagnostic accuracy and prognostic capability of the GOLD and LLN definition when compared to an expert-based diagnosis. Methods In a prospective cohort study, 405 patients aged ≥ 65 years with a general practitioner's diagnosis of COPD were recruited and followed up for 4.5 (median; quartiles 3.9; 5.1 years. Prevalence rates of COPD according to GOLD and three LLN definitions and diagnostic performance measurements were calculated. The reference standard was the diagnosis of COPD of an expert panel that used all available diagnostic information, including spirometry and bodyplethysmography. Results Compared to the expert panel diagnosis, 'GOLD-COPD' misclassified 69 (28% patients, and the three LLNs misclassified 114 (46%, 96 (39%, and 98 (40% patients, respectively. The GOLD classification led to more false positives, the LLNs to more false negative diagnoses. The main predictors beyond the FEV1/FVC ratio for an expert diagnosis of COPD were the FEV1 % predicted, and the residual volume/total lung capacity ratio (RV/TLC. Adding FEV1 and RV/TLC to GOLD or LLN improved the diagnostic accuracy, resulting in a significant reduction of up to 50% of the number of misdiagnoses. The expert diagnosis of COPD better predicts exacerbations, hospitalizations and mortality than GOLD or LLN. Conclusions GOLD criteria over-diagnose COPD, while LLN definitions under-diagnose COPD in elderly patients as compared to an expert panel diagnosis. Incorporating FEV1 and RV/TLC into the GOLD-COPD or LLN-based definition brings both definitions closer to expert panel

  13. Evaluation of four novel genetic variants affecting hemoglobin A1c levels in a population-based type 2 diabetes cohort (the HUNT2 study

    Directory of Open Access Journals (Sweden)

    Platou Carl GP

    2011-02-01

    Full Text Available Abstract Background Chronic hyperglycemia confers increased risk for long-term diabetes-associated complications and repeated hemoglobin A1c (HbA1c measures are a widely used marker for glycemic control in diabetes treatment and follow-up. A recent genome-wide association study revealed four genetic loci, which were associated with HbA1c levels in adults with type 1 diabetes. We aimed to evaluate the effect of these loci on glycemic control in type 2 diabetes. Methods We genotyped 1,486 subjects with type 2 diabetes from a Norwegian population-based cohort (HUNT2 for single-nucleotide polymorphisms (SNPs located near the BNC2, SORCS1, GSC and WDR72 loci. Through regression models, we examined their effects on HbA1c and non-fasting glucose levels individually and in a combined genetic score model. Results No significant associations with HbA1c or glucose levels were found for the SORCS1, BNC2, GSC or WDR72 variants (all P-values > 0.05. Although the observed effects were non-significant and of much smaller magnitude than previously reported in type 1 diabetes, the SORCS1 risk variant showed a direction consistent with increased HbA1c and glucose levels, with an observed effect of 0.11% (P = 0.13 and 0.13 mmol/l (P = 0.43 increase per risk allele for HbA1c and glucose, respectively. In contrast, the WDR72 risk variant showed a borderline association with reduced HbA1c levels (β = -0.21, P = 0.06, and direction consistent with decreased glucose levels (β = -0.29, P = 0.29. The allele count model gave no evidence for a relationship between increasing number of risk alleles and increasing HbA1c levels (β = 0.04, P = 0.38. Conclusions The four recently reported SNPs affecting glycemic control in type 1 diabetes had no apparent effect on HbA1c in type 2 diabetes individually or by using a combined genetic score model. However, for the SORCS1 SNP, our findings do not rule out a possible relationship with HbA1c levels. Hence, further studies in other

  14. Individual asbestos exposure: smoking and mortality--a cohort study in the asbestos cement industry.

    OpenAIRE

    Neuberger, M.; Kundi, M

    1990-01-01

    A historical prospective cohort study comprised all persons employed from 1950 to 1981 for at least three years in the oldest asbestos cement factory in the world. From 2816 persons eligible for the study, record based estimates and measurements of dust and fibres and histories of smoking based on interviews were used to calculate individual exposures over time. After observation of 51,218 person-years and registration of 540 deaths, underlying causes of death for this cohort were compared wi...

  15. Feasibility of a cohort study on health risks caused by occupational exposure to radiofrequency electromagnetic fields

    Directory of Open Access Journals (Sweden)

    Wahrendorf Jürgen

    2009-05-01

    Full Text Available Abstract Background The aim of this study was to examine the feasibility of performing a cohort study on health risks from occupational exposure to radiofrequency electromagnetic fields (RF-EMF in Germany. Methods A set of criteria was developed to evaluate the feasibility of such a cohort study. The criteria aimed at conditions of exposure and exposure assessment (level, duration, preferably on an individual basis, the possibility to assemble a cohort and the feasibility of ascertaining various disease endpoints. Results Twenty occupational settings with workers potentially exposed to RF-EMF and, in addition, a cohort of amateur radio operators were considered. Based on expert ratings, literature reviews and our set of predefined criteria, three of the cohorts were identified as promising for further evaluation: the personnel (technicians of medium/short wave broadcasting stations, amateur radio operators, and workers on dielectric heat sealers. After further analyses, the cohort of workers on dielectric heat sealers seems not to be feasible due to the small number of exposed workers available and to the difficulty of assessing exposure (exposure depends heavily on the respective working process and mixture of exposures, e.g. plastic vapours, although exposure was highest in this occupational setting. The advantage of the cohort of amateur radio operators was the large number of persons it includes, while the advantage of the cohort of personnel working at broadcasting stations was the quality of retrospective exposure assessment. However, in the cohort of amateur radio operators the exposure assessment was limited, and the cohort of technicians was hampered by the small number of persons working in this profession. Conclusion The majority of occupational groups exposed to RF-EMF are not practicable for setting up an occupational cohort study due to the small numbers of exposed subjects or due to exposure levels being only marginally higher

  16. Increase in mammography detected breast cancer over time at a community based regional cancer center: a longitudinal cohort study 1990–2005

    Directory of Open Access Journals (Sweden)

    Malmgren Judith A

    2008-05-01

    Full Text Available Abstract Background Coincident with the advent of mammography screening, breast carcinoma in situ has increased in the US population. Methods We conducted a prospective cohort study of all women presenting with primary breast cancer, aged 21–94, and biopsy confirmed Stage 0-IV from 1990–2005 identified and tracked by our registry. Clinical presentation characteristics including age, race, TNM stage, family and pregnancy history, histologic type and method of detection by patient (PtD, physician (PhysD or mammography (MgD were chart abstracted at time of diagnosis. Cases with unknown or other method of detection (n = 84, or unusual cell types (n = 26 were removed (n = 6074. Results From 1990 to 1998 the percentage of PtD and MgD cases was roughly equivalent. In 1999 the percentage of MgD cases increased to 56% and PtD dropped to 37%, a significant 20% differential, constant to 2005 (Pearson chi square = 120.99, p Conclusion In our cohort the relative proportion of mammography detected breast cancer increased over time with a higher increase among women age 50+ and an increase of breast carcinoma in situ exclusively among MgD cases. The increase among women currently targeted by mammography screening programs (age ≥ 50 combined with an increase of breast carcinoma in situ most often detected by mammography screening indicates a possible incidence shift to lower stage breast cancer as a result of mammographic detection.

  17. Antibiotic exposure in the first year of life and later treated asthma, a population based birth cohort study of 143,000 children.

    Science.gov (United States)

    Pitter, Gisella; Ludvigsson, Jonas Filip; Romor, Pierantonio; Zanier, Loris; Zanotti, Renzo; Simonato, Lorenzo; Canova, Cristina

    2016-01-01

    Several epidemiological studies reported an association between antibiotic consumption in the first year of life and later asthma, but results are conflicting and affected by potential biases. We examined this controversial issue in a population-based birth cohort. Using administrative data, we identified 143,163 children born in 1995-2011 in Friuli-Venezia Giulia (Italy) (median follow-up 5.25 years, 927,350 person-years). Antibiotic prescriptions in the first year of life and subsequent treated asthma (defined as ≥2 anti-asthmatic drug prescriptions within a 12-month period) were retrieved from drug prescription records. We estimated incidence rate ratios (IRR) using Poisson regression models, adjusted for perinatal variables and for hospitalizations for infections in the first year of life. We identified 34,957 new-onset asthma cases. Antibiotic consumption in the first year of life increased the risk of new-onset asthma [IRR 1.51, 95 % confidence interval (CI) 1.48-1.54] with a dose-response relationship (p-trend <0.001). The risk was highest for asthma identified at 13-35 months of life (IRR 2.07, 95 % CI 2.00-2.14), but remained statistically significant for asthma identified at 36-71 months (IRR 1.17, 95 % CI 1.14-1.21) and at ≥72 months (IRR 1.15, 95 % CI 1.08-1.22). Antibiotics increased the risk of current asthma at ≥6 years (IRR 1.35, 95 % CI 1.30-1.41) and at ≥13 years of age (IRR 1.19, 95 % CI 1.08-1.33). Antibiotic exposure in infancy is associated with an increased risk of asthma up to adolescence. The association detected at older ages is not explained by reverse causation; however, confounding by respiratory infections not leading to hospital admission cannot be excluded. PMID:25957084

  18. Disability Pension at the Time of Coronary Revascularisation Is Associated with Higher Five-Year Mortality; A Swedish Nationwide, Register-Based Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Katharina Zetterström

    Full Text Available Although coronary revascularisation by coronary artery bypass grafting (CABG and percutaneous coronary intervention (PCI are common procedures, little is known regarding disability pension (DP at the time of coronary revascularisation and its association with mortality. The aim was to investigate the five-year mortality following a first coronary revascularisation among women and men on DP, compared with those not on DP at the time of intervention, accounting for socio-demographic and medical factors.A nationwide prospective population-based cohort study was conducted, using national registers including 70,040 patients (80% men, aged 30-64 years, with a first CABG (n = 24,987; 36% or PCI (n = 45,053; 64% during 1994-2006 in Sweden, who were alive 30 days after the intervention. The main outcome was all-cause and cause-specific mortality within five years or through 31 December 2006, following CABG and PCI, and the exposure was DP at the time of a first coronary revascularisation. Information on DP, patient characteristics, date and cause of death was obtained from nationwide registers. Hazard ratios (HR with 95% confidence intervals (CI for the outcome were estimated, using Cox proportional hazard regression analyses. All analyses were stratified by type of intervention and gender.Four percent died following coronary revascularisation. Cardiovascular disease was the most common cause of death (54%, followed by neoplasms (25%. Regardless of type of intervention, gender and after multivariable adjustments, patients on DP had a higher HR for five-year mortality compared with those not on DP at time of revascularisation (CABG: women HR 2.14; 95% CI 1.59-2.89, men HR 2.09; 1.84-2.38, PCI: women HR 2.25; 1.78-2.83, men HR 1.95; 1.72-2.21. Young women on DP at the time of PCI had a substantially higher HR (HR 4.10; 95% CI: 2.25-7.48.Patients on DP at the time of first coronary revascularisation had a higher five-year risk of mortality compared with

  19. Data linkage in an established longitudinal cohort: the Western Australian Pregnancy Cohort (Raine) Study.

    Science.gov (United States)

    Mountain, Jenny A; Nyaradi, Anett; Oddy, Wendy H; Glauert, Rebecca A; de Klerk, Nick H; Straker, Leon M; Stanley, Fiona J

    2016-01-01

    The Western Australian Data Linkage System is one of a few comprehensive, population-based data linkage systems worldwide, creating links between information from different sources relating to the same individual, family, place or event, while maintaining privacy. The Raine Study is an established cohort study with more than 2000 currently active participants. Individual consent was obtained from participants for information in publicly held databases to be linked to their study data. A waiver of consent was granted where it was impracticable to obtain consent. Approvals to link the datasets were obtained from relevant ethics committees and data custodians. The Raine Study dataset was subsequently linked to academic testing data collected by the Western Australian Department of Education. Examination of diet and academic performance showed that children who were predominantly breastfed for at least 6 months scored higher academically at age 10 than children who were breastfed for less than 6 months. A further study found that better diet quality at ages 1, 2 and 3 years was associated with higher academic scores at ages 10 and 12 years. Examination of nutritional intake at 14 years of age found that a better dietary pattern was associated with higher academic performance. The detailed longitudinal data collected in the Raine Study allowed for adjustment for multiple covariates and confounders. Data linkage reduces the burden on cohort participants by providing additional information without the need to contact participants. It can give information on participants who have been lost to follow-up; provide or complement missing data; give the opportunity for validation studies comparing recall of participants with administrative records; increase the population sample of studies by adding control participants from the general population; and allow for the adjustment of multiple covariates and confounders. The Raine Study dataset is extensive and detailed, and can be

  20. Cumulative exposure to air pollution and long term outcomes after first acute myocardial infarction: A population-based cohort study. Objectives and methodology

    Directory of Open Access Journals (Sweden)

    Steinberg David M

    2010-06-01

    Full Text Available Abstract Background Cardiovascular disease is a leading cause of morbidity and mortality worldwide and epidemiological studies have consistently shown an increased risk for cardiovascular events in relation to exposure to air pollution. The Israel Study of First Acute Myocardial Infarction was designed to longitudinally assess clinical outcomes, psychosocial adjustment and quality of life in patients hospitalized with myocardial infarction. The current study, by introducing retrospective air pollution data, will examine the association between exposure to air pollution and outcome in myocardial infarction survivors. This report will describe the methods implemented and measures employed. The study specifically aims to examine the relationship between residential exposure to air pollution and long-term risk of recurrent coronary event, heart failure, stroke, cardiac and all-cause death in a geographically defined cohort of patients with myocardial infarction. Methods/Design All 1521 patients aged ≤65 years, admitted with first myocardial infarction between February 1992 and February 1993 to the 8 hospitals serving the population of central Israel, were followed for a median of 13 years. Data were collected on sociodemographic, clinical and environmental factors. Data from air quality monitoring stations will be incorporated retrospectively. Daily measures of air pollution will be summarised, allowing detailed maps to be developed in order to reflect chronic exposure for each participant. Discussion This study addresses some of the gaps in understanding of the prognostic importance of air pollution exposure after myocardial infarction, by allowing a sufficient follow-up period, using a well-defined community cohort, adequately controlling for multiple and multilevel confounding factors and providing extensive data on various outcomes.

  1. Abacavir and risk of myocardial infarction in HIV-infected patients on highly active antiretroviral therapy: a population-based nationwide cohort study

    DEFF Research Database (Denmark)

    Obel, Niels; Farkas, D K; Kronborg, G;

    2010-01-01

    OBJECTIVE: The aim of the study was to examine whether exposure to abacavir increases the risk for myocardial infarction (MI). DESIGN, SETTING AND SUBJECTS: This was a prospective nationwide cohort study which included all Danish HIV-infected patients on highly active antiretroviral therapy (HAART......) from 1995 to 2005 (N = 2952). Data on hospitalization for MI and comorbidity were obtained from Danish medical databases. Hospitalization rates for MI after HAART initiation were calculated for patients who used abacavir and those who did not. We used Cox's regression to compute incidence rate ratios...... (IRR) as a measure of relative risk for MI, while controlling for potential confounders (as separate variables and via propensity score) including comorbidity. MAIN OUTCOME: Relative risk of hospitalization with MI in abacavir users compared with abacavir nonusers. RESULTS: Hospitalization rates for MI...

  2. Exposure Assessment in Cohort Studies of Childhood Asthma

    OpenAIRE

    Arrandale, Victoria H.; Brauer, Michael; Brook, Jeffrey R.; Brunekreef, Bert; Gold, Diane R.; London, Stephanie J.; Miller, J. David; Özkaynak, Halûk; Ries, Nola M.; Sears, Malcolm R; Silverman, Frances S.; Takaro, Tim K

    2010-01-01

    Background The environment is suspected to play an important role in the development of childhood asthma. Cohort studies are a powerful observational design for studying exposure–response relationships, but their power depends in part upon the accuracy of the exposure assessment. Objective The purpose of this paper is to summarize and discuss issues that make accurate exposure assessment a challenge and to suggest strategies for improving exposure assessment in longitudinal cohort studies of ...

  3. Cohort Profile: The Malaysian Cohort (TMC) project: a prospective study of non-communicable diseases in a multi-ethnic population

    OpenAIRE

    Jamal, Rahman; Syed Zakaria, Syed Zulkifli; Kamaruddin, Mohd Arman; Abd Jalal, Nazihah; Ismail, Norliza; Mohd Kamil, Norkhamiwati; Abdullah, Noraidatulakma; Baharudin, Norhafizah; Hussin, Noor Hamidah; Othman, Hanita; Mahadi, Nor Muhammad; ,

    2014-01-01

    The Malaysian Cohort study was initiated in 2005 by the Malaysian government. The top-down approach to this population-based cohort study ensured the allocation of sufficient funding for the project which aimed to recruit 100 000 individuals aged 35–70 years. Participants were recruited from rural and urban areas as well as from various socioeconomic groups. The main objectives of the study were to identify risk factors, to study gene-environment interaction and to discover biomarkers for the...

  4. European birth cohort studies on asthma and atopic diseases

    DEFF Research Database (Denmark)

    Keil, T; Kulig, M; Simpson, A;

    2006-01-01

    BACKGROUND: The reasons for the rise in asthma and allergies remain unclear. To identify risk or protective factors, it is essential to carry out longitudinal epidemiological studies, preferably birth cohort studies. In Europe, several birth cohort studies on asthma and atopic diseases have been...... initiated over the last two decades. AIM: One of the work packages within the Global Allergy and Asthma European Network (GA(2)LEN) project was designed to identify and compare European birth cohorts on asthma and atopic diseases. The present review (part I) describes their objectives, study settings......, recruitment process and follow-up rates. A subsequent review (part II) will compare outcome and exposure parameters. METHODS: For each birth cohort, we collected detailed information regarding recruitment process, study setting, baseline data (pregnancy, birth, parents/siblings) as well as follow-up rates...

  5. Do fall-risk-increasing drugs have an impact on mortality in older hip fracture patients? A population-based cohort study

    Directory of Open Access Journals (Sweden)

    Kragh Ekstam A

    2016-04-01

    Full Text Available Annika Kragh Ekstam,1,2 Sölve Elmståhl1 1Division of Geriatric Medicine, Department of Health Sciences, Lund University, Skåne University Hospital, Malmö, 2Department of Medicine, Hässleholm Hospital, Hässleholm, Sweden Objective: The aim of this study was to assess the mortality in hip fracture patients with regard to use of fall-risk-increasing drugs (FRIDs, by comparing survival in exposed and nonexposed individuals. Design: This was a general population-based cohort study. Settings: Data on hip fracture patients were retrieved from three national databases. Participants: All hip fracture patients aged 60 years or older in a Swedish county in 2006 participated in this study. Measurements: We studied the mortality in hip fracture patients by comparing those exposed to FRIDs, combinations of FRIDs, and polypharmacy to nonexposed patients, adjusting for age and sex. For survival estimates in patients using four or more FRIDs, a Cox regression analysis was used, adjusting for age, sex, and use of any four or more drugs. Results: First-year all-cause mortality was 24.6% (N=503 in 2,043 hip fracture patients aged 60 years or older, including 170 males (33.8% and 333 females (66.2%. Patients prescribed four or more FRIDs, five or more drugs (polypharmacy, psychotropic drugs, and cardiovascular drugs showed significantly increased first-year mortality. Exposure to four or more FRIDs (518 patients, 25.4% was associated with an increased mortality at 30 days with odds ratios (ORs 2.01 (95% confidence interval [CI] 1.44–2.79, 90 days with OR 1.56 (95% CI 1.19–2.04, 180 days with OR 1.54 (95% CI 1.20–1.97, and 365 days with OR 1.43 (95% CI 1.13–1.80. Cox regression analyses adjusted for age, sex, and use of any four or more drugs showed a significantly higher mortality in patients treated with four or more FRIDs at 90 days (P=0.015 and 180 days (P=0.012 compared to patients treated with three or less FRIDs. Conclusion: First

  6. Alcohol consumption and the risk of self-reported perennial and seasonal allergic rhinitis in young adult women in a population-based cohort study

    DEFF Research Database (Denmark)

    Bendtsen, P; Grønbæk, M; Kjær, S. K.;

    2008-01-01

    women. Methods Five thousand eight hundred and seventy Danish women aged 20-29 years participated in a prospective cohort study, and were free of seasonal and perennial AR at baseline (1991-1993). Alcohol consumption was assessed by a food frequency questionnaire. The main outcome measures were self......-reported information on seasonal and perennial AR debuting during a mean follow-up period of 7.8 years. Results During follow-up, 831 women developed seasonal AR and 523 women developed perennial AR, corresponding to 14% and 9%. Alcohol consumption was positively associated with the risk of developing perennial AR....... The adjusted odds ratio (OR) for perennial AR was 1.78 (95% CI, 1.13-2.80) among women drinking more than 14 drinks/week compared with women drinking <1 drink/week. There was no association between alcohol consumption and seasonal AR. Having one or two parents with asthma was, after adjustment...

  7. Fish and long-chain n-3 polyunsaturated fatty acid intakes during pregnancy and risk of postpartum depression: a prospective study based on a large national birth cohort

    DEFF Research Database (Denmark)

    Strøm, Marin; Mortensen, Erik Lykke; Halldorsson, Thorhallur I;

    2009-01-01

    BACKGROUND: Mothers may be reluctant to receive medical treatment of postpartum depression (PPD), despite the detrimental consequences the disorder can impose on mother and child. Research on alternative methods of prevention and treatment of PPD is warranted. Previous studies have suggested that...... was linked to the Danish patient and prescription registries for data on clinically identified cases of depression up to 1 y postpartum. Intake of fish and n-3 PUFAs was assessed in midpregnancy with a food-frequency questionnaire. Admission to the hospital for PPD (PPD-admission) and prescription of...... long-chain n-3 polyunsaturated fatty acids (PUFAs) might have a beneficial effect on depression. OBJECTIVE: The objective was to explore the association between intake of fish and n-3 PUFAs during pregnancy and PPD in the Danish National Birth Cohort (DNBC). DESIGN: Exposure information from the DNBC...

  8. Problem drinking and exceeding guidelines for 'sensible' alcohol consumption in Scottish men: associations with life course socioeconomic disadvantage in a population-based cohort study

    Directory of Open Access Journals (Sweden)

    Benzeval Michaela

    2008-09-01

    Full Text Available Abstract Background With surveys suggesting that exceeding guidelines for 'sensible' alcohol intake is commonplace, the health and social impact of modifying intake on a population level is potentially considerable. If public health interventions are to be successfully implemented, it is first important to identify correlates of such behaviours, including socioeconomic disadvantage. This was the aim of the present study. Methods Population-representative cohort study of 576 men from the West of Scotland. Data on life course socioeconomic position were collected in 1988 (at around 55 years of age. Alcohol consumption patterns (detailed seven day recall and problem drinking (CAGE questionnaire were ascertained in 1990/2 (at around 59 years of age. A relative index of inequality was computed to explore the comparative strength of different indicators of social circumstances from different periods of the life course. Results Socioeconomic adversity in both early life and in adulthood was related to an increased risk of exceeding the weekly and daily alcohol guidelines, with adult indicators of socioeconomic position revealing the strongest associations. Of these, material indicators of socioeconomic deprivation in adulthood – car ownership, housing tenure – were marginally more strongly related to heavy alcohol intake and problem drinking than education, income and occupational social class. A substantial proportion of the influence of early life deprivation on alcohol intake was mediated via adult socioeconomic position. Similar results were apparent when problem drinking was the outcome of interest. Conclusion In men in this cohort, exposure to disadvantaged social circumstances across the lifecourse, but particularly in adulthood, is associated with detrimental patterns of alcohol consumption and problem drinking in late middle age.

  9. Valid comparisons and decisions based on clinical registers and population based cohort studies: assessing the accuracy, completeness and epidemiological relevance of a breast cancer query database

    Directory of Open Access Journals (Sweden)

    Jacke Christian Olaf

    2012-12-01

    Full Text Available Abstract Background Data accuracy and completeness are crucial for ensuring both the correctness and epidemiological relevance of a given data set. In this study we evaluated a clinical register in the administrative district of Marburg-Biedenkopf, Germany, for these criteria. Methods The register contained data gathered from a comprehensive integrated breast-cancer network from three hospitals that treated all included incident cases of malignant breast cancer in two distinct time periods from 1996–97 (N=389 and 2003–04 (N=488. To assess the accuracy of this data, we compared distributions of risk, prognostic, and predictive factors with distributions from established secondary databases to detect any deviations from these “true” population parameters. To evaluate data completeness, we calculated epidemiological standard measures as well as incidence-mortality-ratios (IMRs. Results In total, 12% (13 of 109 of the variables exhibited inaccuracies: 9% (5 out of 56 in 1996–97 and 15% (8 out of 53 in 2003–04. In contrast to raw, unstandardized incidence rates, (in- directly age-standardized incidence rates showed no systematic deviations. Our final completeness estimates were IMR=36% (1996–97 and IMR=43% (2003–04. Conclusion Overall, the register contained accurate, complete, and correct data. Regional differences accounted for detected inaccuracies. Demographic shifts occurred. Age-standardized measures indicate an acceptable degree of completeness. The IMR method of measuring completeness was inappropriate for incidence-based data registers. For the rising number of population-based health-care networks, further methodological advancements are necessary. Correct and epidemiologically relevant data are crucial for clinical and health-policy decision-making.

  10. Opium use and mortality in Golestan Cohort Study: prospective cohort study of 50 000 adults in Iran

    OpenAIRE

    Khademi, Hooman; Malekzadeh, Reza; Pourshams, Akram; Jafari, Elham; Salahi, Rasool; Semnani, Shahryar; Abaie, Behrooz; Islami, Farhad; Nasseri-Moghaddam, Siavosh; Etemadi, Arash; Byrnes, Graham; Abnet, Christian C.; Dawsey, Sanford M.; Day, Nicholas E; Pharoah, Paul D

    2012-01-01

    Objectives To investigate the association between opium use and subsequent risk of death. Design Prospective cohort study. Setting The Golestan Cohort Study in north-eastern Iran collected detailed validated data on opium use and other exposures at baseline. Participants were enrolled between January 2004 and June 2008 and were followed to May 2011, with a follow-up success rate of over 99%. Participants 50 045 participants aged 40-75 at baseline. Main outcomes Mortality, all cause and major ...

  11. The Impact of Hypofractionated Whole Breast Radiotherapy on Local Relapse in Patients With Grade 3 Early Breast Cancer: A Population-Based Cohort Study

    Energy Technology Data Exchange (ETDEWEB)

    Herbert, Christopher, E-mail: cherbert@bccancer.bc.ca [Department of Radiation Oncology, BC Cancer Agency, Vancouver, British Columbia (Canada); Nichol, Alan [Department of Radiation Oncology, BC Cancer Agency, Vancouver, British Columbia (Canada); Olivotto, Ivo [Department of Radiation Oncology, BC Cancer Agency, Victoria, British Columbia (Canada); Weir, Lorna [Department of Radiation Oncology, BC Cancer Agency, Vancouver, British Columbia (Canada); Woods, Ryan; Speers, Caroline [Breast Cancer Outcomes Unit, BC Cancer Agency, Vancouver, British Columbia (Canada); Truong, Pauline [Department of Radiation Oncology, BC Cancer Agency, Victoria, British Columbia (Canada); Tyldesley, Scott [Department of Radiation Oncology, BC Cancer Agency, Vancouver, British Columbia (Canada)

    2012-04-01

    Purpose: To determine whether patients with Grade 3 early breast cancer have an inferior rate of local disease control at 10 years with hypofractionated radiotherapy compared with more conventionally fractionated schedules. Methods and Materials: Local relapse rates were compared between patients receiving hypofractionated radiotherapy or conventionally fractionated radiotherapy to the whole breast in a population-based cohort of women with early-stage (T1-T2, N0, M0) Grade 3 breast cancers diagnosed between 1990 and 2000 and referred to the British Columbia Cancer Agency. Cumulative rates of local relapse were estimated using a competing risk method, and factors significant on univariate analysis were included with fractionation group in a multivariate model. The primary end point was local control at 10 years. Results: A total of 1,335 patients with Grade 3 tumors were treated with adjuvant radiotherapy, 252 with conventional fractionation, and 1,083 with a hypofractionated schedule. The 10-year cumulative incidence of local relapse was 6.9% in the hypofractionated group and 6.2% in the conventionally fractionated group (p = 0.99). Conclusions: There is no evidence that hypofractionation is inferior to conventional fractionation for breast conserving therapy in patients with Grade 3 breast cancer in this large population-based series after 10 years of follow-up.

  12. The Impact of Hypofractionated Whole Breast Radiotherapy on Local Relapse in Patients With Grade 3 Early Breast Cancer: A Population-Based Cohort Study

    International Nuclear Information System (INIS)

    Purpose: To determine whether patients with Grade 3 early breast cancer have an inferior rate of local disease control at 10 years with hypofractionated radiotherapy compared with more conventionally fractionated schedules. Methods and Materials: Local relapse rates were compared between patients receiving hypofractionated radiotherapy or conventionally fractionated radiotherapy to the whole breast in a population-based cohort of women with early-stage (T1-T2, N0, M0) Grade 3 breast cancers diagnosed between 1990 and 2000 and referred to the British Columbia Cancer Agency. Cumulative rates of local relapse were estimated using a competing risk method, and factors significant on univariate analysis were included with fractionation group in a multivariate model. The primary end point was local control at 10 years. Results: A total of 1,335 patients with Grade 3 tumors were treated with adjuvant radiotherapy, 252 with conventional fractionation, and 1,083 with a hypofractionated schedule. The 10-year cumulative incidence of local relapse was 6.9% in the hypofractionated group and 6.2% in the conventionally fractionated group (p = 0.99). Conclusions: There is no evidence that hypofractionation is inferior to conventional fractionation for breast conserving therapy in patients with Grade 3 breast cancer in this large population-based series after 10 years of follow-up.

  13. Cohort profile: the Spanish WORKing life Social Security (WORKss) cohort study

    OpenAIRE

    L??pez G??mez, Mar??a Andr??e; Duran Jord??, Xavier, 1974-; Zaballa, Elena; S??nchez Niub??, Albert; Delclos, George L; Benavides, Fernando G.

    2016-01-01

    PURPOSE: The global economy is changing the labour market and social protection systems in Europe. The effect of both changes on health needs to be monitored in view of an ageing population and the resulting increase in prevalence of chronic health conditions. The Spanish WORKing life Social Security (WORKss) cohort study provides unique longitudinal data to study the impact of labour trajectories and employment conditions on health, in terms of sickness absence, permanent disability and deat...

  14. A general semiparametric Z-estimation approach for case-cohort studies

    CERN Document Server

    Nan, Bin

    2012-01-01

    Case-cohort design, an outcome-dependent sampling design for censored survival data, is increasingly used in biomedical research. The development of asymptotic theory for a case-cohort design in the current literature primarily relies on counting process stochastic integrals. Such an approach, however, is rather limited and lacks theoretical justification for outcome-dependent weighted methods due to non-predictability. Instead of stochastic integrals, we derive asymptotic properties for case-cohort studies based on a general Z-estimation theory for semiparametric models with bundled parameters using modern empirical processes. Both the Cox model and the additive hazards model with time-dependent covariates are considered.

  15. Chinese cohort study of chronic kidney disease: design and methods

    Institute of Scientific and Technical Information of China (English)

    Gao Bixia; Zhang Luxia; Wang Haiyan; Zhao Minghui

    2014-01-01

    Background Chronic kidney disease (CKD) is a common disorder associated with multiple adverse clinical consequences,especially cardiovascular risk and end-stage renal disease.A recent national survey demonstrated that CKD has become a leading health problem in China.There is an urgent need to implement an in-depth investigation of the CKD burden and also to explore underlying mechanisms of CKD progression and it association with adverse consequences.Methods The Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE) is the first national CKD cohort in China.It will enroll approximately 3 000 pre-dialysis CKD patients aged between 18 and 74 years and follow-up for at least 5 years.Questionnaires,anthropometric measures,laboratory tests,and biomaterials will be collected at baseline and annually.The principal clinical outcomes of the C-STRIDE consist of renal disease events,cardiovascular events,and death.Based on the longitudinal clinical data and biomaterials,the risk factors with CKD progression and other outcomes will be analyzed,and candidate markers and predicted models will be established.Conclusion The C-STRIDE would provide important evidence for underlying mechanisms of CKD progression,valuable information for clinical guidelines,and healthcare policies in China.

  16. Longitudinal associations between physical load and chronic low back pain in the general population: the Doetichem Cohort Study

    NARCIS (Netherlands)

    Oostrom, S.H.; Verschuren, M.; Vet, de H.C.; Boshuizen, H.C.; Picavet, H.S.

    2012-01-01

    Study Design. Prospective cohort study. Objective. We explored long-term associations between physical load exposure and chronic low back pain (LBP) using data from an ongoing population-based cohort study. Summary of Background Data. Physical load in work or daily life is often studied in relation

  17. Risk of Malignant Neoplasm in Patients with Incident Rheumatoid Arthritis 1980–2007 in relation to a Comparator Cohort: A Population-Based Study

    Science.gov (United States)

    Wright, Kerry

    2016-01-01

    Objective. To determine whether the incidence of malignancy is increased in patients with rheumatoid arthritis (RA) compared to a matched comparison cohort and to identify risk for any individual malignancy in RA. Methods. A cohort of 813 Olmsted County, Minnesota, residents who first fulfilled 1987 ACR criteria for RA in 1980–2007 was previously identified by medical record review. Medical records of 813 RA cases and a comparison cohort of age and sex matched Olmsted County residents without RA were evaluated retrospectively for cancer occurrence. Patients in both cohorts were followed until death, migration from Olmsted County, or 12/31/2014. Results. The RA and non-RA cohorts (mean age at incidence/index date: 55.9 [SD: 15.7] years; 68.4% females in both cohorts) were followed on average of 14.1 (SD: 7.7) and 14.9 (SD: 8.1) years, respectively. Prior to RA incidence/index date, 52 RA patients and 66 non-RA subjects had malignancies excluding NMSC (p = 0.21). During follow-up, significantly more malignancies occurred in patients with RA (n = 143) than in comparator subjects (n = 118; hazard ratio: 1.32; p = 0.027). Inclusion of NMSC obviated this difference. Conclusion. After excluding NMSC, there was a small to moderately increased risk of malignancies in patients with RA. Cancer surveillance is imperative in all patients with RA.

  18. Sickness Absence from Work among Persons with New Physician-Diagnosed Carpal Tunnel Syndrome: A Population-Based Matched-Cohort Study

    Science.gov (United States)

    Atroshi, Isam; Zhou, Caddie; Jöud, Anna; Petersson, Ingemar F.; Englund, Martin

    2015-01-01

    Background Carpal tunnel syndrome is common among employed persons. Data on sickness absence from work in relation to carpal tunnel syndrome have been usually based on self-report and derived from clinical or occupational populations. We aimed to determine sickness absence among persons with physician-diagnosed carpal tunnel syndrome as compared to the general population. Methods In Skåne region in Sweden we identified all subjects, aged 17–57 years, with new physician-made diagnosis of carpal tunnel syndrome during 5 years (2004–2008). For each subject we randomly sampled, from the general population, 4 matched reference subjects without carpal tunnel syndrome; the two cohorts comprised 5456 and 21,667 subjects, respectively (73% women; mean age 43 years). We retrieved social insurance register data on all sickness absence periods longer than 2 weeks from 12 months before to 24 months after diagnosis. Of those with carpal tunnel syndrome 2111 women (53%) and 710 men (48%) underwent surgery within 24 months of diagnosis. We compared all-cause sickness absence and analyzed sickness absence in conjunction with diagnosis and surgery. Results Mean number of all-cause sickness absence days per each 30-day period from 12 months before to 24 months after diagnosis was significantly higher in the carpal tunnel syndrome than in the reference cohort. A new sickness absence period longer than 2 weeks in conjunction with diagnosis was recorded in 12% of the women (n = 492) and 11% of the men (n = 170) and with surgery in 53% (n = 1121) and 58% (n = 408) of the surgically treated, respectively; median duration in conjunction with surgery was 35 days (IQR 27–45) for women and 41 days (IQR 28–50) for men. Conclusions Persons with physician-diagnosed carpal tunnel syndrome have substantially more sickness absence from work than age and sex-matched persons from the general population from1 year before to 2 years after diagnosis. Gender differences were small. PMID:25803841

  19. The income-based disparities in preeclampsia and postpartum hemorrhage: a study of the Korean National Health Insurance cohort data from 2002 to 2013.

    Science.gov (United States)

    Choe, Seung-Ah; Min, Hye-Sook; Cho, Sung-Il

    2016-01-01

    There is limited evidence on the effects of relatively low socioeconomic status on maternal health. Additionally, the global economic recession that began in 2008 could have worsened disparities in maternal complications. To explore disparities in maternal health, we analyzed the occurrence of preeclampsia and postpartum hemorrhage according to level of household income. A population-based cohort data set from the Korean National Health Insurance was used to calculate the age-adjusted incidence, slope index of inequality, and Kunst and Mackenbach relative index of inequality (RIIKM) for preeclampsia and postpartum hemorrhage from 2002 to 2013. In the aggregated data of 65,479 live births, women with lower household income showed a higher risk of developing preeclampsia and postpartum hemorrhage than those with higherhigher incomes after adjusting for conventional risk factors. The absolute and relative inequalities for both complications showed no significant change over the period from 2002 to 2013. Considering the difference in the trends and risks of major obstetric complications according to level of household income, policies to monitor and reduce disparities in maternal health across different economic levels need to be implemented. PMID:27386343

  20. The MANGUA Project: A Population-Based HIV Cohort in Guatemala

    Science.gov (United States)

    García, Juan Ignacio; Samayoa, Blanca; Sabidó, Meritxell; Prieto, Luis Alberto; Nikiforov, Mikhail; Pinzón, Rodolfo; Santa Marina de León, Luis Roberto; Ortiz, José Fernando; Ponce, Ernesto; Mejía, Carlos Rodolfo; Arathoon, Eduardo; Casabona, Jordi; Study Group, The Mangua Cohort

    2015-01-01

    Introduction. The MANGUA cohort is an ongoing multicenter, observational study of people living with HIV/AIDS in Guatemala. The cohort is based on the MANGUA application which is an electronic database to capture essential data from the medical records of HIV patients in care. Methods. The cohort enrolls HIV-positive adults ≥16 years of age. A predefined set of sociodemographic, behavioral, clinical, and laboratory data are registered at entry to the cohort study. Results. As of October 1st, 2012, 21 697 patients had been included in the MANGUA cohort (median age: 33 years, 40.3% female). At enrollment 74.1% had signs of advanced HIV infection and only 56.3% had baseline CD4 cell counts. In the first 12 months after starting antiretroviral treatment 26.9% (n = 3938) of the patients were lost to the program. Conclusions. The implementation of a cohort of HIV-positive patients in care in Guatemala is feasible and has provided national HIV indicators to monitor and evaluate the HIV epidemic. The identified percentages of late presenters and high rates of LTFU will help the Ministry to target their current efforts in improving access to diagnosis and care. PMID:26425365

  1. Second Cancer Risk and Late Mortality in Adult Australians Receiving Allogeneic Hematopoietic Stem Cell Transplantation: A Population-Based Cohort Study.

    Science.gov (United States)

    Vajdic, Claire M; Mayson, Eleni; Dodds, Anthony J; O'Brien, Tracey; Wilcox, Leonie; Nivison-Smith, Ian; Le Marsney, Renate; Daniels, Benjamin; Ashton, Lesley J

    2016-05-01

    We quantified the risk of second cancer and late mortality in a population-based Australian cohort of 3273 adult (≥15 years) allogeneic hematopoietic stem cell transplant recipients (1992 to 2007). Most recipients received nonradiation-based conditioning and a peripheral blood graft from a matched related donor. Using record linkage with death and cancer registries, 79 second cancers were identified a median of 3.5 years after transplantation. The competing-risk adjusted cumulative incidence of second cancers was 3.35% (95% CI, 2.59 to 4.24) at 10 years, and the cancer risk relative to the matched general population was 2.10 (95% CI, 1.65 to 2.56). We observed an excess risk of melanoma and lip, tongue, esophagus, and soft tissue cancers. Cancer risk relative to the general population was elevated for those transplanted for lymphoma, some leukemia subtypes, and severe aplastic anemia, recipients who developed chronic graft-versus-host disease (cGVHD) and irrespective of radiation-based conditioning or stem cell source. In those alive 2 years after transplantation (n = 1463), the cumulative incidence of late mortality was 22.2% (95% CI, 19.7 to 24.9) at 10 years, and the risk of death relative to the matched general population was 13.8 (95% CI, 12.2 to 15.6). In multivariable modeling, risk of late death was reduced for females compared with males and those transplanted for chronic myeloid leukemia compared with acute myeloid leukemia; risk was increased for recipients with discordant sex donors, cGVHD, those undergoing second transplants, and disease relapse. Adults undergoing allogeneic transplantation have unique cancer and mortality risk profiles that continue to warrant prevention and surveillance activities targeted at high-risk subgroups. PMID:26860637

  2. Antibiotics usage in infants during the first 18 months of life in Benin: a population-based cohort study.

    Science.gov (United States)

    Brembilla, A; Mauny, F; Garcia, A; Koura, K G; Deloron, P; Faucher, J-F

    2016-04-01

    Data centered on antibiotics usage and their determinants in African pediatric populations are limited. In order to define the determinants of antibiotics prescriptions (ABPr), we analyzed the data of a birth cohort in Benin. From 2007 to 2009, 538 infants were followed from birth to 18 months in three different health centers. The following determinants were assessed: infants' clinical findings at consultations, mothers' and children's characteristics at birth, and health parameters recorded at scheduled follow-up of general health parameters. Multilevel logistic models were performed for analysis. Among the 4394 consultations, fever represented 53.7 % of consultations, 64.1 % of which were non-malarial fevers. Antibiotics were prescribed during 44.2 % of the consultations and the proportion of ABPr differed significantly among health centers (p breastfeeding score (p < 10(-3)). Studies on the rational use of antibiotics in this population should give priority to children more than 6 months of age, without malaria, and with respiratory and/or enteric symptoms. Our data also advocate for studies specifically designed to assess and improve healthcare providers' compliance to guidelines on antibiotics usage. PMID:26864042

  3. Association between Exposure to Benzodiazepines and Related Drugs and Survivorship of Total Hip Replacement in Arthritis: A Population-Based Cohort Study of 246,940 Patients.

    Directory of Open Access Journals (Sweden)

    Dan Beziz

    Full Text Available Total hip replacement (THR is successful in treating hip arthritis. Prosthetic survivorship may depend on the medications taken by the patient; particularly, the role of benzodiazepines and related drugs (Z-drugs with THR revision has been poorly investigated. Our objective was to compare THR short-term survivorship according to level of exposure to benzodiazepine and Z-drugs.All French patients aged 40 years or older, having undergone primary THR from January 1, 2009, through December 31, 2012, for arthritis according to French national health insurance databases were included in the cohort. Outcome of interest was THR revision, including any surgical procedure in which the implant or any component was changed or removed. Follow-up started the day the primary THR was performed. Observations were right-censored on December 31, 2014, if neither revision nor death had yet occurred. Exposure of interest was the cumulative defined daily doses per day (cDDD/day of benzodiazepines and Z-drugs dispensed within 6 months before or after inclusion. We defined four exposure groups; cDDD/d = 0: unexposed; 0.38: high exposure. THR survivorship was assessed according to level of exposure to benzodiazepines and Z-drugs in univariate and multivariate Cox models adjusted for patient, THR and implanting center characteristics.The study cohort comprised 246,940 individuals: mean age at baseline, 69.9 years; women, 57.9%; unexposed: 51.7%; low exposure: 16.7%; medium exposure: 15.9%; and high exposure: 15.7%. During the median 45-month follow-up, 9043 individuals underwent prosthetic revision. Adjusted hazard ratios in low, medium and high exposed groups were 1.18 (95%CI, 1.12-1.26; P<0.001, 1.32 (95%CI, 1.24-1.40; P<0.001 and 1.37 (95%CI, 1.29-1.45; P<0.001, respectively, compared to unexposed.Exposure to benzodiazepines and Z-drugs is associated with an increased risk of THR revision, with a dose-response relationship. Cautious prescribing might be needed as well

  4. Association between Exposure to Benzodiazepines and Related Drugs and Survivorship of Total Hip Replacement in Arthritis: A Population-Based Cohort Study of 246,940 Patients

    Science.gov (United States)

    Beziz, Dan; Colas, Sandrine; Collin, Cédric; Dray-Spira, Rosemary; Zureik, Mahmoud

    2016-01-01

    Background Total hip replacement (THR) is successful in treating hip arthritis. Prosthetic survivorship may depend on the medications taken by the patient; particularly, the role of benzodiazepines and related drugs (Z-drugs) with THR revision has been poorly investigated. Our objective was to compare THR short-term survivorship according to level of exposure to benzodiazepine and Z-drugs. Design, Setting and Participants All French patients aged 40 years or older, having undergone primary THR from January 1, 2009, through December 31, 2012, for arthritis according to French national health insurance databases were included in the cohort. Outcome of interest was THR revision, including any surgical procedure in which the implant or any component was changed or removed. Follow-up started the day the primary THR was performed. Observations were right-censored on December 31, 2014, if neither revision nor death had yet occurred. Exposure of interest was the cumulative defined daily doses per day (cDDD/day) of benzodiazepines and Z-drugs dispensed within 6 months before or after inclusion. We defined four exposure groups; cDDD/d = 0: unexposed; 0.38: high exposure. THR survivorship was assessed according to level of exposure to benzodiazepines and Z-drugs in univariate and multivariate Cox models adjusted for patient, THR and implanting center characteristics. Results The study cohort comprised 246,940 individuals: mean age at baseline, 69.9 years; women, 57.9%; unexposed: 51.7%; low exposure: 16.7%; medium exposure: 15.9%; and high exposure: 15.7%. During the median 45-month follow-up, 9043 individuals underwent prosthetic revision. Adjusted hazard ratios in low, medium and high exposed groups were 1.18 (95%CI, 1.12–1.26; P<0.001), 1.32 (95%CI, 1.24–1.40; P<0.001) and 1.37 (95%CI, 1.29–1.45; P<0.001), respectively, compared to unexposed. Conclusion and Relevance Exposure to benzodiazepines and Z-drugs is associated with an increased risk of THR revision, with a

  5. Increase in mammography detected breast cancer over time at a community based regional cancer center: a longitudinal cohort study 1990–2005

    International Nuclear Information System (INIS)

    Coincident with the advent of mammography screening, breast carcinoma in situ has increased in the US population. We conducted a prospective cohort study of all women presenting with primary breast cancer, aged 21–94, and biopsy confirmed Stage 0-IV from 1990–2005 identified and tracked by our registry. Clinical presentation characteristics including age, race, TNM stage, family and pregnancy history, histologic type and method of detection by patient (PtD), physician (PhysD) or mammography (MgD) were chart abstracted at time of diagnosis. Cases with unknown or other method of detection (n = 84), or unusual cell types (n = 26) were removed (n = 6074). From 1990 to 1998 the percentage of PtD and MgD cases was roughly equivalent. In 1999 the percentage of MgD cases increased to 56% and PtD dropped to 37%, a significant 20% differential, constant to 2005 (Pearson chi square = 120.99, p < .001). Overall, percent TNM stage 0 (breast carcinoma in situ) cases increased after 1990, percent stage I and III cases declined, and stage II and IV cases remained constant (Pearson chi square = 218.36, p < .001). Increase in MgD over time differed by age group with an 8.5% increase among women age 40–49 and 12% increase among women age 50–95. Women age 21–39 rarely had MgD BC. In forward stepwise logistic regression modeling, significant predictors of MgD BC by order of entry were TNM stage, age at diagnosis, diagnosis year, and race (chi square = 1867.56, p < .001). In our cohort the relative proportion of mammography detected breast cancer increased over time with a higher increase among women age 50+ and an increase of breast carcinoma in situ exclusively among MgD cases. The increase among women currently targeted by mammography screening programs (age ≥ 50) combined with an increase of breast carcinoma in situ most often detected by mammography screening indicates a possible incidence shift to lower stage breast cancer as a result of mammographic detection

  6. perinatal depression in a cohort study of Iranian women

    Directory of Open Access Journals (Sweden)

    Gholam Reza Kheirabadi

    2010-01-01

    Full Text Available Introduction: Childbearing years in the women’s life are associated with the highest risk of depression. Despite the results of some studies that suggested, depression during pregnancy has been associated with poor prenatal care, substance abuse, low birth weight, and preterm delivery and introduced antenatal depression and anxiety as predictors of postnatal depression, researches during past 25 years have focused mostly on postpartum depression so depression during pregnancy is relatively neglected. Materials and methods: We studied depression during third trimester of pregnancy and after delivery, using prospectively gathered data from a cohort of 1898 women. We compared depressive symptom score and the proportion of mothers above a threshold, to indicate probable depressive disorder at each stage. Results: Point prevalence of depressed pregnant women (clinical depression based on BDI score greater than 20 in last trimester of pregnancy, was 22.8% and postnatal rate of depression based on EPD score greater than 12 between 6 to 8 weeks after delivery, was 26.3%. Incidence of PPD in 6 to 8 weeks after delivery in those who were not clinically depressed during pregnancy was, 20.1%. Discussion: We found that history of depression, unplanned pregnancy; being housewife and having 3 or more children were variables with significant relation to ante partum depression. Two main risk factors for post partum depression in this cohort study, were previous history of depression and depression during current pregnancy that highlight the importance of these two variables assessment during pregnancy in order to facilitate timely identification of women at risk.

  7. The influence of cardiovascular morbidity on the prognosis in prostate cancer. Experience from a 12-year nationwide Danish population-based cohort study

    Directory of Open Access Journals (Sweden)

    Jespersen Christina G

    2011-12-01

    Full Text Available Abstract Background To determine the impact of preexisting ischemic heart disease (IHD and stroke on overall survival in prostate cancer patients. Methods We conducted a cohort study of patients with incident prostate cancer registered in the Danish Cancer Registry from 1997 through 2008. We identified patients diagnosed with IHD or stroke prior to the date of prostate cancer diagnosis in the Danish National Patient Registry. We constructed Kaplan-Meier curves to analyze time to death and Cox regression was used to estimate hazard ratios (HRs to compare mortality rates by preexisting IHD or stroke status, adjusting for age, stage, comorbidity, and calendar period. Results Of 30,721 prostate cancer patients, 4,276 (14% had preexisting IHD and 1,331 (4% preexisting stroke. Crude 1- and 5-year survival rates were 85% and 44% in men without preexisting IHD or stroke, 81% and 36% in men with preexisting IHD, and 78% and 27% in men with preexisting stroke. Adjusted HRs were 1.05 (95% CI 1.00-1.10 for patients with IHD and 1.20 (95% CI 1.12-1.30 for patients with stroke compared with patients without preexisting IHD or stroke. Conclusions Preexisting IHD had minimal impact on mortality in prostate cancer patients, whereas overall mortality was 20% higher in prostate cancer patients with preexisting stroke compared to those without IHD or stroke. These results highlight the importance of differentiating between various comorbidities.

  8. Birth outcome and risk of neonatal hypoglycaemia following in utero exposure to pivmecillinam: a population-based cohort study with 414 exposed pregnancies.

    Science.gov (United States)

    Larsen, H; Nielsen, G L; Møller, M; Ebbesen, F; Schønheyder, H C; Sørensen, H T

    2001-01-01

    Concerns have been raised as to the safety of using pivaloyl-conjugated beta-lactam antibiotics during pregnancy as they cause carnitine depletion. Restrictions have been recommended in some Scandinavian countries as drug-induced carnitine depletion could constitute a risk to the developing foetus. One of these drugs, pivmecillinam, is widely used against urinary tract infections but few data exist concerning its safety in pregnancy. In a cohort study, we compared the prevalences of congenital abnormalities, pre-term delivery, low birth weight, low Apgar score and neonatal hypoglycaemia in the offspring of 414 women who had at least 1 prescription for pivmecillinam redeemed during pregnancy with those of the offspring of 7472 pregnant women for whom no drugs were prescribed during pregnancy. The prevalence of congenital abnormalities was 1.7% among 119 infants exposed in the first trimester and 3.7% among the reference group [odds ratio (OR) 0.46; 95% confidence interval (CI) 0.11-1.86]. We found no significantly increased risks in either pre-term delivery (OR 0.91, 95% CI 0.11-1.86), low birth weight (OR 0.57, 95%, CI 0.23-1.41), low Apgar score (OR 2.32, 95% CI 0.30-18.16) or hypoglycaemia (OR 0.73, 95% CI 0.18-3.00) that were induced by carnitine depletion. No significantly increased risk in adverse birth outcome was therefore found in women treated with pivmecillinam. PMID:11450863

  9. Risk ratio estimation in case-cohort studies.

    OpenAIRE

    Sato, T

    1994-01-01

    In traditional (cumulative-incidence) case-control studies, the exposure odds ratio can be used as an estimator of the risk ratio only when the disease under study is rare. The case-cohort study is a recently developed useful modification of the case-control study. This design allows direct estimation of the risk ratio from a fixed cohort, but does not require any rare-disease assumption. This article reviews recent developments in risk ratio estimation procedures for the analysis of case-coh...

  10. Cohort Profile: Sympathetic activity and Ambulatory Blood Pressure in Africans (SABPA) prospective cohort study.

    Science.gov (United States)

    Malan, Leoné; Hamer, Mark; Frasure-Smith, Nancy; Steyn, Hendrik S; Malan, Nicolaas T

    2015-12-01

    Adapting to an over-demanding stressful urban environment may exhaust the psychophysiological resources to cope with these demands, and lead to sympathetic nervous system dysfunction. The evidence that an urban-dwelling lifestyle may be detrimental to the cardiometabolic health of Africans motivated the design of the Sympathetic activity and Ambulatory Blood Pressure in African Prospective cohort study. We aimed to determine neural mechanistic pathways involved in emotional distress and vascular remodelling. The baseline sample included 409 teachers representing a bi-ethnic sex cohort from South Africa. The study was conducted in 2008-09 and repeated after 3-year follow-up in 2011-12, with an 87.8% successful follow-up rate. Seasonal changes were avoided and extensive clinical assessments were performed in a well-controlled setting. Data collection included sociodemographics, lifestyle habits, psychosocial battery and genetic analysis, mental stress responses mimicking daily life stress (blood pressure and haemostatic, cardiometabolic, endothelial and stress hormones). Target organ damage was assessed in the brain, heart, kidney, blood vessels and retina. A unique highly phenotyped cohort is presented that can address the role of a hyperactive sympathetic nervous system and neural response pathways contributing to the burden of cardiometabolic diseases in Africans. PMID:25344943

  11. Candidate pathway-based genetic association study of Platinum and Platinum-Taxane Related Toxicity in a Cohort of Primary Lung Cancer Patients

    Science.gov (United States)

    Johnson, Cassandra; Pankratz, Vernon S.; Velazquez, Ana I.; Aakre, Jeremiah A.; Loprinzi, Charles L.; Staff, Nathan P.; Windebank, Anthony J.; Yang, Ping

    2015-01-01

    Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common toxicity secondary to chemotherapy. Genetic factors may be important in predisposing patients to this adverse effect. Patients and Methods We studied 950 primary lung cancer patients, who received platinum or platinum-combination drug chemotherapy and who had DNA available for study. We analyzed epidemiological risk factors in 279 CIPN patients and 456 non-CIPN patients and genetic risk factors in 141 CIPN patients and 259 non-CIPN patients. The risk factors studied included demographic, diagnostic, and treatment data, as well as 174 tag SNPs (single nucleotide polymorphisms) across 43 candidate genes in the glutathione, cell cycle, DNA repair, cell signaling, and apoptosis pathways. Results Patients who had diabetes mellitus were more likely to have CIPN (p=0.0002). Other epidemiologic risk factors associated with CIPN included number of cycles (p=0.0004) and type of concurrent chemotherapy (p<0.001) . SNPs most associated with CIPN were in glutathione peroxidase 7 (GPX7) gene (p values 0.0015 and 0.0028, unadjusted and adjusted) and in ATP-binding cassette sub-family C member 4 (ABCC4) gene (p values 0.037 and 0.006, unadjusted and adjusted). We also found other suggestive associations in methyl-o-guanine-methyl-transferase (MGMT) and glutathione-S-transferase (GST) isoforms. Conclusions Epidemiological and genetic risk factors associated with CIPN in this cohort, included the type of chemotherapy drug, intensity of chemotherapy treatment, and genes known to be associated with chemotherapy resistance. These findings suggest that differentiating between cytotoxic and neurotoxic mechanisms of chemotherapy drugs is challenging but represents an important step toward individualized therapy and improving quality of life for patients. PMID:25586538

  12. Rheumatic Heart Disease-Attributable Mortality at Ages 5-69 Years in Fiji: A Five-Year, National, Population-Based Record-Linkage Cohort Study.

    Directory of Open Access Journals (Sweden)

    Tom Parks

    Full Text Available Rheumatic heart disease (RHD is considered a major public health problem in developing countries, although scarce data are available to substantiate this. Here we quantify mortality from RHD in Fiji during 2008-2012 in people aged 5-69 years.Using 1,773,999 records derived from multiple sources of routine clinical and administrative data, we used probabilistic record-linkage to define a cohort of 2,619 persons diagnosed with RHD, observed for all-cause mortality over 11,538 person-years. Using relative survival methods, we estimated there were 378 RHD-attributable deaths, almost half of which occurred before age 40 years. Using census data as the denominator, we calculated there were 9.9 deaths (95% CI 9.8-10.0 and 331 years of life-lost (YLL, 95% CI 330.4-331.5 due to RHD per 100,000 person-years, standardised to the portion of the WHO World Standard Population aged 0-69 years. Valuing life using Fiji's per-capita gross domestic product, we estimated these deaths cost United States Dollar $6,077,431 annually. Compared to vital registration data for 2011-2012, we calculated there were 1.6-times more RHD-attributable deaths than the number reported, and found our estimate of RHD mortality exceeded all but the five leading reported causes of premature death, based on collapsed underlying cause-of-death diagnoses.Rheumatic heart disease is a leading cause of premature death as well as an important economic burden in this setting. Age-standardised death rates are more than twice those reported in current global estimates. Linkage of routine data provides an efficient tool to better define the epidemiology of neglected diseases.

  13. The effects of household wealth on HIV prevalence in Manicaland, Zimbabwe – a prospective household census and population-based open cohort study

    Directory of Open Access Journals (Sweden)

    Nadine Schur

    2015-11-01

    Full Text Available Introduction: Intensified poverty arising from economic decline and crisis may have contributed to reductions in HIV prevalence in Zimbabwe. Objectives: To assess the impact of the economic decline on household wealth and prevalent HIV infection using data from a population-based open cohort. Methods: Household wealth was estimated using data from a prospective household census in Manicaland Province (1998 to 2011. Temporal trends in summed asset ownership indices for sellable, non-sellable and all assets combined were compared for households in four socio-economic strata (small towns, agricultural estates, roadside settlements and subsistence farming areas. Multivariate logistic random-effects models were used to measure differences in individual-level associations between prevalent HIV infection and place of residence, absolute wealth group and occupation. Results: Household mean asset scores remained similar at around 0.37 (on a scale of 0 to 1 up to 2007 but decreased to below 0.35 thereafter. Sellable assets fell substantially from 2004 while non-sellable assets continued increasing until 2008. Small-town households had the highest wealth scores but the gap to other locations decreased over time, especially for sellable assets. Concurrently, adult HIV prevalence fell from 22.3 to 14.3%. HIV prevalence was highest in better-off locations (small towns but differed little by household wealth or occupation. Initially, HIV prevalence was elevated in women from poorer households and lower in men in professional occupations. However, most recently (2009 to 2011, men and women in the poorest households had lower HIV prevalence and men in professional occupations had similar prevalence to unemployed men. Conclusions: The economic crisis drove more households into extreme poverty. However, HIV prevalence fell in all socio-economic locations and sub-groups, and there was limited evidence that increased poverty contributed to HIV prevalence decline.

  14. Study Design and Cohort Description of DEFIB-WOMEN

    DEFF Research Database (Denmark)

    Pedersen, Susanne S; Nielsen, Jens Cosedis; Riahi, Sam;

    2016-01-01

    BACKGROUND: Little systematic evidence is available on potential gender differences in patients with an implantable cardioverter defibrillator (ICD) from a real-world cohort. We designed the DEFIB-WOMEN study to examine gender differences on (i) patient reported outcomes (PROs), (ii) procedure- and...... device-related complications, and (iii) ventricular tachyarrhythmia and mortality. This presents the study design and baseline characteristics of the cohort. METHODS: DEFIB-WOMEN is a national, multi-center, prospective, observational study. First-time implanted patients are asked to complete PROs at...... several time points. Information on baseline and follow-up characteristics are captured from patients' medical records, purpose-designed questions, and the Danish national registers. The DEFIB-WOMEN cohort is comprised of 1790 (19% women; 343/1790) patients implanted between June 2010 and April 2013...

  15. A Population-Based Cohort Study of All-Cause and Site-Specific Cancer Incidence Among Patients With Type 1 Diabetes Mellitus in Taiwan

    Directory of Open Access Journals (Sweden)

    Pei-Chun Hsu

    2015-09-01

    Full Text Available Background: The relationship between type 1 diabetes mellitus (T1DM and cancer incidence remains unclear. We sought to assess the all-cause and site-specific cancer incidence in patients with T1DM. Methods: A retrospective cohort study design was employed, in which 14 619 patients with T1DM were retrieved from Taiwan’s National Health Insurance medical claims between 2000 and 2007. The study subjects were followed to the end of 2008, and cancer incidence was assessed. We calculated age-, sex-, and calendar year-standardized incidence ratios (SIRs of all-cause cancer incidence and site-specific neoplasm incidence, with reference to the general population. Results: Seven hundred and sixty patients were identified for all-cause cancer over 86 610 person-years, representing an incidence rate of 87.75 cases per 10 000 person-years. The incidence rate was higher in males than in female patients (109.86 vs 69.75 cases per 10 000 person-years. T1DM was associated with a significantly increased SIR of all-cause cancer (1.13; 95% confidence interval [CI], 1.05–1.22. The sex-specific SIR was significantly elevated in female patients (1.19; 95% CI, 1.07–1.33, but the SIR for male patients was insignificantly elevated (1.09; 95% CI, 0.99–1.20. Pancreatic cancer showed the greatest increase in SIR among both male and female patients with T1DM. Male patients experienced significantly increased SIRs for kidney, rectum, liver, and colon neoplasm, and significantly increased SIRs were noted for ovarian, bladder, and colon cancer in female patients. Conclusions: T1DM was associated with a 13% increase in risk of all-cause cancer incidence. Patients with T1DM should be advised to undergo cancer screening for certain types of cancer.

  16. Epidemiological study of venous thromboembolism in a big Danish cohort

    DEFF Research Database (Denmark)

    Severinsen, Marianne Tang; Kristensen, Søren Risom; Overvad, Kim;

    Introduction: Epidemiological data on venous thromboembolism (VT), i.e. pulmonary emboli (PE) and deep venous thrombosis (DVT) are sparse. We have examined VT-diagnoses registered in a big Danish Cohort study.  Methods: All first-time VT diagnoses in The Danish National Patient Register were...... identified among participants in the Danish cohort study "Diet, Cancer and Health" in which 57,053 50-64 years old persons were included 1993-7. Medical records were retrieved and reviewed by an experienced physician using a detailed standardized form, and information on the diagnostic work-up and presence...

  17. Failure to Thrive in the Term and Preterm Infants of Mothers Depressed in the Postnatal Period: A Population-Based Birth Cohort Study

    Science.gov (United States)

    Drewett, Robert; Blair, Peter; Emmett, Pauline; Emond, Alan

    2004-01-01

    Aims: To examine the relationship between failure to thrive in preterm and term infants and postnatal depression in their mothers. Method: In a whole population birth cohort of 12,391 infants (excluding those born after term or with major congenital abnormalities) failure to thrive over the first nine months was identified using a conditional…

  18. An Agent-Based Modeling Template for a Cohort of Veterans with Diabetic Retinopathy.

    Directory of Open Access Journals (Sweden)

    Theodore Eugene Day

    Full Text Available Agent-based models are valuable for examining systems where large numbers of discrete individuals interact with each other, or with some environment. Diabetic Veterans seeking eye care at a Veterans Administration hospital represent one such cohort.The objective of this study was to develop an agent-based template to be used as a model for a patient with diabetic retinopathy (DR. This template may be replicated arbitrarily many times in order to generate a large cohort which is representative of a real-world population, upon which in-silico experimentation may be conducted.Agent-based template development was performed in java-based computer simulation suite AnyLogic Professional 6.6. The model was informed by medical data abstracted from 535 patient records representing a retrospective cohort of current patients of the VA St. Louis Healthcare System Eye clinic. Logistic regression was performed to determine the predictors associated with advancing stages of DR. Predicted probabilities obtained from logistic regression were used to generate the stage of DR in the simulated cohort.The simulated cohort of DR patients exhibited no significant deviation from the test population of real-world patients in proportion of stage of DR, duration of diabetes mellitus (DM, or the other abstracted predictors. Simulated patients after 10 years were significantly more likely to exhibit proliferative DR (P<0.001.Agent-based modeling is an emerging platform, capable of simulating large cohorts of individuals based on manageable data abstraction efforts. The modeling method described may be useful in simulating many different conditions where course of disease is described in categorical stages.

  19. Population-based utilization of radiation therapy by a Canadian breast cancer cohort

    OpenAIRE

    Mittmann, N; Seung, S.J.; Liu, N.; Porter, J.; Saskin, R.; Hoch, J.S.; Evans, W.K.; Leighl, N.B.; Trudeau, M.; Earle, C.C.

    2014-01-01

    We examined trends in radiation therapy (rt) utilization by a population-based breast cancer cohort in Ontario. The provincial cancer registry provided a breast cancer cohort based on diagnosis dates from April 1, 2005, to March 31, 2010. Staging information was also available. The cohort was then linked, by encrypted health card number, to linkable administrative datasets, including rt utilization.

  20. Incremental health care costs for chronic pain in Ontario, Canada: a population-based matched cohort study of adolescents and adults using administrative data.

    Science.gov (United States)

    Hogan, Mary-Ellen; Taddio, Anna; Katz, Joel; Shah, Vibhuti; Krahn, Murray

    2016-08-01

    Little is known about the economic burden of chronic pain and how chronic pain affects health care utilization. We aimed to estimate the annual per-person incremental medical cost and health care utilization for chronic pain in the Ontario population from the perspective of the public payer. We performed a retrospective cohort study using Ontario health care databases and the electronically linked Canadian Community Health Survey (CCHS) from 2000 to 2011. We identified subjects aged ≥12 years from the CCHS with chronic pain and closely matched them to individuals without pain using propensity score matching methods. We used linked data to determine mean 1-year per-person health care costs and utilization for each group and mean incremental cost for chronic pain. All costs are reported in 2014 Canadian dollars. After matching, we had 19,138 pairs of CCHS respondents with and without chronic pain. The average age was 55 years (SD = 18) and 61% were female. The incremental cost to manage chronic pain was $1742 per person (95% confidence interval [CI], $1488-$2020), 51% more than the control group. The largest contributor to the incremental cost was hospitalization ($514; 95% CI, $364-$683). Incremental costs were the highest in those with severe pain ($3960; 95% CI, $3186-$4680) and in those with most activity limitation ($4365; 95% CI, $3631-$5147). The per-person cost to manage chronic pain is substantial and more than 50% higher than a comparable patient without chronic pain. Costs are higher in people with more severe pain and activity limitations. PMID:26989805

  1. Adverse Renal, Endocrine, Hepatic, and Metabolic Events during Maintenance Mood Stabilizer Treatment for Bipolar Disorder: A Population-Based Cohort Study

    Science.gov (United States)

    Marston, Louise; Walters, Kate; Geddes, John R.; King, Michael; Osborn, David P. J.

    2016-01-01

    Background There is limited, poorly characterized information about adverse events occurring during maintenance treatment of bipolar disorder. We aimed to determine adverse event rates during treatment with lithium, valproate, olanzapine, and quetiapine. Methods and Findings We conducted a propensity score adjusted cohort study using nationally representative United Kingdom electronic health records from January 1, 1995, until December 31, 2013. We included patients who had a diagnosis of bipolar disorder and were prescribed lithium (n = 2148), valproate (n = 1670), olanzapine (n = 1477), or quetiapine (n = 1376) as maintenance mood stabilizer treatment. Adverse outcomes were chronic kidney disease, thyroid disease, hypercalcemia, weight gain, hypertension, type 2 diabetes mellitus, cardiovascular disease, and hepatotoxicity. The propensity score included important demographic, physical health, and mental health predictors of drug treatment allocation. The median duration of drug treatment was 1.48 y (interquartile range 0.64–3.43). Compared to patients prescribed lithium, those taking valproate, olanzapine, and quetiapine had reduced rates of chronic kidney disease stage 3 or more severe, following adjustment for propensity score, age, and calendar year, and accounting for clustering by primary care practice (valproate hazard ratio [HR] 0.56; 95% confidence interval [CI] 0.45–0.69; p diabetes mellitus, cardiovascular disease, or hepatotoxicity. Despite estimates being robust following sensitivity analyses, limitations include the potential for residual confounding and ascertainment bias and an inability to examine dosage effects. Conclusions Lithium use is associated with more renal and endocrine adverse events but less weight gain than commonly used alternative mood stabilizers. Risks need to be offset with the effectiveness and anti-suicidal benefits of lithium and the potential metabolic side effects of alternative treatment options. PMID:27483368

  2. Systematic review of birth cohort studies in Africa

    OpenAIRE

    Alasdair Campbell; Igor Rudan

    2011-01-01

    In sub-Saharan Africa, unacceptably high rates of mortality amongst women and children continue to persist. The emergence of research employing new genomic technologies is advancing knowledge on cause of disease. This review aims to identify birth cohort studies conducted in sub-Saharan Africa and to consider their suitability as a platform to support genetic epidemiological studies.

  3. Investing in Prospective Cohorts for Etiologic Study of Occupational Exposures

    Science.gov (United States)

    Prospective cohorts have played a major role in understanding the role of diet, physical activity, medical conditions, and genes in the development of many diseases, but have not been widely used in the study of occupational exposures. Studies in agriculture are an exception. W...

  4. Determinants of depression in chronic stroke : A prospective cohort study

    NARCIS (Netherlands)

    van de Port, Ingrid G. L.; Kwakkel, Gert; Bruin, Margje; Lindeman, Eline

    2007-01-01

    Purpose. The aim of the study was to identify factors that are significantly related to depression in chronic stroke patients. Methods. Prospective cohort study of stroke patients admitted for rehabilitation. A total of 165 first ever stroke patients over 18 years of age were assessed at one and thr

  5. Effectiveness of general preconception care accompanied by a recruitment approach: Protocol of a community-based cohort study (the Healthy Pregnancy 4 All study)

    NARCIS (Netherlands)

    S.F. van Voorst (Sabine); A.A. Vos (Amber); L.C. de Jong-Potjer (L.); W. Waelput (Wim); E.A.P. Steegers (Eric); S. Denktaş (Semiha)

    2015-01-01

    textabstractIntroduction: Promotion of healthy pregnancies has gained high priority in the Netherlands because of the relative unfavourable perinatal outcomes. In response, a nationwide study Healthy Pregnancy 4 All (HP4ALL) has been initiated. One of the substudies within HP4ALL focuses on preconce

  6. Psychological and personality factors in type 2 diabetes mellitus, presenting the rationale and exploratory results from The Maastricht Study: A population-based cohort study

    OpenAIRE

    van Dooren, F.E.P.; Denollet, J; Verhey, F.R.J.; Stehouwer, C.D.; Sep, S.J.S.; Henry, R.M.; Kremers, S. P. J.; Dagnelie, P C; Schaper, N. C.; van der Kallen, C. J. H.; Koster, A.; Pouwer, F.; Schram, M T

    2016-01-01

    Background Strong longitudinal evidence exists that psychological distress is associated with a high morbidity and mortality risk in type 2 diabetes. Little is known about the biological and behavioral mechanisms that may explain this association. Moreover, the role of personality traits in these associations is still unclear. In this paper, we first describe the design of the psychological part of The Maastricht Study that aims to elucidate these mechanisms. Next, we present exploratory resu...

  7. Hospital visits among women with skeletal-related events secondary to breast cancer and bone metastases: a nationwide population-based cohort study in Denmark

    Directory of Open Access Journals (Sweden)

    Svendsen ML

    2013-03-01

    Full Text Available Marie Louise Svendsen,1 Henrik Gammelager,1 Claus Sværke,1 Mellissa Yong,2 Victoria M Chia,2 Christian F Christiansen,1 Jon P Fryzek1 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Center for Observational Research, Amgen, Thousand Oaks, CA, USA Objective: Skeletal-related events (SREs among women with breast cancer may be associated with considerable use of health-care resources. We characterized inpatient and outpatient hospital visits in a national population-based cohort of Danish women with SREs secondary to breast cancer and bone metastases. Methods: We identified first-time breast cancer patients with bone metastases from 2003 through 2009 who had a subsequent SRE (defined as pathologic fracture, spinal cord compression, radiation therapy, or surgery to bone. Hospital visits included the number of inpatient hospitalizations, length of stay, number of hospital outpatient clinic visits, and emergency room visits. The number of hospital visits was assessed for a pre-SRE period (90 days prior to the diagnostic period, a diagnostic period (14 days prior to the SRE, and a post-SRE period (90 days after the SRE. Patients who experienced more than one SRE during the 90-day post-SRE period were defined as having multiple SREs and were followed until 90 days after the last SRE. Results: We identified 569 women with SREs secondary to breast cancer with bone metastases. The majority of women had multiple SREs (73.1%. A total of 20.9% and 33.4% of women with single and multiple SREs died in the post-SRE period, respectively. SREs were associated with a large number of hospital visits in the diagnostic period, irrespective of the number and type of SREs. Women with multiple SREs generally had a higher number of visits compared to those with a single SRE in the post-SRE period, eg, median length of hospitalization was 5 days (interquartile range 0–15 for women with a single SRE and 13 days (interquartile range 4

  8. Asthma, type 1 and type 2 diabetes mellitus, and inflammatory bowel disease amongst South Asian immigrants to Canada and their children: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Eric I Benchimol

    Full Text Available There is a high and rising rate of immune-mediated diseases in the Western world. Immigrants from South Asia have been reported to be at higher risk upon arrival to the West. We determined the risk of immune-mediated diseases in South Asian and other immigrants to Ontario, Canada, and their Ontario-born children.Population-based cohorts of patients with asthma, type 1 diabetes (T1DM, type 2 diabetes (T2DM, and inflammatory bowel disease (IBD were derived from health administrative data. We determined the standardized incidence, and the adjusted risk of these diseases in immigrants from South Asia, immigrants from other regions, compared with non-immigrant residents of Ontario. The risk of these diseases in the Ontario-born children of immigrants were compared to the children of non-immigrants.Compared to non-immigrants, adults from South Asia had higher risk of asthma (IRR 1.56, 95%CI 1.51-1.61 and T2DM (IRR 2.59, 95%CI 2.53-2.65. Adults from South Asia had lower incidence of IBD than non-immigrants (IRR 0.32, 95%CI 0.22-0.49, as did immigrants from other regions (IRR 0.29, 95%CI 0.20-0.42. Compared to non-immigrant children, the incidence of asthma (IRR 0.66, 95%CI 0.62-0.71 and IBD (IRR 0.47, 95%CI 0.33-0.67 was low amongst immigrant children from South Asia. However, the risk in Ontario-born children of South Asian immigrants relative to the children of non-immigrants was higher for asthma (IRR 1.75, 95%CI 1.69-1.81 and less attenuated for IBD (IRR 0.90, 95%CI 0.65-1.22.Early-life environmental exposures may trigger a genetic predisposition to the development of asthma and IBD in South Asian immigrants and their Canada-born children.

  9. Child Maltreatment in the "Children of the Nineties": A Cohort Study of Risk Factors

    Science.gov (United States)

    Sidebotham, Peter; Heron, Jon

    2006-01-01

    Aim: To analyze the multiple factors affecting the risk of maltreatment in young children within a comprehensive theoretical framework. Methods: The research is based on a large UK cohort study, the Avon Longitudinal Study of Parents and Children. Out of 14,256 children participating in the study, 293 were investigated by social services for…

  10. Breast density and outcome of mammography screening: a cohort study

    DEFF Research Database (Denmark)

    Olsen, A H; Bihrmann, K; Jensen, M-B;

    2009-01-01

    The purpose of this study was to investigate the effect of breast density on breast cancer (BC) mortality in a mammography screening programme. The cohort included 48 052 women participating in mammography screening in Copenhagen, Denmark, where biennial screening is offered to women aged 50...

  11. Impact of Diabetes Mellitus on the Treatment Outcomes of Chemotherapy in Women with Breast Cancer-A Population-Based Prospective Cohort Study

    Institute of Scientific and Technical Information of China (English)

    Yu-Ching Chen; Cheng-Wei Chang; Jorng-Tzong Horng; Yan-Jun Chen; Jin-Tsung Yang

    2015-01-01

    Abstract¾There are few population-based data in investigating the impact of diabetes on chemotherapy adverse effects and treatment outcomes of non-metastatic breast cancer. The purpose of this study is to evaluate whether diabetes affects the patterns of use in chemotherapy, toxic effects of chemotherapy, and treatment outcomes for non-metastatic breast cancer in Taiwan. The study results can provide physicians for making a decision whether or not to use chemotherapy based on the individual patients’ condition.

  12. Birth cohorts

    DEFF Research Database (Denmark)

    Andersen, Anne-Marie Nybo; Madsen, Mia

    2009-01-01

    ; provides practical guidance on how to set-up and maintain birth cohorts for completing family-based studies in life course epidemiology; describes how to undertake appropriate statistical analyses of family-based studies and correctly interpret results from these analyses; and provides examples that...

  13. Aragon workers’ health study – design and cohort description

    Directory of Open Access Journals (Sweden)

    Casasnovas José A

    2012-06-01

    Full Text Available Abstract Background Spain, a Mediterranean country with relatively low rates of coronary heart disease, has a high prevalence of traditional cardiovascular risk factors and is experiencing a severe epidemic of overweight/obesity. We designed the Aragon Workers’ Health Study (AWHS to characterize the factors associated with metabolic abnormalities and subclinical atherosclerosis in a middle aged population in Spain free of clinical cardiovascular disease. The objective of this paper is to describe the study design, aims and baseline characteristics of participants in the AWHS. Methods/Design Longitudinal cohort study based on the annual health exams of 5,400 workers of a car assembly plant in Figueruelas (Zaragoza, Spain. Study participants were recruited during a standardized clinical exam in 2009–2010 (participation rate 95.6%. Study participants will undergo annual clinical exams and laboratory assays, and baseline and triennial collection of biological materials for biobanking and cardiovascular imaging exams (carotid, femoral and abdominal ultrasonography, coronary calcium score, and ankle-arm blood pressure index. Participants will be followed-up for 10 years. Results The average (SD age, body mass index, and waist circumference were 49.3 (8.7 years, 27.7 (3.6 kg/m2 and 97.2 (9.9 cm, respectively, among males (N = 5,048, and 40.8 (11.6 years, 24.4 (3.8 kg/m2, and 81.9 (9.9 cm, among females (N = 351. The prevalence of overweight, obesity, current smoking, hypertension, hypercholesterolemia, and diabetes were 55.0, 23.1, 37.1, 40.3, 75.0, and 7.4%, respectively, among males, and 23.7, 8.3, 45.0, 12.1, 59.5, and 0.6%, respectively, among females. In the initial 587 study participants who completed all imaging exams (94.5% male, the prevalence of carotid plaque, femoral plaque, coronary calcium score >1 to 100, and coronary calcium score >100 was 30.3, 56.9, 27.0, and 8.8%, respectively. 67.7% of study participants had at least

  14. Dietary Antioxidants and Melanoma: Evidence from Cohort and Intervention Studies.

    Science.gov (United States)

    Miura, Kyoko; Green, Adèle C

    2015-01-01

    Melanoma is the most serious form of skin cancer affecting mostly people of Caucasian origin and is associated with high exposure to solar ultraviolet (UV) radiation. Antioxidants in the diet are thought to prevent UV-induced DNA damage and oxidative stress and laboratory-based studies have shown that high antioxidant intakes inhibit melanoma development. Corresponding epidemiological evidence is inconsistent, however. We therefore reviewed results from prospective observational studies and randomized controlled trials (RCTs) to clarify whether consumption of antioxidant vitamin C, E (tocopherol), and A (retinol), carotenoids and selenium, as food, supplements, or both, or high fruit and vegetable intake, reduce the incidence of cutaneous melanoma. A total of 9 studies (2 cohort, 1 nested case-control, 6 RCTs) were included. Neither antioxidant nutrients, individually or combined, nor fruit and vegetable intake showed any strong and significant associations with melanoma, though the number of relevant studies was limited and several had methodological shortcomings. In particular, melanoma was not a primary disease outcome in any of the RCTs and therefore, none adequately accounted for potential confounding by sun exposure. In conclusion, available evidence is currently inadequate to assess possible beneficial effects of antioxidant intake on melanoma risk. PMID:26147450

  15. Comparison of expert and job-exposure matrix-based retrospective exposure assessment of occupational carcinogens in the Netherlands Cohort Study

    NARCIS (Netherlands)

    Offermans, Nadine S. M.; Vermeulen, Roel; Burdorf, Alex; Peters, Susan; Goldbohm, R. Alexandra; van Tongeren, Martie; Kauppinen, T.; Kant, Ijmert; Kromhout, Hans; van den Brandt, Piet A.; Koeman, T.

    2012-01-01

    Objectives Reliable retrospective exposure assessment continues to be a challenge in most population-based studies. Several methodologies exist for estimating exposures retrospectively, of which case-by-case expert assessment and job-exposure matrices (JEMs) are commonly used. This study evaluated t

  16. Long-term mortality in patients diagnosed with pneumococcal meningitis: a Danish nationwide cohort study

    DEFF Research Database (Denmark)

    Roed, Casper; Engsig, Frederik Neess; Omland, Lars; Skinhøj, Peter; Obel, Niels

    2010-01-01

    The objective of the study was to determine the long-term mortality and the causes of death in patients diagnosed with pneumococcal meningitis. The authors performed a nationwide, population-based cohort study including all Danish patients diagnosed with pneumococcal meningitis from 1977 through ...

  17. Role of students’ context in predicting academic performance at a medical school: a retrospective cohort study

    OpenAIRE

    Thiele, Tamara; Pope, Daniel; Singleton, A; Stanistreet, D.

    2016-01-01

    Objectives This study examines associations between medical students’ background characteristics (postcode-based measures of disadvantage, high school attended, sociodemographic characteristics), and academic achievement at a Russell Group University. Design Retrospective cohort analysis. Setting Applicants accepted at the University of Liverpool medical school between 2004 and 2006, finalising their studies between 2010 and 2011. Participants 571 students (with an English home postcode) regi...

  18. Prevalence of abuse reported by pregnant women - impact on postpartum depression and breastfeeding: A prospective population-based analysis in the Norwegian Mother and Child Cohort Study

    OpenAIRE

    Sørbø, Marie Flem

    2016-01-01

    Background: Abuse of women is a violation of human rights, and has adverse impact on physical, mental and reproductive health. Yet, there is limited population based knowledge about the effect on postpartum health and breastfeeding. There is also need for increased understanding about the impact of abuse from different perpetrators. Large scale, population based, prospective studies are requested to assess the public health impact of abuse. Aims: To investigate the prevalence o...

  19. Perinatal depression in a cohort study on Iranian women

    OpenAIRE

    Gholam Reza Kheirabadi; Mohamad Reza Maracy

    2010-01-01

    Background: Childbearing years in the women′s life are associated with the highest risk of depression. In this study depression in third trimester of pregnancy and after delivery was studied. Depressive symptom score and the proportion of mothers above a threshold were compared to indicate probable depressive disorder at each stage. Methods: This prospective cohort study was conducted in rural areas of Isfahan province of Iran from September 2007 to January 2008. Subjects were all in thei...

  20. Migraine and Cognitive Decline Among Women: Prospective Cohort Study

    OpenAIRE

    Rist, Pamela Marie; Kang, Jae Hee Hee; Buring, Julie Elizabeth; Glymour, Maria Lee; Grodstein, Francine; Kurth, Tobias

    2012-01-01

    Objective: To evaluate the association between migraine and cognitive decline among women. Design Prospective cohort study. Setting Women’s Health Study, United States. Participants 6349 women aged 65 or older enrolled in the Women’s Health Study who provided information about migraine status at baseline and participated in cognitive testing during follow-up. Participants were classified into four groups: no history of migraine, migraine with aura, migraine without aura, and past history of m...

  1. Surveillance of hospital contacts among Danish seafarers and fishermen with focus on skin and infectious diseases-a population-based cohort study

    DEFF Research Database (Denmark)

    Kaerlev, Linda; Jensen, Anker; Hannerz, Harald

    2014-01-01

    OBJECTIVES: A systematic overview of time trends in hospital contacts among Danish seafarers and fishermen by job title and analyses on skin and infectious diseases. METHODS: Occupational cohorts with hospital contacts 1994-1998 and 1999-2003. Standardized hospital contact ratios (SHCR) were...... estimated using national rates and ranked by SHCR size. RESULTS: For non-officers in 1994-1998, infectious diseases had the highest SHCR, followed by neoplastic and endocrinal diseases; in 1999-2003 skin diseases were followed by endocrinal and gastrointestinal diseases. For fishermen in 1994-1998, nervous...

  2. Population-based, inception cohort study of the incidence, course, and prognosis of mild traumatic brain injury after motor vehicle collisions

    DEFF Research Database (Denmark)

    Cassidy, John David; Boyle, Eleanor; Carroll, Linda J

    2014-01-01

    -up. RESULTS: Of 7170 adults injured in a motor vehicle collision over the 2-year inception period, 1716 (24%) met our cohort definition of MTBI. There were more women affected (53%), and MTBI was most common in the 18- to 23-year-old group. Most were not hospitalized (73%), but 28% reported loss of...... problems, having headaches, having low back pain, and having thoracic back pain. Loss of consciousness and posttraumatic amnesia were not associated with recovery. CONCLUSIONS: MTBI affects almost a quarter of persons reporting an injury after a traffic collision. The median time to recovery is 100 days...

  3. Respiratory cancer in Danish bakers: a 10 year cohort study.

    OpenAIRE

    Tüchsen, F; Nordholm, L.

    1986-01-01

    A national cohort based on the census at 9 November 1970 and the death registration files from 1970 to 1980 was analysed to see if skilled Danish bakers had an excess of respiratory cancer. The group of skilled bakers was divided into occupational subgroups to try to narrow down the possible causes of cancer. Significant excess mortality was found among skilled bakers in retail bakeries, skilled bakers in hotels and restaurants, and independent bakers. To adjust for confounding factors, the S...

  4. Methods used for successful follow-up in a large scale national cohort study in Thailand

    Directory of Open Access Journals (Sweden)

    Chokkanapitak Jaruwan

    2011-05-01

    Full Text Available Abstract Background Ensuring successful follow-up is essential when conducting a prospective cohort study. Most existing literature reviewing methods to ensure a high response rate is based on experience in developed nations. Findings We report our 4-year follow-up success for a national cohort study examining the health transition underway in Thailand. We began the cohort study in 2005 with a baseline postal questionnaire sent to all 200,000 Thais enrolled as distance learning students at Sukhothai Thammathirat Open University and residing all over Thailand; 87,134 or 44% of the students responded. Subsequently we used University and national media to inform cohort members of study progress. Also, we prepared a health book with study results and health advice which was distributed to all cohort members. After 4 years we repeated the survey and achieved a 71% response rate. In this paper we report the methods used to achieve this response The initial follow-up mail-out generated a response rate of about 48% reflecting the extensive preparatory work between baseline and follow-up. After 4 rounds of telephone contact (more than 100,000 phone calls and 4 related mail-out rounds progressively over 16 months an overall response rate was achieved of just over 71% (n = 60,774. The total cost was US$4.06/respondent - 19% for printing, 21% for postage, 14% for tape measures (included in mail-out, 18% for data processing 22% for prizes and 6% for telephone. Conclusions Many of the methods reported as effective for mail questionnaire and cohort response rates held true for Thailand. These included being associated with a university, incentivating cooperation, follow-up contact, providing a second copy of questionnaire where necessary, and assurance of confidentiality. Telephone contact with the cohort and the small prizes given to responders were particularly important in the Thai context as was Thai leadership of the research team.

  5. Increased Risk of Acute Kidney Injury following Pneumococcal Pneumonia: A Nationwide Cohort Study

    Science.gov (United States)

    Lin, Te-Yu; Chen, Yu-Guang; Lin, Cheng-Li; Kao, Chia-Hung

    2016-01-01

    Purpose Pneumococcal disease leads to renal complications ranging from persistent proteinuria to end-stage renal disease. Studies on the association between pneumococcal pneumonia (PP) and acute kidney injury (AKI) are scant. This study assessed the relationship between PP and risk of AKI. Methods This nationwide population-based cohort study examined data from the Taiwan National Health Insurance Research Database for the period 2000–2011. We identified inpatients with newly diagnosed PP according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. In addition, we selected a comparison cohort from inpatient claims without the diagnosis of PP that was randomly frequency-matched with the PP cohort according to age, sex, index year and comorbidities. We analyzed the risks of AKI by using Cox proportional hazards regression models, adjusted for sex, age, and comorbidities. Results A total of 10,069 patients with PP and 10,069 controls were enrolled in this study. After adjustments for age, sex, and comorbidities, patients with PP had a 1.11-fold risk of developing AKI compared with the comparison cohort. Conclusion This study indicates that AKI risks are higher in patients with PP compared with the comparison cohort. Careful follow-up observation and aggressive treatment are necessary for patients with PP to reduce the risk of AKI. PMID:27362355

  6. Birth cohort differences in the use of medications in a Brazilian population of older elderly: the Bambuí cohort study of aging (1997 and 2008)

    OpenAIRE

    Antônio Ignácio de Loyola Filho; Josélia O A Firmo; Elizabeth Uchôa; Maria Fernanda Lima-Costa

    2011-01-01

    This study examined differences in the use of medications in two birth cohorts (born from 1916 to 1926 and from 1927 to 1937) among older elderly in the population-based cohort study in Bambuí, Minas Gerais State, Brazil. The study used data on participants who were 71-81 years of age in the baseline survey in 1997 (n = 492) and in the 11th wave, in 2008 (n = 620). The number of medications currently consumed (mean = 4.6 and 3.4, respectively) and prevalence of polypharmacy (46.6% and 29.1%, ...

  7. Gamma-Glutamyltransferase and Cancer Incidence: The Ohsaki Cohort Study

    OpenAIRE

    Tsuboya, Toru; Kuriyama, Shinichi; Nagai, Masato; Hozawa, Atsushi; Sugawara, Yumi; Tomata, Yasutake; Kakizaki, Masako; Nishino, Yoshikazu; Tsuji, Ichiro

    2012-01-01

    Background Although experimental studies have shown that gamma-glutamyltransferase (GGT) has a role in tumor progression, epidemiologic evidence for a relationship between GGT and cancer incidence is limited. The present study investigated the association between GGT and cancer incidence and assessed the role of alcohol consumption in this association. Methods We examined a cohort of 15 031 Japanese adults aged 40 to 79 years who attended a health checkup in 1995 and were free of cancer at th...

  8. Adhesive capsulitis and dynamic splinting: a controlled, cohort study

    OpenAIRE

    Willis F Buck; Gaspar Paul D

    2009-01-01

    Abstract Background Adhesive Capsulitis (AC) affects patient of all ages, and stretching protocols are commonly prescribed for this condition. Dynamic splinting has been shown effective in contracture reduction from pathologies including Trismus to plantar fasciitis. The purpose of this study was to examine the efficacy of dynamic splinting on patients with AC. Methods This controlled, cohort study, was conducted at four physical therapy, sports medicine clinics in Texas and California. Sixty...

  9. Cohort Study of Intracameral Moxifloxacin in Postoperative Endophthalmitis Prophylaxis

    OpenAIRE

    Virgilio Galvis; Alejandro Tello; Mary Alejandra Sánchez; Paul Anthony Camacho

    2014-01-01

    We conducted a cohort study to evaluate post-cataract surgery endophthalmitis rates in relation to prophylactic intracameral moxifloxacin administration. A total of 2332 patients (2674 eyes) who underwent phacoemulsification by a single surgeon from January 2007 through December 2012 were included in the study. A total of 1056 eyes did not receive intracameral prophylactic moxifloxacin and the antibiotic was injected in 1618 eyes. The incidence of presumed postoperative endophthalmitis in the...

  10. Gender differences in postpartum depression. A longitudinal cohort study

    OpenAIRE

    Escribà-Agüir, Vicenta; Artazcoz, Lucía

    2010-01-01

    Abstract Background: The course of depression from pregnancy to one year postpartum and their risk factors among mothers and fathers are not known. This study has two aims: 1) To report the longitudinal patterns of depression from third trimester of pregnancy to one year after childbirth and 2) to determine gender differences between women and their partners in the effect of psychosocial and personal factors on postpartum depression. Methods: A longitudinal cohort study was carr...

  11. Deep phenotyping of the unselected COPSAC2010 birth cohort study

    OpenAIRE

    Bisgaard, Hans Flinker; Vissing, Nadja Hawwa; Carson, C. G.; Bischoff, Anne Louise; Følsgaard, Nilofar Vahman; Kreiner‐Møller, E.; Chawes, Bo Lund Krogsgaard; Stokholm, J.; Pedersen, L.; Bjarnadóttir, E.; Thysen, Anna Hammerich; Nilsson, E; Mortensen, L. J.; Olsen, S. F.; Schjørring, S.

    2013-01-01

    Summary Background We hypothesize that perinatal exposures, in particular the human microbiome and maternal nutrition during pregnancy, interact with the genetic predisposition to cause an abnormal immune modulation in early life towards a trajectory to chronic inflammatory diseases such as asthma and others. Objective The aim of this study is to explore these interactions by conducting a longitudinal study in an unselected cohort of pregnant women and their offspring with emphasis on deep cl...

  12. Risk factors for seabather's eruption: a prospective cohort study.

    OpenAIRE

    Kumar, S.; Hlady, W. G.; Malecki, J M

    1997-01-01

    OBJECTIVE: A prospective cohort study was performed to identify risk factors for seabather's eruption. METHODS: Study participants were recruited at four beaches in Palm Beach County, Florida, during three weekends of May and June 1993. Participants were interviewed by telephone after 48 hours regarding medical history, beach activities, development of rashes, and use of possible preventive measures. RESULTS: Seabather's eruption, defined by the occurrence of a rash within two days of exposur...

  13. Perinatal depression in a cohort study on Iranian women

    Directory of Open Access Journals (Sweden)

    Gholam Reza Kheirabadi

    2010-01-01

    Full Text Available Background: Childbearing years in the women′s life are associated with the highest risk of depression. In this study depression in third trimester of pregnancy and after delivery was studied. Depressive symptom score and the proportion of mothers above a threshold were compared to indicate probable depressive disorder at each stage. Methods: This prospective cohort study was conducted in rural areas of Isfahan province of Iran from September 2007 to January 2008. Subjects were all in their third trimester and followed up from the beginning of the study to 6- 8 weeks postpartum. At all, 2156 pregnant women completed the self report questionnaires but 258 were excluded because they were incomplete and final analysis was done with 1898 samples. At the final stage the sample size was decreased to 1291. Results: The prevalence of depression based on BDI score greater than 20 in last trimester of pregnancy, was 22.8% and rate of depression based on EPD score greater than 12 between 6 to 8 weeks after delivery, was 26.3%. Incidence of Post Partum Depression (PPD in 6 to 8 weeks after delivery in those who were not clinically depressed during preg-nancy was 20.1%. Results showed that history of depression, unplanned pregnancy, being housewife and having 3 or more children had significant relation with ante partum depression. Conclusions: Two main risk factors for post partum depression are previous history of depression and depression during current pregnancy. It is important to assess these variables during pregnancy in order to facilitate timely identifi-cation of women at risk.

  14. Deep phenotyping of the unselected COPSAC2010 birth cohort study

    DEFF Research Database (Denmark)

    Bisgaard, Hans Flinker; Vissing, Nadja Hawwa; Carson, C. G.;

    2013-01-01

    We hypothesize that perinatal exposures, in particular the human microbiome and maternal nutrition during pregnancy, interact with the genetic predisposition to cause an abnormal immune modulation in early life towards a trajectory to chronic inflammatory diseases such as asthma and others. The aim...... of this study is to explore these interactions by conducting a longitudinal study in an unselected cohort of pregnant women and their offspring with emphasis on deep clinical phenotyping, exposure assessment, and biobanking. Exposure assessments focus on the human microbiome. Nutritional intervention...... during pregnancy in randomized controlled trials are included in the study to prevent disease and to be able to establish causal relationships. Pregnant women from eastern Denmark were invited during 2008–2010 to a novel unselected ‘COPSAC2010’ cohort. The women visited the clinic during pregnancy weeks...

  15. Is neck pain associated with worse health-related quality of life 6 months later? A population-based cohort study

    DEFF Research Database (Denmark)

    Nolet, P. S.; Cote, P.; Kristman, V. L.;

    2015-01-01

    sampled Saskatchewan adults were included. OUTCOME MEASURES: Outcome measures were the mental component summary (MCS) and physical component summary (PCS) of the Short-Form-36 (SF-36) questionnaire. METHODS: We formed a cohort of 1,100 randomly sampled Saskatchewan adults in September 1995. We used the....... Analysis of variance and t tests were used to measure the crude association among four possible courses of neck pain and HRQoL at 6 months. The neck pain trajectories over 6 months were no or mild neck pain, improving neck pain, worsening neck pain, and persistent neck pain. Finally, analysis of variance....... We did not find an association between neck pain and mental HRQoL. A worsening course of neck pain and persistent neck pain were associated with worse physical HRQoL. CONCLUSIONS: We found that neck pain was negatively associated with physical but not mental HRQoL. Our analysis suggests that neck...

  16. Hospital contacts for endocrine disorders in Adult Life after Childhood Cancer in Scandinavia (ALiCCS): a population-based cohort study

    DEFF Research Database (Denmark)

    de Fine Licht, Sofie; Winther, Jeanette Falck; Gudmundsdottir, Thorgerdur;

    2014-01-01

    BACKGROUND: The pattern of endocrine disorders in long-term survivors of childhood cancer has not been investigated comprehensively. Here, we aimed to assess the lifetime risk of these disorders in Nordic survivors of childhood cancer. METHODS: From the national cancer registries of Denmark...... were linked to the national hospital registries, and observed numbers of first-time hospital contacts for endocrine disorders in survivors of childhood cancer were compared with the expected numbers derived from the population comparison cohort. We calculated the absolute excess risks attributable...... to status as a childhood cancer survivor and standardised hospitalisation rate ratios (SHRRs). FINDINGS: Of the childhood cancer survivors, 3292 had contact with a hospital for an endocrine disorder, yielding a SHRR of 4·8 (95% CI 4·6-5·0); the highest risks were in survivors of leukaemia (SHRR 7·3 [95% CI...

  17. Ten-Year Mortality after a Breast Cancer Diagnosis in Women with Severe Mental Illness: A Danish Population-Based Cohort Study

    Science.gov (United States)

    Ribe, Anette Riisgaard; Laurberg, Tinne; Laursen, Thomas Munk; Charles, Morten; Vedsted, Peter; Vestergaard, Mogens

    2016-01-01

    Background Breast cancer is the leading cause of cancer death in women worldwide. Nevertheless, it is unknown whether higher mortality after breast cancer contributes to the life-expectancy gap of 15 years in women with severe mental illness (SMI). Methods We estimated all-cause mortality rate ratios (MRRs) of women with SMI, women with breast cancer and women with both disorders compared to women with neither disorder using data from nationwide registers in Denmark for 1980–2012. Results The cohort included 2.7 million women, hereof 31,421 women with SMI (12,852 deaths), 104,342 with breast cancer (52,732 deaths), and 1,106 with SMI and breast cancer (656 deaths). Compared to women with neither disorder, the mortality was 118% higher for women with SMI (MRR: 2.18, 95% confidence interval (CI): 2.14–2.22), 144% higher for women with breast cancer (MRR: 2.44, 95% CI: 2.42–2.47) and 327% higher for women with SMI and breast cancer (MRR: 4.27, 95% CI: 3.98–4.57). Among women with both disorders, 15% of deaths could be attributed to interaction. In a sub-cohort of women with breast cancer, the ten-year all-cause-mortality was 59% higher after taking tumor stage into account (MRR: 1.59, 95% CI: 1.47–1.72) for women with versus without SMI. Conclusions The mortality among women with SMI and breast cancer was markedly increased. More information is needed to determine which factors might explain this excess mortality, such as differences between women with and without SMI in access to diagnostics, provision of care for breast cancer or physical comorbidity, health-seeking-behavior, and adherence to treatment. PMID:27462907

  18. Bone Mineral Density and Parathyroid Hormone as Independent Risk Factors for Mortality in Community-Dwelling Older Adults: A Population-Based Prospective Cohort Study in Brazil. The São Paulo Ageing & Health (SPAH) Study.

    Science.gov (United States)

    Domiciano, Diogo S; Machado, Luana G; Lopes, Jaqueline B; Figueiredo, Camille P; Caparbo, Valéria F; Oliveira, Ricardo M; Scazufca, Márcia; McClung, Michael R; Pereira, Rosa Mr

    2016-06-01

    Previous studies have shown a relationship between osteoporosis and increased mortality risk. However, none of these studies performed a concomitant evaluation of the parathyroid hormone (PTH)-calcium-vitamin D axis and bone mass to accurately determine the contribution of each of these parameters to survival in older subjects. Thus, we sought to investigate the association between bone parameters and mortality in a longitudinal, prospective, population-based cohort of 839 elderly subjects. Clinical data (including history of fractures and cardiovascular events) were assessed using a specific questionnaire. Laboratory exams, including serum 25OHD and PTH, were also performed. Bone mineral density (BMD) at the lumbar spine and hip were evaluated using DXA. All analyses were performed at baseline (2005 to 2007). Mortality was recorded during follow-up. Multivariate Cox proportional regression was used to compute hazard ratios for all-cause and cardiovascular mortality. Over a mean 4.06 ± 1.07 years, there were 132 (15.7%) deaths. These individuals were compared to 707 subjects who were alive at the end of the coverage period for mortality data collection. In a multivariate Cox proportional hazards model, age (HR 1.32; 95% CI, 1.13 to 1.55; p = 0.001, for each 5-year increase), male gender (HR 1.90; 95% CI, 1.30 to 2.79; p = 0.001), recurrent falls (more than two in the previous year; HR 1.65; 95% CI, 1.06 to 2.56; p = 0.026), diabetes mellitus (HR 2.17; 95% CI, 1.46 to 3.21; p 49 pg/mL) were at a higher risk of cardiovascular death (HR 3.09; 95% CI, 1.36 to 6.99; p = 0.007) compared with the subjects in the lowest quartile (Mineral Research. PMID:26814375

  19. Adherence to oral anticoagulants in patients with atrial fibrillation—a population-based retrospective cohort study linking health information systems in the Valencia region, Spain: a study protocol

    Science.gov (United States)

    Sanfélix-Gimeno, G; Rodríguez-Bernal, C L; Hurtado, I; Baixáuli-Pérez, C; Librero, J; Peiró, S

    2015-01-01

    Introduction Adherence to oral anticoagulation (OAC) treatment, vitamin K antagonists or new oral anticoagulants, is an essential element for effectiveness. Information on adherence to OAC in atrial fibrillation (AF) and the impact of adherence on clinical outcomes using real-world data barely exists. We aim to describe the patterns of adherence to OAC over time in patients with AF, estimate the associated factors and their impact on clinical events, and assess the same issues with conventional measures of primary and secondary adherence—proportion of days covered (PDC) and persistence—in routine clinical practice. Methods and analysis This is a population-based retrospective cohort study including all patients with AF treated with OAC from 2010 to date in Valencia, Spain; data will be obtained from diverse electronic records of the Valencia Health Agency. Primary outcome measure: adherence trajectories. Secondary outcomes: (1) primary non-adherence; (2) secondary adherence: (a) PDC, (b) persistence. Clinical outcomes: hospitalisation for haemorrhagic or thromboembolic events and death during follow-up. Analysis: (1) description of baseline characteristics, adherence patterns (trajectory models or latent class growth analysis models) and conventional adherence measures; (2) logistic or Cox multivariate regression models, to assess the associations between adherence measures and the covariates, and logistic multinomial regression models, to identify characteristics associated with each trajectory; (3) Cox proportional hazard models, to assess the relationship between adherence and clinical outcomes, with propensity score adjustment applied to further control for potential confounders; (4) to estimate the importance of different healthcare levels in the variations of adherence, logistic or Cox multilevel regression models. Ethics and dissemination This study has been approved by the corresponding Clinical Research Ethics Committee. We plan to disseminate the

  20. Online Prediction of Health Care Utilization in the Next Six Months Based on Electronic Health Record Information: A Cohort and Validation Study

    OpenAIRE

    Hu, Zhongkai; Hao, Shiying; Jin, Bo; Shin, Andrew Y; Zhu, Chunqing; Huang, Min; Wang, Yue; Zheng, Le; Dai, Dorothy; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank; Sylvester, Karl G.; Widen, Eric

    2015-01-01

    Background The increasing rate of health care expenditures in the United States has placed a significant burden on the nation’s economy. Predicting future health care utilization of patients can provide useful information to better understand and manage overall health care deliveries and clinical resource allocation. Objective This study developed an electronic medical record (EMR)-based online risk model predictive of resource utilization for patients in Maine in the next 6 months across all...

  1. A prospective cohort study on vegetable and fruit consumption and stomach cancer risk in the netherlands

    NARCIS (Netherlands)

    Botterweck, A.A.M.; Brandt, P.A. van den; Goldbohm, R.A.

    1998-01-01

    The association between vegetable and fruit consumption and stomach cancer risk was investigated in the Netherlands Cohort Study among 120,852 men and women aged 55-69 years at the start in September 1986. Analyses were based on 282 incident stomach cancer cases after 6.3 years of follow-up. Age- an

  2. An inventory of Canadian pregnancy and birth cohort studies: research in progress

    Directory of Open Access Journals (Sweden)

    Joly Marie-Pier

    2012-10-01

    Full Text Available Abstract Background A web-based inventory was developed as a voluntary registry of Canadian pregnancy and birth cohort studies, with the objective to foster collaboration and sharing of research tools among cohort study groups as a means to enrich research in maternal and child health across Canada. Description Information on existing birth cohort studies conducted in Canada exclusively or as part of broader international initiatives was accessed by searching the literature in PubMed and PsychInfo databases. Additional studies were identified by enquiring about the research activities of researchers at Canadian universities or working in affiliated hospitals or research centres or institutes. Of the fifty-eight birth cohort studies initially identified, forty-six were incorporated into the inventory if they were of a retrospective and/or prospective longitudinal design and with a minimum of two phases of data collection, with the first period having occurred before, during, or shortly after pregnancy and had an initial study sample size of a minimum of 200 participants. Information collected from each study was organized into four main categories: basic information, data source and period of collection, exposures, and outcome measures and was coded and entered into an Excel spreadsheet. The information incorporated into the Excel spreadsheet was double checked, completed when necessary, and verified for completeness and accuracy by contacting the principal investigator or research coordinator. All data collected were then uploaded onto the website of the Institute of Human Development Child and Youth Health of the Canadian Institutes of Health Research. Subsequently, the database was updated and developed as an online searchable inventory on the website of the Maternal, Infant, Child and Youth Research Network. Conclusions This inventory is unique, as it represents detailed information assembled for the first time on a large number of Canadian

  3. Cohort Profile: The Skin Cancer After Organ Transplant Study

    OpenAIRE

    Madeleine, Margaret M; Johnson, Lisa G.; Daling, Janet R.; Schwartz, Stephen M.; Carter, Joseph J.; Berg, Daniel; Nelson, Karen; Davis, Connie L.; Galloway, Denise A.

    2012-01-01

    The Skin Cancer after Organ Transplant (SCOT) study was designed to investigate the link between genus beta human papillomavirus (HPV) and squamous cell skin cancer (SCSC). We focused on a population receiving immunosuppressive therapy for extended periods, transplant patients, as they are at extremely high risk for developing SCSC. Two complementary projects were conducted in the Seattle area: (i) a retrospective cohort with interview data from 2004 recipients of renal or cardiac transplants...

  4. Clinical disorders in a post war British cohort reaching retirement: evidence from the First National Birth Cohort Study

    OpenAIRE

    Pierce , MB; Silverwood, RJ; Nitsch, D.; Adams, JE; Stephen, AM; Nip, W; Macfarlane, P; Wong, A.; Richards, M.; Hardy, R; Kuh, D.; on behalf of the NSHD Scientific and Data Collection Teams

    2012-01-01

    Background The medical needs of older people are growing because the proportion of the older population is increasing and disease boundaries are widening. This study describes the distribution and clustering of 15 common clinical disorders requiring medical treatment or supervision in a representative British cohort approaching retirement, and how health tracked across adulthood. Methods and Findings The data come from a cohort of 2661 men and women, 84% of the target sample, fo...

  5. Historical cohort study of in utero exposure to uterotonic drugs and cognitive function in young adult life

    DEFF Research Database (Denmark)

    Sørensen, Henrik Toft; Steffensen, Flemming Hald; Sabroe, Svend;

    1999-01-01

    #ENTITYSTARTX02022;OBJECTIVE: To examine whether in utero exposure to uterotonic drugs effects cognitive performance in draft-age men. #ENTITYSTARTX02022;DESIGN: Historical cohort study based on birth registry data and cognitive function measured during evaluations for military service. #ENTITYST......#ENTITYSTARTX02022;OBJECTIVE: To examine whether in utero exposure to uterotonic drugs effects cognitive performance in draft-age men. #ENTITYSTARTX02022;DESIGN: Historical cohort study based on birth registry data and cognitive function measured during evaluations for military service...

  6. ADHD in international adoptees: a national cohort study.

    Science.gov (United States)

    Lindblad, Frank; Weitoft, Gunilla Ringbäck; Hjern, Anders

    2010-01-01

    Several investigators have reported an increased frequency of attention/hyperactivity symptoms in international adoptees, though population-based studies are lacking. In this national cohort study, we aimed to determine the prevalence of ADHD medication in international adoptees in Sweden, in comparison to the general population. A further purpose was to study gender, age at adoption and region of origin as predictors of ADHD medication in international adoptees. The study population consisted of all Swedish residents born in 1985-2000 with Swedish-born parents, divided into 16,134 adoptees, and a comparison population of 1,326,090. ADHD medications were identified in the Swedish Prescribed Drug Register during 2006. Logistic regression was used to calculate the odds ratios. The rates of ADHD medication were higher in international adoptees than in the comparison population for both boys (5.3 vs. 1.5% for 10-15-year olds) and girls (2.1 vs. 0.3% for 10-15-year olds). International adoptees from all regions of birth more often consumed ADHD medication compared with the majority population, but the age and sex adjusted odds ratios were particularly high for adoptees from Eastern Europe, Middle East/Africa and Latin America. Adjusting for maternal education and single parenthood increased the odds ratios even further. The risk also increased with higher age at adoption. Adoptees from Eastern Europe have a very high risk for ADHD medication. A structured identification and support programme should be tailored for this group. Adoptees from other regions have a more moderately increased risk, which should be communicated to adoptive parents and to professionals who care for adoptees in their clinical practice. PMID:19543791

  7. Nurse competence between three generational nurse cohorts: A cross-sectional study.

    Science.gov (United States)

    Meretoja, Riitta; Numminen, Olivia; Isoaho, Hannu; Leino-Kilpi, Helena

    2015-08-01

    Research indicates significant differences between nurse cohorts in many work-related factors. This study compared nurse competence between three generational cohorts comprising the current nursing workforce. The Nurse Competence Scale was used to collect data for this cross-sectional study from 2052 nurses in a university hospital in Finland. Data were analysed statistically. Significant differences were found between nurse cohorts in their competence. The length of work experience had a significant impact on the development of competence. The oldest cohort, with the longest work experience, had the highest competence scores (70.1 on a visual analogue scale), and the youngest had the lowest (59.0). All cohorts were most competent in patient-related nursing tasks, in maintenance of professional competence and in ethical care. Nurses were weakest in the development of nursing practice and the use of evidence-based knowledge. Targeted interventions in teaching-coaching for different nurse generations are needed to ensure the maintenance of nurse competence and high-quality patient care. PMID:24689751

  8. CT maxillary sinus evaluation-A retrospective cohort study

    Science.gov (United States)

    Vaz, Paula; Faria-Almeida, Ricardo; Braga, Ana-Cristina; Felino, António

    2015-01-01

    Background Proximity of the dental roots to the sinus floor makes dental disease a probable cause of maxillary sinusitis. The aim of this study was to find out if maxillary sinus pathologic changes were more prevalent in patients with dental disease and to evaluate the performance of computed tomography (CT) in analyzing and detecting apical periodontitis and other odontogenic causes on the maxillary sinusitis etiology in a Portuguese Caucasian population. Material and Methods Retrospective cohort study. The total sample of 504 patients and their CT was included in this study. The patients were from a private dental clinic, specializing in oral surgery, where the first complaint was not directly related to sinus disease, but with dental pathology. For each patient, the etiological factors of maxillary sinusitis and the imaging CT findings were analyzed. All the axial, coronal and sagittal CT slices were evaluated and general data were registered. The latter was selected based on the maxillary sinus CT published literature. Results 32.40% of patients presented normal sinus (without any etiological factor associated), 29.00% showed presence of etiological and imaging findings in the maxillary sinus, 20.60% had only imaging changes in the maxillary sinus and 18.00% of patients presented only etiological factors and no change in the maxillary sinus. Conclusions Radiological imaging is an important tool for establishing the diagnosis of maxillary sinus pathology. These results indicate that the CT scan should be an excellent tool for complement the odontogenic sinusitis diagnosis. Key words: Maxillary sinusitis/etiology, odontogenic, computed tomography, maxillary sinus. PMID:25858084

  9. Intimate Partner Violence and Depression Symptom Severity among South African Women during Pregnancy and Postpartum: Population-Based Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Alexander C Tsai

    2016-01-01

    Full Text Available Violence against women by intimate partners remains unacceptably common worldwide. The evidence base for the assumed psychological impacts of intimate partner violence (IPV is derived primarily from studies conducted in high-income countries. A recently published systematic review identified 13 studies linking IPV to incident depression, none of which were conducted in sub-Saharan Africa. To address this gap in the literature, we analyzed longitudinal data collected during the course of a 3-y cluster-randomized trial with the aim of estimating the association between IPV and depression symptom severity.We conducted a secondary analysis of population-based, longitudinal data collected from 1,238 pregnant women during a 3-y cluster-randomized trial of a home visiting intervention in Cape Town, South Africa. Surveys were conducted at baseline, 6 mo, 18 mo, and 36 mo (85% retention. The primary explanatory variable of interest was exposure to four types of physical IPV in the past year. Depression symptom severity was measured using the Xhosa version of the ten-item Edinburgh Postnatal Depression Scale. In a pooled cross-sectional multivariable regression model adjusting for potentially confounding time-fixed and time-varying covariates, lagged IPV intensity had a statistically significant association with depression symptom severity (regression coefficient b = 1.04; 95% CI, 0.61-1.47, with estimates from a quantile regression model showing greater adverse impacts at the upper end of the conditional depression distribution. Fitting a fixed effects regression model accounting for all time-invariant confounding (e.g., history of childhood sexual abuse yielded similar findings (b = 1.54; 95% CI, 1.13-1.96. The magnitudes of the coefficients indicated that a one-standard-deviation increase in IPV intensity was associated with a 12.3% relative increase in depression symptom severity over the same time period. The most important limitations of our study

  10. Trends and Determinants of Prescription Drug Use during Pregnancy and Postpartum in British Columbia, 2002-2011: A Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Kate Smolina

    Full Text Available To describe trends, patterns, and determinants of prescription drug use during pregnancy and postpartum.This is a retrospective, population-based study of all women who gave birth between January 2002 and 31 December 2011 in British Columbia, Canada. Study population consisted of 225,973 women who had 322,219 pregnancies. We examined administrative datasets containing person-specific information on filled prescriptions, hospitalizations, and medical services. Main outcome measures were filled prescriptions during pregnancy and postpartum. We used logistic regressions to examine associations between prescription drug use and maternal characteristics.Approximately two thirds of women filled a prescription during pregnancy, increasing from 60% in 2002 to 66% in 2011. The proportion of pregnant women using medicines in all three trimesters of pregnancy increased from 20% in 2002 to 27% in 2011. Use of four or more different types of prescription drug during at least one trimester increased from 8.4% in 2002 to 11.7% in 2011. Higher BMI, smoking during pregnancy, age under 25, carrying multiples, and being diagnosed with a chronic condition all significantly increased the odds of prescription drug use during pregnancy.The observed increase in the number of prescriptions and number of different drugs being dispensed suggests a trend in prescribing practices with potentially important implications for mothers, their neonates, and caregivers. Monitoring of prescribing practices and further research into the safety of most commonly prescribed medications is crucial in better understanding risks and benefits to the fetus and the mother.

  11. The use of new technologies in Cohort studies

    Directory of Open Access Journals (Sweden)

    Carlos Antonio Bruno da Silva

    2010-03-01

    élites de posicionamento (GPS para a localização de residências, o uso de coletas de DNA para comparações futuras, as bases de dados institucionais e governamentais são fontes de informações que abreviam, minimizam gastos e dão maior confiabilidade aos estudos de muito longa duração.Tem-se visto antigos trabalhos realizados há décadas sendo submetidos a novas avaliações estatísticas com o desenvolvimento de novas teorias e descobertas. Neste número da revista brasileira em promoção da saúde, acompanhamos o nascimento de uma nova coorte(14, que acompanhará a evolução dos determinantes de saúde de população de uma grande comunidade do Nordeste do Brasil.REFERÊNCIAS1. Morabia A, Guthold R. Wilhelm Weinberg’s 1913Large Retrospective Cohort Study: a rediscovery. Am JEpidemiol. 2007;165(7:727-33.2. Doll R. Cohort studies: history of the method. II.Retrospective cohort studies. Soz Praventivmed.2001;46(3:152-60. Erratum in: Soz Praventivmed2002;47(2:90.3. Dawber TR, Meadors GF, Moore Jr. FE. Epidemiologicalapproaches to heart disease: the Framingham Study.Am J Public Health Nations Health. 1951;41(3:279-81.4. Fonseca MGU, Peres F, Firmo JOA, Uchoa E.,Percepção de risco: maneiras de pensar e agirno manejo de agrotóxicos. Ciênc saúde coletiva[periódico na Internet]. 2007 Mar [acesso em 2010Maio 26]; 12(1:39-50. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232007000100009&lng=en&nrm=iso. doi: 10.1590/S1413-81232007000100009.5. Victora CG, Barros FC. Cohort profile: the 1982Pelotas (Brazil birth cohort study. Int J Epidemiol.2006;35(2:237-42.6. Armenian HK (editor. Applications of the case-controlmethod. Epidemiol Rev. 1994;16:1-164.7. Samet JM, Muñoz A. Evolution of the cohort study.Epidemiol Rev. 1998;20(1:1-14.8. Doll R. Cohort studies: history of the method. II.Retrospective cohort studies. Soz Praventivmed.2001;46(3:152-60. Erratum in: Soz Praventivmed2002;47(2:909. Lima-Costa MF, Barreto SM. Tipos de

  12. Association between dental pain and tooth loss with health-related quality of life: the Korea national health and nutrition examination survey: A population-based cohort study.

    Science.gov (United States)

    Yang, Sung-Eun; Park, Yong-Gyu; Han, Kyungdo; Kim, Sin-Young

    2016-08-01

    Dental pain and tooth loss are global public health concerns. However, there have been no large cross-sectional epidemiologic studies of a representative sample of an entire country's populations. The purpose of this study was to evaluate the relationships between dental pain and tooth loss with health-related quality of life (HRQOL) using a well characterized, nationally representative, population-based study.This study analyzed data of 3924, representing 21,836,566 adults from the 2012 Korea National Health and Nutrition Examination Survey. Subjects were divided into 4 groups as follows: tooth loss of up to 8 teeth without dental pain, tooth loss of up to 8 teeth with dental pain, tooth loss of 8 to 28 teeth without dental pain, and tooth loss of 8 to 28 teeth with dental pain. Logistic regression was applied to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (CI), controlling for a range of covariates.Among the 3924 subjects, representing an estimated 21,836,566 adults, the prevalence of tooth loss of 8 to 28 teeth was 24.6% and the prevalence of dental pain was 35%. The tooth loss of 8 to 28 teeth with dental pain group showed the highest level of impaired HRQOL in all 5 dimensions, and the tooth loss up to 8 teeth without dental pain group showed the lowest level. The proportion of both groups without dental pain decreased significantly from the younger age to older age group. After adjustment for sociodemographic factors, the ORs (95% CI) of mobility, self-case, usual activity, pain/discomfort, and anxiety/depression were 1.93 (1.32-2.84), 1.90 (1.25-2.90), 1.46 (0.88-2.43), 1.48 (0.88-2.49), and 1.46 (0.85-2.51) in tooth loss of 8 to 28 teeth with dental pain group. Although the ORs of tooth loss of 8 to 28 teeth without dental pain group did not significantly increase.Dental pain and tooth loss has a considerable impact of HRQOL in the Korean adult population. In our study, HRQOL is more closely associated with dental pain than with

  13. Oral health follow-up studies in the 1993 Pelotas (Brazil) birth cohort study: methodology and principal results

    OpenAIRE

    Marco A Peres; Barros, Aluísio Jardim; Peres, Karen Glazer; Araújo, Cora Luiza; Ana M. B. Menezes; Hallal, Pedro C; Victora, Cesar G.

    2010-01-01

    The aim of this study was to describe oral health follow-up studies nested in a birth cohort. A population-based birth cohort was launched in 1993 in Pelotas, Rio Grande do Sul State, Brazil. Two oral health follow-up studies were conducted at six (n = 359) and 12 (n = 339) years of age. A high response rate was observed at 12 years of age; 94.4% of the children examined at six years of age were restudied in 2005. The mean DMF-T index at age 12 was 1.2 (SD = 1.6) for the entire sample, rangin...

  14. Epidemiology and outcomes of previously undiagnosed diabetes in older women with breast cancer: an observational cohort study based on SEER-Medicare

    Directory of Open Access Journals (Sweden)

    Griffiths Robert I

    2012-12-01

    Full Text Available Abstract Background In breast cancer, diabetes diagnosed prior to cancer (previously diagnosed is associated with advanced cancer stage and increased mortality. However, in the general population, 40% of diabetes is undiagnosed until glucose testing, and evidence suggests one consequence of increased evaluation and management around breast cancer diagnosis is the increased detection of previously undiagnosed diabetes. Biological factors – for instance, higher insulin levels due to untreated disease - and others underlying the association between previously diagnosed diabetes and breast cancer could differ in those whose diabetes remains undiagnosed until cancer. Our objectives were to identify factors associated with previously undiagnosed diabetes in breast cancer, and to examine associations between previously undiagnosed diabetes and cancer stage, treatment patterns, and mortality. Methods Using Surveillance, Epidemiology, and End Results-Medicare, we identified women diagnosed with breast cancer and diabetes between 01/2001 and 12/2005. Diabetes was classified as previously diagnosed if it was identified within Medicare claims between 24 and 4 months before cancer diagnosis, and previously undiagnosed if it was identified from 3 months before to ≤ 3 months after cancer. Patients were followed until 12/2007 or death, whichever came first. Multivariate analyses were performed to examine risk factors for previously undiagnosed diabetes and associations between undiagnosed (compared to previously diagnosed diabetes, cancer stage, treatment, and mortality. Results Of 2,418 patients, 634 (26% had previously undiagnosed diabetes; the remainder had previously diagnosed diabetes. The mean age was 77.8 years, and 49.4% were diagnosed with in situ or stage I disease. Age > 80 years (40% of the cohort and limited health system contact (primary care physician and/or preventive services prior to cancer were associated with higher adjusted odds of

  15. Utility of Hippocrates’ prognostic aphorism to predict death in the modern era: prospective cohort study

    OpenAIRE

    St. John, Philip D.; Montgomery, Patrick R

    2014-01-01

    Objective To determine if one of Hippocrates’ aphorisms, identifying good cognition and good appetite as two prognostic factors, predicts death in community living older adults in the modern era. Design Secondary analysis of an existing population based cohort study. Setting Manitoba Study of Health and Aging. Participants 1751 community living adults aged more than 65 enrolled in the Manitoba Study of Health and Aging in 1991 and followed over five years. Main outcome measure Time to death. ...

  16. Is Statin Use Associated With Tendon Rupture? A Population-Based Retrospective Cohort Analysis.

    Science.gov (United States)

    Contractor, Tahmeed; Beri, Abhimanyu; Gardiner, Joseph C; Tang, Xiaoqin; Dwamena, Francesca C

    2015-01-01

    Previous case reports and small studies have suggested that 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors (HMG-CoA-Is) may increase the risk of tendon rupture. We conducted a population-based retrospective cohort evaluation to better assess this relationship. From approximately 800,000 enrollees of a private insurance database, those who were aged ≤64 years with at least 1 year of continuous enrollment were selected. Exposure was defined as initiation of HMG-CoA-I after the beginning of the study period. Each exposed person was matched with 2 controls of similar age and gender. Baseline characteristics, including known risk factors for tendon rupture, were compared between exposed and control cohorts with fidelity to the study's matched design. After adjusting for differences in follow-up and baseline characteristics, incidence rate ratios for tendon rupture was assessed in HMG-CoA-I users and nonusers. A total of 34,749 exposed patients were matched with 69,498 controls. There was no difference in the occurrence of tendon ruptures in HMG-CoA-I users versus nonusers. The results remained unchanged after adjustment for age and gender. In conclusion, this population-based retrospective cohort evaluation suggests that use of HMG-CoA-Is as a group are not associated with tendon rupture. PMID:24451300

  17. The Usage of an SNP-SNP Relationship Matrix for Best Linear Unbiased Prediction (BLUP) Analysis Using a Community-Based Cohort Study

    OpenAIRE

    Lee, Young-Sup; Kim, Hyeon-Jeong; Cho, Seoae; Kim, Heebal

    2014-01-01

    Best linear unbiased prediction (BLUP) has been used to estimate the fixed effects and random effects of complex traits. Traditionally, genomic relationship matrix-based (GRM) and random marker-based BLUP analyses are prevalent to estimate the genetic values of complex traits. We used three methods: GRM-based prediction (G-BLUP), random marker-based prediction using an identity matrix (so-called single-nucleotide polymorphism [SNP]-BLUP), and SNP-SNP variance-covariance matrix (so-called SNP-...

  18. Mortality Prediction after the First Year of Kidney Transplantation: An Observational Study on Two European Cohorts

    Science.gov (United States)

    Lorent, Marine; Giral, Magali; Pascual, Manuel; Koller, Michael T.; Steiger, Jürg; Trébern-Launay, Katy; Legendre, Christophe; Kreis, Henri; Mourad, Georges; Garrigue, Valérie; Rostaing, Lionel; Kamar, Nassim; Kessler, Michèle; Ladrière, Marc; Morelon, Emmanuel; Buron, Fanny; Golshayan, Dela; Foucher, Yohann

    2016-01-01

    After the first year post transplantation, prognostic mortality scores in kidney transplant recipients can be useful for personalizing medical management. We developed a new prognostic score based on 5 parameters and computable at 1-year post transplantation. The outcome was the time between the first anniversary of the transplantation and the patient’s death with a functioning graft. Afterwards, we appraised the prognostic capacities of this score by estimating time-dependent Receiver Operating Characteristic (ROC) curves from two prospective and multicentric European cohorts: the DIVAT (Données Informatisées et VAlidées en Transplantation) cohort composed of patients transplanted between 2000 and 2012 in 6 French centers; and the STCS (Swiss Transplant Cohort Study) cohort composed of patients transplanted between 2008 and 2012 in 6 Swiss centers. We also compared the results with those of two existing scoring systems: one from Spain (Hernandez et al.) and one from the United States (the Recipient Risk Score, RRS, Baskin-Bey et al.). From the DIVAT validation cohort and for a prognostic time at 10 years, the new prognostic score (AUC = 0.78, 95%CI = [0.69, 0.85]) seemed to present significantly higher prognostic capacities than the scoring system proposed by Hernandez et al. (p = 0.04) and tended to perform better than the initial RRS (p = 0.10). By using the Swiss cohort, the RRS and the the new prognostic score had comparable prognostic capacities at 4 years (AUC = 0.77 and 0.76 respectively, p = 0.31). In addition to the current available scores related to the risk to return in dialysis, we recommend to further study the use of the score we propose or the RRS for a more efficient personalized follow-up of kidney transplant recipients. PMID:27152510

  19. Identification and classification of high risk groups for Coal Workers' Pneumoconiosis using an artificial neural network based on occupational histories: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Sun Gao

    2009-09-01

    Full Text Available Abstract Background Coal workers' pneumoconiosis (CWP is a preventable, but not fully curable occupational lung disease. More and more coal miners are likely to be at risk of developing CWP owing to an increase in coal production and utilization, especially in developing countries. Coal miners with different occupational categories and durations of dust exposure may be at different levels of risk for CWP. It is necessary to identify and classify different levels of risk for CWP in coal miners with different work histories. In this way, we can recommend different intervals for medical examinations according to different levels of risk for CWP. Our findings may provide a basis for further emending the measures of CWP prevention and control. Methods The study was performed using longitudinal retrospective data in the Tiefa Colliery in China. A three-layer artificial neural network with 6 input variables, 15 neurons in the hidden layer, and 1 output neuron was developed in conjunction with coal miners' occupational exposure data. Sensitivity and ROC analyses were adapted to explain the importance of input variables and the performance of the neural network. The occupational characteristics and the probability values predicted were used to categorize coal miners for their levels of risk for CWP. Results The sensitivity analysis showed that influence of the duration of dust exposure and occupational category on CWP was 65% and 67%, respectively. The area under the ROC in 3 sets was 0.981, 0.969, and 0.992. There were 7959 coal miners with a probability value Conclusion The duration of dust exposure and occupational category were the two most important factors for CWP. Coal miners at different levels of risk for CWP could be classified by the three-layer neural network analysis based on occupational history.

  20. Can linked emergency department data help assess the out-of-hospital burden of acute lower respiratory infections? A population-based cohort study

    Directory of Open Access Journals (Sweden)

    Moore Hannah C

    2012-08-01

    Full Text Available Abstract Background There is a lack of data on the out-of-hospital burden of acute lower respiratory infections (ALRI in developed countries. Administrative datasets from emergency departments (ED may assist in addressing this. Methods We undertook a retrospective population-based study of ED presentations for respiratory-related reasons linked to birth data from 245,249 singleton live births in Western Australia. ED presentation rates Results ED data from metropolitan WA, representing 178,810 births were available for analysis. From 35,136 presentations, 18,582 (52.9% had an International Classification of Diseases (ICD code for ALRI and 434 had a symptom code directly relating to an ALRI ICD code. A further 9600 presentations had a non-specific diagnosis. From the combined 19,016 ALRI presentations, the highest rates were in non-Aboriginal children aged 6–11 months (81.1/1000 child-years and Aboriginal children aged 1–5 months (314.8/1000. Croup and bronchiolitis accounted for the majority of ALRI ED presentations. Of Aboriginal births, 14.2% presented at least once to ED before age 5 years compared to 6.5% of non-Aboriginal births. Male sex and maternal age Conclusions ED data can give an insight into the out-of-hospital burden of ALRI. Presentation rates to ED for ALRI were high, but are minimum estimates due to current limitations of the ED datasets. Recommendations for improvement of these data are provided. Despite these limitations, ALRI, in particular bronchiolitis and croup are important causes of presentation to paediatric EDs.

  1. Impact of injecting drug use on response to highly active antiretroviral treatment in HIV-1-infected patients: a nationwide population-based cohort study

    DEFF Research Database (Denmark)

    Larsen, Mette Vang; Omland, Lars Haukali Hvass; Gerstoft, Jan;

    2010-01-01

    .0002). Absolute CD4(+) cell count and survival were lower for IDUs compared to non-IDUs (adjusted mortality rate ratio 3.6 (95% CI 2.9-4.3)). IDUs were more likely to receive a first regimen based on protease inhibitors (PIs) compared to non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens for...

  2. Serum YKL-40 and gestational diabetes - an observational cohort study

    DEFF Research Database (Denmark)

    Gybel-Brask, Dorte; Johansen, Julia S; Christiansen, Ib J;

    2016-01-01

    To examine serum YKL-40 in women developing gestational diabetes mellitus (GDM). In the present large observational cohort study of 1179 pregnant women, we determined serum YKL-40 four times during pregnancy (at gestational age 12, 20, 25, and 32 weeks). Pregnancy outcome was obtained from medical...... records. Sixty-eight women (5.8%) developed GDM. Serum YKL-40 increased from gestational age (GA) 12 weeks and the following weeks in the women who developed GDM and was independent of BMI, parity, and maternal age (OR = 2.69, 95% CI: 1.45-5.00, p = 0.002). No association was found between serum YKL-40...

  3. Psychosocial work environment and antidepressant medication: a prospective cohort study

    DEFF Research Database (Denmark)

    Bonde, Jens Peter; Munch-Hansen, T.; Wieclaw, J.;

    2009-01-01

    antidepressant medication. METHODS: Information on all antidepressant drugs (AD) purchased at pharmacies from 1995 through 2006 was obtained for a cohort of 21,129 Danish public service workers that participated in work climate surveys carried out during the period 2002-2005. Individual self-reports of...... alone. None of the measured psychosocial work environment factors were consistently related to prescription of antidepressant drugs during the follow-up period. CONCLUSION: The study does not indicate that a poor psychosocial work environment among public service employees is related to prescription of...... antidepressant pharmaceuticals. These findings need cautious interpretation because of lacking individual exposure assessments Udgivelsesdato: 2009...

  4. Systematically missing confounders in individual participant data meta-analysis of observational cohort studies

    DEFF Research Database (Denmark)

    Jackson, D.; White, I.; Kostis, J.B.;

    2009-01-01

    One difficulty in performing meta-analyses of observational cohort studies is that the availability of confounders may vary between cohorts, so that some cohorts provide fully adjusted analyses while others only provide partially adjusted analyses. Commonly, analyses of the association between an...

  5. Trauma, comorbidity, and mortality following diagnoses of severe stress and adjustment disorders: a nationwide cohort study.

    Science.gov (United States)

    Gradus, Jaimie L; Antonsen, Sussie; Svensson, Elisabeth; Lash, Timothy L; Resick, Patricia A; Hansen, Jens Georg

    2015-09-01

    Longitudinal outcomes following stress or trauma diagnoses are receiving attention, yet population-based studies are few. The aims of the present cohort study were to examine the cumulative incidence of traumatic events and psychiatric diagnoses following diagnoses of severe stress and adjustment disorders categorized using International Classification of Diseases, Tenth Revision, codes and to examine associations of these diagnoses with all-cause mortality and suicide. Data came from a longitudinal cohort of all Danes who received a diagnosis of reaction to severe stress or adjustment disorders (International Classification of Diseases, Tenth Revision, code F43.x) between 1995 and 2011, and they were compared with data from a general-population cohort. Cumulative incidence curves were plotted to examine traumatic experiences and psychiatric diagnoses during the study period. A Cox proportional hazards regression model was used to examine the associations of the disorders with mortality and suicide. Participants with stress diagnoses had a higher incidence of traumatic events and psychiatric diagnoses than did the comparison group. Each disorder was associated with a higher rate of all-cause mortality than that seen in the comparison cohort, and strong associations with suicide were found after adjustment. This study provides a comprehensive assessment of the associations of stress disorders with a variety of outcomes, and we found that stress diagnoses may have long-lasting and potentially severe consequences. PMID:26243737

  6. Cohort Coefficients

    DEFF Research Database (Denmark)

    Kristensen, Gustav

    2013-01-01

    Cohorts are the aggregate of individuals who experience the same event within the same time interval. Cohorts can be based on people born in a given year, for example in 1940 or within a span of years, e.g. born in 1940-1944. The year of birth is here the defining event for cohorts. The health di...

  7. Real-world hospital costs for nonchemotherapy drugs and nondrug care associated with platinum-based doublets in the first-line setting for advanced nonsquamous non-small-cell lung cancer in Chinese patients: a retrospective cohort study

    Science.gov (United States)

    Chen, Jianhua; Wu, Shengqi; Hu, Chenping; Yang, Yicheng; Rajan, Narayan; Chen, Yun; Yang, Canjuan; Li, Jianfeng; Chen, Wendong

    2016-01-01

    Objective The objective of this study was to compare hospital costs per treatment cycle (HCTC) for nonchemotherapy drugs and nondrug care associated with platinum-based doublets in the first-line setting for advanced nonsquamous non-small-cell lung cancer (AdvNS-NSCLC) in Chinese patients. Methods Patients receiving platinum-based doublets in the first-line setting for AdvNS-NSCLC from 2010 to 2012 in two Chinese tertiary hospitals were identified to create the retrospective study cohort. Propensity score methods were used to create matched treatment groups for head-to-head comparisons on HCTC between pemetrexed–platinum and other platinum-based doublets. Multiple linear regression analyses were performed to rank studied platinum-based doublets for their associations with the log10 scale of HCTC for nonchemotherapy drugs and nondrug care. Results Propensity score methods created matched treatment groups for pemetrexed–platinum versus docetaxel–platinum (61 pairs), paclitaxel–platinum (39 pairs), gemcitabine–platinum (93 pairs), and vinorelbine–platinum (73 pairs), respectively. Even though the log10 scale of HCTC for nonchemotherapy drugs and nondrug care associated with pemetrexed–platinum was ranked lowest in all patients (coefficient −0.174, P=0.015), which included patients experiencing any hematological adverse events (coefficient −0.199, P=0.013), neutropenia (coefficient −0.426, P=0.021), or leukopenia (coefficient −0.406, P=0.001), pemetrexed–platinum had the highest total HCTC (median difference from RMB 1,692 to RMB 7,400, Pline setting for AdvNS-NSCLC, the higher acquisition costs for nonplatinum cytotoxic drugs associated with pemetrexed–platinum could be partially offset by its significantly lower hospital costs for nonchemotherapy drugs and nondrug care.

  8. Program specific admission testing and dropout for sports science students: a prospective cohort study

    DEFF Research Database (Denmark)

    O'Neill, Lotte; Christensen, Mette Krogh; Vonsild, Maria Cecilie;

    2014-01-01

    admission strategy was also independently associated with dropout for sports science students in a university setting. The study design was a prospective cohort study with a 2 year follow-up. The population was 449 sports science students admitted to a university in the years 2002-2007. The analysis was......-based admission. This result may fit with elements of previous dropout theory, student-environment fit theory and perhaps also with self-efficacy theory....

  9. Incidence of obstetric anal sphincter injuries after training to protect the perineum: cohort study

    OpenAIRE

    Laine, Katariina; Skjeldestad, Finn Egil; Sandvik, Leiv; Staff, Anne Cathrine

    2012-01-01

    Objective To compare the incidence of obstetric anal sphincter injuries (OASIS) in two time periods, before and after implementing a training programme for improved perineal support aimed at reducing the incidence of obstetric anal sphincter injuries. The secondary aim was to study incidence of obstetric anal sphincter injuries in subgroups defined by risk factors for OASIS. Design Population-based cohort study. Setting University hospital setting in Oslo, Norway. Participants Two...

  10. BMI changes in children and adolescents attending a specialized childhood obesity center: a cohort study

    OpenAIRE

    Maggio, Albane Bertha; Saunders, Catherine Tamsin; Gal-Duding, Claudine; Beghetti, Maurice; Martin, Xavier; Farpour-Lambert, Nathalie; Chamay-weber, Catherine

    2013-01-01

    Background Multidisciplinary group therapies for obese children and adolescents are effective but difficult to implement. There is a crucial need to evaluate simpler management programs that target the obese child and his family. This study aimed to determine changes in body mass indexes (BMI) after individual family-based obesity intervention with a pediatrician in a specialized obesity center for child and adolescent. Methods This cohort study included 283 patients (3.3 to 17.1 years, mean ...

  11. Length of Stay for Mental and Behavioural Disorders Postpartum in Primiparous Mothers: A Cohort Study

    OpenAIRE

    Fenglian Xu; Marie-Paule Austin; Nicole Reilly; Lisa Hilder; Sullivan, Elizabeth A

    2014-01-01

    Background: Previous research showed that there was a significant increase in psychiatric hospital admission of postpartum mothers. The aim of the current study is to describe the length of hospital stays and patient days for mental and behavioural disorders (MBD) of new mothers in the first year after birth. Method: This was a cohort study based on linked population data between the New South Wales (NSW) Midwives Data Collection (MDC) and the NSW Admitted Patients Data Collection (APDC). The...

  12. Type D personality is a risk factor for psychosomatic symptoms and musculoskeletal pain among adolescents: a cross-sectional study of a large population-based cohort of Swedish adolescents

    Directory of Open Access Journals (Sweden)

    Condén Emelie

    2013-01-01

    Full Text Available Abstract Background Type D personality, or the “distressed personality”, is a psychosocial factor associated with negative health outcomes, although its impact in younger populations is unclear. The purpose of this study was to investigate the prevalence of Type D personality and the associations between Type D personality and psychosomatic symptoms and musculoskeletal pain among adolescences. Methods A population-based, self-reported cross-sectional study conducted in Västmanland, Sweden with a cohort of 5012 students in the age between 15–18 years old. The participants completed the anonymous questionnaire Survey of Adolescent Life in Västmanland 2008 during class hour. Psychosomatic symptoms and musculoskeletal pain were measured through index measuring the presence of symptoms and how common they were. DS14 and its two component subscales of negative affectivity (NA and social inhibition (SI were measured as well. Results There was a difference depending on sex, where 10.4% among boys and 14.6% among girls (p =  Conclusions There was a strong association between Type D personality and both psychosomatic symptoms and musculoskeletal pain where adolescent with a type D personality reported more symptoms. The present study contributes to the mapping of the influence of Type D on psychosomatic symptoms and musculoskeletal pain among adolescents.

  13. Nested Cohort

    Science.gov (United States)

    NestedCohort is an R software package for fitting Kaplan-Meier and Cox Models to estimate standardized survival and attributable risks for studies where covariates of interest are observed on only a sample of the cohort.

  14. Near Work Related Behaviors Associated with Myopic Shifts among Primary School Students in the Jiading District of Shanghai: A School-Based One-Year Cohort Study

    OpenAIRE

    You, Xiaofang; Wang, Ling; Tan, Hui; He, Xiangui; Qu, Xiaomei; Shi, Huijing; Zhu, Jianfeng; Zou, Haidong

    2016-01-01

    Purpose To investigate the characteristics of various near work related behaviors among primary students and their associations with changes in myopia related ocular biometric parameters during one-year of follow up. Methods A school-based sample of 4,814 primary 1st to 4th grade students aged 6–10 years old were selected by cluster randomization based on probability proportion to size in 2013. At baseline, students together with their parents filled in a self-administered questionnaire on 9 ...

  15. Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring : design of a prospective cohort study

    NARCIS (Netherlands)

    Geraedts, Hilde A. E.; Zijlstra, Wiebren; Zhang, Wei; Bulstra, Sjoerd; Stevens, Martin

    2014-01-01

    Background: With the number of older adults in society rising, frailty becomes an increasingly prevalent health condition. Regular physical activity can prevent functional decline and reduce frailty symptoms. In particular, home-based exercise programs can be beneficial in reducing frailty of older

  16. Effect of a community oriented problem based learning curriculum on quality of primary care delivered by graduates: historical cohort comparison study

    OpenAIRE

    Tamblyn, Robyn; Abrahamowicz, Michal; Dauphinee, Dale; Girard, Nadyne; BARTLETT, GILLIAN; Grand'Maison, Paul; Brailovsky, Carlos

    2005-01-01

    Objective To assess whether the transition from a traditional curriculum to a community oriented problem based learning curriculum at Sherbrooke University is associated with the expected improvements in preventive care and continuity of care without a decline in diagnosis and management of disease.

  17. Development of an updated phytoestrogen database for use with the SWAN Food Frequency Questionnaire: intakes and food sources in a community-based, multiethnic cohort study

    OpenAIRE

    Huang, Mei-Hua; Norris, Jean; Han, Weijuan; Block, Torin; Gold, Ellen; Crawford, Sybil; Greendale, Gail

    2012-01-01

    Phytoestrogens, heterocyclic phenols found in plants, may benefit several health outcomes. However, epidemiologic studies of the health effects of dietary phytoestrogens have yielded mixed results, in part due to challenges inherent in estimating dietary intakes. The goal of this study was to improve the estimates of dietary phytoestrogen consumption using a modified Block Food Frequency Questionnaire (FFQ), a 137-item FFQ created for the Study of Women’s Health Across the Nation (SWAN) in 19...

  18. The impact of low-level lead toxicity on school performance among children in the Chicago Public Schools: a population-based retrospective cohort study

    OpenAIRE

    Evens, Anne; Hryhorczuk, Daniel; Lanphear, Bruce P.; Rankin, Kristin M; Lewis, Dan A; Forst, Linda; Rosenberg, Deborah

    2015-01-01

    Background Environmental lead exposure poses a risk to educational performance, especially among poor, urban children. Previous studies found low-level lead exposure was a risk factor for diminished academic abilities, however, this study is distinct because of the very large sample size and because it controlled for very low birth weight and early preterm birth–two factors closely associated with lower academic performance. In this study we examined the association between lead concentration...

  19. Short‐term and long‐term outcomes in 133 429 emergency patients admitted with angina or myocardial infarction in Scotland, 1990–2000: population‐based cohort study

    OpenAIRE

    Capewell, S; Murphy, N F; MacIntyre, K.; Frame, S; Stewart, S.; Chalmers, J.W.T.; Boyd, J.; Finlayson, A; Redpath, A.; McMurray, J J V

    2006-01-01

    Objective: To analyse short- and long-term outcomes and prognostic factors in a large population-based cohort of unselected patients with a first emergency admission for suspected acute coronary syndrome between 1990 and 2000 in Scotland. Methods: All first emergency admissions for acute myocardial infarction (AMI) and all first emergency admissions for angina (the proxy for unstable angina) between 1990 and 2000 in Scotland (population 5.1 million) were identified. Survival to five years...

  20. Drug adherence and multidisciplinary care in patients with multiple sclerosis: Protocol of a prospective, web-based, patient-centred, nation-wide, Dutch cohort study in glatiramer acetate treated patients (CAIR study

    Directory of Open Access Journals (Sweden)

    Siepman Theodora

    2011-03-01

    an investigator-initiated, prospective, web-based, patient-centred, nation-wide cohort study in the Netherlands. The primary objective is to investigate whether GA adherence is associated with specific disciplines of care or quantities of specific care. The secondary objective is to investigate whether GA adherence is associated with specific aspects of the socio-economic situation, health care and caregivers, disease, treatment or patient characteristics. All data are acquired on-line via a study website. All RRMS patients in the Netherlands starting GA treatment are eligible. Patients are informed by neurologists, nurses, and websites from national MS patient organisations. All data, except on disability, are obtained by patient self-reports on pre-defined and random time points. The number of missed doses and the number of patients having discontinued GA treatment at 6 and 12 months are measures of adherence. Per care discipline the number of sessions and the total duration of care are measures of received care. The full spectrum of non-experimental care that is available in the Netherlands is assessed. Care includes 'physical' contacts, contacts by telephone or internet, health-promoting activities and community care activities. Care received over the preceding 14 days is assessed by patients at baseline and every other week thereafter up to month 12. Every 3 months neurologists and nurses record care disciplines to which patients have been referred. The Dutch Adherence Questionnaire-90 (DAQ-90 is a 90-item questionnaire based on the World Health Organisation (WHO 2003 report on adherence and comprehensively assesses five domains of evidence-based determinants of adherence: socio-economic, health care and caregivers, disease, treatment, and patient-related factors. In addition, self-efficacy is assessed by the MS Self-Efficacy Scale (MSSES, and mood and health-related quality of life (HRQoL by the Multiple Sclerosis Quality of Life-54 questionnaire (MSQoL-54