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Sample records for european population-based multicenter

  1. Occupational noise, smoking, and a high body mass index are risk factors for age-related hearing impairment and moderate alcohol consumption is protective: A European population-based multicenter study

    DEFF Research Database (Denmark)

    Fransen, E.; Topsakal, V.; Hendrickx, J.J.

    2008-01-01

    A multicenter study was set up to elucidate the environmental and medical risk factors contributing to age-related hearing impairment (ARHI). Nine subsamples, collected by nine audiological centers across Europe, added up to a total of 4,083 subjects between 53 and 67 years. Audiometric data (pur...

  2. Occupational noise, smoking, and a high body mass index are risk factors for age-related hearing impairment and moderate alcohol consumption is protective: a European population-based multicenter study.

    NARCIS (Netherlands)

    Fransen, E.; Topsakal, V.; Hendrickx, J.J.; Laer, L. van; Huyghe, J.R.; Eyken, E. van; Lemkens, N.; Hannula, S.; Maki-Torkko, E.; Jensen, M.; Demeester, K.; Tropitzsch, A.; Bonaconsa, A.; Mazzoli, M.; Espeso, A.; Verbruggen, K.; Huyghe, J.; Huygen, P.L.M.; Kunst, S.; Manninen, M.; Diaz-Lacava, A.; Steffens, M.; Wienker, T.F.; Pyykko, I.; Cremers, C.W.R.J.; Kremer, H.; Dhooge, I.; Stephens, D.; Orzan, E.; Pfister, M.; Bille, M.; Parving, A.; Sorri, M.; Heyning, P. van de; Camp, G. van

    2008-01-01

    A multicenter study was set up to elucidate the environmental and medical risk factors contributing to age-related hearing impairment (ARHI). Nine subsamples, collected by nine audiological centers across Europe, added up to a total of 4,083 subjects between 53 and 67 years. Audiometric data

  3. Toric phakic intraocular lens: European multicenter study.

    Science.gov (United States)

    Dick, H Burkhard; Alió, Jorge; Bianchetti, Marco; Budo, Camille; Christiaans, Bern Jurriën; El-Danasoury, M Alaa; Güell, José L; Krumeich, Jörg; Landesz, Monika; Loureiro, Fransico; Luyten, Gregorius P M; Marinho, Antonio; Rahhal, Mohamed Saleh; Schwenn, Oliver; Spirig, Raimund; Thomann, Urs; Venter, Jan

    2003-01-01

    To evaluate safety, efficacy, predictability, stability, complications, and patient satisfaction after implantation of Artisan toric phakic intraocular lenses (TPIOLs) for the correction of myopia or hyperopia with astigmatism. Prospective, nonrandomized, comparative (self-controlled) multicenter trial. Seventy eyes of 53 patients (mean, 35 years; range, 22-59 years) with preoperative spherical equivalent between +6.50 and -21.25 diopters (D) and cylinder between 1.50 and 7.25 D. Seventy eyes underwent implantation of a TPIOL with an optical zone of 5.0 mm (Artisan, Ophtec, Groningen, The Netherlands). The dioptric power of the intraocular lens was calculated by considering refraction, keratometry, and anterior chamber depth. The follow-up was 6 months in all cases. Lenses were available in powers ranging from +12.0 D to -23.5 D (spherical equivalent) in 0.5-D increments, with additional cylinder from 1.0 D to 7.0 D, also in 0.5-D increments. The main parameters assessed were best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), refraction, endothelial cell count (ECC), intraocular pressure, slit-lamp biomicroscopy, indirect ophthalmoscopy, subjective complaints, and patient satisfaction. Eyes were divided into group A, myopia (n = 48), with an average preoperative spherical equivalent of -8.90 +/- 4.52 D, and group B, hyperopia (n = 22), with an average preoperative spherical equivalent of +3.25 +/- 1.98 D. No eyes in either group experienced a loss in BSCVA, and 46 eyes gained 1 or more lines of their preoperative BSCVA. In 62 eyes (88.6%), UCVA was 20/40 or better. There was a significant reduction in spherical errors and astigmatism in all cases after surgery. All eyes of both groups were within +/-1.00 D of target refraction, and 51 eyes (72.9%) were within +/-0.50 D of target refraction. There was a 4.5% mean total loss of ECC during the first 6 months. No serious complications were observed. Overall patient satisfaction was very

  4. Bile acids in a multicenter, population-based case-control study of stillbirth

    Science.gov (United States)

    Silver, Robert M.; Parker, Corette B.; Goldenberg, Robert; Reddy, Uma M.; Dudley, Donald J.; Saade, George R.; Hogue, Carol J. Rowland; Coustan, Donald; Varner, Michael W.; Koch, Matthew A.; Conway, Deborah; Bukowski, Radek; Pinar, Halit; Stoll, Barbara; Moore, Janet; Willinger, Marian

    2015-01-01

    OBJECTIVE We sought to compare bile acids in women with and without stillbirth in a population-based study. STUDY DESIGN The Stillbirth Collaborative Research Network conducted a multisite, population-based case-control study of stillbirth (fetal deaths ≥20 weeks). Maternal sera were obtained at the time of enrollment and frozen at −80° until assay for bile acids. RESULTS Assays were performed in 581 women with stillbirth and 1546 women with live births. Bile acid levels were slightly higher in women with stillbirth (geometric mean [95% confidence interval {CI}] = 3.2 [3.0–3.5]) compared to live births (2.9 [2.7–3.1], P = .0327). However, the difference was not significant after adjustment for baseline risk factors for stillbirth. The proportion of women with elevated levels (≥10 or ≥40 μmol/L) was similar in stillbirths and live births. Results were similar when the analysis was limited to subsets of stillbirths and live births. In women with stillbirths not associated with fetal anomalies or obstetric complications bile acid levels were higher than in women with term live births (geometric mean [95% CI] = 3.4 [3.0–3.8] vs 2.9 [2.7–3.0], P = .0152, unadjusted; P = .06, adjusted). However, a similar proportion of women in both groups had levels ≥10 mmol/L (10.7 vs 7.2%; odds ratio [OR], 1.54; 95% CI, 0.97–2.44; adjusted OR, 1.29; 95% CI, 0.78–2.15) and ≥40 μmol/L (1.7 vs 0.7%; OR, 2.58; 95% CI, 0.85–7.84; adjusted OR, 2.28; 95% CI, 0.79–6.56). CONCLUSION Our data do not support testing for bile acids in cases of stillbirth in the absence of clinical evidence of intrahepatic cholestasis of pregnancy. PMID:24215860

  5. Risk factors for operated carpal tunnel syndrome: a multicenter population-based case-control study

    Directory of Open Access Journals (Sweden)

    Mandes Anna

    2009-09-01

    Full Text Available Abstract Background Carpal tunnel syndrome (CTS is a socially and economically relevant disease caused by compression or entrapment of the median nerve within the carpal tunnel. This population-based case-control study aims to investigate occupational/non-occupational risk factors for surgically treated CTS. Methods Cases (n = 220 aged 18-65 years were randomly drawn from 13 administrative databases of citizens who were surgically treated with carpal tunnel release during 2001. Controls (n = 356 were randomly sampled from National Health Service registry records and were frequency matched by age-gender-specific CTS hospitalization rates. Results At multivariate analysis, risk factors were blue-collar/housewife status, BMI ≥ 30 kg/m2, sibling history of CTS and coexistence of trigger finger. Being relatively tall (cut-offs based on tertiles: women ≥165 cm; men ≥175 cm was associated with lower risk. Blue-collar work was a moderate/strong risk factor in both sexes. Raised risks were apparent for combinations of biomechanical risk factors that included frequent repetitivity and sustained force. Conclusion This study strongly underlines the relevance of biomechanical exposures in both non-industrial and industrial work as risk factors for surgically treated CTS.

  6. A European multicenter randomized double-blind placebo-controlled monotherapy clinical trial of milnacipran in treatment of fibromyalgia

    DEFF Research Database (Denmark)

    Branco, Jaime C; Zachrisson, Olof; Perrot, Serge

    2010-01-01

    This randomized, double-blind, placebo-controlled, multicenter study investigated the efficacy and safety of milnacipran in the treatment of fibromyalgia (FM) in a European population.......This randomized, double-blind, placebo-controlled, multicenter study investigated the efficacy and safety of milnacipran in the treatment of fibromyalgia (FM) in a European population....

  7. The prevalence of genetic and serologic markers in an unselected European population-based cohort of IBD patients

    DEFF Research Database (Denmark)

    Riis, Lene; Vind, Ida; Vermeire, Severine

    2007-01-01

    by genetic heterogeneity. We aimed to investigate the prevalence of polymorphisms in CARD15 and TLR4 and occurrence of anti-Saccharomyces cerevisiae (ASCA) and antineutrophil cytoplasmic antibodies (pANCA) in a European population-based IBD cohort. METHODS: Individuals from the incident cohort were genotyped...... for three mutations in CARD15 and the Asp299gly mutation in TLR4. Levels of ASCA and pANCA were assessed. Disease location and behaviour at time of diagnosis was obtained from patient files. RESULTS: Overall CARD15 mutation rate was 23.9% for CD and 9.6% for UC patients (P ....5% of CD patients with no north-south difference, and was associated with complicated disease. pANCA was most common in North European UC patients and not associated with disease phenotype. CONCLUSION: The prevalence of mutations in CARD15 varied across Europe, and was not correlated to the incidence of CD...

  8. Systemic antibiotic prescribing to paediatric outpatients in 5 European countries: A population-based cohort study

    NARCIS (Netherlands)

    J. Holstiege (Jakob); J.C. Schink (Julian); M. Molokhia (Mariam); G. Mazzaglia (Giampiero); F. Innocenti (Francesco); A. Oteri (Alessandro); I. Bezemer (Irene); E. Poluzzi (Elisabetta); A. Puccini (A.); S.P. Ulrichsen (Sinna P.); M.C.J.M. Sturkenboom (Miriam); G. Trifirò (Gianluca); C. Garbe (Claus)

    2014-01-01

    textabstractBackground: To describe the utilisation of antibiotics in children and adolescents across 5 European countries based on the same drug utilisation measures and age groups. Special attention was given to age-group-specific distributions of antibiotic subgroups, since comparison in this

  9. Ross Procedure in Neonates and Infants: A European Multicenter Experience.

    NARCIS (Netherlands)

    Schoof, PH

    2015-01-01

    BACKGROUND: Infants and neonates with severe left ventricular outflow tract obstruction may require pulmonary autograft replacement of the aortic root. In this retrospective multicenter cohort study, we present our experience with the Ross procedure in neonates and infants with a focus on midterm

  10. Ross procedure in neonates and infants: A european multicenter experience

    NARCIS (Netherlands)

    A. Mookhoek (Aart); E.I. Charitos (Efstratios); M.G. Hazekamp (Mark); A.J.J.C. Bogers (Ad); J. Hörer (Jürgen); R. Lange (Rüdiger); R. Hetzer (Roland); J. Sachweh (Jörg); A. Riso (Arlindo); U. Stierle (Ulrich); J.J.M. Takkenberg (Hanneke); P.H. Schoof (Paul)

    2015-01-01

    textabstractBackground Infants and neonates with severe left ventricular outflow tract obstruction may require pulmonary autograft replacement of the aortic root. In this retrospective multicenter cohort study, we present our experience with the Ross procedure in neonates and infants with a focus on

  11. Population-based reference values for the European Organization for Research and Treatment of Cancer Head and Neck module.

    Science.gov (United States)

    Hammerlid, Eva; Adnan, Ali; Silander, Ewa

    2017-10-01

    The purpose of this study was to establish population-based norms for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35 (EORTC QLQ-HN35) to be used as references to facilitate the interpretation of results from health-related quality of life (HRQOL) studies of patients with head and neck cancer. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and QLQ-HN35 were sent to a random sample representing the Swedish general population. The response rate was 69% (1504 participants of 2200 invited). The scores for the QLQ-C30 were comparable to previously published reference values. The reference values for the QLQ-HN35 were low, indicating few head and neck-specific problems in the population. For illustrative purposes, we also compared these reference values to our previously published HRQOL results obtained from patients with head and neck cancer at diagnosis and from 3-year survivors. These new reference values for EORTC QLQ-HN35 may be useful in future HRQOL studies. © 2017 Wiley Periodicals, Inc.

  12. Ross Procedure in Neonates and Infants: A European Multicenter Experience.

    Science.gov (United States)

    Mookhoek, Aart; Charitos, Efstratios I; Hazekamp, Mark G; Bogers, Ad J J C; Hörer, Jürgen; Lange, Rüdiger; Hetzer, Roland; Sachweh, Joerg S; Riso, Arlindo; Stierle, Ulrich; Takkenberg, Johanna J M; Schoof, Paul H

    2015-12-01

    Infants and neonates with severe left ventricular outflow tract obstruction may require pulmonary autograft replacement of the aortic root. In this retrospective multicenter cohort study, we present our experience with the Ross procedure in neonates and infants with a focus on midterm survival and pulmonary autograft durability. A retrospective observational study was performed in 76 infants (aged less than 1 year) operated on in six congenital cardiac centers in The Netherlands and Germany between 1990 and 2013. Patients had a pulmonary autograft replacement of the aortic valve with (68%) or without (32%) septal myectomy. Median patient age was 85 days (range, 6 to 347). Early mortality (n = 13, 17%) was associated with neonatal age, preoperative use of intravenous inotropic drugs, and congenital aortic arch defects. Five patients (9%) died during follow-up. Freedom from autograft reintervention was 98% at 10 years. Echocardiography demonstrated good valve function, with no or trace regurgitation in 73% of patients. Freedom from right ventricular outflow tract reintervention was 51% at 10 years. Univariable analysis demonstrated superior freedom from reintervention of pulmonary homografts compared with aortic homografts or xenografts. Pulmonary autograft replacement of the aortic valve in neonates and infants is a high-risk operation but offers a durable neoaortic valve. Midterm durability reflects successful adaptation of the autograft to the systemic circulation. Late mortality associated with heart failure was an unexpected finding. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Performance indicators evaluation of the population-based breast cancer screening programme in Northern Portugal using the European Guidelines.

    Science.gov (United States)

    Bento, Maria José; Gonçalves, Guilherme; Aguiar, Ana; Castro, Clara; Veloso, Vitor; Rodrigues, Vítor

    2015-10-01

    To evaluate the first 10 years of operation of the population-based breast cancer screening programme implemented in the Northern Region of Portugal, using selected recommended standard performance indicators. Data from women aged 50-69 screened with two-view mammography, biennially, in the period 2000-2009, were included. Main performance indicators were compared with the recommended levels of the European Guidelines. A total of 202,039 screening examinations were performed, 71,731 (35.5%) in the initial screening and 130,308 (64.5%) in the subsequent screening. Coverage rate by examination reached 74.3% of the target population, in the last period evaluated. Recall rates were 8.1% and 2.4% and cancer detection rates were 4.4/1000 and 2.9/1000 respectively, for initial and subsequent screenings. The breast cancer detection rate, expressed as a multiple of the background expected incidence was 3.1 in initial screen and 2.2 in subsequent screen. The incidence of invasive interval cancers met the desirable recommended levels both the first and second years since last screening examination, in the initial and subsequent screenings. Invasive tumours screenings. Less favourable size, grading and biomarkers expression were found in interval cancers compared to screen-detected cancers. Breast cancer screening programme in the Northern Region of Portugal was well accepted by the population. Most of the performance indicators were consistent with the desirable levels of the European Guidelines, which indicate an effective screening programme. Future research should verify the consistency of some of these results by using updated information from a larger population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Population based external validation of a European predictive model for respiratory syncytial virus hospitalization of premature infants born 33 to 35 weeks of gestational age

    DEFF Research Database (Denmark)

    Stensballe, Lone G; Fullarton, John R; Carbonell-Estrany, Xavier

    2010-01-01

    Prospectively collected population-based data on 2529 Danish infants born at 33 to 35 weeks of gestation were used to validate an European predictive model of respiratory syncytial virus (RSV) hospitalization. The model was found to be robust with a diagnostic accuracy of 65.9% to distinguish...

  15. Occurrence of Anaemia in the First Year of Inflammatory Bowel Disease in a European Population-based Inception Cohort-An ECCO-EpiCom Study

    DEFF Research Database (Denmark)

    Burisch, Johan; Vegh, Zsuzsanna; Katsanos, Konstantinnos H.

    2017-01-01

    Background and aims: Anaemia is an important complication of inflammatory bowel disease (IBD). The aim of this study was to determine the prevalence of anaemia and the practice of anaemia screening during the first year following diagnosis in a European prospective population-based inception coho...

  16. Natural disease course of Crohn's disease during the first 5 years after diagnosis in a European population-based inception cohort

    DEFF Research Database (Denmark)

    Burisch, Johan; Kiudelis, Gediminas; Kupcinskas, Limas

    2018-01-01

    OBJECTIVE: The Epi-IBD cohort is a prospective population-based inception cohort of unselected patients with inflammatory bowel disease from 29 European centres covering a background population of almost 10 million people. The aim of this study was to assess the 5-year outcome and disease course ...

  17. Priorities for treatment, care and information if faced with serious illness: A comparative population-based survey in seven European countries

    NARCIS (Netherlands)

    Higginson, I.J.; Gomes, B.; Calanzani, N.; Gao, W.; Bausewein, C.; Daveson, B.A.; Deliens, L.; Ferreira, P.L.; Toscani, F.; Gysels, M.; Ceulemans, L.; Simon, S.T.; Cohen, J.; Harding, R.

    2014-01-01

    Background: Health-care costs are growing, with little population-based data about peoples priorities for end-of-life care, to guide service development and aid discussions. Aim: We examined variations in peoples priorities for treatment, care and information across seven European countries. Design:

  18. Priorities for treatment, care and information if faced with serious illness: a comparative population-based survey in seven European countries

    NARCIS (Netherlands)

    Higginson, I.J.; Gomes, B.; Calanzani, N.; Gao, W.; Bausewein, C.; Daveson, B.A.; Deliens, L.; Ferreira, P.L.; Toscani, F.; Gysels, M.; Ceulemans, L.; Simon, S.T.; Cohen, J.; Harding, R.

    2014-01-01

    BACKGROUND: Health-care costs are growing, with little population-based data about people's priorities for end-of-life care, to guide service development and aid discussions. AIM: We examined variations in people's priorities for treatment, care and information across seven European countries.

  19. European experience of the convergent atrial fibrillation procedure: multicenter outcomes in consecutive patients.

    Science.gov (United States)

    Geršak, Borut; Zembala, Michael O; Müller, Dirk; Folliguet, Thierry; Jan, Matevz; Kowalski, Oskar; Erler, Stefan; Bars, Clement; Robic, Boris; Filipiak, Krzysztof; Wimmer-Greinecker, Gerhard

    2014-04-01

    The objective of this collaborative, multicenter, European effort was to evaluate the outcomes of the convergent procedure for the treatment of persistent and long-standing persistent atrial fibrillation (AF) in consecutive patients at 4 European centers. Outcomes of consecutive patients, undergoing the convergent procedure at 4 European centers, were evaluated in this study. Epicardial ablation was performed before endocardial ablation. Convergent procedure outcomes were recorded by interrogation of implanted loop recorders or Holter monitors. Rhythm status and required interventions (antiarrhythmic drugs, cardioversions, and repeat ablations) were quantified 6 and 12 months after the procedure. Outcomes, monitoring type, and patient baseline characteristics were analyzed and reported. Seventy-three consecutive patients presenting with persistent AF (30.1%) or long-standing persistent AF (69.9%) underwent the convergent procedure between January 2010 and December 2011. At 6 months, 82% (56/68) were in sinus rhythm. At 12 months, 80% (53/66) were in sinus rhythm; single-procedure maintenance of sinus rhythm without postblanking period interventions was 76% (50/66); 52% (34/66) were in sinus rhythm and not receiving antiarrhythmic drugs. This multicenter European collaborative effort demonstrated that the convergent procedure is a safe and efficacious treatment option for persistent and long-standing persistent AF. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  20. Investigation of occupational and environmental causes of respiratory cancers (ICARE: a multicenter, population-based case-control study in France

    Directory of Open Access Journals (Sweden)

    Luce Danièle

    2011-12-01

    Full Text Available Abstract Background Occupational causes of respiratory cancers need to be further investigated: the role of occupational exposures in the aetiology of head and neck cancers remains largely unknown, and there are still substantial uncertainties for a number of suspected lung carcinogens. The main objective of the study is to examine occupational risk factors for lung and head and neck cancers. Methods/design ICARE is a multi-center, population-based case-control study, which included a group of 2926 lung cancer cases, a group of 2415 head and neck cancer cases, and a common control group of 3555 subjects. Incident cases were identified in collaboration with cancer registries, in 10 geographical areas. The control group was a random sample of the population of these areas, with a distribution by sex and age comparable to that of the cases, and a distribution by socioeconomic status comparable to that of the population. Subjects were interviewed face to face, using a standardized questionnaire collecting particularly information on tobacco and alcohol consumption, residential history and a detailed description of occupational history. Biological samples were also collected from study subjects. The main occupational exposures of interest are asbestos, man-made mineral fibers, formaldehyde, polycyclic aromatic hydrocarbons, chromium and nickel compounds, arsenic, wood dust, textile dust, solvents, strong acids, cutting fluids, silica, diesel fumes, welding fumes. The complete list of exposures of interest includes more than 60 substances. Occupational exposure assessment will use several complementary methods: case-by-case evaluation of exposure by experts; development and use of algorithms to assess exposure from the questionnaires; application of job-exposure matrices. Discussion The large number of subjects should allow to uncover exposures associated with moderate increase in risks, and to evaluate risks associated with infrequent or widely

  1. Adjunctive corticosteroid therapy for Pneumocystis carinii pneumonia in AIDS: a randomized European multicenter open label study

    DEFF Research Database (Denmark)

    Nielsen, T L; Eeftinck Schattenkerk, J K; Jensen, B N

    1992-01-01

    Fifty-nine human immunodeficiency virus type-1-infected patients with a microscopically proven first episode of moderate to severe Pneumocystis carinii pneumonia (PCP) were enrolled into a randomized European multicenter study. The effect of adjunctive corticosteroid (CS) therapy was assessed on (a...... (10%) in the CS group; p = 0.01. The 90-day survival was 69% in controls versus 87% in CS patients; p = 0.07. Based on these data we conclude that adjunctive CS therapy for moderate to severe PCP in AIDS patients reduces the acute mortality and the need for mechanical ventilation....

  2. Factors associated with good self-rated health in European adolescents: a population-based cross-sectional study.

    Science.gov (United States)

    Novak, Dario; Štefan, Lovro; Emeljanovas, Arunas; Mieziene, Brigita; Milanović, Ivana; Janić, Snežana Radisavljević; Kawachi, Ichiro

    2017-12-01

    The aim of the present study was to investigate self-reported health status and associated factors. In this cross-sectional study, the participants were 6501 adolescents (52% females) aged 14-19 years from three European countries: Croatia, Lithuania and Serbia. Self-rated health was assessed by using one item question: "How would you perceive your health?" The answers were arranged along a 5-point Likert-type scale: (1) very poor, (2) poor, (3) fair, (4) good and (5) excellent. The outcome was binarized as "good" (fair, good and excellent) and "poor" health (very poor and poor). Potential factors associated with self-rated health included demographic (age, gender, socioeconomic status and body-mass index), social (social capital) and lifestyle (physical activity and psychological distress) variables. In both univariate and multivariate models, being older, being a boy, having higher level of family, neighbourhood and school social capital, participating in moderate-to-vigorous physical activity more frequently and having low psychological distress were associated with good self-rated health. Our findings suggest strong associations between social and lifestyle factors and self-rated health. Other explanatory variables will require future research.

  3. Mediterranean Diet and Its Correlates among Adolescents in Non-Mediterranean European Countries: A Population-Based Study.

    Science.gov (United States)

    Novak, Dario; Štefan, Lovro; Prosoli, Rebeka; Emeljanovas, Arunas; Mieziene, Brigita; Milanović, Ivana; Radisavljević-Janić, Snežana

    2017-02-22

    Little is known about the factors which might influence the adherence to a Mediterranean diet in non-Mediterranean European countries. Thus, the main purpose of this study was to determine the associations between socioeconomic, psychological, and physical factors on a Mediterranean diet. In this cross-sectional study, participants were 14-18-year-old adolescents (N = 3071) from two non-Mediterranean countries: Lithuania (N = 1863) and Serbia (N = 1208). The dependent variable was Mediterranean diet, and was assessed with the Mediterranean Diet Quality Index for children and adolescents questionnaire. Independent variables were gender, body-mass index, self-rated health, socioeconomic status, psychological distress, physical activity, and sedentary behavior. The associations between dependent and independent variables were analyzed by using logistic regression. Results showed that higher adherence to a Mediterranean diet was associated with higher self-rated health, socioeconomic status, and physical activity, yet low adherence to a Mediterranean diet was associated with being female, having higher body-mass index, psychological distress, and sedentary behavior. Our findings suggest that future studies need to explore associations between lifestyle habits-especially in target populations, such as primary and secondary school students.

  4. Natural disease course of Crohn's disease during the first 5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study.

    Science.gov (United States)

    Burisch, Johan; Kiudelis, Gediminas; Kupcinskas, Limas; Kievit, Hendrika Adriana Linda; Andersen, Karina Winther; Andersen, Vibeke; Salupere, Riina; Pedersen, Natalia; Kjeldsen, Jens; D'Incà, Renata; Valpiani, Daniela; Schwartz, Doron; Odes, Selwyn; Olsen, Jóngerð; Nielsen, Kári Rubek; Vegh, Zsuzsanna; Lakatos, Peter Laszlo; Toca, Alina; Turcan, Svetlana; Katsanos, Konstantinos H; Christodoulou, Dimitrios K; Fumery, Mathurin; Gower-Rousseau, Corinne; Zammit, Stefania Chetcuti; Ellul, Pierre; Eriksson, Carl; Halfvarson, Jonas; Magro, Fernando Jose; Duricova, Dana; Bortlik, Martin; Fernandez, Alberto; Hernández, Vicent; Myers, Sally; Sebastian, Shaji; Oksanen, Pia; Collin, Pekka; Goldis, Adrian; Misra, Ravi; Arebi, Naila; Kaimakliotis, Ioannis P; Nikuina, Inna; Belousova, Elena; Brinar, Marko; Cukovic-Cavka, Silvija; Langholz, Ebbe; Munkholm, Pia

    2018-01-23

    The Epi-IBD cohort is a prospective population-based inception cohort of unselected patients with inflammatory bowel disease from 29 European centres covering a background population of almost 10 million people. The aim of this study was to assess the 5-year outcome and disease course of patients with Crohn's disease (CD). Patients were followed up prospectively from the time of diagnosis, including collection of their clinical data, demographics, disease activity, medical therapy, surgery, cancers and deaths. Associations between outcomes and multiple covariates were analysed by Cox regression analysis. In total, 488 patients were included in the study. During follow-up, 107 (22%) patients received surgery, while 176 (36%) patients were hospitalised because of CD. A total of 49 (14%) patients diagnosed with non-stricturing, non-penetrating disease progressed to either stricturing and/or penetrating disease. These rates did not differ between patients from Western and Eastern Europe. However, significant geographic differences were noted regarding treatment: more patients in Western Europe received biological therapy (33%) and immunomodulators (66%) than did those in Eastern Europe (14% and 54%, respectively, P<0.01), while more Eastern European patients received 5-aminosalicylates (90% vs 56%, P<0.05). Treatment with immunomodulators reduced the risk of surgery (HR: 0.4, 95% CI 0.2 to 0.6) and hospitalisation (HR: 0.3, 95% CI 0.2 to 0.5). Despite patients being treated early and frequently with immunomodulators and biological therapy in Western Europe, 5-year outcomes including surgery and phenotype progression in this cohort were comparable across Western and Eastern Europe. Differences in treatment strategies between Western and Eastern European centres did not affect the disease course. Treatment with immunomodulators reduced the risk of surgery and hospitalisation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

  5. Occurrence of Anaemia in the First Year of Inflammatory Bowel Disease in a European Population-based Inception Cohort-An ECCO-EpiCom Study.

    Science.gov (United States)

    Burisch, Johan; Vegh, Zsuzsanna; Katsanos, Konstantinnos H; Christodoulou, Dimitrios K; Lazar, Daniela; Goldis, Adrian; O'Morain, Colm; Fernandez, Alberto; Pereira, Santos; Myers, Sally; Sebastian, Shaji; Pedersen, Natalia; Olse, Jóngerð; Rubek Nielsen, Kári; Schwartz, Doron; Odes, Selwyn; Almer, Sven; Halfvarson, Jonas; Turk, Niksa; Cukovic-Cavka, Silvja; Nikulina, Inna; Belousova, Elena; Duricova, Dana; Bortlik, Martin; Shonová, Olga; Salupere, Riina; Barros, Louisa; Magro, Fernando; Jonaitis, Laimas; Kupcinskas, Limas; Turcan, Svetlana; Kaimakliotis, Ioannis; Ladefoged, Karin; Kudsk, Karen; Andersen, Vibeke; Vind, Ida; Thorsgaard, Niels; Oksanen, Pia; Collin, Pekka; Dal Piaz, Giulia; Santini, Alessia; Niewiadomski, Ola; Bell, Sally; Moum, Bjørn; Arebi, Naila; Kjeldsen, Jens; Carlsen, Katrine; Langholz, Ebbe; Lakatos, Peter Laszlo; Munkholm, Pia; Gerdes, Lars Ulrik; Dahlerup, Jens Frederik

    2017-10-01

    Anaemia is an important complication of inflammatory bowel disease [IBD]. The aim of this study was to determine the prevalence of anaemia and the practice of anaemia screening during the first year following diagnosis, in a European prospective population-based inception cohort. Newly diagnosed IBD patients were included and followed prospectively for 1 year in 29 European and one Australian centre. Clinical data including demographics, medical therapy, surgery and blood samples were collected. Anaemia was defined according to the World Health Organization criteria. A total of 1871 patients (Crohn's disease [CD]: 686, 88%; ulcerative colitis [UC]: 1,021, 87%; IBD unclassified [IBDU] 164. 81%) were included in the study. The prevalence of anaemia was higher in CD than in UC patients and, overall, 49% of CD and 39% of UC patients experienced at least one instance of anaemia during the first 12 months after diagnosis. UC patients with more extensive disease and those from Eastern European countries, and CD patients with penetrating disease or colonic disease location, had higher risks of anaemia. CD and UC patients in need of none or only mild anti-inflammatory treatment had a lower risk of anaemia. In a significant proportion of patients, anaemia was not assessed until several months after diagnosis, and in almost half of all cases of anaemia a thorough work-up was not performed. Overall, 42% of patients had at least one instance of anaemia during the first year following diagnosis. Most patients were assessed for anaemia regularly; however, a full anaemia work-up was frequently neglected in this community setting.

  6. European Project on Osteoarthritis (EPOSA: methodological challenges in harmonization of existing data from five European population-based cohorts on aging

    Directory of Open Access Journals (Sweden)

    Schaap Laura A

    2011-11-01

    Full Text Available Abstract Background The European Project on OSteoArthritis (EPOSA, here presented for the first time, is a collaborative study involving five European cohort studies on aging. This project focuses on the personal and societal burden and its determinants of osteoarthritis (OA. The aim of the current report is to describe the purpose of the project, the post harmonization of the cross-national data and methodological challenges related to the harmonization process Methods The study includes data from cohort studies in five European countries (Germany, Italy, the Netherlands, Spain and the United Kingdom on older community-dwelling persons aged ≥ 59 years. The study design and main characteristics of the five cohort studies are described. Post harmonization algorithms are developed by finding a "common denominator" to merge the datasets and weights are calculated to adjust for differences in age and sex distribution across the datasets. Results A harmonized database was developed, consisting of merged data from all participating countries. In total, 10107 persons are included in the harmonized dataset with a mean age of 72.8 years (SD 6.1. The female/male ratio is 53.3/46.7%. Some variables were difficult to harmonize due to differences in wording and categories, differences in classifications and absence of data in some countries. The post harmonization algorithms are described in detail in harmonization guidelines attached to this paper. Conclusions There was little evidence of agreement on the use of several core data collection instruments, in particular on the measurement of OA. The heterogeneity of OA definitions hampers comparing prevalence rates of OA, but other research questions can be investigated using high quality harmonized data. By publishing the harmonization guidelines, insight is given into (the interpretation of all post harmonized data of the EPOSA study.

  7. European multicenter experience with valve-sparing reoperations after the Ross procedure.

    Science.gov (United States)

    Mookhoek, Aart; de Kerchove, Laurent; El Khoury, Gebrine; Weimar, Timo; Luciani, Giovanni Battista; Mazzucco, Alessandro; Bogers, Ad J J C; Aicher, Diana; Schäfers, Hans-Joachim; Charitos, Efstratios I; Stierle, Ulrich; Takkenberg, Johanna J M

    2015-11-01

    Autograft valve preservation at reoperation may conserve some of the advantages of the Ross procedure. However, results of long-term follow-up are lacking. In this retrospective multicenter study, we present our experience with valve-sparing reoperations after the Ross procedure, with a focus on long-term outcome. A total of 86 patients from 6 European centers, who underwent valve-sparing reoperation after the Ross procedure between 1997 and 2013, were included in the study. Reoperation was performed a median of 9.1 years after the Ross procedure in patients with a median age of 38.4 years (interquartile range: 27.1-51.6 years). Preoperative severe autograft regurgitation (grade ≥3) was present in 46% of patients. In-hospital mortality was 1%. During a median follow-up of 4.3 years, 3 more patients died of noncardiac causes, resulting in a cumulative survival at 8 years of 89% (95% confidence interval: 65%-97%). Fifteen patients required a reintervention after valve-sparing reoperation, mostly owing to prolapse or retraction of autograft cusps. Freedom from reintervention was 76% (95% confidence interval: 57%-87%) at 8 years. The reintervention hazard was increased in patients who had isolated and/or severe aortic regurgitation at valve-sparing reoperation. In patients without reintervention after valve-sparing autograft reoperation (n = 63), severe aortic regurgitation was present in 3% at last follow-up. Valve-sparing autograft reoperations after the Ross procedure carry a low operative risk, with acceptable reintervention rates in the first postoperative decade. Patients with isolated and/or severe autograft regurgitation have an increased hazard of reintervention after valve-sparing reoperation; for these patients, careful preoperative weighing of surgical options is required. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  8. Day-Case Treatment of Peripheral Arterial Disease: Results from a Multi-Center European Study

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    Spiliopoulos, Stavros, E-mail: stavspiliop@med.uoa.gr, E-mail: stavspiliop@upatras.gr; Karnabatidis, Dimitrios, E-mail: karnaby@med.upatras.gr [Patras University Hospital, Department of Interventional Radiology (Greece); Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr; Diamantopoulos, Athanasios, E-mail: adiamantopoulos@gmail.com [Guy’s and St Thomas’ Hospitals, NHS Foundation Trust, King’s Health Partners, Department of Interventional Radiology (United Kingdom); Ali, Tariq, E-mail: tariq.ali@addenbrookes.nhs.uk [Addenbrooke’s University Hospital, NHS Foundation Trust, Department of Interventional Radiology (United Kingdom); Kitrou, Panagiotis, E-mail: panoskitrou@gmail.com [Patras University Hospital, Department of Interventional Radiology (Greece); Cannavale, Alessandro, E-mail: alessandro.cannavale@hotmail.com; Krokidis, Miltiadis, E-mail: miltiadis.krokidis@addenbrookes.nhs.uk [Addenbrooke’s University Hospital, NHS Foundation Trust, Department of Interventional Radiology (United Kingdom)

    2016-12-15

    PurposeThe purpose of the study was to investigate safety and feasibility of day-case endovascular procedures for the management of peripheral arterial disease.Materials and MethodsThis was a multi-center, retrospective study including all patients treated over a 30-month period with endovascular angioplasty or stenting for intermittent claudication (IC) or critical limb ischemia (CLI) on a day-case basis, in Interventional Radiology (IR) departments of three European tertiary hospitals. Exclusion criteria were not related to the type of lesion and included unavailability of an adult able to take care of patient overnight; high bleeding risk and ASA score ≥4. Primary efficacy outcome was the rate of procedures performed on an outpatient basis requiring no further hospitalization and primary safety outcome was freedom from 30-day major complications’ rate.ResultsThe study included 652 patients (male 75 %; mean age 68 ± 10 years; range: 27–93), 24.6 % treated for CLI. In 53.3 % of the cases a 6Fr sheath was used. Technical success was 97.1 %. Haemostasis was obtained by manual compression in 52.4 % of the accesses. The primary efficacy outcome occurred in 95.4 % (622/652 patients) and primary safety outcome in 98.6 % (643/652 patients). Major complications included five (0.7 %) retroperitoneal hematomas requiring transfusion; one (0.1 %) common femoral artery pseudoaneurysm successfully treated with US-guided thrombin injection, two cases of intra-procedural distal embolization treated with catheter-directed local thrombolysis and one on-table cardiac arrest necessitating >24 h recovery. No major complication was noted after same-day discharge.ConclusionsDay-case endovascular procedures for the treatment of IC or CLI can be safely and efficiently performed in experienced IR departments of large tertiary hospitals.

  9. European multicenter analytical evaluation of the Abbott ARCHITECT STAT high sensitive troponin I immunoassay.

    Science.gov (United States)

    Krintus, Magdalena; Kozinski, Marek; Boudry, Pascal; Capell, Nuria Estañ; Köller, Ursula; Lackner, Karl; Lefèvre, Guillaume; Lennartz, Lieselotte; Lotz, Johannes; Herranz, Antonio Mora; Nybo, Mads; Plebani, Mario; Sandberg, Maria B; Schratzberger, Wolfgang; Shih, Jessie; Skadberg, Øyvind; Chargui, Ahmed Taoufik; Zaninotto, Martina; Sypniewska, Grazyna

    2014-11-01

    International recommendations highlight the superior value of cardiac troponins (cTns) for early diagnosis of myocardial infarction along with analytical requirements of improved precision and detectability. In this multicenter study, we investigated the analytical performance of a new high sensitive cardiac troponin I (hs-cTnI) assay and its 99th percentile upper reference limit (URL). Laboratories from nine European countries evaluated the ARCHITECT STAT high sensitive troponin I (hs-TnI) immunoassay on the ARCHITECT i2000SR/i1000SR immunoanalyzers. Imprecision, limit of blank (LoB), limit of detection (LoD), limit of quantitation (LoQ) linearity of dilution, interferences, sample type, method comparisons, and 99th percentile URLs were evaluated in this study. Total imprecision of 3.3%-8.9%, 2.0%-3.5% and 1.5%-5.2% was determined for the low, medium and high controls, respectively. The lowest cTnI concentration corresponding to a total CV of 10% was 5.6 ng/L. Common interferences, sample dilution and carryover did not affect the hs-cTnI results. Slight, but statistically significant, differences with sample type were found. Concordance between the investigated hs-cTnI assay and contemporary cTnI assay at 99th percentile cut-off was found to be 95%. TnI was detectable in 75% and 57% of the apparently healthy population using the lower (1.1 ng/L) and upper (1.9 ng/L) limit of the LoD range provided by the ARCHITECT STAT hs-TnI package insert, respectively. The 99th percentile values were gender dependent. The new ARCHITECT STAT hs-TnI assay with improved analytical features meets the criteria of high sensitive Tn test and will be a valuable diagnostic tool.

  10. Crohn's disease and ulcerative colitis. Occurrence, course and prognosis during the first year of disease in a European population-based inception cohort.

    Science.gov (United States)

    Burisch, Johan

    2014-01-01

    Inflammatory bowel diseases (IBD), consisting of Crohn's disease (CD) and ulcerative colitis (UC), are chronic immune mediated diseases of unknown aetiology. Traditionally, the highest occurrence of both UC and CD is found in North America and Europe, including Scandinavia and the United Kingdom, while the diseases remain rare in Eastern Europe. Until recently, few population-based cohort data were available on the epidemiology of IBD in Eastern Europe. However, recent studies from Hungary and Croatia have reported steep increases in IBD incidence that means they are now comparable with Western European countries. The reasons for these changes remain unknown but could include an increasing awareness of the diseases, better access to diagnostic procedures, methodological bias in previous studies from Eastern Europe, or real differences in environmental factors, lifestyle and genetic susceptibility. The aim of this thesis was to create a prospective European population-based inception cohort of incident IBD patients in order to investigate whether an East-West gradient in the incidence of IBD exists in Europe. Furthermore, we investigated possible differences throughout Europe during the first year subsequent to diagnosis in terms of clinical presentation, disease outcome, treatment choices, frequency of environmental risk factors, as well as patient-reported health-related quality of life (HRQoL) and quality of care (QoC). Finally, we assessed resource utilization during the initial year of disease in both geographic regions. A total number of 31 centres from 14 Western and 8 Eastern European countries covering a total background population of approximately 10.1 million participated in this study. During the inclusion period from 1 January to 31 December 2010 a total number of 1,515 patients aged 15 years or older were included in the cohort. Annual incidence rates were twice as high in Western Europe (CD: 6.3/100,000; UC: 9.8/100,000) compared to Eastern Europe (CD

  11. Priorities for treatment, care and information if faced with serious illness: a comparative population-based survey in seven European countries.

    Science.gov (United States)

    Higginson, Irene J; Gomes, Barbara; Calanzani, Natalia; Gao, Wei; Bausewein, Claudia; Daveson, Barbara A; Deliens, Luc; Ferreira, Pedro L; Toscani, Franco; Gysels, Marjolein; Ceulemans, Lucas; Simon, Steffen T; Cohen, Joachim; Harding, Richard

    2014-02-01

    Health-care costs are growing, with little population-based data about people's priorities for end-of-life care, to guide service development and aid discussions. We examined variations in people's priorities for treatment, care and information across seven European countries. Telephone survey of a random sample of households; we asked respondents their priorities if 'faced with a serious illness, like cancer, with limited time to live' and used multivariable logistic regressions to identify associated factors. Members of the general public aged ≥ 16 years residing in England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain. In total, 9344 individuals were interviewed. Most people chose 'improve quality of life for the time they had left', ranging from 57% (95% confidence interval: 55%-60%, Italy) to 81% (95% confidence interval: 79%-83%, Spain). Only 2% (95% confidence interval: 1%-3%, England) to 6% (95% confidence interval: 4%-7%, Flanders) said extending life was most important, and 15% (95% confidence interval: 13%-17%, Spain) to 40% (95% confidence interval: 37%-43%, Italy) said quality and extension were equally important. Prioritising quality of life was associated with higher education in all countries (odds ratio = 1.3 (Flanders) to 7.9 (Italy)), experience of caregiving or bereavement (England, Germany, Portugal), prioritising pain/symptom control over having a positive attitude and preferring death in a hospice/palliative care unit. Those prioritising extending life had the highest home death preference of all groups. Health status did not affect priorities. Across all countries, extending life was prioritised by a minority, regardless of health status. Treatment and care needs to be reoriented with patient education and palliative care becoming mainstream for serious conditions such as cancer.

  12. Vitamin C and hyperglycemia in the European Prospective Investigation into Cancer--Norfolk (EPIC-Norfolk) study: a population-based study.

    Science.gov (United States)

    Sargeant, L A; Wareham, N J; Bingham, S; Day, N E; Luben, R N; Oakes, S; Welch, A; Khaw, K T

    2000-06-01

    To examine the cross-sectional association between plasma vitamin C, self-reported diabetes, and HbA1c. Data from a population-based study of diet, cancer, and chronic disease were analyzed. A total of 2,898 men and 3,560 women 45-74 years of age who were registered with general practices in Norfolk, U.K., were recruited to the European Prospective Investigation Into Cancer-Norfolk study between 1995 and 1998. Mean plasma vitamin C levels were significantly higher in individuals with HbA1c levels self-reported diabetes or prevalent undiagnosed hyperglycemia (HbA1c > or = 7%). An inverse gradient of mean plasma vitamin C was found in both sexes across quintiles of HbA1c distribution vegetarian diet, alcohol consumption, physical activity, dietary vitamin E, dietary fiber, dietary saturated fat, and smoking history). The unadjusted change in HbA1c per 20 micromol/l increase in vitamin C estimated by linear regression was -0.12% (-0.14 to -0.09) in men and -0.09% (-0.11 to -0.07) in women. After adjusting for the possible confounders, these values were -0.08% (-0.11 to -0.04) in men and -0.05% (-0.07 to -0.03) in women. An inverse association was found between plasma vitamin C and HbA1c. Dietary measures to increase plasma vitamin C may be an important public health strategy for reducing the prevalence of diabetes.

  13. European multicenter experience with valve-sparing reoperations after the Ross procedure

    NARCIS (Netherlands)

    A. Mookhoek (Aart); L. De Kerchove (Laurent); G. El Khoury (Gebrine); T. Weimar (Timo); G.B. Luciani (Giovanni Battista); A. Mazzucco (Alessandro); A.J.J.C. Bogers (Ad); D. Aicher (Diana); H.J. Schäfers (Hans J.); E.I. Charitos (Efstratios); U. Stierle (Ulrich); J.J.M. Takkenberg (Hanneke)

    2015-01-01

    textabstractBackground Autograft valve preservation at reoperation may conserve some of the advantages of the Ross procedure. However, results of long-term follow-up are lacking. In this retrospective multicenter study, we present our experience with valve-sparing reoperations after the Ross

  14. Multi-center study on the characteristics and treatment strategies of patients with Graves' orbitopathy: the first European Group on Graves' Orbitopathy experience

    NARCIS (Netherlands)

    Prummel, Mark F.; Bakker, Annemieke; Wiersinga, Wilmar M.; Baldeschi, Lelio; Mourits, Maarten P.; Kendall-Taylor, Pat; Perros, Petros; Neoh, Chris; Dickinson, A. Jane; Lazarus, John H.; Lane, Carol M.; Heufelder, Armin E.; Kahaly, George J.; Pitz, Suzanne; Orgiazzi, Jacques; Hullo, Alain; Pinchera, Aldo; Marcocci, Claudio; Sartini, Maria S.; Rocchi, Roberto; Nardi, Marco; Krassas, Gerry E.; Halkias, A.

    2003-01-01

    To improve management of patients with Graves' orbitopathy, a multi-center collaborative approach is necessary in order to have large enough sample sizes for meaningful randomized clinical trials. This is hampered by a lack of consensus on how to investigate the eye condition. The European Group on

  15. RANDOMIZED EUROPEAN MULTICENTER TRIAL OF SURFACTANT REPLACEMENT THERAPY FOR SEVERE NEONATAL RESPIRATORY-DISTRESS SYNDROME - SINGLE VERSUS MULTIPLE DOSES OF CUROSURF

    NARCIS (Netherlands)

    SPEER, CP; ROBERTSON, B; CURSTEDT, T; HALLIDAY, HL; COMPAGNONE, D; GEFELLER, O; HARMS, K; HERTING, E; MCCLURE, G; REID, M; TUBMAN, R; HERIN, P; NOACK, G; KOK, J; KOPPE, J; VANSONDEREN, L; LAUFKOTTER, E; KOHLER, W; BOENISCH, H; ALBRECHT, K; HANSSLER, L; HAIM, M; OETOMO, SB; Okken, Albert; ALTFELD, PC; GRONECK, P; KACHEL, W; RELIER, JP; WALTI, H

    There is now convincing evidence that the severity of neonatal respiratory distress syndrome can be reduced by surfactant replacement therapy; however, the optimal therapeutic regimen has not been defined. This randomized European multicenter trial was designed to determine whether the beneficial

  16. Inflammatory cytokines and the risk to develop type 2 diabetes: results of the prospective population-based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study.

    Science.gov (United States)

    Spranger, Joachim; Kroke, Anja; Möhlig, Matthias; Hoffmann, Kurt; Bergmann, Manuela M; Ristow, Michael; Boeing, Heiner; Pfeiffer, Andreas F H

    2003-03-01

    A subclinical inflammatory reaction has been shown to precede the onset of type 2 (non-insulin-dependent) diabetes. We therefore examined prospectively the effects of the central inflammatory cytokines interleukin (IL)-1beta, IL-6, and tumor necrosis factor-alpha (TNF-alpha) on the development of type 2 diabetes. We designed a nested case-control study within the prospective population-based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study including 27,548 individuals. Case subjects were defined to be those who were free of type 2 diabetes at baseline and subsequently developed type 2 diabetes during a 2.3-year follow-up period. A total of 192 cases of incident type 2 diabetes were identified and matched with 384 non-disease-developing control subjects. IL-6 and TNF-alpha levels were found to be elevated in participants with incident type 2 diabetes, whereas IL-1beta plasma levels did not differ between the groups. Analysis of single cytokines revealed IL-6 as an independent predictor of type 2 diabetes after adjustment for age, sex, BMI, waist-to-hip ratio (WHR), sports, smoking status, educational attainment, alcohol consumption, and HbA(1c) (4th vs. the 1st quartile: odds ratio [OR] 2.6, 95% CI 1.2-5.5). The association between TNF-alpha and future type 2 diabetes was no longer significant after adjustment for BMI or WHR. Interestingly, combined analysis of the cytokines revealed a significant interaction between IL-1beta and IL-6. In the fully adjusted model, participants with detectable levels of IL-1beta and elevated levels of IL-6 had an independently increased risk to develop type 2 diabetes (3.3, 1.7-6.8), whereas individuals with increased concentrations of IL-6 but undetectable levels of IL-1beta had no significantly increased risk, both compared with the low-level reference group. These results were confirmed in an analysis including only individuals with HbA(1c) <5.8% at baseline. Our data suggest that the pattern of

  17. Diagnosis and treatment for clinically localized prostate cancer. Adherence to the European Association of Urology clinical guidelines in a nationwide population-based study - GESCAP group.

    Science.gov (United States)

    Gómez-Veiga, F; Rodríguez-Antolín, A; Miñana, B; Hernández, C; Suárez, J F; Fernández-Gómez, J M; Unda, M; Burgos, J; Alcaraz, A; Rodríguez, P; Medina, R; Castiñeiras, J; Moreno, C; Pedrosa, E; Cózar, J M

    To assess the adherence to European Association of Urology (EAU) guidelines in the management of prostate cancer (PCa) in Spain. Epidemiological, population-based, study including a national representative sample of 3,918 incident patients with histopathological confirmation during 2010; 95% of the patient's sample was followed up for at least one year. Diagnosis along with treatment related variables (for localized PCa -low, intermediate, high and locally-advanced by D'Amico risk stratification) was recorded. Differences between groups were tested with Chi-squared and Kruskal-Wallis tests. Mean (SD) age of PCa patients was 68.48 (8.18). Regarding diagnostic by biopsy procedures, 64.56% of all patients had 8-12 cores in first biopsy and 46.5% of the patients over 75 years, with PSA<10ng/mL were biopsied. Staging by Computer Tomography (CT) or Bone Scan (BS) was used for determining tumor extension in 60.09% of high-risk cases and was applied differentially depending on patients' age; 3,293 (84.05%) patients received a treatment for localized PCa. Radical prostatectomy was done in 1,277 patients and 206 out of these patients also had a lymphadenectomy, being 4.64% low-risk, 22.81% intermediate-risk and 36.00% high-risk patients; 86.08% of 1,082 patients who had radiotherapy were treated with 3D or IMRT and 35.77% received a dose ≥75Gy; 419 patients were treated with brachytherapy (BT): 54.81% were low-risk patients, 22.84% intermediate-risk and 12.98% high-risk. Hormonotherapy (HT, n=521) was applied as single therapy in 9.46% of low-risk and 17.92% of intermediate-risk patients. Additionally, HT was combined with RT in 14.34% of lower-risk patients and 58.26% of high-risk patients, and 67.19% low-intermediate risk with RT and/or BT received neoadjuvant/concomitant/adjuvant HT. Finally, 83.75% of high-risk patients undergoing RT and/or BT also received HT. Although EAU guidelines for PCa management are easily available in Europe, the adherence to their

  18. Survival of 86,690 patients with thyroid cancer : A population-based study in 29 European countries from EUROCARE-5

    NARCIS (Netherlands)

    Dal Maso, L.; Tavilla, A.; Pacini, F.; Serraino, D.; van Dijk, B. A. C.; Chirlaque, M. D.; Capocaccia, R.; Larranaga, N.; Colonna, M.; Agius, D.; Ardanaz, E.; Rubio-Casadevall, J.; Kowalska, A.; Virdone, S.; Mallone, S.; Amash, H.; De Angelis, R.

    Background: Incidence rates of thyroid cancer (TC) increased in several countries during the last 30 years, while mortality rates remained unchanged, raising important questions for treatment and follow-up of TC patients. This study updates population-based estimates of relative survival (RS) after

  19. European multicenter study on antimicrobial resistance in bacteria isolated from companion animal urinary tract infections

    NARCIS (Netherlands)

    Marques, Cátia; Gama, Luís Telo; Belas, Adriana; Bergström, Karin; Beurlet, Stéphanie; Briend-Marchal, Alexandra; Broens, Els M; Costa, Marta; Criel, Delphine; Damborg, Peter; van Dijk, Marloes A M; van Dongen, A.M.; Dorsch, Roswitha; Espada, Carmen Martin; Gerber, Bernhard; Kritsepi-Konstantinou, Maria; Loncaric, Igor; Mion, Domenico; Misic, Dusan; Movilla, Rebeca; Overesch, Gudrun; Perreten, Vincent; Roura, Xavier; Steenbergen, Joachim; Timofte, Dorina; Wolf, Georg; Zanoni, Renato Giulio; Schmitt, Sarah; Guardabassi, Luca; Pomba, Constança

    2016-01-01

    BACKGROUND: There is a growing concern regarding the increase of antimicrobial resistant bacteria in companion animals. Yet, there are no studies comparing the resistance levels of these organisms in European countries. The aim of this study was to investigate geographical and temporal trends of

  20. Crohn's disease and ulcerative colitis. Occurrence, course and prognosis during the first year of disease in a European population-based inception cohort

    DEFF Research Database (Denmark)

    Burisch, Johan

    2014-01-01

    European countries. The reasons for these changes remain unknown but could include an increasing awareness of the diseases, better access to diagnostic procedures, methodological bias in previous studies from Eastern Europe, or real differences in environmental factors, lifestyle and genetic susceptibility...... nurses were not used in Eastern European IBD centres. Expenses for the cohort during the initial year of disease exceeded four million Euros with most money spent on diagnostics and surgery. Biological therapy accounted for one fourth costs in Western European CD patients. Long-term follow-up of the Epi...

  1. Lactobacillus GG administered in oral rehydration solution to children with acute diarrhea: a multicenter European trial.

    Science.gov (United States)

    Guandalini, S; Pensabene, L; Zikri, M A; Dias, J A; Casali, L G; Hoekstra, H; Kolacek, S; Massar, K; Micetic-Turk, D; Papadopoulou, A; de Sousa, J S; Sandhu, B; Szajewska, H; Weizman, Z

    2000-01-01

    The probiotic Lactobacillus GG is effective in promoting a more rapid recovery of acute, watery diarrhea in children with rotavirus enteritis. Very limited information is available, however, on the potential role of such agents in non-rotaviral diarrheal episodes. Furthermore, no evidence is available concerning the efficacy of Lactobacillus GG administered in the oral rehydration solution during oral rehydration therapy. A multicenter trial was conducted to evaluate the efficacy of Lactobacillus GG administered in the oral rehydration solution to patients with acute-onset diarrhea of all causes. Children 1 month to 3 years of age with acute-onset diarrhea were enrolled in a double-blind, placebo-controlled investigation. Patients were randomly allocated to group A, receiving oral rehydration solution plus placebo, or group B, receiving the same preparation but with a live preparation of Lactobacillus GG (at least 10(10) CFU/250 ml). After rehydration in the first 4 to 6 hours, patients were offered their usual feedings plus free access to the same solution until diarrhea stopped. One hundred forty children were enrolled in group A, and 147 in group B. There were no differences at admission between the groups in age, sex, previous types of feeding, previous duration of diarrhea, use of antibiotics, weight, height, weight-height percentile, prevalence of fever, overall status, degree of dehydration, and percentage of in- versus outpatients. Duration of diarrhea after enrollment was 71.9 +/- 35.8 hours in group A versus 58.3 +/- 27.6 hours in group B (mean +/- SD; P = 0.03). In rotavirus-positive children, diarrhea lasted 76.6 +/- 41.6 hours in group A versus 56.2 +/- 16.9 hours in groups B (P children with acute diarrhea is safe and results in shorter duration of diarrhea, less chance of a protracted course, and faster discharge from the hospital.

  2. Artiflex Toric foldable phakic intraocular lens: short-term results of a prospective European multicenter study.

    Science.gov (United States)

    Doors, Muriël; Budo, Camille J; Christiaans, Ben J; Luger, Michiel; Marinho, Antonio A P; Dick, H Burkhard; Güell, Jose L; Nuijts, Rudy M M A

    2012-10-01

    To evaluate the short-term efficacy, predictability, stability, and safety of the foldable Artiflex Toric phakic intraocular lens (pIOL; Ophtec) for the correction of myopia with astigmatism. Prospective, nonrandomized multicenter study. One hundred fifteen eyes of 73 patients were implanted with an Artiflex Toric pIOL. Mean implanted spherical and cylindrical powers were -7.10 ± 2.70 diopters (D) and -2.14 ± 0.80 D, respectively. Total follow-up was 6 months. Outcome parameters included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), subjective manifest refraction (used for vector analysis), intraocular pressure, and endothelial cell density (ECD). At 6 months, 99.0% of eyes had a UCVA of ≥20/40, and 81.8% of eyes were ±0.5 D of the intended refraction. In 74.5% postoperative UCVA was equal to or better than preoperative BSCVA; 2 eyes lost 2 or more lines of BSCVA postoperatively because of the development of synechiae. In 75.5% of eyes the remaining cylinder was ±0.5 D. There was a significant decrease in ECD after 3 months (4.8% ± 11.9%), with no additional decline between 3 and 6 months. There were few complications, except for the incidence of pigment and nonpigment precipitates (14.8% and 12.2%, respectively at 6 months). Mean misalignment was 0.6 ± 1.5 degrees (range 0-8). The Artiflex Toric pIOL effectively and safely corrects myopia and astigmatism in the short term, with stable and predictable visual results after 6 months, when strict inclusion criteria are applied. Deposition of pigment and nonpigment precipitates on the pIOL warrants further investigation. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. European multicenter study on antimicrobial resistance in bacteria isolated from companion animal urinary tract infections

    DEFF Research Database (Denmark)

    Marques, Cátia; Gama, Luís Telo; Belas, Adriana

    2016-01-01

    of antimicrobial resistant bacteria causing urinary tract infection (UTI) in companion animals in Europe. The antimicrobial susceptibility of 22 256 bacteria isolated from dogs and cats with UTI was determined. Samples were collected between 2008 and 2013 from 16 laboratories of 14 European countries....... The prevalence of antimicrobial resistance of the most common bacteria was determined for each country individually in the years 2012-2013 and temporal trends of bacteria resistance were established by logistic regression. RESULTS: The aetiology of uropathogenic bacteria differed between dogs and cats. For all...

  4. The representativeness of a European multi-center network for influenza-like-illness participatory surveillance.

    Science.gov (United States)

    Cantarelli, Pietro; Debin, Marion; Turbelin, Clément; Poletto, Chiara; Blanchon, Thierry; Falchi, Alessandra; Hanslik, Thomas; Bonmarin, Isabelle; Levy-Bruhl, Daniel; Micheletti, Alessandra; Paolotti, Daniela; Vespignani, Alessandro; Edmunds, John; Eames, Ken; Smallenburg, Ronald; Koppeschaar, Carl; Franco, Ana O; Faustino, Vitor; Carnahan, AnnaSara; Rehn, Moa; Colizza, Vittoria

    2014-09-20

    The Internet is becoming more commonly used as a tool for disease surveillance. Similarly to other surveillance systems and to studies using online data collection, Internet-based surveillance will have biases in participation, affecting the generalizability of the results. Here we quantify the participation biases of Influenzanet, an ongoing European-wide network of Internet-based participatory surveillance systems for influenza-like-illness. In 2011/2012 Influenzanet launched a standardized common framework for data collection applied to seven European countries. Influenzanet participants were compared to the general population of the participating countries to assess the representativeness of the sample in terms of a set of demographic, geographic, socio-economic and health indicators. More than 30,000 European residents registered to the system in the 2011/2012 season, and a subset of 25,481 participants were selected for this study. All age classes (10 years brackets) were represented in the cohort, including under 10 and over 70 years old. The Influenzanet population was not representative of the general population in terms of age distribution, underrepresenting the youngest and oldest age classes. The gender imbalance differed between countries. A counterbalance between gender-specific information-seeking behavior (more prominent in women) and Internet usage (with higher rates in male populations) may be at the origin of this difference. Once adjusted by demographic indicators, a similar propensity to commute was observed for each country, and the same top three transportation modes were used for six countries out of seven. Smokers were underrepresented in the majority of countries, as were individuals with diabetes; the representativeness of asthma prevalence and vaccination coverage for 65+ individuals in two successive seasons (2010/2011 and 2011/2012) varied between countries. Existing demographic and national datasets allowed the quantification of the

  5. A prospective multicenter European study on flexible ureterorenoscopy for the management of renal stone

    Directory of Open Access Journals (Sweden)

    Francesco Berardinelli

    2016-06-01

    Full Text Available ABSTRACT Purpose The aim of this study was to describe the outcomes and the complications of retrograde intrarenal surgery (RIRS for renal stones in a multi-institutional working group. Materials and Methods From 2012 to 2014, we conducted a prospective study including all RIRS performed for kidney stones in 4 European centers. Demographic information, disease characteristics, and perioperative and postoperative data were gathered. Patients and stone data, procedure characteristics, results and safety outcomes were analyzed and compared by descriptive statistics. Complications were reported using the standardized Clavien system. Results Three hundred and fifty-six patients underwent 377 RIRS with holmium laser lithotripsy for renal stones. The RIRS was completed in all patients with a mean operative time of 63.5 min. The stone-free status was confirmed endoscopically and through fluoroscopic imaging after the first procedure in 73.6%. The second procedure was performed in twenty patients (5.6% achieving an overall stone free rate of 78.9%. The overall complication rate was 15.1%. Intra-operative and post-operative complications were seen in 24 (6.7% and 30 (8.4% cases, respectively. Conclusions RIRS is a minimally invasive procedure with good results in terms of stone-free and complications rate.

  6. European multicenter analytical evaluation of the Abbott ARCHITECT STAT high sensitive troponin I immunoassay

    DEFF Research Database (Denmark)

    Krintus, Magdalena; Kozinski, Marek; Boudry, Pascal

    2014-01-01

    high sensitive cardiac troponin I (hs-cTnI) assay and its 99th percentile upper reference limit (URL). METHODS: Laboratories from nine European countries evaluated the ARCHITECT STAT high sensitive troponin I (hs-TnI) immunoassay on the ARCHITECT i2000SR/i1000SR immunoanalyzers. Imprecision, limit...... hs-cTnI assay and contemporary cTnI assay at 99th percentile cut-off was found to be 95%. TnI was detectable in 75% and 57% of the apparently healthy population using the lower (1.1 ng/L) and upper (1.9 ng/L) limit of the LoD range provided by the ARCHITECT STAT hs-TnI package insert, respectively....... The 99th percentile values were gender dependent. CONCLUSIONS: The new ARCHITECT STAT hs-TnI assay with improved analytical features meets the criteria of high sensitive Tn test and will be a valuable diagnostic tool....

  7. Sexual behavior of gender-dysphoric individuals before gender-confirming interventions: a European multicenter study.

    Science.gov (United States)

    Cerwenka, Susanne; Nieder, Timo O; Cohen-Kettenis, Peggy; De Cuypere, Griet; Haraldsen, Ira R Hebold; Kreukels, Baudewijntje P C; Richter-Appelt, Hertha

    2014-01-01

    A transsexual course of development that starts before puberty (early onset) or during or after puberty, respectively (late onset), may lead to diverse challenges in coping with sexual activity. The authors explored the sexual behavior of 380 adult male-to-female and female-to-male individuals diagnosed according to DSM-IV-TR criteria who had not yet undergone gender-confirming interventions. Data originated from the European Network for the Investigation of Gender Incongruence Initiative, conducted in Belgium, Germany, The Netherlands, and Norway. Information on outcome variables was collected using self-administered questionnaires at first clinical presentation. Compared with late-onset male-to-females, early-onset individuals tended to show sexual attraction toward males more frequently (50.5%), involve genitals less frequently in partner-related sexual activity, and consider penile sensations and orgasm as more negative. Early-onset female-to-males predominantly reported sexual attraction toward females (84.0%), whereas those with a late-onset more frequently showed other sexual attractions (41.7%). The study (a) shows that early- and late-onset male-to-females differ considerably with regard to coping strategies involving their body during sexual relations and (b) reveals initial insights into developmental pathways of late-onset female-to-males.

  8. Progress in implantable gastric stimulation: summary of results of the European multi-center study.

    Science.gov (United States)

    De Luca, Maurizio; Segato, Gianni; Busetto, Luca; Favretti, Franco; Aigner, Franz; Weiss, Helmut; de Gheldere, Charles; Gaggiotti, Giorgio; Himpens, Jacques; Limao, Jorge; Scheyer, Matthias; Toppino, Mauro; Zurmeyer, Ernst L; Bottani, Giorgio; Penthaler, Heinrich

    2004-09-01

    The Implantable Gastric Stimulator (IGS(R)), a pacemaker-like device, has been found to be safe and effective to induce and maintain weight loss. The LOSS (Laparoscopic Obesity Stimulation Survey) is a prospective non-randomized trial which enrolled 69 patients involving 11 investigator centers in 5 European Countries. In 19 patients, ghrelin was analyzed. Between January 2002 and December 2003, 69 patients (F/M 49/20), mean age 41 years (18-65) underwent IGS implantation. Mean BMI was 41 (35-57), mean weight 115.0 kg (65-160) and mean excess weight (EW) 52 kg (13-89). The IGS was actived 30 days after implantation. In a subset of 19 patients studied further, 0, 6, and 12 months appetite and satiety score were evaluated and 0 and 6 months ghrelin profile was analyzed. The mean +/- standard error %EWL was: 8.6+/-1.8 at 1 month, 15.8+/-2.3 at 3 months, 17.8+/-2.6 at 6 months, 21.0+/-3.5 at 10 months, and 21.0+/-5.0 at 15 months. There were no intraoperative surgical or long-term complications. 7 intra-operative gastric penetrations occurred, observed by gastroscopy, without sequelae. 1 patient required a reoperation to remove a retained lead needle. In the subset of 19 patients, appetite was reduced and post-prandial and inter-prandial satiety was increased after IGS implantation. In the 19 patients, despite weight reduction, ghrelin did not increase. IGS can be implanted laparoscopically with minimal perioperative complications. Appetite is reduced and satiety is increased after the implantation. Ghrelin levels could be one of the mechanisms explaining weight loss and weight maintenance in IGS patients. If weight loss is maintained, IGS could be considered a good option for selected patients.

  9. Family adaptation to cerebral palsy in adolescents: A European multicenter study.

    Science.gov (United States)

    Guyard, Audrey; Michelsen, Susan I; Arnaud, Catherine; Fauconnier, Jerome

    2017-02-01

    Factors promoting family adaptation to child's disability are poorly studied together. The aim of the study was to describe the family adaptation to disability and to identify determinants associated with using a global theoretical model. 286 families of teenagers [13-17 years] with cerebral palsy (CP) from 4 European disability registers were included and visited at home. Face to face interviews were performed in order to measure parental distress, perceived impact in various dimensions of family life, family resources and stressors. Relationships were modelled with structural equations. 31.8% of parents living with an adolescent with CP showed clinically significant high stress requiring professional assistance. The main stressors were the level of motor impairment and behavioural disorders in adolescent. A good family functioning was the best protective factor. Respite in care and a parents' positive attitude were significantly related to less parental distress. Material support, socioeconomical level, marital status or parental qualifications did not appear to be significant protector factors. Particular attention must be paid not only on physical condition but also on adolescent psychological problems to improve family adaptation. Families at risk of experiencing severe distress should be targeted early and proactive caregiver interventions on the whole family should be performed. Family is a dynamic system: facing disability, it tries to recover its balance with available resources and its perception of the situation. Literature highlights potential stressors and protecting factors that could affect the disabled child's family adaptation but few papers study a global model including most of these factors. This study validated a global theoretical model of family adaptation to disability at adolescence. It identified behaviour disorders and motor impairment level as main stressors, family functioning as the largest protecting factors, and equipment and

  10. Family adaptation to cerebral palsy in adolescents: A European multicenter study

    Science.gov (United States)

    Guyard, Audrey; Michelsen, Susan I.; Arnaud, Catherine; Fauconnier, Jerome

    2017-01-01

    Background and aim Factors promoting family adaptation to child’s disability are poorly studied together. The aim of the study was to describe the family adaptation to disability and to identify determinants associated with using a global theoretical model. Materials and methods 286 families of teenagers [13–17 years] with cerebral palsy (CP) from 4 European disability registers were included and visited at home. Face to face interviews were performed in order to measure parental distress, perceived impact in various dimensions of family life, family resources and stressors. Relationships were modelled with structural equations. Results 31.8% of parents living with an adolescent with CP showed clinically significant high stress requiring professional assistance. The main stressors were the level of motor impairment and behavioural disorders in adolescent. A good family functioning was the best protective factor. Respite in care and a parents’ positive attitude were significantly related to less parental distress. Material support, socioeconomical level, marital status or parental qualifications did not appear to be significant protector factors. Conclusions Particular attention must be paid not only on physical condition but also on adolescent psychological problems to improve family adaptation. Families at risk of experiencing severe distress should be targeted early and proactive caregiver interventions on the whole family should be performed. What this paper adds Family is a dynamic system: facing disability, it tries to recover its balance with available resources and its perception of the situation. Literature highlights potential stressors and protecting factors that could affect the disabled child’s family adaptation but few papers study a global model including most of these factors. This study validated a global theoretical model of family adaptation to disability at adolescence. It identified behaviour disorders and motor impairment level as main

  11. Left-Sided Reoperations After Arterial Switch Operation: A European Multicenter Study.

    Science.gov (United States)

    Vida, Vladimiro L; Zanotto, Lorenza; Zanotto, Lucia; Stellin, Giovanni; Padalino, Massimo; Sarris, Georges; Protopapas, Eleftherios; Prospero, Carol; Pizarro, Christian; Woodford, Edward; Tlaskal, Thomas; Berggren, Hakan; Kostolny, Martin; Omeje, Ikenna; Asfour, Boulos; Kadner, Alexander; Carrel, Thierry; Schoof, Paul H; Nosal, Matej; Fragata, Josè; Kozłowski, Michał; Maruszewski, Bohdan; Vricella, Luca A; Cameron, Duke E; Sojak, Vladimir; Hazekamp, Mark; Salminen, Jukka; Mattila, Ilkka P; Cleuziou, Julie; Myers, Patrick O; Hraska, Viktor

    2017-09-01

    We sought to report the frequency, types, and outcomes of left-sided reoperations (LSRs) after an arterial switch operation (ASO) for patients with D-transposition of the great arteries (D-TGA) and double-outlet right ventricle (DORV) TGA-type. Seventeen centers belonging to the European Congenital Heart Surgeons Association (ECHSA) contributed to data collection. We included 111 patients who underwent LSRs after 7,951 ASOs (1.4%) between January 1975 and December 2010. Original diagnoses included D-TGA (n = 99) and DORV TGA-type (n = 12). Main indications for LSR were neoaortic valve insufficiency (n = 52 [47%]) and coronary artery problems (CAPs) (n = 21 [19%]). Median age at reoperation was 8.2 years (interquartile range [IQR], 2.9-14 years). Seven patients died early after LSRs (6.3%); 4 patients with D-TGA (5.9%) and 3 patients with DORV TGA-type (25%) (p = 0.02). Median age at last follow-up was 16.1 years (IQR, 9.9-21.8 years). Seventeen patients (16%) required another reoperation, which was more frequent in patients with DORV- TGA type (4 of 9 [45%]) than in patients with D-TGA (13 of 95 [14%]). Late death occurred in 4 patients (4 of 104 [3.8%]). The majority of survivors were asymptomatic at last clinical examination (84 of 100 [84%]). Reoperations for residual LSRs are infrequent but may become necessary late after an ASO, predominantly for neoaortic valve insufficiency and CAPs. Risk at reoperation is not negligible, and DORV TGA-type anatomy, as well as procedures on the coronary arteries, were significantly associated with a higher morbidity and a lower overall survival. Recurrent reoperations after LSRs may be required. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  12. A short-term trial of tacrolimus ointment for atopic dermatitis. European Tacrolimus Multicenter Atopic Dermatitis Study Group

    NARCIS (Netherlands)

    Ruzicka, T.; Bieber, T.; Schöpf, E.; Rubins, A.; Dobozy, A.; Bos, J. D.; Jablonska, S.; Ahmed, I.; Thestrup-Pedersen, K.; Daniel, F.; Finzi, A.; Reitamo, S.

    1997-01-01

    Tacrolimus (FK 506) is an effective immunosuppressant drug for the prevention of rejection after organ transplantation, and preliminary studies suggest that topical application of tacrolimus is effective in the treatment of atopic dermatitis. We conducted a randomized, doubleblind, multicenter study

  13. Trends in cause and place of death for children in Portugal (a European country with no Paediatric palliative care) during 1987-2011: a population-based study.

    Science.gov (United States)

    Forjaz de Lacerda, Ana; Gomes, Barbara

    2017-12-22

    Children and adolescents dying from complex chronic conditions require paediatric palliative care. One aim of palliative care is to enable a home death if desired and well supported. However, there is little data to inform care, particularly from countries without paediatric palliative care, which constitute the majority worldwide. This is an epidemiological study analysing death certificate data of decedents aged between 0 and 17 years in Portugal, a developed Western European country without recognised provision of paediatric palliative care, from 1987 to 2011. We analysed death certificate data on cause and place of death; the main outcome measure was home death. Complex chronic conditions included cancer, cardiovascular, neuromuscular, congenital/genetic, respiratory, metabolic, gastro-intestinal, renal, and haematology/immunodeficiency conditions. Multivariate analysis determined factors associated with home death in these conditions. Annual deaths decreased from 3268 to 572. Of 38,870 deaths, 10,571 were caused by complex chronic conditions, their overall proportion increasing from 23.7% to 33.4% (22.4% to 45.4% above age 1-year). For these children, median age of death increased from 0.5 to 4.32-years; 19.4% of deaths occurred at home, declining from 35.6% to 11.5%; factors associated with home death were year of death (adjusted odds ratio 0.89, 95% confidence interval 0.89-0.90), age of death (6-10 year-olds 21.46, 16.42-28.04, reference neonates), semester of death (October-March 1.18, 1.05-1.32, reference April-September), and cause of death (neuromuscular diseases 1.59, 1.37-1.84, reference cancer), with wide regional variation. This first trend analysis of paediatric deaths in Portugal (an European country without paediatric palliative care) shows that palliative care needs are increasing. Children are surviving longer and, in contrast with countries where paediatric palliative care is thriving, there is a long-term trend of dying in hospital instead

  14. Nutrition and physical activity behaviours among Mäori, Pacific and NZ European children: identifying opportunities for population-based interventions.

    Science.gov (United States)

    Utter, Jennifer; Scragg, Robert; Schaaf, David; Fitzgerald, Eljon

    2006-02-01

    To describe how the prevalences of nutrition and physical activity behaviours vary by ethnicity, while controlling for other socio-demographic characteristics, and to identify appropriate points of intervention for defined ethnic populations of New Zealand children. Secondary data analysis of the 2002 National Children's Nutrition Survey. Few ethnic differences were significant for fruit and vegetable consumption and indicators of physical activity. Where ethnic differences in physical activity were significant, Mäori children and Pacific children were more active than New Zealand European/Other (NZEO) children. Pacific children and, Mäori children were significantly more likely to skip meals than NZEO children. Pacific children and Mäori children were significantly more likely to buy some/most of the food they consumed at school from the tuckshop or dairy while NZEO children were more likely to bring their school food only from home. Likewise, Pacific children and Mäori children were significantly more likely to be high consumers of some fatty and sugary foods than NZEO children. Meal skipping and purchasing food away from home were common for Mäori children and Pacific children; school-based programs that aim to improve access to and subsidise the price of healthy foods, including breakfast, could greatly benefit Mäori and Pacific students. Efforts to improve fruit and vegetable consumption and physical activity should be more universally applied and made culturally appropriate for all children.

  15. European non-invasive trisomy evaluation (EU-NITE) study: a multicenter prospective cohort study for non-invasive fetal trisomy 21 testing.

    Science.gov (United States)

    Verweij, E J; Jacobsson, B; van Scheltema, P A; de Boer, M A; Hoffer, M J V; Hollemon, D; Westgren, M; Song, K; Oepkes, D

    2013-10-01

    To evaluate the performance of a directed non-invasive prenatal testing method of cell-free DNA analysis for fetal trisomy 21 (T21) by shipping the whole blood samples from Europe to a laboratory in the USA. A European multicenter prospective, consecutive cohort study was performed enrolling pregnant women from Sweden and the Netherlands. Blood samples were drawn just prior to a planned of invasive diagnostic procedure in a population at increased risk for fetal T21 and then shipped to the USA without any blood processing. Chromosome-selective sequencing was carried out on chromosome 21 with reporting high risk or low risk of T21. Karyotyping or rapid aneuploidy detection was used as the clinical reference standard. Of the 520 eligible study subjects, a T21 test result was obtained in 504/520 (96.9%). Risk assessment was accurate in 503/504 subjects (99.8%). There was one false negative result for T21 (sensitivity 17/18, 94.4%, and specificity 100%). This is the first prospective European multicenter study showing that non-invasive prenatal testing using directed sequencing of cell-free DNA applied to blood samples shipped across the Atlantic Ocean, is highly accurate for assessing risk of fetal T21. © 2013 John Wiley & Sons, Ltd.

  16. Accuracy evaluation of five blood glucose monitoring systems obtained from the pharmacy: a European multicenter study with 453 subjects

    NARCIS (Netherlands)

    Tack, C.J.; Pohlmeier, H.; Behnke, T.; Schmid, V.; Grenningloh, M.; Forst, T.; Pfutzner, A.

    2012-01-01

    BACKGROUND: This multicenter study was conducted to evaluate the performance of five recently introduced blood glucose (BG) monitoring (BGM) devices under daily routine conditions in comparison with the YSI (Yellow Springs, OH) 2300 Stat Plus glucose analyzer. METHODS: Five hundred one diabetes

  17. Association between participation in life situations of children with cerebral palsy and their physical, social, and attitudinal environment: a cross-sectional multicenter European study.

    Science.gov (United States)

    Colver, Allan; Thyen, Ute; Arnaud, Catherine; Beckung, Eva; Fauconnier, Jerome; Marcelli, Marco; McManus, Vicki; Michelsen, Susan I; Parkes, Jackie; Parkinson, Kathryn; Dickinson, Heather O

    2012-12-01

    To evaluate how participation of children with cerebral palsy (CP) varied with their environment. Home visits to children. Administration of Assessment of Life Habits and European Child Environment Questionnaires. Structural equation modeling of putative associations between specific domains of participation and environment, while allowing for severity of child's impairments and pain. European regions with population-based registries of children with CP. Children (n=1174) aged 8 to 12 years were randomly selected from 8 population-based registries of children with CP in 6 European countries. Of these, 743 (63%) agreed to participate; 1 further region recruited 75 children from multiple sources. Thus, there were 818 children in the study. Not applicable. Participation in life situations. For the hypothesized associations, the models confirmed that higher participation was associated with better availability of environmental items. Higher participation in daily activities-mealtimes, health hygiene, personal care, and home life-was significantly associated with a better physical environment at home (Penvironment in the community. Participation in social roles (responsibilities, relationships, recreation) was associated with attitudes of classmates and social support at home. School participation was associated with attitudes of teachers and therapists. Environment explained between 14% and 52% of the variation in participation. The findings confirmed the social model of disability. The physical, social, and attitudinal environment of disabled children influences their participation in everyday activities and social roles. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. Population-based study for human papillomavirus (HPV) infection in young women in Japan: A multicenter study by the Japanese human papillomavirus disease education research survey group (J-HERS).

    Science.gov (United States)

    Sasagawa, Toshiyuki; Maehama, Toshiyuki; Ideta, Kazuhisa; Irie, Takuya

    2016-02-01

    A multi-center study was conducted to examine 6,628 eligible Japanese women aged from 16 to 50 years for uterine cervical abnormality and HPV infection with a liquid based-cytology test and a novel HPV test using the PCR-SSOP-Luminex(®) method identifying 31 HPV genotypes. In 3,047 normal subjects, the overall prevalence across all HPV types was 25%, while that of the common 13 high-risk (Common-13HR) types (HPV-16, 18. 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68) was 17%, and that of the definite high-risk (Definite-HR) types (HPV-16, 18. 31, 33, 35, 45, 52, and 58) was 12%. For Definite-HR, HPV-52, 16, and 58 were the most common, HPV-31 was relatively common, and HPV-18 was less common, while HPV-33, 35, and 45 were rare. Seven Definite-HR excluding HPV-45 and seven Possible-HR (HPV-39, 51, 56, 66, 68, 70, and 82) HPV types were identified as a single type infection in patients with high-grade squamous intraepithelial lesion (HSIL) or worse. The Common-13HR types were detected in 89% of subjects with HSIL, whereas either Definite-HR or Possible-HR types were detected in 95% of HSIL. These 1420 HPV types appear to be involved with HSIL or worse in Japan. The prevalences of multiple-type HPV infections were identified in roughly half of HPV-positive subjects, and decreased significantly with age in normal population and abnormal cytology groups, although the prevalences of single-type infections increased with age in the latter group. Most HPV infections are cleared for some years, while a certain HR-HPV type persists to induce HSIL. © 2015 Wiley Periodicals, Inc.

  19. Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus: The DALI Lifestyle Pilot.

    Science.gov (United States)

    Simmons, David; Jelsma, Judith G M; Galjaard, Sander; Devlieger, Roland; van Assche, Andre; Jans, Goele; Corcoy, Rosa; Adelantado, Juan M; Dunne, Fidelma; Desoye, Gernot; Harreiter, Jürgen; Kautzky-Willer, Alexandra; Damm, Peter; Mathiesen, Elisabeth R; Jensen, Dorte M; Andersen, Lise Lotte; Lapolla, Annunziata; Dalfra, Maria; Bertolotto, Alessandra; Wender-Ozegowska, Ewa; Zawiejska, Agnieszka; Hill, David; Rebollo, Pablo; Snoek, Frank J; van Poppel, Mireille N M

    2015-09-01

    Ways to prevent gestational diabetes mellitus (GDM) remain unproven. We compared the impact of three lifestyle interventions (healthy eating [HE], physical activity [PA], and both HE and PA [HE+PA]) on GDM risk in a pilot multicenter randomized trial. Pregnant women at risk for GDM (BMI ≥29 kg/m2) from nine European countries were invited to undertake a 75-g oral glucose tolerance test before 20 weeks' gestation. Those without GDM were randomized to HE, PA, or HE+PA. Women received five face-to-face and four optional telephone coaching sessions, based on the principles of motivational interviewing. A gestational weight gain (GWG) Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  20. Predicting sickness impact profile at six months after stroke: further results from the European multi-center CERISE study

    NARCIS (Netherlands)

    Stummer, C.A.; Verheyden, G.; Putman, K.; Jenni, W.; Schupp, W.; Wit, L. De

    2015-01-01

    PURPOSE: To develop prognostic models and equations for predicting participation at six months after stroke. METHODS: This European prospective cohort study recruited 532 consecutive patients from four rehabilitation centers. Participation was assessed at six months after stroke with the Sickness

  1. Gender-specific differences in carotid intima-media thickness and its progression over three years: A multicenter European study

    NARCIS (Netherlands)

    Kozakova, M.; Palombo, C.; Morizzo, C.; Nolan, J.J.; Konrad, T.; Dekker, J.M.; Balkau, B.; Nilsson, P.M.

    2013-01-01

    This multicentre European study evaluated, in a young-to-middle-aged healthy population without carotid atherosclerosis, the gender-related differences in carotid intima-media thickness (IMT) and its short-term (3-year) progression, and whether these differences are related to different vascular

  2. A European multi-center trial investigating the anti-restenotic effect of intravascular sonotherapy after stenting of de novo lesions (EUROSPAH: EUROpean Sonotherapy Prevention of Arterial Hyperplasia).

    Science.gov (United States)

    Serruys, P W; Hoye, A; Grollier, G; Colombo, A; Symons, J; Mudra, H

    2004-01-01

    Intravascular sonotherapy (IST) reduces neointimal hyperplasia post-stenting in animal studies. Euro-SPAH is a multi-center, double blind, randomized trial investigating the efficacy of IST to reduce in-stent late loss. Patients with angina or silent ischaemia with stented de novo lesions were randomised to sham or IST. The sample size had a 90% power to detect a late loss difference of 0.21 mm at 6 months. The secondary endpoints were MACE at 1, 6, 12 months and neo-intimal hyperplasia on IVUS at 6 months. At 23 sites in Europe, 403 patients were randomized, with successful treatment with sham or IST in 95.6%. There were no significant differences between the groups in terms of baseline demographics or lesion characteristics. Angiographic follow-up was obtained in 89%. In-stent late loss was not significantly different. The restenosis rate at 6 months was 23% in the IST group versus 25% in the sham group. The IVUS measurements confirm the absence of effect of IST on neointimal hyperplasia. At one year, the event-free survival did not significantly differ between the two groups. The use of sonotherapy following stent implantation in de novo lesions does not reduce intra-stent neointimal hyperplasia, or effect the angiographic restenosis rate compared to sham treatment.

  3. Enumeration of antigen-specific CD8+ T lymphocytes by single-platform, HLA tetramer-based flow cytometry: a European multicenter evaluation.

    Science.gov (United States)

    Heijnen, Ingmar A F M; Barnett, David; Arroz, Maria J; Barry, Simon M; Bonneville, Marc; Brando, Bruno; D'hautcourt, Jean-Luc; Kern, Florian; Tötterman, Thomas H; Marijt, Erik W A; Bossy, David; Preijers, Frank W M B; Rothe, Gregor; Gratama, Jan W

    2004-11-01

    HLA class I peptide tetramers represent powerful diagnostic tools for detection and monitoring of antigen-specific CD8(+) T cells. The impetus for the current multicenter study is the critical need to standardize tetramer flow cytometry if it is to be implemented as a routine diagnostic assay. Hence, the European Working Group on Clinical Cell Analysis set out to develop and evaluate a single-platform tetramer-based method that used cytomegalovirus (CMV) as the antigenic model. Absolute numbers of CMV-specific CD8(+) T cells were obtained by combining the percentage of tetramer-binding cells with the absolute CD8(+) T-cell count. Six send-outs of stabilized blood from healthy individuals or CMV-carrying donors with CMV-specific CD8(+) T-cell counts of 3 to 10 cells/microl were distributed to 7 to 16 clinical sites. These sites were requested to enumerate CD8(+) T cells and, in the case of CMV-positive donors, CMV-specific subsets on three separate occasions using the standard method. Between-site coefficients of variation of less than 10% (absolute CD8(+) T-cell counts) and approximately 30% (percentage and absolute numbers of CMV-specific CD8(+) T cells) were achieved. Within-site coefficients of variation were approximately 5% (absolute CD8(+) T-cell counts), approximately 9% (percentage CMV-specific CD8(+) T cells), and approximately 17% (absolute CMV-specific CD8(+) T-cell counts). The degree of variation tended to correlate inversely with the proportion of CMV-specific CD8(+) T-cell subsets. The single-platform MHC tetramer-based method for antigen-specific CD8(+) T-cell counting has been evaluated by a European group of laboratories and can be considered a reproducible assay for routine enumeration of antigen-specific CD8(+) T cells. (c) 2004 Wiley-Liss, Inc.

  4. Clinical characteristics and treatment outcomes of patients with major depressive disorder and comorbid anxiety disorders - results from a European multicenter study.

    Science.gov (United States)

    Dold, Markus; Bartova, Lucie; Souery, Daniel; Mendlewicz, Julien; Serretti, Alessandro; Porcelli, Stefano; Zohar, Joseph; Montgomery, Stuart; Kasper, Siegfried

    2017-08-01

    This naturalistic European multicenter study aimed to elucidate the association between major depressive disorder (MDD) and comorbid anxiety disorders. Demographic and clinical information of 1346 MDD patients were compared between those with and without concurrent anxiety disorders. The association between explanatory variables and the presence of comorbid anxiety disorders was examined using binary logistic regression analyses. 286 (21.2%) of the participants exhibited comorbid anxiety disorders, 10.8% generalized anxiety disorder (GAD), 8.3% panic disorder, 8.1% agoraphobia, and 3.3% social phobia. MDD patients with comorbid anxiety disorders were characterized by younger age (social phobia), outpatient status (agoraphobia), suicide risk (any anxiety disorder, panic disorder, agoraphobia, social phobia), higher depressive symptom severity (GAD), polypsychopharmacy (panic disorder, agoraphobia), and a higher proportion receiving augmentation treatment with benzodiazepines (any anxiety disorder, GAD, panic disorder, agoraphobia, social phobia) and pregabalin (any anxiety disorder, GAD, panic disorder). The results in terms of treatment response were conflicting (better response for panic disorder and poorer for GAD). The logistic regression analyses revealed younger age (any anxiety disorder, social phobia), outpatient status (agoraphobia), suicide risk (agoraphobia), severe depressive symptoms (any anxiety disorder, GAD, social phobia), poorer treatment response (GAD), and increased administration of benzodiazepines (any anxiety disorder, agoraphobia, social phobia) and pregabalin (any anxiety disorder, GAD, panic disorder) to be associated with comorbid anxiety disorders. Our findings suggest that the various anxiety disorders subtypes display divergent clinical characteristics and are associated with different variables. Especially comorbid GAD appears to be characterized by high symptom severity and poor treatment response. Copyright © 2017 Elsevier Ltd. All

  5. Risk of upper aerodigestive tract cancer and type of alcoholic beverage: a European multicenter case-control study.

    LENUS (Irish Health Repository)

    Marron, Manuela

    2012-07-01

    The general relationship between cancers of the upper aerodigestive tract (UADT) and alcohol drinking is established. Nevertheless, it is uncertain whether different types of alcoholic beverages (wine, beer and liquor) carry different UADT cancer risks. Our study included 2,001 UADT cancer cases and 2,125 controls from 14 centres in 10 European countries. All cases were histologically or cytologically confirmed squamous cell carcinomas. Controls were frequency matched by sex, age and centre. Logistic regression models were used to estimate odds ratios (OR) and 95 % confidence intervals (95 %CI) adjusted for age, sex, centre, education level, vegetable and fruit intake, tobacco smoking and alcohol drinking, where appropriate. Risk of beverage-specific alcohol consumption were calculated among \\'pure drinker\\' who consumed one beverage type exclusively, among \\'predominant drinkers\\' who consumed one beverage type to more than 66 % and among \\'mixed drinkers\\' who consumed more than one beverage type to similar proportions. Compared to never drinkers and adjusted for cumulative alcohol consumption, the OR and 95 %CI for wine, beer and liquor drinking, respectively, were 1.24 (0.86, 1.78), 1.54 (1.05, 2.27) and 0.94 (0.53, 1.64) among \\'pure drinkers\\' (p value for heterogeneity across beverage types = 0.306), 1.05 (0.76,1.47), 1.25 (0.87,1.79) and 1.43 (0.95, 2.16) among \\'predominant drinkers\\' (p value = 0.456), and 1.09 (0.79, 1.50), 1.20 (0.88, 1.63) and 1.12 (0.82, 1.53) among \\'mixed drinkers\\' (p value = 0.889). Risk of UADT cancer increased with increasing consumption of all three alcohol beverage types. Our findings underscore the strong and comparable carcinogenic effect of ethanol in wine, beer and liquor on organs of the UADT.

  6. Data harmonization and federated analysis of population-based studies: the BioSHaRE project.

    Science.gov (United States)

    Doiron, Dany; Burton, Paul; Marcon, Yannick; Gaye, Amadou; Wolffenbuttel, Bruce H R; Perola, Markus; Stolk, Ronald P; Foco, Luisa; Minelli, Cosetta; Waldenberger, Melanie; Holle, Rolf; Kvaløy, Kirsti; Hillege, Hans L; Tassé, Anne-Marie; Ferretti, Vincent; Fortier, Isabel

    2013-11-21

    Individual-level data pooling of large population-based studies across research centres in international research projects faces many hurdles. The BioSHaRE (Biobank Standardisation and Harmonisation for Research Excellence in the European Union) project aims to address these issues by building a collaborative group of investigators and developing tools for data harmonization, database integration and federated data analyses. Eight population-based studies in six European countries were recruited to participate in the BioSHaRE project. Through workshops, teleconferences and electronic communications, participating investigators identified a set of 96 variables targeted for harmonization to answer research questions of interest. Using each study's questionnaires, standard operating procedures, and data dictionaries, harmonization potential was assessed. Whenever harmonization was deemed possible, processing algorithms were developed and implemented in an open-source software infrastructure to transform study-specific data into the target (i.e. harmonized) format. Harmonized datasets located on server in each research centres across Europe were interconnected through a federated database system to perform statistical analysis. Retrospective harmonization led to the generation of common format variables for 73% of matches considered (96 targeted variables across 8 studies). Authenticated investigators can now perform complex statistical analyses of harmonized datasets stored on distributed servers without actually sharing individual-level data using the DataSHIELD method. New Internet-based networking technologies and database management systems are providing the means to support collaborative, multi-center research in an efficient and secure manner. The results from this pilot project show that, given a strong collaborative relationship between participating studies, it is possible to seamlessly co-analyse internationally harmonized research databases while allowing

  7. Population-based analysis of non-steroidal anti-inflammatory drug use among children in four European countries in the SOS project: What size of data platforms and which study designs do we need to assess safety issues?

    NARCIS (Netherlands)

    V.E. Valkhoff (Vera); R. Schade (René); G.W. 't Jong (Geert); S.A. Romio (Silvana); M.J. Schuemie (Martijn); A. Arfe (Andrea); C. Garbe (Claus); R.M.C. Herings (Ron); S. Lucchi (Silvia); G. Picelli (Gino); J.C. Schink (Julian); H. Straatman (Huub); M. Villa (Marco); E.J. Kuipers (Ernst); M.C.J.M. Sturkenboom (Miriam)

    2013-01-01

    textabstractBackground: Data on utilization patterns and safety of non-steroidal anti-inflammatory drugs (NSAIDs) in children are scarce. The purpose of this study was to investigate the utilization of NSAIDs among children in four European countries as part of the Safety Of non-Steroidal

  8. Enumeration of antigen-specific CD8+ T lymphocytes by single-platform, HLA tetramer-based flow cytometry: a European multicenter evaluation.

    NARCIS (Netherlands)

    Heijnen, I.; Barnett, D.; Arroz, M.J.; Barry, S.M.; Bonneville, M.; Brando, B.; D'Hautcourt, J.L.; Kern, F.; Totterman, T.H.; Marijt, E.W.; Bossy, D.; Preijers, F.W.M.B.; Rothe, G.; Gratama, J.W.

    2004-01-01

    BACKGROUND: HLA class I peptide tetramers represent powerful diagnostic tools for detection and monitoring of antigen-specific CD8(+) T cells. The impetus for the current multicenter study is the critical need to standardize tetramer flow cytometry if it is to be implemented as a routine diagnostic

  9. Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus: The DALI Lifestyle Pilot

    NARCIS (Netherlands)

    Simmons, D.; Jelsma, J.G.M.; Galjaard, S.; Devlieger, R.; van Assche, A.; Jans, G.; Corcoy, R.; Adelantado, J.M.; Dunne, F.; Desoye, G.; Harreiter, J.; Kautzky-Willer, A.; Damm, P.; Mathiesen, E.R.; Jensen, D.M.; Andersen, L.L.; Lapolla, A.; Dalfra, M.; Bertolotto, A.; Wender-Ozegowska, E.; Zawiejska, A.; Hill, D.; Rebollo, P.; Snoek, F.J.; van Poppel, M.N.M.

    2015-01-01

    OBJECTIVE Ways to prevent gestational diabetes mellitus (GDM) remain unproven. We compared the impact of three lifestyle interventions (healthy eating [HE], physical activity [PA], and both HE and PA [HE+PA]) on GDM risk in a pilot multicenter randomized trial. RESEARCH DESIGN AND METHODS Pregnant

  10. Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus

    DEFF Research Database (Denmark)

    Simmons, David; Jelsma, Judith G M; Galjaard, Sander

    2015-01-01

    OBJECTIVE: Ways to prevent gestational diabetes mellitus (GDM) remain unproven. We compared the impact of three lifestyle interventions (healthy eating [HE], physical activity [PA], and both HE and PA [HE+PA]) on GDM risk in a pilot multicenter randomized trial. RESEARCH DESIGN AND METHODS...

  11. Patient, lesion, and procedural variables as risk factors for luminal re-narrowing after successful coronary angioplasty: a quantitative analysis in 653 patients with 778 lesions. Multicenter European Research Trial with Cilazapril after Angioplasty to prevent Transluminal Coronary Obstruction and Restenosis (MERCATOR) Study Group

    NARCIS (Netherlands)

    Hermans, W. R.; Rensing, B. J.; Foley, D. P.; Tijssen, J. G.; Rutsch, W.; Emanuelsson, H.; Danchin, N.; Wijns, W.; Chappuis, F.; Serruys, P. W.

    1993-01-01

    Follow-up angiography at 6 months was obtained in 94% of the 693 patients (778 successfully dilated coronary lesions) enrolled in the Multicenter European Research trial with Cilazapril after Angioplasty to prevent Transluminal Coronary Obstruction and Restenosis (MERCATOR) trial--a double-blind,

  12. Validity of the rheumatoid arthritis impact of disease (RAID) score and definition of cut-off points for disease activity states in a population-based European cohort of patients with rheumatoid arthritis.

    Science.gov (United States)

    Salaffi, Fausto; Di Carlo, Marco; Vojinovic, Jelena; Tincani, Angela; Sulli, Alberto; Soldano, Stefano; Andreoli, Laura; Dall'Ara, Francesca; Ionescu, Ruxandra; Simić Pašalić, Katarina; Balčune, Ineta; Ferraz-Amaro, Iván; Tlustochowicz, Malgorzata; Butrimienė, Irena; Punceviciene, Egle; Toroptsova, Natalia; Grazio, Simeon; Morović-Vergles, Jadranka; Masaryk, Pavol; Otsa, Kati; Bernardes, Miguel; Boyadzhieva, Vladimira; Cutolo, Maurizio

    2017-05-24

    To assess the validity of the rheumatoid arthritis impact of disease (RAID) for measuring disease activity of rheumatoid arthritis (RA) and to determine cut-off values for defining the disease activity states. A total of 622 RA patients from an European database have been included. Cross-validation was based on assessment of convergent and discriminant validity. Optimal cut-offs were determined against external criteria by calculating the respective 25th and 75th percentiles mean values of RAID. External criteria included definitions for remission (REM), low disease activity (LDA), moderate disease activity (MDA) and high disease activity (HDA), cut-offs of the 28-joint disease activity score-C-reactive protein (DAS28-CRP) score. The RAID showed a moderate degree of correlation with respect to DAS28-CRP (rho=0.417; Pcut-off values for REM: RAID ≤3; for LDA: RAID >3 and ≤4; for MDA: RAID >4 and ≤6; for HDA: RAID >6. Mean RAID differed significantly between patients classified as REM, LDA, MDA or HDA (P=0.001). The cut-offs revealed good measurement characteristics in cross-validation analysis, had great discriminatory performance in distinguishing patients with different levels of disease activity and are suited for widespread use in everyday practice application and research. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  13. The decline of the impetigo epidemic caused by the epidemic European fusidic acid-resistant impetigo clone: an 11.5-year population-based incidence study from a community in Western Norway.

    Science.gov (United States)

    Rørtveit, Sverre; Skutlaberg, Dag Harald; Langeland, Nina; Rortveit, Guri

    2014-12-01

    From around the year 2000, Northern Europe experienced a rise in impetigo caused by Staphylococcus aureus resistant to fusidic acid. A single clone of S. aureus was found to be the bacterial pathogen involved in the impetigo outbreak in Norway, Sweden, the UK and Ireland, termed 'the epidemic European fusidic acid-resistant impetigo clone' (EEFIC). We have followed the incidence of impetigo during the years 2001-2012 based on all patients in general practice in the island community of Austevoll, Western Norway. We previously reported a marked decline of impetigo incidence in Austevoll, from 0.0260 cases per person-year in 2002 to 0.0038 in 2009. This article explores indications of an end to the impetigo epidemic caused by the EEFIC clone. All four general practitioners (GPs) in the community (mean population = 4400) were asked to diagnose impetigo in a uniform way and to take bacterial specimens from all impetigo cases. Phenotypic characteristics of specimen bacteria were determined for the whole period and molecular analyses were performed on isolates in the period 2008-2012. We observed a further decline in incidence of impetigo in Austevoll in the study period. The proportion of fusidic acid-resistant S. aureus isolates decreased during the period 2002-2012, with a mean of 80% in the epidemic years of 2002-2004, 55% in 2005-2009, and 6% in 2010-2012. In total, 44 S. aureus isolates from impetigo were subject to molecular analyses in the period 2008-2012, and 11 were found to be related to the EEFIC. All EEFIC isolates were found in 2008-2009, with no new isolates in 2010-2012. There is an apparent end to the impetigo epidemic related to the EEFIC in this population in Western Norway.

  14. Influenza vaccination coverage rates in 5 European countries: a population-based cross-sectional analysis of the seasons 02/03, 03/04 and 04/05.

    Science.gov (United States)

    Müller, D; Szucs, T D

    2007-10-01

    Influenza continues to be a considerable health problem in Europe. Vaccination is the only preventive measure, reducing mortality and morbidity of influenza in all age groups The objective of this survey was to assess and compare the level of influenza vaccination coverage during three consecutive influenza seasons (02/03, 03/04, 04/05) in the five European countries United Kingdom, France, Italy, Germany and Spain, understand the driving forces and barriers to vaccination now and 3 years ago and determine vaccination intentions for the following winter. We conducted a random-sampling, telephone-based household survey among non-institutionalized individuals representative of the population aged 14 and over. The surveys used the same questionnaire for all three seasons. The data were subsequently pooled. Four target groups were determined for analysis: (1) persons aged 65 and over; (2) people working in the medical field; (3) persons suffering from chronic illness and (4) a group composed of persons aged 65 and over or working in the medical field or suffering from a chronic illness. The overall sample consisted of 28,021 people. The influenza vaccination coverage rate increased from 21.0% in season 02/03 to 23.6% in season 03/04 and then to 23.7% in season 04/05. The differences between the seasons are statistically significant (p = 0.01). The highest rate over all countries and seasons had Germany in season 04/05 with 26.5%, Spain had in season 02/03 with 19.3% the lowest rate totally. The coverage rate in the target group composed of person's aged 65 and over or working in the medical field or suffering from a chronic illness was 49.7% in season 02-04 and 50.0% in season 04/05. The driving forces and barriers to vaccination did not change over the years. The most frequent reasons for being vaccinated given by vaccines were: influenza, considered to be a serious illness which people wanted to avoid, having received advise from the family doctor or nurse to be

  15. Evolving patterns in the diagnosis of reactive gastropathy: data from a prospective Central European multicenter study with proposal of a new histologic scoring system.

    Science.gov (United States)

    Wolf, Eva-Maria; Plieschnegger, Wolfgang; Schmack, Bertram; Bordel, Hartmut; Höfler, Bernd; Eherer, Andreas; Schulz, Tilman; Vieth, Michael; Langner, Cord

    2014-12-01

    Histologic examination of gastric biopsies is crucial for determining the cause of gastritis. This prospective multicenter study was undertaken to investigate different histologic parameters arguing in favor or against the diagnosis of reactive gastropathy and to correlate findings with patient's symptoms and endoscopic findings. A total of 1123 individuals aged 15-93 years participated in a prospective multicenter study (histoGERD trial). Diagnosis of Helicobacter gastritis was made following the Updated Sydney System. Diagnosis of reactive gastropathy was based upon Dixon's parameters of foveolar hyperplasia, smooth muscle fibers in the lamina propria and vasodilatation and congestion of mucosal capillaries. Including paucity of acute and chronic inflammatory cells in analysis, a new score with visual analog scales for the diagnosis of reactive gastropathy was developed. All three histologic parameters in favor of the diagnosis of reactive gastropathy were positively associated with the endoscopic diagnosis of gastritis (p acute and chronic inflammatory cells in lamina propria was positively associated with Helicobacter infection (p gastritis. Our score demonstrated strong association between histologic and endoscopic diagnoses (p < 0.001), yet not with patient's symptoms. In conclusion, our data prove foveolar hyperplasia, smooth muscle fibers and vasodilatation and congestion as key histologic parameters for the diagnosis of reactive gastropathy. The proposed score may enhance the diagnostic accuracy. It should be validated in future studies. Copyright © 2014 Elsevier GmbH. All rights reserved.

  16. Self-Care Practices for Common Colds by Primary Care Patients: Study Protocol of a European Multicenter Survey—The COCO Study

    National Research Council Canada - National Science Library

    Weltermann, Birgitta M; Gerasimovska-Kitanovska, Biljana; Thielmann, Anika; Chambe, Juliette; Lingner, Heidrun; Pirrotta, Enzo; Buczkowski, Krzysztof; Tekiner, Selda; Czachowski, Slawomir; Edirne, Tamer; Zielinski, Andrzej; Yikilkan, Hülya; Koskela, Tuomas; Petrazzuoli, Ferdinando; Hoffman, Robert D; Petek Šter, Marija; Guede Fernández, Clara; Uludağ, Ayşegül; Hoffmann, Kathryn; Mevsim, Vildan; Kreitmayer Pestic, Sanda

    2015-01-01

    Background. Self-care for common colds is frequent, yet little is known about the spectrum, regional differences, and potential risks of self-care practices in patients from various European regions. Methods/Design...

  17. A 10-year follow-up of the European multicenter trial of interferon beta-1b in secondary-progressive multiple sclerosis

    NARCIS (Netherlands)

    Kuhle, J.; Hardmeier, M.; Disanto, G.; Gugleta, K.; Ecsedi, M.; Lienert, C.; Amato, M. P.; Baum, K.; Buttmann, M.; Bayas, A.; Brassat, D.; Brochet, B.; Confavreux, C.; Edan, G.; Farkkila, M.; Fredrikson, S.; Frontoni, M.; D'Hooghe, M.; Hutchinson, M.; De Keyser, J.; Kieseier, B. C.; Kuempfel, T.; Rio, J.; Polman, C.; Roullet, E.; Stolz, C.; Vass, K.; Wandinger, K. P.; Kappos, L.

    Objectives: To explore long-term effects of treatment and prognostic relevance of variables assessed at baseline and during the European secondary progressive multiple sclerosis (SPMS) trial of interferon beta 1b (IFNB-1b). Methods: We assessed 362 patients (60% female; median age 41 years; Expanded

  18. Foldable Artiflex phakic intraocular lens for the correction of myopia: two-year follow-up results of a prospective European multicenter study.

    Science.gov (United States)

    Dick, H Burkhard; Budo, Camille; Malecaze, Francois; Güell, Josep L; Marinho, Antonio A P; Nuijts, Rudy M M A; Luyten, Gregorius P M; Menezo, Jose L; Kohnen, Thomas

    2009-04-01

    To evaluate the safety, efficacy, predictability, stability, and complications of the foldable Artiflex iris-fixated intraocular lens (Ophtec BV, Groningen, The Netherlands) for the correction of myopia in phakic eyes. Prospective, nonrandomized, open-label, multicenter trial. Two hundred ninety eyes of 191 patients aged 18 to 60 years with average spherical equivalent of -7.33+/-2.60 diopters (D; range, -12.63 to -1.5 D) were analyzed. All eyes underwent implantation of the foldable iris-fixated Artiflex phakic intraocular lens (PIOL) with an optic zone of 6 mm. The follow-up was 2 years. Phakic intraocular lenses were implanted in powers ranging from -2.0 to -12.0 D. The main parameters assessed were best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), refraction, and endothelial cell count. After 2 years, a UCVA of 20/40 or better was observed in 97.2% of eyes. The BSCVA was 20/40 or better in all eyes. A gain of 1 line or more of BSCVA was found in 49.9% of eyes, and 0.8% lost 2 or more lines. The mean endothelial cell change was -0.05%, 1.79%, and -1.07% at 6 months, 1 year, and 2 years, respectively. Complications were comparable with complications that have been reported previously of the Artisan PIOL, the only exception being a higher incidence of iris pigment precipitates (4.8% at 2 years after surgery). After 2 years of follow-up, the implantation of the foldable iris-fixated Artiflex intraocular lens proved to be effective and predictable for the correction of myopia in phakic eyes.

  19. Clinical effectiveness of hymenoptera venom immunotherapy: a prospective observational multicenter study of the European academy of allergology and clinical immunology interest group on insect venom hypersensitivity.

    Directory of Open Access Journals (Sweden)

    Franziska Ruëff

    Full Text Available BACKGROUND: Treatment failure during venom immunotherapy (VIT may be associated with a variety of risk factors. OBJECTIVE: Our aim was to evaluate the association of baseline serum tryptase concentration (BTC and of other parameters with the frequency of VIT failure during the maintenance phase. METHODS: In this observational prospective multicenter study, we followed 357 patients with established honey bee or vespid venom allergy after the maintenance dose of VIT had been reached. In all patients, VIT effectiveness was either verified by sting challenge (n = 154 or patient self-reporting of the outcome of a field sting (n = 203. Data were collected on BTC, age, gender, preventive use of anti-allergic drugs (oral antihistamines and/or corticosteroids right after a field sting, venom dose, antihypertensive medication, type of venom, side effects during VIT, severity of index sting reaction preceding VIT, and duration of VIT. Relative rates were calculated with generalized additive models. RESULTS: 22 patients (6.2% developed generalized symptoms during sting challenge or after a field sting. A strong association between the frequency of VIT failure and BTC could be excluded. Due to wide confidence bands, however, weaker effects (odds ratios <3 of BTC were still possible, and were also suggested by a selective analysis of patients who had a sting challenge. The most important factor associated with VIT failure was a honey bee venom allergy. Preventive use of anti-allergic drugs may be associated with a higher protection rate. INTERPRETATION: It is unlikely that an elevated BTC has a strong negative effect on the rate of treatment failures. The magnitude of the latter, however, may depend on the method of effectiveness assessment. Failure rate is higher in patients suffering from bee venom allergy.

  20. Clinical effectiveness of hymenoptera venom immunotherapy: a prospective observational multicenter study of the European academy of allergology and clinical immunology interest group on insect venom hypersensitivity.

    Science.gov (United States)

    Ruëff, Franziska; Przybilla, Bernhard; Biló, Maria Beatrice; Müller, Ulrich; Scheipl, Fabian; Seitz, Michael J; Aberer, Werner; Bodzenta-Lukaszyk, Anna; Bonifazi, Floriano; Campi, Paolo; Darsow, Ulf; Haeberli, Gabrielle; Hawranek, Thomas; Küchenhoff, Helmut; Lang, Roland; Quercia, Oliviero; Reider, Norbert; Schmid-Grendelmeier, Peter; Severino, Maurizio; Sturm, Gunter Johannes; Treudler, Regina; Wüthrich, Brunello

    2013-01-01

    Treatment failure during venom immunotherapy (VIT) may be associated with a variety of risk factors. Our aim was to evaluate the association of baseline serum tryptase concentration (BTC) and of other parameters with the frequency of VIT failure during the maintenance phase. In this observational prospective multicenter study, we followed 357 patients with established honey bee or vespid venom allergy after the maintenance dose of VIT had been reached. In all patients, VIT effectiveness was either verified by sting challenge (n = 154) or patient self-reporting of the outcome of a field sting (n = 203). Data were collected on BTC, age, gender, preventive use of anti-allergic drugs (oral antihistamines and/or corticosteroids) right after a field sting, venom dose, antihypertensive medication, type of venom, side effects during VIT, severity of index sting reaction preceding VIT, and duration of VIT. Relative rates were calculated with generalized additive models. 22 patients (6.2%) developed generalized symptoms during sting challenge or after a field sting. A strong association between the frequency of VIT failure and BTC could be excluded. Due to wide confidence bands, however, weaker effects (odds ratios honey bee venom allergy. Preventive use of anti-allergic drugs may be associated with a higher protection rate. It is unlikely that an elevated BTC has a strong negative effect on the rate of treatment failures. The magnitude of the latter, however, may depend on the method of effectiveness assessment. Failure rate is higher in patients suffering from bee venom allergy.

  1. Self-Care Practices for Common Colds by Primary Care Patients: Study Protocol of a European Multicenter Survey—The COCO Study

    Directory of Open Access Journals (Sweden)

    Birgitta M. Weltermann

    2015-01-01

    Full Text Available Background. Self-care for common colds is frequent, yet little is known about the spectrum, regional differences, and potential risks of self-care practices in patients from various European regions. Methods/Design. We describe the study protocol for a cross-sectional survey in 27 primary care centers from 14 European countries. At all sites, 120 consecutive adult patients, who visit their general practitioner for any reason, filled in a self-administered 27-item questionnaire. This addresses patients’ self-care practices for common colds. Separately, the subjective level of discomfort when having a common cold, knowing about the diseases’ self-limited nature, and medical and sociodemographic data are requested. Additionally, physicians are surveyed on their use of and recommendations for self-care practices. We are interested in investigating which self-care practices for common colds are used, whether the number of self-care practices used is influenced by knowledge about the self-limited nature of the disease, and the subjective level of discomfort when having a cold and to identify potential adverse interactions with chronic physician-prescribed medications. Further factors that will be considered are, for example, demographic characteristics, chronic conditions, and sources of information for self-care practices. All descriptive and analytical statistics will be performed on the pooled dataset and stratified by country and site. Discussion. To our knowledge, COCO is the first European survey on the use of self-care practices for common colds. The study will provide new insight into patients’ and general practitioners’ self-care measures for common colds across Europe.

  2. Representativeness in population-based studies

    DEFF Research Database (Denmark)

    Drivsholm, Thomas Bo; Eplov, Lene Falgaard; Davidsen, Michael

    2006-01-01

    Decreasing rates of participation in population-based studies increasingly challenge the interpretation of study results, in both analytic and descriptive epidemiology. Consequently, estimates of possible differences between participants and non-participants are increasingly important...

  3. Trends in the use of partial nephrectomy for cT1 renal tumors: Analysis of a 10-yr European multicenter dataset.

    Science.gov (United States)

    Simone, G; De Nunzio, C; Ferriero, M; Cindolo, L; Brookman-May, S; Papalia, R; Sperduti, I; Collura, D; Leonardo, C; Anceschi, U; Tuderti, G; Misuraca, L; Dalpiaz, O; Hatzl, S; Lodde, M; Trenti, E; Pastore, A L; Palleschi, G; Lotrecchiano, G; Salzano, L; Carbone, A; De Cobelli, O; Tubaro, A; Schips, L; Zigeuner, R; Tostain, J; May, M; Guaglianone, S; Muto, G; Gallucci, M

    2016-11-01

    Although extensively addressed in US registries, the utilization rate of Partial Nephrectomy has been poorly addressed in European settings. Our aim is to evaluate the impact of hospital volume on the use of PN for cT1 renal tumors. 2526 patients with cT1N0M0 renal tumors treated with either PN or radical nephrectomy at 10 European centres in the last decade were included in the analysis. Joinpoint regression analysis was used to identify significant changes over time in linear slope of the trend for each center. The correlation between yearly caseload and the slopes was assessed with the non-parametric Spearman test. Coincident pairwise tests and regression analyses were used to generate and compare the trends of high-volume (HV), mid-volume (MV) and low-volume (LV) groups. Yearly caseload was significantly associated with increased use of PN (R = 0.69, p = 0.028). The utilization rate of PN was stable at LV centres (p = 0.67, p = 0.7, p = 0.76, for cT1, cT1a, and cT1b tumors, respectively), while increased significantly at MV (p = 0.002, 0.0005 and 0.007, respectively) and HV centers (all p < 0.0001). Regression analysis confirmed the trends for HV and MV as significantly different from those observed in LV centres (all p ≤ 0.002) and highlighted significant differences also between MV and HV centres (all p ≤ 0.03). We confirmed the association between caseload and the use of PN for cT1 tumors. Our findings suggest that a minimum caseload might turn the tide also in LV centres while a selective referral to HV centers for cT1b tumors should be considered. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Self-Care for Common Colds by Primary Care Patients: A European Multicenter Survey on the Prevalence and Patterns of Practices—The COCO Study

    Directory of Open Access Journals (Sweden)

    Anika Thielmann

    2016-01-01

    Full Text Available Background. Patients use self-care to relieve symptoms of common colds, yet little is known about the prevalence and patterns across Europe. Methods/Design. In a cross-sectional study 27 primary care practices from 14 countries distributed 120 questionnaires to consecutive patients (≥18 years, any reason for consultation. A 27-item questionnaire asked for patients’ self-care for their last common cold. Results. 3,074 patients from 27 European sites participated. Their mean age was 46.7 years, and 62.5% were females. 99% of the participants used ≥1 self-care practice. In total, 527 different practices were reported; the age-standardized mean was 11.5 (±SD 6.0 per participant. The most frequent self-care categories were foodstuffs (95%, extras at home (81%, preparations for intestinal absorption (81%, and intranasal applications (53%. Patterns were similar across all sites, while the number of practices varied between and within countries. The most frequent single practices were water (43%, honey (42%, paracetamol (38%, oranges/orange juice (38%, and staying in bed (38%. Participants used 9 times more nonpharmaceutical items than pharmaceutical items. The majority (69% combined self-care with and without proof of evidence, while ≤1% used only evidence-based items. Discussion. This first cross-national study on self-care for common colds showed a similar pattern across sites but quantitative differences.

  5. A prospective, multicenter, observational study on quality of life after laparoscopic inguinal hernia repair with ProGrip laparoscopic, self-fixating mesh according to the European Registry for Abdominal Wall Hernias Quality of Life Instrument.

    Science.gov (United States)

    Muysoms, Filip E; Vanlander, Aude; Ceulemans, Robrecht; Kyle-Leinhase, Iris; Michiels, Maarten; Jacobs, Ivo; Pletinckx, Pieter; Berrevoet, Frederik

    2016-11-01

    There is an increasing interest in patient-reported outcome measurement to evaluate hernia operations. Several hernia-specific quality of life (QoL) scales have been proposed, but none are constructed for preoperative assessment. The European Registry for Abdominal Wall Hernias (EuraHS) proposed the short, 9-question EuraHS-QoL instrument for assessment pre- and postoperatively. The EuraHS-QoL was evaluated in a prospective, multicenter validation study alongside the Visual Analogue Scale, Verbal Rating Scale, and Carolina Comfort Scale (https://clinicaltrials.gov; NCT01936584). We included 101 patients undergoing unilateral laparoscopic inguinal hernia repair with ProGrip laparoscopic, self-fixating mesh. Clinical follow-up at 12 months was 87% complete. The EuraHS-QoL score shows good internal consistency (Cronbach's α ≥ .90), good test-retest reliability (Spearman correlation coefficient r ≥ 0.72), and high correlation for pain with the Visual Analogue Scale, the Verbal Rating Scale, the Carolina Comfort Scale pain scale (r between 0.64 and 0.86), and for restriction of activity with the Carolina Comfort Scale movement scale (r between 0.65 and 0.79). Our results show significant improvement in quality of life at 3 weeks compared with preoperative and further significant improvement at 12 months (P 75%) or with a 95%) in the majority of the patients. The EuraHS-QoL instrument is a short and valid patient-reported outcome measurement following groin hernia repair. Laparoscopic inguinal hernia repair with ProGrip laparoscopic, self-fixating mesh results in a favorable outcome and significant improvement of quality of life compared with the preoperative assessment. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Aspiration Therapy As a Tool to Treat Obesity: 1- to 4-Year Results in a 201-Patient Multi-Center Post-Market European Registry Study.

    Science.gov (United States)

    Nyström, Max; Machytka, Evzen; Norén, Erik; Testoni, Pier Alberto; Janssen, Ignace; Turró Homedes, Jesus; Espinos Perez, Jorge Carlos; Turro Arau, Roman

    2018-02-01

    The objective of this post-market study was to evaluate long-term safety and efficacy of aspiration therapy (AT) in a clinical setting in five European clinics. The AspireAssist® System (Aspire Bariatrics, Inc. King of Prussia, PA) is an endoscopic weight loss therapy utilizing a customized percutaneous endoscopic gastrostomy tube and an external device to aspirate approximately 30% of ingested calories after a meal, in conjunction with lifestyle counseling. A total of 201 participants, with body mass index (BMI) of 35.0-70.0 kg/m2, were enrolled in this study from June 2012 to December 2016. Mean baseline BMI was 43.6 ± 7.2 kg/m2. Mean percent total weight loss at 1, 2, 3, and 4 years, respectively, was 18.2% ± 9.4% (n/N = 155/173), 19.8% ± 11.3% (n/N = 82/114), 21.3% ± 9.6% (n/N = 24/43), and 19.2% ± 13.1% (n/N = 12/30), where n is the number of measured participants and N is the number of participants in the absence of withdrawals or lost to follow-up. Clinically significant reductions in glycated hemoglobin (HbA1C), triglycerides, and blood pressure were observed. For participants with diabetes, HbA1C decreased by 1% (P < 0.0001) from 7.8% at baseline to 6.8% at 1 year. The only serious complications were buried bumpers, experienced by seven participants and resolved by removal/replacement of the A-Tube, and a single case of peritonitis, resolved with a 2-day course of intravenous antibiotics. This study establishes that aspiration therapy is a safe, effective, and durable weight loss therapy in people with classes II and III obesity in a clinical setting. ISRCTN 49958132.

  7. Responsiveness and clinically meaningful improvement, according to disability level, of five walking measures after rehabilitation in multiple sclerosis: a European multicenter study.

    Science.gov (United States)

    Baert, Ilse; Freeman, Jennifer; Smedal, Tori; Dalgas, Ulrik; Romberg, Anders; Kalron, Alon; Conyers, Helen; Elorriaga, Iratxe; Gebara, Benoit; Gumse, Johanna; Heric, Adnan; Jensen, Ellen; Jones, Kari; Knuts, Kathy; Maertens de Noordhout, Benoît; Martic, Andrej; Normann, Britt; Eijnde, Bert O; Rasova, Kamila; Santoyo Medina, Carmen; Truyens, Veronik; Wens, Inez; Feys, Peter

    2014-09-01

    Evaluation of treatment effects on walking requires appropriate and responsive outcome measures. To determine responsiveness of 5 walking measures and provide reference values for clinically meaningful improvements, according to disability level, in persons with multiple sclerosis (pwMS). Walking tests were measured pre- and postrehabilitation in 290 pwMS from 17 European centers. Combined anchor- and distribution-based methods determined responsiveness of objective short and long walking capacity tests (Timed 25-Foot Walk [T25FW] and 2- and 6-Minute Walk Tests [2MWT and 6MWT] and of the patient-reported Multiple Sclerosis Walking Scale-12 [MSWS-12]). A global rating of change scale, from patients' and therapists' perspective, was used as external criteria to determine the area under the receiver operating characteristic curve (AUC), minimally important change (MIC), and smallest real change (SRC). Patients were stratified into disability subgroups (Expanded Disability Status Scale score ≤4 [n = 98], >4 [n = 186]). MSWS-12, 2MWT, and 6MWT were more responsive (AUC 0.64-0.73) than T25FW (0.50-0.63), especially in moderate to severely disabled pwMS. Clinically meaningful changes (MICs) from patient and therapist perspective were -10.4 and -11.4 for MSWS-12 (P < .01), 9.6 m and 6.8 m for 2MWT (P < .05), and 21.6 m (P < .05) and 9.1 m (P = .3) for 6MWT. In subgroups, MIC was significant from patient perspective for 2MWT (10.8 m) and from therapist perspective for MSWS-12 (-10.7) in mildly disabled pwMS. In moderate to severely disabled pwMS, MIC was significant for MSWS-12 (-14.1 and -11.9). Long walking tests and patient-reported MSWS-12 were more appropriate than short walking tests in detecting clinically meaningful improvement after physical rehabilitation, particularly the MSWS-12 for moderate to severely disabled pwMS. © The Author(s) 2014.

  8. A Population-Based Study of Effects of Genetic Loci on Orofacial Clefts

    DEFF Research Database (Denmark)

    Moreno Uribe, L M; Fomina, T; Munger, R G

    2017-01-01

    the effects of 17 top loci on cleft types in both isolated and nonisolated cases in the largest consortium to date of European-descent population-based studies. Our analytic approach focused on a mother-child dyad case-control design, but it also allowed analyzing mother-only or child-only genotypes...

  9. Phenotyping asthma, rhinitis and eczema in MeDALL population-based birth cohorts

    DEFF Research Database (Denmark)

    Garcia-Aymerich, J; Benet, M; Saeys, Y

    2015-01-01

    at 4 years and 14 585 at 8 years from seven European population-based birth cohorts (MeDALL project). At each age period, children were grouped, using partitioning cluster analysis, according to the distribution of 23 variables covering symptoms 'ever' and 'in the last 12 months', doctor diagnosis, age...

  10. Comparison between zofenopril and ramipril in combination with acetylsalicylic acid in patients with left ventricular systolic dysfunction after acute myocardial infarction: results of a randomized, double-blind, parallel-group, multicenter, European study (SMILE-4).

    Science.gov (United States)

    Borghi, Claudio; Ambrosioni, Ettore; Novo, Salvatore; Vinereanu, Dragos; Ambrosio, Giuseppe

    2012-01-01

    Angiotensin-converting enzyme inhibitors (ACEIs) are largely employed for treating patients with left ventricular dysfunction (LVD), but their efficacy may be negatively affected by concomitant administration of acetylsalicylic acid (ASA), with some difference among the different compounds. The interaction between ASA and the two ACEIs zofenopril and ramipril may result in a different impact on survival of cardiac patients, due to differences in the pharmacological properties of the two ACEIs. This phase IIIb, randomized, double-blind, parallel-group, multicenter, European study compared the safety and efficacy of zofenopril (60 mg/day) and ramipril (10 mg/day) plus ASA (100 mg/day), in 771 patients with LVD (clinical signs of heart failure or a left ventricular ejection fraction <45%) following acute myocardial infarction (AMI). The primary study end point was 1-year combined occurrence of death or hospitalization for cardiovascular causes. In the intention-to-treat population, the primary outcome was significantly reduced by zofenopril (n = 365) vs ramipril (n = 351) (odds ratio [OR]: 0.70, and 95% confidence interval [CI]: 0.51-0.96; P = 0.028) as a result of a decrease in cardiovascular hospitalization (OR: 0.64,95% CI: 0.46-0.88; P = 0.006). Mortality rate was not significantly different between the 2 treatments (OR: 1.51, 95% CI: 0.70-3.27; P = 0.293). Blood pressure values did not significantly change during the 1-year follow-up. N-terminal pro-brain natriuretic peptide levels were progressively reduced during the study, with no statistically significant between-treatment differences. Proportion of patients with deterioration of renal function during the study was similar between the 2 groups. Drug safety profile was comparable between treatments. In patients with LVD following AMI, the efficacy of zofenopril associated with ASA was superior to that of ramipril plus ASA, indicating some important clinical implications for the future use of ACEIs in patients

  11. Allogeneic stem cell transplantation after reduced-intensity conditioning in patients with myelofibrosis: a prospective, multicenter study of the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation.

    NARCIS (Netherlands)

    Kroger, N.; Holler, E.; Kobbe, G.; Bornhauser, M.; Schwerdtfeger, R.; Baurmann, H.; Nagler, A.; Bethge, W.; Stelljes, M.; Uharek, L.; Wandt, H.; Burchert, A.; Corradini, P.; Schubert, J.; Kaufmann, Martin; Dreger, P.; Wulf, G.G.; Einsele, H.; Zabelina, T.; Kvasnicka, H.M.; Thiele, J.; Brand, R.; Zander, A.R.; Niederwieser, D.; Witte, T.J.M. de

    2009-01-01

    From 2002 to 2007, 103 patients with primary myelofibrosis or postessential thrombocythemia and polycythemia vera myelofibrosis and a median age of 55 years (range, 32-68 years) were included in a prospective multicenter phase 2 trial to determine efficacy of a busulfan (10 mg/kg)/fludarabine (180

  12. [The effectiveness of population-based breast cancer screening programme].

    Science.gov (United States)

    Szynglarewicz, Bartłomiej; Matkowski, Rafał; Kasprzak, Piotr; Kotowska, Jolanta; Forgacz, Józef; Pudełko, Marek; Kornafel, Jan

    2009-02-01

    Well-organised mammography screening programme can significantly reduce the breast cancer mortality However, changes in mortality rates take a long time thus some early indicators are usually used to monitor the effectiveness of the programme. If these operational objectives are accomplished then the programme can replicate the mortality reduction achieved in randomised trials. To evaluate the quality of breast cancer screening programme in the region of Lower Silesia during the first year of its operating. Centrally organised breast cancer screening has been introduced since the beginning of the year 2007. This population-based programme is designed for women aged 50-69. Females undergoing treatment or being followed-up due to breast cancer are not invited. Screen-film two-view mammography without clinical examination is used as a screening test which is to be performed every two years. The second level diagnostic tools are breast clinical examination and additional imaging (mammography and ultrasound). Following further assessment women are referred to the examination at the routine round length of the programme, at the less interval (short-term recall) or biopsy procedures. Quality assessment was done via early indicators according to the European guidelines. The attendance rate was 41% (79,143 women screened within 192,613 eligible population for one year). Technical repeat rate, further assessment rate, and short-term recall rate were: 0.26%, 6.85%, and 0.91%, respectively. Pathologically confirmed breast cancer was revealed in 364 women giving the detection rate 4.59 for 1000. Cancer detection rate to expected incidence ratio was 3.35. Mammography service performed during the first year of breast cancer screening programme in the region of Lower Silesia conforms to quality assessment parameters recommended by the European guidelines at the acceptable level. The main problem at the start of this programme is too low coverage. Invitation process must be

  13. Psychiatric comorbidities in children and adolescents with psoriasis - a population-based cohort study

    DEFF Research Database (Denmark)

    Todberg, T; Egeberg, A; Jensen, P

    2017-01-01

    Psoriasis is present in 2-3% of the adult European population(1) and 0.7-1.2% in children(1,2) . Adults with psoriasis have increased risk of depression(3) , and US data reported an increased risk of psychiatric diseases in pediatrics with psoriasis(4) , however European data are lacking. Primary...... outcomes were to examine the risk of psychiatric disorders including use of psychopharmacotherapy in children with psoriasis compared to healthy controls in a population-based cohort study. This article is protected by copyright. All rights reserved.......Psoriasis is present in 2-3% of the adult European population(1) and 0.7-1.2% in children(1,2) . Adults with psoriasis have increased risk of depression(3) , and US data reported an increased risk of psychiatric diseases in pediatrics with psoriasis(4) , however European data are lacking. Primary...

  14. Population-based Analysis of Bronchiolitis Epidemiology in Valencia, Spain.

    Science.gov (United States)

    Muñoz-Quiles, Cintia; López-Lacort, Mónica; Úbeda-Sansano, Isabel; Alemán-Sánchez, Sara; Pérez-Vilar, Silvia; Puig-Barberà, Joan; Díez-Domingo, Javier

    2016-03-01

    There is a lack of European epidemiologic population-based studies on bronchiolitis and respiratory syncytial virus (RSV) bronchiolitis including both hospitalizations and primary care attendance. A retrospective cohort of all children born between 2009 and 2012 was followed from birth to 2 years of age using population and health databases. We searched for global bronchiolitis (International Classification of Diseases, 9th revision, Clinical Modification codes 466.1, 466.11 and 466.19) and RSV bronchiolitis (code 466.11 and code 466.19 with positive RSV test) in the first appearance either in primary care or in hospitalization databases. A preterm subcohort (International Classification of Diseases, 9th revision, Clinical Modification codes 765) was also analyzed. The cohort consisted of 198,223 children of whom 41,479 were diagnosed of bronchiolitis (incidence rate 16.4/100 children infants, hospitalization incidence was more than double, and the mean length of hospitalization was 29% longer. Most (87%) bronchiolitis cases are managed in primary care offices. Approximately 2 out of every 10 children bronchiolitis, 3 out of every 100 are hospitalized and 1.6 out of every 100 are hospitalized with RSV bronchiolitis in our cohort. Infants between 2 and 10 weeks constitute a risk group for severe bronchiolitis.

  15. Meckel-Gruber Syndrome : a population-based study on prevalence, prenatal diagnosis, clinical features, and survival in Europe

    NARCIS (Netherlands)

    Barisic, Ingeborg; Boban, Ljubica; Loane, Maria; Garne, Ester; Wellesley, Diana; Calzolari, Elisa; Dolk, Helen; Addor, Marie-Claude; Bergman, Jorieke E. H.; Braz, Paula; Draper, Elizabeth S.; Haeusler, Martin; Khoshnood, Babak; Klungsoyr, Kari; Pierini, Anna; Queisser-Luft, Annette; Rankin, Judith; Rissmann, Anke; Verellen-Dumoulin, Christine

    Meckel-Gruber Syndrome is a rare autosomal recessive lethal ciliopathy characterized by the triad of cystic renal dysplasia, occipital encephalocele and postaxial polydactyly. We present the largest population-based epidemiological study to date using data provided by the European Surveillance of

  16. Population-based register of acute myocardial infarction: manual of operations

    DEFF Research Database (Denmark)

    Madsen, Mette; Gudnason, Vilmundur; Pajak, Andrzej

    2007-01-01

    available in most European countries.Innovations in medical, invasive and biological treatments have substantially contributed to the escalating costs of health services. It is therefore urgent to obtain reliable information on the magnitude and distribution of the disease for both adequate health planning...... model for the implementation of a population-based register. It recommends to start from a minimum data set and then follow a stepwise procedure.Before implementing a population-based register, it is important to identify the target population under surveillance which should preferably cover a well......-defined geographical and administrative area or region representative of the whole country for which population data and vital statistics (mortality and hospital discharge records at minimum) are routinely collected and easily available each year. All cases among residents should be recorded even if the case occurs...

  17. Allogeneic stem cell transplantation after reduced-intensity conditioning in patients with myelofibrosis: a prospective, multicenter study of the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation.

    Science.gov (United States)

    Kröger, Nicolaus; Holler, Ernst; Kobbe, Guido; Bornhäuser, Martin; Schwerdtfeger, Rainer; Baurmann, Herrad; Nagler, Arnon; Bethge, Wolfgang; Stelljes, Matthias; Uharek, Lutz; Wandt, Hannes; Burchert, Andreas; Corradini, Paolo; Schubert, Jörg; Kaufmann, Martin; Dreger, Peter; Wulf, Gerald G; Einsele, Hermann; Zabelina, Tatjana; Kvasnicka, Hans Michael; Thiele, Jürgen; Brand, Ronald; Zander, Axel R; Niederwieser, Dietger; de Witte, Theo M

    2009-12-17

    From 2002 to 2007, 103 patients with primary myelofibrosis or postessential thrombocythemia and polycythemia vera myelofibrosis and a median age of 55 years (range, 32-68 years) were included in a prospective multicenter phase 2 trial to determine efficacy of a busulfan (10 mg/kg)/fludarabine (180 mg/m(2))-based reduced-intensity conditioning regimen followed by allogeneic stem cell transplantation from related (n = 33) or unrelated donors (n = 70). All but 2 patients (2%) showed leukocyte and platelet engraftment after a median of 18 and 22 days, respectively. Acute graft-versus-host disease grade 2 to 4 occurred in 27% and chronic graft-versus-host disease in 43% of the patients. Cumulative incidence of nonrelapse mortality at 1 year was 16% (95% confidence interval, 9%-23%) and significantly lower for patients with a completely matched donor (12% vs 38%; P = .003). The cumulative incidence of relapse at 3 years was 22% (95% confidence interval, 13%-31%) and was influenced by Lille risk profile (low, 14%; intermediate, 22%; and high, 34%; P = .02). The estimated 5-year event-free and overall survival was 51% and 67%, respectively. In a multivariate analysis, age older than 55 years (hazard ratio = 2.70; P = .02) and human leukocyte antigen-mismatched donor (hazard ratio = 3.04; P = .006) remained significant factors for survival. The study was registered at www.clinicaltrials.gov as #NCT 00599547.

  18. Determinants of successful implementation of population-based cancer screening programmes

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Törnberg, Sven; von Karsa, Lawrence

    2012-01-01

    consider when planning, implementing and running population based cancer screening programmes. The list is general and is applicable to breast, cervical and colorectal cancer screening. It is based on evidence presented in the three European Union guidelines on quality assurance in cancer screening......) piloting or trial implementation, (5) scaling up from pilot to service, (6) running of full-scale programme, and (7) sustainability. For each phase, a substantial number of specified conditions have to be met. Successful implementation of a cancer screening programme requires societal acceptance and local...

  19. Interim Feed The Future Population Based Assessment of Cambodia

    Data.gov (United States)

    US Agency for International Development — This is the interim population based survey of Feed the Future in Cambodia for 2015. The data is split into survey modules. Modules A through C includes location...

  20. Beta Blockers and Breast Cancer Mortality: A Population- Based Study

    National Research Council Canada - National Science Library

    Thomas I. Barron; Roisin M. Connolly; Linda Sharp; Kathleen Bennett; Kala Visvanathan

    2011-01-01

    .... A series of population-based observational studies were conducted to examine associations between beta blocker use and breast tumor characteristics at diagnosis or breast cancer-specific mortality...

  1. Multicenter data acquisition made easy

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Henriksen, Nadia Abdelaal; Jørgensen, Lars Nannestad

    2010-01-01

    The process for data collection in multicenter trials may be troublesome and expensive. We report our experience with the spreadsheet function in Googledocs for this purpose.......The process for data collection in multicenter trials may be troublesome and expensive. We report our experience with the spreadsheet function in Googledocs for this purpose....

  2. Association between restless legs syndrome and migraine: a population-based study.

    Science.gov (United States)

    Zanigni, Stefano; Giannini, Giulia; Melotti, Roberto; Pattaro, Cristian; Provini, Federica; Cevoli, Sabina; Facheris, Maurizio F; Cortelli, Pietro; Pramstaller, Peter P

    2014-09-01

    A higher prevalence of restless legs syndrome (RLS) in migraineurs has been reported in clinical samples and in two large-scale clinical trials performed on healthcare workers but general population-based studies on this topic are lacking. The aim of this study was to assess the association between migraine and RLS in an Italian rural adult population-based setting. The presence of migraine and RLS was assessed via a computer-assisted personal interview and self-administered questionnaires according to current diagnostic criteria in 1567 participants of a preliminary phase of an adult population-based study performed in South Tyrol, Italy. Migraineurs had an increased risk of having RLS also after adjustment for confounding factors such as age, sex, major depression, anxiety and sleep quality (odds ratio 1.79; confidence interval 1.00-3.19; P = 0.049). This association was not modified by aura status and possible causes of secondary RLS. RLS was not significantly associated with tension-type headache. Restless legs syndrome and migraine were associated in our rural adult population. This association could be explained by a possible shared pathogenic pathway which would implicate new management strategies of these two disorders. © 2014 The Author(s) European Journal of Neurology © 2014 EAN.

  3. Thrombolysis for acute ischaemic stroke with alteplase in an Asian population: results of the multicenter, multinational Safe Implementation of Thrombolysis in Stroke-Non-European Union World (SITS-NEW).

    Science.gov (United States)

    Rha, Joung-Ho; Shrivastava, Vasantha Padma; Wang, Yongjun; Lee, Kim En; Ahmed, Niaz; Bluhmki, Erich; Hermansson, Karin; Wahlgren, Nils

    2014-10-01

    Safe Implementation of Thrombolysis in Stroke-Non-European Union World was a multinational, prospective, open, monitored, observational study of intravenous alteplase as thrombolytic therapy in clinical practice. Safe Implementation of Thrombolysis in Stroke-Non-European Union World was required to assess the safety of alteplase in an Asian population by comparison with results from the European Safe Implementation of Thrombolysis in Stroke-Monitoring Study and pooled results from randomized controlled trials. To evaluate the efficacy and safety of intravenous alteplase (0·9 mg/kg) as thrombolytic therapy within three-hours of onset of acute ischaemic stroke in an Asian population. The 591 patients included were treated at 48 centers in four countries (South Korea, China, India, and Singapore) between 2006 and 2008. Primary outcomes were symptomatic (deterioration in National Institutes of Health Stroke Scale score ≥4 or death within the first 24 h) intracerebral haemorrhage type 2 22-36 h after the thrombolysis and mortality at three-month follow-up. The secondary outcome was functional independence (modified Rankin Scale score 0-2) at three-months. Results were compared with those from Safe Implementation of Thrombolysis in Stroke-Monitoring Study (n = 6483) and pooled results of patients (n = 415) who received intravenous alteplase (0·9 mg/kg) zero- to three-hours from onset of stroke symptoms in four randomized controlled trials (National Institute of Neurological Disorders and Stroke A and B, Altephase Thrombolysis for Acute Noninterventional Therapy in Ischaemic Stroke, and European Cooperative Acute Stroke Study II). Results are presented as Safe Implementation of Thrombolysis in Stroke-Non-European Union World vs. Safe Implementation of Thrombolysis in Stroke-Monitoring Study vs. pooled randomized controlled trials. Median age was 64 vs. 68 vs. 70 years, National Institutes of Health Stroke Scale score at baseline was 12 vs. 12 vs. 13

  4. Nationwide and population-based prescription patterns in bipolar disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2016-01-01

    OBJECTIVES: The aim of the present study was to describe prescription patterns and changes in these patterns over the last decade for patients diagnosed with bipolar disorder in mental healthcare, using population-based and nationwide data, and to relate the findings to recommendations from...... international guidelines. METHODS: A population-based, nationwide study was carried out. It included register-based longitudinal data on all patients with a first-ever contact with mental healthcare with a diagnosis of mania/bipolar disorder from the entire Danish population, and all prescription data...

  5. QTL mapping for combining ability in different population-based ...

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Genetics; Volume 92; Issue 3. QTL mapping for combining ability in different population-based NCII designs: a simulation study. Lanzhi Li Congwei Sun ... The NCII design (North Carolina mating design II) has been widely applied in studies of combining ability and heterosis. The objective of our ...

  6. Population Based Survey of Chronic Non-Communicable Diseases ...

    African Journals Online (AJOL)

    Population Based Survey of Chronic Non-Communicable Diseases at Gilgel Gibe Field Research Center, Southwest Ethiopia. ... Blood pressure was taken three times from each individual and blood sugar and lipid levels were determined after an overnight fasting. Data were analyzed using SPSS for Windows version 16.0 ...

  7. Socioeconomic inequalities in homicide mortality: a population-based comparative study of 12 European countries

    NARCIS (Netherlands)

    Stickley, Andrew; Leinsalu, Mall; Kunst, Anton E.; Bopp, Matthias; Strand, Bjørn Heine; Martikainen, Pekka; Lundberg, Olle; Kovács, Katalin; Artnik, Barbara; Kalediene, Ramune; Rychtaříková, Jitka; Wojtyniak, Bogdan; Mackenbach, Johan P.

    2012-01-01

    Recent research has suggested that violent mortality may be socially patterned and a potentially important source of health inequalities within and between countries. Against this background the current study assessed socioeconomic inequalities in homicide mortality across Europe. To do this,

  8. Multicenter population-based study on the prevalence of early onset dementia in Japan: vascular dementia as its prominent cause.

    Science.gov (United States)

    Ikejima, Chiaki; Ikeda, Manabu; Hashimoto, Mamoru; Ogawa, Yusuke; Tanimukai, Satoshi; Kashibayashi, Tetsuo; Miyanaga, Kazuo; Yonemura, Kimie; Kakuma, Tatsuyuki; Murotani, Kenta; Asada, Takashi

    2014-03-01

    In Japan, the government and media have become aware of the issues of early onset dementia (EOD), but policies for EOD have not yet been established and support systems are inadequate. To provide practical data about EOD, a two-step postal survey was performed. A questionnaire requesting information on EOD cases was sent to target institutions in five catchment areas in Japan. According to the answers from the institutions, we estimated the prevalence of EOD using census data and determined the illnesses causing EOD. As a quality control study, the authors reviewed every diagnosis in a quarter of the reported cases using the medical and psychiatric records and neuroimaging data. This study was conducted from 2006 to 2007. Information from 2469 patients was collected from 12,747 institutions, and 2059 subjects with EOD were identified. The estimated prevalence of EOD was 47.6 per 100,000 (95% confidence interval, 47.1-48.1) for all of Japan. Of the illnesses causing EOD, vascular dementia (VaD) was the most frequent (39.8%), followed by Alzheimer's disease. The prevalence of EOD in Japan appeared to be similar to that in Western countries. However, unlike previously reported international experience, VaD was the most frequent cause of EOD in all catchment areas in Japan. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.

  9. Prevalence of microcephaly in Europe : population based study

    NARCIS (Netherlands)

    Morris, Joan K.; Rankin, Judith; Garne, Ester; Loane, Maria; Greenlees, Ruth; Addor, Marie-Claude; Arriola, Larraitz; Barisic, Ingeborg; Bergman, Jorieke E. H.; Csaky-Szunyogh, Melinda; Dias, Carlos; Draper, Elizabeth S.; Gatt, Miriam; Khoshnood, Babak; Klungsoyr, Kari; Kurinczuk, Jennifer J.; Lynch, Catherine; McDonnell, Robert; Nelen, Vera; Neville, Amanda J.; O'Mahony, Mary T.; Pierini, Anna; Randrianaivo, Hanitra; Rissmann, Anke; Tucker, David; Verellen-Dumoulin, Christine; de Walle, Hermien E. K.; Wellesley, Diana; Wiesel, Awi; Dolk, Helen

    2016-01-01

    OBJECTIVES To provide contemporary estimates of the prevalence of microcephaly in Europe, determine if the diagnosis of microcephaly is consistent across Europe, and evaluate whether changes in prevalence would be detected using the current European surveillance performed by EUROCAT (the European

  10. Alternative antibody for the detection of CA15-3 antigen: a European multicenter study for the evaluation of the analytical and clinical performance of the Access BR Monitor assay on the UniCel Dxl 800 Immunoassay System.

    Science.gov (United States)

    Molina, Rafael; Gion, Massimo; Gressner, Axel; Troalen, Frédéric; Auge, Jose Maria; Holdenrieder, Stefan; Zancan, Matelda; Wycislo, Matthias; Stieber, Petra

    2008-01-01

    Cancer antigen CA15-3 antigen is known as a valuable marker for the management of breast cancer. The analytical and clinical performance of the Access BR Monitor Immunoassay System (Beckman Coulter) was evaluated at five different European sites and compared with a reference system, defined as CA15-3 on the Elecsys System (Roche Diagnostics). Total imprecision (% CV) of the BR Monitor ranged between 5.5% and 11.7%, and inter-laboratory reproducibility between 3.4% and 5.1%. Linearity upon dilution showed a mean recovery of 98.5% (SD + 9.1%). Endogenous interferents had no influence on BR Monitor levels (mean recoveries: hemoglobin 112%, bilirubin 111%, triglycerides 108%). There was no high-dose hook effect up to 13,540 kU/L. Clinical performance investigated in sera from individuals showed a general correlation between the Access BR Monitor and Elecsys CA15-3 (R = 0.797), with a slope of 1.383. CA15-3 serum levels, as measured by the BR Monitor, were low in healthy individuals (n = 267, median = 11.9 kU/L, 95th percentile = 23.5 kU/L), higher in individuals with various benign diseases (n = 549, medians = 11.3-15.6 kU/L, 95th percentiles = 21.6-54.6 kU/L) and even higher in individuals suffering from various cancers (n = 995, medians = 11.2-22.8 kU/L, 95th percentiles = 30.0-429.7 kU/L). Best diagnostic accuracy for cancer detection against the relevant benign control group by the BR Monitor was found for locoregional and metastatic breast cancer, as well as for ovarian cancer [area under the curve (AUC) 0.619, 0.897 and 0.774]. Results for the reference CA15-3 assay were comparable (AUC 0.611, 0.887 and 0.818). The Access BR Monitor provides accurate methodological characteristics and demonstrates an analytical and clinical correlation with Elecsys CA15-3. Best diagnostic accuracy for the BR Monitor was found in breast and ovarian cancer. Our results also suggest a clinical value of the BR Monitor in other cancers.

  11. Alternative antibody for the detection of CA19-9 antigen: a European multicenter study for the evaluation of the analytical and clinical performance of the Access GI Monitor assay on the UniCel Dxl 800 Immunoassay System.

    Science.gov (United States)

    Stieber, Petra; Molina, Rafael; Gion, Massimo; Gressner, Axel; Troalen, Frédéric; Holdenrieder, Stefan; Auge, Jose Maria; Zancan, Matelda; Wycislo, Matthias; Jarrige, Véronique

    2008-01-01

    Gastrointestinal cancer antigen CA19-9 is known as a valuable marker for the management of patients with pancreatic cancer. The analytical and clinical performance of the Access GI Monitor assay (Beckman Coulter) was evaluated on the UniCel Dxl 800 Immunoassay System at five different European sites and compared with a reference method, defined as CA19-9 on the Elecsys System (Roche Diagnostics). Total imprecision (%CV) of the GI Monitor ranged between 3.4% and 7.7%, and inter-laboratory reproducibility between 3.6% and 4.0%. Linearity upon dilution showed a mean recovery of 97.4% (SD + 7.2%). Endogenous interferents had no influence on GI Monitor levels (mean recoveries: hemoglobin 103%, bilirubin 106%, triglycerides 106%). There was no high-dose hook effect up to 115,000 kU/L. Clinical performance investigated in sera from 1811 individuals showed a good correlation between the Access GI Monitor and Elecsys CA19-9 (R = 0.959, slope = 1.004, intercept = +0.17). GI Monitor serum levels were low in healthy individuals (n = 267, median = 6.0 kU/L, 95th percentile=23.1 kU/L), higher in individuals with various benign diseases (n = 550, medians = 5.8-13.4 kU/L, 95th percentiles = 30.1-195.5 kU/L) and even higher in individuals suffering from various cancers (n = 995, medians = 8.4-233.8 kU/L, 95th percentiles = 53.7-13,902 kU/L). Optimal diagnostic accuracy for cancer detection against the relevant benign control group by the GI Monitor was found for pancreatic cancer [area under the curve (AUC) 0.83]. Results for the reference CA19-9 assay were comparable (AUC 0.85). The Access GI Monitor provides very good methodological characteristics and demonstrates an excellent analytical and clinical correlation with the Elecsys CA19-9. The GI Monitor shows the best diagnostic accuracy in pancreatic cancer. Our results also suggest a clinical value of the GI Monitor in other cancers.

  12. Alternative antibody for the detection of CA125 antigen: a European multicenter study for the evaluation of the analytical and clinical performance of the Access OV Monitor assay on the UniCel Dxl 800 Immunoassay System.

    Science.gov (United States)

    Holdenrieder, Stefan; Molina, Rafael; Gion, Massimo; Gressner, Axel; Troalen, Frédéric; Auge, Jose Maria; Zancan, Matelda; Wycislo, Matthias; Stieber, Petra

    2008-01-01

    Cancer antigen CA125 is known as a valuable marker for the management of ovarian cancer. The analytical and clinical performance of the Access OV Monitor Immunoassay System (Beckman Coulter) was evaluated at five different European sites and compared with a reference system, defined as CA125 on the Elecsys System (Roche Diagnostics). Total imprecision (% CV) of the OV Monitor ranged between 3.1% and 8.8%, and inter-laboratory reproducibility between 4.7% and 5.0%. Linearity upon dilution showed a mean recovery of 100% (SD + 8.1%). Endogenous interferents had no influence on OV Monitor levels (mean recoveries: hemoglobin 107%, bilirubin 103%, triglycerides 103%). There was no high-dose hook effect up to 27,193 kU/L. Clinical performance investigated in sera from 1811 individuals showed a good correlation between the Access OV Monitor and Elecsys CA125 (R = 0.982, slope = 0.921, intercept = +1.951). OV Monitor serum levels were low in healthy individuals (n = 267, median = 9.7 kU/L, 95th percentile = 30.8 kU/L), higher in individuals with various benign diseases (n = 549, medians = 10.9-16.4 kU/L, 95th percentiles = 44.2-355 kU/L) and even higher in individuals suffering from various cancers (n = 995, medians = 12.4-445 kU/L; 95th percentiles = 53.4-4664 kU/L). Optimal diagnostic accuracy for cancer detection against the relevant benign control group by the OV Monitor was found for ovarian cancer [area under the curve (AUC) 0.898]. Results for the reference CA125 assay were comparable (AUC 0.899). The Access OV Monitor provides very good methodological characteristics and demonstrates an excellent analytical and clinical correlation with Elecsys CA125. The best diagnostic accuracy for the OV Monitor was found in ovarian cancer. Our results also suggest a clinical value of the OV Monitor in other cancers.

  13. Additive influence of genetic predisposition and conventional risk factors in the incidence of coronary heart disease: a population-based study in Greece

    Science.gov (United States)

    An additive genetic risk score (GRS) for coronary heart disease (CHD) has previously been associated with incident CHD in the population-based Greek European Prospective Investigation into Cancer and nutrition (EPIC) cohort. In this study, we explore GRS-‘environment’ joint actions on CHD for severa...

  14. A multicenter study confirms CD226 gene association with systemic sclerosis-related pulmonary fibrosis

    NARCIS (Netherlands)

    Bossini-Castillo, L.; Simeon, C.P.; Beretta, L.; Broen, J.C.A.; Vonk, M.C.; Rios-Fernandez, R.; Espinosa, G.; Carreira, P.; Camps, M.T.; Castillo, M.J.; Gonzalez-Gay, M.A.; Beltran, E.; Carmen Freire, M.; Narvaez, J.; Tolosa, C.; Witte, T.; Kreuter, A.; Schuerwegh, A.J.; Hoffmann-Vold, A.M.; Hesselstrand, R.; Lunardi, C.; Laar, J.M. van; Chee, M.M.; Herrick, A.; Koeleman, B.P.; Denton, C.P.; Fonseca, C.; Radstake, T.R.D.J.; Martin, J.; Spanish Scleroderma, G.

    2012-01-01

    INTRODUCTION: CD226 genetic variants have been associated with a number of autoimmune diseases and recently with systemic sclerosis (SSc). The aim of this study was to test the influence of CD226 loci in SSc susceptibility, clinical phenotypes and autoantibody status in a large multicenter European

  15. Early childhood measles vaccinations are not associated with paediatric IBD: a population-based analysis.

    Science.gov (United States)

    Shaw, Souradet Y; Blanchard, James F; Bernstein, Charles N

    2015-04-01

    Early childhood vaccinations have been hypothesized to contribute to the emergence of paediatric inflammatory bowel disease [IBD] in developed countries. Using linked population-based administrative databases, we aimed to explore the association between vaccination with measles-containing vaccines and the risk for IBD. This was a case-control study using the University of Manitoba IBD Epidemiology Database [UMIBDED]. The UMIBDED was linked to the Manitoba Immunization Monitoring System [MIMS], a population-based database of immunizations administered in Manitoba. All paediatric IBD cases in Manitoba, born after 1989 and diagnosed before March 31, 2008, were included. Controls were matched to cases on the basis of age, sex, and region of residence at time of diagnosis. Measles-containing vaccinations received in the first 2 years of life were documented, with vaccinations categorized as 'None' or 'Complete', with completeness defined according to Manitoba's vaccination schedule. Conditional logistic regression models were fitted to the data, with models adjusted for physician visits in the first 2 years of life and area-level socioeconomic status at case date. A total of 951 individuals [117 cases and 834 controls] met eligibility criteria, with average age of diagnosis among cases at 11 years. The proportion of IBD cases with completed vaccinations was 97%, compared with 94% of controls. In models adjusted for physician visits and area-level socioeconomic status, no statistically significant association was detected between completed measles vaccinations and the risk of IBD (adjusted odds ratio [AOR]: 1.5; 95% confidence interval [CI]: 0.5-4.4; p = 0.419]. No significant association between completed measles-containing vaccination in the first 2 years of life and paediatric IBD could be demonstrated in this population-based study. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For

  16. Low birthweight and neuromotor development: a population based, controlled study.

    Science.gov (United States)

    Sommerfelt, K; Ellertsen, B; Markestad, T

    1996-05-01

    The aims of the study were to investigate: (a) the relationship between low birthweight (LBW) and pre-school neuromotor development; and (b) the predictive value of various pre-, peri-, and neonatal factors for neuromotor development in LBW pre-school children. A population based sample of 144 5-year-old LBW children (birthweight neuromotor development. We conclude that motor functions essential for daily activities are intact in most LBW preschoolers.

  17. Recurrence of hyperemesis gravidarum across generations: population based cohort study

    OpenAIRE

    Vikanes, ?se; Skj?rven, Rolv; Grjibovski, Andrej M; Gunnes, Nina; Vangen, Siri; Magnus, Per

    2010-01-01

    Objective To estimate the risk of hyperemesis gravidarum (hyperemesis) according to whether the daughters and sons under study were born after pregnancies complicated by hyperemesis. Design Population based cohort study. Setting Registry data from Norway. Participants Linked generational data from the medical birth registry of Norway (1967-2006): 544?087 units of mother and childbearing daughter and 399?777 units of mother and child producing son. Main outcome measure Hyperemesis in daughters...

  18. Cyberbullying among Finnish adolescents ? a population-based study

    OpenAIRE

    Lindfors Pirjo L; Kaltiala-Heino Riittakerttu; Rimpelä Arja H

    2012-01-01

    Abstract Background Cyberbullying, threatening or harassing another via the internet or mobile phones, does not cause physically harm and thus the consequences are less visible. Little research has been performed on the occurrence of cyberbullying among adolescents or the perception of its seriousness. Only a few population-based studies have been published, none of which included research on the witnessing of cyberbullying. Here, we examined exposure to cyberbullying during the last year, an...

  19. A population-based prospective study of optic neuritis

    DEFF Research Database (Denmark)

    Soelberg, K; Jarius, S; Skejoe, Hanne Pernille Bro

    2017-01-01

    BACKGROUND: Optic neuritis (ON) is often associated with multiple sclerosis (MS). Early diagnosis is critical to optimal patient management. OBJECTIVE: To estimate the incidence of acute ON and the rates of conversion to MS and antibody-mediated ON. METHOD: Population-based prospective study......: The prospective incidence of ON was estimated. MRI enabled a diagnosis of MS in a subgroup of patients. Antibody-mediated ON with specificity for MOG was detected in 4% of cases....

  20. Women's intentions to breastfeed: a population-based cohort study.

    Science.gov (United States)

    Lutsiv, O; Pullenayegum, E; Foster, G; Vera, C; Giglia, L; Chapman, B; Fusch, C; McDonald, S D

    2013-11-01

    Given that intention to breastfeed is a strong predictor of breastfeeding initiation and duration, the objectives of this study were to estimate the population-based prevalence and the factors associated with the intention to breastfeed. Retrospective population-based cohort study. All hospitals in Ontario, Canada (1 April 2009-31 March 2010). Women who gave birth to live, term, singletons/twins. Patient, healthcare provider, and hospital factors that may be associated with intention to breastfeed were analysed using univariable and multivariable regression. Population-based prevalence of intention to breastfeed and its associated factors. The study included 92,364 women, of whom 78,806 (85.3%) intended to breastfeed. The odds of intending to breastfeed were higher amongst older women with no health problems and women who were cared for exclusively by midwives (adjusted OR 3.64, 95% CI 3.13-4.23). Being pregnant with twins (adjusted OR 0.73, 95% CI 0.57-0.94), not attending antenatal classes (adjusted OR 0.58, 95% CI 0.54-0.62), having previous term or preterm births (adjusted OR 0.79, 95% CI 0.78-0.81, and adjusted OR 0.87, 95% CI 0.82-0.93, respectively), and delivering in a level-1 hospital (adjusted OR 0.85, 95% CI 0.77-0.93) were associated with a lower intention to breastfeed. In this population-based study ~85% of women intended to breastfeed their babies. Key factors that are associated with the intention to breastfeed were identified, which can now be targeted for intervention programmes aimed at increasing the prevalence of breastfeeding and improving overall child and maternal health. © 2013 RCOG.

  1. Intent to breastfeed: a population-based perspective.

    Science.gov (United States)

    Chertok, Ilana R Azulay; Luo, Juhua; Culp, Stacey; Mullett, Martha

    2011-06-01

    Prenatal maternal intent to breastfeed can indicate postnatal breastfeeding practices and may serve to indicate potential barriers to breastfeeding. Breastfeeding rates in West Virginia, a primarily rural state, are among the lowest in the United States, and minimal research has been published to date on population-based prenatal intent to breastfeed among rural women. Secondary data analysis of population-based data was conducted using two state-linked datasets. State data included all live singleton births from at least 20 weeks of gestation in West Virginia from 2004 to 2006, for a total of 52,899 births. Results from the logistic regression model for the population-based study indicate that variables predicting intent to breastfeed among pregnant women in West Virginia include insurance status, maternal education, maternal age, parity, marital status, timing of prenatal care initiation, and prenatal smoking status. Prenatal identification of characteristics associated with lack of intent to breastfeed can serve to inform healthcare providers of women who are at risk for not breastfeeding for directed breastfeeding promotion and intervention, complementing education of healthy lifestyle choices such as breastfeeding promotion with smoking cessation.

  2. Factors associated with quality of life in active childhood epilepsy: a population-based study.

    Science.gov (United States)

    Reilly, Colin; Atkinson, Patricia; Das, Krishna B; Chin, Richard F M; Aylett, Sarah E; Burch, Victoria; Gillberg, Christopher; Scott, Rod C; Neville, Brian G R

    2015-05-01

    Improving health-related quality of life (HRQOL), rather than just reducing seizures, should be the principal goal in comprehensive management of childhood epilepsy. There is a lack of population-based data on predictors of HRQOL in childhood epilepsy. The Children with Epilepsy in Sussex Schools (CHESS) study is a prospective, population-based study involving school-aged children (5-15 years) with active epilepsy (on one or more AED and/or had a seizure in the last year) in a defined geographical area in the UK. Eighty-five of 115 (74% of eligible population) children underwent comprehensive psychological assessment including measures of cognition, behaviour, and motor functioning. Parents of the children completed the Quality of Life in Childhood Epilepsy (QOLCE).Clinical data on eligible children was extracted using a standardised pro forma. Linear regression analysis was undertaken to identify factors significantly associated with total Quality of Life in this population. Factors independently significantly associated (p QOLCE scores were seizures before 24 months, cognitive impairment (IQ QOLCE when children with IQ < 50 were excluded from analysis. The majority of factors associated with parent reported HRQOL in active childhood epilepsy are related to neurobehavioural and/or psychosocial aspects of the condition. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  3. Extraskeletal osteosarcoma : A European Musculoskeletal Oncology Society study on 266 patients

    NARCIS (Netherlands)

    Longhi, A.; Bielack, S.; Grimer, R.; Whelan, J.; Windhager, R; Leithner, Andreas; Gronchi, A.; Biau, David J.; Jutte, P.; Krieg, A. H.; Klenke, Frank M.; Grignani, G.; Donati, D. M.; Capanna, R.; Casanova, Jose; Gerrand, Craig; Bisogno, G.; Hecker-Nolting, Stefanie; De Lisa, M.; D'Ambrosio, Lia; Willegger, M.; Scoccianti, G.; FERRARI, S

    Purpose: Prognosis of extraskeletal osteosarcoma (ESOS) is reported to be poorer than that of skeletal osteosarcoma. This multicenter retrospective study aimed to evaluate factors influencing ESOS prognosis. Patients and methods: Members of the European Musculoskeletal Oncology Society (EMSOS)

  4. Fraser syndrome : epidemiological study in a European population

    NARCIS (Netherlands)

    Barisic, Ingeborg; Odak, Ljubica; Loane, Maria; Garne, Ester; Wellesley, Diana; Calzolari, Elisa; Dolk, Helen; Addor, Marie-Claude; Arriola, Larraitz; Bergman, Jorieke; Bianca, Sebastiano; Boyd, Patricia A; Draper, Elizabeth S; Gatt, Miriam; Haeusler, Martin; Khoshnood, Babak; Latos-Bielenska, Anna; McDonnell, Bob; Pierini, Anna; Rankin, Judith; Rissmann, Anke; Queisser-Luft, Annette; Verellen-Dumoulin, Christine; Stone, David; Tenconi, Romano

    Fraser syndrome is a rare autosomal recessive disorder characterized by cryptophthalmos, cutaneous syndactyly, laryngeal, and urogenital malformations. We present a population-based epidemiological study using data provided by the European Surveillance of Congenital Anomalies (EUROCAT) network of

  5. Strabismus Incidence in a Danish Population-Based Cohort of Children.

    Science.gov (United States)

    Torp-Pedersen, Tobias; Boyd, Heather A; Skotte, Line; Haargaard, Birgitte; Wohlfahrt, Jan; Holmes, Jonathan M; Melbye, Mads

    2017-10-01

    To our knowledge, there have been few population-based studies of strabismus incidence conducted. Our population-based study provides valuable data for health services planning and identifying research needs. To determine the incidence and age distribution of strabismus, overall and by subtype, among children 7 years or younger. This population-based cohort study was conducted with data from 96 842 children enrolled in the Danish National Birth Cohort. Age-specific incidence and cumulative incidence and median age at the detection of strabismus, overall and by subtype. The study cohort included 96 842 children born between 1996 and 2008 who are predominantly Caucasian and is composed of approximately 30% of births in Denmark, with a boy-girl ratio of 51:49. Overall, 1309 cases of strabismus were identified in the cohort. We found an overall cumulative strabismus incidence of 2.56% (95% CI, 2.42-2.69) at 7 years. The overall incidence was similar among boys and girls. Two hundred sixteen participants (16.5%) (95% CI, 14.5-18.6) had congenital esotropia, 177 (13.5%) (95% CI, 11.7-15.5) had fully accommodative esotropia, 252 (19.3%) (95% CI, 17.1-21.5) had partially accommodative esotropia, and 181 (13.8%) (95% CI, 12.0-15.8) had exotropia. The esotropia:exotropia ratio was 5.4:1 (95% CI, 3.4:1 to 7.5:1). Age-specific incidence curves for congenital esotropia, fully accommodative esotropia, partially accommodative esotropia, and all exotropia revealed interactions between strabismus subtype and age, suggesting that the different subtypes had different age-specific patterns of incidence (P < .001 for all comparisons between pairs of curves). The median age at detection for the 4 subtypes was 0, 32.0, 26.1, and 16.6 months, respectively. In a national, population-based cohort study, we found a cumulative incidence of strabismus consistent with those reported in smaller European and American cohorts, but a somewhat higher esotropia:exotropia ratio than those that

  6. A Population-Based Clinical Trial of Irinotecan and Carboplatin

    Directory of Open Access Journals (Sweden)

    Derick Lau

    2009-01-01

    Full Text Available Purpose. Phase I trials of anticancer drugs are commonly conducted using the method of modified Fibonacci. We have developed a population-based design for phase I trials of combining anticancer drugs such as irinotecan and carboplatin. Patients and Methods. Intrapatient dose escalation of irinotecan and carboplatin was performed according to a predetermined schema to reach individual dose-limiting toxicity (DLT in 50 patients with solid tumors refractory to previous chemotherapy. The individual toxicity-limiting dose levels were analyzed for normal distribution using the method of Ryan-Joiner and subsequently used to determine a population-based maximum tolerated dose (pMTD. For comparison, a simulation study was performed using the method of modified Fibonacci. Results. The most common dose-limiting toxicities (DLTs included neutropenia (58%, thrombocytopenia (16%, and diarrhea (8%. The frequency of individual toxicity-limiting dose levels of 50 patients approximated a normal distribution. The dose levels associated with individual limiting toxicities ranged from level 1 (irinotecan 100 mg/m2 and carboplatin AUC = 4 mg/mL x min to level 8 (irinotecan 350 mg/m2 and carboplatin AUC = 6. The pMTD was determined to be dose level 3 (150 mg/m2 for irinotecan and AUC = 5 for carboplatin. In contrast, the MTD was determined to be dose level 4 (200 mg/m2 for irinotecan and AUC 5 for carboplatin by modified-Fibonacci simulation. Conclusions. The population-based design of phase I trial allows optimization of dose intensity and derivation of a pMTD. The pMTD has been applied in phase II trial of irinotecan and carboplatin in patients with small-cell lung cancer.

  7. Effect of Preoperative Geriatric Evaluation on Outcomes After Elective Surgery: A Population-Based Study.

    Science.gov (United States)

    McIsaac, Daniel I; Huang, Allen; Wong, Coralie A; Wijeysundera, Duminda N; Bryson, Gregory L; van Walraven, Carl

    2017-12-01

    Randomized and nonrandomized single-center studies suggest that preoperative geriatric evaluation improves postoperative outcomes in older adults. The generalizability and population-level effect of preoperative geriatric evaluation has not been determined. Our objective was to measure the adjusted association between preoperative geriatric evaluation and postoperative outcomes. Multilevel multivariable regression model analysis of a population-based historical cohort. Publicly funded universal healthcare system in Ontario, Canada. All adults aged 65 and older having major, elective, noncardiac surgery from 2002 to 2014 (N = 266,499). We studied geriatric consultations and comprehensive assessments performed in the 4 months prior to surgery. These were identified using validated methods. Ninety-day survival (primary outcome), in-hospital complications, length of stay, 30-day readmissions, need for supported discharge, and 90-day costs of care. The 7,352 participants (2.8%) who had a preoperative geriatric evaluation had longer 90-day survival than those who who did not (adjusted hazard ratio = 0.81, 95% confidence interval = 0.68-0.95). Length of stay and complication rates did not differ between groups, but participants evaluated by a geriatrician preoperatively had higher rates of supported discharge, readmission rates, and costs of care. Sensitivity analyses supported the association between preoperative geriatric assessment and 90-day survival. In individuals aged 65 and older undergoing major, elective, noncardiac surgery, preoperative geriatric evaluation was associated with longer 90-day survival, but it is used infrequently. Given these results, and those of previous small studies, the influence of a geriatric evaluation on postoperative outcomes should be determined in a multicenter randomized trial. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  8. A multicenter evaluation of the Biotest legionella urinary antigen EIA

    DEFF Research Database (Denmark)

    Harrison, Timothy; Uldum, Søren; Alexiou-Daniel, Stella

    1998-01-01

    OBJECTIVES: To undertake a multicenter study to evaluate the Biotest legionella urinary antigen enzyme immunoassay (EIA) performance against those EIAs already in use in 14 European laboratories. METHODS: Each laboratory examined urine specimens from appropriate patients using both their current...... in the laboratories' current EIAs, and in 94.6% of those specimens which were positive for Legionella pneumophila serogroup 1. CONCLUSION: The Biotest EIA is simple to use and specific and the results obtained in different laboratories show excellent agreement. The assay compares well existing EIAs, at least for L...

  9. Meckel-Gruber Syndrome: a population-based study on prevalence, prenatal diagnosis, clinical features, and survival in Europe

    DEFF Research Database (Denmark)

    Barisic, Ingeborg; Boban, Ljubica; Loane, Maria

    2015-01-01

    Meckel-Gruber Syndrome is a rare autosomal recessive lethal ciliopathy characterized by the triad of cystic renal dysplasia, occipital encephalocele and postaxial polydactyly. We present the largest population-based epidemiological study to date using data provided by the European Surveillance......, but regional differences were observed. There were 145 (75.9%) terminations of pregnancy after prenatal diagnosis, 13 (6.8%) fetal deaths, 33 (17.3%) live births. In addition to cystic kidneys (97.7%), encephalocele (83.8%) and polydactyly (87.3%), frequent features include other central nervous system...

  10. Population based screening for prostate cancer : tumor characteristics

    NARCIS (Netherlands)

    I.W. van der Cruijsen (Ingrid W)

    2008-01-01

    markdownabstract__Abstract__ The European Randomized study of Screening for Prostate Cancer is a multi-centre randomized controlled trial to examine whether screening for prostate cancer has an effect on prostate cancer mortality. The total study cohort consists of 268.000 men in eight

  11. Assessment of military population-based psychological resilience programs.

    Science.gov (United States)

    Morgan, Brenda J; Bibb, Sandra C Garmon

    2011-09-01

    Active duty service members' (ADSMs) seemingly poor adaptability to traumatic stressors is a risk to force health. Enhancing the psychological resilience of ADSMs has become a key focus of Department of Defense (DoD) leaders and the numbers of military programs for enhancing psychological resilience have increased. The purpose of this article is to describe the results of an assessment conducted to determine comprehensiveness of current psychological resilience building programs that target ADSMs. A modified six-step, population-based needs assessment was used to evaluate resilience programs designed to meet the psychological needs of the ADSM population. The assessment results revealed a gap in published literature regarding program outcomes. DoD leaders may benefit from targeted predictive research that assesses program effectiveness outcomes. The necessity of including preventive, evidence-based interventions in new programs, such as positive emotion interventions shown to enhance psychological resilience in civilian samples, is also recommended.

  12. Metabolic biomarkers and gallstone disease - a population-based study

    DEFF Research Database (Denmark)

    Shabanzadeh, Daniel Mønsted; Skaaby, Tea; Sørensen, Lars Tue

    2017-01-01

    ). RESULTS: Gallstone disease was associated with fasting glucose (OR 1.14, 95% CI [1.05;1.24]), fasting insulin (OR 1.03, 95% CI [1.01;1.05]), homeostasis model assessment insulin resistance (OR 1.18, 95% CI [1.02;1.36]), the metabolic syndrome (OR 1.51, 95% CI [1.16;1.96]), white blood cell count (OR 1......OBJECTIVES: The objectives for this study were to examine the associations between metabolic biomarkers of obesity including insulin resistance, vascular dysfunction, systemic inflammation, genetic susceptibility and ultrasound proven gallstone disease or cholecystectomy in a population-based cross......-sectional study. MATERIAL AND METHODS: A total of 2650 participants were included, of whom 422 had gallstone disease. Associations between selected metabolic biomarkers and gallstone disease were estimated by multivariable logistic regression models and expressed as odds ratio (OR) and 95% confidence interval (CI...

  13. Urinary incontinence and hydration: A population-based analysis.

    Science.gov (United States)

    Willis-Gray, Marcella; Wu, Jennifer M; Markland, Alayne

    2017-04-18

    To determine if there is an association between urinary incontinence (UI) and an objective measure of hydration status in men and women in a nationwide, population-based sample. We utilized data from the 2009 to 2010 and 2011 to 2012 National Health and Nutrition Examination Surveys (NHANES), cross sectional surveys of the US non-institutionalized population. Our primary outcome was moderate/severe UI measured using a validated scale. Our exposure of interest was hydration status. Urine osmolality ≥ 800 mOsm/kg defined dehydration versus adequate hydration (kidney disease, the interaction of age with osmolality, and hysterectomy (women only). Among the 11 482 total subjects, 9497 (83%-4882 men and 4615 women) had both UI and urine osmolality data. Compared to women, men were less likely to report UI (5.9% vs 18.9%; P incontinence in men or women. © 2017 Wiley Periodicals, Inc.

  14. Benzodiazepine use and risk of dementia: prospective population based study

    Science.gov (United States)

    Bazin, Fabienne; Verdoux, Hélène; Dartigues, Jean-François; Pérès, Karine; Kurth, Tobias; Pariente, Antoine

    2012-01-01

    Objective To evaluate the association between use of benzodiazepines and incident dementia. Design Prospective, population based study. Setting PAQUID study, France. Participants 1063 men and women (mean age 78.2 years) who were free of dementia and did not start taking benzodiazepines until at least the third year of follow-up. Main outcome measures Incident dementia, confirmed by a neurologist. Results During a 15 year follow-up, 253 incident cases of dementia were confirmed. New use of benzodiazepines was associated with an increased risk of dementia (multivariable adjusted hazard ratio 1.60, 95% confidence interval 1.08 to 2.38). Sensitivity analysis considering the existence of depressive symptoms showed a similar association (hazard ratio 1.62, 1.08 to 2.43). A secondary analysis pooled cohorts of participants who started benzodiazepines during follow-up and evaluated the association with incident dementia. The pooled hazard ratio across the five cohorts of new benzodiazepine users was 1.46 (1.10 to 1.94). Results of a complementary nested case-control study showed that ever use of benzodiazepines was associated with an approximately 50% increase in the risk of dementia (adjusted odds ratio 1.55, 1.24 to 1.95) compared with never users. The results were similar in past users (odds ratio 1.56, 1.23 to 1.98) and recent users (1.48, 0.83 to 2.63) but reached significance only for past users. Conclusions In this prospective population based study, new use of benzodiazepines was associated with increased risk of dementia. The result was robust in pooled analyses across cohorts of new users of benzodiazepines throughout the study and in a complementary case-control study. Considering the extent to which benzodiazepines are prescribed and the number of potential adverse effects of this drug class in the general population, indiscriminate widespread use should be cautioned against. PMID:23045258

  15. Scleroderma prevalence: demographic variations in a population-based sample.

    Science.gov (United States)

    Bernatsky, S; Joseph, L; Pineau, C A; Belisle, P; Hudson, M; Clarke, A E

    2009-03-15

    To estimate the prevalence of systemic sclerosis (SSc) using population-based administrative data, and to assess the sensitivity of case ascertainment approaches. We ascertained SSc cases from Quebec physician billing and hospitalization databases (covering approximately 7.5 million individuals). Three case definition algorithms were compared, and statistical methods accounting for imperfect case ascertainment were used to estimate SSc prevalence and case ascertainment sensitivity. A hierarchical Bayesian latent class regression model that accounted for possible between-test dependence conditional on disease status estimated the effect of patient characteristics on SSc prevalence and the sensitivity of the 3 ascertainment algorithms. Accounting for error inherent in both the billing and the hospitalization data, we estimated SSc prevalence in 2003 at 74.4 cases per 100,000 women (95% credible interval [95% CrI] 69.3-79.7) and 13.3 cases per 100,000 men (95% CrI 11.1-16.1). Prevalence was higher for older individuals, particularly in urban women (161.2 cases per 100,000, 95% CrI 148.6-175.0). Prevalence was lowest in young men (in rural areas, as low as 2.8 cases per 100,000, 95% CrI 1.4-4.8). In general, no single algorithm was very sensitive, with point estimates for sensitivity ranging from 20-73%. We found marked differences in SSc prevalence according to age, sex, and region. In general, no single case ascertainment approach was very sensitive for SSc. Therefore, using data from multiple sources, with adjustment for the imperfect nature of each, is an important strategy in population-based studies of SSc and similar conditions.

  16. A population-based study of birth defects in Malaysia.

    Science.gov (United States)

    Thong, M K; Ho, J J; Khatijah, N N

    2005-01-01

    Birth defects are one of the leading causes of paediatric disability and mortality in developed and developing countries. Data on birth defects from population-based studies originating from developing countries are lacking. One of the objectives of this study was to determine the epidemiology of major birth defects in births during the perinatal period in Kinta district, Perak, Malaysia over a 14-month period, using a population-based birth defect register. There were 253 babies with major birth defects in 17,720 births, giving an incidence of 14.3/1000 births, a birth prevalence of 1 in 70. There were 80 babies with multiple birth defects and 173 with isolated birth defects. The exact syndromic diagnosis of the babies with multiple birth defects could not be identified in 18 (22.5%) babies. The main organ systems involved in the isolated birth defects were cardiovascular (13.8%), cleft lip and palate (11.9%), clubfeet (9.1%), central nervous system (CNS) (including neural tube defects) (7.9%), musculoskeletal (5.5%) and gastrointestinal systems (4.7%), and hydrops fetalis (4.3%). The babies with major birth defects were associated with lower birth weights, premature deliveries, higher Caesarean section rates, prolonged hospitalization and increased specialist care. Among the cohort of babies with major birth defects, the mortality rate was 25.2% during the perinatal period. Mothers with affected babies were associated with advanced maternal age, birth defects themselves or their relatives but not in their other offspring, and significantly higher rates of previous abortions. The consanguinity rate of 2.4% was twice that of the control population. It is concluded that a birth defects register is needed to monitor these developments and future interventional trials are needed to reduce birth defects in Malaysia.

  17. Regional variability in the prevalence of cerebral white matter lesions: an MRI study in 9 European countries (CASCADE).

    Science.gov (United States)

    Launer, L J; Berger, K; Breteler, M M B; Dufouil, C; Fuhrer, R; Giampaoli, S; Nilsson, L-G; Pajak, A; de Ridder, M; van Dijk, E J; Sans, S; Schmidt, R; Hofman, A

    2006-01-01

    White matter lesions (WML) on MRI of the brain are common in both demented and nondemented older persons. They may be due to ischemic events and are associated with cognitive and physical impairments. It is not known whether the prevalence of these WML in the general population differs across European countries in a pattern similar to that seen for coronary heart disease. Here we report the prevalence of WML in 1,805 men and women drawn from population-based samples of 65- to 75-year-olds in ten European cohorts. Data were collected using standardized methods as a part of the multicenter study CASCADE (Cardiovascular Determinants of Dementia). Centers were grouped by region: south (Italy, Spain, France), north (Netherlands, UK, Sweden), and central (Austria, Germany, Poland). In this 10-year age stratum, 92% of the sample had some lesions, and the prevalence increased with age. The prevalence of WML was highest in the southern region, even after adjusting for differences in demographic and selected cardiovascular risk factors. Brain aging leading to disabilities will increase in the future. As a means of hypothesis generation and for health planning, further research on the geographic distribution of WML may lead to the identification of new risk factors for these lesions.

  18. A modular informatics platform for effective support of collaborative and multicenter studies in cardiology.

    Science.gov (United States)

    Marinelli, Martina; Positano, Vincenzo; Lorenzoni, Valentina; Caselli, Chiara; Mangione, Maurizio; Marcheschi, Paolo; Puzzuoli, Stefano; Esposito, Natalia; L'Abbate, Giuseppe Andrea; Neglia, Danilo

    2016-12-01

    Collaborative and multicenter studies permit a large number of patients to be enrolled within a reasonable time and providing the opportunity to collect different data. Informatics platforms play an important role in management, storage, and exchange of data between the participants involved in the study. In this article, we describe a modular informatics platform designed and developed to support collaborative and multicenter studies in cardiology. In each developed module, data management is implemented following local defined protocols. The modular characteristic of the developed platform allows independent transfer of different kinds of data, such as biological samples, imaging raw data, and patients' digital information. Moreover, it offers safe central storage of the data collected during the study. The developed platform was successfully tested during a European collaborative and multicenter study, focused on evaluating multimodal non-invasive imaging to diagnose and characterize ischemic heart disease. © The Author(s) 2015.

  19. Sleep patterns and insomnia among adolescents: a population-based study.

    Science.gov (United States)

    Hysing, Mari; Pallesen, Ståle; Stormark, Kjell M; Lundervold, Astri J; Sivertsen, Børge

    2013-10-01

    The aim of the current study was to examine sleep patterns and rates of insomnia in a population-based study of adolescents aged 16-19 years. Gender differences in sleep patterns and insomnia, as well as a comparison of insomnia rates according to DSM-IV, DSM-V and quantitative criteria for insomnia (Behav. Res. Ther., 41, 2003, 427), were explored. We used a large population-based study in Hordaland county in Norway, conducted in 2012. The sample included 10,220 adolescents aged 16-18 years (54% girls). Self-reported sleep measurements included bedtime, rise time, time in bed, sleep duration, sleep efficiency, sleep onset latency, wake after sleep onset, rate and frequency and duration of difficulties initiating and maintaining sleep and rate and frequency of tiredness and sleepiness. The adolescents reported short sleep duration on weekdays (mean 6:25 hours), resulting in a sleep deficiency of about 2 h. A majority of the adolescents (65%) reported sleep onset latency exceeding 30 min. Girls reported longer sleep onset latency and a higher rate of insomnia than boys, while boys reported later bedtimes and a larger weekday-weekend discrepancy on several sleep parameters. Insomnia prevalence rates ranged from a total prevalence of 23.8 (DSM-IV criteria), 18.5 (DSM-V criteria) and 13.6% (quantitative criteria for insomnia). We conclude that short sleep duration, long sleep onset latency and insomnia were prevalent in adolescents. This warrants attention as a public health concern in this age group. © 2013 European Sleep Research Society.

  20. Determinants of hyperhomocysteinemia in healthy and hypertensive subjects: A population-based study and systematic review.

    Science.gov (United States)

    Han, Liyuan; Liu, Yanfen; Wang, Changyi; Tang, Linlin; Feng, Xiaoqi; Astell-Burt, Thomas; Wen, Qi; Duan, Donghui; Lu, Nanjia; Xu, Guodong; Wang, Kaiyue; Zhang, Lu; Gu, Kaibo; Chen, Sihan; Ma, Jianping; Zhang, Tao; You, Dingyun; Duan, Shiwei

    2017-10-01

    Hyperhomocysteinemia (HHcy) is known to increase the risk of many diseases. Factors influencing HHcy in healthy and hypertensive subjects remain under-researched. A large population-based study was conducted in 60 communities from Shenzhen, China. Responses to standardized questions on lifestyle factors and blood samples were collected from all participants after a 12-h overnight fast. Multiple linear and multivariate logistic regressions were used to explore risk factors for HHcy. Results were then compared to those from a systematic review of English-language articles listed in Pubmed, EBSCOhost, Web of Science, Embase and Cochrane libraries that investigated HHcy risk factors in healthy and hypertensive subjects. A total of 1586 healthy (Male/Female = 642/944) and 5935 hypertensive subjects (Male/Female = 2928/3007) participated in our population-based study. In logistic regression analyses, age, BMI and creatinine (Cr) were risk factors, while being female, fruit intake and physical activity were protective factors for HHcy in healthy subjects. In hypertensive subjects, seven [age, smoking, salt intake, systolic blood pressure (SBP), uric acid, triglycerides (TG), and Cr] and four [female, fruit intake, total cholesterol (TC), and glucose] factors were associated with higher and lower HHcy respectively. The review of 71 studies revealed that potential risk factors for Hcy included nutritional, physiologic, lifestyle habits, ethnicity, genetics, interactions between gene-environment, gene-gene, gene-nutritional, environment-environment, nutritional-nutritional. Our study indicates the potential importance of increasing folic acid and vitamin B supplementation, daily fruit and vegetable intake, regular exercise and refraining from tobacco smoking and alcohol consumption as preventive strategies for Hcy. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  1. Rare chromosome abnormalities, prevalence and prenatal diagnosis rates from population-based congenital anomaly registers in Europe

    DEFF Research Database (Denmark)

    Wellesley, Diana; Dolk, Helen; Boyd, Patricia A

    2012-01-01

    The aim of this study is to quantify the prevalence and types of rare chromosome abnormalities (RCAs) in Europe for 2000-2006 inclusive, and to describe prenatal diagnosis rates and pregnancy outcome. Data held by the European Surveillance of Congenital Anomalies database were analysed on all...... the cases from 16 population-based registries in 11 European countries diagnosed prenatally or before 1 year of age, and delivered between 2000 and 2006. Cases were all unbalanced chromosome abnormalities and included live births, fetal deaths from 20 weeks gestation and terminations of pregnancy for fetal...... anomaly. There were 10 323 cases with a chromosome abnormality, giving a total birth prevalence rate of 43.8/10 000 births. Of these, 7335 cases had trisomy 21,18 or 13, giving individual prevalence rates of 23.0, 5.9 and 2.3/10 000 births, respectively (53, 13 and 5% of all reported chromosome errors...

  2. Population-based study of presbyopia in Nicaragua.

    Science.gov (United States)

    Hookway, Larry A; Frazier, Marcela; Rivera, Nelson; Ramson, Prasidh; Carballo, Luis; Naidoo, Kovin

    2016-11-01

    Uncorrected presbyopia can greatly impact a person's quality of life and employment prospects. Nicaragua is the poorest country in Latin America and there are no population-based reports of prevalence of presbyopia in Nicaragua. A cross-sectional population-based household survey was conducted. The sample was selected through random cluster sampling. Adults 35 years and older were enlisted through a door-to-door method using aged-based sampling. All enumerated household members 35 years and older were asked to attend a free visual acuity screening. Autorefraction was done and then uncorrected distance vision and near visual acuity were measured for all subjects. All those who had distance or near vision that was 6/12 or worse underwent a clinical examination, which included refraction at distance and near. Free spectacles were provided. Of the 3,390 subjects surveyed, 37.1 per cent reported that they wore spectacles on a regular basis. A total of 1,871 (55.2 per cent) of those enumerated were examined. The prevalence of near visual impairment (6/12 [N 6] or worse) was 79.6 per cent for the 35 to 49-year-old group, 97.3 per cent for the 50 to 64-year-old group and 96.7 per cent for the 65 and over group. Of those reporting for the examination, 82.2 per cent did not have glasses. Of those examined, 10 per cent did not need spectacles, four per cent were given spectacles for distance only, 38 per cent spectacles for distance and near, 42 per cent spectacles for near only and seven per cent were referred for medical evaluation due to ocular pathology. During the refractions, 91.5 per cent were corrected to 6/12 or better at distance and 89.4 per cent were corrected to 6/12 or better at near. The majority of the participants who were examined did not have the spectacles that they needed. Over one-third of those participants who presented without spectacles had distance vision better than 6/12 and could be improved to good near vision with ready-made near-only spectacles

  3. Men's health: a population-based study on social inequalities.

    Science.gov (United States)

    Bastos, Tássia Fraga; Alves, Maria Cecília Goi Porto; Barros, Marilisa Berti de Azevedo; Cesar, Chester Luiz Galvão

    2012-11-01

    This study evaluates social inequalities in health according to level of schooling in the male population. This was a cross-sectional, population-based study with a sample of 449 men ranging from 20 to 59 years of age and living in Campinas, São Paulo State, Brazil. The chi-square test was used to verify associations, and a Poisson regression model was used to estimate crude and adjusted prevalence ratios. Men with less schooling showed higher rates of alcohol consumption and dependence, smoking, sedentary lifestyle during leisure time, and less healthy eating habits, in addition to higher prevalence of bad or very bad self-rated health, at least one chronic disease, hypertension, and other health problems. No differences were detected between the two schooling strata in terms of use of health services, except for dental services. The findings point to social inequality in health-related behaviors and in some health status indicators. However, possible equity was observed in the use of nearly all types of health services.

  4. Amyotrophic lateral sclerosis in Catalonia: a population based study.

    Science.gov (United States)

    Pradas, Jesús; Puig, Teresa; Rojas-García, Ricard; Viguera, María Luisa; Gich, Ignasi; Logroscino, Giancarlo

    2013-05-01

    Our objective was to determine the incidence and clinical-epidemiological characteristics of an ALS cohort patient in Catalonia (Spain). We conducted a population based registry for a three-year period (1999-2001) in Catalonia (6,361,365 inhabitants) using several sources of information. The original El Escorial diagnostic criteria (1994) for ALS were applied for the classification of patients. New cases diagnosed between 1 January 1999 and 31 December 2001 were 215 (118 males and 97 females), with an annual crude incidence rate of 1.4/100,000 (95% CI 1.3-1.8). This rate showed a peak age between 75 and 79 years. The incidence rate was 1.6 (95% CI 1.5-2.2) in males and 1.2 (95% CI 1.1-1.7) in females. Prevalence at the end of the period was 5.4/100,000 of the total population. Median age at onset was 64.3 years. Onset of symptoms was bulbar or generalized in 38% of cases. Mean disease duration at diagnosis was 11.0 months. Median time of survival from onset was 30.8 months. In conclusion, ALS incidence in Catalonia is within the range of other countries across Europe with different geographic, environmental and socioeconomic situations. However, as in other studies conducted in the Mediterranean area, Catalonia incidence is in the lower range of rates in Europe.

  5. Comorbidities of Idiopathic Thrombocytopenic Purpura: A Population-Based Study

    Directory of Open Access Journals (Sweden)

    M. A. Feudjo-Tepie

    2009-01-01

    Full Text Available A person experiencing more than one medical condition may have ambiguous clinical presentation. ITP is a serious autoimmune disease with little epidemiological evidence on its burden, risk factors, and comorbidities. Using the United Kingdom general practice research database, we conducted a 14 years population-based case control-type study to explore medical conditions more likely to cooccur with ITP and their temporal relationship in association with ITP. ITP patients were matched to non-ITP on practice, age, gender, and follow-up period. Potential comorbidities were represented by patients’ medical information at the preferred term level of the MedDRA international classification. As well as death (OR=60.0; 95% CI [4.47–806.0] and known clinical signs and symptoms of ITP, ITP is associated with considerable number of medical conditions. The association between ITP and some of these conditions is apparent both before and after ITP diagnosis. Specific targeted studies can now be setup to reexamine observed associations.

  6. Calcium intake by adolescents: a population-based health survey

    Directory of Open Access Journals (Sweden)

    Daniela de Assumpção

    2016-06-01

    Full Text Available Abstract Objective To analyze calcium intake in adolescents according to sociodemographic variables, health-related behaviors, morbidities, and body mass index. Methods This was a cross-sectional population-based study, with a two-stage cluster sampling that used data from a survey conducted in Campinas, São Paulo, Brazil, between 2008 and 2009. Food intake was assessed using a 24-hour dietary recall. The study included 913 adolescents aged 10-19 years. Results Average nutrient intake was significantly lower in the segment with lower education of the head of the family and lower per capita family income, in individuals from other cities or states, those who consumed fruit less than four times a week, those who did not drink milk daily, those who were smokers, and those who reported the occurrence of headaches and dizziness. Higher mean calcium intake was found in individuals that slept less than seven hours a day. The prevalence of calcium intake below the recommendation was 88.6% (95% CI: 85.4-91.2. Conclusion The results alert to an insufficient calcium intake and suggest that certain subgroups of adolescents need specific strategies to increase the intake of this nutrient.

  7. Obstetrician and gynecologists' population-based screening practices.

    Science.gov (United States)

    Jelin, Angie C; Anderson, Britta; Wilkins-Haug, Louise; Schulkin, Jay

    2016-03-01

    The ability to obtain genetic information can now be accomplished in far greater detail, and more quickly than in the past. It is important to understand obstetrician-gynecologists' (ob-gyns) screening practices as these changes occur. Cross-sectional survey was performed by mailing paper surveys to Fellows of the American College of Obstetricians and Gynecologists and a subset of Fellows who belong to the Collaborative Ambulatory Research Network (CARN). Response rates were 57% for the CARN network. Almost all responders (92%) offer population-based genetic screening in the prenatal period and almost all (93%) conduct counseling prior to the provision of genetic testing. Almost all (92%) counsel patients when the result is positive, with 46% being the primary counselor and 55% calling the patient themselves. When results are negative, 73% counsel with 58% indicating they are the primary counselor and 17% call patients themselves. A total of 72% have received continuing medical education (CME) on genetics within 5 years, with 79% receiving CME at conferences and 21% receiving CME online. Ob-gyns have a large role in providing patients new genetic screening technologies. This role requires a significant knowledge base, some of which can be obtained by online modules; however, our study suggests online education is underutilized as a means for CME on genetic screening among ob-gyns.

  8. Population-Based Study of Trachoma in Guatemala.

    Science.gov (United States)

    Silva, Juan Carlos; Diaz, Marco Antonio; Maul, Eugenio; Munoz, Beatriz E; West, Sheila K

    2015-01-01

    A prevalence survey for active trachoma in children aged under 10 years and trichiasis in women aged 40 years and older was carried out in four districts in the Sololá region in Guatemala, which is suspected of still having a trachoma problem. Population-based surveys were undertaken in three districts, within 15 randomly selected communities in each district. In addition, in a fourth district that borders the third district chosen, we surveyed the small northern sub-district, by randomly selecting three communities in each community, 100 children aged under 10 years were randomly selected, and all females over 40 years. Five survey teams were trained and standardized. Trachoma was graded using the World Health Organization simplified grading scheme and ocular swabs were taken in cases of clinical follicular or inflammatory trachoma. Prevalence estimates were calculated at district and sub-district level. Trachoma rates at district level varied from 0-5.1%. There were only two sub-districts where active trachoma approached 10% (Nahualá Costa, 8.1%, and Santa Catarina Costa, 7.3%). Trichiasis rates in females aged 40 years and older varied from 0-3%. Trachoma was likely a problem in the past. Trachoma is disappearing in the Sololá region in Guatemala. Health leadership may consider further mapping of villages around the areas with an especially high rate of trachoma and infection, and instituting trichiasis surgery and active trachoma intervention where needed.

  9. Anxiety disorders in young people: a population-based study

    Directory of Open Access Journals (Sweden)

    Thaíse Campos Mondin

    2013-12-01

    Full Text Available Objective: To assess the prevalence of anxiety disorders and associated factors in young adults. Methods: Cross-sectional population-based study of individuals between the ages of 18 and 24 years randomly selected from 89 census-based sectors to ensure an adequate sample size. Household selection within the sectors was performed according to a systematic sampling process. Anxiety disorders were assessed using the Mini International Neuropsychiatric Interview (MINI. The final sample comprised 1,560 young adults. Results: Of the participants who were diagnosed with anxiety disorders, 12.3% had agoraphobia, 9.7% had generalised anxiety disorder, 4.0% had social phobia, 3.3% had obsessive-compulsive disorder, 2.5% had panic disorder, and 2.1% had post-traumatic stress disorder; only 23.8% had received any previous treatment. Anxiety disorders were associated with sex, socioeconomic status, psychiatric problems in parents, alcohol abuse, and tobacco use. Conclusions: The identification of factors associated with anxiety disorders in young people enables us to develop intervention strategies. Anxiety disorders are not only highly prevalent but are also associated with significant functional impairment, significant reductions in quality of life, lower productivity, and higher rates of comorbidities.

  10. Increasing incidence of cataract surgery: Population-based study

    Science.gov (United States)

    Gollogly, Heidrun E.; Hodge, David O.; St. Sauver, Jennifer L.; Erie, Jay C.

    2015-01-01

    PURPOSE To estimate the incidence of cataract surgery in a defined population and to determine longitudinal cataract surgery patterns. SETTING Mayo Clinic, Rochester, Minnesota, USA. DESIGN Cohort study. METHODS Rochester Epidemiology Project (REP) databases were used to identify all incident cataract surgeries in Olmsted County, Minnesota, between January 1, 2005, and December 31, 2011. Age-specific and sex-specific incidence rates were calculated and adjusted to the 2010 United States white population. Data were merged with previous REP data (1980 to 2004) to assess temporal trends in cataract surgery. Change in the incidence over time was assessed by fitting generalized linear models assuming a Poisson error structure. The probability of second-eye cataract surgery was calculated using the Kaplan-Meier method. RESULTS Included were 8012 cataract surgeries from 2005 through 2011. During this time, incident cataract surgery significantly increased (P cataract surgery steadily increased over the past 3 decades (P cataract surgery steadily increased over the past 32 years and has not leveled off, as reported in Swedish population-based series. Second-eye surgery was performed sooner and more frequently, with 60% of residents having second-eye surgery within 3-months of first-eye surgery. PMID:23820302

  11. Population-based absolute risk estimation with survey data.

    Science.gov (United States)

    Kovalchik, Stephanie A; Pfeiffer, Ruth M

    2014-04-01

    Absolute risk is the probability that a cause-specific event occurs in a given time interval in the presence of competing events. We present methods to estimate population-based absolute risk from a complex survey cohort that can accommodate multiple exposure-specific competing risks. The hazard function for each event type consists of an individualized relative risk multiplied by a baseline hazard function, which is modeled nonparametrically or parametrically with a piecewise exponential model. An influence method is used to derive a Taylor-linearized variance estimate for the absolute risk estimates. We introduce novel measures of the cause-specific influences that can guide modeling choices for the competing event components of the model. To illustrate our methodology, we build and validate cause-specific absolute risk models for cardiovascular and cancer deaths using data from the National Health and Nutrition Examination Survey. Our applications demonstrate the usefulness of survey-based risk prediction models for predicting health outcomes and quantifying the potential impact of disease prevention programs at the population level.

  12. Aligning population-based care management with chronic disease complexity.

    Science.gov (United States)

    Hewner, Sharon; Seo, Jin Young; Gothard, Sandra E; Johnson, Barbara J

    2014-01-01

    Risk-stratified care management requires knowledge of the complexity of chronic disease and comorbidity, information that is often not readily available in the primary care setting. The purpose of this article was to describe a population-based approach to risk-stratified care management that could be applied in primary care. Three populations (Medicaid, Medicare, and privately insured) at a regional health plan were divided into risk-stratified cohorts based on chronic disease and complexity, and utilization was compared before and after the implementation of population-specific care management teams of nurses. Risk-stratified care management was associated with reductions in hospitalization rates in all three populations, but the opportunities to avoid admissions were different. Knowledge of population complexity is critical to the development of risk-stratified care management in primary care, and a complexity matrix can help nurses identify gaps in care and align interventions to cohort and population needs. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Population-based study of presbyopia in Shahroud, Iran.

    Science.gov (United States)

    Hashemi, Hassan; Khabazkhoob, Mehdi; Jafarzadehpur, Ebrahim; Mehravaran, Shiva; Emamian, Mohammad Hassan; Yekta, AbbasAli; Shariati, Mohammad; Fotouhi, Akbar

    2012-12-01

    There is limited information regarding the prevalence of presbyopia in different parts of the world. The add power and the prevalence of presbyopia by age and gender in general population of Shahroud, north of Iran, were studied. Population-based cross-sectional study. Using random cluster sampling, 6311 people from the 40- to 64-year-old population of Shahroud were invited. Of the invited population, 5190 individuals (82.2%) participated in the study. Presbyopia was defined as the correction of near vision to logMAR 1 (N8 point) with at least 1 D of add power. Near visual acuity of participants was evaluated with a logMAR chart at a distance of 40 cm. Mean add power in the age groups of 40-44, 45-49, 50-54, 55-59 and 60-64 years was 0.65, 1.30, 1.70, 1.87 and 2.08 D, respectively. For each 5-year increase in age, a 0.35 D increase in add power was noted. The prevalence of presbyopia was 58.15% (95% confidence interval: 56.46-59.84). Presbyopia was more prevalent in women (P presbyopia was less prevalent. More than 50% of the over 45-year-old individuals were presbyopic and 17% of the over 60 individuals were free of this condition. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

  14. Calcium intake by adolescents: a population-based health survey.

    Science.gov (United States)

    de Assumpção, Daniela; Dias, Marcia Regina Messaggi Gomes; de Azevedo Barros, Marilisa Berti; Fisberg, Regina Mara; de Azevedo Barros Filho, Antonio

    2016-01-01

    To analyze calcium intake in adolescents according to sociodemographic variables, health-related behaviors, morbidities, and body mass index. This was a cross-sectional population-based study, with a two-stage cluster sampling that used data from a survey conducted in Campinas, São Paulo, Brazil, between 2008 and 2009. Food intake was assessed using a 24-hour dietary recall. The study included 913 adolescents aged 10-19 years. Average nutrient intake was significantly lower in the segment with lower education of the head of the family and lower per capita family income, in individuals from other cities or states, those who consumed fruit less than four times a week, those who did not drink milk daily, those who were smokers, and those who reported the occurrence of headaches and dizziness. Higher mean calcium intake was found in individuals that slept less than seven hours a day. The prevalence of calcium intake below the recommendation was 88.6% (95% CI: 85.4-91.2). The results alert to an insufficient calcium intake and suggest that certain subgroups of adolescents need specific strategies to increase the intake of this nutrient. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  15. Safety and efficacy of the long-term adjuvant treatment of primary intermediate- to high-risk malignant melanoma (UICC/AJCC stage II and III) with a standardized fermented European mistletoe (Viscum album L.) extract. Results from a multicenter, comparative, epidemiological cohort study in Germany and Switzerland.

    Science.gov (United States)

    Augustin, Matthias; Bock, Paul R; Hanisch, Jürgen; Karasmann, Marita; Schneider, Berthold

    2005-01-01

    Mistletoe therapy is the most frequently used complementary treatment in cancer patients in Germany and Switzerland. However, its safety and efficacy were controversially discussed, also in case of malignant melanoma (MM). The present study should evaluate the therapeutic safety and efficacy of a long-term therapy with a standardized fermented European mistletoe (Viscum album L.) extract Iscador (FME) during post-surgical aftercare of primary intermediate to high-risk MM (UICC/AJCC stage II-III) patients and compare it with an untreated parallel control group from the same cohort. The study was designed as a multicenter, comparative, retrolective, epidemiological cohort study with parallel groups, carried out according to the guidelines of Good Epidemiological Practice (GEP). All patients suffered from surgically treated and histopathologically confirmed primary MM in UICC/AJCC stage II-III without distant metastases. In the study group, FME was administered subcutaneously 2-3 times weekly for at least three months, while the untreated control group was merely observed ("watchful waiting"). In both groups some patients also received radio-, chemo-, and/or immunotherapy. The patients were followed until the last visit or until death. Unselected, chronologically ordered, and standardized anonymous data from medical records that satisfied the predefined eligibility criteria were included for the "per protocol" analysis. Safety was assessed by the number of patients with FME-associated adverse drug reactions (ADRs) and by the search for tumor enhancement. The primary endpoint of efficacy was the adjusted tumor-related survival. Secondary end-points were the overall-, the disease-free- and the brain metastasis-free survival. The survival results were analyzed after adjustment for baseline imbalances, treatment regimens and other potential confounders by the Cox proportional hazard regression method. 686 eligible patients (329 FME vs. 357 controls) from 35 centers were

  16. Can an alert in primary care electronic medical records increase participation in a population-based screening programme for colorectal cancer? COLO-ALERT, a randomised clinical trial

    OpenAIRE

    Guiriguet-Capdevila, Carolina; Muñoz-Ortiz, Laura; Rivero-Franco, Irene; Vela-Vallespín, Carme; Vilarrubí-Estrella, Mercedes; Torres-Salinas, Miquel; Grau-Cano, Jaume; Burón-Pust, Andrea; Hernández-Rodríguez, Cristina; Fuentes-Peláez, Antonio; Reina-Rodríguez, Dolores; De León-Gallo, Rosa; Mendez-Boo, Leonardo; Torán-Monserrat, Pere

    2014-01-01

    Background Colorectal cancer is an important public health problem in Spain. Over the last decade, several regions have carried out screening programmes, but population participation rates remain below recommended European goals. Reminders on electronic medical records have been identified as a low-cost and high-reach strategy to increase participation. Further knowledge is needed about their effect in a population-based screening programme. The main aim of this study is to evaluate the effec...

  17. A Population-Based Study of Effects of Genetic Loci on Orofacial Clefts.

    Science.gov (United States)

    Moreno Uribe, L M; Fomina, T; Munger, R G; Romitti, P A; Jenkins, M M; Gjessing, H K; Gjerdevik, M; Christensen, K; Wilcox, A J; Murray, J C; Lie, R T; Wehby, G L

    2017-10-01

    Prior genome-wide association studies for oral clefts have focused on clinic-based samples with unclear generalizability. Prior samples were also small for investigating effects by cleft type and exclusively studied isolated clefts (those occurring without other birth defects). We estimated the effects of 17 top loci on cleft types in both isolated and nonisolated cases in the largest consortium to date of European-descent population-based studies. Our analytic approach focused on a mother-child dyad case-control design, but it also allowed analyzing mother-only or child-only genotypes to maximize power. Our total sample included 1,875 cases with isolated clefts, 459 cases with nonisolated clefts, and 3,749 controls. After correcting for multiple testing, we observed significant associations between fetal single-nucleotide polymorphisms (SNPs) at IRF6, PAX7, 8q21.3, 8q24, KIAA1598-VAX1, and MAFB and isolated cleft lip only (CLO) and cleft lip and palate (CLP). Significant associations were observed between isolated CLO and fetal SNPs near TPM1 and NOG1 and between CLP and fetal SNPs at ABCA4-ARHGAP29, THADA, FOXE1, and SPRY2. Overall, effects were similar for isolated CLO and CLP, except for ABCA4-ARHGAP29. A protective effect was observed for the fetal NOG1 SNP on cleft palate only, opposite in direction to the effect on CLO. For most fetal SNPs, a dose-response allelic effect was observed. No evidence of parent-of-origin or maternal genome effects was observed. Overall, effect direction and magnitude were similar between isolated and nonisolated clefts, suggesting that several loci are modifiers of cleft risk in both isolated and nonisolated forms. Our results provide reliable estimates of the effects of top loci on risks of oral clefts in a population of European descent.

  18. Exposure to genocide and the risk of schizophrenia: a population-based study.

    Science.gov (United States)

    Levine, S Z; Levav, I; Goldberg, Y; Pugachova, I; Becher, Y; Yoffe, R

    2016-03-01

    No evidence exists on the association between genocide and the incidence of schizophrenia. This study aims to identify critical periods of exposure to genocide on the risk of schizophrenia. This population-based study comprised of all subjects born in European nations where the Holocaust occurred from 1928 to 1945, who immigrated to Israel by 1965 and were indexed in the Population Register (N = 113 932). Subjects were followed for schizophrenia disorder in the National Psychiatric Case Registry from 1950 to 2014. The population was disaggregated to compare groups that immigrated before (indirect exposure: n = 8886, 7.8%) or after (direct exposure: n = 105 046, 92.2%) the Nazi or fascist era of persecutions began. The latter group was further disaggregated to examine likely initial prenatal or postnatal genocide exposures. Cox regression modelling was computed to compare the risk of schizophrenia between the groups, adjusting for confounders. The likely direct group was at a statistically (p schizophrenia (hazard ratio = 1.27, 95% confidence interval 1.06-1.51) than the indirect group. Also, the likely combined in utero and postnatal, and late postnatal (over age 2 years) exposure subgroups were statistically at greater risk of schizophrenia than the indirect group (p schizophrenia, and identified in utero and postnatal (combined) and late postnatal (age over 2 years) exposures as critical periods of risk.

  19. The Urban-Rural Gradient In Asthma: A Population-Based Study in Northern Europe

    Directory of Open Access Journals (Sweden)

    Signe Timm

    2015-12-01

    Full Text Available The early life environment appears to have a persistent impact on asthma risk. We hypothesize that environmental factors related to rural life mediate lower asthma prevalence in rural populations, and aimed to investigate an urban-rural gradient, assessed by place of upbringing, for asthma. The population-based Respiratory Health In Northern Europe (RHINE study includes subjects from Denmark, Norway, Sweden, Iceland and Estonia born 1945–1973. The present analysis encompasses questionnaire data on 11,123 RHINE subjects. Six categories of place of upbringing were defined: farm with livestock, farm without livestock, village in rural area, small town, city suburb and inner city. The association of place of upbringing with asthma onset was analysed with Cox regression adjusted for relevant confounders. Subjects growing up on livestock farms had less asthma (8% than subjects growing up in inner cities (11% (hazard ratio 0.72 95% CI 0.57–0.91, and a significant urban-rural gradient was observed across six urbanisation levels (p = 0.02. An urban-rural gradient was only evident among women, smokers and for late-onset asthma. Analyses on wheeze and place of upbringing revealed similar results. In conclusion, this study suggests a protective effect of livestock farm upbringing on asthma development and an urban-rural gradient in a Northern European population.

  20. Sleep and academic performance in later adolescence: results from a large population-based study.

    Science.gov (United States)

    Hysing, Mari; Harvey, Allison G; Linton, Steven J; Askeland, Kristin G; Sivertsen, Børge

    2016-06-01

    The aim of the current study was to assess the association between sleep duration and sleep patterns and academic performance in 16-19 year-old adolescents using registry-based academic grades. A large population-based study from Norway conducted in 2012, the youth@hordaland-survey, surveyed 7798 adolescents aged 16-19 years (53.5% girls). The survey was linked with objective outcome data on school performance. Self-reported sleep measures provided information on sleep duration, sleep efficiency, sleep deficit and bedtime differences between weekday and weekend. School performance [grade point average (GPA)] was obtained from official administrative registries. Most sleep parameters were associated with increased risk for poor school performance. After adjusting for sociodemographic information, short sleep duration and sleep deficit were the sleep measures with the highest odds of poor GPA (lowest quartile). Weekday bedtime was associated significantly with GPA, with adolescents going to bed between 22:00 and 23:00 hours having the best GPA. Also, delayed sleep schedule during weekends was associated with poor academic performance. The associations were somewhat reduced after additional adjustment for non-attendance at school, but remained significant in the fully adjusted models. In conclusion, the demonstrated relationship between sleep problems and poor academic performance suggests that careful assessment of sleep is warranted when adolescents are underperforming at school. Future studies are needed on the association between impaired sleep in adolescence and later functioning in adulthood. © 2016 European Sleep Research Society.

  1. Noise Annoyance in Urban Children: A Cross-Sectional Population-Based Study

    Directory of Open Access Journals (Sweden)

    Natacha Grelat

    2016-10-01

    Full Text Available Acoustical and non-acoustical factors influencing noise annoyance in adults have been well-documented in recent years; however, similar knowledge is lacking in children. The aim of this study was to quantify the annoyance caused by chronic ambient noise at home in children and to assess the relationship between these children′s noise annoyance level and individual and contextual factors in the surrounding urban area. A cross sectional population-based study was conducted including 517 children attending primary school in a European city. Noise annoyance was measured using a self-report questionnaire adapted for children. Six noise exposure level indicators were built at different locations at increasing distances from the child′s bedroom window using a validated strategic noise map. Multilevel logistic models were constructed to investigate factors associated with noise annoyance in children. Noise indicators in front of the child′s bedroom (p ≤ 0.01, family residential satisfaction (p ≤ 0.03 and socioeconomic characteristics of the individuals and their neighbourhood (p ≤ 0.05 remained associated with child annoyance. These findings illustrate the complex relationships between our environment, how we may perceive it, social factors and health. Better understanding of these relationships will undoubtedly allow us to more effectively quantify the actual effect of noise on human health.

  2. Noise Annoyance in Urban Children: A Cross-Sectional Population-Based Study

    Science.gov (United States)

    Grelat, Natacha; Houot, Hélène; Pujol, Sophie; Levain, Jean-Pierre; Defrance, Jérôme; Mariet, Anne-Sophie; Mauny, Frédéric

    2016-01-01

    Acoustical and non-acoustical factors influencing noise annoyance in adults have been well-documented in recent years; however, similar knowledge is lacking in children. The aim of this study was to quantify the annoyance caused by chronic ambient noise at home in children and to assess the relationship between these children′s noise annoyance level and individual and contextual factors in the surrounding urban area. A cross sectional population-based study was conducted including 517 children attending primary school in a European city. Noise annoyance was measured using a self-report questionnaire adapted for children. Six noise exposure level indicators were built at different locations at increasing distances from the child′s bedroom window using a validated strategic noise map. Multilevel logistic models were constructed to investigate factors associated with noise annoyance in children. Noise indicators in front of the child′s bedroom (p ≤ 0.01), family residential satisfaction (p ≤ 0.03) and socioeconomic characteristics of the individuals and their neighbourhood (p ≤ 0.05) remained associated with child annoyance. These findings illustrate the complex relationships between our environment, how we may perceive it, social factors and health. Better understanding of these relationships will undoubtedly allow us to more effectively quantify the actual effect of noise on human health. PMID:27801858

  3. The effectiveness of a population-based skin cancer screening program: evidence from Germany.

    Science.gov (United States)

    Kaiser, Micha; Schiller, Jörg; Schreckenberger, Christopher

    2017-03-28

    In this paper, we analyze how a nationwide population-based skin cancer screening program (SCS) implemented in Germany in 2008 has impacted the number of hospital discharges following malignant skin neoplasm diagnosis and the malignant melanoma mortality rate per 100,000 inhabitants. Our panel data, drawn from the Eurostat database, cover subregions in 22 European countries, measured at the lowest nomenclature of territorial units for statistics (NUTS) level for 2000-2013. Applying fixed effects methods, we find a significantly positive and robust effect of the German SCS on the number of patients diagnosed with malignant skin neoplasm. However, the program does not significantly influence the melanoma mortality rate. This finding conflicts with the decreased melanoma mortality rate found for the pilot SCS program in northern Germany. Our results indicate that Germany's nationwide SCS program is effective in terms of a higher diagnosis rate for malignant skin neoplasms and thus may contribute to an improvement in the early detection of skin cancer.

  4. Recurrence of hyperemesis gravidarum across generations: population based cohort study

    Science.gov (United States)

    Skjærven, Rolv; Grjibovski, Andrej M; Gunnes, Nina; Vangen, Siri; Magnus, Per

    2010-01-01

    Objective To estimate the risk of hyperemesis gravidarum (hyperemesis) according to whether the daughters and sons under study were born after pregnancies complicated by hyperemesis. Design Population based cohort study. Setting Registry data from Norway. Participants Linked generational data from the medical birth registry of Norway (1967-2006): 544 087 units of mother and childbearing daughter and 399 777 units of mother and child producing son. Main outcome measure Hyperemesis in daughters in mother and childbearing daughter units and hyperemesis in female partners of sons in mother and child producing son units. Results Daughters who were born after a pregnancy complicated by hyperemesis had a 3% risk of having hyperemesis in their own pregnancy, while women who were born after an unaffected pregnancy had a risk of 1.1% (unadjusted odds ratio 2.9, 95% confidence interval 2.4 to 3.6). Female partners of sons who were born after pregnancies complicated by hyperemesis had a risk of 1.2% (1.0, 0.7 to 1.6). Daughters born after a pregnancy not complicated by hyperemesis had an increased risk of the condition if the mother had hyperemesis in a previous or subsequent pregnancy (3.2 (1.6 to 6.4) if hyperemesis had occurred in one of the mother’s previous pregnancies and 3.7 (1.5 to 9.1) if it had occurred in a later pregnancy). Adjustment for maternal age at childbirth, period of birth, and parity did not change the estimates. Restrictions to firstborns did not influence the results. Conclusions Hyperemesis gravidarum is more strongly influenced by the maternal genotype than the fetal genotype, though environmental influences along the maternal line cannot be excluded as contributing factors. PMID:21030362

  5. Sleep and Multisystem Biological Risk: A Population-Based Study

    Science.gov (United States)

    Carroll, Judith E.; Irwin, Michael R.; Merkin, Sharon Stein; Seeman, Teresa E.

    2015-01-01

    Background Short sleep and poor sleep quality are associated with risk of cardiovascular disease, diabetes, cancer, and mortality. This study examines the contribution of sleep duration and sleep quality on a multisystem biological risk index that is known to be associated with morbidity and mortality. Methods Analyses include a population-based sample from the Midlife Development in the United States survey recruited to the Biomarker substudy. A total of 1,023 participants aged 54.5 years (SD = 11.8), 56% female and 77.6% white, were included in the analyses. A multisystem biological risk index was derived from 22 biomarkers capturing cardiovascular, immune, lipid-metabolic, glucose-metabolic, sympathetic, parasympathetic, and hypothalamic-pituitary-adrenal systems. Self-reported average sleep duration was categorized as short (Sleep quality was determined using the Pittsburgh Sleep Quality Index categorized as normal (≤5) and poor quality (>5) sleep. Findings Linear mixed effect models adjusting for age, gender, race, education, income, BMI, and health status were performed. As compared to normal sleepers, multisystem biological risk in both short (B(SE) = .38(.15), pPoor quality sleep alone was associated with elevated multisystem biological risk (B(SE) = .15(.06), p = .01), but was not significant after adjustment for health status. All short sleepers reported poor sleep quality. However in the long sleepers, only those who reported poor sleep quality exhibited elevated multisystem biological risk (B(SE) = .93(.3), p = .002). Conclusions Self-reported poor sleep quality with either short or long sleep duration is associated with dysregulation in physiological set points across regulatory systems, leading to elevated multisystem biological risk. Physicians should inquire about sleep health in the assessment of lifestyle factors related to disease risk, with evidence that healthy sleep is associated with lower multisystem biological risk. PMID:25714703

  6. Beta blockers and breast cancer mortality: a population- based study.

    Science.gov (United States)

    Barron, Thomas I; Connolly, Roisin M; Sharp, Linda; Bennett, Kathleen; Visvanathan, Kala

    2011-07-01

    Preclinical studies have demonstrated that antagonism of β₂-adrenergic signaling inhibits several pathways necessary for breast tumor progression and metastasis. A series of population-based observational studies were conducted to examine associations between beta blocker use and breast tumor characteristics at diagnosis or breast cancer-specific mortality. Linked national cancer registry and prescription dispensing data were used to identify women with a diagnosis of stage I to IV invasive breast cancer between January 1, 2001, and December 31, 2006. Women taking propranolol (β₁/β₂ antagonist; n = 70) or atenolol (β₁ antagonist; n = 525), in the year before breast cancer diagnosis were matched (1:2) to women not taking a beta blocker (n = 4,738). Associations between use of propranolol or atenolol and risk of local tumor invasion at diagnosis (T4 tumor), nodal or metastatic involvement at diagnosis (N2/N3/M1 tumor), and time to breast cancer-specific mortality were assessed. Propranolol users were significantly less likely to present with a T4 (odds ratio [OR], 0.24, 95% CI, 0.07 to 0.85) or N2/N3/M1 (OR, 0.20; 95% CI, 0.04 to 0.88) tumor compared with matched nonusers. The cumulative probability of breast cancer-specific mortality was significantly lower for propranolol users compared with matched nonusers (hazard ratio, 0.19; 95% CI, 0.06 to 0.60). There was no difference in T4 or N2/N3/M1 tumor incidence or breast cancer-specific mortality between atenolol users and matched nonusers. The results provide evidence in humans to support preclinical observations suggesting that inhibiting the β₂-adrenergic signaling pathway can reduce breast cancer progression and mortality.

  7. Population-based meta-analysis of furosemide pharmacokinetics.

    Science.gov (United States)

    Van Wart, Scott A; Shoaf, Susan E; Mallikaarjun, Suresh; Mager, Donald E

    2014-03-01

    Furosemide is a loop diuretic frequently used to treat fluid overload conditions such as hepatic cirrhosis and congestive heart failure (CHF). A population-based meta-analysis approach in NONMEM® was used to develop a PK model characterizing the time-course of furosemide in plasma and excretion into the urine for healthy subjects and fluid overload patients. Furosemide PK data from healthy subjects receiving 80 mg of oral furosemide were supplemented with additional individual and aggregate plasma concentration and urinary excretion versus time data from the literature after intravenous (i.v.) or oral furosemide administration (10-500 mg) to healthy subjects or fluid overload patients. A three-compartment model with zero-order input following i.v. administration (or first-order absorption using a Weibull function after oral administration) and first-order elimination best described furosemide PK. A covariate analysis identified creatinine clearance (CL(CR)) as a statistically significant predictor of renal clearance (CL(R)), with a population mean CL(R) of 4.67, 3.11, 1.95 and 1.17 l/h for a subject with normal renal function (CL(CR) = 120 ml/min) or mild (CL(CR) = 80 ml/min), moderate (CL(CR) = 50 ml/min) or severe (CLCR  = 30 ml/min) renal impairment. Oral bioavailability was 59.1% and non-renal clearance was 2.02 l/h. A PC-VPC and other model diagnostics demonstrated that the population PK model can reasonably predict the rate of urinary furosemide excretion over time using dosing history and commonly available demographic data, allowing for convenient assessment of PK-PD relationships for furosemide when given alone or in combination with other agents used to treat fluid overload conditions. Copyright © 2013 John Wiley & Sons, Ltd.

  8. Hypervolemia for Hypertension Pathophysiology: A Population-Based Study

    Directory of Open Access Journals (Sweden)

    Ender Hür

    2014-01-01

    Full Text Available Objectives. Hypertension and hypervolemia relationship was proven among renal disease, although it is not known in normal population. Present study determines the fluid distribution defects in relation to blood pressure. Material and Methods. In a population-based survey in Turkey demographics, height, weight, blood pressure, urine analysis, and serum creatinine measurements were recorded. Bioimpedance measured with the Body Composition Monitor. Results. Total 2034 population of 71.6% male, mean age 47 ± 12.6 (18–89 years, systolic blood pressure (SBP 134.7 ± 20, diastolic blood pressure 77.9 ± 11.6 mmHg. Body mass index (BMI was 28.5 ± 4.5 (15.8–50.6 kg/m2; overhydration was 0.05 ± 1.05 L. There was a correlation between extracellular water (ECW/height and SBP (r = 0.21, P < 0.001. Receiver operating characteristic (ROC curve with the performance of 0.60 (P < 0.001 that showed cut-off value of ECW/height was 10.06 L/m, with the 69% sensitivity and 45% specificity for SBP: 140 mmHg values. Risk factors for high SBP were increase of ECW/Height, age, BMI and presence of diabetes. ECW/height, SBP, and fat tissue index (FTI increased in BMI categories (low, normal, and obese and in diabetics. SBP and FTI were lower in smokers. Conclusions. High blood pressure may be accompanied by increased extracellular volume indices. In the future volume status assessment could be of use in evaluating the effectiveness of pharmacological intervention in the treatment of hypertension.

  9. Young adults' trajectories of Ecstasy use: a population based study.

    Science.gov (United States)

    Smirnov, Andrew; Najman, Jake M; Hayatbakhsh, Reza; Plotnikova, Maria; Wells, Helene; Legosz, Margot; Kemp, Robert

    2013-11-01

    Young adults' Ecstasy use trajectories have important implications for individual and population-level consequences of Ecstasy use, but little relevant research has been conducted. This study prospectively examines Ecstasy trajectories in a population-based sample. Data are from the Natural History Study of Drug Use, a retrospective/prospective cohort study conducted in Australia. Population screening identified a probability sample of Ecstasy users aged 19-23 years. Complete data for 30 months of follow-up, comprising 4 time intervals, were available for 297 participants (88.4% of sample). Trajectories were derived using cluster analysis based on recent Ecstasy use at each interval. Trajectory predictors were examined using a generalized ordered logit model and included Ecstasy dependence (World Mental Health Composite International Diagnostic Instrument), psychological distress (Hospital Anxiety Depression Scale), aggression (Young Adult Self Report) and contextual factors (e.g. attendance at electronic/dance music events). Three Ecstasy trajectories were identified (low, intermediate and high use). At its peak, the high-use trajectory involved 1-2 days Ecstasy use per week. Decreasing frequency of use was observed for intermediate and high-use trajectories from 12 months, independently of market factors. Intermediate and high-use trajectory membership was predicted by past Ecstasy consumption (>70 pills) and attendance at electronic/dance music events. High-use trajectory members were unlikely to have used Ecstasy for more than 3 years and tended to report consistently positive subjective effects at baseline. Given the social context and temporal course of Ecstasy use, Ecstasy trajectories might be better understood in terms of instrumental rather than addictive drug use patterns. © 2013 Elsevier Ltd. All rights reserved.

  10. Fatal colonic ischemia: A population-based study.

    Science.gov (United States)

    Acosta, Stefan; Ogren, Mats; Sternby, Nils-Herman; Bergqvist, David; Björck, Martin

    2006-11-01

    To estimate the incidence of fatal colonic ischaemia (CI) and the cause-specific mortality of CI, and to describe the localization and extension of colonic infarction and quantify the risk factors associated with CI. Between 1970 and 1982 the autopsy rate in Malmö, Sweden, was 87%, creating the possibilities for a population-based study. Out of 23,446 clinical autopsies, 997 cases were coded for intestinal ischaemia in a database. In addition, 7569 forensic autopsy protocols were analysed. In a case-control study nested in the clinical autopsy cohort, four CI-free controls, matched for gender, age at death and year of death, were identified for each fatal CI case in order to evaluate the risk factors. The cause-specific mortality ratio was 1.7/1000 autopsies. The overall incidence of autopsy-verified fatal CI was 1.7/100,000 person years, increasing with age up to 23/100,000 person years in octogenarians. Fatal cardiac failure (odds ratio (OR) 5.2), fatal valvular disease (OR 4.3), previous stroke (OR 2.5) and recent surgery (OR 3.4) were risk factors for fatal CI. Narrowing/occlusion of the inferior mesenteric artery (IMA) at the aortic origin was present in 68% of the patients. The most common segments affected by transmural infarctions were the sigmoid (83%) and the descending (77%) colon. Heart failure, atherosclerotic occlusion/stenoses of the IMA and recent surgery were the main risk factors causing colonic hypoperfusion and infarction. Segments of transmural infarctions were observed within the left colon in 94% of the patients. Awareness of the diagnosis and its associated cardiac comorbidities might help to improve survival.

  11. Candidate genes and cerebral palsy: a population-based study.

    Science.gov (United States)

    Gibson, Catherine S; Maclennan, Alastair H; Dekker, Gustaaf A; Goldwater, Paul N; Sullivan, Thomas R; Munroe, David J; Tsang, Shirley; Stewart, Claudia; Nelson, Karin B

    2008-11-01

    The objective of this study was to examine whether selected genetic polymorphisms in the infant are associated with later-diagnosed cerebral palsy. A population-based case-control study was conducted of 28 single-nucleotide polymorphisms measured in newborn screening blood spots. A total of 413 children with later-diagnosed cerebral palsy were born to white women in South Australia in 1986-1999, and there were 856 control children. Distributions of genotypic frequencies were examined in total cerebral palsy, in gestational age groups, and by types of cerebral palsy and gender. Genotyping was performed by using a TaqMan assay. For inducible nitric-oxide synthase, possession of the T allele was more common in all children with cerebral palsy and for heterozygotes who were born at term. For lymphotoxin alpha, homozygous variant status was associated with risk for cerebral palsy and with spastic hemiplegic or quadriplegic cerebral palsy. Among term infants, heterozygosity for the endothelial protein C receptor single-nucleotide polymorphism was more frequent in children with cerebral palsy. In preterm infants, the variant A allele of interleukin 8 and heterozygosity for the beta-2 adrenergic receptor were associated with cerebral palsy risk. Interleukin 8 heterozygote status was associated with spastic diplegia. Variants of several genes were associated with cerebral palsy in girls but not in boys. Two of the 28 single-nucleotide polymorphisms examined were associated with all types of spastic cerebral palsy in both gestational age groups and others with cerebral palsy in gestational age or cerebral palsy subgroups. Some of these associations support previous findings. There may be a genetic contribution to cerebral palsy risk, and additional investigation is warranted of genes and gene-environment interactions in cerebral palsy.

  12. European communion

    DEFF Research Database (Denmark)

    Manners, Ian James

    2013-01-01

    Political theory of European union, through an engagement between political concepts and theoretical understandings, provides a means of identifying the EU as a political object. It is argued that understanding the projects, processes and products of European union, based on ‘sharing’ or ‘communion......’, provides a better means of perceiving the EU as a political object rather than terms such as ‘integration’ or ‘co-operation’. The concept of ‘European communion’ is defined as the ‘subjective sharing of relationships’, understood as the extent to which individuals or groups believe themselves to be sharing...... relations (or not), and the consequences of these beliefs for European political projects, processes and products. By exploring European communion through an engagement with contemporary political theory, using very brief illustrations from the Treaty of Lisbon, the article also suggests that European...

  13. Cyberbullying among Finnish adolescents--a population-based study.

    Science.gov (United States)

    Lindfors, Pirjo L; Kaltiala-Heino, Riittakerttu; Rimpelä, Arja H

    2012-11-23

    Cyberbullying, threatening or harassing another via the internet or mobile phones, does not cause physically harm and thus the consequences are less visible. Little research has been performed on the occurrence of cyberbullying among adolescents or the perception of its seriousness. Only a few population-based studies have been published, none of which included research on the witnessing of cyberbullying. Here, we examined exposure to cyberbullying during the last year, and its frequency and perceived seriousness among 12 to 18-year-old adolescents in Finland. We studied four dimensions of cyberbullying: being a victim, bully, or both victim and bully of cyberbullying, and witnessing the cyberbullying of friends. Self-administered questionnaires, including four questions on cyberbullying, were mailed to a representative sample of 12-, 14-, 16-, and 18-year-old Finns in 2009 (the Adolescent Health and Lifestyle Survey). The respondents could answer via the internet or paper questionnaire. The number of respondents was 5516 and the response rate was 56%. Girls more often than boys reported experiencing at least one dimension of cyberbullying during the last year. The proportion was highest among 14-year-olds and lowest among 18-year-olds of both sexes. Among girls, the most commonly encountered dimension was witnessing the cyberbullying of friends (16%); and being a victim was slightly more common than being a bully (11% vs. 9%). Among boys, an equal proportion, approximately 10%, had been a victim, a bully, or had witnessed cyberbullying. The proportion of bully-victims was 4%. Serious and disruptive cyberbullying was experienced by 2% of respondents and weekly cyberbullying by 1%; only 0.5% of respondents had been bullied weekly and considered bullying serious and disruptive. Adolescents are commonly exposed to cyberbullying, but it is rarely frequent or considered serious or disruptive. Cyberbullying exposure differed between sexes, such that girls more often than

  14. Population-Based Incidence and Prevalence of Systemic Lupus Erythematosus

    Science.gov (United States)

    Somers, Emily C.; Marder, Wendy; Cagnoli, Patricia; Lewis, Emily E.; DeGuire, Peter; Gordon, Caroline; Helmick, Charles G.; Wang, Lu; Wing, Jeffrey J.; Dhar, J. Patricia; Leisen, James; Shaltis, Diane; McCune, W. Joseph

    2014-01-01

    Objective To estimate the incidence and prevalence of systemic lupus erythematosus (SLE) in a sociodemographically diverse southeastern Michigan source population of 2.4 million people. Methods SLE cases fulfilling the American College of Rheumatology classification criteria (primary case definition) or meeting rheumatologist-judged SLE criteria (secondary definition) and residing in Wayne or Washtenaw Counties during 2002–2004 were included. Case finding was performed from 6 source types, including hospitals and private specialists. Age-standardized rates were computed, and capture–recapture was performed to estimate underascertainment of cases. Results The overall age-adjusted incidence and prevalence (ACR definition) per 100,000 persons were 5.5 (95% confidence interval [95% CI] 5.0–6.1) and 72.8 (95% CI 70.8–74.8). Among females, the incidence was 9.3 per 100,000 persons and the prevalence was 128.7 per 100,000 persons. Only 7 cases were estimated to have been missed by capture–recapture, adjustment for which did not materially affect the rates. SLE prevalence was 2.3-fold higher in black persons than in white persons, and 10-fold higher in females than in males. Among incident cases, the mean ± SD age at diagnosis was 39.3 ± 16.6 years. Black SLE patients had a higher proportion of renal disease and end-stage renal disease (ESRD) (40.5% and 15.3%, respectively) as compared to white SLE patients (18.8% and 4.5%, respectively). Black patients with renal disease were diagnosed as having SLE at younger age than white patients with renal disease (mean ± SD 34.4 ± 14.9 years versus 41.9 ± 21.3 years; P = 0.05). Conclusion SLE prevalence was higher than has been described in most other population-based studies and reached 1 in 537 among black female persons. There were substantial racial disparities in the burden of SLE, with black patients experiencing earlier age at diagnosis, >2-fold increases in SLE incidence and prevalence, and increased

  15. Cyberbullying among Finnish adolescents – a population-based study

    Science.gov (United States)

    2012-01-01

    Background Cyberbullying, threatening or harassing another via the internet or mobile phones, does not cause physically harm and thus the consequences are less visible. Little research has been performed on the occurrence of cyberbullying among adolescents or the perception of its seriousness. Only a few population-based studies have been published, none of which included research on the witnessing of cyberbullying. Here, we examined exposure to cyberbullying during the last year, and its frequency and perceived seriousness among 12 to 18-year-old adolescents in Finland. We studied four dimensions of cyberbullying: being a victim, bully, or both victim and bully of cyberbullying, and witnessing the cyberbullying of friends. Methods Self-administered questionnaires, including four questions on cyberbullying, were mailed to a representative sample of 12-, 14-, 16-, and 18-year-old Finns in 2009 (the Adolescent Health and Lifestyle Survey). The respondents could answer via the internet or paper questionnaire. Results The number of respondents was 5516 and the response rate was 56%. Girls more often than boys reported experiencing at least one dimension of cyberbullying during the last year. The proportion was highest among 14-year-olds and lowest among 18-year-olds of both sexes. Among girls, the most commonly encountered dimension was witnessing the cyberbullying of friends (16%); and being a victim was slightly more common than being a bully (11% vs. 9%). Among boys, an equal proportion, approximately 10%, had been a victim, a bully, or had witnessed cyberbullying. The proportion of bully-victims was 4%. Serious and disruptive cyberbullying was experienced by 2% of respondents and weekly cyberbullying by 1%; only 0.5% of respondents had been bullied weekly and considered bullying serious and disruptive. Conclusions Adolescents are commonly exposed to cyberbullying, but it is rarely frequent or considered serious or disruptive. Cyberbullying exposure differed between

  16. Cyberbullying among Finnish adolescents – a population-based study

    Directory of Open Access Journals (Sweden)

    Lindfors Pirjo L

    2012-11-01

    Full Text Available Abstract Background Cyberbullying, threatening or harassing another via the internet or mobile phones, does not cause physically harm and thus the consequences are less visible. Little research has been performed on the occurrence of cyberbullying among adolescents or the perception of its seriousness. Only a few population-based studies have been published, none of which included research on the witnessing of cyberbullying. Here, we examined exposure to cyberbullying during the last year, and its frequency and perceived seriousness among 12 to 18-year-old adolescents in Finland. We studied four dimensions of cyberbullying: being a victim, bully, or both victim and bully of cyberbullying, and witnessing the cyberbullying of friends. Methods Self-administered questionnaires, including four questions on cyberbullying, were mailed to a representative sample of 12-, 14-, 16-, and 18-year-old Finns in 2009 (the Adolescent Health and Lifestyle Survey. The respondents could answer via the internet or paper questionnaire. Results The number of respondents was 5516 and the response rate was 56%. Girls more often than boys reported experiencing at least one dimension of cyberbullying during the last year. The proportion was highest among 14-year-olds and lowest among 18-year-olds of both sexes. Among girls, the most commonly encountered dimension was witnessing the cyberbullying of friends (16%; and being a victim was slightly more common than being a bully (11% vs. 9%. Among boys, an equal proportion, approximately 10%, had been a victim, a bully, or had witnessed cyberbullying. The proportion of bully-victims was 4%. Serious and disruptive cyberbullying was experienced by 2% of respondents and weekly cyberbullying by 1%; only 0.5% of respondents had been bullied weekly and considered bullying serious and disruptive. Conclusions Adolescents are commonly exposed to cyberbullying, but it is rarely frequent or considered serious or disruptive. Cyberbullying

  17. Burden of valvular heart diseases: a population-based study.

    Science.gov (United States)

    Nkomo, Vuyisile T; Gardin, Julius M; Skelton, Thomas N; Gottdiener, John S; Scott, Christopher G; Enriquez-Sarano, Maurice

    2006-09-16

    Valvular heart diseases are not usually regarded as a major public-health problem. Our aim was to assess their prevalence and effect on overall survival in the general population. We pooled population-based studies to obtain data for 11 911 randomly selected adults from the general population who had been assessed prospectively with echocardiography. We also analysed data from a community study of 16 501 adults who had been assessed by clinically indicated echocardiography. In the general population group, moderate or severe valve disease was identified in 615 adults. There was no difference in the frequency of such diseases between men and women (p=0.90). Prevalence increased with age, from 0.7% (95% CI 0.5-1.0) in 18-44 year olds to 13.3% (11.7-15.0) in the 75 years and older group (p<0.0001). The national prevalence of valve disease, corrected for age and sex distribution from the US 2000 population, is 2.5% (2.2-2.7). In the community group, valve disease was diagnosed in 1505 (1.8% adjusted) adults and frequency increased considerably with age, from 0.3% (0.2-0.3) of the 18-44 year olds to 11.7% (11.0-12.5) of those aged 75 years and older, but was diagnosed less often in women than in men (odds ratio 0.90, 0.81-1.01; p=0.07). The adjusted mortality risk ratio associated with valve disease was 1.36 (1.15-1.62; p=0.0005) in the population and 1.75 (1.61-1.90; p<0.0001) in the community. Moderate or severe valvular diseases are notably common in this population and increase with age. In the community, women are less often diagnosed than are men, which could indicate an important imbalance in view of the associated lower survival. Valve diseases thus represent an important public-health problem.

  18. European Institutions?

    NARCIS (Netherlands)

    Meacham, Darian

    2016-01-01

    The aim of this article is to sketch a phenomenological theory of political institutions and to apply it to some objections and questions raised by Pierre Manent about the project of the European Union and more specifically the question of “European Construction”, i.e. what is the aim of the

  19. Selective Europeanization

    DEFF Research Database (Denmark)

    Hoch Jovanovic, Tamara; Lynggaard, Kennet

    2014-01-01

    political contexts at the European level. We further show how the “translation” of international norms to a domestic context has worked to reinforce the original institutional setup, dating back to the mid-1950s. The translation of European-level minority policy developed in the 1990s and 2000s works most...

  20. Family Aggregation and Heritability of ESRD in Taiwan: A Population-Based Study.

    Science.gov (United States)

    Wu, Hsin Hsu; Kuo, Chang Fu; Li, I Jung; Weng, Cheng Hao; Lee, Cheng Chia; Tu, Kun Hua; Liu, Shou Hsuan; Chen, Yung Chang; Yang, Chih Wei; Luo, Shue Fen; See, Lai Chu; Yu, Kuang Hui; Huang, Lu Hsiang; Zhang, Weiya; Doherty, Michael; Tian, Ya Chung

    2017-11-01

    Aggregation of end-stage renal disease (ESRD) has been observed in families of European origin, as well as those of African origin. However, it is not well documented if this disease aggregates in Asian families. Furthermore, the contribution of genetic factors and shared environmental factors to family aggregation remains unclear. Population-based cross-sectional cohort study. All 23,422,955 individuals registered in the Taiwan National Health Insurance Research Database in 2013. Among these, 47.45%, 57.45%, 47.29%, and 1.51% had a known parent, child, sibling, or twin, respectively. We identified 87,849 patients who had a diagnosis of ESRD. Family history of ESRD. ESRD and heritability defined as the proportion of phenotypic variance attributable to genetic factors. Having an affected first-degree relative with ESRD was associated with an adjusted relative risk of 2.46 (95% CI, 2.32-2.62). Relative risks were 96.38 (95% CI, 48.3-192.34) for twins of patients with ESRD, 2.15 (95% CI, 2.02-2.29) for parents, 2.78 (95% CI, 2.53-3.05) for offspring, 4.96 (95% CI, 4.19-5.88) for siblings, and 1.66 (95% CI, 1.54-1.78) for spouses without genetic similarities. Heritability in this study was 31.1% to 11.4% for shared environmental factors and 57.5% for nonshared environmental factors. This was a registry database study and we did not have detailed information about clinical findings or the definite causes of ESRD. This whole population-based family study in Asia confirmed, in a Taiwanese population, that a family history of ESRD is a strong risk factor for this disease. Moderate heritability was noted and environmental factors were related to disease. Family history of ESRD is an important piece of clinical information. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  1. Tolerable rates of visual field progression in a population-based sample of patients with glaucoma.

    Science.gov (United States)

    Salonikiou, Angeliki; Founti, Panayiota; Kilintzis, Vassilis; Antoniadis, Antonis; Anastasopoulos, Eleftherios; Pappas, Theofanis; Raptou, Anastasia; Topouzis, Fotis

    2017-09-28

    To provide population-based data on the maximum tolerable rate of progression to avoid visual impairment (maxTRoP_VI) and blindness (maxTRoP_BL) from open-angle glaucoma (OAG). Participants with OAG in the Thessaloniki Eye Study (cross-sectional, population-based study in a European population) were included in the analysis. Visual impairment was defined as mean deviation (MD) equal to or worse than -12 dB and blindness as MD equal to or worse than -24 dB. Additional thresholds for visual impairment were tested. For each participant maxTRoP_VI was defined as the rate of progression which would not lead to visual impairment during expected lifetime. MaxTRoP_BL was defined accordingly. Both parameters were calculated for each OAG subject using age, sex, MD and life expectancy data. The eye with the better MD per subject was included in the analysis. Among 135 subjects with OAG, 123 had reliable visual fields and were included in the analysis. The mean age was 73±6 years and the median MD was -3.65±5.28 dB. Among those, 69.1% would have a maxTRoP_VI slower than -1 dB/year and 18.7% would have a maxTRoP_VI between -1 and -2 dB/year. Also, 72.4% would have a maxTRoP_BL slower than -2 dB/year. For all tested thresholds for visual impairment, approximately 86% of the OAG study participants would not be able to tolerate a rate of progression equal to or faster than -2 dB/year. The majority of patients with glaucoma in our study would have a maximum tolerable rate of progression slower than -1 dB/year in their better eye. Patient-tailored strategies to monitor the visual field are important, but raise the issue of feasibility with regard to the number of visual field tests needed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Factors predicting survival in ALS: a multicenter Italian study.

    Science.gov (United States)

    Calvo, Andrea; Moglia, Cristina; Lunetta, Christian; Marinou, Kalliopi; Ticozzi, Nicola; Ferrante, Gianluca Drago; Scialo, Carlo; Sorarù, Gianni; Trojsi, Francesca; Conte, Amelia; Falzone, Yuri M; Tortelli, Rosanna; Russo, Massimo; Chiò, Adriano; Sansone, Valeria Ada; Mora, Gabriele; Silani, Vincenzo; Volanti, Paolo; Caponnetto, Claudia; Querin, Giorgia; Monsurrò, Maria Rosaria; Sabatelli, Mario; Riva, Nilo; Logroscino, Giancarlo; Messina, Sonia; Fini, Nicola; Mandrioli, Jessica

    2017-01-01

    The aim of this multicenter, retrospective study is to investigate the role of clinical characteristics and therapeutic intervention on ALS prognosis. The study included patients diagnosed from January 1, 2009 to December 31, 2013 in 13 Italian referral centers for ALS located in 10 Italian regions. Caring neurologists collected a detailed phenotypic profile and follow-up data until death into an electronic database. One center collected also data from a population-based registry for ALS. 2648 incident cases were collected. The median survival time from onset to death/tracheostomy was 44 months (SE 1.18, CI 42-46). According to univariate analysis, factors related to survival from onset to death/tracheostomy were: age at onset, diagnostic delay, site of onset, phenotype, degree of certainty at diagnosis according to revised El Escorial criteria (R-EEC), presence/absence of dementia, BMI at diagnosis, patients' provenance. In the multivariate analysis, age at onset, diagnostic delay, phenotypes but not site of onset, presence/absence of dementia, BMI, riluzole use, R-EEC criteria were independent prognostic factors of survival in ALS. We compared patients from an ALS Registry with patients from tertiary centers; the latter ones were younger, less frequently bulbar, but more frequently familial and definite at diagnosis. Our large, multicenter study demonstrated the role of some clinical and demographic factors on ALS survival, and showed some interesting differences between referral centers' patients and the general ALS population. These results can be helpful for clinical practice, in clinical trial design and to validate new tools to predict disease progression.

  3. Genetic structure of Balearic honeybee populations based on microsatellite polymorphism

    Directory of Open Access Journals (Sweden)

    Moritz Robin FA

    2003-05-01

    Full Text Available Abstract The genetic variation of honeybee colonies collected in 22 localities on the Balearic Islands (Spain was analysed using eight polymorphic microsatellite loci. Previous studies have demonstrated that these colonies belong either to the African or west European evolutionary lineages. These populations display low variability estimated from both the number of alleles and heterozygosity values, as expected for the honeybee island populations. Although genetic differentiation within the islands is low, significant heterozygote deficiency is present, indicating a subpopulation genetic structure. According to the genetic differentiation test, the honeybee populations of the Balearic Islands cluster into two groups: Gimnesias (Mallorca and Menorca and Pitiusas (Ibiza and Formentera, which agrees with the biogeography postulated for this archipelago. The phylogenetic analysis suggests an Iberian origin of the Balearic honeybees, thus confirming the postulated evolutionary scenario for Apis mellifera in the Mediterranean basin. The microsatellite data from Formentera, Ibiza and Menorca show that ancestral populations are threatened by queen importations, indicating that adequate conservation measures should be developed for protecting Balearic bees.

  4. Antihypertensive drug use during pregnancy: a population based study

    Directory of Open Access Journals (Sweden)

    Carmen D'Amore

    2015-09-01

    Full Text Available PURPOSE. The study aimed at assessing if the European guideline on the use of antihypertensive drugs (AD in pregnancy are followed in clinical practice. We also evaluated the association between the use of non-recommended drugs and individual characteristics. METHODS. This study analyzed a cohort of 86 171 singleton deliveries occurring between 2009-2010 in the Lombardy region, Italy. Women with first prescription of AD during pregnancy were considered as incident users. Methyldopa, labetalol and nifedipine were considered as "recommended drugs"; all other AD were considered as "non-recommended". Odds Ratio and 95% confidence intervals were estimated. RESULTS. Among the 1009 patients (1.2% exposed to AD during pregnancy, 675 (66.9% were incident users. Among the incident users, 31% received non-recommended drugs; this proportion decreased to 18% among women who started treatment in the third trimester. Women with at least four concomitant diseases had an elevated risk of receiving non-recommended drugs in pregnancy (OR 2.68; 95% CI 1.10-6.73. CONCLUSIONS. Exposure to recommended antihypertensives increased during pregnancy. Nevertheless, a fraction of users that continued or began treatment with non-recommended medications was still present.

  5. Fall Injuries in Nepal: A Countrywide Population-based Survey.

    Science.gov (United States)

    Gupta, Shailvi; Gupta, Shyam Kumar; Devkota, Sagar; Ranjit, Anju; Swaroop, Mamta; Kushner, Adam L; Nwomeh, Benedict C; Victorino, Gregory P

    2015-01-01

    .8). Surgical care was not delivered to those who died for the following reasons: no time (n = 4), facility/personnel not available (n = 1), fear/no trust (n = 1), and no need (n = 1). The Nepal SOSAS study provides countrywide, population-based data on fall-injury prevalence in Nepal and has identified falls as a crucial public health concern. These data highlight persistent barriers to access to care for the injured and the need to improve trauma care systems in developing countries such as Nepal. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Sleep and depression in postpartum women: a population-based study

    National Research Council Canada - National Science Library

    Dørheim, Signe Karen; Bondevik, Gunnar Tschudi; Eberhard-Gran, Malin; Bjorvatn, Bjørn

    2009-01-01

    ...) identify factors independently associated with either condition, and (3) explore associations between specific postpartum sleep components and depression. Cross-sectional. Population-based. All women (n = 4191...

  7. Asthma medication prescribing before, during and after pregnancy : A study in seven European regions

    NARCIS (Netherlands)

    Charlton, Rachel A; Pierini, Anna; Klungsøyr, Kari; Neville, Amanda J; Jordan, Susan; Jong-van den Berg, de Lolkje; Thayer, Daniel; Bos, H Jens; Puccini, Aurora; Hansen, Anne V; Gini, Rosa; Engeland, Anders; Nybo Andersen, Anne-Marie; Dolk, Helen; Garne, Ester

    2016-01-01

    OBJECTIVES: To explore utilisation patterns of asthma medication before, during and after pregnancy as recorded in seven European population-based databases. DESIGN: A descriptive drug utilisation study. SETTING: 7 electronic healthcare databases in Denmark, Norway, the Netherlands, Italy (Emilia

  8. Cost-effectiveness and budget impact analysis of a population-based screening program for colorectal cancer.

    Science.gov (United States)

    Pil, L; Fobelets, M; Putman, K; Trybou, J; Annemans, L

    2016-07-01

    Colorectal cancer (CRC) is one of the leading causes of cancer mortality in Belgium. In Flanders (Belgium), a population-based screening program with a biennial immunochemical faecal occult blood test (iFOBT) in women and men aged 56-74 has been organised since 2013. This study assessed the cost-effectiveness and budget impact of the colorectal population-based screening program in Flanders (Belgium). A health economic model was conducted, consisting of a decision tree simulating the screening process and a Markov model, with a time horizon of 20years, simulating natural progression. Predicted mortality and incidence, total costs, and quality-adjusted life-years (QALYs) with and without the screening program were calculated in order to determine the incremental cost-effectiveness ratio of CRC screening. Deterministic and probabilistic sensitivity analyses were conducted, taking into account uncertainty of the model parameters. Mortality and incidence were predicted to decrease over 20years. The colorectal screening program in Flanders is found to be cost-effective with an ICER of 1681/QALY (95% CI -1317 to 6601) in males and €4,484/QALY (95% CI -3254 to 18,163). The probability of being cost-effective given a threshold of €35,000/QALY was 100% and 97.3%, respectively. The budget impact analysis showed the extra cost for the health care payer to be limited. This health economic analysis has shown that despite the possible adverse effects of screening and the extra costs for the health care payer and the patient, the population-based screening program for CRC in Flanders is cost-effective and should therefore be maintained. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  9. European Whiteness?

    DEFF Research Database (Denmark)

    Blaagaard, Bolette

    2008-01-01

    Born out of the United States’ (U.S.) history of slavery and segregation and intertwined with gender studies and feminism, the field of critical whiteness studies does not fit easily into a European setting and the particular historical context that entails. In order for a field of European...... critical whiteness studies to emerge, its relation to the U.S. theoretical framework, as well as the particularities of the European context need to be taken into account.. The article makes a call for a multi-layered approach to take over from the identity politics so often employed in the fields of U...

  10. Risk of cardiovascular disease in a traditional African population with a high infectious load: a population-based study.

    Directory of Open Access Journals (Sweden)

    Jacob J E Koopman

    Full Text Available BACKGROUND: To test the inflammatory origin of cardiovascular disease, as opposed to its origin in western lifestyle. Population-based assessment of the prevalences of cardiovascular risk factors and cardiovascular disease in an inflammation-prone African population, including electrocardiography and ankle-arm index measurement. Comparison with known prevalences in American and European societies. METHODOLOGY/PRINCIPAL FINDINGS: Traditional population in rural Ghana, characterised by adverse environmental conditions and a high infectious load. Population-based sample of 924 individuals aged 50 years and older. Median values for cardiovascular risk factors, including waist circumference, BMI, blood pressure, and markers of glucose and lipid metabolism and inflammation. Prevalence of myocardial infarction detected by electrocardiography and prevalence of peripheral arterial disease detected by ankle-arm index. When compared to western societies, we found the Ghanaians to have more proinflammatory profiles and less cardiovascular risk factors, including obesity, dysglycaemia, dyslipidaemia, and hypertension. Prevalences of cardiovascular disease were also lower. Definite myocardial infarction was present in 1.2% (95%CI: 0.6 to 2.4%. Peripheral arterial disease was present in 2.8% (95%CI: 1.9 to 4.1%. CONCLUSIONS/SIGNIFICANCE: Taken together, our data indicate that for the pathogenesis of cardiovascular disease inflammatory processes alone do not suffice and additional factors, probably lifestyle-related, are mandatory.

  11. Euclidean supergravity and multi-centered solutions

    Science.gov (United States)

    Sabra, W. A.

    2017-04-01

    In ungauged supergravity theories, the no-force condition for BPS states implies the existence of stable static multi-centered solutions. The first solutions to Einstein-Maxwell theory with a positive cosmological constant describing an arbitrary number of charged black holes were found by Kastor and Traschen. Generalisations to five and higher dimensional theories were obtained by London. Multi-centered solutions in gauged supergravity, even with time-dependence allowed, have yet to be constructed. In this letter we construct supersymmetry-preserving multi-centered solutions for the case of D = 5, N = 2 Euclidean gauged supergravity coupled to an arbitrary number of vector multiplets. Higher dimensional Einstein-Maxwell multi-centered solutions are also presented.

  12. Euclidean supergravity and multi-centered solutions

    Directory of Open Access Journals (Sweden)

    W.A. Sabra

    2017-04-01

    Full Text Available In ungauged supergravity theories, the no-force condition for BPS states implies the existence of stable static multi-centered solutions. The first solutions to Einstein–Maxwell theory with a positive cosmological constant describing an arbitrary number of charged black holes were found by Kastor and Traschen. Generalisations to five and higher dimensional theories were obtained by London. Multi-centered solutions in gauged supergravity, even with time-dependence allowed, have yet to be constructed. In this letter we construct supersymmetry-preserving multi-centered solutions for the case of D=5, N=2 Euclidean gauged supergravity coupled to an arbitrary number of vector multiplets. Higher dimensional Einstein–Maxwell multi-centered solutions are also presented.

  13. Is type 2 diabetes mellitus a significant problem in European adolescents?

    OpenAIRE

    Erhardt, Eva; Molnár, Dénes

    2008-01-01

    The rapidly rising incidence of type 2 diabetes mellitus in young patients is well known in North America, especially in some minorities. Population-based data suggest that the epidemic of paediatric obesity is being followed by an increase in type 2 diabetes mellitus, but for European countries there are such no population-based incidence and prevalence data. From the available data the magnitude of the problem in the European Caucasian population seems to be much less than in North America....

  14. The epidemiology of pituitary adenomas in Iceland, 1955-2012: a nationwide population-based study.

    Science.gov (United States)

    Agustsson, Tomas Thor; Baldvinsdottir, Tinna; Jonasson, Jon G; Olafsdottir, Elinborg; Steinthorsdottir, Valgerdur; Sigurdsson, Gunnar; Thorsson, Arni V; Carroll, Paul V; Korbonits, Márta; Benediktsson, Rafn

    2015-11-01

    Pituitary adenomas (PA) are among the most common human neoplasms. To describe the epidemiology and assess the disease burden of clinically significant PAs, population-based studies are needed. Iceland has a small well-defined population. The aim of this study is to describe the epidemiology of PAs in Iceland over an expanded period of time. This is a retrospective observational study, including all PAs diagnosed in Iceland from 1955 to 2012. Extensive clinical information was gathered in a database. Prevalence rates for all PA subtypes were calculated along with standardized incidence rates (SIR). Sex ratios and relationships with adenoma size, age, and symptoms were assessed. We identified 471 individuals: 190 men and 281 women. Total prevalence in 2012 was 115.57/100, 000, prolactinomas were most prevalent (54.37/100, 000) followed by non-functioning adenomas (NFPAs) (42.32/100 ,000). Throughout the period, NFPAs were most common (43.0%) followed by prolactinomas (39.9%) and 11.3% had acromegaly and 5.7% Cushing's disease. Women are diagnosed younger with smaller adenomas. Total SIR has increased significantly and is now 5.8/100 000 per year. In this nationwide study spanning six decades, we have confirmed PAs rising prevalence and incidence rates noted in recent studies. We demonstrated higher overall prevalence and incidence rates than ever previously recorded with an increasing predominance of NFPAs, which is not explained by incidental findings alone. There is a relationship with the introduction of imaging modalities, but the vast majority of patients are symptomatic at diagnosis. This underlines the importance of increased awareness, education, and appropriate allocation of resources for this growing group of patients. © 2015 European Society of Endocrinology.

  15. Association between ischemic stroke and carbon monoxide poisoning: A population-based retrospective cohort analysis.

    Science.gov (United States)

    Lin, Chia-Wei; Chen, Wei-Kung; Hung, Dong-Zong; Chen, Yi-Wen; Lin, Cheng-Li; Sung, Fung-Chang; Kao, Chia-Hung

    2016-04-01

    The long-term consequence of cardiovascular health has not been evaluated for patients with carbon monoxide (CO) poisoning. This study evaluated the risk of ischemic stroke using population-based data. We identified 8705 inpatients with CO intoxication diagnosed from 2000 to 2011 from the Taiwan National Health Insurance Research Database. The control cohort consisted of 34,820 persons randomly identified from patients without exposure frequency matched by age, sex, and the year of hospitalization. Incidence and hazard ratio (HR) of ischemic stroke were evaluated by sociodemographic factors and comorbidities by the end of 2011. The incidence of ischemic stroke revealed a significant increase in the CO-poisoning cohort over the follow-up period (pincidence of ischemic stroke was near 2.5-fold greater in the CO-poisoned cohort than in controls (5.49 versus 2.02 per 1000 person-years), with an adjusted HR of 2.60 (95% confidence interval (CI)=2.15-3.15). The adjusted HR for those without comorbidities was slightly higher (2.76, 95% CI=2.13-3.58). The age-specific CO-poisoning to non-CO-poisoning relative risk was greatest in the youngest group (20-34years) (adjusted HR=6.45; 95% CI=3.30-12.6). CO poisoning is associated with a long-term risk of increased incident ischemic stroke. Further study on the mechanism of ischemic stroke for CO poisoning affects is needed. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  16. Characterization of mitochondrial haplogroups in a large population-based sample from the United States.

    Science.gov (United States)

    Mitchell, Sabrina L; Goodloe, Robert; Brown-Gentry, Kristin; Pendergrass, Sarah A; Murdock, Deborah G; Crawford, Dana C

    2014-07-01

    Mitochondrial DNA (mtDNA) haplogroups are valuable for investigations in forensic science, molecular anthropology, and human genetics. In this study, we developed a custom panel of 61 mtDNA markers for high-throughput classification of European, African, and Native American/Asian mitochondrial haplogroup lineages. Using these mtDNA markers, we constructed a mitochondrial haplogroup classification tree and classified 18,832 participants from the National Health and Nutrition Examination Surveys (NHANES). To our knowledge, this is the largest study to date characterizing mitochondrial haplogroups in a population-based sample from the United States, and the first study characterizing mitochondrial haplogroup distributions in self-identified Mexican Americans separately from Hispanic Americans of other descent. We observed clear differences in the distribution of maternal genetic ancestry consistent with proposed admixture models for these subpopulations, underscoring the genetic heterogeneity of the United States Hispanic population. The mitochondrial haplogroup distributions in the other self-identified racial/ethnic groups within NHANES were largely comparable to previous studies. Mitochondrial haplogroup classification was highly concordant with self-identified race/ethnicity (SIRE) in non-Hispanic whites (94.8 %), but was considerably lower in admixed populations including non-Hispanic blacks (88.3 %), Mexican Americans (81.8 %), and other Hispanics (61.6 %), suggesting SIRE does not accurately reflect maternal genetic ancestry, particularly in populations with greater proportions of admixture. Thus, it is important to consider inconsistencies between SIRE and genetic ancestry when performing genetic association studies. The mitochondrial haplogroup data that we have generated, coupled with the epidemiologic variables in NHANES, is a valuable resource for future studies investigating the contribution of mtDNA variation to human health and disease.

  17. Population-Based Survey of Filamentous Fungi and Antifungal Resistance in Spain (FILPOP Study)

    Science.gov (United States)

    Mellado, E.; Peláez, T.; Pemán, J.; Zapico, S.; Alvarez, M.; Rodríguez-Tudela, J. L.; Cuenca-Estrella, M.

    2013-01-01

    A population-based survey was conducted to investigate the epidemiology of and antifungal resistance in Spanish clinical strains of filamentous fungi isolated from deep tissue samples, blood cultures, and respiratory samples. The study was conducted in two different periods (October 2010 and May 2011) to analyze seasonal variations. A total of 325 strains were isolated in 29 different hospitals. The average prevalence was 0.0016/1,000 inhabitants. Strains were identified by sequencing of DNA targets and susceptibility testing by the European Committee for Antimicrobial Susceptibility Testing reference procedure. The most frequently isolated genus was Aspergillus, accounting for 86.3% of the isolates, followed by Scedosporium at 4.7%; the order Mucorales at 2.5%; Penicillium at 2.2%, and Fusarium at 1.2%. The most frequent species was Aspergillus fumigatus (48.5%), followed by A. flavus (8.4%), A. terreus (8.1%), A. tubingensis (6.8%), and A. niger (6.5%). Cryptic/sibling Aspergillus species accounted for 12% of the cases. Resistance to amphotericin B was found in 10.8% of the isolates tested, while extended-spectrum triazole resistance ranged from 10 to 12.7%, depending on the azole tested. Antifungal resistance was more common among emerging species such as those of Scedosporium and Mucorales and also among cryptic species of Aspergillus, with 40% of these isolates showing resistance to all of the antifungal compounds tested. Cryptic Aspergillus species seem to be underestimated, and their correct classification could be clinically relevant. The performance of antifungal susceptibility testing of the strains implicated in deep infections and multicentric studies is recommended to evaluate the incidence of these cryptic species in other geographic areas. PMID:23669377

  18. European Security

    DEFF Research Database (Denmark)

    Møller, Bjørn

    Theoretical chapters on "Security", "Organisations" and "Regions," Historical Chapters on "Europe and Its Distinguishing Features" and on "The United Nations," "NATO," "The CSCE/OSCE and the Council of Europe" and "The European Union"......Theoretical chapters on "Security", "Organisations" and "Regions," Historical Chapters on "Europe and Its Distinguishing Features" and on "The United Nations," "NATO," "The CSCE/OSCE and the Council of Europe" and "The European Union"...

  19. Orthostatic Hypotension and the Long-Term Risk of Dementia: A Population-Based Study.

    Directory of Open Access Journals (Sweden)

    Frank J Wolters

    2016-10-01

    Full Text Available Orthostatic hypotension (OH is a common cause of transient cerebral hypoperfusion in the population. Cerebral hypoperfusion is widely implicated in cognitive impairment, but whether OH contributes to cognitive decline and dementia is uncertain. We aimed to determine the association between OH and the risk of developing dementia in the general population.Between 4 October 1989 and 17 June 1993, we assessed OH in non-demented, stroke-free participants of the population-based Rotterdam Study. OH was defined as a ≥20 mm Hg drop in systolic blood pressure (SBP or ≥10 mm Hg drop in diastolic blood pressure (DBP within 3 min from postural change. We furthermore calculated within participant variability in SBP related to postural change, expressed as coefficient of variation. Follow-up for dementia was conducted until 1 January 2014. We determined the risk of dementia in relation to OH and SBP variability, using a Cox regression model, adjusted for age; sex; smoking status; alcohol intake; SBP; DBP; cholesterol:high-density lipoprotein ratio; diabetes; body mass index; use of antihypertensive, lipid-lowering, or anticholinergic medication; and apolipoprotein E genotype. Finally, we explored whether associations varied according to compensatory increase in heart rate. Among 6,204 participants (mean ± standard deviation [SD] age 68.5 ± 8.6 y, 59.7% female with a median follow-up of 15.3 y, 1,176 developed dementia, of whom 935 (79.5% had Alzheimer disease and 95 (8.1% had vascular dementia. OH was associated with an increased risk of dementia (adjusted hazard ratio [aHR] 1.15, 95% CI 1.00-1.34, p = 0.05, which was similar for Alzheimer disease and vascular dementia. Similarly, greater SBP variability with postural change was associated with an increased risk of dementia (aHR per SD increase 1.08, 95% CI 1.01-1.16, p = 0.02, which was similar when excluding those who fulfilled the formal criteria for OH (aHR 1.08, 95% CI 1.00-1.17, p = 0.06. The risk

  20. Orthostatic Hypotension and the Long-Term Risk of Dementia: A Population-Based Study.

    Science.gov (United States)

    Wolters, Frank J; Mattace-Raso, Francesco U S; Koudstaal, Peter J; Hofman, Albert; Ikram, M Arfan

    2016-10-01

    Orthostatic hypotension (OH) is a common cause of transient cerebral hypoperfusion in the population. Cerebral hypoperfusion is widely implicated in cognitive impairment, but whether OH contributes to cognitive decline and dementia is uncertain. We aimed to determine the association between OH and the risk of developing dementia in the general population. Between 4 October 1989 and 17 June 1993, we assessed OH in non-demented, stroke-free participants of the population-based Rotterdam Study. OH was defined as a ≥20 mm Hg drop in systolic blood pressure (SBP) or ≥10 mm Hg drop in diastolic blood pressure (DBP) within 3 min from postural change. We furthermore calculated within participant variability in SBP related to postural change, expressed as coefficient of variation. Follow-up for dementia was conducted until 1 January 2014. We determined the risk of dementia in relation to OH and SBP variability, using a Cox regression model, adjusted for age; sex; smoking status; alcohol intake; SBP; DBP; cholesterol:high-density lipoprotein ratio; diabetes; body mass index; use of antihypertensive, lipid-lowering, or anticholinergic medication; and apolipoprotein E genotype. Finally, we explored whether associations varied according to compensatory increase in heart rate. Among 6,204 participants (mean ± standard deviation [SD] age 68.5 ± 8.6 y, 59.7% female) with a median follow-up of 15.3 y, 1,176 developed dementia, of whom 935 (79.5%) had Alzheimer disease and 95 (8.1%) had vascular dementia. OH was associated with an increased risk of dementia (adjusted hazard ratio [aHR] 1.15, 95% CI 1.00-1.34, p = 0.05), which was similar for Alzheimer disease and vascular dementia. Similarly, greater SBP variability with postural change was associated with an increased risk of dementia (aHR per SD increase 1.08, 95% CI 1.01-1.16, p = 0.02), which was similar when excluding those who fulfilled the formal criteria for OH (aHR 1.08, 95% CI 1.00-1.17, p = 0.06). The risk of

  1. Strabismus Incidence in a Danish Population-Based Cohort of Children

    DEFF Research Database (Denmark)

    Torp-Pedersen, Tobias; Boyd, Heather A; Skotte, Line

    2017-01-01

    Importance: To our knowledge, there have been few population-based studies of strabismus incidence conducted. Our population-based study provides valuable data for health services planning and identifying research needs. Objective: To determine the incidence and age distribution of strabismus, ov...

  2. Cardiovascular Disease Risk in a Large, Population-Based Cohort of Breast Cancer Survivors

    NARCIS (Netherlands)

    Boekel, N.B.; Schaapveld, M.; Gietema, J.A.; Russell, N.S.; Poortmans, P.; Theuws, J.C.; Schinagl, D.A.; Rietveld, D.H.; Versteegh, M.I.; Visser, O; Rutgers, E.J.; Aleman, B.M.; Leeuwen, F.E. van

    2016-01-01

    PURPOSE: To conduct a large, population-based study on cardiovascular disease (CVD) in breast cancer (BC) survivors treated in 1989 or later. METHODS AND MATERIALS: A large, population-based cohort comprising 70,230 surgically treated stage I to III BC patients diagnosed before age 75 years between

  3. Universal Screening for Emotional and Behavioral Problems: Fitting a Population-Based Model

    Science.gov (United States)

    Schanding, G. Thomas, Jr.; Nowell, Kerri P.

    2013-01-01

    Schools have begun to adopt a population-based method to conceptualizing assessment and intervention of students; however, little empirical evidence has been gathered to support this shift in service delivery. The present study examined the fit of a population-based model in identifying students' behavioral and emotional functioning using a…

  4. Survival in a population-based cohort of dementia patients: predictors and causes of mortality

    NARCIS (Netherlands)

    Boersma, F.; van den Brink, W.; Deeg, D. J.; Eefsting, J. A.; van Tilburg, W.

    1999-01-01

    To examine predictors of survival time and causes of mortality in a population-based cohort of demented subjects. Longitudinal naturalistic follow-up study. A rural area in The Netherlands. The study population consisted of 102 demented subjects derived from a population-based, two-stage prevalence

  5. Population-based treatment and outcomes of Stage I uterine serous carcinoma

    NARCIS (Netherlands)

    Putten, L.J.M. van der; Hoskins, P.; Tinker, A.; Lim, P.; Aquino-Parsons, C.; Kwon, J.S.

    2014-01-01

    OBJECTIVE: Uterine serous carcinoma (USC) is a rare type of endometrial cancer that often recurs in patients with Stage I disease. Our objective was to evaluate treatment and outcomes in Stage I USC in the context of a population-based study. METHODS: This was a population-based retrospective cohort

  6. Event detection using population-based health care databases in randomized clinical trials

    DEFF Research Database (Denmark)

    Thuesen, Leif; Jensen, Lisette Okkels; Tilsted, Hans Henrik

    2013-01-01

    To describe a new research tool, designed to reflect routine clinical practice and relying on population-based health care databases to detect clinical events in randomized clinical trials.......To describe a new research tool, designed to reflect routine clinical practice and relying on population-based health care databases to detect clinical events in randomized clinical trials....

  7. European visit

    CERN Multimedia

    2006-01-01

    The European Commissioner for Science and Research, Janez Potočnik, (on the right) visited the CMS assembly hall accompanied by Jim Virdee, Deputy Spokesman of CMS (on the left), and Robert Aymar, Director-General of CERN. The European Commissioner for Science and Research, Janez Potočnik, visited CERN on Tuesday 31 January. He was welcomed by the Director-General, Robert Aymar, who described the missions and current activities of CERN to him, in particular the realisation of the LHC with its three components: accelerator, detectors, storage and processing of data. The European Commissioner then visited the CMS assembly hall, then the hall for testing the LHC magnets and the ATLAS cavern. During this first visit since his appointment at the end of 2004, Janez Potočnik appeared very interested by the operation of CERN, an example of successful scientific co-operation on a European scale. The many projects (30 on average) that CERN and the European Commission carry out jointly for the benefit of res...

  8. Health literacy in a population-based sample of adult men and women in a South Eastern European country

    NARCIS (Netherlands)

    Toçi, E.; Burazeri, G.; Myftiu, S.; Sorensen, K.; Brand, H.

    2016-01-01

    BACKGROUND: Health literacy (HL) may be an important determinant of health, but this concept is largely under-researched in Albania, a transitional country in the Western Balkans which is currently undergoing major political and socioeconomic changes. We aimed to assess the sociodemographic

  9. Differences in outcome between twins and singletons born very preterm: results from a population-based European cohort.

    NARCIS (Netherlands)

    Papiernik, E.; Zeitlin, J.; Delmas, D.; Blondel, B.; Kunzel, W.; Cuttini, M.; Weber, T.; Petrou, S.; Gortner, L.; Kollee, L.A.A.; Draper, E.S.

    2010-01-01

    BACKGROUND: About 10% of twins are born before 32 weeks of gestation and very preterm birth rates are increasing. Preterm twins tend to have more favourable outcomes than singletons of the same gestational age, but fewer data are available for very preterm infants. This study aims to determine

  10. Differences in outcome between twins and singletons born very preterm: results from a population-based European cohort

    DEFF Research Database (Denmark)

    Papiernik, Emile; Zeitlin, Jennifer; Delmas, Dominique

    2010-01-01

    About 10% of twins are born before 32 weeks of gestation and very preterm birth rates are increasing. Preterm twins tend to have more favourable outcomes than singletons of the same gestational age, but fewer data are available for very preterm infants. This study aims to determine whether outcom...

  11. Differences in outcome between twins and singletons born very preterm: results from a population-based European cohort

    DEFF Research Database (Denmark)

    Papiernik, Emile; Zeitlin, Jennifer; Delmas, Dominique

    2010-01-01

    About 10% of twins are born before 32 weeks of gestation and very preterm birth rates are increasing. Preterm twins tend to have more favourable outcomes than singletons of the same gestational age, but fewer data are available for very preterm infants. This study aims to determine whether outcomes...

  12. Calibrating a population-based job-exposure matrix using inspection measurements to estimate historical occupational exposure to lead for a population-based cohort in Shanghai, China

    NARCIS (Netherlands)

    Koh, Dong Hee; Bhatti, Parveen; Coble, Joseph B.; Stewart, Patricia A.; Lu, Wei; Shu, Xiao Ou; Ji, Bu Tian; Xue, Shouzheng; Locke, Sarah J.; Portengen, Lutzen; Yang, Gong; Chow, Wong Ho; Gao, Yu Tang; Rothman, Nathaniel; Vermeulen, Roel; Friesen, Melissa C.

    2014-01-01

    The epidemiologic evidence for the carcinogenicity of lead is inconsistent and requires improved exposure assessment to estimate risk. We evaluated historical occupational lead exposure for a population-based cohort of women (n=74,942) by calibrating a job-exposure matrix (JEM) with lead fume

  13. European Cinema

    NARCIS (Netherlands)

    Elsaesser, Thomas

    2005-01-01

    In the face of renewed competition from Hollywood since the early 1980s and the challenges posed to Europe's national cinemas by the fall of the Wall in 1989, independent filmmaking in Europe has begun to re-invent itself. European Cinema: Face to Face with Hollywood re-assesses the different

  14. The impact of cancer incidence and stage on optimal utilization of radiotherapy. Methodology of a population based analysis by the ESTRO-HERO project

    DEFF Research Database (Denmark)

    Borras, Josep M; Barton, Michael; Grau, Cai

    2015-01-01

    in stage at diagnosis across countries. The most important impact on the OUP by country was due to changes in relative frequency of tumours rather than stage at diagnosis. CONCLUSIONS: This methodology can be adapted using European data, thus facilitating the planning of resources required to cope......-HERO project. MATERIALS AND METHODS: Data from Australian Collaboration for Cancer Outcomes Research and Evaluation (CCORE) were used. Population based stages at diagnosis from the cancer registries of Belgium, Slovenia, the Greater Poland region of Poland, and The Netherlands were used to assess the OUP...

  15. European Competence Network on Mastocytosis (ECNM)

    DEFF Research Database (Denmark)

    Valent, Peter; Arock, Michel; Bonadonna, Patrizia

    2012-01-01

    The European Competence Network on Mastocytosis (ECNM) was initiated in 2002 as a multidisciplinary and multinational cooperative approach to increase awareness and to improve diagnosis and therapy of mastocytosis. The network is composed of local centers, physicians, and scientists who have...... cooperate closely with their US colleagues, with patient-organizations in Europe and in the USA, and with other scientific networks. The ECNM also launched a mastocytosis registry that has been activated in 2012. Using the central database of this registry, cooperative multicenter studies, which should...

  16. Chronic myeloid leukaemia in Spain: Its presentation characteristics have changed. Spanish section of the EUTOS population-based registry.

    Science.gov (United States)

    Osorio, S; Casado, L F; Giraldo, P; Maestro, B; Andrade, M; Redondo, S; García-Gutiérrez, V; Ayala, R; Garcia, N; Steegmann, J L

    2016-01-01

    To provide more reliable data on the epidemiology of chronic myeloid leukaemia (CML) in Spain than are currently available. The EUTOS population-based project of European LeukemiaNet is a population registry of new CML cases in patients 18 years of age or older from 22 European areas. The Spanish section included the autonomous communities of Madrid, Castilla-La Mancha and Aragon, from 1-2-2010 to 31-12-2012. A total of 250 cases were recorded in 35 months. The overall incidence was 1.08 cases/10(5) inhabitants-year, with a predominance of men (58%) and clear differences among the communities. The incidence standardised by age was similar (overall, 1.04; men, 1.31; women, 0.81). The median age was 54 years. The incidence increased with age, reaching a peak at>65 years, although 31.7% of cases appeared between the ages of 20 and 44 years. Four percent of cases were diagnosed in advanced stages (2.4% in accelerated phase, 1.6% in blast crisis), 56% were asymptomatic, 38% had splenomegaly, and the Sokal score was high in 11% (lower than what was previously reflected in the literature). The current incidence of CML in Spain is higher than previously reported and similar to that of the European studies. Unlike the classical descriptions, CML presented mostly in asymptomatic form, with no splenomegaly, less leucocytosis and in stages with better prognosis. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  17. Diabetes, metformin use, and colon cancer: a population-based cohort study in Taiwan

    National Research Council Canada - National Science Library

    Tseng, Chin-Hsiao

    2012-01-01

    A retrospective cohort study, using a population-based reimbursement database, was conducted for investigating the relationship between diabetes and colon cancer and assessing whether metformin had a protective effect...

  18. Survival trends in metastatic bladder cancer in the United States: A population based study

    Directory of Open Access Journals (Sweden)

    Binay Kumar Shah

    2015-01-01

    Conclusions: This population-based study shows that decreases in 6-month and 12-month relative survival rates among patients with MBC in 2001-2010 compared to 1991-2000, specifically, more pronounced among CC men and Oth men.

  19. Osteoporosis-related fracture case definitions for population-based administrative data

    National Research Council Canada - National Science Library

    Lix, Lisa M; Azimaee, Mahmoud; Osman, Beliz Acan; Caetano, Patricia; Morin, Suzanne; Metge, Colleen; Goltzman, David; Kreiger, Nancy; Prior, Jerilynn; Leslie, William D

    2012-01-01

    Population-based administrative data have been used to study osteoporosis-related fracture risk factors and outcomes, but there has been limited research about the validity of these data for ascertaining fracture cases...

  20. Sex differences in lifetime risk and first manifestation of cardiovascular disease: Prospective population based cohort study

    NARCIS (Netherlands)

    M.J.G. Leening (Maarten); B.S. Ferket (Bart); E.W. Steyerberg (Ewout); M. Kavousi (Maryam); J.W. Deckers (Jaap); D. Nieboer (Daan); J. Heeringa (Jan); M.L.P. Portegies (Marileen); A. Hofman (Albert); M.A. Ikram (Arfan); M.G.M. Hunink (Myriam); O.H. Franco (Oscar); B.H.Ch. Stricker (Bruno); J.C.M. Witteman (Jacqueline); J.W. Roos-Hesselink (Jolien)

    2014-01-01

    textabstractObjective: To evaluate differences in first manifestations of cardiovascular disease between men and women in a competing risks framework. Design: Prospective population based cohort study. Setting: People living in the community in Rotterdam, the Netherlands. Participants: 8419

  1. A population-based cohort study of oral health in South Brazil : the Porto Alegre study

    OpenAIRE

    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 M.; 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....

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

    OpenAIRE

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

    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....

  3. EPIDEMIOLOGY OF MALIGNANT TUMORS OF LARGE SALIVARY GLANDS (POPULATION-BASED STUDY

    Directory of Open Access Journals (Sweden)

    V. M. Merabishvili

    2016-01-01

    Full Text Available Introduction. Malignant tumors of large salivary glands are a relatively rare malignancy. In 2014 as a whole in Russia 1236 cases of these diseases were registered. According to the latest data of the Interna- tional Agency for Research on Cancer (Volume X the most common standardized incidence rate in various countries ranges from 0.6-0.9 per 100,000 men and 0.4-0.6 per 100,000 women. aim of study. The aim of this study is to carry out for the first time in Russia an estimation of a complex of analytical rates including an evaluation of observed and relative survival rates to assess the effectiveness of cancer control related to patients with a diagnosis of malignant tumors of large salivary glands. material and methods. An estimation of a complex of analytical rates was conducted in accordance with database of the Population-based Cancer Registry of St. Petersburg. There were selected 896 patients with a diagnosis of malignant tumors of large salivary glands from 1994 to 2013. Results. It was found that the most frequent value of the standardized incidence rates of malignant tumors of large salivary glands in different countries of the world community for the male population was 0.6-0.9 per 100,000 population and 0.4-0.6 for the female. These values were 0000 equal to 0.7 and 0.4 0/ in Russia (2014, and 0.6 and 0.5 0/ in St. Petersburg (2014. The vast majority 0000 of recorded cases of malignant tumors of large salivary glands were for S07.9 - of malignant tumors of large salivary glands undefined. 46.6 % of primary patients had early stages (I + II. A relative 5-year survival rate was 61.9 % for men and 69.9 % for women, which was slightly less than the European average (Eurocare. Conclusion. This study for the first time in Russia allowed estimating series of analytical rates character- izing the effectiveness of cancer control related to patients with malignant tumors of large salivary glands in St. Petersburg including estimations of a 5

  4. Incidence of multiple sclerosis in the Republic of Ireland: A prospective population-based study.

    Science.gov (United States)

    O'Connell, K; Tubridy, N; Hutchinson, M; McGuigan, C

    2017-04-01

    Multiple sclerosis (MS) incidence and prevalence is increasing worldwide, with a disproportionally higher rate in women. Recent studies have questioned the presence of a latitudinal gradient in Europe. Ireland is a high prevalence country for MS with a previously reported North-South gradient making it ideal to further explore this concept. In this study we prospectively determined the incidence rate of newly diagnosed MS in Ireland over a 12-month period and demonstrated the presence of a North-South gradient. A national prospective population-based observational study was performed to ascertain all new cases of MS diagnosed from 1st March 2014 - 28th February 2015 in the Ireland. Within the main study there was a smaller nested cohort study to explore clinical outcomes with a view to future prospective follow-up of this cohort. Sources of case ascertainment included neurologists, MS nurse specialists and MS support services. The Irish census 2011 was used to obtain population statistics and the incidence rate was age-standardized to a European Standardised Population (ESP 2011). The North-South gradient was assessed, by comparing incidence rates between northern and southern counties. 292 patients fulfilled the inclusion criteria equating to an age-standardised incidence rate (A-SIR) of 6/100,000 (95% CI: 5.3-6.6); for women the rate was 8.7/100,000 (95% CI: 7.7-9.6) and for men 3.3/100,000 (95% CI: 3.0-3.7). The female to male sex ratio was 2.7:1. Mean age at diagnosis amongst the RRMS group was 37 years (SD: 9.6) and 55 years (SD: 7.7) in the PPMS group; there were no gender differences associated with age of diagnosis. Onset was progressive in 10% of cases. A significant difference was seen in incidence rates between the northern region (A-SIR: 9.6×10 5 , CI: 6.9-12.3) and the southern region (A-SIR: 5.1×10 5 , CI: 3.8-6.3) (Z-score =3.34, pIreland and shows that Ireland has a high incidence rate, comparable with the rest of the British Isles, with a

  5. Quality is the key for emerging issues of population-based colonoscopy screening

    Directory of Open Access Journals (Sweden)

    Jin Young Yoon

    2018-01-01

    Full Text Available Colonoscopy is currently regarded as the gold standard and preferred method of screening for colorectal cancer (CRC. However, the benefit of colonoscopy screening may be blunted by low participation rates in population-based screening programs. Harmful effects of population-based colonoscopy screening may include complications induced by colonoscopy itself and by sedation, psychosocial distress, potential over-diagnosis, and socioeconomic burden. In addition, harmful effects of colonoscopy may increase with age and comorbidities. As the risk of adverse events in population-based colonoscopy screening may offset the benefit, the adverse events should be managed and monitored. To adopt population-based colonoscopy screening, consensus on the risks and benefits should be developed, focusing on potential harm, patient preference, socioeconomic considerations, and quality improvement of colonoscopy, as well as efficacy for CRC prevention. As suboptimal colonoscopy quality is a major pitfall of population-based screening, adequate training and regulation of screening colonoscopists should be the first step in minimizing variations in quality. Gastroenterologists should promote quality improvement, auditing, and training for colonoscopy in a population-based screening program.

  6. Anorectal malformations and pregnancy-related disorders : a registry-based case-control study in 17 European regions

    NARCIS (Netherlands)

    Wijers, C. H. W.; van Rooij, I. A. L. M.; Bakker, M. K.; Marcelis, C. L. M.; Addor, M. C.; Barisic, I.; Beres, J.; Bianca, S.; Bianchi, F.; Calzolari, E.; Greenlees, R.; Lelong, N.; Latos-Bielenska, A.; Dias, C. M.; McDonnell, R.; Mullaney, C.; Nelen, V.; O'Mahony, M.; Queisser-Luft, A.; Rankin, J.; Zymak-Zakutnia, N.; de Blaauw, I.; Roeleveld, N.; de Walle, H. E. K.

    Objective To identify pregnancy-related risk factors for different manifestations of congenital anorectal malformations (ARMs). Design A population-based case-control study. Setting Seventeen EUROCAT (European Surveillance of Congenital Anomalies) registries, 1980-2008. Population The study

  7. The Organization of European Cancer Institute Pathobiology Working Group and its support of European biobanking infrastructures for translational cancer research.

    Science.gov (United States)

    Riegman, Peter H J; de Jong, Bas W D; Llombart-Bosch, Antonio

    2010-04-01

    Today's translational cancer research increasingly depends on international multi-center studies. Biobanking infrastructure or comprehensive sample exchange platforms to enable networking of clinical cancer biobanks are instrumental to facilitate communication, uniform sample quality, and rules for exchange. The Organization of European Cancer Institutes (OECI) Pathobiology Working Group supports European biobanking infrastructure by maintaining the OECI-TuBaFrost exchange platform and organizing regular meetings. This platform originated from a European Commission project and is updated with knowledge from ongoing and new biobanking projects. This overview describes how European biobanking projects that have a large impact on clinical biobanking, including EuroBoNeT, SPIDIA, and BBMRI, contribute to the update of the OECI-TuBaFrost exchange platform. Combining the results of these European projects enabled the creation of an open (upon valid registration only) catalogue view of cancer biobanks and their available samples to initiate research projects. In addition, closed environments supporting active projects could be developed together with the latest views on quality, access rules, ethics, and law. With these contributions, the OECI Pathobiology Working Group contributes to and stimulates a professional attitude within biobanks at the European comprehensive cancer centers. Improving the fundamentals of cancer sample exchange in Europe stimulates the performance of large multi-center studies, resulting in experiments with the desired statistical significance outcome. With this approach, future innovation in cancer patient care can be realized faster and more reliably.

  8. Comparison of pain-resilient working individuals to population-based case controls with/without momentary low back pain.

    Science.gov (United States)

    Rolli Salathé, C; Melloh, M; Kälin, W; Semmer, N K; Roth, M; Müller, U; Elfering, A

    2013-10-01

    Few studies have examined the 20% of individuals who never experience an episode of low back pain (LBP). To date, no investigation has been undertaken that examines a group who claim to have never experienced LBP in their lifetime in comparison to two population-based case-control groups with and without momentary LBP. This study investigates whether LBP-resilient workers between 50 and 65 years had better general health, demonstrated more positive health behaviour and were better able to achieve routine activities compared with both case-control groups. Forty-two LBP-resilient participants completed the same pain assessment questionnaire as a population-based LBP sample from a nationwide, large-scale cross-sectional survey in Switzerland. The LBP-resilient participants were pairwise compared to the propensity score-matched case controls by exploring differences in demographic and work characteristics, and by calculating odds ratios (ORs) and effect sizes. A discriminant analysis explored group differences, while the multiple logistic regression analysis specified single indicators which accounted for group differences. LBP-resilient participants were healthier than the case controls with momentary LBP and achieved routine activities more easily. Compared to controls without momentary LBP, LBP-resilient participants had a higher vitality, a lower workload, a healthier attitude towards health and behaved more healthily by drinking less alcohol. By demonstrating a difference between LBP-resilient participants and controls without momentary LBP, the question that arises is what additional knowledge can be attained. Three underlying traits seem to be relevant about LBP-resilient participants: personality, favourable work conditions and subjective attitudes/attributions towards health. These rationales have to be considered with respect to LBP prevention. © 2013 European Federation of International Association for the Study of Pain Chapters.

  9. Endovascular Versus Open Repair as Primary Strategy for Ruptured Abdominal Aortic Aneurysm: A National Population-based Study.

    Science.gov (United States)

    Gunnarsson, K; Wanhainen, A; Djavani Gidlund, K; Björck, M; Mani, K

    2016-01-01

    In randomized trials, no peri-operative survival benefit has been shown for endovascular (EVAR) repair of ruptured abdominal aortic aneurysm (rAAA) when compared with open repair. The aim of this study was to investigate the effect of primary repair strategy on early and midterm survival in a non-selected population based study. The Swedish Vascular Registry was consulted to identify all rAAA repairs performed in Sweden in the period 2008-12. Centers with a primary EVAR strategy (treating > 50% of rAAA with EVAR) were compared with centers with a primary open repair strategy. Peri-operative outcome, midterm survival, and incidence of rAAA repair/100,000 inhabitants aged > 50 years were assessed. In total, 1,304 patients were identified. Three primary EVAR centers (pEVARc) operated on 236 patients (74.6% EVAR). Twenty-six primary open repair centers (pORc) operated 1,068 patients (15.6% EVAR). Patients treated at pEVARc were more often referrals (28.0% vs. 5.3%; p strategy at 30 days (pEVARc 28.0%, n = 66; pORc 27.4%, n = 296 [p = .87]), 1 year (pEVARc 39.9%, n = 93; pORc 34.7%, n = 366 [p = .19]), or 2 years (42.1%, n = 94; 38.3%, n = 394 [p = .28]), either overall or in subgroups based on age or referral status. Overall, patients treated with EVAR were older (mean age 76.4 vs. 74.0 years; p strategy, either peri-operatively or in the midterm. The study supports the early findings of the randomized controlled trials in a national population based setting. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  10. Acute cardiovascular events and all-cause mortality in patients with hyperthyroidism: a population-based cohort study.

    Science.gov (United States)

    Dekkers, Olaf M; Horváth-Puhó, Erzsébet; Cannegieter, Suzanne C; Vandenbroucke, Jan P; Sørensen, Henrik Toft; Jørgensen, Jens Otto L

    2017-01-01

    Several studies have shown an increased risk for cardiovascular disease (CVD) in hyperthyroidism, but most studies have been too small to address the effect of hyperthyroidism on individual cardiovascular endpoints. Our main aim was to assess the association among hyperthyroidism, acute cardiovascular events and mortality. It is a nationwide population-based cohort study. Data were obtained from the Danish Civil Registration System and the Danish National Patient Registry, which covers all Danish hospitals. We compared the rate of all-cause mortality as well as venous thromboembolism (VTE), acute myocardial infarction (AMI), ischemic and non-ischemic stroke, arterial embolism, atrial fibrillation (AF) and percutaneous coronary intervention (PCI) in the two cohorts. Hazard ratios (HR) with 95% confidence intervals (95% CI) were estimated. The study included 85 856 hyperthyroid patients and 847 057 matched population-based controls. Mean follow-up time was 9.2 years. The HR for mortality was highest in the first 3 months after diagnosis of hyperthyroidism: 4.62, 95% CI: 4.40-4.85, and remained elevated during long-term follow-up (>3 years) (HR: 1.35, 95% CI: 1.33-1.37). The risk for all examined cardiovascular events was increased, with the highest risk in the first 3 months after hyperthyroidism diagnosis. The 3-month post-diagnosis risk was highest for atrial fibrillation (HR: 7.32, 95% CI: 6.58-8.14) and arterial embolism (HR: 6.08, 95% CI: 4.30-8.61), but the risks of VTE, AMI, ischemic and non-ischemic stroke and PCI were increased also 2- to 3-fold. We found an increased risk for all-cause mortality and acute cardiovascular events in patients with hyperthyroidism. © 2017 European Society of Endocrinology.

  11. Mental health problems in adolescents with delayed sleep phase: results from a large population-based study in Norway.

    Science.gov (United States)

    Sivertsen, Børge; Harvey, Allison G; Pallesen, Ståle; Hysing, Mari

    2015-02-01

    The aim of the current study was to compare mental health problems, resilience and family characteristics in adolescents with and without delayed sleep phase (DSP) in a population-based sample. Data were taken from the youth@hordaland-survey, a large population-based study in Hordaland County in Norway conducted in 2012. In all, 9338 adolescents aged 16-19 years (53.5% girls) provided self-reported data on a wide range of instruments assessing mental health symptoms, including depression, anxiety, obsessive-compulsive behaviours, attention deficit hyperactive disorder (ADHD) symptoms, perfectionism, resilience and sleep. Measures of socioeconomic status were also included. Three hundred and six adolescents (prevalence 3.3%) were classified as having DSP [according to the International Classification of Sleep Disorders-2 (ICSD-2)] criteria. Adolescents with DSP reported higher levels of depression, anxiety and ADHD symptoms. Adolescents with DSP also exhibited significantly lower levels of resilience. The Cohen's d effect sizes ranged from small [obsessive-compulsive disorder (OCD): d = 0.15] to moderate (inattention: d = 0.71). In the fully adjusted model, the significant predictors of DSP included inattention [odds ratio (OR): 2.11], lack of personal structure (OR: 2.07), low (OR: 1.85) and high (OR: 1.91) paternal education, parents not living together (OR: 1.81), hyperactivity/inattention (OR: 1.71) and poorer family economy (OR: 1.59). In conclusion, the high symptom load across a range of mental health measures suggests that a broad and thorough clinical approach is warranted when adolescents present with DSP. © 2014 European Sleep Research Society.

  12. Prevalence and Regional Distribution of Lower Limb Amputations from 2006 to 2012 in Germany: A Population based Study.

    Science.gov (United States)

    Heyer, K; Debus, E S; Mayerhoff, L; Augustin, M

    2015-12-01

    International studies show conflicting results regarding the frequency of lower limb amputations over time. However, published data are often based on event related amputation frequencies per year, on hospital statistics or on regional surveys. Thus, they do not allow population based statements. The present study assesses the population based epidemiology of amputations in Germany. Secondary analyses of 80 German statutory health insurance companies with 4 million insurants nationwide in 2012 were performed. From 2006 to 2012, lower limb amputations were identified in the entire population and in persons with diabetes mellitus (DM) and arterial occlusive disease (AOD). Lower limb amputations and persons with DM and arterial occlusive diseases were extracted by specific operation procedure codes and International Classification of Diseases-10 codes. Descriptive standardized analyses by age, sex, and regional distribution were conducted. The proportion of patients with at least one lower limb amputation in the entire population stayed constant over time at 0.04% (95% confidence interval [CI] 0.04-0.04). Extrapolated to the German population in 2012 there were 49,150 cases and 32,767 persons with amputations. In 2012, about 70% of amputations were minor (0.03% [95% CI 0.03-0.03]) versus major amputations (0.01% [95% CI 0.01-0.01]). Related to DM and AOD, there was a small decrease in the amputation rate per patient, even though the DM prevalence increased by 10.4%. The amputation rates per patient in Germany have remained stable in the overall population and show slight decline in patients with diabetes mellitus and with arterial occlusive disease between 2006 and 2012. In the future, intensified preventive measures are crucial to reduce the number of amputations of the lower extremities permanently. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  13. Epidemiological patterns of leukaemia in 184 countries: a population-based study.

    Science.gov (United States)

    Miranda-Filho, Adalberto; Piñeros, Marion; Ferlay, Jacques; Soerjomataram, Isabelle; Monnereau, Alain; Bray, Freddie

    2018-01-01

    Leukaemia is a heterogeneous group of haemopoietic cancers that comprises a number of diverse and biologically distinct subgroups. We examine the leukaemia burden worldwide and highlight the distinct incidence patterns in order to elucidate explanatory factors that may support preventive measures and health resource planning. We aimed to estimate the global burden of leukaemia incidence according to the four major subtypes stratified by age and sex. In this population-based study, we assessed leukaemia incidence for the major subtypes using the Cancer Incidence in Five Continents Volume X (CI5-X), which includes data from 290 cancer registries in 68 countries covering the diagnostic period 2003-07, for all ages and both sexes. We then extracted counts and incidence rates in 184 countries for the year 2012 from IARC's GLOBOCAN database of national estimates. We calculated age-specific incidence rates per 100 000 person-years and age-standardised rates (ASRs) using the world standard population by country, sex, age group, and where applicable, by major subtypes. We excluded from all analyses registries for which the total number of leukaemia cases was less than 100 or the proportion of microscopically verified (MV%) cases was less than 80% (2572 cases). 717 863 cases between 2003-07 were included in this analysis. More than 350 000 new leukaemia cases were estimated in 2012. We observed substantial variation in incidence between and within world regions. The highest leukaemia incidence rates for both sexes were estimated in Australia and New Zealand (ASR per 100 000 11·3 in males and 7·2 in females), Northern America (10·5 in males and 7·2 in females), and western Europe (9·6 in males and 6·0 in females), and the lowest was in in western Africa (1·4 in males and 1·2 in females). Rates were generally higher in males than females with an overall male to female ratio of 1·4. In children, acute lymphoblastic leukaemia was the main subtype in all studied

  14. Screening for Prostate Cancer Starting at Age 50-54 Years. A Population-based Cohort Study.

    Science.gov (United States)

    Carlsson, Sigrid; Assel, Melissa; Ulmert, David; Gerdtsson, Axel; Hugosson, Jonas; Vickers, Andrew; Lilja, Hans

    2017-01-01

    Current prostate cancer screening guidelines conflict with respect to the age at which to initiate screening. To evaluate the effect of prostate-specific antigen (PSA) screening versus zero screening, starting at age 50-54 yr, on prostate cancer mortality. This is a population-based cohort study comparing 3479 men aged 50 yr through 54 yr randomized to PSA-screening in the Göteborg population-based prostate cancer screening trial, initiated in 1995, versus 4060 unscreened men aged 51-55 yr providing cryopreserved blood in the population-based Malmö Preventive Project in the pre-PSA era, during 1982-1985. Cumulative incidence and incidence rate ratios of prostate cancer diagnosis, metastasis, and prostate cancer death. At 17 yr, regular PSA-screening in Göteborg of men in their early 50s carried a more than two-fold higher risk of prostate cancer diagnosis compared with the unscreened men in Malmö (incidence rate ratio [IRR] 2.56, 95% confidence interval [CI] 2.18, 3.02), but resulted in a substantial decrease in the risk of metastases (IRR 0.43, 95% CI 0.22, 0.79) and prostate cancer death (IRR 0.29, 95% CI 0.11, 0.67). There were 57 fewer prostate cancer deaths per 10000 men (95% CI 22, 92) in the screened group. At 17 yr, the number needed to invite to PSA-screening and the number needed to diagnose to prevent one prostate cancer death was 176 and 16, respectively. The study is limited by lack of treatment information and the comparison of the two different birth cohorts. PSA screening for prostate cancer can decrease prostate cancer mortality among men aged 50-54 yr, with the number needed to invite and number needed to detect to prevent one prostate cancer death comparable to those previously reported from the European Randomized Study of Screening for Prostate Cancer for men aged 55-69 yr, at a similar follow-up. Guideline groups could consider whether guidelines for PSA screening should recommend starting no later than at ages 50-54 yr. Guideline

  15. First definition of reference intervals of liver function tests in China: a large-population-based multi-center study about healthy adults.

    Science.gov (United States)

    Mu, Runqing; Chen, Wenxiang; Pan, Baishen; Wang, Lanlan; Hao, Xiaoke; Huang, Xianzhang; Qiao, Rui; Zhao, Min; Zhang, Chuanbao; Guo, Wei; Huang, Hengjian; Ma, Yueyun; Zhuang, Junhua; Zhang, Jie; Shang, Hong

    2013-01-01

    Reference intervals of Liver function tests are very important for the screening, diagnosis, treatment, and monitoring of liver diseases. We aim to establish common reference intervals of liver function tests specifically for the Chinese adult population. A total of 3210 individuals (20-79 years) were enrolled in six representative geographical regions in China. Analytes of ALT, AST, GGT, ALP, total protein, albumin and total bilirubin were measured using three analytical systems mainly used in China. The newly established reference intervals were based on the results of traceability or multiple systems, and then validated in 21 large hospitals located nationwide qualified by the National External Quality Assessment (EQA) of China. We had been established reference intervals of the seven liver function tests for the Chinese adult population and found there were apparent variances of reference values for the variables for partitioning analysis such as gender(ALT, GGT, total bilirubin), age(ALP, albumin) and region(total protein). More than 86% of the 21 laboratories passed the validation in all subgroup of reference intervals and overall about 95.3% to 98.8% of the 1220 validation results fell within the range of the new reference interval for all liver function tests. In comparison with the currently recommended reference intervals in China, the single side observed proportions of out of range of reference values from our study for most of the tests deviated significantly from the nominal 2.5% such as total bilirubin (15.2%), ALP (0.2%), albumin (0.0%). Most of reference intervals in our study were obviously different from that of other races. These used reference intervals are no longer applicable for the current Chinese population. We have established common reference intervals of liver function tests that are defined specifically for Chinese population and can be universally used among EQA-approved laboratories located all over China.

  16. Segmentation of age-related white matter changes in a clinical multi-center study

    DEFF Research Database (Denmark)

    Dyrby, Tim B.; Rostrup, E.; Baare, W.F.C.

    2008-01-01

    Leukoaraiosis And Disability (LADIS). Semi-manually delineated WMC were used for validating the segmentation produced by the neural networks. The neural network segmentation demonstrated high consistency between subjects and centers, making it a promising technique for large studies. For WMC volumes less than......) pruning method in the training stage. Six optimized neural networks were produced to investigate the impact of different input information on WMC segmentation. The automatic segmentation method was applied to MR scans of 362 non-demented elderly subjects from 11 centers in the European multi-center study...

  17. The incidence of amyotrophic lateral sclerosis in Friuli Venezia Giulia, Italy, from 2002 to 2009: a retrospective population-based study.

    Science.gov (United States)

    Drigo, Daniela; Verriello, Lorenzo; Clagnan, Elena; Eleopra, Roberto; Pizzolato, Gilberto; Bratina, Alessio; D'Amico, Delia; Sartori, Arianna; Masè, Giovanni; Simonetto, Marco; Lazzarino de Lorenzo, Lucio; Cecotti, Laura; Zanier, Loris; Pisa, Federica; Barbone, Fabio

    2013-01-01

    We conducted a retrospective population-based study to estimate the incidence of amyotrophic lateral sclerosis (ALS) in Friuli Venezia Giulia, Italy, from 2001 to 2009. Multiple sources were used for case ascertainment: Health databases, archives of the neurology departments and of the regional chapter of the Italian ALS Association. The diagnosis was validated through clinical documentation review. Crude and standardized incidence rates (IRs) per 100,000 person-years were calculated. We identified 262 incident ALS cases, 50.4% men, 4.2% familial. Half of the patients had spinal onset (56.8% in men) and 25.2% bulbar (29% in women). Bulbar onset had a similar frequency in women (31.7%) and men (31.5%) aged 67 or above at diagnosis. The crude IR was 2.72 (95% confidence interval, 95% CI, 2.39-3.05) and the male:female ratio 1.08. The IR peaked in the 65-74 age group, with a second increase in men 85 years and older. The IR standardized to the 2001 Italian population was 2.38 (95% CI 2.13-2.63) and to the 2000 European population 2.58 (95% CI 2.34-2.81). This retrospective study found IRs of ALS in the range of Italian and European prospective population-based registries, suggesting an almost complete case ascertainment. Copyright © 2013 S. Karger AG, Basel.

  18. Comparison of population-based association study methods correcting for population stratification.

    Directory of Open Access Journals (Sweden)

    Feng Zhang

    Full Text Available Population stratification can cause spurious associations in population-based association studies. Several statistical methods have been proposed to reduce the impact of population stratification on population-based association studies. We simulated a set of stratified populations based on the real haplotype data from the HapMap ENCODE project, and compared the relative power, type I error rates, accuracy and positive prediction value of four prevailing population-based association study methods: traditional case-control tests, structured association (SA, genomic control (GC and principal components analysis (PCA under various population stratification levels. Additionally, we evaluated the effects of sample sizes and frequencies of disease susceptible allele on the performance of the four analytical methods in the presence of population stratification. We found that the performance of PCA was very stable under various scenarios. Our comparison results suggest that SA and PCA have comparable performance, if sufficient ancestral informative markers are used in SA analysis. GC appeared to be strongly conservative in significantly stratified populations. It may be better to apply GC in the stratified populations with low stratification level. Our study intends to provide a practical guideline for researchers to select proper study methods and make appropriate inference of the results in population-based association studies.

  19. Projections of population-based twinning rates through the year 2100.

    Science.gov (United States)

    Oleszczuk, J J; Keith, D M; Keith, L G; Rayburn, W F

    1999-11-01

    To present the first compilation of population-based twinning rates published after the year 1990 and to project population-based twinning rates through the year 2100. We searched the Internet-based MEDLINE database for articles published after 1990 in which population-based twinning rates were described. We used population-based data from national statistical authorities from Australia, Austria, Canada, Finland, Hong Kong, Israel, Japan, Norway, Singapore and Sweden, published by Y. Imaizumi in a recent article. U.S. figures were based on data from the National Center for Health Statistics. Annual growth rates of twinning were calculated and graphed, making the assumption that these rates would remain constant throughout the next century. Our report presents the most recent population-based twinning rates. When projected through the year 2015, twinning rates reach figures that could best be described as derived from a Jules Verne novel: Sweden, in this model, would have four times more twin than singleton births. We strongly suggest that physicians reexamine their patterns of prescribing ovulation-inducing agents, which carry a greatly increased risk of multiple pregnancy.

  20. Long-term Exposure to Air Pollution and Cardiovascular Mortality: An Analysis of 22 European Cohorts.

    NARCIS (Netherlands)

    Beelen, Rob|info:eu-repo/dai/nl/30483100X; Stafoggia, Massimo; Raaschou-Nielsen, Ole; Andersen, Zorana Jovanovic; Xun, Wei W; Katsouyanni, Klea; Dimakopoulou, Konstantina; Brunekreef, Bert|info:eu-repo/dai/nl/067548180; Weinmayr, Gudrun; Hoffmann, Barbara; Wolf, Kathrin; Samoli, Evangelia; Houthuijs, Danny; Nieuwenhuijsen, Mark; Oudin, Anna; Forsberg, Bertil; Olsson, David; Salomaa, Veikko; Lanki, Timo; Yli-Tuomi, Tarja; Oftedal, Bente; Aamodt, Geir; Nafstad, Per; De Faire, Ulf; Pedersen, Nancy L; Ostenson, Claes-Göran; Fratiglioni, Laura; Penell, Johanna; Korek, Michal; Pyko, Andrei; Eriksen, Kirsten Thorup; Tjønneland, Anne; Becker, Thomas; Eeftens, Marloes|info:eu-repo/dai/nl/315028300; Bots, Michiel; Meliefste, Kees; Wang, Meng; Bueno-de-Mesquita, Bas; Sugiri, Dorothea; Krämer, Ursula; Heinrich, Joachim; de Hoogh, Kees; Key, Timothy; Peters, Annette; Cyrys, Josef; Concin, Hans; Nagel, Gabriele; Ineichen, Alex; Schaffner, Emmanuel; Probst-Hensch, Nicole; Dratva, Julia; Ducret-Stich, Regina; Vilier, Alice; Clavel-Chapelon, Françoise; Stempfelet, Morgane; Grioni, Sara; Krogh, Vittorio; Tsai, Ming-Yi; Marcon, Alessandro; Ricceri, Fulvio; Sacerdote, Carlotta; Galassi, Claudia; Migliore, Enrica; Ranzi, Andrea; Cesaroni, Giulia; Badaloni, Chiara; Forastiere, Francesco; Tamayo, Ibon; Amiano, Pilar; Dorronsoro, Miren; Katsoulis, Michail; Trichopoulou, Antonia; Vineis, Paolo; Hoek, Gerard|info:eu-repo/dai/nl/069553475

    2014-01-01

    BACKGROUND:: Air pollution has been associated with cardiovascular mortality, but it remains unclear as to whether specific pollutants are related to specific cardiovascular causes of death. Within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE), we investigated the

  1. Significant male preponderance in childhood acute lymphoblastic leukemia in India and regional variation: tertiary care center experience, systematic review, and evaluation of population-based data.

    Science.gov (United States)

    Kulkarni, Ketan Prasad; Marwaha, Ram Kumar

    2013-09-01

    Although, a slight male preponderance has been reported in childhood acute lymphoblastic leukemia (ALL) from several developed nations, several Indian studies suggest a skewed gender ratio in ALL. To assess the gender ratio at presentation in ALL in India, we used a three-prong approach: (i) center audit, (ii) systematic review of published studies on ALL in India, and (iii) assessment of population based registry data. Data on gender at presentation in ALL were extracted from these multiple sources. In our center audit, we observed a significantly higher of male:female (M:F) ratio of 3.16:1 (P = .046) in ALL as compared to world literature. In the systematic review of all ALL studies from India, 367 articles were identified and reviewed. A total of 4230 and 1843 boys and girls in these studies were assessed and the M:F ratio was 2.503:1; much higher than the world ratio but not significantly different (P = .10). Population-based data obtained from the National Cancer Registry Program also depicted a male preponderance, especially from large cities in India in a consistent manner since 1984. There is also significant (P = .025) interregional variation in the gender ratio in India. Our study clearly demonstrates a consistent male preponderance in childhood ALL in India along with significant interregional variations over the last three decades. There is a clear need of prospective nationwide multicenter assessment of high-resolution data to confirm this important observation and assess its implications, especially on the health care system.

  2. Meckel-Gruber Syndrome: a population-based study on prevalence, prenatal diagnosis, clinical features, and survival in Europe.

    Science.gov (United States)

    Barisic, Ingeborg; Boban, Ljubica; Loane, Maria; Garne, Ester; Wellesley, Diana; Calzolari, Elisa; Dolk, Helen; Addor, Marie-Claude; Bergman, Jorieke Eh; Braz, Paula; Draper, Elizabeth S; Haeusler, Martin; Khoshnood, Babak; Klungsoyr, Kari; Pierini, Anna; Queisser-Luft, Annette; Rankin, Judith; Rissmann, Anke; Verellen-Dumoulin, Christine

    2015-06-01

    Meckel-Gruber Syndrome is a rare autosomal recessive lethal ciliopathy characterized by the triad of cystic renal dysplasia, occipital encephalocele and postaxial polydactyly. We present the largest population-based epidemiological study to date using data provided by the European Surveillance of Congenital Anomalies (EUROCAT) network. The study population consisted of 191 cases of MKS identified between January 1990 and December 2011 in 34 European registries. The mean prevalence was 2.6 per 100,000 births in a subset of registries with good ascertainment. The prevalence was stable over time, but regional differences were observed. There were 145 (75.9%) terminations of pregnancy after prenatal diagnosis, 13 (6.8%) fetal deaths, 33 (17.3%) live births. In addition to cystic kidneys (97.7%), encephalocele (83.8%) and polydactyly (87.3%), frequent features include other central nervous system anomalies (51.4%), fibrotic/cystic changes of the liver (65.5% of cases with post mortem examination) and orofacial clefts (31.8%). Various other anomalies were present in 64 (37%) patients. As nowadays most patients are detected very early in pregnancy when liver or kidney changes may not yet be developed or may be difficult to assess, none of the anomalies should be considered obligatory for the diagnosis. Most cases (90.2%) are diagnosed prenatally at 14.3 ± 2.6 (range 11-36) gestational weeks and pregnancies are mainly terminated, reducing the number of LB to one-fifth of the total prevalence rate. Early diagnosis is important for timely counseling of affected couples regarding the option of pregnancy termination and prenatal genetic testing in future pregnancies.

  3. Customized versus Population-Based Birth Weight References for Predicting Fetal and Neonatal Undernutrition.

    Science.gov (United States)

    Fernández-Alba, Juan Jesús; González-Macías, Carmen; León Del Pino, Raquel; Prado Fernandes, Fabiana; Lagares Franco, Carolina; Moreno-Corral, Luis Javier; Torrejón Cardoso, Rafael

    2016-01-01

    The aim of our study was to construct a model of customized birth weight curves based on a Spanish population and to compare the ability of this customized model to our population-based chart to predict a neonatal ponderal index (PI) percentile. We developed a model that can predict the 10th percentile for a fetus according to gestational age and gender as well as maternal weight, height, and age. We compared the ability of this customized model to that of our own population-based model to predict a neonatal PI percentile. Data from a large database were used (32,854 live newborns, from 1993 through 2012). Only singleton pregnancies with a gestational age at delivery of 32-42 weeks were included. In the entire pregnant population, the customized method was superior to the population-based method for detecting newborns with a PI percentile (sensitivity: 55 vs. 40.96%; specificity: 99.6 vs. 91.23%; positive predictive value: 11.49 vs. 9.55%, and negative predictive value: 98.84 vs. 98.55%, respectively). In pregnant women with a BMI >90th percentile, the sensitivity was 75%, compared to 50% in the population-based method. In pregnant women with a height >90th percentile, the sensitivity was almost as high as in the population-based method (61.53 vs. 33.33%). The customized birth weight curve is superior to the population-based method for the detection of newborns with a PI percentile. This is especially the case in women in the higher scales of height and weight as well as in preterm babies. © 2015 S. Karger AG, Basel.

  4. Population-based age group specific annual incidence rates of symptomatic age-related macular degeneration.

    Science.gov (United States)

    Saari, Jukka M

    2014-01-01

    To study the population-based annual incidence rates of exudative, dry and all cases of symptomatic age-related macular degeneration (AMD) in different age and sex groups. This is a one year, prospective, population-based study on all consecutive new patients with AMD in the hospital district of Central Finland. The diagnosis was confirmed in all patients with slit lamp biomicroscopy, optical coherence tomography (OCT) using a Spectralis HRA + OCT device, and the Heidelberg Eye Explorer 1.6.2.0 program. Fluorescein angiograms were taken when needed. The population-based annual incidence rates of all cases of symptomatic AMD increased from 0.03% (95% CI, 0.01-0.05%) in the age group 50-59 years to 0.82% (95% CI, 0.55-1.09%) in the age group 85-89 years and were 0.2% (95% CI, 0.17-0.24%) in exudative, 0.11% (95% CI, 0.09-0.14%) in dry, and 0.32% (95% CI, 0.28-0.36%) in all cases of AMD in the age group 60 years and older. During the next 20 years in Central Finland the population-based annual incidence rates can be estimated to increase to 0.27% (95% CI, 0.24-0.30%) in exudative, to 0.13% (95% CI, 0.11-0.15%) in dry, and to 0.41% (95% CI, 0.37-0.45%) in all cases of AMD in the age group 60 years and older. The population-based annual incidence of AMD did not show statistically significant differences between males and females (p>0.1). The population-based age-group specific annual incidence rates of symptomatic AMD of this study may help to plan health care provision for patients of AMD.

  5. Progression to impaired glucose regulation and diabetes in the population-based Inter99 study

    DEFF Research Database (Denmark)

    Engberg, Susanne; Vistisen, Dorte; Lau, Cathrine

    2009-01-01

    Objective: To estimate the progression rates to impaired glucose regulation (impaired fasting glucose or impaired glucose tolerance) and diabetes in the Danish population-based Inter99 study and in a high-risk subpopulation, separately. Research Design and Methods: From a population-based primary...... prevention study, the Inter99 study, 4,615 individuals without diabetes at baseline and with relevant follow-up data were divided into a low- and a high-risk group based on a risk estimate of ischemic heart disease or the presence of risk factors (smoking, hypertension, hypercholesterolemia, obesity...

  6. EUROCOURSE recipe for cancer surveillance by visible population-based cancer RegisTrees in Europe: From roots to fruits.

    Science.gov (United States)

    Coebergh, Jan Willem; van den Hurk, Corina; Louwman, Marieke; Comber, Harry; Rosso, Stefano; Zanetti, Roberto; Sacchetto, Lidia; Storm, Hans; van Veen, Evert-Ben; Siesling, Sabine; van den Eijnden-van Raaij, Janny

    2015-06-01

    Currently about 160 population-based cancer registries (CRs) in Europe have extensive experience in generating valid information on variation in cancer risk and survival with time and place. Most CRs cover all cancers, but some are confined to specific cancers or to children. They cover 15-55% of the populations in all of the larger member states of the European Union (EU), except the United Kingdom (UK), and 100% coverage in 80% of those with populations below 20 million. The EU FP 7 EUROCOURSE project, which operated in 2009-2013, explored the essential role of CRs in cancer research and public health, and also focused attention on their programme owners (POs) and stakeholders (e.g. cancer societies, oncological professionals, cancer patient groups, and planners, providers and evaluators of cancer care and mass screening). Generally, all CRs depended on their regional and/or national oncological context and were increasingly involved in population-based studies of quality of cancer care, long-term prognosis and quality of life, one third being very active. Within the public health domain, CRs, in addition to describing the variety of environmental and lifestyle-related cancer epidemics, have also contributed actively to aetiologic research by a European databases that showed wide discrepancies in cancer risk and survival across the EU, and in more depth by follow-up of cohorts and recruitment for case-control studies. CRs were also actively contributing to independent evaluation of mass screening as an intervention which affects quality of care and cancer mortality. The potential of CRs for clinical evaluation has grown substantially through interaction with clinical stakeholders and more incidentally biobanks, also with greater involvement of patient groups - with a special focus on elderly patients who generally do not take part in clinical trials. Whereas 25-35% of CRs are active in a range of cancer research areas, the rest have a low profile and usually

  7. Incidence and Natural History of Idiopathic Chronic Inflammatory Demyelinating Polyneuropathy: A Population-Based Study in Iceland.

    Science.gov (United States)

    Hafsteinsdottir, Brynhildur; Olafsson, Elias

    2016-01-01

    We report a population-based study conducted in Iceland to determine the incidence, clinical characteristics and prognosis of idiopathic chronic inflammatory demyelinating polyneuropathy (CIDP) during a 21-year period. Cases were identified from the records of all practicing neurologists in the country, the only neurology department in the country and both neurophysiology laboratories. All index cases met the 2010 European Federation of Neurological Societies/Peripheral Nerve Society criteria for CIDP. Nineteen individuals fulfilled the diagnostic criteria during the study period. The average annual incidence was 0.3/100,000 (95% CI 0.04-2.47). There were 14 men (74%) in a gender ratio of 1:2.8. The mean age at diagnosis was 57 (range 19-81 years): women, 36 years and men, 63 years; p = 0.0006. The disease course was remitting-relapsing in 21% and chronic progressive or monophasic in 79%. The average length of follow-up was 6.9 years. The standardized mortality ratio for the 21-year study period was 0.9 (95% CI 0.3-2.2). We believe we have identified all diagnosed with CIDP in Iceland during a 21-year period. Many had no or only limited disease progression over the years and mortality is not increased compared with the general population. © 2016 S. Karger AG, Basel.

  8. Obesity and impaired cognitive functioning in the elderly: a population-based cross-sectional study (NEDICES).

    Science.gov (United States)

    Benito-León, J; Mitchell, A J; Hernández-Gallego, J; Bermejo-Pareja, F

    2013-06-01

    Studies of high body mass index (BMI) and cognition in the elderly have shown conflicting results. While some studies have shown a detrimental effect of high BMI on cognitive function, others have observed beneficial effects on cognition. Our aim was to assess cognitive function in a large population-based sample of overweight (BMI 25-29.9 kg/m(2) ) and obese (BMI ≥ 30 kg/m(2) ) community-dwelling elderly participants compared with their counterparts with BMI Spain [the Neurological Diseases in Central Spain study (NEDICES)] underwent a neuropsychological assessment, including tests of global cognitive performance [measured with a 37-item version of the Mini-Mental State Examination (37-MMSE)], psychomotor speed, verbal fluency, memory and pre-morbid intelligence. There were 507 with BMI Test-A (number of errors; indeed more errors), verbal fluency, delayed free recall, immediate logical memory and pre-morbid intelligence. In this large population sample, overweight and obese participants performed poorer on formal neuropsychological tests than their counterparts with BMI < 25 kg/m(2) . These results support the hypothesis of a detrimental effect of high BMI on impaired cognition in the elderly. © 2013 The Author(s) European Journal of Neurology © 2013 EFNS.

  9. Self-rated health and social capital in Iraqi immigrants to Sweden: The MEDIM population-based study.

    Science.gov (United States)

    Bennet, Louise; Lindström, Martin

    2017-09-01

    Poor self-rated health is an estimator of quality of life and a predictor of mortality seldom studied in immigrant populations. This work aimed to study self-rated health in relation to social capital, socioeconomic status, lifestyle and comorbidity in immigrants from Iraq - one of the largest non-European immigrant group in Sweden today - and to compare it with the self-rated health of native Swedes. The study was a cross-sectional population-based study conducted from 2010 to 2012 among citizens of Malmö, Sweden, aged 30-65 years and born in Iraq or Sweden. All participants underwent a health examination and answered questionnaires on self-rated health, social capital, comorbidity, lifestyle and socioeconomic status. In total, 1348 Iraqis and 677 Swedes participated. Poor self-rated health was identified in 43.9% of Iraqis and 21.9% of native Swedes ( pcapital was highly prevalent in the immigrants. Female gender showed higher odds of poor self-rated health in Iraqis than in Swedes (OR 1.8, 95% CI 1.4-2.5, pinteraction=0.024), independent of other risk factors connected to social capital, socioeconomic status, lifestyle or comorbidity. Although public health initiatives promoting social capital, socioeconomic status and comorbidity in immigrants are crucial, the excess risk of poor self-rated health in Iraqi women is not fully attributed to known risk factors for self-rated health, but remains to be further explored.

  10. Temporal trends in obesity, osteoporosis treatment, bone mineral density, and fracture rates: a population-based historical cohort study.

    Science.gov (United States)

    Leslie, William D; Lix, Lisa M; Yogendran, Marina S; Morin, Suzanne N; Metge, Colleen J; Majumdar, Sumit R

    2014-04-01

    Diverging international trends in fracture rates have been observed, with most reports showing that fracture rates have stabilized or decreased in North American and many European populations. We studied two complementary population-based historical cohorts from the Province of Manitoba, Canada (1996-2006) to determine whether declining osteoporotic fracture rates in Canada are attributable to trends in obesity, osteoporosis treatment, or bone mineral density (BMD). The Population Fracture Registry included women aged 50 years and older with major osteoporotic fractures, and was used to assess impact of changes in osteoporosis treatment. The BMD Registry included all women aged 50 years and older undergoing BMD tests, and was used to assess impact of changes in obesity and BMD. Model-based estimates of temporal changes in fracture rates (Fracture Registry) were calculated. Temporal changes in obesity and BMD and their association with fracture rates (BMD Registry) were estimated. In the Fracture Registry (n=27,341), fracture rates declined 1.6% per year (95% confidence interval [CI], 1.3% to 2.0%). Although osteoporosis treatment increased from 5.6% to 17.4%, the decline in fractures was independent of osteoporosis treatment. In the BMD Registry (n=36,587), obesity increased from 12.7% to 27.4%. Femoral neck BMD increased 0.52% per year and lumbar spine BMD increased 0.32% per year after covariate adjustment (pobesity or osteoporosis treatment. © 2014 American Society for Bone and Mineral Research.

  11. Association between restless legs syndrome and hypertension: a preliminary population-based study in South Tyrol, Italy.

    Science.gov (United States)

    Giannini, G; Zanigni, S; Melotti, R; Gögele, M; Provini, F; Facheris, M F; Cortelli, P; Pramstaller, P P

    2014-01-01

    Restless legs syndrome (RLS) is a sleep-related movement disorder characterized by an irresistible urge to move the legs accompanied by paresthesia and/or dysesthesia that begins or worsens in the evening and night and that is partially or totally relieved by movement. Many studies have investigated the association between RLS and cardiovascular risk factors, particularly hypertension, leading to conflicting results. The aim of this study was to assess the association between RLS and hypertension considering also other cardiovascular risk factors that could act as confounders. In all, 1709 participants of an on-going adult population-based study performed in South Tyrol, northern Italy, were enrolled. RLS was assessed through face-to-face interviews according to current International Restless Legs Syndrome Study Group diagnostic criteria. The presence of hypertension was self-reported and determined by questionnaires administered by trained study nurses. The association between RLS and hypertension was not significant after adjustment for age, sex, diabetes mellitus, history of myocardial infarction, raised blood lipids and body mass index (odds ratio 1.24, 95% CI 0.85-1.80, P = 0.271). Despite the small sample size of this study, RLS and hypertension were not associated in our adult population after adjustment for possible confounding factors. The presence of other cardiovascular risk factors could play a role as a confounder of this association. © 2013 The Author(s) European Journal of Neurology © 2013 EFNS.

  12. Risk factors and consequences of maternal anaemia and elevated haemoglobin levels during pregnancy: a population-based prospective cohort study.

    Science.gov (United States)

    Gaillard, Romy; Eilers, Paul H C; Yassine, Siham; Hofman, Albert; Steegers, Eric A P; Jaddoe, Vincent W V

    2014-05-01

    To determine sociodemographic and life style-related risk factors and trimester specific maternal, placental, and fetal consequences of maternal anaemia and elevated haemoglobin levels in pregnancy. In a population-based prospective cohort study of 7317 mothers, we measured haemoglobin levels in early pregnancy [gestational age median 14.4 weeks (inter-quartile-range 12.5-17.5)]. Anaemia (haemoglobin ≤11 g/dl) and elevated haemoglobin levels (haemoglobin ≥13.2 g/dl) were defined according to the WHO criteria. Maternal blood pressure, placental function and fetal growth were measured in each trimester. Data on gestational hypertensive disorders and birth outcomes was collected from hospitals. Older maternal age, higher body mass index, primiparity and European descent were associated with higher haemoglobin levels (P pregnancy (mean differences 5.1 mmHg, 95% confidence interval [CI] 3.8, 6.5 and 4.1 mmHg, 95% CI 3.0, 5.2, respectively) and with a higher risk of third trimester uterine artery notching (RR 1.3, 95% CI 1.0, 1.7). As compared with maternal normal haemoglobin levels, not anaemia, but elevated haemoglobin levels were associated with fetal head circumference, length, and weight growth restriction from third trimester onwards (P pregnancy. Elevated haemoglobin levels are associated with increased risks of maternal, placental, and fetal complications. © 2014 John Wiley & Sons Ltd.

  13. Underweight and malnutrition in home care: A multicenter study.

    Science.gov (United States)

    Lahmann, Nils A; Tannen, Antje; Suhr, Ralf

    2016-10-01

    This study aimed to provide representative figures about the prevalence of underweight and malnutrition among home care clients, and to determine the associated risk factors and the provided nutritional nursing interventions. In 2012, a multicenter point prevalence study was conducted among 878 randomly selected clients from 100 randomly selected home care services across Germany. Following a standardized study protocol, demographics, nutritional assessments (Body Mass Index, Malnutrition Universal Screening Tool (MUST), Mini nutritional Assessment - short form (MNA-sf), nurses' clinical judgment on nutritional status) and interventions were assessed. Common nutritional risk factors for underweight and malnutrition were analyzed in a logistic regression model. Malnutrition figures varied between 4.8% (MNA-sf) and 6.8% (MUST), underweight between 8.7% (BMI nutritional status. Mental overload (OR 8.1/4.4), needs help with feeding (OR 5.0/2.8) and loss of appetite (OR 3.6/3.9) were highly associated with malnutrition/underweight. Malnutrition and underweight are important issues in home care clients. Regular weighing should be performed in all home care clients so that a potential weight loss can be detected in time. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  14. Isotretinoin exposure during pregnancy: A population-based study in the Netherlands

    NARCIS (Netherlands)

    T.P.L. Zomerdijk (Timo); R. Ruiter (Rikje); L.M.A. Houweling (Leanne); R.M.C. Herings (Ron); M.C.J.M. Sturkenboom (Miriam); S.M.J.M. Straus (Sabine); B.H.Ch. Stricker (Bruno)

    2014-01-01

    textabstractObjective: To estimate isotretinoin exposure in Dutch pregnant women despite the implemented pregnancy prevention programme (PPP) and second, to analyse the occurrence of adverse fetal or neonatal outcomes in these isotretinoin exposed pregnancies.Design: Population-based study.Setting:

  15. A Population-Based Study of Preschoolers' Food Neophobia and Its Associations with Food Preferences

    Science.gov (United States)

    Russell, Catherine Georgina; Worsley, Anthony

    2008-01-01

    Objective: This cross-sectional study was designed to investigate the relationships between food preferences, food neophobia, and children's characteristics among a population-based sample of preschoolers. Design: A parent-report questionnaire. Setting: Child-care centers, kindergartens, playgroups, day nurseries, and swimming centers. Subjects:…

  16. Use of Incretin Agents and Risk of Pancreatic Cancer : A Population-Based Cohort Study

    NARCIS (Netherlands)

    Knapen, Lotte M; van Dalem, Judith; Keulemans, Yolande C; van Erp, Nielka P; Bazelier, Marloes T; De Bruin, Marie L; Leufkens, Hubert G M; Croes, Sander; Neef, Cees; de Vries, Frank; Driessen, Johanna H M

    Aim To investigate the association between the use of incretin agents and the risk of pancreatic cancer. Methods A retrospective population-based cohort study, using data from the Clinical Practice Research Datalink, 2007–2012, was conducted. Patients (n = 182 428) with at least one non-insulin

  17. Use of incretin agents and risk of pancreatic cancer: a population-based cohort study

    NARCIS (Netherlands)

    Knapen, L.M.; Dalem, J. van; Keulemans, Y.C.; Erp, N. van; Bazelier, M.T.; Bruin, M.L. De; Leufkens, H.G.; Croes, S.; Neef, C.; Vries, F de; Driessen, J.H.

    2016-01-01

    AIM: To investigate the association between the use of incretin agents and the risk of pancreatic cancer. METHODS: A retrospective population-based cohort study, using data from the Clinical Practice Research Datalink, 2007-2012, was conducted. Patients (n = 182 428) with at least one non-insulin

  18. Population-based reference values for bone mineral density in young men

    DEFF Research Database (Denmark)

    Høiberg, M; Nielsen, Torben Leo; Wraae, K

    2007-01-01

    in the Odense Androgen Study (OAS). RESULTS: Peak BMD was attained within the third decade. Obesity (BMI > 30 kg/m2) was associated with higher BMD. Abuse of anabolic steroids as well as chronic illness was associated with lower BMD. Our population-based reference values for BMD of the total hip (1.078 +/- 0...

  19. Mortality in British hip fracture patients, 2000-2010 : a population-based retrospective cohort study

    NARCIS (Netherlands)

    Klop, Corinne; Welsing, Paco M J; Cooper, Cyrus; Harvey, Nicholas C; Elders, Petra J M; Bijlsma, Johannes W J; Leufkens, Hubert G M; de Vries, Frank

    BACKGROUND: Data on recent trends in mortality after hip fracture are scarce. Aims were therefore to examine secular trends in all-cause and cause-specific mortality post hip fracture and to compare this to the general population from 2000 to 2010. METHODS: Population-based cohort study within the

  20. Mortality in British hip fracture patients, 2000-2010: A population-based retrospective cohort study

    NARCIS (Netherlands)

    Klop, C.; Welsing, P.M.J.; Cooper, C.; Harvey, N.C.; Elders, P.J.M.; Bijlsma, J.W.J.; Leufkens, H.G.M.; de Vries, F.

    2014-01-01

    Background: Data on recent trends in mortality after hip fracture are scarce. Aims were therefore to examine secular trends in all-cause and cause-specific mortality post hip fracture and to compare this to the general population from 2000 to 2010. Methods: Population-based cohort study within the

  1. Population-based metagenomics analysis reveals markers for gut microbiome composition and diversity

    NARCIS (Netherlands)

    Zhernakova, A.; Kurilshikov, A.; Bonder, M.J.; Tigchelaar, E.F.; Schirmer, M.; Vatanen, T.; Mujagic, Z.; Vila, A.V.; Falony, G.; Vieira-Silva, S.; Wang, J; Imhann, F.; Brandsma, E.; Jankipersadsing, S.A.; Joossens, M.; Cenit, M.C.; Deelen, P.; Swertz, M.A.; Weersma, R.K.; Feskens, E.J.M.; Netea, M.G.; Gevers, D.; Jonkers, D.; Franke, L.; Aulchenko, Y.S.; Huttenhower, C.; Raes, J.; Hofker, M.H.; Xavier, R.J.; Wijmenga, C.; Fu, J.

    2016-01-01

    Deep sequencing of the gut microbiomes of 1135 participants from a Dutch population-based cohort shows relations between the microbiome and 126 exogenous and intrinsic host factors, including 31 intrinsic factors, 12 diseases, 19 drug groups, 4 smoking categories, and 60 dietary factors. These

  2. Genetic transmission of Alzheimer disease among families in a Dutch population-based study

    NARCIS (Netherlands)

    C.M. van Duijn (Cornelia); L.A. Farrer (Lindsay); L.A. Cupples (Adrienne); A. Hofman (Albert)

    1993-01-01

    textabstractWe evaluated age at onset and transmission patterns of Alzheimer's disease (AD) in families of 198 patients who had onset of symptoms before the age of 65 years and were diagnosed before the age of 70 years. Patients were ascertained in a population based study in The Netherlands. The

  3. Acute hospital, community, and indirect costs of stroke associated with atrial fibrillation: population-based study.

    LENUS (Irish Health Repository)

    Hannon, Niamh

    2014-10-30

    No economic data from population-based studies exist on acute or late hospital, community, and indirect costs of stroke associated with atrial fibrillation (AF-stroke). Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic agents.

  4. Risk of new primary nonbreast cancers after breast cancer treatment: a Dutch population-based study.

    NARCIS (Netherlands)

    Schaapveld, M.; Visser, O.; Louwman, M.J.; Vries, EG de; Willemse, P.H.; Otter, R.; Graaf, W.T.A. van der; Coebergh, J.W.; Leeuwen, F.E. van

    2008-01-01

    PURPOSE: To assess the risk of secondary nonbreast cancers (SNBCs) in a recently treated population-based cohort of breast cancer patients focused on the association with treatment and prognostic implications. PATIENTS AND METHODS: In 58,068 Dutch patients diagnosed with invasive breast cancer

  5. Risk of new primary nonbreast cancers after breast cancer treatment: A dutch population-based study

    NARCIS (Netherlands)

    M. Schaapveld (Michael); O.J. Visser (Otto); M.W.J. Louwman (Marieke); E.G.E. de Vries (Elisabeth); P.H.B. Willemse (Pax); R. Otter (Renée); W.T.A. van der Graaf (Winette); J.W.W. Coebergh (Jan Willem); F.E. van Leeuwen (Flora)

    2008-01-01

    textabstractPurpose: To assess the risk of secondary nonbreast cancers (SNBCs) in a recently treated population-based cohort of breast cancer patients focused on the association with treatment and prognostic implications. Patients and Methods: In 58,068 Dutch patients diagnosed with invasive breast

  6. Risk of new primary nonbreast cancers after breast cancer treatment : A Dutch population-based study

    NARCIS (Netherlands)

    Schaapveld, Michael; Visser, Otto; Louwman, Marieke J.; de Vries, Elisabeth G. E.; Willemse, Pax H. B.; Otter, Renee; van der Graaf, Winette T. A.; Coebergh, Jan-Willem W.; van Leeuwen, Flora E.

    2008-01-01

    Purpose To assess the risk of secondary nonbreast cancers (SNBCs) in a recently treated population-based cohort of breast cancer patients focused on the association with treatment and prognostic implications. Patients and Methods In 58,068 Dutch patients diagnosed with invasive breast cancer between

  7. Survival in Mediterranean Ambulatory Patients With Chronic Heart Failure. A Population-based Study

    NARCIS (Netherlands)

    Frigola Capell, E.; Comin-Colet, J.; Davins-Miralles, J.; Gich-Saladich, I.J.; Wensing, M.; Verdu-Rotellar, J.M.

    2013-01-01

    INTRODUCTION AND OBJECTIVES: Scarce research has been performed in ambulatory patients with chronic heart failure in the Mediterranean area. Our aim was to describe survival trends in our target population and the impact of prognostic factors. METHODS: We carried out a population-based retrospective

  8. Risk of infections in patients with gout: a population-based cohort study

    NARCIS (Netherlands)

    Spaetgens, B.; Vries, F de; Driessen, J.H.; Leufkens, H.G.M.; Souverein, P.C.; Boonen, A.; Meer, J.W.M. van der; Joosten, L.A.B.

    2017-01-01

    To investigate the risk of various types of infections (pneumonia and urinary tract infection (UTI)), and infection-related mortality in patients with gout compared with population-based controls. A retrospective cohort study was conducted using data from the UK Clinical Practice Research Datalink

  9. Health-Related Quality of Life in Cervical Cancer Survivors: A Population-Based Survey

    NARCIS (Netherlands)

    I.J. Korfage (Ida); M.L.E. Essink-Bot (Marie-Louise); F. Mols (Floortje); L.V. van de Poll-Franse (Lonneke); R.F.M.P. Kruitwagen (Roy); M. van Ballegooijen (Marjolein)

    2009-01-01

    textabstractPURPOSE: In a population-based sample of cervical cancer survivors, health-related quality of life (HRQoL) was assessed 2-10 years postdiagnosis. METHODS AND MATERIALS: All patients given a diagnosis of cervical cancer in 1995-2003 in the Eindhoven region, The Netherlands, and alive

  10. House dust mites and their allergens in Danish mattresses -- results from a population based study

    DEFF Research Database (Denmark)

    Sidenius, Kirsten E; Hallas, Thorkil E; Poulsen, Lars K.

    2002-01-01

    The purpose of this study was to identify the level of house dust mites (HDMs) and their allergens in mattresses, not selected on their owners atopic status, and to find associated factors. Dust was collected from 68 mattresses. The recruitment was population-based and conducted during...

  11. Primary mucinous carcinoma of the skin: a population-based study

    DEFF Research Database (Denmark)

    Breiting, Line; Christensen, Lise Hanne; Dahlstrøm, Karin

    2008-01-01

    Primary mucinous carcinoma of the skin (PMCS) is a rare malignant tumor deriving from the sweat glands. It is typically located on the head and is often mistaken for a metastasis from a more common primary tumor of the breast or gastrointestinal tract. We present the first population-based study...

  12. Infertility and subfecundity in population-based samples from Denmark, Germany, Italy, Poland and Spain

    DEFF Research Database (Denmark)

    Karmaus, Wilfried; Juul, Svend

    1999-01-01

    Background: No uniform data which give basic Information on the societal burden of infertility and subfecundity exists in Europe. Methods: In a population-based survey the prevalence of subfecundity was ascertained by means of a standardized interview with women in Denmark, Germany, Poland, Italy...

  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. Methods of Suicide among Cancer Patients: A Nationwide Population-Based Study

    Science.gov (United States)

    Chung, Kuo-Hsuan; Lin, Herng-Ching

    2010-01-01

    A 3-year nationwide population-based data set was used to explore methods of suicide (violent vs. nonviolent) and possible contributing factors among cancer patients in Taiwan. A total of 1,065 cancer inpatients who committed suicide were included as our study sample. The regression shows that those who had genitourinary cancer were 0.55 times (p…

  15. Long-Term Benefits of Full-Day Kindergarten: A Longitudinal Population-Based Study

    Science.gov (United States)

    Brownell, M. D.; Nickel, N. C.; Chateau, D.; Martens, P. J.; Taylor, C.; Crockett, L.; Katz, A.; Sarkar, J.; Burland, E.; Goh, C. Y.

    2015-01-01

    In the first longitudinal, population-based study of full-day kindergarten (FDK) outcomes beyond primary school in Canada, we used linked administrative data to follow 15 kindergarten cohorts (n ranging from 112 to 736) up to grade 9. Provincial assessments conducted in grades 3, 7, and 8 and course marks and credits earned in grade 9 were…

  16. A review of population-based studies on hypertension in Ghana ...

    African Journals Online (AJOL)

    Background: Hypertension is becoming a common health problem worldwide with increasing life expectancy and increasing prevalence of risk factors. Epidemiological data on hypertension in Ghana is necessary to guide policy and develop effective interventions. Methods: A review of population-based studies on ...

  17. Associated Medical Disorders and Disabilities in Children with Autistic Disorder: A Population-Based Study

    Science.gov (United States)

    Kielinen, Marko; Rantala, Heikki; Timonen, Eija; Linna, Sirkka-Liisa; Moilanen, Irma

    2004-01-01

    A population-based survey was conducted among 152,732 Finnish children and adolescents aged under 16 years and living in northern Finland. Diagnoses and associated medical conditions were derived from the hospital and institutional records of this area. One hundred and eighty-seven children with DSM-IV autistic disorder were identified. Associated…

  18. A UK population-based study of the relationship between mental disorder and victimisation

    NARCIS (Netherlands)

    Hart, C.; Vet, R. de; Moran, P.; Hatch, S.L.; Dean, K.

    2012-01-01

    PURPOSE: To establish the prevalence of victimisation in a UK population-based sample and to investigate the association between mental disorder and victimisation in both cross-sectional and prospective manner, whilst adjusting for potential confounds. METHODS: Data from the National Child

  19. Parents and Infants: Determinants of Attachment in a Longitudinal Population-Based Study

    OpenAIRE

    Tharner, Anne

    2011-01-01

    textabstractDoes a postnatal depression influence the mother-child relationship? Can a father with depressive or anxiety symptoms build up a secure attachment with his child? Does breastfeeding have consequences for the bond between mother and child? These and more questions are examined in a Longitudinal Population-Based Study.

  20. Frontotemporal dementia in The Netherlands : patient characteristics and prevalence estimates from a population-based study

    NARCIS (Netherlands)

    Rosso, Sonia M; Donker Kaat, Laura; Baks, Timo; Joosse, Marijke; de Koning, Inge; Pijnenburg, Yolande; de Jong, Daniëlle; Dooijes, Dennis; Kamphorst, Wouter; Ravid, Rivka; Niermeijer, Martinus F; Verheij, Frans; Kremer, H P; Scheltens, Philip; van Duijn, Cornelia M; Heutink, Peter; van Swieten, John C

    Since 1994, a population-based study of frontotemporal dementia (FTD) in The Netherlands has aimed to ascertain all patients with FTD, and first prevalence estimates based on 74 patients were reported in 1998. Here, we present new prevalence estimates after expansion of our FTD population to 245

  1. Frontotemporal dementia in The Netherlands: patient characteristics and prevalence estimates from a population-based study.

    NARCIS (Netherlands)

    S.M. Rosso (Sonia); L. Donker Kaat (Laura); T. Baks (Timo); M. Joosse (Marijke); I. de Koning (Inge); Y. Pijnenburg (Yolande); D. de Jong (Danielle); D. Dooijes (Dennis); W. Kamphorst (Wouter); R. Ravid (Rivka); M.F. Niermeijer (Martinus); F. Verheij (Fop); H.P. Kremer; P. Scheltens (Philip); C.M. van Duijn (Cornelia); P. Heutink (Peter); J.C. van Swieten (John)

    2003-01-01

    textabstractSince 1994, a population-based study of frontotemporal dementia (FTD) in The Netherlands has aimed to ascertain all patients with FTD, and first prevalence estimates based on 74 patients were reported in 1998. Here, we present new prevalence estimates after expansion of our FTD

  2. A Population-Based Longitudinal Study of Depression in Children with Developmental Disabilities in Manitoba

    Science.gov (United States)

    Shooshtari, Shahin; Brownell, Marni; Dik, Natalia; Chateau, Dan; Yu, C. T.; Mills, Rosemary S. L.; Burchill, Charles A.; Wetzel, Monika

    2014-01-01

    In this population-based study, prevalence of depression was estimated and compared between children with and without developmental disability (DD). Twelve years of administrative data were linked to identify a cohort of children with DD living in the Canadian province of Manitoba. Children in the study cohort were matched with children without DD…

  3. The clinical epidemiology of urachal carcinoma: results of a large, population based study

    NARCIS (Netherlands)

    Bruins, H.M.; Visser, O.; Ploeg, M.; Hulsbergen- van de Kaa, C.A.; Kiemeney, L.A.L.M.; Witjes, J.A.

    2012-01-01

    PURPOSE: Survival data on urachal carcinoma are sparse due to the low prevalence of this cancer. We report urachal carcinoma clinical outcomes and prognostic factors in a large, population based cohort of patients with long-term followup. MATERIALS AND METHODS: Data were collected from the

  4. Correlation of anxiety and depression symptoms in patients with restless legs syndrome: a population based survey

    OpenAIRE

    Sevim, S; Dogu, O; Kaleagasi, H.; Aral, M; Metin, O; Camdeviren, H

    2004-01-01

    Background and objectives: Restless legs syndrome (RLS) is an important and common cause of insomnia, and previous studies indicate that psychiatric wellbeing may be impaired among RLS patients. We aimed to investigate the interaction between anxiety/depression and RLS in a population based survey.

  5. Normal values and determinants of circadian urine production in older men : A population based study

    NARCIS (Netherlands)

    Blanker, M. H.; Bernsen, R. M.; Bosch, J. L. Ruud; Thomas, S.; Groeneveld, F. P.; Prins, A.; Bohnen, A. M.

    2002-01-01

    PURPOSE: We evaluated circadian urine production and its determinants in a large population based sample of older men. MATERIALS AND METHODS: We collected data on 1,688 men 50 to 78 years old, without radical prostatectomy, prostate or bladder cancer, neurogenic bladder disease or negative advice

  6. Epilepsy Among Children and Adolescents with Autism Spectrum Disorders: A Population-Based Study

    Science.gov (United States)

    Jokiranta, Elina; Sourander, Andre; Suominen, Auli; Timonen-Soivio, Laura; Brown, Alan S.; Sillanpää, Matti

    2014-01-01

    The present population-based study examines associations between epilepsy and autism spectrum disorders (ASD). The cohort includes register data of 4,705 children born between 1987 and 2005 and diagnosed as cases of childhood autism, Asperger's syndrome or pervasive developmental disorders--not otherwise specified. Each case was matched to four…

  7. Regular exercise, anxiety, depression and personality: A population-based study

    NARCIS (Netherlands)

    de Moor, M.H.M.; Beem, A.L.; Stubbe, J.H.; Boomsma, D.I.; de Geus, E.J.C.

    2006-01-01

    Objectives: To examine whether regular exercise is associated with anxiety, depression and personality in a large population-based sample as a function of gender and age. Methods: The sample consisted of adolescent and adult twins and their families (N = 19,288) who participated in the study on

  8. Regular exercise, anxiety, depression and personality: a population-based study

    NARCIS (Netherlands)

    de Moor, M. H. M.; Beem, A. L.; Stubbe, J. H.; Boomsma, D. I.; de Geus, E. J. C.

    2006-01-01

    To examine whether regular exercise is associated with anxiety, depression and personality in a large population-based sample as a function of gender and age. The sample consisted of adolescent and adult twins and their families (N=19,288) who participated in the study on lifestyle and health from

  9. 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

  10. Development of Population-Based Resilience Measures in the Primary School Setting

    Science.gov (United States)

    Sun, Jing; Stewart, Donald

    2007-01-01

    Purpose: The purpose of the population-based study in the paper is to report on progress in formulating instruments to measure children's resilience and associated protective factors in family, primary school and community contexts. Design/methodology/approach: In this paper a total of 2,794 students, 1,558 parents/caregivers, and 465 staff were…

  11. Population-based reference values for bone mineral density in young men

    DEFF Research Database (Denmark)

    Høiberg, M; Nielsen, T L; Wraae, Kristian

    2007-01-01

    Population-based reference values for peak bone mass density in Danish men. BMD of total hip (1.078 +/- 0,14 g/cm2) differed significantly from values from National Health and Nutrition Examination Survey III and of total lumbar spine ((1.073 +/- 0.125 g/cm2) differed significantly from Hologic...

  12. Retesting with the TRUE Test in a population-based twin cohort with hand eczema

    DEFF Research Database (Denmark)

    Lerbaek, Anne; Kyvik, Kirsten Ohm; Menné, Torkil

    2007-01-01

    Population-based studies on contact allergy with retesting of individuals are infrequently performed. Variable degrees of persistence are reported when individuals with contact allergy are retested with years in between. The patch test results of 270 individuals tested in 2005-2006 are presented ...

  13. Spontaneous preterm delivery among primiparous women at low risk in Denmark: a population based study

    DEFF Research Database (Denmark)

    Langhoff-Roos, Jens; Kesmodel, Ulrik; Jacobsson, Bo

    2006-01-01

    can be compared internationally. DESIGN: Population based study. PARTICIPANTS: 99.8% of all deliveries in Denmark, 1995-2004. MAIN OUTCOME MEASURES: Proportion of babies born at less than 37 weeks' completed gestation for each year in the overall population and in a standard population at low risk...

  14. Recurrence risk of low Apgar score among term singletons: a population-based cohort study

    NARCIS (Netherlands)

    Ensing, Sabine; Schaaf, Jelle M.; Abu-Hanna, Ameen; Mol, Ben W. J.; Ravelli, Anita C. J.

    2014-01-01

    To examine the risk of recurrence of low Apgar score in a subsequent term singleton pregnancy. Population-based cohort study. The Netherlands. A total of 190,725 women with two subsequent singleton term live births between 1999 and 2007. We calculated the recurrence risk of low Apgar score after

  15. The Prevalence of Suicidal Phenomena in Adolescents: A Systematic Review of Population-Based Studies

    Science.gov (United States)

    Evans, Emma; Hawton, Keith; Rodham, Karen; Deeks, Jonathan

    2005-01-01

    The results of a systematic review of the international literature on the prevalence of suicidal phenomena in adolescents, including the influence of survey method, gender, and ethnicity are reported. The literature was searched using six electronic databases to identify all population-based studies of self-reported suicidal phenomena; 128 studies…

  16. Benefits, pitfalls, and future design of population-based registers in neurodegenerative disease.

    Science.gov (United States)

    Rooney, James P K; Brayne, Carol; Tobin, Katy; Logroscino, Giancarlo; Glymour, M Maria; Hardiman, Orla

    2017-06-13

    Population-based disease registers identify and characterize all cases of disease, including those that might otherwise be neglected. Prospective population-based registers in neurodegeneration are necessary to provide comprehensive data on the whole phenotypic spectrum and can guide planning of health services. With the exception of the rare disease amyotrophic lateral sclerosis, few complete population-based registers exist for neurodegenerative conditions. Incomplete ascertainment, limitations and uncertainty in diagnostic categorization, and failure to recognize sources of bias reduce the accuracy and usefulness of many registers. Common biases include population stratification, the use of prevalent rather than incident cases in earlier years, changes in disease understanding and diagnostic criteria, and changing demographics over time. Future registers are at risk of funding shortfalls and changes to privacy legislation. Notwithstanding, as heterogeneities of clinical phenotype and disease pathogenesis are increasingly recognized in the neurodegenerations, well-designed longitudinal population-based disease registers will be an essential requirement to complete clinical understanding of neurodegenerative diseases. © 2017 American Academy of Neurology.

  17. Undertreatment of hypertension in a population-based study in The Netherlands

    NARCIS (Netherlands)

    Klungel, O.H.; de Boer, A; Paes, A.H.P.; Seidell, J C; Nagelkerke, N.J.; Bakker, A

    OBJECTIVE: To estimate the level of undertreatment of hypertension in a population-based study by taking into account the co-existence of additional cardiovascular risk factors in untreated hypertensives, uncontrolled blood pressure among pharmacologically treated hypertensives and within-person

  18. Surgery for Recurrent Epithelial Ovarian Cancer in the Netherlands: A Population-Based Cohort Study

    NARCIS (Netherlands)

    Laar, R. van de; Kruitwagen, R.F.P.M.; Hout, J. in't; Zusterzeel, P.L.M.; Gorp, T. Van; Massuger, L.F.A.G.

    2016-01-01

    OBJECTIVE: The value of secondary cytoreductive surgery (SCS) in patients with recurrent epithelial ovarian cancer is controversial. The aim of this population-based study was to investigate the role of SCS in the Netherlands. METHODS: Data of 408 patients who underwent SCS between 2000 and 2013

  19. Minor Self-Harm and Psychiatric Disorder: A Population-Based Study

    Science.gov (United States)

    Skegg, Keren; Nada-Raja, Shyamala; Moffit, Terrie E.

    2004-01-01

    Little is known about the extent to which minor self-harm in the general population is associated with psychiatric disorder. A population-based sample of 980 young adults was interviewed independently about past-year suicidal and self-harm behavior and thoughts, and psychiatric disorders. Self-harm included self-harmful behaviors such as…

  20. 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

  1. Relationship Status among Parents of Children with Autism Spectrum Disorders: A Population-Based Study

    Science.gov (United States)

    Freedman, Brian H.; Kalb, Luther G.; Zablotsky, Benjamin; Stuart, Elizabeth A.

    2012-01-01

    Despite speculation about an 80% divorce rate among parents of children with an Autism Spectrum Disorder (ASD), very little empirical and no epidemiological research has addressed the issue of separation and divorce among this population. Data for this study was taken from the 2007 National Survey of Children's Health, a population-based,…

  2. Sickness benefit claims due to mental disorders in Brazil : associations in a population-based study

    NARCIS (Netherlands)

    Barbosa-Branco, Anadergh; Bultmann, Ute; Steenstra, Ivan

    2012-01-01

    This study aims to determine the prevalence and duration of sickness benefit claims due to mental disorders and their association with economic activity, sex, age, work-relatedness and income replacement using a population-based study of sickness benefit claims (> 15 days) due to mental disorders in

  3. Incidence, Risk Factors, and Outcomes for Enterococcus spp. Blood Stream Infections: A Population-Based Study

    Directory of Open Access Journals (Sweden)

    E.O. Billington

    2014-09-01

    Conclusions: This is the second population-based study to assess the risk factors for enterococcal BSI and compare the characteristics of infection with E. faecalis and E. faecium. Results suggest that BSI with E. faecalis and E. faecium should be regarded as two clinically different entities with unique sets of risk factors and microbiologic characteristics.

  4. Non-Hodgkin's lymphoma in the Netherlands : Results from a population based registry

    NARCIS (Netherlands)

    Krol, ADG; Le Cessie, S; Snijder, S; Kluin-Nelemans, JC; Kluin, PM; Noordijk, EM

    2003-01-01

    The Comprehensive Cancer Centre West (CCCW) population based non-Hodgkin's lymphoma (NHL) registry contains information on all newly diagnosed NHL patients living in the region covered by the CCCW. Patients were entered from June 1st 1981 to December 31st 1989. Follow-up is still ongoing, median

  5. Risk of infections in patients with gout : a population-based cohort study

    NARCIS (Netherlands)

    Spaetgens, B; de Vries, F; Driessen, J H M; Leufkens, H G; Souverein, P C; Boonen, A; van der Meer, J W M; Joosten, L A B

    2017-01-01

    To investigate the risk of various types of infections (pneumonia and urinary tract infection (UTI)), and infection-related mortality in patients with gout compared with population-based controls. A retrospective cohort study was conducted using data from the UK Clinical Practice Research Datalink

  6. Birth and parental characteristics and risk of neuroblastoma in a population-based Norwegian cohort study

    OpenAIRE

    Bj?rge, T; Engeland, A; S. Tretli; Heuch, I.

    2008-01-01

    In this population-based Norwegian cohort study (2.1 million children), the impact of birth and parental characteristics on the risk of neuroblastoma (178 cases) was evaluated. In children below the age of 18 months, there was an increased neuroblastoma risk among those with congenital malformations and suggestion of increased risk when the mother had pre-eclampsia.

  7. Sex differences in subjective and actigraphic sleep measures: A population-based study of elderly persons

    NARCIS (Netherlands)

    Berg, J.F. van den; Miedema, H.M.E.; Tulen, J.H.M.; Hofman, A.; Neven, A.K.; Tiemeier, H.

    2009-01-01

    Study Objectives: To investigate and explain sex differences in subjective and actigraphic sleep parameters in community-dwelling elderly persons. Design: Cross-sectional study. Setting: The study was embedded in the Rotterdam Study, a population-based study. Participants: Nine hundred fifty-six

  8. Obstetric intensive care unit admission: a 2-year nationwide population-based cohort study

    NARCIS (Netherlands)

    Zwart, J.J.; Dupuis, J.R.O.; Richters, A.; Öry, F.; Roosmalen, J. van

    2010-01-01

    Purpose: As part of a larger nationwide enquiry into severe maternal morbidity, our aim was to assess the incidence and possible risk factors of obstetric intensive care unit (ICU) admission in the Netherlands. Methods: In a 2-year nationwide prospective population-based cohort study, all ICU

  9. Psychological Abuse between Parents: Associations with Child Maltreatment from a Population-Based Sample

    Science.gov (United States)

    Chang, Jen Jen; Theodore, Adrea D.; Martin, Sandra L.; Runyan, Desmond K.

    2008-01-01

    Objective: This study examined the association between partner psychological abuse and child maltreatment perpetration. Methods: This cross-sectional study examined a population-based sample of mothers with children aged 0-17 years in North and South Carolina (n = 1,149). Mothers were asked about the occurrence of potentially neglectful or abusive…

  10. Referral to palliative care in COPD and other chronic diseases: A population-based study

    NARCIS (Netherlands)

    Beernaert, K.; Cohen, J.; Deliens, L.; Devroey, D.; Vanthomme, K.; Pardon, K.; Block, L.

    2013-01-01

    Aim To describe how patients with COPD, heart failure, dementia and cancer differ in frequency and timing of referral to palliative care services. Methods We performed a population-based study with the Sentinel Network of General Practitioners in Belgium. Of 2405 registered deaths respectively 5%,

  11. Population-based Results of Chemoradiotherapy for Limited Stage Small Cell Lung Cancer in The Netherlands

    NARCIS (Netherlands)

    Damhuis, R.; Widder, J.; Senan, S.

    Aims: Treatment guidelines for limited stage small cell lung cancer (LS-SCLC) favour early concurrent chemoradiotherapy (CRT). Little is known about contemporary, real-world treatment patterns and outcome. We evaluated population-based practice patterns of CRT and corresponding survival in the

  12. Emotional development in children with tics : a longitudinal population-based study

    NARCIS (Netherlands)

    Hoekstra, P. J.; Lundervold, A. J.; Lie, S. A.; Gillberg, C.; Plessen, Kerstin J.

    Children with tics often experience accompanying problems that may have more impact on their well being and quality of life than the tics themselves. The present study investigates characteristics and the course of associated problems. In a population-based follow-up study, we investigated the

  13. Reliability of Semiautomated Computational Methods for Estimating Tibiofemoral Contact Stress in the Multicenter Osteoarthritis Study

    Directory of Open Access Journals (Sweden)

    Donald D. Anderson

    2012-01-01

    Full Text Available Recent findings suggest that contact stress is a potent predictor of subsequent symptomatic osteoarthritis development in the knee. However, much larger numbers of knees (likely on the order of hundreds, if not thousands need to be reliably analyzed to achieve the statistical power necessary to clarify this relationship. This study assessed the reliability of new semiautomated computational methods for estimating contact stress in knees from large population-based cohorts. Ten knees of subjects from the Multicenter Osteoarthritis Study were included. Bone surfaces were manually segmented from sequential 1.0 Tesla magnetic resonance imaging slices by three individuals on two nonconsecutive days. Four individuals then registered the resulting bone surfaces to corresponding bone edges on weight-bearing radiographs, using a semi-automated algorithm. Discrete element analysis methods were used to estimate contact stress distributions for each knee. Segmentation and registration reliabilities (day-to-day and interrater for peak and mean medial and lateral tibiofemoral contact stress were assessed with Shrout-Fleiss intraclass correlation coefficients (ICCs. The segmentation and registration steps of the modeling approach were found to have excellent day-to-day (ICC 0.93–0.99 and good inter-rater reliability (0.84–0.97. This approach for estimating compartment-specific tibiofemoral contact stress appears to be sufficiently reliable for use in large population-based cohorts.

  14. Multi-Centered First Order Formalism

    CERN Document Server

    Ferrara, Sergio; Shcherbakov, Andrey; Yeranyan, Armen

    2013-01-01

    We propose a first order formalism for multi-centered black holes with flat tree-dimensional base-space, within the stu model of N=2, D=4 ungauged Maxwell-Einstein supergravity. This provides a unified description of first order flows of this universal sector of all models with a symmetric scalar manifold which can be obtained by dimensional reduction from five dimensions. We develop a D=3 Cartesian formalism which suitably extends the definition of central and matter charges, as well as of black hole effective potential and first order "fake" superpotential, in order to deal with not necessarily axisimmetric solutions, and thus with multi-centered and/or (under-)rotating extremal black holes. We derive general first order flow equations for composite non-BPS and almost BPS classes, and we analyze some of their solutions, retrieving various single-centered (static or under-rotating) and multi-centered known systems. As in the t^3 model, the almost BPS class turns out to split into two general branches, and th...

  15. Multi-centered first order formalism

    Science.gov (United States)

    Ferrara, Sergio; Marrani, Alessio; Shcherbakov, Andrey; Yeranyan, Armen

    2013-05-01

    We propose a first order formalism for multi-centered black holes with flat three-dimensional base-space, within the stu model of N = 2, D = 4 ungauged MaxwellEinstein supergravity. This provides a unified description of first order flows of this universal sector of all models with a symmetric scalar manifold which can be obtained by dimensional reduction from five dimensions. We develop a D = 3 Cartesian formalism which suitably extends the definition of central and matter charges, as well as of black hole effective potential and first order "fake" superpotential, in order to deal with not necessarily axisimmetric solutions, and thus with multi-centered and/or (under-)rotating extremal black holes. We derive general first order flow equations for composite non-BPS and almost BPS classes, and we analyze some of their solutions, retrieving various single-centered (static or under-rotating) and multi-centered known systems. As in the t 3 model, the almost BPS class turns out to split into two general branches, and the well known almost BPS system is shown to be a particular solution of the second branch.

  16. Comparisons of serum vitamin D levels, status, and determinants in populations with and without chronic kidney disease not requiring renal dialysis: a 24-hour urine collection population-based study.

    Science.gov (United States)

    Guessous, Idris; McClellan, William; Kleinbaum, David; Vaccarino, Viola; Zoller, Otmar; Theler, Jean-Marc; Paccaud, Fred; Burnier, Michel; Bochud, Murielle

    2014-09-01

    Vitamin D deficiency is frequent in the general population and might be even more prevalent among populations with kidney failure. We compared serum vitamin D levels, vitamin D insufficiency/deficiency status, and vitamin D level determinants in populations without chronic kidney disease (CKD) and with CKD not requiring renal dialysis. This was a cross-sectional, multicenter, population-based study conducted from 2010 to 2011. Participants were from 10 centers that represent the geographical and cultural diversity of the Swiss adult population (≥15 years old). CKD was defined using estimated glomerular filtration rate and 24-hour albuminuria. Serum vitamin D was measured by liquid chromatography-tandem mass spectrometry. Statistical procedures adapted for survey data were used. We compared 25-hydroxy-vitamin D (25(OH)D) levels and the prevalence of vitamin D insufficiency/deficiency (serum 25(OH)D dialysis. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  17. Population-based screening for colorectal cancer using an immunochemical faecal occult blood test: a comparison of two invitation strategies.

    Science.gov (United States)

    Van Roosbroeck, Sofie; Hoeck, Sarah; Van Hal, Guido

    2012-10-01

    To date, there is no screening programme for colorectal cancer (CRC) in Flanders, Belgium. However, The European Code Against Cancer (2003) recommends a population-based approach for CRC screening. This study aimed to obtain information about potential participation rates for a population-based screening programme for CRC in Flanders, and to compare two invitation strategies. In 2009, a trial programme for CRC screening was set up in three Flemish areas for all average-risk people aged 50-74 years, using an immunochemical faecal occult blood test (iFOBT) with a cut-off value set at 75 ng/ml of haemoglobin. The faecal sampling set was sent at random by post (mail group) or provided by the general practitioner (GP group). In total, 19,542 people were invited to participate. Of these, 8229 provided a faecal sample, resulting in an overall participation rate of 42.1%. Participation by mail and through the GP was 52.3% (95% CI, 51.3-53.2) and 27.7% (95% CI, 26.7-28.6), respectively. The difference of 24.6% was statistically significant (95% CI, 23.3-25.9, pCRC screening was almost three times higher for people invited by mail as opposed to people invited through a GP (OR=2.96, 95% CI, 2.78-3.14, pCRC screening than men (OR=1.22, 95% CI, 1.15-1.30, pCRC was diagnosed in 18 (5.7%) individuals. Compliance for follow-up colonoscopy was 72.9%, and did not differ between the mail (72.4%, 95% CI, 67.5-77.3) and GP groups (74.3, 95% CI, 66.2-82.5). Inviting people for CRC screening by means of a direct-mail invitation, and including a faecal sampling set (iFOBT), results in much higher participation rates than inviting people through the GP. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. The potential of the European network of congenital anomaly registers (EUROCAT) for drug safety surveillance : a descriptive study

    NARCIS (Netherlands)

    Meijer, Willemijn M.; Cornel, Martina C.; Dolk, Helen; de Walle, Hermien E. K.; Armstrong, Nicola C.; de Jong-van den Berg, Lolkje T. W.

    Background European Surveillance of Congenital Anomalies (EUROCAT) is a network of population-based congenital anomaly registries in Europe surveying more than I million births per year, or 25% of the births in the European Union. This paper describes the potential of the EUROCAT collaboration for

  19. Multicenter study of the Artisan phakic intraocular lens.

    Science.gov (United States)

    Budo, C; Hessloehl, J C; Izak, M; Luyten, G P; Menezo, J L; Sener, B A; Tassignon, M J; Termote, H; Worst, J G

    2000-08-01

    To assess the Artisan intraocular lens to correct myopia in phakic eyes. European multicenter study sponsored by Ophtec BV, Groningen, The Netherlands. In this prospective multicenter clinical study, the Artisan lens was implanted in 518 eyes between September 1991 and October 1999. The power of the lenses ranged from -5.0 to -20.0 diopters (D). Follow-up examinations were performed at 6 months and 1, 2, and 3 years. Follow-up ranged from 6 months (n = 454) to 3 years (n = 249). The preoperative uncorrected visual acuity (UCVA) was not recorded but was estimated to be worse than 0.1. The preoperative mean best spectacle-corrected visual acuity (BSCVA) was 0.67 +/- 0.26 (SD). Endothelial cell counts were done at 6 months and 1, 2, and 3 years in a subgroup of 129 eyes. A UCVA of 20/40 or better was observed in 76.8% of eyes regardless of the postoperative goal. A BSCVA of 20/40 or better was observed in 93.9% of eyes and remained stable throughout the follow-up. Of the eyes with extremely high myopia (>-15.0 D), 63.3% gained 2 or more lines of BSCVA; of those with moderate myopia (-5.0 to -10.0 D), 23.5% gained 2 or more lines. The mean endothelial cell density change was 4.8% at 6 months, 2.4% at 1 year, 1.7% at 2 years, and 0.7% at 3 years. The incidence of persistent adverse events at 3 years was relatively low. Secondary surgical interventions included repositioning of the lens because of poor initial placement and lens exchange because of preoperative power calculation errors. Glare and halo effects during night driving were noted and were related to large pupils in young patients. The Artisan lens is a safe, stable, efficacious, and predictable method to correct -5.0 to -20.0 D of myopia. This study suggests that the corneal endothelial cell loss is stabilized to the physiologically normal level after 3 years.

  20. Parallel genetic algorithm with population-based sampling approach to discrete optimization under uncertainty

    Science.gov (United States)

    Subramanian, Nithya

    Optimization under uncertainty accounts for design variables and external parameters or factors with probabilistic distributions instead of fixed deterministic values; it enables problem formulations that might maximize or minimize an expected value while satisfying constraints using probabilities. For discrete optimization under uncertainty, a Monte Carlo Sampling (MCS) approach enables high-accuracy estimation of expectations but it also results in high computational expense. The Genetic Algorithm (GA) with a Population-Based Sampling (PBS) technique enables optimization under uncertainty with discrete variables at a lower computational expense than using Monte Carlo sampling for every fitness evaluation. Population-Based Sampling uses fewer samples in the exploratory phase of the GA and a larger number of samples when `good designs' start emerging over the generations. This sampling technique therefore reduces the computational effort spent on `poor designs' found in the initial phase of the algorithm. Parallel computation evaluates the expected value of the objective and constraints in parallel to facilitate reduced wall-clock time. A customized stopping criterion is also developed for the GA with Population-Based Sampling. The stopping criterion requires that the design with the minimum expected fitness value to have at least 99% constraint satisfaction and to have accumulated at least 10,000 samples. The average change in expected fitness values in the last ten consecutive generations is also monitored. The optimization of composite laminates using ply orientation angle as a discrete variable provides an example to demonstrate further developments of the GA with Population-Based Sampling for discrete optimization under uncertainty. The focus problem aims to reduce the expected weight of the composite laminate while treating the laminate's fiber volume fraction and externally applied loads as uncertain quantities following normal distributions. Construction of

  1. Population-Based Assessment of Exposure to Risk Behaviors in Motion Pictures

    Science.gov (United States)

    Sargent, James D.; Worth, Keilah A.; Beach, Michael; Gerrard, Meg; Heatherton, Todd F.

    2008-01-01

    The aim of most population-based studies of media is to relate a specific exposure to an outcome of interest. A research program has been developed that evaluates exposure to different components of movies in an attempt of assess the association of such exposure with the adoption of substance use during adolescence. To assess exposure to movie substance use, one must measure both viewing time and content. In developing the exposure measure, the study team was interested in circumventing a common problem in exposure measurement, where measures often conflate exposure to media with attention to media. Our aim in this paper is to present a validated measure of exposure to entertainment media, the Beach method, which combines recognition of a movie title with content analysis of the movie for substance use, to generate population based measures of exposure to substance use in this form of entertainment. PMID:19122801

  2. Risk perception among women receiving genetic counseling: a population-based follow-up study

    DEFF Research Database (Denmark)

    Mikkelsen, Ellen M; Sunde, Lone; Johansen, Christoffer

    2007-01-01

    . CONCLUSION: This population-based study of women with a family history of breast or ovarian cancer indicates that genetic counseling can help them both to reduce their perceived risk and to achieve a more realistic view of their risk of developing breast cancer. Udgivelsesdato: 2007-null......BACKGROUND: We aimed to explore the impact of genetic counseling on perceived personal lifetime risk of breast cancer, the accuracy of risk perception, and possible predictors of inaccurate risk perception 1 year following counseling. METHODS: We conducted a population-based prospective follow......-up study of 213 women who received genetic counseling for hereditary breast and ovarian cancer, 319 women who underwent mammography (Reference Group I), and a random sample of 1070 women from the general population (Reference Group II). RESULTS: Women who received genetic counseling decreased...

  3. Epidemiology of subtypes of hyperthyroidism in Denmark: a population-based study

    DEFF Research Database (Denmark)

    Carle, Allan; Pedersen, Inge Bulow; Knudsen, Nils

    2011-01-01

    Objective: Few population-based studies have described the epidemiology of subtypes of hyperthyroidism. Design: A prospective population-based study, monitoring two well-defined Danish cohorts in Aalborg with moderate iodine deficiency (nZ311 102) and Copenhagen with only mild iodine deficiency (n......Z227 632).Methods: A laboratory monitoring system identified subjects with thyroid function tests suggesting overt hyperthyroidism (low s-TSH combined with high s-thyroxine or s-triiodothyronine). For all subjects, we collected information on medical history, thyroid scintigraphy and thyroid hormone...... receptor antibody (TRAb) measurement. Information was used to disprove or verify primary overt hyperthyroidism and to subclassify hyperthyroidism into nosological disorders.Results: From 1997 to 2000 (2 027 208 person-years of observation), we verified 1682 new cases of overt hyperthyroidism. The overall...

  4. Incidence of hand eczema in a population-based twin cohort

    DEFF Research Database (Denmark)

    Lerbaek, A; Kyvik, Kirsten Ohm; Ravn, H

    2007-01-01

    BACKGROUND: Population-based studies on the incidence of hand eczema are sparse. OBJECTIVES: The aim of this prospective follow-up study was to determine the incidence rate of hand eczema in a population-based twin cohort. Secondly, the role of genetic factors and other potential risk factors...... for hand eczema was investigated. METHODS: A questionnaire on self-reported hand eczema was answered by 5610 and 4128 twin individuals in 1996 and 2005, respectively. Data were analysed in a Poisson regression analysis. RESULTS: The crude incidence rate was 8.8 cases per 1000 person-years (95% confidence...... interval, [CI] 7.7-9.9). Incidence rate ratios (IRRs) dependent on the co-twin's hand eczema status revealed a significant, doubled risk for monozygotic twin individuals with a co-twin affected by hand eczema, compared with dizygotic twin individuals with a co-twin affected by hand eczema (IRR 2.4, 95% CI...

  5. Rationale for and protocol of a multi-national population-based bacteremia surveillance collaborative

    Directory of Open Access Journals (Sweden)

    Church Deirdre L

    2009-07-01

    Full Text Available Abstract Background Bloodstream infections are frequent causes of human illness and cause major morbidity and death. In order to best define the epidemiology of these infections and to track changes in occurrence, adverse outcome, and resistance rates over time, population based methodologies are optimal. However, few population-based surveillance systems exist worldwide, and because of differences in methodology inter-regional comparisons are limited. In this report we describe the rationale and propose first practical steps for developing an international collaborative approach to the epidemiologic study and surveillance for bacteremia. Findings The founding collaborative participants represent six regions in four countries in three continents with a combined annual surveillance population of more than 8 million residents. Conclusion Future studies from this collaborative should lead to a better understanding of the epidemiology of bloodstream infections.

  6. Achieving high acceptability of HIV testing in a population-based survey among immigrants in Finland.

    Science.gov (United States)

    Tiittala, Paula J; Kivelä, Pia S; Ristola, Matti A; Surcel, Heljä-Marja; Koponen, Päivikki M S; Mölsä, Mulki; Ollgren, Jukka; Liitsola, Kirsi

    2015-06-01

    The aim of this study was to assess the acceptability of human immunodeficiency virus (HIV) testing among migrants in Finland and the factors contributing to non-acceptance. The Finnish Migrant Health and Wellbeing Study 'Maamu' was the first national population-based Health Interview and Examination Survey (HIS/HES) among migrants in Finland. A total of 386 Kurdish, Russian and Somali immigrants in Helsinki participated in the study. Despite the participants' different sociodemographic backgrounds, a high rate of test acceptability (92%, 95% CI 90-95) was achieved. HIV test acceptance was associated with pretest counselling, ability to understand spoken Finnish or Swedish and employment status. No participants tested positive for HIV. The results imply that a universal HIV testing strategy is well accepted in a low-HIV prevalence immigrant population and can be included in a general health examination in immigrant population-based surveys. © 2015 the Nordic Societies of Public Health.

  7. Spontaneous Abortion, Stillbirth and Hyperthyroidism: A Danish Population-Based Study

    OpenAIRE

    Andersen, Stine Linding; Olsen, J?rn; Wu, Chun Sen; Laurberg, Peter

    2014-01-01

    Objectives Pregnancy loss in women suffering from hyperthyroidism has been described in case reports, but the risk of pregnancy loss caused by maternal hyperthyroidism in a population is unknown. We aimed to evaluate the association between maternal hyperthyroidism and pregnancy loss in a population-based cohort study. Study Design All pregnancies in Denmark from 1997 to 2008 leading to hospital visits (n = 1,062,862) were identified in nationwide registers together with information on matern...

  8. Increased migraine risk in osteoporosis patients: a nationwide population-based study

    OpenAIRE

    Wu, Chieh-Hsin; Zhang, Zi-hao; Wu, Ming-Kung; Wang, Chiu-Huan; Lu, Ying-Yi; Lin, Chih-Lung

    2016-01-01

    Background Osteoporosis and migraine are both important public health problems and may have overlapping pathophysiological mechanisms. The aim of this study was to use a Taiwanese population-based dataset to assess migraine risk in osteoporosis patients. Methods The Taiwan National Health Insurance Research Database was used to analyse data for 40,672 patients aged ?20?years who had been diagnosed with osteoporosis during 1996?2010. An additional 40,672 age-matched patients without osteoporos...

  9. Wealth Inequality and Mental Disability Among the Chinese Population: A Population Based Study

    OpenAIRE

    Wang, Zhenjie; Du, Wei; Pang, Lihua; Zhang, Lei; Chen, Gong; Zheng, Xiaoying

    2015-01-01

    In the study described herein, we investigated and explored the association between wealth inequality and the risk of mental disability in the Chinese population. We used nationally represented, population-based data from the second China National Sample Survey on Disability, conducted in 2006. A total of 1,724,398 study subjects between the ages of 15 and 64, including 10,095 subjects with mental disability only, were used for the analysis. Wealth status was estimated by a wealth index tha...

  10. Oral cancer in Cali, Colombia: a population-based analysis of incidence and mortality trends.

    OpenAIRE

    Dora Ordóñez; Natalia Aragón; Luz Stella García; Paola Collazos; Luis Eduardo Bravo

    2014-01-01

    Objective. To describe the time trends of the incidence and mortality rates of oral cancer (OC) in Cali, Colombia between 1962-2007. Materials and methods. Age-standardized (Segi’s world population) incidence (ASIR) and mortality (ASMR) rates for oral cancer were estimated using data from the Population-based Cancer Registry of Cali, Colombia and from the database of the Municipal Secretary of Public Health (MSPH) respectively. Annual percentage change (APC) was used to measure the changes in...

  11. Enhancing the Value of Population-Based Risk Scores for Institutional-Level Use.

    Science.gov (United States)

    Raza, Sajjad; Sabik, Joseph F; Rajeswaran, Jeevanantham; Idrees, Jay J; Trezzi, Matteo; Riaz, Haris; Javadikasgari, Hoda; Nowicki, Edward R; Svensson, Lars G; Blackstone, Eugene H

    2016-07-01

    We hypothesized that factors associated with an institution's residual risk unaccounted for by population-based models may be identifiable and used to enhance the value of population-based risk scores for quality improvement. From January 2000 to January 2010, 4,971 patients underwent aortic valve replacement (AVR), either isolated (n = 2,660) or with concomitant coronary artery bypass grafting (AVR+CABG; n = 2,311). Operative mortality and major morbidity and mortality predicted by The Society of Thoracic Surgeons (STS) risk models were compared with observed values. After adjusting for patients' STS score, additional and refined risk factors were sought to explain residual risk. Differences between STS model coefficients (risk-factor strength) and those specific to our institution were calculated. Observed operative mortality was less than predicted for AVR (1.6% [42 of 2,660] vs 2.8%, p risk factors, and body surface area, creatinine, glomerular filtration rate, blood urea nitrogen, and heart failure across all levels of functional class were identified as refined risk-factor variables associated with residual risk. In many instances, risk-factor strength differed substantially from that of STS models. Scores derived from population-based models can be enhanced for institutional level use by adjusting for institution-specific additional and refined risk factors. Identifying these and measuring differences in institution-specific versus population-based risk-factor strength can identify areas to target for quality improvement initiatives. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Frontotemporal dementia in The Netherlands: patient characteristics and prevalence estimates from a population-based study.

    OpenAIRE

    Rosso, Sonia; Donker Kaat, Laura; Baks, Timo; Joosse, Marijke; de Koning, Inge; Pijnenburg,Yolande; de Jong, Danielle; Dooijes, Dennis; Kamphorst, Wouter; Ravid, Rivka; Niermeijer, Martinus; Verheij, Fop; Kremer, H.P.; Scheltens, Philip; van Duijn, Cornelia

    2003-01-01

    textabstractSince 1994, a population-based study of frontotemporal dementia (FTD) in The Netherlands has aimed to ascertain all patients with FTD, and first prevalence estimates based on 74 patients were reported in 1998. Here, we present new prevalence estimates after expansion of our FTD population to 245 patients, with emphasis on the prevalence in the province Zuid-Holland where the main study centre is located. All neurologists and physicians in nursing homes received a yearly postal enq...

  13. Contemporary Trends of Reported Sepsis Among Maternal Decedents in Texas: A Population-Based Study

    OpenAIRE

    Oud, Lavi

    2015-01-01

    Introduction Recent studies indicate that death certificate-based single-cause-of-death diagnoses can substantially underestimate the contribution of sepsis to mortality in the general population and among maternal decedents. There are no population-based data in the United States on the patterns of the contribution of sepsis to pregnancy-associated deaths. Methods We studied the Texas Inpatient Public Use Data File to identify pregnancy-associated hospitalizations with reported hospital deat...

  14. Analysis of family- and population-based samples in cohort genome-wide association studies.

    Science.gov (United States)

    Manichaikul, Ani; Chen, Wei-Min; Williams, Kayleen; Wong, Quenna; Sale, Michèle M; Pankow, James S; Tsai, Michael Y; Rotter, Jerome I; Rich, Stephen S; Mychaleckyj, Josyf C

    2012-02-01

    Cohort studies typically sample unrelated individuals from a population, although family members of index cases may also be recruited to investigate shared familial risk factors. Recruitment of family members may be incomplete or ancillary to the main cohort, resulting in a mixed sample of independent family units, including unrelated singletons and multiplex families. Multiple methods are available to perform genome-wide association (GWA) analysis of binary or continuous traits in families, but it is unclear whether methods known to perform well on ascertained pedigrees, sibships, or trios are appropriate in analysis of a mixed unrelated cohort and family sample. We present simulation studies based on Multi-Ethnic Study of Atherosclerosis (MESA) pedigree structures to compare the performance of several popular methods of GWA analysis for both quantitative and dichotomous traits in cohort studies. We evaluate approaches suitable for analysis of families, and combined the best performing methods with population-based samples either by meta-analysis, or by pooled analysis of family- and population-based samples (mega-analysis), comparing type 1 error and power. We further assess practical considerations, such as availability of software and ability to incorporate covariates in statistical modeling, and demonstrate our recommended approaches through quantitative and binary trait analysis of HDL cholesterol (HDL-C) in 2,553 MESA family- and population-based African-American samples. Our results suggest linear modeling approaches that accommodate family-induced phenotypic correlation (e.g., variance-component model for quantitative traits or generalized estimating equations for dichotomous traits) perform best in the context of combined family- and population-based cohort GWAS.

  15. The Prevalence and Causes of Primary Infertility in Iran: A Population-Based Study

    OpenAIRE

    Kazemijaliseh, Hadigheh; Tehrani, Fahimeh Ramezani; Behboudi-Gandevani, Samira; Hosseinpanah, Farhad; Khalili, Davood; Azizi, Fereidoun

    2015-01-01

    Background: Primary infertility is a health issue among women over the world. The aim of this study was to investigate the prevalence and causes of primary infertility based on a population-based study in an urban area of Iran. Materials and Methods: In a cross-sectional study, a total of 1067 married women who participated in the Tehran Lipid and Glucose Study were randomly selected using systematic random sampling. Unmarried women, those with unwilling pregnancy and duration of marriage bel...

  16. History of depression and risk of hyperemesis gravidarum: a population-based cohort study

    OpenAIRE

    Kjeldgaard, Helena Kames; Eberhard-Gran, Malin; Benth, J?rat? ?altyt?; Nordeng, Hedvig; Vikanes, ?se Vigdis

    2017-01-01

    Hyperemesis gravidarum (HG) is a pregnancy condition characterised by debilitating nausea and vomiting. HG has been associated with depression during pregnancy but the direction of the association remains unclear. The aim of this study was to assess whether previous depression is associated with HG. This is a population-based pregnancy cohort study using data from The Norwegian Mother and Child Cohort Study. The study reviewed 731 pregnancies with HG and 81,055 pregnancies without. Logistic r...

  17. Statin Use and Risk of Prostate Cancer: Results from a Population-based Epidemiologic Study

    OpenAIRE

    Agalliu, Ilir; Salinas, Claudia A.; Hansten, Philip D; Ostrander, Elaine A.; Stanford, Janet L

    2008-01-01

    Epidemiologic studies of statin use in relation to prostate cancer risk have been inconclusive. Recent evidence, however, suggests that longer-term use may reduce risk of more advanced disease. The authors conducted a population-based study of 1,001 incident prostate cancer cases diagnosed in 2002–2005 and 942 age-matched controls from King County, Washington, to evaluate risk associated with statin use. Logistic regression was used to generate odds ratios for ever use, current use, and durat...

  18. The protocols for the 10/66 dementia research group population-based research programme.

    Science.gov (United States)

    Prince, Martin; Ferri, Cleusa P; Acosta, Daisy; Albanese, Emiliano; Arizaga, Raul; Dewey, Michael; Gavrilova, Svetlana I; Guerra, Mariella; Huang, Yueqin; Jacob, K S; Krishnamoorthy, E S; McKeigue, Paul; Rodriguez, Juan Llibre; Salas, Aquiles; Sosa, Ana Luisa; Sousa, Renata M M; Stewart, Robert; Uwakwe, Richard

    2007-07-20

    Latin America, China and India are experiencing unprecedentedly rapid demographic ageing with an increasing number of people with dementia. The 10/66 Dementia Research Group's title refers to the 66% of people with dementia that live in developing countries and the less than one tenth of population-based research carried out in those settings. This paper describes the protocols for the 10/66 population-based and intervention studies that aim to redress this imbalance. Cross-sectional comprehensive one phase surveys have been conducted of all residents aged 65 and over of geographically defined catchment areas in ten low and middle income countries (India, China, Nigeria, Cuba, Dominican Republic, Brazil, Venezuela, Mexico, Peru and Argentina), with a sample size of between 1000 and 3000 (generally 2000). Each of the studies uses the same core minimum data set with cross-culturally validated assessments (dementia diagnosis and subtypes, mental disorders, physical health, anthropometry, demographics, extensive non communicable disease risk factor questionnaires, disability/functioning, health service utilisation, care arrangements and caregiver strain). Nested within the population based studies is a randomised controlled trial of a caregiver intervention for people with dementia and their families (ISRCTN41039907; ISRCTN41062011; ISRCTN95135433; ISRCTN66355402; ISRCTN93378627; ISRCTN94921815). A follow up of 2.5 to 3.5 years will be conducted in 7 countries (China, Cuba, Dominican Republic, Venezuela, Mexico, Peru and Argentina) to assess risk factors for incident dementia, stroke and all cause and cause-specific mortality; verbal autopsy will be used to identify causes of death. The 10/66 DRG baseline population-based studies are nearly complete. The incidence phase will be completed in 2009. All investigators are committed to establish an anonymised file sharing archive with monitored public access. Our aim is to create an evidence base to empower advocacy, raise

  19. Profiles of sedentary and non-sedentary young men ? a population-based MOPO study

    OpenAIRE

    Pyky, Riitta; Jauho, Anna-Maiju; Ahola, Riikka; Ik?heimo, Tiina M.; Koivumaa-Honkanen, Heli; M?ntysaari, Matti; J?ms?, Timo; Korpelainen, Raija

    2015-01-01

    Background Sedentary behavior is associated with poor well-being in youth with adverse trajectories spanning to adulthood. Still, its determinants are poorly known. Our aim was to profile sedentary and non-sedentary young men and to clarify their differences in a population-based setting. Methods A total of 616 men (mean age 17.9, SD 0.6) attending compulsory conscription for military service completed a questionnaire on health, health behavior, socioeconomic situation and media use. They und...

  20. The Clustering of Smear-Positive Tuberculosis in Dabat, Ethiopia: A Population Based Cross Sectional Study

    OpenAIRE

    Takele Tadesse; Meaza Demissie; Yemane Berhane; Yigzaw Kebede; Markos Abebe

    2013-01-01

    BACKGROUND: In Ethiopia where tuberculosis epidemic remains high, studies that describe hotspots of the disease are unavailable. This study tried to detect the spatial distribution and clustering of smear-positive tuberculosis cases in Dabat, Ethiopia. METHODS AND FINDINGS: A population-based cross sectional study conducted in the Dabat Health and Demographic Surveillance System site from October 2010 to September 2011 identified smear-positive tuberculosis cases. Trained field workers collec...

  1. Prison tobacco control policies and deaths from smoking in United States prisons: population based retrospective analysis

    OpenAIRE

    Binswanger, Ingrid A; Carson, E Ann; Krueger, Patrick M; Mueller, Shane R; Steiner, John F; Sabol, William J

    2014-01-01

    Objective To determine the mortality attributable to smoking and years of potential life lost from smoking among people in prison and whether bans on smoking in prison are associated with reductions in smoking related deaths. Design Analysis of cross sectional survey data with the smoking attributable mortality, morbidity, and economic costs system; population based time series analysis. Setting All state prisons in the United States. Main outcome measures Prevalence of smoking from cross sec...

  2. OCCUPATIONAL EXPOSURE AND COPD:A DANISH POPULATION-BASED STUDY

    OpenAIRE

    Würtz, Else Toft

    2015-01-01

    Chronic Obstructive Pulmonary Disease (COPD) is a common disease. The main risk factor is smoking although 15% of the COPD cases are expected to be preventable if the occupational exposures from vapour, gas, dust, and fume were eliminated; the population attributable fraction (PAF).The thesis addresses the association between occupational exposure and COPD in a population-based cohort of Danes aged 45-84-years.4717 participants were included at baseline and 2624 at the four year follow-up. CO...

  3. Cutaneous melanoma in Latin America: a population-based descriptive study.

    Science.gov (United States)

    Sortino-Rachou, Ana Maria; Curado, Maria Paula; Cancela, Marianna de Camargo

    2011-03-01

    Cutaneous melanoma incidences vary between geographic regions and are a health concern for Caucasians and for all ethnic populations. In Latin America, data from population-based cancer registries of cutaneous melanoma incidence rates have rarely been reported. We searched the Cancer Incidence in Five Continents volume IX (CI5-IX) database for cutaneous melanoma and select cases by topography (C43) from 11 population-based cancer registries in Latin America. Between 1998 and 2002, a total of 4,465 cutaneous melanoma cases were reported in Latin America. The average age-standardized incidence rates (per 100,000 persons-year) was 4.6 (male) and 4.3 (female). This study presents an overview of cutaneous melanoma incidence in Latin America, highlighting the need to enhance coverage of population-based cancer registries in Latin America, to allow for a better understanding of this neoplasm in the region. Thus it can help in implementing primary prevention programs for the whole Latino population. At this point in time, early detection messages should target young women and older men in Latin America.

  4. Stages of development and injury patterns in the early years: a population-based analysis

    Directory of Open Access Journals (Sweden)

    Simpson Kelly

    2006-07-01

    Full Text Available Abstract Background In Canada, there are many formal public health programs under development that aim to prevent injuries in the early years (e.g. 0–6. There are paradoxically no population-based studies that have examined patterns of injury by developmental stage among these young children. This represents a gap in the Canadian biomedical literature. The current population-based analysis explores external causes and consequences of injuries experienced by young children who present to the emergency department for assessment and treatment. This provides objective evidence about prevention priorities to be considered in anticipatory counseling and public health planning. Methods Four complete years of data (1999–2002; n = 5876 cases were reviewed from the Kingston sites of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP, an ongoing injury surveillance initiative. Epidemiological analyses were used to characterize injury patterns within and across age groups (0–6 years that corresponded to normative developmental stages. Results The average annual rate of emergency department-attended childhood injury was 107 per 1000 (95% CI 91–123, with boys experiencing higher annual rates of injury than girls (122 vs. 91 per 1000; p Conclusion This population-based injury surveillance analysis provides a strong evidence-base to inform and enhance anticipatory counseling and other public health efforts aimed at the prevention of childhood injury during the early years.

  5. The use of customised versus population-based birthweight standards in predicting perinatal mortality.

    Science.gov (United States)

    Zhang, X; Platt, R W; Cnattingius, S; Joseph, K S; Kramer, M S

    2007-04-01

    The objective of this study was to critically examine potential artifacts and biases underlying the use of 'customised' standards of birthweight for gestational age (GA). Population-based cohort study. Sweden. A total of 782,303 singletons > or =28 weeks of gestation born in 1992-2001 to Nordic mothers with complete data on birthweight; GA; and maternal age, parity, height, and pre-pregnancy weight. We compared perinatal mortality in four groups of infants based on the following classification of small for gestational age (SGA): non-SGA based on either population-based or customised standards (the reference group), SGA based on the population-based standard only, SGA based on the customised standard only, and SGA according to both standards. We used graphical methods to compare GA-specific birthweight cutoffs for SGA using the two standards and also used logistic regression to control for differences in GA and maternal pre-pregnancy body mass index (BMI) in the four groups. Perinatal mortality, including stillbirth and neonatal death. Customisation led to a large artifactual increase in the proportion of SGA infants born preterm. Adjustment for differences in GA and maternal BMI markedly reduced the excess risk among infants classified as SGA by customised standards only. The large increase in perinatal mortality risk among infants classified as SGA based on customised standards is largely an artifact due to inclusion of more preterm births.

  6. Cutaneous melanoma in Latin America: a population-based descriptive study

    Directory of Open Access Journals (Sweden)

    Ana Maria Sortino-Rachou

    2011-03-01

    Full Text Available Cutaneous melanoma incidences vary between geographic regions and are a health concern for Caucasians and for all ethnic populations. In Latin America, data from population-based cancer registries of cutaneous melanoma incidence rates have rarely been reported. We searched the Cancer Incidence in Five Continents volume IX (CI5-IX database for cutaneous melanoma and select cases by topography (C43 from 11 population-based cancer registries in Latin America. Between 1998 and 2002, a total of 4,465 cutaneous melanoma cases were reported in Latin America. The average age-standardized incidence rates (per 100,000 persons-year was 4.6 (male and 4.3 (female. This study presents an overview of cutaneous melanoma incidence in Latin America, highlighting the need to enhance coverage of population-based cancer registries in Latin America, to allow for a better understanding of this neoplasm in the region. Thus it can help in implementing primary prevention programs for the whole Latino population. At this point in time, early detection messages should target young women and older men in Latin America.

  7. 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.

  8. A population-based survey on family intentions and fertility awareness in women and men in the United Kingdom and Denmark

    DEFF Research Database (Denmark)

    Vassard, Ditte; Lallemant, Camille; Nyboe Andersen, Anders

    2016-01-01

    -related decrease in female fertility, most desired having children at an age when female fertility has declined. Women who were not sufficiently aware of the impact of advanced age were significantly more likely to have their first child at a higher age. There is a need for developing educational programs......BACKGROUND: Across several European countries family formation is increasingly postponed. The aims of the study were to investigate the desire for family building and fertility awareness in the UK and Denmark. METHODS: A population-based internet survey was used among women (n = 1,000) and men (n...... = 237) from the UK (40%) and Denmark (60%). Data covered socio-demographics, family formation, and awareness of female age-related fertility. Data analysis used descriptive statistics and logistic regression analysis for studying associations between low fertility awareness and desired family formation...

  9. Health-related quality of life and self-reported long-term conditions: a population-based survey.

    Science.gov (United States)

    Zimmermann, Ivan R; Silva, Marcus T; Galvao, Tais F; Pereira, Mauricio G

    2017-01-01

    To estimate and compare the effect of self-reported long-term health conditions and sociodemographic factors on perceived health-related quality of life (HRQoL). A population-based survey of adults (18 to 65 years) living in Brasilia, Brazil, was conducted in 2012. Descriptive and multivariate analyses using a Tobit model were performed with data on sociodemographic variables, self-reported conditions, and the European Quality of Life-5 Dimensions (EQ-5D) health states, providing utility scores (preferred health state) between 0 and 1 for HRQoL estimates. The mean utility of 1,820 adults interviewed (mean age: 38.4±12.6 years) was 0.883 (95% confidence interval [95%CI] 0.874-0.892), with 76.2% in the highest utility range (0.8 to 1.0). EQ-5D dimensions with moderate problems were pain/discomfort (33.8%) and anxiety/depression (20.5%). Serious problems were reported by only 0.3% of the sample in the mobility and self-care domain and by 3.1% in the pain/discomfort domain. Multivariate analysis revealed reduced HRQoL in individuals with depression, diabetes, and hypertension. Living in satellite towns (outside the city core), belonging to a lower economic class, or not being formally employed were also associated with decreased HRQoL. Beta coefficients for these impacts ranged from -0.033 (not formally employed) to -0.141 (depression), reflecting the strongest impact. Of the long-term health conditions studied, depression had the greatest impact on HRQoL. Social class, employment status, and place of residence also affected HRQoL.

  10. Health-related quality of life and self-reported long-term conditions: a population-based survey

    Directory of Open Access Journals (Sweden)

    Ivan R. Zimmermann

    Full Text Available Objective: To estimate and compare the effect of self-reported long-term health conditions and sociodemographic factors on perceived health-related quality of life (HRQoL. Methods: A population-based survey of adults (18 to 65 years living in Brasilia, Brazil, was conducted in 2012. Descriptive and multivariate analyses using a Tobit model were performed with data on sociodemographic variables, self-reported conditions, and the European Quality of Life-5 Dimensions (EQ-5D health states, providing utility scores (preferred health state between 0 and 1 for HRQoL estimates. Results: The mean utility of 1,820 adults interviewed (mean age: 38.4±12.6 years was 0.883 (95% confidence interval [95%CI] 0.874-0.892, with 76.2% in the highest utility range (0.8 to 1.0. EQ-5D dimensions with moderate problems were pain/discomfort (33.8% and anxiety/depression (20.5%. Serious problems were reported by only 0.3% of the sample in the mobility and self-care domain and by 3.1% in the pain/discomfort domain. Multivariate analysis revealed reduced HRQoL in individuals with depression, diabetes, and hypertension. Living in satellite towns (outside the city core, belonging to a lower economic class, or not being formally employed were also associated with decreased HRQoL. Beta coefficients for these impacts ranged from -0.033 (not formally employed to -0.141 (depression, reflecting the strongest impact. Conclusion: Of the long-term health conditions studied, depression had the greatest impact on HRQoL. Social class, employment status, and place of residence also affected HRQoL.

  11. Copeptin Is Associated with Kidney Length, Renal Function, and Prevalence of Simple Cysts in a Population-Based Study

    Science.gov (United States)

    Ponte, Belen; Pruijm, Menno; Ackermann, Daniel; Vuistiner, Philippe; Guessous, Idris; Ehret, Georg; Alwan, Heba; Youhanna, Sonia; Paccaud, Fred; Mohaupt, Markus; Péchère-Bertschi, Antoinette; Vogt, Bruno; Burnier, Michel; Martin, Pierre-Yves; Devuyst, Olivier

    2015-01-01

    Arginine vasopressin (AVP) has a key role in osmoregulation by facilitating water transport in the collecting duct. Recent evidence suggests that AVP may have additional effects on renal function and favor cyst growth in polycystic kidney disease. Whether AVP also affects kidney structure in the general population is unknown. We analyzed the association of copeptin, an established surrogate for AVP, with parameters of renal function and morphology in a multicentric population-based cohort. Participants from families of European ancestry were randomly selected in three Swiss cities. We used linear multilevel regression analysis to explore the association of copeptin with renal function parameters as well as kidney length and the presence of simple renal cysts assessed by ultrasound examination. Copeptin levels were log-transformed. The 529 women and 481 men had median copeptin levels of 3.0 and 5.2 pmol/L, respectively (Pcopeptin level was associated inversely with eGFR (β=−2.1; 95% confidence interval [95% CI], −3.3 to −0.8; P=0.002) and kidney length (β=−1.2; 95% CI, −1.9 to −0.4; P=0.003) but positively with 24-hour urinary albumin excretion (β=0.11; 95% CI, 0.01 to 0.20; P=0.03) and urine osmolality (β=0.08; 95% CI, 0.05 to 0.10; Pcopeptin level and the presence of renal cysts (odds ratio, 1.6; 95% CI, 1.1 to 2.4; P=0.02). These results suggest that AVP has a pleiotropic role in renal function and may favor the development of simple renal cysts. PMID:25270071

  12. Association between Molar Incisor Hypomineralization in Schoolchildren and Both Prenatal and Postnatal Factors: A Population-Based Study.

    Directory of Open Access Journals (Sweden)

    Luciana Fonseca Pádua Gonçalves Tourino

    Full Text Available Although studies throughout the world have investigated potential factors involved in the occurrence of molar incisor hypomineralization (MIH, the findings are varied and inconclusive.The aim of the present study was to evaluate the prevalence of MIH and identify associated prenatal, perinatal and postnatal factors among Brazilian schoolchildren aged 8 and 9 years.A cross-sectional study was conducted with a randomly selected population-based sample of 1181 schoolchildren. Information on demographic and socioeconomic characteristics as well as prenatal, perinatal and postnatal aspects was obtained through questionnaires. The clinical examination included the investigation of MIH based on the criteria of the European Academy of Paediatric Dentistry. Dental caries in the permanent dentition and developmental defects of enamel (DDE on the primary second molars were also recorded. Data analysis involved descriptive statistics, bivariate tests and Poisson regression with robust variance.The prevalence of MIH was 20.4%. MIH was more frequent among children with dental caries in the permanent dentition (PR: 2.67; 95% CI: 1.98-3.61, those with DDE on the primary second molars (PR: 2.54; 95% CI: 1.87-3.45 and those who experienced asthma/bronchitis in the first four years of life (PR: 1.93; 95% CI: 1.45-2.56.The prevalence of MIH was high and was associated with dental caries, the presence of DDE on primary second molars and the experience of asthma/bronchitis in early life. These findings could be useful in the identification of children in need of shorter recall intervals to prevent the consequences of MIH, such as enamel breakdown dental caries.

  13. An 18 year population-based study on site of origin and outcome of patients with peritoneal malignancy in Ireland.

    Science.gov (United States)

    Solon, J G; O'Neill, M; Chang, K H; Deady, S; Cahill, R; Moran, B; Shields, C; Mulsow, J

    2017-10-01

    Peritoneal malignancy (PM) is predominantly metastatic spread from advanced gastrointestinal or gynaecological cancer. PM is generally considered incurable and therefore has rarely been the focus of novel therapeutic strategies. This study assessed patterns and survival outcomes for patients with PM in Ireland. The National Cancer Registry Ireland database was interrogated to identify patients diagnosed with PM during the period 1994-2012. Patient and tumour characteristics were retrieved and survival outcomes calculated. 5791 patients were diagnosed during the study period. Median age at diagnosis was 68 years; females accounted for 62%. The incidence increased annually from 228 in 1994 to 401 in 2012. Primary PM accounted for 3% of cases. Colorectal (22%), ovarian (16%) and gastric (13%) cancers accounted for the majority of cases of secondary PM. Almost 75% of patients had PM at initial presentation. Almost 40% of patients (n = 2274) underwent surgical intervention, while 44% (n = 2560) had tumour directed chemotherapy. The median survival (MS) in patients with secondary PM was 6.6 months, and did not improve significantly during the study period. Outcomes were best in patients with ovarian cancer (MS 15.9 months) and colorectal cancer (MS 14.3 months) and worst in patients with lung (MS 2.4 months) and pancreas (MS 1.9 months) cancers. This is the first population-based study from Ireland to report the incidence and outcomes for PM. PM is more common than previously reported and survival remains poor. These findings highlight the need for greater clinician awareness and the need to focus on new therapeutic approaches to improve patient outcomes. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  14. Limited risks of major congenital anomalies in children of mothers with coeliac disease: a population-based cohort study.

    Science.gov (United States)

    Ban, L; West, J; Abdul Sultan, A; Dhalwani, N N; Ludvigsson, J F; Tata, L J

    2015-12-01

    To examine major congenital anomaly (CA) risks in children of mothers with coeliac disease (CD) compared with mothers without CD. Population-based cohort study. Linked maternal-child medical records from a large primary care database from the UK. A total of 562,332 live singletons of mothers with and without CD in 1990-2013. We calculated the absolute major CA risks in children whose mothers had CD, and whether this was diagnosed or undiagnosed before childbirth. Logistic regression with a generalised estimating equation was used to estimate adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) for CAs associated with CD. Fourteen system-specific major CA groups classified according to the European Surveillance of Congenital Anomalies and neural tube defects (NTDs). Major CA risk in 1880 children of mothers with CD was 293 per 10,000 liveborn singletons, similar to the risk in those without CD (282; aOR 0.98, 95% CI 0.74-1.30). The risk was slightly higher in 971 children, whose mothers were undiagnosed (350; aOR 1.14, 95% CI 0.79-1.64), than in 909 children whose mothers were diagnosed (231; aOR 0.80, 95% CI 0.52-1.24). There was a three-fold increase in nervous system anomalies in the children of mothers with undiagnosed CD (aOR 2.98, 95% CI 1.06-8.33, based on five exposed cases and one had an NTD), and these women were all diagnosed with CD at least 4 years after their children were born. There was no statistically significant increase in risk of major CAs in children of mothers with coeliac disease overall, compared with the general population. © 2014 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  15. Changes in Mycobacterium tuberculosis genotype families over 20 years in a population-based study in Northern Malawi.

    Directory of Open Access Journals (Sweden)

    Judith R Glynn

    Full Text Available BACKGROUND: Despite increasing interest in possible differences in virulence and transmissibility between different genotypes of M. tuberculosis, very little is known about how genotypes within a population change over decades, or about relationships to HIV infection. METHODS AND PRINCIPAL FINDINGS: In a population-based study in rural Malawi we have examined smears and cultures from tuberculosis patients over a 20-year period using spoligotyping. Isolates were grouped into spoligotype families and lineages following previously published criteria. Time trends, HIV status, drug resistance and outcome were examined by spoligotype family and lineage. In addition, transmissibility was examined among pairs of cases with known epidemiological contact by assessing the proportion of transmissions confirmed for each lineage, on the basis of IS6110 RFLP similarity of the M tuberculosis strains. 760 spoligotypes were obtained from smears from 518 patients from 1986-2002, and 377 spoligotypes from cultures from 347 patients from 2005-2008. There was good consistency in patients with multiple specimens. Among 781 patients with first episode tuberculosis, the majority (76% had Lineage 4 ("European/American" strains; 9% had Lineage 3 ("East-African/Indian"; 8% Lineage 1 ("Indo-Oceanic"; and 2% Lineage 2 ("East-Asian"; others unclassifiable. Over time the proportion of Lineage 4 decreased from >90% to 60%, with an increase in the other 3 lineages (p<0.001. Lineage 1 strains were more common in those with HIV infection, even after adjusting for age, sex and year. There were no associations with drug resistance or outcome, and no differences by lineage in the proportion of pairs in which transmission was confirmed. CONCLUSIONS: This is the first study to describe long term trends in the four M. tuberculosis lineages in a population. Lineage 4 has probably been longstanding in this population, with relatively recent introductions and spread of Lineages1-3, perhaps

  16. Association between Molar Incisor Hypomineralization in Schoolchildren and Both Prenatal and Postnatal Factors: A Population-Based Study.

    Science.gov (United States)

    Tourino, Luciana Fonseca Pádua Gonçalves; Corrêa-Faria, Patrícia; Ferreira, Raquel Conceição; Bendo, Cristiane Baccin; Zarzar, Patrícia Maria; Vale, Miriam Pimenta

    2016-01-01

    Although studies throughout the world have investigated potential factors involved in the occurrence of molar incisor hypomineralization (MIH), the findings are varied and inconclusive. The aim of the present study was to evaluate the prevalence of MIH and identify associated prenatal, perinatal and postnatal factors among Brazilian schoolchildren aged 8 and 9 years. A cross-sectional study was conducted with a randomly selected population-based sample of 1181 schoolchildren. Information on demographic and socioeconomic characteristics as well as prenatal, perinatal and postnatal aspects was obtained through questionnaires. The clinical examination included the investigation of MIH based on the criteria of the European Academy of Paediatric Dentistry. Dental caries in the permanent dentition and developmental defects of enamel (DDE) on the primary second molars were also recorded. Data analysis involved descriptive statistics, bivariate tests and Poisson regression with robust variance. The prevalence of MIH was 20.4%. MIH was more frequent among children with dental caries in the permanent dentition (PR: 2.67; 95% CI: 1.98-3.61), those with DDE on the primary second molars (PR: 2.54; 95% CI: 1.87-3.45) and those who experienced asthma/bronchitis in the first four years of life (PR: 1.93; 95% CI: 1.45-2.56). The prevalence of MIH was high and was associated with dental caries, the presence of DDE on primary second molars and the experience of asthma/bronchitis in early life. These findings could be useful in the identification of children in need of shorter recall intervals to prevent the consequences of MIH, such as enamel breakdown dental caries.

  17. Health-related quality of life in the Brazilian Amazon: a population-based cross-sectional study.

    Science.gov (United States)

    Silva, Marcus Tolentino; Caicedo Roa, Monica; Galvao, Tais Freire

    2017-08-14

    To analyze perceptions of health-related quality of life and associated factors in populations from the Manaus Metropolitan Region. We conducted a population-based cross-sectional study from May to August 2015. Adults aged 18 years and older were selected using probabilistic three-phase cluster sampling and stratified by sex and age, based on official estimates. Quality of life data were collected using the European Quality of Life 5-Dimensions 3-Levels (EQ-5D-3L) along with socioeconomic, demographic, and health perception data. Utility scores were calculated using the Brazilian version of the EQ-5D-3L. Descriptive statistics were derived, and a multivariate Tobit regression model with correction for complex sampling was performed to identify the variables that influence utility levels. A total of 4001 participants were included. The average utility score was 0.886 (95% confidence interval [CI]: 0.881-0.890) with significant differences according to living area (the capital (0.882 ± 0.144) or inner cities (0.908 ± 0.122; p life than women (β = 0.041, p life compared with being formally employed (β = 0.031, p = 0.037). The poorest people had a lower quality of life than the richest people (β = -0.118, p life in the Manaus Metropolitan Region was high, as expected for the general population, and was higher among individuals who lived in the inner cities, men and those in higher social classes. Gender discrepancies and differences in quality of life between the capital and inner cities should be further investigated.

  18. Sleep patterns in children with ADHD: a population-based cohort study from birth to 11 years.

    Science.gov (United States)

    Scott, Nicola; Blair, Peter S; Emond, Alan M; Fleming, Peter J; Humphreys, Joanna S; Henderson, John; Gringras, Paul

    2013-04-01

    Associations between sleep duration and disturbance in infancy and early childhood and attention deficit hyperactivity disorder diagnoses were investigated. Data from the Avon Longitudinal Study of Parents and Children, a population-based prospective longitudinal birth-cohort study of children born in 1991-1992 in South-West England, were employed. Eight thousand, one hundred and ninety-five children were assessed using the Development and Well-Being Assessment. One hundred and seventy-three cases (2.1%) met criteria for attention deficit hyperactivity disorder. Parental report at eight time points showed children with attention deficit hyperactivity disorder slept less than peers. Absolute differences were small and mainly restricted to night-time sleep, with no strong evidence of differences from controls, except at 69 months [5 years 9 months; 12 min (95% CI: 5-19), P = 0.001], at 81 months [6 years 9 months; 15 min (95% CI: 8-22), P sleep along a normative centiles chart, a shift in sleep duration from one centile to a lower centile was a useful predictor of attention deficit hyperactivity disorder. Age-specific decreases of >1SD in sleep duration across adjacent time points was a significant predictor of attention deficit hyperactivity disorder at 3-5 years (P = 0.047). In children with attention deficit hyperactivity disorder, shorter sleep duration and sleep disturbances appear early and predate the usual age of clinical diagnosis. The rate of change of sleep duration relative to an individual, rather than absolute sleep duration at any stage, may prove beneficial in identifying increased risk of attention deficit hyperactivity disorder. © 2012 European Sleep Research Society.

  19. [Trends in educational inequalities in smoking among adolescents in Germany : Evidence from four population-based studies].

    Science.gov (United States)

    Kuntz, Benjamin; Waldhauer, Julia; Moor, Irene; Rathmann, Katharina; Richter, Matthias; Orth, Boris; Piontek, Daniela; Kraus, Ludwig; Zeiher, Johannes; Lampert, Thomas

    2017-10-04

    In Germany, smoking prevalence among adolescents has significantly declined since the early 2000s. However, data show that adolescent smoking rates considerably differ between different types of secondary schools. The aim of our study was to examine how educational inequalities in adolescent smoking behaviour have developed over time. Data were used from four population-based studies (each consisting of repeated cross-sectional surveys from 2001-2015): the representative surveys of the Federal Centre for Health Education, the German Health Interview and Examination Survey for Children and Adolescents, the Health Behaviour in School-aged Children Study, and the European School Survey Project on Alcohol and Other Drugs. Each study comprised different age groups (within the age range of 11-17 years) and used different smoking measures. Adolescents' educational status was based on the attended type of secondary school. Absolute and relative educational inequalities were presented as prevalence differences and prevalence ratios, respectively. Despite methodical differences, all four studies similarly reveal that adolescent smoking rates have significantly declined in all educational groups. However, lower smoking rates among secondary school students attending higher educational tracks could be observed. While absolute educational inequalities tended to decrease over time, relative inequalities between educational groups remained rather stable or even increased. Declining adolescent smoking rates suggest that smoking may have lost some of its attractiveness for young people. Our findings further emphasize the importance of tobacco control measures such as raising cigarette taxes, smoking bans, and increasing minimum legal age for tobacco purchase. As relative educational inequalities in adolescent smoking rates did not diminish over time, setting- and target group-specific interventions should focus more on students in middle and lower secondary school tracks.

  20. Influence of definition based versus pragmatic birth registration on international comparisons of perinatal and infant mortality: population based retrospective study.

    Science.gov (United States)

    Joseph, K S; Liu, Shiliang; Rouleau, Jocelyn; Lisonkova, Sarka; Hutcheon, Jennifer A; Sauve, Reg; Allen, Alexander C; Kramer, Michael S

    2012-02-17

    To examine variations in the registration of extremely low birthweight and early gestation births and to assess their effect on perinatal and infant mortality rankings of industrialised countries. Retrospective population based study. Australia, Canada, European countries, and the United States for 2004; Australia, Canada, and New Zealand for 2007. National data on live births and on fetal, neonatal, and infant deaths. Reported proportions of live births with birth weight/gestational age of less than 500 g, less than 1000 g, less than 24 weeks, and less than 28 weeks; crude rates of fetal, neonatal, and infant mortality; mortality rates calculated after exclusion of births under 500 g, under 1000 g, less than 24 weeks, and less than 28 weeks. The proportion of live births under 500 g varied widely from less than 1 per 10,000 live births in Belgium and Ireland to 10.8 per 10,000 live births in Canada and 16.9 in the United States. Neonatal deaths under 500 g, as a proportion of all neonatal deaths, also ranged from less than 1% in countries such as Luxembourg and Malta to 29.6% in Canada and 31.1% in the United States. Rankings of countries based on crude fetal, neonatal, and infant mortality rates differed substantially from rankings based on rates calculated after exclusion of births with a birth weight of less than 1000 g or a gestational age of less than 28 weeks. International differences in reported rates of extremely low birthweight and very early gestation births probably reflect variations in registration of births and compromise the validity of international rankings of perinatal and infant mortality.

  1. Cost effectiveness of population based BRCA1 founder mutation testing in Sephardi Jewish women.

    Science.gov (United States)

    Patel, Shreeya; Legood, Rosa; Evans, D Gareth; Turnbull, Clare; Antoniou, Antonis C; Menon, Usha; Jacobs, Ian; Manchanda, Ranjit

    2017-12-26

    Population-based BRCA1/BRCA2 founder-mutation testing has been demonstrated as cost-effective compared to family-history(FH) based testing in Ashkenazi Jewish(AJ) women. However, only one of the three AJ BRCA1/BRCA2 founder-mutations (185delAG(c.68_69delAG), 5382insC(c.5266dupC) and 6174delT(c.5946delT)) is found in the Sephardi Jewish(SJ) population (185delAG(c.68_69delAG)) and the overall prevalence of BRCA mutations in the SJ population is accordingly lower (0.7% compared to 2.5% in the AJ population). Cost-effectiveness analyses of BRCA testing have not previously been performed at these lower BRCA prevalence levels seen in SJ. Here we present a cost-effectiveness analysis for UK and US populations comparing population-testing with Clinical-criteria/FH-based testing in SJ women. A Markov model was built comparing the lifetime costs-&-effects of population-based BRCA1-testing with testing using FH-based clinical criteria in SJ women ≥30years. BRCA1-carriers identified were offered MRI/mammograms and risk-reducing surgery. Costs are reported at 2015 prices. Outcomes include breast cancer(BC), ovarian cancer(OC) and excess deaths from heart disease. All costs-&-outcomes are discounted at 3.5%. The time horizon is life-time, and perspective is payer. The incremental-cost-effectiveness-ratio (ICER) per quality-adjusted life-year (QALY) was calculated. Parameter uncertainty was evaluated through one-way and probabilistic-sensitivity-analysis (PSA). Population-testing resulted in gain in life-expectancy of 12months (QALY=1.00). The baseline discounted ICER for UK population-based testing =£67.04/QALY and for US population=$308.42/QALY. Results were robust in the one-way sensitivity analysis. The PSA showed 100% of simulations were cost-effective at £20,000/QALY UK and the $100,000/QALY US WTP thresholds. Scenario analysis showed, population-testing remains cost-effective in UK and US populations even if pre-menopausal oophorectomy does not reduce BC-risk or if

  2. Signs and symptoms associated with early pregnancy loss: findings from a population-based preconception cohort.

    Science.gov (United States)

    Sapra, K J; Buck Louis, G M; Sundaram, R; Joseph, K S; Bates, L M; Galea, S; Ananth, C V

    2016-04-01

    What is the relationship between signs and symptoms of early pregnancy and pregnancy loss early pregnancy loss, with more severe bleeding and bleeding accompanied by lower abdominal cramping associated with greater incidence of loss; conversely, vomiting is associated with decreased incidence of early pregnancy loss, even in the setting of vaginal bleeding, while nausea alone is not. Two previous cohort studies with preconception enrollment suggested that bleeding is associated with loss while nausea is inversely associated with loss though these studies were limited by small study size and reporting after loss ascertainment. No prior preconception cohort study has examined multiple signs and symptoms in relation to pregnancy loss. Population-based preconception cohort of 501 couples discontinuing contraception to try for pregnancy in 16 counties in Michigan and Texas, USA. Participants were followed daily until positive home pregnancy test or 12 months of trying without an hCG pregnancy; women who became pregnant were followed daily from 2 to 7 weeks post-conception. Three hundred and forty-seven women had a positive home pregnancy test denoting hCG pregnancy. Three hundred and forty-one women remained after excluding ineligible pregnancies. Women recorded daily from 2 to 7 weeks post-conception their signs and symptoms, including vaginal bleeding (none, spotting, light, moderate and heavy), lower abdominal cramping, nausea and vomiting. Pregnancy losses were ascertained by a subsequent negative home pregnancy test, clinical confirmation or onset of menses, depending on gestational age at loss; time-to-loss was measured in days post-conception. Cumulative incidence functions and 95% confidence intervals (CIs) were constructed for each sign or symptom, and hazard ratios (HRs) and 95% CIs for presence compared with absence of signs or symptoms were estimated using Cox proportional hazard models. Women experienced lower abdominal cramping (85%), nausea (48

  3. Impact of the revised International Prognostic Scoring System, cytogenetics and monosomal karyotype on outcome after allogeneic stem cell transplantation for myelodysplastic syndromes and secondary acute myeloid leukemia evolving from myelodysplastic syndromes: a retrospective multicenter study of the European Society of Blood and Marrow Transplantation.

    Science.gov (United States)

    Koenecke, Christian; Göhring, Gudrun; de Wreede, Liesbeth C; van Biezen, Anja; Scheid, Christof; Volin, Liisa; Maertens, Johan; Finke, Jürgen; Schaap, Nicolaas; Robin, Marie; Passweg, Jakob; Cornelissen, Jan; Beelen, Dietrich; Heuser, Michael; de Witte, Theo; Kröger, Nicolaus

    2015-03-01

    The aim of this study was to determine the impact of the revised 5-group International Prognostic Scoring System cytogenetic classification on outcome after allogeneic stem cell transplantation in patients with myelodysplastic syndromes or secondary acute myeloid leukemia who were reported to the European Society for Blood and Marrow Transplantation database. A total of 903 patients had sufficient cytogenetic information available at stem cell transplantation to be classified according to the 5-group classification. Poor and very poor risk according to this classification was an independent predictor of shorter relapse-free survival (hazard ratio 1.40 and 2.14), overall survival (hazard ratio 1.38 and 2.14), and significantly higher cumulative incidence of relapse (hazard ratio 1.64 and 2.76), compared to patients with very good, good or intermediate risk. When comparing the predictive performance of a series of Cox models both for relapse-free survival and for overall survival, a model with simplified 5-group cytogenetics (merging very good, good and intermediate cytogenetics) performed best. Furthermore, monosomal karyotype is an additional negative predictor for outcome within patients of the poor, but not the very poor risk group of the 5-group classification. The revised International Prognostic Scoring System cytogenetic classification allows patients with myelodysplastic syndromes to be separated into three groups with clearly different outcomes after stem cell transplantation. Poor and very poor risk cytogenetics were strong predictors of poor patient outcome. The new cytogenetic classification added value to prediction of patient outcome compared to prediction models using only traditional risk factors or the 3-group International Prognostic Scoring System cytogenetic classification. Copyright© Ferrata Storti Foundation.

  4. EUROPEAN AUSTERITY WITHOUT GROWTH? EUROPEAN GROWTH WITHOUT EUROPEAN DEMOCRACY?

    Directory of Open Access Journals (Sweden)

    Montani Guido

    2011-07-01

    Full Text Available The European project is facing a crisis. Citizens no longer understand what the EU is about. Young people and the new ruling class have forgotten the clear message of the European project launched just after the Second World War "No wars ever again among Europeans." The founding fathers of the European Union are mentioned in history textbooks, but today Europe is felt as an irritating bureaucracy. In Europe, peace and economic stability are considered as a natural state, a gift from above. Why keep a useless EU alive? The state of the European Union is swiftly degenerating. In almost all the member states, the anti-European forces are gaining ground. Populism is not a new ideology and is not necessarily European: let's recall Peronism. In today's Europe populism is the new manifestation of nationalism. In Italy the Lega Nord is in Berlusconi's eurosceptic government. In France, the National Front is endangering UMP's hegemony. In Belgium the rows between the Flemish and the Walloons threatens the state's unity. In the Netherlands, Hungary, the Czech Republic, Austria and Finland, populist forces are either in the government or strongly influencing the government. National-populism is different from the nationalism of the past. De Gaulle's nationalism was an ideology founded on the "grandeur" of France's history and on a certain idea of Europe, which was "l'Europe de patrie", a kind of European unity accepting French leadership in world politics. Today national-populism is a form of micro-nationalism: it opposes the European project but without having a serious alternative. This is why populism is dangerous. Its real goal is not only the breaking down of the European Union but also the disintegration of the old nation states into micro-ethnic states, as what happened in former Yugoslavia.

  5. Calibrating a population-based job-exposure matrix using inspection measurements to estimate historical occupational exposure to lead for a population-based cohort in Shanghai, China

    Science.gov (United States)

    Koh, Dong-Hee; Bhatti, Parveen; Coble, Joseph B.; Stewart, Patricia A; Lu, Wei; Shu, Xiao-Ou; Ji, Bu-Tian; Xue, Shouzheng; Locke, Sarah J.; Portengen, Lutzen; Yang, Gong; Chow, Wong-Ho; Gao, Yu-Tang; Rothman, Nathaniel; Vermeulen, Roel; Friesen, Melissa C.

    2012-01-01

    The epidemiologic evidence for the carcinogenicity of lead is inconsistent and requires improved exposure assessment to estimate risk. We evaluated historical occupational lead exposure for a population-based cohort of women (n=74,942) by calibrating a job-exposure matrix (JEM) with lead fume (n=20,084) and lead dust (n=5,383) measurements collected over four decades in Shanghai, China. Using mixed-effect models, we calibrated intensity JEM ratings to the measurements using fixed-effects terms for year and JEM rating. We developed job/industry-specific estimates from the random-effects terms for job and industry. The model estimates were applied to subjects’ jobs when the JEM probability rating was high for either job or industry; remaining jobs were considered unexposed. The models predicted that exposure increased monotonically with JEM intensity rating and decreased 20–50-fold over time. The cumulative calibrated JEM estimates and job/industry-specific estimates were highly correlated (Pearson correlation=0.79–0.84). Overall, 5% of the person-years and 8% of the women were exposed to lead fume; 2% of the person-years and 4% of the women were exposed to lead dust. The most common lead-exposed jobs were manufacturing electronic equipment. These historical lead estimates should enhance our ability to detect associations between lead exposure and cancer risk in future epidemiologic analyses. PMID:22910004

  6. Cabergoline for Cushing's disease: a large retrospective multicenter study.

    Science.gov (United States)

    Ferriere, A; Cortet, C; Chanson, P; Delemer, B; Caron, P; Chabre, O; Reznik, Y; Bertherat, J; Rohmer, V; Briet, C; Raingeard, I; Castinetti, F; Beckers, A; Vroonen, L; Maiter, D; Cephise-Velayoudom, F L; Nunes, M L; Haissaguerre, M; Tabarin, A

    2017-03-01

    The efficacy of cabergoline in Cushing's disease (CD) is controversial. The aim of this study was to assess the efficacy and tolerability of cabergoline in a large contemporary cohort of patients with CD. We conducted a retrospective multicenter study from thirteen French and Belgian university hospitals. Sixty-two patients with CD received cabergoline monotherapy or add-on therapy. Symptom score, biological markers of hypercortisolism and adverse effects were recorded. Twenty-one (40%) of 53 patients who received cabergoline monotherapy had normal urinary free cortisol (UFC) values within 12 months (complete responders), and five of these patients developed corticotropic insufficiency. The fall in UFC was associated with significant reductions in midnight cortisol and plasma ACTH, and with clinical improvement. Compared to other patients, complete responders had similar median baseline UFC (2.0 vs 2.5xULN) and plasma prolactin concentrations but received lower doses of cabergoline (1.5 vs 3.5 mg/week, P 12 months), cabergoline was withdrawn in 28% of complete responders because of treatment escape or intolerance. Overall, sustained control of hypercortisolism was obtained in 23% of patients for 32.5 months (19-105). Nine patients on steroidogenesis inhibitors received cabergoline add-on therapy for 19 months (1-240). Hypercortisolism was controlled in 56% of these patients during the first year of treatment with cabergoline at 1.0 mg/week (0.5-3.5). About 20-25% of CD patients are good responders to cabergoline therapy allowing long-term control of hypercortisolism at relatively low dosages and with acceptable tolerability. No single parameter, including the baseline UFC and prolactin levels, predicted the response to cabergoline. © 2017 European Society of Endocrinology.

  7. Neurophysiology versus clinical genetics in Rett syndrome: A multicenter study

    Science.gov (United States)

    Halbach, Nicky; Julu, Peter; Witt‐Engerström, Ingegerd; Pini, Giorgio; Bigoni, Stefania; Hansen, Stig; Apartopoulos, Flora; Delamont, Robert; van Roozendaal, Kees; Scusa, Maria F.; Borelli, Paolo; Candel, Math; Curfs, Leopold

    2016-01-01

    Many studies have attempted to establish the genotype–phenotype correlation in Rett syndrome (RTT). Cardiorespiratory measurements provide robust objective data, to correlate with each of the different clinical phenotypes. It has important implications for the management and treatment of this syndrome. The aim of this study was to correlate the genotype with the quantitative cardiorespiratory data obtained by neurophysiological measurement combined with a clinical severity score. This international multicenter study was conducted in four European countries from 1999 to 2012. The study cohort consisted of a group of 132 well‐defined RTT females aged between 2 and 43 years with extended clinical, molecular, and neurophysiological assessments. Diagnosis of RTT was based on the consensus criteria for RTT and molecular confirmation. Genotype–phenotype analyses of clinical features and cardiorespiratory data were performed after grouping mutations by the same type and localization or having the same putative biological effect on the MeCP2 protein, and subsequently on eight single recurrent mutations. A less severe phenotype was seen in females with CTS, p.R133C, and p.R294X mutations. Autonomic disturbances were present in all females, and not restricted to nor influenced by one specific group or any single recurrent mutation. The objective information from non‐invasive neurophysiological evaluation of the disturbed central autonomic control is of great importance in helping to organize the lifelong care for females with RTT. Further research is needed to provide insights into the pathogenesis of autonomic dysfunction, and to develop evidence‐based management in RTT. © 2016 The Authors. American Journal of Medical Genetics Part A published by Wiley Periodicals, Inc. PMID:27354166

  8. Isotretinoin, pregnancies, abortions and birth defects: a population-based perspective

    Science.gov (United States)

    Bérard, Anick; Azoulay, Laurent; Koren, Gideon; Blais, Lucie; Perreault, Sylvie; Oraichi, Driss

    2007-01-01

    What is already known about this subject As of now, no population-based data exist on the incidence of pregnancy, elective abortions, and birth defects while on isotretinoin. From surveys or interventional studies, it is known that pregnancy rates while on isotretinoin are comparable to the baseline rate, and that birth defect rates associated with first-trimester exposure are 10 times greater than in the general population. Given that women decide to terminate pregnancies based on the available data, population-based estimates are needed. What this study adds This first non-interventional population-based study on the risk of pregnancy while being exposed to isotretinoin has shown that the rate of pregnancy is four times greater than what has been published to date (32.7/1000 person-years). Any pregnancy while using isotretinoin is the result of a failure of pregnancy prevention strategies, hence, thus far, pregnancy prevention programmes have failed. The rate of elective abortions is much higher than previously reported (84%). Women of a lower socio-economic level and high users of healthcare services are more likely to become pregnant while on isotretinoin, suggesting that high use of health services increase the opportunity of having a prescription for isotretinoin or of having a pregnancy diagnosis. Aims To estimate the population-based incidence rates of pregnancy, spontaneous and elective abortions, and birth defects associated with isotretinoin use, and to determine predictors of pregnancy while on isotretinoin. Methods Using the RAMQ (medical and pharmaceutical data), MED-ECHO (hospitalizations) and ISQ (births and deaths) databases for the period 1984–2002, a cohort of 8609 women between 13 and 45 years of age and with a first prescription for isotretinoin (date of entry in the cohort) was identified. Women were eligible if they were insured by RAMQ for their medications at least 12 months before entry in the cohort and until 1 month after the end of

  9. Multicenter assessment of the reproducibility of volumetric radiofrequency-based intravascular ultrasound measurements in coronary lesions that were consecutively stented

    DEFF Research Database (Denmark)

    Huisman, Jennifer; Egede, Rasmus; Rdzanek, Adam

    2012-01-01

    To assess in a multicenter design the between-center reproducibility of volumetric virtual histology intravascular ultrasound (VH-IVUS) measurements with a semi-automated, computer-assisted contour detection system in coronary lesions that were consecutively stented. To evaluate the reproducibility...... of volumetric VH-IVUS measurements, experienced analysts of 4 European IVUS centers performed independent analyses (in total 8,052 cross-sectional analyses) to obtain volumetric data of 40 coronary segments (length 20.0 ± 0.3 mm) from target lesions prior to percutaneous intervention that were performed...

  10. Measuring stress before and during pregnancy: a review of population-based studies of obstetric outcomes.

    Science.gov (United States)

    Witt, Whitney P; Litzelman, Kristin; Cheng, Erika R; Wakeel, Fathima; Barker, Emily S

    2014-01-01

    Mounting evidence from clinic and convenience samples suggests that stress is an important predictor of adverse obstetric outcomes. Using a proposed theoretical framework, this review identified and synthesized the population-based literature on the measurement of stress prior to and during pregnancy in relation to obstetric outcomes. Population-based, peer-reviewed empirical articles that examined stress prior to or during pregnancy in relation to obstetric outcomes were identified in the PubMed and PsycInfo databases. Articles were evaluated to determine the domain(s) of stress (environmental, psychological, and/or biological), period(s) of stress (preconception and/or pregnancy), and strength of the association between stress and obstetric outcomes. Thirteen studies were evaluated. The identified studies were all conducted in developed countries. The majority of studies examined stress only during pregnancy (n = 10); three examined stress during both the preconception and pregnancy periods (n = 3). Most studies examined the environmental domain (e.g. life events) only (n = 9), two studies examined the psychological domain only, and two studies examined both. No study incorporated a biological measure of stress. Environmental stressors before and during pregnancy were associated with worse obstetric outcomes, although some conflicting findings exist. Few population-based studies have examined stress before or during pregnancy in relation to obstetric outcomes. Although considerable variation exists in the measurement of stress across studies, environmental stress increased the risk for poor obstetric outcomes. Additional work using a lifecourse approach is needed to fill the existing gaps in the literature and to develop a more comprehensive understanding of the mechanisms by which stress impacts obstetric outcomes.

  11. Formula and breast feeding in infant food allergy: A population-based study.

    Science.gov (United States)

    Goldsmith, Alice J; Koplin, Jennifer J; Lowe, Adrian J; Tang, Mimi Lk; Matheson, Melanie C; Robinson, Marnie; Peters, Rachel; Dharmage, Shyamali C; Allen, Katrina J

    2016-04-01

    To determine whether infant-feeding practices, including duration of exclusive breastfeeding and use of partially hydrolysed formula, modify the risk of developing infant food allergy. In an observational population-based study, 1 year olds were recruited from community immunisation clinics in Melbourne, Australia. Parent-reported data on infant-feeding practices and potential confounders were collected prior to infant skin prick testing for four food allergens. Sensitised infants attended hospital-based oral food challenges to establish food allergy status. Multiple logistic regression was used to investigate associations between breastfeeding and formula-feeding and infant food allergy adjusting for possible confounding variables. A total of 5276 (74% response) infants participated. Of the 4537 for whom food allergy status was determined, 515 (11.3%) were food allergic (challenge-proven in the context of skin prick testing positive (≥2 mm)). After adjusting for confounding variables, there was no association between duration of exclusive breastfeeding and food allergy. Use of partially hydrolysed formula did not reduce the risk of food allergy compared with cow's milk formula in the general population (adjusted odds ratios 1.03 (confidence interval 0.67-1.50)). Duration of exclusive breastfeeding and use of partially hydrolysed formula were not associated with food allergy at 1 year of age in this large population-based study. These findings have implications for population-based infant-feeding guidelines and do not support the use of partially hydrolysed formula for food allergy prevention. © 2016 The Authors Journal of Paediatrics and Child Health © 2016 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  12. Population-based cancer survival in the United States: Data, quality control, and statistical methods.

    Science.gov (United States)

    Allemani, Claudia; Harewood, Rhea; Johnson, Christopher J; Carreira, Helena; Spika, Devon; Bonaventure, Audrey; Ward, Kevin; Weir, Hannah K; Coleman, Michel P

    2017-12-15

    Robust comparisons of population-based cancer survival estimates require tight adherence to the study protocol, standardized quality control, appropriate life tables of background mortality, and centralized analysis. The CONCORD program established worldwide surveillance of population-based cancer survival in 2015, analyzing individual data on 26 million patients (including 10 million US patients) diagnosed between 1995 and 2009 with 1 of 10 common malignancies. In this Cancer supplement, we analyzed data from 37 state cancer registries that participated in the second cycle of the CONCORD program (CONCORD-2), covering approximately 80% of the US population. Data quality checks were performed in 3 consecutive phases: protocol adherence, exclusions, and editorial checks. One-, 3-, and 5-year age-standardized net survival was estimated using the Pohar Perme estimator and state- and race-specific life tables of all-cause mortality for each year. The cohort approach was adopted for patients diagnosed between 2001 and 2003, and the complete approach for patients diagnosed between 2004 and 2009. Articles in this supplement report population coverage, data quality indicators, and age-standardized 5-year net survival by state, race, and stage at diagnosis. Examples of tables, bar charts, and funnel plots are provided in this article. Population-based cancer survival is a key measure of the overall effectiveness of services in providing equitable health care. The high quality of US cancer registry data, 80% population coverage, and use of an unbiased net survival estimator ensure that the survival trends reported in this supplement are robustly comparable by race and state. The results can be used by policymakers to identify and address inequities in cancer survival in each state and for the United States nationally. Cancer 2017;123:4982-93. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Published 2017. This article is a U

  13. [Population based norms of the Spanish version of the SF-12V2 for Murcia (Spain)].

    Science.gov (United States)

    Monteagudo Piqueras, Olga; Hernando Arizaleta, Lauro; Palomar Rodríguez, Joaquín A

    2011-01-01

    Questionnaires on perceived health provide information on health results. Reference values are needed to assess these results. Previous studies have provided Spanish population-based norms for the SF-12v1. The aim of this study was to obtain the population-based norms for the Spanish version of the SF-12v2 for Murcia. A cross-sectional telephone survey was carried out in 3,486 community-dwelling persons aged over 18 years old in the region of Murcia. The central tendency, dispersion and percentiles were calculated for each of the eight scales and the physical and mental summary components (PCS and MCS) of the SF-12v2. Known groups were compared to evaluate construct validity (Student's t-test and ANOVA). A total of 3, 381 persons took part in the study (50.5% men). The mean age was 43.6 years in men and 46.0 in women. The mean PSC was 48.6 (± 10.6) and the mean MCS was 53.6 (± 10.7). These scores were higher (more favorable) in men, the youngest age groups, in persons with higher education and in those no chronic illnesses (p=0.000). In all the dimensions and summary components, men had better scores than women. The dimension with the worst score in both men and women was general health and the PCS. These results should be considered as the population-based norms for the Spanish version of the SF-12v2 for Murcia but may also be useful to establish health aims in similar populations. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  14. Unilateral Vocal Fold Paralysis and Risk of Pneumonia: A Nationwide Population-Based Cohort Study.

    Science.gov (United States)

    Tsai, Ming-Shao; Yang, Yao-Hsu; Liu, Chia-Yen; Lin, Meng-Hung; Chang, Geng-He; Tsai, Yao-Te; Li, Hsueh-Yu; Tsai, Ying-Huang; Hsu, Cheng-Ming

    2018-01-01

    Objective To investigate pneumonia risk among patients with unilateral vocal fold paralysis (UVFP). Study Design Retrospective population-based cohort study. Setting This study used data from the National Health Insurance Research Database of Taiwan, a nationwide population-based database. Subjects and Methods A total of 419 patients newly diagnosed with UVFP between January 1, 1997, and December 31, 2013, were identified from the Longitudinal Health Insurance Database 2000, a nationally representative database of 1 million randomly selected patients. Moreover, 1676 patients without UVFP were matched to patients with UVFP at a 1:4 ratio based on age, sex, socioeconomic status, urbanization level, and site-specific cancers. Patients were followed up until death or the end of the study period (December 31, 2013). The primary outcome was the occurrence of pneumonia. Results The cumulative incidence of pneumonia was significantly higher for patients with UVFP than those without UFVP ( P < .001). The adjusted Cox proportional hazard model showed that UVFP was significantly associated with a higher incidence of pneumonia (hazard ratio, 1.97; 95% CI, 1.35-2.86; P < .001). Subgroup analyses demonstrated that UVFP was an independent risk factor of pneumonia for 4 subgroups: young (18-50 years), older (≥51 years), male, and cancer. Conclusion This is the first nationwide population-based cohort study to investigate the association between UVFP and pneumonia. The findings indicate that UVFP is an independent risk factor of pneumonia. Given the study results, physicians should be aware of the potential for pneumonia occurrence following UVFP.

  15. Population-based prevalence of multiple radiographically-defined hip morphologies: the Johnston County Osteoarthritis Project.

    Science.gov (United States)

    Raveendran, R; Stiller, J L; Alvarez, C; Renner, J B; Schwartz, T A; Arden, N K; Jordan, J M; Nelson, A E

    2018-01-01

    To provide the first prevalence estimates of different radiographic hip morphologies relevant to dysplasia and femoroacetabular impingement in a well-characterized USA population-based cohort. Cross-sectional data were from the baseline examination (1991-1997) of a large population-based prospective longitudinal cohort study (The Johnston County Osteoarthritis Project). HipMorf software (Oxford, UK) was used to assess hip morphology on anteroposterior (AP) pelvis radiographs. Weighted, sex-stratified prevalence estimates and 95% confidence intervals for four key hip morphologies (AP alpha angle, triangular index sign, lateral center edge angle (LCEA), and protrusio acetabula) were derived and further stratified by age, race and body mass index (BMI). A total of 5192 hips from 2596 individuals were included (31% African American, 43% male, mean age 63 years, mean BMI 29 kg/m2). Cam morphology was seen in more than 25% of men and 10% of women. Mild dysplasia was present in about 1/3 of men and women, while pincer morphology was identified in 7% of men and 10% of women. Femoral side (cam) morphologies were more common and more frequently bilateral among men, while pincer morphologies were more common in women; mixed morphologies were infrequent. African-Americans were more likely to have protrusio acetabula than whites. We report the first population-based prevalence estimates of radiographic hip morphologies relevant to femoroacetabular impingement (FAI) and dysplasia in the USA. These morphologies are very common, with ¼ men and 1/10 women having cam morphology, 1/3 of all adults having mild dysplasia, and 1/15 men and 1/10 women having pincer morphology in at least one hip. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  16. Population based allele frequencies of disease associated polymorphisms in the Personalized Medicine Research Project

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    Stefanski Elisha L

    2010-06-01

    Full Text Available Abstract Background There is a lack of knowledge regarding the frequency of disease associated polymorphisms in populations and population attributable risk for many populations remains unknown. Factors that could affect the association of the allele with disease, either positively or negatively, such as race, ethnicity, and gender, may not be possible to determine without population based allele frequencies. Here we used a panel of 51 polymorphisms previously associated with at least one disease and determined the allele frequencies within the entire Personalized Medicine Research Project population based cohort. We compared these allele frequencies to those in dbSNP and other data sources stratified by race. Differences in allele frequencies between self reported race, region of origin, and sex were determined. Results There were 19544 individuals who self reported a single racial category, 19027 or (97.4% self reported white Caucasian, and 11205 (57.3% individuals were female. Of the 11,208 (57% individuals with an identifiable region of origin 8337 or (74.4% were German. 41 polymorphisms were significantly different between self reported race at the 0.05 level. Stratification of our Caucasian population by self reported region of origin revealed 19 polymorphisms that were significantly different (p = 0.05 between individuals of different origins. Further stratification of the population by gender revealed few significant differences in allele frequencies between the genders. Conclusions This represents one of the largest population based allele frequency studies to date. Stratification by self reported race and region of origin revealed wide differences in allele frequencies not only by race but also by region of origin within a single racial group. We report allele frequencies for our Asian/Hmong and American Indian populations; these two minority groups are not typically selected for population allele frequency detection. Population wide

  17. Injuries in Aleppo, Syria; first population-based estimates and characterization of predominant types

    Directory of Open Access Journals (Sweden)

    Maziak Wasim

    2006-03-01

    Full Text Available Abstract Background Despite the growing burden of injuries worldwide, Syria and many other Arab countries still lack population-based estimates of different types of injuries. This study aims toprovide first population-based estimates of major injuries in Syria and characterize groups at increased risk. Methods An interviewer-administered population-based survey of adults 18–65 years residing in Aleppo, Syria was conducted in 2004. The study sample involved 2038 household representatives in Aleppo (45.2% men, mean age 35.3 ± 12.1, response rate 86%. We inquired about participants self-reported injuries in the past year that required medical attention as well as injuries among their household members. When reported, injuries were further assessed according to type, place, and outcome. Results Overall, there was 153 self-reported injuries in the past year (77.3 per 1000 adult respondents, 93.1 per 1000 in men and 64.4 per 1000 in women, p = 0.02. Other than gender, injuries differed by age (the older age group being least affected, and place of occurrence, as men were more likely to sustain traffic injuries and be injured outside the home. Injuries were reported among 236 household members (21.0 per 1000, and were slightly more frequent in children than adults (22.0 per 1000 for children, and 19.7 per 1000 for adults, p = 0.2. Traffic injuries, falls, and poisoning (food were by far the most common types of injury experienced by participants as well as their household members. Falls and traffic injuries seem to have caused most morbidity for the injured, while burns, although not frequently reported, were associated with an unfavorable outcome in the majority of cases. Conclusion This information provides baseline information about the burden of different injuries in Syria, and the sociodemographic factors related to them.

  18. Systemic inflammation in chronic obstructive pulmonary disease: a population-based study

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    Sánchez Guadalupe

    2010-05-01

    Full Text Available Abstract Background Elevated circulating levels of several inflammatory biomarkers have been described in selected patient populations with COPD, although less is known about their population-based distribution. The aims of this study were to compare the levels of several systemic biomarkers between stable COPD patients and healthy subjects from a population-based sample, and to assess their distribution according to clinical variables. Methods This is a cross-sectional study design of participants in the EPI-SCAN study (40-80 years of age. Subjects with any other condition associated with an inflammatory process were excluded. COPD was defined as a post-bronchodilator FEV1/FVC Results We compared 324 COPD patients and 110 reference subjects. After adjusting for gender, age, BMI and tobacco consumption, COPD patients showed higher levels of CRP (0.477 ± 0.023 vs. 0.376 ± 0.041 log mg/L, p = 0.049, TNF-α (13.12 ± 0.59 vs. 10.47 ± 1.06 pg/mL, p = 0.033, IL-8 (7.56 ± 0.63 vs. 3.57 ± 1.13 pg/ml; p = 0.033 and NOx (1.42 ± 0.01 vs. 1.36 ± 0.02 log nmol/l; p = 0.048 than controls. In COPD patients, serum concentrations of some biomarkers were related to severity and their exercise tolerance was related to serum concentrations of CRP, IL-6, IL-8, fibrinogen and albumin. Conclusions Our results provide population-based evidence that COPD is independently associated with low-grade systemic inflammation, with a different inflammatory pattern than that observed in healthy subjects.

  19. Systemic inflammation in chronic obstructive pulmonary disease: a population-based study.

    Science.gov (United States)

    Garcia-Rio, Francisco; Miravitlles, Marc; Soriano, Joan B; Muñoz, Luis; Duran-Tauleria, Enric; Sánchez, Guadalupe; Sobradillo, Víctor; Ancochea, Julio

    2010-05-25

    Elevated circulating levels of several inflammatory biomarkers have been described in selected patient populations with COPD, although less is known about their population-based distribution. The aims of this study were to compare the levels of several systemic biomarkers between stable COPD patients and healthy subjects from a population-based sample, and to assess their distribution according to clinical variables. This is a cross-sectional study design of participants in the EPI-SCAN study (40-80 years of age). Subjects with any other condition associated with an inflammatory process were excluded. COPD was defined as a post-bronchodilator FEV1/FVC prescription of medication. Subjects were evaluated with quality-of-life questionnaires, spirometry and 6-minute walk tests. Serum C-reactive protein (CRP), tumor necrosis factor (TNF)-alpha, interleukins (IL-6 and IL-8), alpha1-antitrypsin, fibrinogen, albumin and nitrites/nitrates (NOx) were measured. We compared 324 COPD patients and 110 reference subjects. After adjusting for gender, age, BMI and tobacco consumption, COPD patients showed higher levels of CRP (0.477 +/- 0.023 vs. 0.376 +/- 0.041 log mg/L, p = 0.049), TNF-alpha (13.12 +/- 0.59 vs. 10.47 +/- 1.06 pg/mL, p = 0.033), IL-8 (7.56 +/- 0.63 vs. 3.57 +/- 1.13 pg/ml; p = 0.033) and NOx (1.42 +/- 0.01 vs. 1.36 +/- 0.02 log nmol/l; p = 0.048) than controls. In COPD patients, serum concentrations of some biomarkers were related to severity and their exercise tolerance was related to serum concentrations of CRP, IL-6, IL-8, fibrinogen and albumin. Our results provide population-based evidence that COPD is independently associated with low-grade systemic inflammation, with a different inflammatory pattern than that observed in healthy subjects.

  20. Neighborhood deprivation is strongly associated with participation in a population-based health check

    DEFF Research Database (Denmark)

    Bender, Anne Mette; Kawachi, Ichiro; Jørgensen, Torben

    2015-01-01

    BACKGROUND: We sought to examine whether neighborhood deprivation is associated with participation in a large population-based health check. Such analyses will help answer the question whether health checks, which are designed to meet the needs of residents in deprived neighborhoods, may increase...... screening for ischemic heart disease and lifestyle counseling. The study population was randomly drawn from a population of 179,097 persons living in 73 neighborhoods in Denmark. Data on neighborhood deprivation (percentage with basic education, with low income and not in work) and individual socioeconomic...

  1. Mortality in myasthenia gravis: A nationwide population-based follow-up study in Denmark

    DEFF Research Database (Denmark)

    Hansen, Julie S; Danielsen, Ditte H; Somnier, Finn E

    2016-01-01

    INTRODUCTION: In previous studies of myasthenia gravis (MG), increased mortality has been reported. The aim of this study was to estimate mortality in patients with acetylcholine receptor antibody-positive (AChR-Ab-seropositive) MG in a nationwide population-based, long-term follow-up study....... All patients and controls were followed until January 1, 2009. Mortality rates and estimated mortality rate ratios (MRRs) were calculated. RESULTS: Of 702 AChR-Ab-seropositive MG patients, 302 died during follow-up. Overall mortality was higher for patients with MG (MRR = 1.41, range 1...

  2. Perinatal Advantages and Disadvantages of Being Underweight before Pregnancy: A Population-Based Study.

    Science.gov (United States)

    Trojner Bregar, Andreja; Blickstein, Isaac; Bržan Šimenc, Gabrijela; Janša, Vid; Verdenik, Ivan; Lučovnik, Miha; Tul, Nataša

    2017-01-01

    To evaluate the advantages and disadvantages of being underweight before pregnancy. Cohort study of a large population-based dataset of singleton births was used to compare maternal and neonatal outcomes of pre-gravid underweight body mass index (BMI 4,000 g, less cesarean births and a lower incidence of gestational diabetes and hypertensive disorders. A tradeoff exists between the advantages of being lean before pregnancy in terms of less maternal morbidity in return for gaining a more advanced gestational age and higher birth weight. © 2016 S. Karger AG, Basel.

  3. MMAS Versus Population-Based EA on a Family of Dynamic Fitness Functions

    DEFF Research Database (Denmark)

    Lissovoi, Andrei; Witt, Carsten

    2015-01-01

    We study the behavior of a population-based EA and the Max–Min Ant System (MMAS) on a family of deterministically-changing fitness functions, where, in order to find the global optimum, the algorithms have to find specific local optima within each of a series of phases. In particular, we prove...... function extended over a finite alphabet of μ symbols, whereas population size μ−1 is not sufficient. Furthermore, we show that MMAS does not require additional modifications to track the optimum of the finite-alphabet Maze functions, and, using a novel drift statement to simplify the analysis, reduce...

  4. MMAS vs. Population-based EA on a family of dynamic fitness functions

    DEFF Research Database (Denmark)

    Lissovoi, Andrei; Witt, Carsten

    2014-01-01

    We study the behavior of a population-based EA and the Max-Min Ant System (MMAS) on a family of deterministically-changing fitness functions, where, in order to find the global optimum, the algorithms have to find specific local optima within each of a series of phases. In particular, we prove...... a Maze function extended over a finite alphabet of μ symbols, whereas population size μ-1 is not sufficient. Furthermore, we show that MMAS does not require additional modifications to track the optimum of the finite-alphabet Maze functions, and, using a novel drift statement to simplify the analysis...

  5. Variables associated with olfactory disorders in adults: A U.S. population-based analysis

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    Julia Noel

    2017-03-01

    Full Text Available Objective: Olfactory dysfunction is known to have significant social, psychological, and safety implications. Despite increasingly recognized prevalence, potential risk factors for olfactory loss have been arbitrarily documented and knowledge is limited in scale. The aim of this study is to identify potential demographic and exposure variables correlating with olfactory dysfunction. Methods: Cross-sectional analysis of the 2011–2012 and 2013–2014 editions of the National Health Examination and Nutrition Survey was performed. The utilized survey reports from a nationally representative sample of about 5000 persons each year located in counties across the United States. There is an interview and physical examination component which includes demographic, socioeconomic, dietary, and health-related questions as well as medical, dental, physiologic measurements, and laboratory tests. 3594 adult respondents from 2011 to 2012 and 3708 respondents from 2013 to 2014 were identified from the above population-based database. The frequency of self-reported disorders as well as performance on odor identification testing was determined in relation to demographic factors, occupational or environmental exposures, and urinary levels of environmental and industrial compounds. Results: In both subjective and objective analysis, smell disorders were significantly more common with increasing age. While the non-Hispanic Black and non-Hispanic Asian populations were less likely to report subjective olfactory loss, they, along with Hispanics, performed more poorly on odor identification than Caucasians. Those with limited education had a decreased prevalence of hyposmia. Women outperformed men on smell testing. Those reporting exposure to vapors were more likely to experience olfactory dysfunction, and urinary levels of manganese, 2-Thioxothiazolidine-4-carboxylic acid, and 2-Aminothiazoline-4-carboxylic acid were lower among respondents with subjective smell

  6. Investigating Measures of Social Context on 2 Population-Based Health Surveys, Hawaii, 2010-2012.

    Science.gov (United States)

    Pobutsky, Ann M; Baker, Kathleen Kromer; Reyes-Salvail, Florentina

    2015-12-17

    Measures from the Social Context Module of the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System were used on 2 population-based health surveys in Hawaii to explicate the role of the nonmedical and social determinants of health; these measures were also compared with conventional socioeconomic status (SES) variables. Results showed that the self-reported SES vulnerabilities of food and housing insecurity are both linked to demographic factors and physical and mental health status and significant when controlling for the conventional measures of SES. The social context module indicators should be increasingly used so results can inform appropriate interventions for vulnerable populations.

  7. The protocols for the 10/66 dementia research group population-based research programme

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    Salas Aquiles

    2007-07-01

    Full Text Available Abstract Background Latin America, China and India are experiencing unprecedentedly rapid demographic ageing with an increasing number of people with dementia. The 10/66 Dementia Research Group's title refers to the 66% of people with dementia that live in developing countries and the less than one tenth of population-based research carried out in those settings. This paper describes the protocols for the 10/66 population-based and intervention studies that aim to redress this imbalance. Methods/design Cross-sectional comprehensive one phase surveys have been conducted of all residents aged 65 and over of geographically defined catchment areas in ten low and middle income countries (India, China, Nigeria, Cuba, Dominican Republic, Brazil, Venezuela, Mexico, Peru and Argentina, with a sample size of between 1000 and 3000 (generally 2000. Each of the studies uses the same core minimum data set with cross-culturally validated assessments (dementia diagnosis and subtypes, mental disorders, physical health, anthropometry, demographics, extensive non communicable disease risk factor questionnaires, disability/functioning, health service utilisation, care arrangements and caregiver strain. Nested within the population based studies is a randomised controlled trial of a caregiver intervention for people with dementia and their families (ISRCTN41039907; ISRCTN41062011; ISRCTN95135433; ISRCTN66355402; ISRCTN93378627; ISRCTN94921815. A follow up of 2.5 to 3.5 years will be conducted in 7 countries (China, Cuba, Dominican Republic, Venezuela, Mexico, Peru and Argentina to assess risk factors for incident dementia, stroke and all cause and cause-specific mortality; verbal autopsy will be used to identify causes of death. Discussion The 10/66 DRG baseline population-based studies are nearly complete. The incidence phase will be completed in 2009. All investigators are committed to establish an anonymised file sharing archive with monitored public access. Our

  8. Association of Common Polymorphisms in the Nicotinic Acetylcholine Receptor Alpha4 Subunit Gene with an Electrophysiological Endophenotype in a Large Population-Based Sample.

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    A Mobascher

    Full Text Available Variation in genes coding for nicotinic acetylcholine receptor (nAChR subunits affect cognitive processes and may contribute to the genetic architecture of neuropsychiatric disorders. Single nucleotide polymorphisms (SNPs in the CHRNA4 gene that codes for the alpha4 subunit of alpha4/beta2-containing receptors have previously been implicated in aspects of (mostly visual attention and smoking-related behavioral measures. Here we investigated the effects of six synonymous but functional CHRNA4 exon 5 SNPs on the N100 event-related potential (ERP, an electrophysiological endophenotype elicited by a standard auditory oddball. A total of N = 1,705 subjects randomly selected from the general population were studied with electroencephalography (EEG as part of the German Multicenter Study on nicotine addiction. Two of the six variants, rs1044396 and neighboring rs1044397, were significantly associated with N100 amplitude. This effect was pronounced in females where we also observed an effect on reaction time. Sequencing of the complete exon 5 region in the population sample excluded the existence of additional/functional variants that may be responsible for the observed effects. This is the first large-scale population-based study investigation the effects of CHRNA4 SNPs on brain activity measures related to stimulus processing and attention. Our results provide further evidence that common synonymous CHRNA4 exon 5 SNPs affect cognitive processes and suggest that they also play a role in the auditory system. As N100 amplitude reduction is considered a schizophrenia-related endophenotype the SNPs studied here may also be associated with schizophrenia outcome measures.

  9. Functional correlates of cognitive dysfunction in multiple sclerosis: A multicenter fMRI Study.

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    Rocca, Maria A; Valsasina, Paola; Hulst, Hanneke E; Abdel-Aziz, Khaled; Enzinger, Christian; Gallo, Antonio; Pareto, Debora; Riccitelli, Gianna; Muhlert, Nils; Ciccarelli, Olga; Barkhof, Frederik; Fazekas, Franz; Tedeschi, Gioacchino; Arévalo, Maria J; Filippi, Massimo

    2014-12-01

    In this multicenter study, we applied functional magnetic resonance imaging (fMRI) to define the functional correlates of cognitive dysfunction in patients with multiple sclerosis (MS). fMRI scans during the performance of the N-back task were acquired from 42 right-handed relapsing remitting (RR) MS patients and 52 sex-matched right-handed healthy controls, studied at six European sites using 3.0 Tesla scanners. Patients with at least two abnormal (function of increasing task difficulty, CI MS patients had reduced activations of several areas located in the fronto-parieto-temporal lobes as well as reduced deactivations of regions which are part of the default mode network compared to the other two groups. Significant correlations were found between abnormal fMRI patterns of activations and deactivations and behavioral measures, cognitive performance, and brain T2 and T1 lesion volumes. This multicenter study supports the theory that a preserved fMRI activity of the frontal lobe is associated with a better cognitive profile in MS patients. It also indicates the feasibility of fMRI to monitor disease evolution and treatment effects in future studies. © 2014 Wiley Periodicals, Inc.

  10. Physical activity and fatigue in chronic obstructive pulmonary disease - A population based study.

    Science.gov (United States)

    Andersson, Mikael; Stridsman, Caroline; Rönmark, Eva; Lindberg, Anne; Emtner, Margareta

    2015-08-01

    In subjects with chronic obstructive pulmonary disease (COPD), symptoms of fatigue, concomitant heart disease and low physical activity levels are more frequently described than in subjects without COPD. However, there are no population-based studies addressing the relationship between physical activity, fatigue and heart disease in COPD. The aim was to compare physical activity levels among subjects with and without COPD in a population based study, and to evaluate if concomitant heart disease and fatigue was associated to physical activity. In this, 470 subjects with COPD and 659 subjects without COPD (non-COPD) participated in examinations including structured interview and spirometry. A ratio of the forced expiratory volume in one second (FEV1)/best of forced vital capacity (FVC) and vital capacity (VC) fatigue with the Functional Assessment of Chronic Illness Therapy - Fatigue scale (FACIT-F). The prevalence of low physical activity was higher among subjects with FEV1 fatigue, OR 2.33 (1.31-4.13); while obesity was the only significant factor among non-COPD subjects, OR 2.26 (1.17-4.35). Physical activity levels are reduced when lung function is decreased below 80% of predicted, and the factors associated with low physical activity are different among subject with and without COPD. We propose that the presence of fatigue and heart disease are useful to evaluate when identifying subjects for pulmonary rehabilitation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Association between alcohol consumption and systolic ventricular function: a population-based study.

    Science.gov (United States)

    Yousaf, Haroon; Rodeheffer, Richard J; Paterick, Timothy E; Ashary, Zain; Ahmad, Mirza Nubair; Ammar, Khawaja Afzal

    2014-06-01

    Although moderate alcohol consumption is associated with decreased clinical heart failure, there are no population-based studies evaluating the relationship between alcohol consumption and left ventricular (LV) systolic function. We sought to evaluate the relationship between alcohol consumption and LV systolic function in the community. In a population-based random sample of 2,042 adults, age ≥45 years, we assessed alcohol consumption by a self-administered questionnaire. Responders were categorized by alcohol consumption level: abstainer, former drinker, light drinker (2 drinks a day). Systolic function was assessed by echocardiography. We identified 38 cases of systolic dysfunction in 182 abstainers, 309 former drinkers, 1,028 light drinkers, 251 moderate drinkers, and 146 heavy drinkers. A U-shaped relationship was observed between alcohol consumption and moderate systolic dysfunction (LV ejection fraction [LVEF] ≤40%), with the lowest prevalence in light drinkers (0.9%) compared to the highest prevalence in heavy drinkers (5.5%) (odds ratio 0.14, 95% CI 0.04-0.43). This association persisted across different strata of risk factors of systolic dysfunction as well as in multivariate analysis. No significant association between alcohol consumption and systolic function was seen in subjects with LVEF >50% or ≤50%. There is a U-shaped relationship between alcohol consumption volume and LVEF, with the lowest risk of moderate LV dysfunction (LVEF ≤40%) observed in light drinkers (consumption and cardiovascular disease prevalence. Copyright © 2014 Mosby, Inc. All rights reserved.

  12. High prevalence of undiagnosed coeliac disease in adults: a Swedish population-based study.

    Science.gov (United States)

    Ivarsson, A; Persson, L A; Juto, P; Peltonen, M; Suhr, O; Hernell, O

    1999-01-01

    To determine the prevalence of coeliac disease in a population-based sample of Swedish adults. Population-based cross-sectional study. Northern Sweden. A total of 1894 adults (76%) out of 2500 invited, randomly selected from the population register after stratification for age and sex. Prevalence of biopsy verified coeliac disease, symptoms of undiagnosed cases, and results of antiendomysium and antigliadin serum antibody tests. Coeliac disease was confirmed by intestinal biopsy showing enteropathy in 10 individuals (seven women and three men), corresponding to a prevalence of 5.3 per 1000 (95% CI = 2.5-9.7). The majority of cases (eight out of 10) had not been diagnosed prior to the screening, although many had symptoms compatible with coeliac disease. All individuals with antiendomysium antibody positivity who were subjected to a small intestinal biopsy had enteropathy. Furthermore, all of them also had elevated levels of antigliadin antibodies type IgA and/or IgG. Coeliac disease is common, albeit mostly undiagnosed, in Swedish adults. It is likely that the situation is no better in other countries. This highlights the importance of keeping coeliac disease in mind, and of promptly investigating individuals with unexplained, even mild, symptoms compatible with the disease. Serological markers, e.g. antigliadin and antiendomysium antibodies, are useful tools within this active case-finding strategy, although the final diagnosis should be based on an intestinal biopsy demonstrating enteropathy.

  13. Preventable trauma deaths: from panel review to population based-studies

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    Vesconi Sergio

    2006-04-01

    Full Text Available Abstract Preventable trauma deaths are defined as deaths which could be avoided if optimal care has been delivered. Studies on preventable trauma deaths have been accomplished initially with panel reviews of pre-hospital and hospital charts. However, several investigators questioned the reliability and validity of this method because of low reproducibility of implicit judgments when they are made by different experts. Nevertheless, number of studies were published all around the world and ultimately gained some credibility, particularly in regions where comparisons were made before and after trauma system implementation with a resultant fall in mortality. During the last decade of century the method of comparing observed survival with probability of survival calculated from large trauma registries has obtained popularity. Preventable trauma deaths were identified as deaths occurred notwithstanding a high calculated probability of survival. In recent years, preventable trauma deaths studies have been replaced by population-based studies, which use databases representative of overall population, therefore with high epidemiologic value. These databases contain readily available information which carry out the advantage of objectivity and large numbers. Nowadays, population-based researches provide the strongest evidence regarding the effectiveness of trauma systems and trauma centers on patient outcomes.

  14. Does geography influence the treatment and outcomes of colorectal cancer? A population-based analysis.

    Science.gov (United States)

    Helewa, Ramzi M; Turner, Donna; Wirtzfeld, Debrah; Park, Jason; Hochman, David; Czaykowski, Piotr; Singh, Harminder; Shu, Emma; Xue, Lin; McKay, Andrew

    2013-06-17

    The Canadian province of Manitoba covers a large geographical area but only has one major urban center, Winnipeg. We sought to determine if regional differences existed in the quality of colorectal cancer care in a publicly funded health care system. This was a population-based historical cohort analysis of the treatment and outcomes of Manitobans diagnosed with colorectal cancer between 2004 and 2006. Administrative databases were utilized to assess quality of care using published quality indicators. A total of 2,086 patients were diagnosed with stage I to IV colorectal cancer and 42.2% lived outside of Winnipeg. Patients from North Manitoba had a lower odds of undergoing major surgery after controlling for other confounders (odds ratio (OR): 0.48, 95% confidence interval (CI): 0.26 to 0.90). No geographic differences existed in the quality measures of 30-day operative mortality, consultations with oncologists, surveillance colonoscopy, and 5-year survival. However, there was a trend towards lower survival in North Manitoba. We found minimal differences by geography. However, overall compliance with quality measures is low and there are concerning trends in North Manitoba. This study is one of the few to evaluate population-based benchmarks for colorectal cancer therapy in Canada.

  15. A population-based study of preschoolers' food neophobia and its associations with food preferences.

    Science.gov (United States)

    Russell, Catherine Georgina; Worsley, Anthony

    2008-01-01

    This cross-sectional study was designed to investigate the relationships between food preferences, food neophobia, and children's characteristics among a population-based sample of preschoolers. A parent-report questionnaire. Child-care centers, kindergartens, playgroups, day nurseries, and swimming centers. 371 two- to five-year-old Australian children. Associations between food neophobia and the food preferences and characteristics. Analysis of variance, analysis of covariance, Pearson product-moment correlations, and Fisher z test were used to estimate and compare the associations between these variables. Food neophobia was associated with reduced preferences for all food groups, but especially for vegetables (r = -0.60; P food types (r = -0.55; P food types (r = 0.42; P food types (r = 0.25; P food preferences (r = -0.59; P food preferences overall (r = -0.55; P food neophobia and a child's age, sex, or history of breast-feeding. The study confirms and extends results obtained in experimental research and population-based intake studies of food neophobia to children's everyday food preferences. The findings suggest that preschool children's everyday food preferences are strongly associated with food neophobia but not with children's age, sex, or history of breast-feeding. When aiming to influence children's food preferences, the effects of food neophobia and strategies to reduce it should be considered.

  16. On the Estimation of Heritability with Family-Based and Population-Based Samples

    Directory of Open Access Journals (Sweden)

    Youngdoe Kim

    2015-01-01

    Full Text Available For a family-based sample, the phenotypic variance-covariance matrix can be parameterized to include the variance of a polygenic effect that has then been estimated using a variance component analysis. However, with the advent of large-scale genomic data, the genetic relationship matrix (GRM can be estimated and can be utilized to parameterize the variance of a polygenic effect for population-based samples. Therefore narrow sense heritability, which is both population and trait specific, can be estimated with both population- and family-based samples. In this study we estimate heritability from both family-based and population-based samples, collected in Korea, and the heritability estimates from the pooled samples were, for height, 0.60; body mass index (BMI, 0.32; log-transformed triglycerides (log TG, 0.24; total cholesterol (TCHL, 0.30; high-density lipoprotein (HDL, 0.38; low-density lipoprotein (LDL, 0.29; systolic blood pressure (SBP, 0.23; and diastolic blood pressure (DBP, 0.24. Furthermore, we found differences in how heritability is estimated—in particular the amount of variance attributable to common environment in twins can be substantial—which indicates heritability estimates should be interpreted with caution.

  17. 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 lon...... first admitted for epilepsy at later ages. CONCLUSIONS: There is a strong association between epilepsy and schizophrenia or schizophrenia-like psychosis. The two conditions may share common genetic or environmental causes.......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...... longitudinal registers. SUBJECTS: The cohort comprised 2.27 million people. MAIN OUTCOME MEASURES: Epilepsy, psychosis, personal birth data. RESULTS: We found an increased risk of schizophrenia (relative risk 2.48, 95% confidence interval 2.20 to 2.80) and schizophrenia-like psychosis (2.93, 2.69 to 3...

  18. The contribution of chromosomal abnormalities to congenital heart defects: a population-based study.

    Science.gov (United States)

    Hartman, Robert J; Rasmussen, Sonja A; Botto, Lorenzo D; Riehle-Colarusso, Tiffany; Martin, Christa L; Cragan, Janet D; Shin, Mikyong; Correa, Adolfo

    2011-12-01

    We aimed to assess the frequency of chromosomal abnormalities among infants with congenital heart defects (CHDs) in an analysis of population-based surveillance data. We reviewed data from the Metropolitan Atlanta Congenital Defects Program, a population-based birth-defects surveillance system, to assess the frequency of chromosomal abnormalities among live-born infants and fetal deaths with CHDs delivered from January 1, 1994, to December 31, 2005. Among 4430 infants with CHDs, 547 (12.3%) had a chromosomal abnormality. CHDs most likely to be associated with a chromosomal abnormality were interrupted aortic arch (type B and not otherwise specified; 69.2%), atrioventricular septal defect (67.2%), and double-outlet right ventricle (33.3%). The most common chromosomal abnormalities observed were trisomy 21 (52.8%), trisomy 18 (12.8%), 22q11.2 deletion (12.2%), and trisomy 13 (5.7%). In conclusion, in our study, approximately 1 in 8 infants with a CHD had a chromosomal abnormality. Clinicians should have a low threshold at which to obtain testing for chromosomal abnormalities in infants with CHDs, especially those with certain types of CHDs. Use of new technologies that have become recently available (e.g., chromosomal microarray) may increase the identified contribution of chromosomal abnormalities even further.

  19. Measurement of nuchal translucency for prenatal screening of congenital heart defects: a population-based evaluation.

    Science.gov (United States)

    Jouannic, Jean-Marie; Thieulin, Anne-Claire; Bonnet, Damien; Houyel, Lucile; Lelong, Nathalie; Goffinet, François; Khoshnood, Babak

    2011-12-01

    (1) Assess sensitivity of the measurement of nuchal translucency (NT), for the prenatal screening of congenital heart defect (CHD) on population-based data; (2) examine whether the sensitivity of NT varies for specific types of cardiac defects. Using population-based data of the Paris Registry of Congenital Malformation for 935 fetuses with CHD and without chromosomal anomalies for the period 2001 to 2007, we calculated sensitivity of NT, its positive predictive value and likelihood ratio, for all CHD and for six types of CHD. Sensitivity of NT was 7.1 and 4.2% for the 2.5 and 3.5 mm cut-off values, respectively; when isolated ventricular septal defects were excluded, sensitivity increased to 9.9 and 6.3%. Positive predictive values were 1.1 and 3.2% for 2.5 and 3.5 mm cut-offs, respectively. Of the six defects examined, sensitivity of NT was highest for heterotaxy followed by hypoplastic left heart syndrome and coarctation of aorta. Prevalence of CHD was about fourfold higher for fetuses with NT ≥ 3.5 mm (3.2%) than in the general population. This higher risk is comparable to that of other risk factors commonly used for early referral to specialized echocardiography. Nevertheless, our results, suggest that NT is not a very effective or efficient tool for the prenatal screening of CHD. Copyright © 2011 John Wiley & Sons, Ltd.

  20. Validation of population-based disease simulation models: a review of concepts and methods

    Directory of Open Access Journals (Sweden)

    Sharif Behnam

    2010-11-01

    Full Text Available Abstract Background Computer simulation models are used increasingly to support public health research and policy, but questions about their quality persist. The purpose of this article is to review the principles and methods for validation of population-based disease simulation models. Methods We developed a comprehensive framework for validating population-based chronic disease simulation models and used this framework in a review of published model validation guidelines. Based on the review, we formulated a set of recommendations for gathering evidence of model credibility. Results Evidence of model credibility derives from examining: 1 the process of model development, 2 the performance of a model, and 3 the quality of decisions based on the model. Many important issues in model validation are insufficiently addressed by current guidelines. These issues include a detailed evaluation of different data sources, graphical representation of models, computer programming, model calibration, between-model comparisons, sensitivity analysis, and predictive validity. The role of external data in model validation depends on the purpose of the model (e.g., decision analysis versus prediction. More research is needed on the methods of comparing the quality of decisions based on different models. Conclusion As the role of simulation modeling in population health is increasing and models are becoming more complex, there is a need for further improvements in model validation methodology and common standards for evaluating model credibility.

  1. Population-based dietary approaches for the prevention of noncommunicable diseases.

    Science.gov (United States)

    Somasundaram, Noel P; Kalupahana, Nishan Sudheera

    2016-04-01

    As the incidence of noncommunicable diseases such as diabetes continues to rise at an alarming rate in South-East Asia, it is imperative that urgent and population-wide strategies are adopted. The most important contributors to the rise in noncommunicable disease are a rise in mean caloric intake and a decrease in physical activity. The evidence for population-based dietary approaches to counter these factors is reviewed. Several structural and cohesive interdepartmental coordination efforts are required for effective implementation of prevention strategies. Since low- and middle-income countries may lack the frameworks for effective and integrated multi-stakeholder intervention, implementation of population-based dietary and physical-activity approaches may be delayed and may be too late for effective prevention in current at-risk cohorts. Evidence-based strategies to decrease energy intake and increase physical activity are now well established and their urgent adoption by Member States of the World Health Organization South-East Asia Region is essential. In the context of Sri Lanka, for example, it is recommended that the most effective and easy-to-implement interventions would be media campaigns, restrictions on advertisement of unhealthy foods, taxation of unhealthy foods, subsidies for production of healthy foods, and laws on nutrition labelling that introduce colour coding of packaged foods.

  2. Skeletal measurements among infants who die during the perinatal period: new population-based reference

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, Oeystein E.; Rosendahl, Karen [Department of Radiology, Haukeland University Hospital, 5021 Bergen (Norway); Lie, Rolv T. [Section for Medical Statistics and Medical Birth Registry of Norway, University of Bergen, Bergen (Norway); Maartmann-Moe, Helga [Department of Pathology, Haukeland University Hospital, Bergen (Norway); Pirhonen, Jouko [Department of Obstetrics and Gynaecology, Ullevaal Hospital, University of Oslo, Oslo (Norway); Lachman, Ralph S. [International Skeletal Dysplasia Registry, Cedars-Sinai Medical Center, Los Angeles, California (United States)

    2002-09-01

    Background: Reference data for roentgen skeletal measurements among infants who die during the perinatal period is not available, although it might prove helpful in the study of pre-autopsy radiographs. Objective: Our aim was to define new population-based reference data for skeletal measurements among infants who die during the perinatal period. Materials and methods: We routinely took standardised pre-autopsy radiographs of aborted and stillborn fetuses from 16 weeks gestational age to 7 days after delivery during a period of 11 years in our hospital. The data presented here represents nearly all perinatal deaths in a well-defined geographical area during the study period. We calculated detailed plots of estimated 10th-90th centiles and quartiles of different skeletal measurements by gestational age at death. Results: High correlations were seen between birth weight and the different skeletal measurements, including cranial width (r>0.9, P<0.001). We were not able to identify any asymmetrical pattern of skeletal growth. Reference plots for femoral, tibial, humeral, radial and lumbar spine lengths, and for pelvic width are presented. Conclusions: We suggest that the current population-based reference data might be beneficial, and that skeletal radiographic measurements might contribute substantially in the assessment of fetal growth stage and in detection of skeletal abnormalities in infants who die during the perinatal period. (orig.)

  3. Design of PREVENCION: a population-based study of cardiovascular disease in Peru.

    Science.gov (United States)

    Medina-Lezama, Josefina; Chirinos, Julio A; Zea Díaz, Humberto; Morey, Oscar; Bolanos, Juan F; Munoz-Atahualpa, Edgar; Chirinos-Pacheco, Julio

    2005-11-02

    Latin America is undergoing the epidemiologic transition that occurred earlier in developed countries, and is likely to face a gigantic epidemic of heart disease in the next few years unless urgent action is taken. The first essential component of any effective cardiovascular disease (CVD) control program is to establish reliable estimates of cardiovascular disease-related morbidity and mortality. However, such data from population-based studies in Latin America are still lacking. In this paper, we present the design and operation of PREVENCION (Estudio Peruano de Prevalencia de Enfermedades Cardiovasculares, for Peruvian Study of the Prevalence of Cardiovascular diseases). PREVENCION is an ongoing population-based study on a representative sample of the civilian non-institutionalized population of the second largest city in Peru. Its population is comparable to the rest of the Peruvian urban population and closely resembles other Latin American populations in countries such as Bolivia and Ecuador. Our study will contribute to the enormous task of understanding and preventing CVD in Latin America.

  4. Carvedilol use is associated with reduced cancer risk: A nationwide population-based cohort study.

    Science.gov (United States)

    Lin, Chin-Sheng; Lin, Wei-Shiang; Lin, Cheng-Li; Kao, Chia-Hung

    2015-04-01

    To investigate the effect of carvedilol on the incidence of cancer in a large population-based cohort study. Data were obtained from the Taiwan National Health Insurance Research Database. The cohort study included 6771 patients who received long-term carvedilol treatment between 2000 and 2010 (carvedilol cohort) and 6771 matched controls (noncarvedilol cohort). A Cox proportional hazards model was used to evaluate the risk of cancer in the patients treated with carvedilol. With the mean follow-up period of 5.17 years and 4.93 years in the carvedilol and noncarvedilol cohorts, respectively, the patients in the carvedilol cohort had a 26% reduction of cancer risk compared with those in the noncarvedilol cohort (hazard ratio [HR]=0.74; 95% confidence interval [CI]=0.63-0.87; pcancer site, treatment with carvedilol in the carvedilol cohort resulted in significantly lower incidence of stomach and lung cancers than in the noncarvedilol cohort. This nationwide population-based cohort study demonstrated that long-term treatment with carvedilol is associated with reduced upper gastrointestinal tract and lung cancer risk, indicating that carvedilol could be a potential agent in these cancers prevention. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. "Hardcore" definitions and their application to a population-based sample of smokers.

    Science.gov (United States)

    Costa, Michelle L; Cohen, Joanna E; Chaiton, Michael O; Ip, David; McDonald, Paul; Ferrence, Roberta

    2010-08-01

    As smoking prevalence declines, some suggest that so-called "hardcore" smokers will come to represent a growing and irreducible proportion of current smokers ("hardening hypothesis"). Different definitions of a "hardcore" smoker have been used in the literature. This paper describes population-based definitions of "hardcore" smokers and compares estimates of the prevalence of "hardcore" smokers derived using these definitions. Definitions identified in a comprehensive literature search were reduced to their component constructs. We estimated the prevalence of "hardcore" smokers as a proportion of all current adult smokers in Ontario, Canada, using data from the Ontario Tobacco Survey (2005-2008; N = 4,130). Definition concordance was examined using bivariate cross-tabulations. Six definitions were identified in the literature. Five definitions included constructs of quit intentions and quit attempts, four included nicotine dependence, three included long-term use, and one included a measure of smoker knowledge about smoking hazards and confronting substantial societal disapprobation of smoking. Estimates of "hardcore" smoker prevalence in Ontario based on these definitions ranged from 0.03% to 13.77%. Estimates of the prevalence of "hardcore" smokers in Ontario varied considerably between the six definitions of the "hardcore" smokers found in the population-based literature. This study underscores the need for consensus on the best definition of "hardcore" smoker.

  6. Incidence of sialolithiasis in Denmark: a nationwide population-based register study.

    Science.gov (United States)

    Schrøder, Stine Attrup; Andersson, Mikael; Wohlfahrt, Jan; Wagner, Niels; Bardow, Allan; Homøe, Preben

    2017-04-01

    Sialolithiasis is a frequent disorder affecting the salivary glands. The incidence rate (IR) has been reported to be 2.9-5.5 per 100,000 person-years, but all previous studies have been based on selected hospital data. In this study, we conducted a population-based study evaluating the IR of sialolithiasis and the IR variation according to age, gender and geography in Denmark. We included data from hospitals as well as from private ear, nose and throat (ENT) clinics. The study was based on registry data on all sialolithiasis cases in Denmark between 2003 and 2009 extracted from the Danish National Patient Registry (hospital cohort) and the Danish Regions Centre for Healthcare Statistics (private ENT clinic cohort). To validate the diagnosis, the proportion of visually confirmed cases was estimated based on patient records from subsamples of the two cohorts. The IR was 7.27 and 14.10 per 100,000 person-years based on visually confirmed cases only and on all cases, respectively. The highest IR was observed among 60- to 70-year-olds, in the North Denmark region and among females. In the validation subsamples, 35% of assumed sialoliths were visually confirmed in the private ENT clinic cohort and 59% in the hospital cohort. In this first population-based study of IR on sialolithiasis, we found a substantially higher IR. With respect to both visually confirmed cases and all cases, this is higher than previously reported from studies based on selected hospital data.

  7. Cervical dilation at time of caesarean delivery in nulliparous women: a population-based cohort study.

    Science.gov (United States)

    Riddell, C A; Kaufman, J S; Strumpf, E C; Abenhaim, H A; Hutcheon, J A

    2017-10-01

    Our objective was to describe contemporary practice patterns in the timing of caesarean delivery in relation to cervical dilation, overall and by indication for caesarean. Our secondary objective was to examine how commonly caesarean delivery was performed for labour dystocia at dilations below 4 cm or without the use of oxytocin, overall and between hospitals. Retrospective, population-based cohort study. Ontario, Alberta, and British Columbia, Canada, 2008-2012. Nulliparous women in labour who delivered term singletons in cephalic position. Histograms were used to examine the distribution of cervical dilation at time of caesarean delivery, overall and by indication for caesarean. Funnel plots were used to illustrate variation in hospital-level rates of caesarean deliveries for labour dystocia that were performed early (dilation) or without the use of oxytocin. Cervical dilation (in centimetres) at time of caesarean delivery. The population-based cohort comprised 392 025 women, of whom 18.8% had a caesarean delivery. Of first-stage caesareans for labour dystocia in women who entered labour spontaneously, 13.6% (95% CI 12.9, 14.2) had dilations dilation or without oxytocin varies substantially across hospitals and suggests the need for institutions to review their practices and ensure that management of labour practice guidelines are followed. Many caesareans for labour dystocia are performed early during labour (dilation) or without oxytocin. © 2016 Royal College of Obstetricians and Gynaecologists.

  8. Cardiovascular disease and diagnosis of amyotrophic lateral sclerosis: A population based study.

    Science.gov (United States)

    Kioumourtzoglou, Marianthi-Anna; Seals, Ryan M; Gredal, Ole; Mittleman, Murray A; Hansen, Johnni; Weisskopf, Marc G

    Amyotrophic lateral sclerosis (ALS) is a rapidly fatal neurodegenerative disease of unknown etiology. We investigated the association between ALS diagnosis and prior cardiovascular disease (CVD), and CVD-specific, hospital admissions in the Danish population. We conducted a population based nested case-control study, including 3182 Danish residents diagnosed with ALS at age ≥20 years (1982-2009) and 100 randomly selected controls for each case, matched on age, gender and vital status. We estimated odds ratios (OR) associated with CVD, and CVD-specific hospital admissions, adjusting for socioeconomic and marital status, region of residence and past diabetes and obesity diagnoses. The estimated adjusted OR for any CVD admission at least three years prior to the date of ALS diagnosis was 1.15 (95% CI 1.04-1.27). Our results varied across cause-specific admissions; for atherosclerosis the OR was 1.36 (95% CI 1.02-1.80) and for ischemic heart disease 1.14 (95% CI 0.99-1.31), while we observed no association with hypertensive and cerebrovascular diseases. Adjusting for or stratifying by COPD status, a cigarette-smoking correlate, did not change our results. In conclusion, in our population based study we found evidence for a moderately elevated association with CVD that was stronger for specific conditions, such as atherosclerosis. Our findings may have important implications for ALS pathogenesis.

  9. A population-based cohort study of breastfeeding according to gestational age at term delivery.

    Science.gov (United States)

    Lutsiv, Olha; Giglia, Lucia; Pullenayegum, Eleanor; Foster, Gary; Vera, Claudio; Chapman, Barbara; Fusch, Christoph; McDonald, Sarah D

    2013-11-01

    Because breastfeeding is the optimal form of infant feeding, this study was conducted to determine the effect of gestational age on breastfeeding in term infants. A retrospective population-based cohort study of singleton/twin hospital births was conducted in Ontario, Canada between April 1, 2009, and March 31, 2010. Multivariate logistic regression was used to determine the adjusted effect of gestational age on breastfeeding. Our study population comprised 92,364 infants, of whom 80,297 (86.9%) were exclusively or partially breastfed at the time of hospital discharge. Multivariate logistic regression analyses demonstrated that early-term infants had lower odds of being breastfed compared with infants born at 41 weeks gestation (40 weeks: aOR, 0.93; 95% CI, 0.86-0.99; 39 weeks: aOR, 0.87; 95% CI, 0.81-0.93; 38 weeks: aOR, 0.81; 95% CI, 0.75-0.88; 37 weeks: aOR, 0.74; 95% CI, 0.67-0.82). Using a population-based approach, we found that infants born at 40, 39, 38, and 37 weeks gestation had increasingly lower odds of being breastfed compared with infants born at 41 weeks. Clinicians need to be made aware of the differences in outcomes of infants delivered at early and late term, so that appropriate breastfeeding support can be provided to women at risk for not breastfeeding. Copyright © 2013 Mosby, Inc. All rights reserved.

  10. What is the most cost-effective population-based cancer screening program for Chinese women?

    Science.gov (United States)

    Woo, Pauline P S; Kim, Jane J; Leung, Gabriel M

    2007-02-20

    To develop a policy-relevant generalized cost-effectiveness (CE) model of population-based cancer screening for Chinese women. Disability-adjusted life-years (DALYs) averted and associated screening and treatment costs under population-based screening using cervical cytology (cervical cancer), mammography (breast cancer), and fecal occult blood testing (FOBT), sigmoidoscopy, FOBT plus sigmoidoscopy, or colonoscopy (colorectal cancer) were estimated, from which average and incremental CE ratios were generated. Probabilistic sensitivity analysis was undertaken to assess stochasticity, parameter uncertainty, and model assumptions. Cervical, breast, and colorectal cancers were together responsible for 13,556 DALYs (in a 1:4:3 ratio, respectively) in Hong Kong's 3.4 million female population annually. All status quo strategies were dominated, thus confirming the suboptimal efficiency of opportunistic screening. Current patterns of screening averted 471 DALYs every year, which could potentially be more than doubled to 1,161 DALYs under the same screening and treatment budgetary threshold of US $50 million with 100% Pap coverage every 4 years and 30% coverage of colonoscopy every 10 years. With higher budgetary caps, biennial mammographic screening starting at age 50 years can be introduced. Our findings have informed how best to achieve allocative efficiency in deploying scarce cancer care dollars but must be coupled with better integrated care planning, improved intersectoral coordination, increased resources, and stronger political will to realize the potential health and economic gains as demonstrated.

  11. Insulin resistance, the metabolic syndrome, and risk of incident cardiovascular disease: a population-based study

    DEFF Research Database (Denmark)

    Jeppesen, Jørgen; Hansen, Tine Willum; Rasmussen, Susanne

    2007-01-01

    OBJECTIVES: The goal was to clarify if insulin resistance (IR) would predict cardiovascular disease (CVD) independent of the metabolic syndrome (MetSyn). BACKGROUND: Although the cause of MetSyn is not well defined, IR has been proposed to be an important cause. Only a small number of population......-based studies have sought to clarify if IR predicts CVD independent of MetSyn. METHODS: This was a prospective Danish population-based study of 2,493 men and women, age 41 to 72 years, without major CVD at baseline. We defined MetSyn according to both the International Diabetes Foundation (IDF) and the National......, and NCEP-HOMA-IR as belonging to the highest 16% of the HOMA-IR distribution. RESULTS: Over a median follow-up of 9.4 years, the incidence of CV end points (CV death, nonfatal ischemic heart disease, and nonfatal stroke) amounted to 233 cases. In proportional hazard models, adjusting for age, gender...

  12. Impact of preoperative chronic renal failure on liver transplantation: a population-based cohort study

    Directory of Open Access Journals (Sweden)

    Chung PC

    2016-12-01

    Full Text Available Peter Chi-Ho Chung,1,2 Hsiu-Pin Chen,1,2 Jr-Rung Lin,3,4 Fu-Chao Liu,1,2 Huang-Ping Yu1,2 1Department of Anesthesiology, Chang Gung Memorial Hospital, 2College of Medicine, 3Clinical Informatics and Medical Statistics Research Center, 4Graduate Institute of Clinical Medicine, Chang Gung University, Taoyuan, Taiwan Purpose: The purpose of this study was to assess whether preoperative chronic renal failure (CRF affects the rates of postoperative complications and survival after liver transplantation. Methods: This population-based retrospective cohort study included 2,931 recipients of liver transplantation performed between 1998 and 2012, enrolled from the Taiwan National Health Insurance Research Database. Patients were divided into two groups, based on the presence or absence of preoperative CRF. Results: The overall estimated survival rate of liver transplantation recipients (LTRs with preoperative CRF was significantly lower than that of patients without preoperative CRF (P=0.0085. There was no significant difference between the groups in terms of duration of intensive care unit stay, total hospital stay, bacteremia, postoperative bleeding, and pneumonia during hospitalization. Long-term adverse effects, including cerebrovascular disease and coronary heart disease, were not different between patients with versus without CRF. Conclusion: These findings suggest that LTRs with preoperative CRF have a higher rate of mortality. Keywords: chronic renal failure, cohort study, survival rate, liver transplantation, population-based study

  13. Population-based characteristics of fatal and hospital admissions for poisoning in Fiji: TRIP Project-11

    Science.gov (United States)

    Peiris-John, Roshini; Kafoa, Berlin; Wainiqolo, Iris; Reddy, Ravi Krishnan; McCaig, Eddie; Ameratunga, Shanthi N

    2013-01-01

    This study investigated the incidence and characteristics of poisoning fatalities and hospital admissions among indigenous Fijians and Indians in Viti Levu, Fiji. Individuals with a mechanism of injury classified as poisoning were identified using the Fiji injury surveillance in hospitals system, a population-based registry established for 12 months in Viti Levu, and analysed using population-based denominators. The mean annual rates of fatalities and hospitalisations were 2.3 and 26.0 per 100 000, respectively. Over two-thirds of poisonings occurred among people of Indian ethnicity. Most intentional poisoning admissions occurred among women (58.3%) and in 15–29-year-old individuals (73.8%). Unintentional poisoning admission rates were highest among Indian boys aged 0–14 years. While over 75% of events occurred at home, the substances involved were not systematically identified. The findings indicate the need for a strategy that addresses the differing contexts across age group, gender and ethnicity, and a lead agency responsible for implementing and monitoring its effectiveness. PMID:23353079

  14. Colonoscopy and flexible sigmoidoscopy practice patterns in Ontario: a population-based study.

    Science.gov (United States)

    Schultz, Susan E; Vinden, Chris; Rabeneck, Linda

    2007-07-01

    To conduct a population-based study on the provision of large bowel endoscopic services in Ontario. Data from the following databases were analyzed: the Ontario Health Insurance Plan, the Institute for Clinical Evaluative Sciences Physicians Database and Statistics Canada. The flexible sigmoidoscopy and colonoscopy rates per 10,000 persons (50 to 74 years of age) by region between April 1, 2001, and March 31, 2002, were calculated, as well as the numbers and types of physicians who performed each procedure. In 2001/2002, a total of 172,108 colonoscopies and 43,400 flexible sigmoidoscopies were performed in Ontario for all age groups. The colonoscopy rate was approximately five times that of flexible sigmoidoscopy; rates varied from 463.1 colonoscopies per 10,000 people in the north to 286.8 colonoscopies per 10,000 people in the east. Gastroenterologists in all regions tended to perform more procedures per physician, but because of the large number of general surgeons, the total number of procedures performed by each group was almost the same. Population-based rates of colonoscopies and flexible sigmoidoscopies are low in Ontario, as are the procedure volumes of approximately one-quarter of physicians.

  15. Determinants of change in polypharmacy status in Switzerland: the population-based CoLaus study.

    Science.gov (United States)

    Abolhassani, Nazanin; Castioni, Julien; Marques-Vidal, Pedro; Vollenweider, Peter; Waeber, Gérard

    2017-09-01

    This study aimed to assess the prevalence, the change, and the determinants of change in polypharmacy in a population-based sample. Baseline (2003-2006) and follow-up (2009-2012) data are from 4679 participants aged between 35 and 75 years (53.5% women, mean age 52.6 ± 10.6 years) from the population of Lausanne, Switzerland. Polypharmacy was defined by the regular use of ≥5 drugs. Four categories of change were defined: never (no polypharmacy at baseline and follow-up), initiating (no polypharmacy at baseline but at follow-up), maintaining, or quitting. Polypharmacy increased from 7.7% at baseline to 15.3% at follow-up. Cardiovascular drugs were the most prescribed medicines at baseline and follow-up. Gender, age, obesity, smoking, previously diagnosed hypertension, or diabetes or dyslipidemia were significantly and independently associated with initiating and maintaining polypharmacy. In a population-based sample, prevalence of polypharmacy doubled over a 5.6-year period. The main determinants of initiating polypharmacy were age, overweight and obesity, smoking status, and previously diagnosed cardiovascular risk factors.

  16. The International Adoption Project: population-based surveillance of Minnesota parents who adopted children internationally.

    Science.gov (United States)

    Hellerstedt, Wendy L; Madsen, Nikki J; Gunnar, Megan R; Grotevant, Harold D; Lee, Richard M; Johnson, Dana E

    2008-03-01

    To conduct the first population-based surveillance in the United States of parents who adopted children from countries outside of the United States. A 556-item survey was mailed to 2,977 parents who finalized an international adoption in Minnesota between January 1990 and December 1998; 1,834 (62%) parents returned a survey. Eighty-eight percent of the parents reported transracial adoptions (97% of the parents were white); 57% of the adopted children were Asian; 60% were female; and on average, the children were 18 months-old at the time of placement. Only 15% of the parents reported household annual incomes less than $50,000 and 71% reported they had college educations. Sixty-one percent traveled to their child's country of birth prior to the adoption. Almost three-quarters involved their children in experiences related to their birth countries and 98% would recommend international adoption. Three-quarters of the parents believe that parental leave was an issue for them as they adopted. This is the first population-based survey of U.S. parents who have adopted internationally. The adoptive parents were socioeconomically different than birth parents in Minnesota and their families are most likely to be transracial. Because international adoption has become more prevalent, it is important to understand the strengths and needs of families that are created through this unique form of migration.

  17. Low frequency of defective mismatch repair in a population-based series of upper urothelial carcinoma

    Directory of Open Access Journals (Sweden)

    Isfoss Björn L

    2005-03-01

    Full Text Available Abstract Background Upper urothelial cancer (UUC, i.e. transitional cell carcinomas of the renal pelvis and the ureter, occur at an increased frequency in patients with hereditary nonpolyposis colorectal cancer (HNPCC. Defective mismatch repair (MMR specifically characterizes HNPCC-associated tumors, but also occurs in subsets of some sporadic tumors, e.g. in gastrointestinal cancer and endometrial cancer. Methods We assessed the contribution of defective MMR to the development of UUC in a population-based series from the southern Swedish Cancer Registry, through microsatellite instability (MSI analysis and immunohistochemical evaluation of expression of the MMR proteins MLH1, PMS2, MSH2, and MSH6. Results A MSI-high phenotype was identified in 9/216 (4% successfully analyzed patients and a MSI-low phenotype in 5/216 (2%. Loss of MMR protein immunostaining was found in 11/216 (5% tumors, and affected most commonly MSH2 and MSH6. Conclusion This population-based series indicates that somatic MMR inactivation is a minor pathway in the development of UUC, but tumors that display defective MMR are, based on the immunohistochemical expression pattern, likely to be associated with HNPCC.

  18. Population-Based Study of Sleep Apnea in Pregnancy and Maternal and Infant Outcomes.

    Science.gov (United States)

    Bin, Yu Sun; Cistulli, Peter A; Ford, Jane B

    2016-06-15

    To examine the association between sleep apnea and pregnancy outcomes in a large population-based cohort. Population-based cohort study using linked birth and hospital records was conducted in New South Wales, Australia. Participants were all women who gave birth from 2002 to 2012 (n = 636,227). Sleep apnea in the year before pregnancy or during pregnancy was identified from hospital records. Outcomes of interest were gestational diabetes, pregnancy hypertension, planned delivery, caesarean section, preterm birth, perinatal death, 5-minute Apgar score, admission to neonatal intensive care or special care nursery, and infant size for gestational age. Maternal outcomes were identified using a combination of hospital and birth records. Infant outcomes came from the birth record. Modified Poisson regression models were used to examine associations between sleep apnea and each outcome taking into account maternal age, country of birth, socioeconomic disadvantage, smoking, obesity, parity, pre-existing diabetes and hypertension. Sleep apnea was significantly associated with pregnancy hypertension (adjusted RR 1.43; 95% CI 1.18-1.73), planned delivery (1.15; 1.07-1.23), preterm birth (1.50; 1.21-1.84), 5-minute Apgar Sleep apnea is associated with higher rates of obstetric complications and intervention, as well as preterm delivery. Future research should examine if these are independent of obstetric history. © 2016 American Academy of Sleep Medicine.

  19. Pubertal trajectory in females with Rett syndrome: a population-based study.

    Science.gov (United States)

    Knight, Olivia; Bebbington, Ami; Siafarikas, Aris; Woodhead, Helen; Girdler, Sonya; Leonard, Helen

    2013-11-01

    Rett syndrome is a severe genetic neurodevelopmental disorder mainly affecting females. The aim of this study was to describe pubertal development in a population-based cohort of females with Rett syndrome. To assess pubertal trajectory we used six waves of data provided by parents of girls and women, recruited through the Australian population-based Rett Syndrome Database. The age at which adrenarche, thelarche or menarche occurred was used as the parameter for time to event (survival) analysis. The relationships between BMI, mutation type and the trajectories were investigated, using Cox proportional hazards. One quarter of girls reached adrenarche by 9.6 years, half by 11 years and three quarters by 12.6 years. Half reached menarche by 14 years (range 8-23). Being underweight was associated with later age at adrenarche, thelarche and menarche, while higher BMI (overweight) was associated with earlier onset. In general, girls with C-terminal deletions and early truncating mutations reached pubertal stages earlier and those with the p.R168X mutation reached them later. The pubertal course in Rett syndrome may be abnormal, sometimes with early adrenarche but delayed menarche. These features may be genotype dependent and may have varying relationships with growth and bone acquisition. Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  20. Smoldering multiple myeloma risk factors for progression: a Danish population-based cohort study.

    Science.gov (United States)

    Sørrig, Rasmus; Klausen, Tobias W; Salomo, Morten; Vangsted, Annette J; Østergaard, Brian; Gregersen, Henrik; Frølund, Ulf Christian; Andersen, Niels F; Helleberg, Carsten; Andersen, Kristian T; Pedersen, Robert S; Pedersen, Per; Abildgaard, Niels; Gimsing, Peter

    2016-09-01

    Several risk scores for disease progression in patients with smoldering multiple myeloma (SMM) have been proposed; however, all have been developed using single-center registries. To examine risk factors for time to progression (TTP) to multiple myeloma (MM) for SMM, we analyzed a nationwide population-based cohort of 321 patients with newly diagnosed SMM registered within the Danish Multiple Myeloma Registry between 2005 and 2014. Significant univariable risk factors for TTP were selected for multivariable Cox regression analyses. We found that both an M-protein ≥30 g/L and immunoparesis significantly influenced TTP (HR 2.7, 95%CI (1.5;4.7), P = 0.001, and HR 3.3, 95%CI (1.4;7.8), P = 0.002, respectively). High free light chain (FLC) ratio did not significantly influence TTP in our cohort. Therefore, our data do not support recent IMWG proposal of identifying patients with FLC ratio above 100 as having ultra high-risk of transformation to MM. Using only immunoparesis and M-protein ≥30 g/L, we created a scoring system to identify low-, intermediate-, and high-risk SMM. This first population-based study of patients with SMM confirms that an M-protein ≥30 g/L and immunoparesis remain important risk factors for progression to MM. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Invasive aspergillosis: results of multicenter study

    Directory of Open Access Journals (Sweden)

    N. N. Klimko

    2014-09-01

    Full Text Available We present the results of a multicenter study of 445 patients with “proven” and “probable” invasive aspergillosis (EORTC/MSG, 2008. Invasive aspergillosis usually occurs in patients with hematological malignancies (88 %, main underlying diseases were acute myeloid and acute lymphoblastic leukemia. The risk factors: prolonged agranulocytosis (64 %, cytostatic chemotherapy (57 %, corticosteroid treatment (45 %, and allogeneic hematopoietic stem cells transplantation (29 %. The pathogens – A. fumigatus (42 %, A. niger (33 %, and A. flavus (21 %. The main site of infection were lungs (86 %. 12 week overall survival was 83 %. Bronchoscopy use for the early diagnosis (p = 0.01, adequatetherapy with voriconazole (p = 0.002 and secondary antifungal prophylaxis (p = 0.0003 were positive prognostic factors for survival of patients with invasive aspergillosis.

  2. Educating in European Identity?

    National Research Council Canada - National Science Library

    Enrique Banús

    2007-01-01

    In the last decades, the claim for a "European identity" has been manifested sometimes as a solution for the citizens' distance to the European project, sometimes also as a precondition for a further...

  3. Prevalence of refractive error in Europe: the European Eye Epidemiology (E3) Consortium

    NARCIS (Netherlands)

    K.M. Williams (Katie M.); V.J.M. Verhoeven (Virginie); P. Cumberland (Phillippa); G. Bertelsen (Geir); C. Wolfram (Christian); G.H.S. Buitendijk (Gabrielle); A. Hofman (Albert); C.M. van Duijn (Cornelia); J.R. Vingerling (Hans); R.W.A.M. Kuijpers (Robert); R. Höhn (René); A. Mirshahi (Alireza); A.P. Khawaja (Anthony P.); R.N. Luben (Robert N.); M.G. Erke (Maja Gran); T. Von Hanno (Therese); O. Mahroo (Omar); R. Hogg (Ruth); C. Gieger (Christian); A. Cougnard-Grégoire (Audrey); E. Anastasopoulos (Eleftherios); A. Bron (Alain); J.-F. Dartigues; J.-F. Korobelnik (Jean-François); C. Creuzot-Garcher (Catherine); F. Topouzis (Fotis); C. Delcourt (Cécile); J.S. Rahi (Jugnoo); T. Meitinger (Thomas); A. Fletcher (Astrid); P.J. Foster (Paul J.); N. Pfeiffer (Norbert); C.C.W. Klaver (Caroline); C.J. Hammond (Christopher)

    2015-01-01

    textabstractTo estimate the prevalence of refractive error in adults across Europe. Refractive data (mean spherical equivalent) collected between 1990 and 2013 from fifteen population-based cohort and cross-sectional studies of the European Eye Epidemiology (E3) Consortium were combined in a random

  4. Prevalence of Contact Allergy to p-Phenylenediamine in the European General Population

    NARCIS (Netherlands)

    Diepgen, Thomas L.; Naldi, Luigi; Bruze, Magnus; Cazzaniga, Simone; Schuttelaar, Marie-Louise; Elsner, Peter; Goncalo, Margarida; Ofenloch, Robert; Svensson, Ake

    Population-based studies on contact allergy to p-phenylenediamine (PPD) are scarce. A cross-sectional study was performed to assess the prevalence of contact allergy to PPD and its risk factors in the general population of 5 European countries. A total of 10,425 subjects were interviewed, and a

  5. European breast cancer service screening outcomes: a first balance sheet of the benefits and harms

    NARCIS (Netherlands)

    Paci, E.; Broeders, M.J.M.; Hofvind, S.; Puliti, D.; Duffy, S.W.

    2014-01-01

    A recent comprehensive review has been carried out to quantify the benefits and harms of the European population-based mammographic screening programs. Five literature reviews were conducted on the basis of the observational published studies evaluating breast cancer mortality reduction, breast

  6. Cross-national differences in grip strength among 50+ year old Europeans

    DEFF Research Database (Denmark)

    Andersen-Ranberg, Karen; Petersen, Inge; Frederiksen, Henrik

    2009-01-01

    with higher rates of functional decline and mortality, and thus may be used as a health indicator, it is of interest to examine whether the results on extremely old can be reproduced in a large-scale European survey. GS was measured in a cross-sectional population-based sample of 27,456 individuals aged 50...

  7. The Incidence and Risk of Herpes Zoster in Patients With Sleep Disorders: A Population-Based Cohort Study

    National Research Council Canada - National Science Library

    Chung, Wei-Sheng; Lin, Hsuan-Hung; Cheng, Nan-Cheng

    2016-01-01

    .... Studies on sleep disorders and the risk of herpes zoster (HZ) are scant.We conducted a population-based cohort study to evaluate the risk of HZ in patients with sleep disorders and potential risk factors for HZ development...

  8. Exposure to residential radon and lung cancer in Spain: a population-based case-control study

    National Research Council Canada - National Science Library

    Barros-Dios, Juan Miguel; Barreiro, María Amparo; Ruano-Ravina, Alberto; Figueiras, Adolfo

    2002-01-01

    ... exposure display inconsistencies. The authors therefore decided to conduct a population-based case-control study in northwest Spain to determine the risk of lung cancer associated with exposure to residential radon...

  9. Global 15 x 15 Minute Grids of the Downscaled Population Based on the SRES B2 Scenario, 1990 and 2025

    Data.gov (United States)

    National Aeronautics and Space Administration — The Global 15x15 Minute Grids of the Downscaled Population Based on the Special Report on Emissions Scenarios (SRES) B2 Scenario, 1990 and 2025, are geospatial...

  10. Sexual Behaviors and HIV Status: A Population-Based Study Among Older Adults in Rural South Africa

    National Research Council Canada - National Science Library

    Rosenberg, Molly S; Gómez-Olivé, Francesc X; Rohr, Julia K; Houle, Brian C; Kabudula, Chodziwadziwa W; Wagner, Ryan G; Salomon, Joshua A; Kahn, Kathleen; Berkman, Lisa F; Tollman, Stephen M; Bärnighausen, Till

    2017-01-01

    .... METHODS:We analyzed data from a population-based sample of 5059 men and women aged 40 years and older from the study Health and Aging in AfricaLongitudinal Studies of INDEPTH Communities (HAALSI...

  11. A Population-Based Study on Comorbidity in Children with Severe Motor and Intellectual Disabilities: Focus on Feasibility and Prevalence

    NARCIS (Netherlands)

    R.J.G. Veugelers (Rebekka)

    2006-01-01

    textabstractComorbidity is common in children with severe motor and intellectual disabilities (SMID). We performed a population-based study in 196 children with SMID, focusing on respiratory infections, respiratory function, constipation, dysphagia, gastro-oesophageal reflux and nutritional

  12. Oncogenic human papillomavirus genital infection in southern Iranian women: population-based study versus clinic-based data

    National Research Council Canada - National Science Library

    Eghbali, Seyed Sajjad; Amirinejad, Roya; Obeidi, Narges; Mosadeghzadeh, Shiva; Vahdat, Katayoun; Azizi, Fatemeh; Pazoki, Raha; Sanjdideh, Zahra; Amiri, Zahra; Nabipour, Iraj; Zandi, Keivan

    2012-01-01

    ... for developing the strategies to prevent the primary and secondary cervical cancer. In different parts of Iran, there is a lack of population-based studies to determine the prevalence of HPV in the general population...

  13. Exposure to ambient air pollution and the incidence of dementia: A population-based cohort study.

    Science.gov (United States)

    Chen, Hong; Kwong, Jeffrey C; Copes, Ray; Hystad, Perry; van Donkelaar, Aaron; Tu, Karen; Brook, Jeffrey R; Goldberg, Mark S; Martin, Randall V; Murray, Brian J; Wilton, Andrew S; Kopp, Alexander; Burnett, Richard T

    2017-11-01

    Emerging studies have implicated air pollution in the neurodegenerative processes. Less is known about the influence of air pollution, especially at the relatively low levels, on developing dementia. We conducted a population-based cohort study in Ontario, Canada, where the concentrations of pollutants are among the lowest in the world, to assess whether air pollution exposure is associated with incident dementia. The study population comprised all Ontario residents who, on 1 April 2001, were 55-85years old, Canadian-born, and free of physician-diagnosed dementia (~2.1 million individuals). Follow-up extended until 2013. We used population-based health administrative databases with a validated algorithm to ascertain incident diagnosis of dementia as well as prevalent cases. Using satellite observations, land-use regression model, and an optimal interpolation method, we derived long-term average exposure to fine particulate matter (≤2.5μm in diameter) (PM 2.5 ), nitrogen dioxide (NO 2 ), and ozone (O 3 ), respectively at the subjects' historical residences based on a population-based registry. We used multilevel spatial random-effects Cox proportional hazards models, adjusting for individual and contextual factors, such as diabetes, brain injury, and neighborhood income. We conducted various sensitivity analyses, such as lagging exposure up to 10years and considering a negative control outcome for which no (or weaker) association with air pollution is expected. We identified 257,816 incident cases of dementia in 2001-2013. We found a positive association between PM 2.5 and dementia incidence, with a hazard ratio (HR) of 1.04 (95% confidence interval (CI): 1.03-1.05) for every interquartile-range increase in exposure to PM 2.5 . Similarly, NO 2 was associated with increased incidence of dementia (HR=1.10; 95% CI: 1.08-1.12). No association was found for O 3 . These associations were robust to all sensitivity analyses examined. These estimates translate to 6.1% of

  14. Cardiovascular Disease Risk in a Large, Population-Based Cohort of Breast Cancer Survivors

    Energy Technology Data Exchange (ETDEWEB)

    Boekel, Naomi B.; Schaapveld, Michael [Epidemiology, Netherlands Cancer Institute, Amsterdam (Netherlands); Gietema, Jourik A. [Medical Oncology, University Medical Center Groningen, Groningen (Netherlands); Russell, Nicola S. [Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands); Poortmans, Philip [Radiation Oncology, Institute Verbeeten, Tilburg (Netherlands); Radiation Oncology, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Theuws, Jacqueline C.M. [Radiotherapy, Catharina Hospital Eindhoven, Eindhoven (Netherlands); Schinagl, Dominic A.X. [Radiation Oncology, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Rietveld, Derek H.F. [Radiation Oncology, VU University Medical Center Amsterdam, Amsterdam (Netherlands); Versteegh, Michel I.M. [Steering Committee Cardiac Interventions Netherlands, Leiden University Medical Center, Leiden (Netherlands); Visser, Otto [Registration and Research, Comprehensive Cancer Center The Netherlands, Utrecht (Netherlands); Rutgers, Emiel J.T. [Surgery, Netherlands Cancer Institute, Amsterdam (Netherlands); Aleman, Berthe M.P. [Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands); Leeuwen, Flora E. van, E-mail: f.v.leeuwen@nki.nl [Epidemiology, Netherlands Cancer Institute, Amsterdam (Netherlands)

    2016-04-01

    Purpose: To conduct a large, population-based study on cardiovascular disease (CVD) in breast cancer (BC) survivors treated in 1989 or later. Methods and Materials: A large, population-based cohort comprising 70,230 surgically treated stage I to III BC patients diagnosed before age 75 years between 1989 and 2005 was linked with population-based registries for CVD. Cardiovascular disease risks were compared with the general population, and within the cohort using competing risk analyses. Results: Compared with the general Dutch population, BC patients had a slightly lower CVD mortality risk (standardized mortality ratio 0.92, 95% confidence interval [CI] 0.88-0.97). Only death due to valvular heart disease was more frequent (standardized mortality ratio 1.28, 95% CI 1.08-1.52). Left-sided radiation therapy after mastectomy increased the risk of any cardiovascular event compared with both surgery alone (subdistribution hazard ratio (sHR) 1.23, 95% CI 1.11-1.36) and right-sided radiation therapy (sHR 1.19, 95% CI 1.04-1.36). Radiation-associated risks were found for not only ischemic heart disease, but also for valvular heart disease and congestive heart failure (CHF). Risks were more pronounced in patients aged <50 years at BC diagnosis (sHR 1.48, 95% CI 1.07-2.04 for left- vs right-sided radiation therapy after mastectomy). Left- versus right-sided radiation therapy after wide local excision did not increase the risk of all CVD combined, yet an increased ischemic heart disease risk was found (sHR 1.14, 95% CI 1.01-1.28). Analyses including detailed radiation therapy information showed an increased CVD risk for left-sided chest wall irradiation alone, left-sided breast irradiation alone, and internal mammary chain field irradiation, all compared with right-sided breast irradiation alone. Compared with patients not treated with chemotherapy, chemotherapy used ≥1997 (ie, anthracyline-based chemotherapy) increased the risk of CHF (sHR 1.35, 95% CI 1

  15. Latent variable mixture models to test for differential item functioning: a population-based analysis.

    Science.gov (United States)

    Wu, Xiuyun; Sawatzky, Richard; Hopman, Wilma; Mayo, Nancy; Sajobi, Tolulope T; Liu, Juxin; Prior, Jerilynn; Papaioannou, Alexandra; Josse, Robert G; Towheed, Tanveer; Davison, K Shawn; Lix, Lisa M

    2017-05-15

    Comparisons of population health status using self-report measures such as the SF-36 rest on the assumption that the measured items have a common interpretation across sub-groups. However, self-report measures may be sensitive to differential item functioning (DIF), which occurs when sub-groups with the same underlying health status have a different probability of item response. This study tested for DIF on the SF-36 physical functioning (PF) and mental health (MH) sub-scales in population-based data using latent variable mixture models (LVMMs). Data were from the Canadian Multicentre Osteoporosis Study (CaMos), a prospective national cohort study. LVMMs were applied to the ten PF and five MH SF-36 items. A standard two-parameter graded response model with one latent class was compared to multi-class LVMMs. Multivariable logistic regression models with pseudo-class random draws characterized the latent classes on demographic and health variables. The CaMos cohort consisted of 9423 respondents. A three-class LVMM fit the PF sub-scale, with class proportions of 0.59, 0.24, and 0.17. For the MH sub-scale, a two-class model fit the data, with class proportions of 0.69 and 0.31. For PF items, the probabilities of reporting greater limitations were consistently higher in classes 2 and 3 than class 1. For MH items, respondents in class 2 reported more health problems than in class 1. Differences in item thresholds and factor loadings between one-class and multi-class models were observed for both sub-scales. Demographic and health variables were associated with class membership. This study revealed DIF in population-based SF-36 data; the results suggest that PF and MH sub-scale scores may not be comparable across sub-groups defined by demographic and health status variables, although effects were frequently small to moderate in size. Evaluation of DIF should be a routine step when analysing population-based self-report data to ensure valid comparisons amongst sub-groups.

  16. Estimating the variance of cancer prevalence from population-based registries.

    Science.gov (United States)

    Gigli, Anna; Mariotto, Angela; Clegg, Limin X; Tavilla, Andrea; Corazziari, Isabella; Capocaccia, Riccardo; Hachey, Mark; Steve, Scoppa

    2006-06-01

    Cancer prevalence is the proportion of people in a population diagnosed with cancer in the past and still alive. One way to estimate prevalence is via population-based registries, where data on diagnosis and life status of all incidence cases occurring in the covered population are collected. In this paper, a method to estimate the complete prevalence and its variance from population-based registries is presented. In order to obtain unbiased estimates of the complete prevalence, its calculation can be thought as made by three steps. Step 1 counts the incidence cases diagnosed during the period of registration and still alive. Step 2 estimates the expected number of survivors among cases lost to follow-up. Step 3 estimates the complete prevalence by taking into account cases diagnosed before the start of registration. The combination of steps 1+2 is defined as the counting method, to estimate the limited duration prevalence; step 3 is the completeness index method, to estimate the complete prevalence. For early established registries, steps 1+2 are more important than step 3, because observation time is long enough to include all past diagnosed cases still alive in the prevalence data. For more recently established registries, step 3 is by far the most critical because a large part of prevalence might have been diagnosed before the period of registration (Corazziari I, Mariotto A, Capocaccia R. Correcting the completeness bias of observed prevalence. Tumori 1999; 85: 370-81). The work by Clegg LX, Gail MH, Feuer EJ. Estimating the variance of disease-prevalence estimates from population-based registries. Biometrics 2002; 55: 1137-44. considers the problem of the variability of the estimated prevalence up to step 2. To our knowledge, no other work has considered the variability induced by correcting for the unobserved cases diagnosed before the period of registration, crucial to estimate the prevalence in recent registries. An analytic approach is considered to

  17. Brain Metastases in Newly Diagnosed Breast Cancer: A Population-Based Study.

    Science.gov (United States)

    Martin, Allison M; Cagney, Daniel N; Catalano, Paul J; Warren, Laura E; Bellon, Jennifer R; Punglia, Rinaa S; Claus, Elizabeth B; Lee, Eudocia Q; Wen, Patrick Y; Haas-Kogan, Daphne A; Alexander, Brian M; Lin, Nancy U; Aizer, Ayal A

    2017-08-01

    Population-based estimates of the incidence and prognosis of brain metastases at diagnosis of breast cancer are lacking. To characterize the incidence proportions and median survivals of patients with breast cancer and brain metastases at the time of cancer diagnosis. Patients with breast cancer and brain metastases at the time of diagnosis were identified using the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute. Data were stratified by subtype, age, sex, and race. Multivariable logistic and Cox regression were performed to identify predictors of the presence of brain metastases at diagnosis and factors associated with all-cause mortality, respectively. For incidence, we identified a population-based sample of 238 726 adult patients diagnosed as having invasive breast cancer between 2010 and 2013 for whom the presence or absence of brain metastases at diagnosis was known. Patients diagnosed at autopsy or with an unknown follow-up were excluded from the survival analysis, leaving 231 684 patients in this cohort. Incidence proportion and median survival of patients with brain metastases and newly diagnosed breast cancer. We identified 968 patients with brain metastases at the time of diagnosis of breast cancer, representing 0.41% of the entire cohort and 7.56% of the subset with metastatic disease to any site. A total of 57 were 18 to 40 years old, 423 were 41 to 60 years old, 425 were 61-80 years old, and 63 were older than 80 years. Ten were male and 958 were female. Incidence proportions were highest among patients with hormone receptor (HR)-negative human epidermal growth factor receptor 2 (HER2)-positive (1.1% among entire cohort, 11.5% among patients with metastatic disease to any distant site) and triple-negative (0.7% among entire cohort, 11.4% among patients with metastatic disease to any distant site) subtypes. Median survival among the entire cohort with brain metastases was 10.0 months. Patients with HR

  18. Hypothyroidism and Risk of Mild Cognitive Impairment in Elderly Persons - A Population Based Study

    Science.gov (United States)

    Parsaik, Ajay K; Singh, Balwinder; Roberts, Rosebud O; Pankratz, Shane; Edwards, Kelly K.; Geda, Yonas E; Gharib, H; Boeve, Bradley F; Knopman, David S; Petersen, Ronald C

    2014-01-01

    IMPORTANCE Association of clinical and subclinical hypothyroidism with mild cognitive impairment (MCI) is not established. OBJECTIVE To evaluate the association of clinical and subclinical hypothyroidism with MCI in a large population based cohort. DESIGN A cross-sectional, population-based study. SETTING Olmsted County, Minnesota. PARTICIPANTS Randomly selected participants were aged 70 to 89 years on October 1, 2004, and were without documented prevalent dementia. A total of 2,050 participants were evaluated and underwent in-person interview, neurological evaluation and neuropsychological testing to assess performance in memory, attention/executive function, visuospatial, and language domains. Subjects were diagnosed by consensus as cognitively normal, MCI or dementia according to published criteria. Clinical and subclinical hypothyroidism was ascertained from a medical records-linkage system. MAIN OUTCOME MEASURES Association of clinical and subclinical hypothyroidism with MCI. Results Among 1904 eligible participants, the frequency of MCI was 16% in 1450 subjects with normal thyroid function, 17% in 313 subjects with clinical hypothyroidism, and 18% in 141 subjects with subclinical hypothyroidism. After adjusting for covariates (age, gender, education, education years, sex, ApoE ε 4, depression, diabetes, hypertension, stroke, BMI and coronary artery disease) we found no significant association between clinical or subclinial hypothyroidism and MCI [OR 0.99 (95% CI 0.66–1.48) and OR 0.88 (95% CI 0.38–2.03) respectively]. No effect of gender interaction was seen on these effects. In stratified analysis, the odds of MCI with clinical and subclinical hypothyroidisn among males was 1.02 (95%CI, 0.57–1.82) and 1.29 (95%CI 0.68–2.44), among females was 1.04 (95% 0.66–1.66) and 0.86 (95% CI 0.37–2.02) respectively. Conclusion In this population based cohort of eldery, neither clinical nor subclinical hypothyrpodism was associated with MCI. Our findings

  19. Prevalence and correlates of diabetes mellitus in Malawi: population-based national NCD STEPS survey.

    Science.gov (United States)

    Msyamboza, Kelias Phiri; Mvula, Chimwemwe J; Kathyola, Damson

    2014-05-12

    Previously considered as a disease of the affluent, west or urban people and not of public health importance, diabetes mellitus is increasingly becoming a significant cause of morbidity and mortality in sub-Saharan Africa. However, population-based data to inform prevention, treatment and control are lacking. Using the WHO STEPwise approach to chronic disease risk factor surveillance, a population-based, nationwide cross-sectional survey was conducted between July and September 2009 on participants aged 25-64 years. A multi-stage cluster sample design and weighting were used to produce a national representative data for that age range. Detailed findings on the magnitude of diabetes mellitus and impaired fasting blood glucose are presented in this paper. Fasting blood glucose measurement was conducted on 3056 participants (70.2% females, 87.9% from rural areas). The age- sex standardised population-based mean fasting blood glucose was 4.3 mmol/L (95% CI 4.1-4.4 mmol/L) with no significant differences by age, sex and location (urban/rural). The overall prevalence of impaired fasting blood glucose was 4.2% (95% CI 3.0%-5.4%). Prevalence of impaired blood glucose was higher in men than in women, 5.7% (95% CI 3.9%-7.5%) vs 2.7% (95% CI 1.6%- 3.8%), p prevalence of raised fasting blood glucose or currently on medication for diabetes was 5.6% (95% CI 2.6%- 8.5%). Although the prevalence of diabetes was higher in men than women, 6.5% (95% CI 2.6%-10.3%) vs 4.7% (95% CI 2.4%-7.0%), in rural than urban, 5.4% (95% CI 2.4%-8.4%) vs 4.4% (95% CI 2.8%-5.9%) and in males in rural than males in urban, 6.9% (95% CI 2.8%-11.0%) vs 3.2% (95% CI 0.1%-6.3%), the differences were not statistically significant, p > 0.05. Compared to previous estimates, prevalence of diabetes increased from prevalence of impaired fasting blood glucose and diabetes mellitus call for the implementation of primary healthcare approaches such as the WHO package for essential non-communicable diseases

  20. Epidemiological study of prostate cancer (EPICAP): a population-based case–control study in France

    Science.gov (United States)

    2014-01-01

    Background Prostate cancer is the most common cancer in male in most Western countries, including France. Despite a significant morbidity and mortality to a lesser extent, the etiology of prostate cancer remains largely unknown. Indeed, the only well-established risk factors to date are age, ethnicity and a family history of prostate cancer. We present, here, the rationale and design of the EPIdemiological study of Prostate CAncer (EPICAP), a population-based case–control study specifically designed to investigate the role of environmental and genetic factors in prostate cancer. The EPICAP study will particularly focused on the role of circadian disruption, chronic inflammation, hormonal and metabolic factors in the occurrence of prostate cancer. Methods/Design EPICAP is a population-based case–control study conducted in the département of Hérault in France. Eligible cases are all cases of prostate cancers newly diagnosed in 2012-2013 in men less than 75 years old and residing in the département of Hérault at the time of diagnosis. Controls are men of the same age as the cases and living in the département of Hérault, recruited in the general population. The sample will include a total of 1000 incident cases of prostate cancer and 1000 population-based controls over a 3-year period (2012-2014). The cases and controls are face-to-face interviewed using a standardized computed assisted questionnaire. The questions focus primarily on usual socio-demographic characteristics, personal and family medical history, lifestyle, leisure activities, residential and occupational history. Anthropometric measures and biological samples are also collected for cases and controls. Discussion The EPICAP study aims to answer key questions in prostate cancer etiology: (1) role of circadian disruption through the study of working hours, chronotype and duration/quality of sleep, (2) role of chronic inflammation and anti-inflammatory drugs, (3) role of hormonal and metabolic

  1. Prenatal diagnosis of six major cardiac malformations in Europe - A population based study

    NARCIS (Netherlands)

    Garne, E

    Aim. To present data on prenatal diagnosis of six major cardiac malformations in low-risk European populations. Methods. Data from 12 Eurocat registries on congenital malformations. All registries have multiple sources of information and use the same methods of data collection and coding. The six

  2. Overall and cause-specific mortality in Crohn's disease: a meta-analysis of population-based studies

    DEFF Research Database (Denmark)

    Duricova, Dana; Pedersen, Eva Natalia G.; Elkjaer, Margarita

    2010-01-01

    An overview of mortality risk among unselected patients with Crohn's disease (CD) is lacking. We therefore performed a systematic review and meta-analysis of population-based studies on overall and cause-specific mortality in CD.......An overview of mortality risk among unselected patients with Crohn's disease (CD) is lacking. We therefore performed a systematic review and meta-analysis of population-based studies on overall and cause-specific mortality in CD....

  3. Methods and background characteristics of the TOHNN study: a population-based study of oral health conditions in northern Norway

    Directory of Open Access Journals (Sweden)

    Gro Eirin Holde

    2016-02-01

    Full Text Available Objectives: The aim of the Tromstannen – Oral Health in Northern Norway (TOHNN study was to investigate oral health and dental-related diseases in an adult population. This article provides an overview of the background of the study and a description of the sample characteristics and methods employed in data collection. Study design: Cross-sectional population-based study including a questionnaire and clinical dental examination. Methods: A randomly selected sample of 2,909 individuals (20–79 years old drawn from the population register was invited to participate in the study. The data were collected between October 2013 and November 2014 in Troms County in northern Norway. The questionnaire focused on oral health-related behaviours and attitudes, oral health-related quality of life, sense of coherence, dental anxiety and symptoms from the temporomandibular joint. The dental examinations, including radiographs, were conducted by 11 dental teams in 5 dental offices. The examination comprised of registration of dental caries, full mouth periodontal status, temporomandibular disorders, mucosal lesions and height and weight. The participants were grouped by age (20–34, 35–49, 50–64 and 65–79 and ethnicity (Norwegian, Sámi, other European and other world. Results: From the original sample of 2,909 individuals, 1,986 (68.3% people participated, of whom 1,019 (51.3% were women. The highest attendance rate was among women 20–34 years old (80.3% and the lowest in the oldest age group of women (55.4%. There was no difference in response rate between rural and urban areas. There was a positive correlation between population size and household gross income (p < 0.001 and education level (p < 0.001. The majority of Sámi resided in smaller municipalities. In larger cities, most participants used private dental health care services, whereas, in rural areas, most participants used the public dental health care service. Conclusion: The TOHNN

  4. Predialysis chronic kidney disease correlates with increased risk of pyogenic liver abscess: a population-based cohort study.

    Science.gov (United States)

    Lai, Shih-Wei; Lin, Cheng-Li; Liao, Kuan-Fu

    2017-10-01

    The incidence of pyogenic liver abscess in Taiwan appears to be much higher than that in western countries. However, little is known about the incidence of pyogenic liver abscess among patients with predialysis chronic kidney disease. The objective of this study was to assess the association between predialysis chronic kidney disease and the risk of pyogenic liver abscess in Taiwan. This population-based, retrospective, cohort study was conducted to analyse the database of the Taiwan National Health Insurance Program. There were 81118 subjects aged 20-84 years with newly diagnosed chronic kidney disease as the predialysis chronic kidney disease group since 2000-2010, and 81118 randomly selected subjects without chronic kidney disease as the nonchronic kidney disease group. The predialysis chronic kidney disease group and the nonchronic kidney disease group were matched with sex, age and comorbidities. The incidence of pyogenic liver abscess at the end of 2013 was calculated in both groups. Subjects who currently received dialysis therapy before the endpoint were excluded from the study. The multivariable Cox proportional hazards regression model was used to assess the hazard ratio (HR) and 95% confidence interval (CI) for the risk of pyogenic liver abscess associated with predialysis chronic kidney disease and other comorbidities including alcohol-related disease, biliary stone, chronic liver disease and diabetes mellitus. The overall incidence of pyogenic liver abscess was 1·65-fold higher in the predialysis chronic kidney disease group than that in the nonchronic kidney disease group (1·38 vs. 0·83 per 1000 person-years, 95% CI 1·59, 1·71). After adjustment for covariables, the adjusted HR of pyogenic liver abscess was 1·51(95% CI 1·30, 1·76) for the predialysis chronic kidney disease group, comparing with the nonchronic kidney disease group. In addition, the adjusted HR would increase to 3·31 (95% CI 2·61, 4·19) for subjects with predialysis chronic

  5. Methods and background characteristics of the TOHNN study: a population-based study of oral health conditions in northern Norway

    Science.gov (United States)

    Holde, Gro Eirin; Oscarson, Nils; Tillberg, Anders; Marstrander, Peter; Jönsson, Birgitta

    2016-01-01

    Objectives The aim of the Tromstannen – Oral Health in Northern Norway (TOHNN) study was to investigate oral health and dental-related diseases in an adult population. This article provides an overview of the background of the study and a description of the sample characteristics and methods employed in data collection. Study design Cross-sectional population-based study including a questionnaire and clinical dental examination. Methods A randomly selected sample of 2,909 individuals (20–79 years old) drawn from the population register was invited to participate in the study. The data were collected between October 2013 and November 2014 in Troms County in northern Norway. The questionnaire focused on oral health-related behaviours and attitudes, oral health-related quality of life, sense of coherence, dental anxiety and symptoms from the temporomandibular joint. The dental examinations, including radiographs, were conducted by 11 dental teams in 5 dental offices. The examination comprised of registration of dental caries, full mouth periodontal status, temporomandibular disorders, mucosal lesions and height and weight. The participants were grouped by age (20–34, 35–49, 50–64 and 65–79) and ethnicity (Norwegian, Sámi, other European and other world). Results From the original sample of 2,909 individuals, 1,986 (68.3%) people participated, of whom 1,019 (51.3%) were women. The highest attendance rate was among women 20–34 years old (80.3%) and the lowest in the oldest age group of women (55.4%). There was no difference in response rate between rural and urban areas. There was a positive correlation between population size and household gross income (p dental health care services, whereas, in rural areas, most participants used the public dental health care service. Conclusion The TOHNN study has the potential to generate new knowledge on a wide range of oral health conditions beneficial to the population in Troms County. Due to the high participation

  6. [Factors associated with prostate cancer screening: a population-based study].

    Science.gov (United States)

    Amorim, Vivian Mae Schmidt Lima; Barros, Marilisa Berti de Azevedo; César, Chester Luiz Galvão; Goldbaum, Moisés; Carandina, Luana; Alves, Maria Cecília Goi Porto

    2011-02-01

    The aim of this study was to analyze the prevalence of prostate cancer screening among men aged 50 years or older based on socioeconomic, demographic, and health-related behavioral variables and the presence of morbidity. A population-based cross-sectional study was performed. The following factors were associated with failure to undergo screening: age under 70 years; less than eight years of schooling; per capita household income less than one-half the minimum wage; not having diabetes; lack of visual impairment; and lack of visit to the dentist in the previous year. The Brazilian public healthcare system accounted for 41% of the reported prostate cancer screening tests. According to the present study, despite controversy over the effectiveness of digital rectal examination and prostate-specific antigen for detecting prostate cancer, a significant portion of the male population has been undergoing these tests, the access to which displays significant socioeconomic inequalities.

  7. Prevalence of cardiac right left shunts in migraine: a population-based case-control study.

    Science.gov (United States)

    Küper, Michael; Rabe, Kasja; Holle, Dagny; Savidou, Irini; Dommes, Peter; Frings, Markus; Diener, Hans Christoph; Katsarava, Zaza

    2013-02-01

    We aimed to investigate the prevalence of cardiac right left shunts (RLS) in population-based samples of subjects with migraine with aura (n = 42), migraine without aura (n = 44) and controls without headache (n = 41). Cardiac RLS was assessed with transcranial Doppler sonography with intravenous injection of saline. Prevalence of RLS was highest in migraineurs with aura (45.2%) compared to migraineurs without aura (34.1%) and controls (41.5%). Permanent as opposed to latent RLS was more common among patients with migraine with aura (40.5%) than in patients with migraine without aura (23.3%) or controls (24.4%). Differences did not reach statistical significance between the three groups (p = 0.564 for RLS prevalence, p = 0.349 for prevalence of permanent shunts). Our data implicate a trend towards higher prevalence of RLS with larger shunts in subjects with migraine with aura.

  8. Incidence of zoonotic Salmonella species bacteraemia: a multi-national population-based study

    DEFF Research Database (Denmark)

    Laupland, Kevin; Schønheyder, Henrik Carl; Lyytikäinen, Outi

    2009-01-01

    , Canada; combined population 7.5 million residents annually) during 2000-2007. Results: A total of 480 zoonotic Salmonella species bacteraemias were identified for an overall annual incidence of 8.1 per million population. The incidence was lowest in the spring and highest in the summer, and progressively......Objectives: Although zoonotic (non-typhoidal) Salmonella species are important causes of invasive infections worldwide, few studies have investigated their epidemiology at the population level. The objective of this study was to define the incidence of zoonotic Salmonella species bacteraemia...... in a large multi-national population and to evaluate temporal and regional differences. Methods: Population-based laboratory surveillance for all zoonotic Salmonella species bacteraemias was conducted in five regions (Finland, Canberra, Australia, North Jutland Region, Denmark, and Calgary and Sherbrooke...

  9. Quality assurance of the Western Denmark Heart Registry, a population-based healthcare register

    DEFF Research Database (Denmark)

    Rasmussen, Linda Aagaard; Bøtker, Hans Erik; Jensen, Lisette Okkels

    2017-01-01

    INTRODUCTION: During the past decade, the mandatory population-based healthcare database, the Western Denmark Heart Registry (WDHR), has provided the data for several research projects. As in most clinical registries, the data quality has not been validated thoroughly. This study was undertaken...... to evaluate the quality of registrations in the WDHR. METHODS: The audit supervised procedures from involved departments that were performed in 2013. An experienced research nurse completed data collection, and an experienced consultant evaluated the agreement between the WDHR and patient records. Indistinct.......8% in the discharge module. For PCI procedures, the errors were 3.8% in the history module, 2.2% in the procedure module and 1.6% in the discharge module. CAG and CT-CAG had slightly more errors. CONCLUSIONS: The quality control of the WDHR revealed that overall data errors were lower than 3% and for procedure...

  10. Quality assurance of the Western Denmark heart registry, a population-based healthcare register

    DEFF Research Database (Denmark)

    Rasmussen, Linda Aagaard; Bøtker, Hans Erik; Jensen, Lisette Okkels

    2017-01-01

    Introduction: During the past decade, the mandatory population-based healthcare database, the Western Denmark Heart Registry (WDHR), has provided the data for several research projects. As in most clinical registries, the data quality has not been validated thoroughly. This study was undertaken...... to evaluate the quality of registrations in the WDHR. Methods: The audit supervised procedures from involved departments that were performed in 2013. An experienced research nurse completed data collection and an experienced consultant evaluated the agreement between the WDHR and patient records. Indistinct.......8% in the discharge module. For PCI procedures, the errors were 3.8% in the history module, 2.2% in the procedure module and 1.6% in the discharge module. CAG and CTCAG had slightly more errors. Conclusions: The quality control of the WDHR revealed that overall data errors were lower than 3% and for procedure...

  11. C-reactive protein, insulin resistance and risk of cardiovascular disease: a population-based study

    DEFF Research Database (Denmark)

    Hansen, T.W.; Olsen, M.H.; Rasmussen, S.

    2008-01-01

    BACKGROUND: C-reactive protein (CRP), a marker of inflammation, and insulin resistance (IR), a metabolic disorder, are closely related. CRP and IR have both been identified as significant risk factors of cardiovascular disease (CVD) after adjustment for conventional CVD risk factors....... It is not clear whether CRP predicts CVD independent of IR. DESIGN: Prospective population-based study. METHODS: Two thousand three hundred and fifty-seven Danish men and women, recruited from the general population, aged 41-72 years, without major CVD at baseline were studied. Traditional and new risk factors...... were recorded at baseline. CRP was determined by a high-sensitivity assay, and IR was determined by the homoeostasis model assessment (HOMA-IR) method. RESULTS: Over a median follow-up of 9.4 years, the incidence of the prespecified CV event, defined as the composite event of CV death, nonfatal...

  12. Epidemiology of maternal injuries during pregnancy in a population-based study, 1997-2005.

    Science.gov (United States)

    Tinker, Sarah C; Reefhuis, Jennita; Dellinger, Ann M; Jamieson, Denise J

    2010-12-01

    Maternal injuries during pregnancy are common and can cause adverse pregnancy outcomes. We sought to describe factors related to injury during pregnancy. We analyzed data from the National Birth Defects Prevention Study (NBDPS), a population-based, case-control study of birth defects in 10 U.S. states. We estimated the proportion of control mothers, a random sample of mothers delivering infants without major birth defects in the study regions, who reported an injury during pregnancy. We assessed associations with maternal and paternal characteristics using logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI). Between October 1997 and December 2005, 490 (7.4%) of 6609 mothers reported 527 injuries during pregnancy. Falls caused over half of reported injuries during pregnancy (51.6%), and 9.5% of reported injuries were intentionally inflicted. Mothers who reported an injury during pregnancy were more likely to be aged injuries during pregnancy.

  13. Predicting sexual infidelity in a population-based sample of married individuals.

    Science.gov (United States)

    Whisman, Mark A; Gordon, Kristina Coop; Chatav, Yael

    2007-06-01

    Predictors of 12-month prevalence of sexual infidelity were examined in a population-based sample of married individuals (N = 2,291). Predictor variables were organized in terms of involved-partner (e.g., personality, religiosity), marital (e.g., marital dissatisfaction, partner affair), and extradyadic (e.g., parenting) variables. Annual prevalence of infidelity was 2.3%. Controlling for marital dissatisfaction and demographic variables, infidelity was predicted by greater neuroticism and lower religiosity; wives' pregnancy also increased the risk of infidelity for husbands. In comparison, self-esteem and partners' suspected affair were predictive of infidelity when controlling for demographic variables but were not uniquely predictive of infidelity when also controlling for marital dissatisfaction. Religiosity and wives' pregnancy moderated the association between marital dissatisfaction and infidelity.

  14. Population-based case-control study of breast cancer in Albania

    Directory of Open Access Journals (Sweden)

    Pajenga E.

    2013-01-01

    Full Text Available In Albania, breast cancer is an important cause of death among women, with increasing incidence from 65 cases in 1970, to 400 cases in 2007. This is the first study concerning breast cancer risk factors in Albania. We used a population-based case-control study of 948 women with breast cancer compared with 1019 controls recruited from other hospitals through random selection. Early age at menarche was found to be a significantly strong risk factor during the pre- and postmenopausal groups with OR 10.04 and 12.1, respectively. In addition, nulliparity is associated with higher risk while abortion did not indicate any influence in the multivariate model. The findings from this study have shown that reproductive and menstrual variables are significant predictors of breast cancer risk in Albanian women, as seen in studies of other western countries.

  15. Association between Gastroesophageal Reflux Disease and Appendicitis: A Population-Based Case-Control Study

    Science.gov (United States)

    Kao, Li-Ting; Tsai, Ming-Chieh; Lin, Herng-Ching; Lee, Cha-Ze

    2016-01-01

    Appendicitis and gastroesophageal reflux disease (GERD) are both prevalent diseases and might share similar pathological mechanisms. The aim of this study was to investigate the association between GERD and appendicitis using a large population-based dataset. This study used administrative claims data from the Taiwan Longitudinal Health Insurance Database 2005. We identified 7113 patients with appendicitis as cases, and 28452 matched patients without appendicitis as controls. This study revealed that GERD was found in 359 (5.05%) cases and 728 (2.56%) controls (p appendicitis were 1.96 (95% CI: 1.56~2.47), 2.36 (95% CI: 1.94~2.88), and 1.71 (95% CI: 1.31~2.22) than controls, respectively. We concluded that patients with appendicitis had higher odds of prior GERD than those without appendicitis regardless of age group. PMID:26932391

  16. Semantic Verbal Fluency: Normative Data in Older Spanish Adults From NEDICES Population-Based Cohort.

    Science.gov (United States)

    Contador, Israel; Almondes, Katie; Fernández-Calvo, Bernardino; Boycheva, Elina; Puertas-Martín, Verónica; Benito-León, Julián; Bermejo-Pareja, Félix

    2016-09-06

    We aimed to provide the normative data stratified by age, sex and educational attainment for two semantic categories (animal and fruits) in older Spanish adults. A representative sample of 2,744 non-demented older individuals with different socioeconomic background was selected from the Neurological Disorders in Central Spain (NEDICES), a population-based study. Normative data are presented in percentile ranks and divided into four age-tables with different midpoints, using the overlapping interval procedure. Correlation analyses showed that age, education and sex influence significantly the scores in both semantic tasks. Normative data presented here covered two urban (Margaritas & Lista) and one rural areas (Arévalo). These norms may provide useful data for screening cognitive impairment more accurately in Spanish older adults. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. The Effects of Social Reforms on Mental Disability in China: Population-Based Study.

    Science.gov (United States)

    Wang, Zhenjie; Zhang, Lei; Li, Ning; Guo, Chao; Chen, Gong; Zheng, Xiaoying

    2016-04-01

    Few studies have explored how mental disabilities have changed with the waves of Chinese social reforms that occurred between 1912 and 2006. The present study evaluated population-based data from the Second China National Sample Survey on Disability to investigate these trends and their effects on mental disabilities. The Cox proportional hazards model was used to estimate the association between social reforms and mental disabilities. The confounding variables considered were as follows: survey age, gender, residence in 2006, ethnicity, and living arrangements in 2006. The highest risks of mental disabilities were observed in subjects born during the Mao Zedong era. Subjects who experienced social turbulence during their early development may have increased risks of mental disabilities in adulthood. The results and discussion herein contribute to our understanding of mental disabilities in China within the context of changing political, socioeconomic, and health system conditions and a developing mental health system. © 2016 APJPH.

  18. [Population-based breast cancer screening: certainties, controversies, and future perspectives].

    Science.gov (United States)

    Apesteguía Ciriza, Luis; Pina Insausti, Luis Javier

    2014-01-01

    Population-based breast cancer screening programs based on mammography must maintain a high level of quality, so the results must be constantly monitored. Although most authors consider that these programs have decreased the mortality due to breast cancer by about 30%, others claim that the mortality has decreased by only about 12% due to errors in the randomization of patients, because the rate of advanced tumors has hardly decreased and because adjuvant treatment also improves survival. Other criticisms focus on overdiagnosis and overtreatment. We believe that despite the unquestionable value of mammographic screening, we should be open to certain changes such as the stratification of patients by their level of risk and the introduction of complementary techniques like tomosynthesis, ultrasonography, and magnetic resonance imaging in selected cases. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.

  19. 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...... subcohort members identified in the cohort during follow-up in 2006. MAIN OUTCOME MEASURE: Effect of four groups of fertility drugs (gonadotrophins, clomifene citrate, human chorionic gonadotrophin, and gonadotrophin releasing hormone) on overall risk of ovarian cancer after adjustment for potential...... hormone (0.80, 0.42 to 1.51). Furthermore, no associations were found between all four groups of fertility drugs and number of cycles of use, length of follow-up, or parity. CONCLUSION: No convincing association was found between use of fertility drugs and risk of ovarian cancer....

  20. Gender differences of cannabis smoking on serum leptin levels: population-based study

    Directory of Open Access Journals (Sweden)

    Fernanda P. Moreira

    2018-02-01

    Full Text Available Objective: To evaluate the serum leptin levels in cannabis smokers. Methods: This was a cross-sectional population-based study of participants between the ages of 18 and 35 years. The data were collected through a self-administered questionnaire covering sociodemographic data and the use of psychoactive substances. Leptin levels were measured using a commercial ELISA kit. Results: Of the 911 participants, 6.7% were identified as cannabis smokers and had significantly lower leptin levels (p = 0.008. When stratified by gender, there was a significant decrease in leptin levels among male smokers (p = 0.039. Conclusion: Cannabis smoking was linked to leptin levels in men, suggesting that the response to biological signals may be different between men and women.

  1. A population-based study of high-grade gliomas and mutated isocitrate dehydrogenase 1

    DEFF Research Database (Denmark)

    Dahlrot, Rikke H; Kristensen, Bjarne W; Hjelmborg, Jacob

    2012-01-01

    High-grade gliomas have a dismal prognosis, and prognostic factors are needed to optimize treatment algorithms. In this study we identified clinical prognostic factors as well as the prognostic value of isocitrate dehydrogenase 1 (IDH1) status in a population-based group of patients with high......-grade gliomas. Using the Danish Cancer Registry and the Danish Pathology Databank we identified 359 patients: 234 had WHO grade IV gliomas, 58 had WHO grade III gliomas, and 67 were diagnosed clinically. Mutated IDH1 was predominantly observed in oligodendroglial tumors (WHO grade III). Patients with mutated...... IDH1 had a significantly better outcome than patients with wildtype IDH1: 2-year OS 59% and 18%, respectively (HR 0.38, 95% CI 0.21-0.68). However, when adjusting for other prognostic factors, IDH1 status was not a significant independent prognostic factor (HR=0.58, 95% CI 0.32-1.07). Young age...

  2. Inflammatory bowel disease in pregnancy: a population-based study of prevalence and pregnancy outcomes.

    Science.gov (United States)

    Shand, A W; Chen, J S; Selby, W; Solomon, M; Roberts, C L

    2016-10-01

    To determine the prevalence of the inflammatory bowel diseases (IBD), ulcerative colitis (UC) and Crohn's disease (CD), in pregnant women and determine pregnancy and fetal/neonatal outcomes. Population-based cohort study. New South Wales, Australia, 2001-11. A total of 630 742 women who delivered at ≥20 weeks of gestation. Descriptive and multivariate regression analyses of perinatal data linked to hospital admission data. We compared birth outcomes of women with and without a documented diagnosis of IBD. Caesarean section, severe maternal morbidity, preterm birth Pregnancy-associated IBD is more common than previously reported. Pregnancies complicated by IBD at or near the time of birth have significantly higher rates of adverse pregnancy outcomes than pregnancies of women without IBD. Increased rates preterm birth and caesarean section in women with inflammatory bowel disease. © 2016 Royal College of Obstetricians and Gynaecologists.

  3. Pulmonary Hypoplasia Induced by Oligohydramnios: Findings from Animal Models and a Population-Based Study

    Directory of Open Access Journals (Sweden)

    Chun-Shan Wu

    2017-02-01

    Full Text Available Pulmonary hypoplasia is a substantial cause of death in newborn infants, and oligohydramnios is one of the most commonly associated abnormalities. Lung growth is influenced by physical factors such as the intrauterine space, lung liquid volume and pressure, and fetal breathing movements. During lung development, the main physical force experienced by the lungs is stretching induced by breathing movements and the lung fluid in the airspaces. Oligohydramnios reduces the intrathoracic cavity size, thus disrupting fetal lung growth and leading to pulmonary hypoplasia. The exact mechanism by which oligohydramnios alters the respiratory system structure and the effect of oligohydramnios on long-term respiratory outcomes remain unknown. In this review, we summarize the effects of oligohydramnios on lung development, discuss the mechanisms of oligohydramnios-induced pulmonary hypoplasia identified in various animal studies, and describe the long-term respiratory outcomes in childhood of oligohydramnios-exposed fetuses reported by a population-based study.

  4. Gender differences of cannabis smoking on serum leptin levels: population-based study.

    Science.gov (United States)

    Moreira, Fernanda P; Wiener, Carolina D; Oliveira, Jacqueline F de; Souza, Luciano D M; da Silva, Ricardo A; Portela, Luis V; Lara, Diogo R; Jansen, Karen; Oses, Jean Pierre

    2018-02-01

    To evaluate the serum leptin levels in cannabis smokers. This was a cross-sectional population-based study of participants between the ages of 18 and 35 years. The data were collected through a self-administered questionnaire covering sociodemographic data and the use of psychoactive substances. Leptin levels were measured using a commercial ELISA kit. Of the 911 participants, 6.7% were identified as cannabis smokers and had significantly lower leptin levels (p = 0.008). When stratified by gender, there was a significant decrease in leptin levels among male smokers (p = 0.039). Cannabis smoking was linked to leptin levels in men, suggesting that the response to biological signals may be different between men and women.

  5. Snus and risk of gastroesophageal reflux. A population-based case-control study

    DEFF Research Database (Denmark)

    Lie, Tina Malene; Bomme, Maria; Hveem, Kristian

    2017-01-01

    on the third Nord-Trøndelag health study (HUNT3), a population-based study of all adult residents in Nord-Trøndelag County, Norway, performed in 2006-2009. The association between self-reported severe heartburn/regurgitation and snus use was assessed by logistic regression. RESULTS: Compared to never snus...... between 50-60 and 60-70 years had a reduced risk (OR 0.67, 95% CI 0.49-0.93 and OR 0.51, 95% CI 0.28-0.94, respectively). CONCLUSIONS: Daily snus users had a reduced risk of GERS. However, previous snus users and subgroups of snus users had an increased risk of GERS indicating reverse causality...

  6. 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...... 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 native Danes...

  7. Maternal factors influencing infant abdominal circumference and birth weight - a population based study

    DEFF Research Database (Denmark)

    Tanvig, Mette

    2012-01-01

    Objective: 1) To examine the impact of maternal pregestational Body Mass Index (BMI) and smoking on infant abdominal circumference (AC) and birth weight. 2) To define reference curves for AC and birth weight in offspring of healthy, non-smoking, normal weight women. Design: Population-based study...... outcome measures: Birth AC and weight in relation to pregestational maternal BMI, maternal smoking and medical conditions (any). Results: Infant AC and birth weight increased significantly (pmaternal BMI. Smoking was negatively associated with AC resulting in a reduction in AC (95......-score of birth weight than to Z-score of AC (p maternal smoking status and pregestational BMI, and pregestational BMI correlates more to birth weight than to AC. Using data from offspring of healthy, non-smoking mothers with normal pregestational BMI we...

  8. Clinical course of alcoholic liver cirrhosis: a Danish population-based cohort study

    DEFF Research Database (Denmark)

    Jepsen, Peter; Ott, Peter; Andersen, Per Kragh

    2010-01-01

    ) or hepatic encephalopathy first (4% within 1 year). Subsequent complications occurred in an unpredictable order among patients with ascites or variceal bleeding. CONCLUSION: Patients with alcoholic cirrhosis had a high prevalence of complications at the time of cirrhosis diagnosis. The presence and type......The clinical course of alcoholic cirrhosis, a condition with a high mortality, has not been well described. We examined prevalence, risk, chronology, and mortality associated with three complications of cirrhosis: ascites, variceal bleeding, and hepatic encephalopathy. We followed a population......-based cohort of 466 Danish patients diagnosed with alcoholic cirrhosis in 1993-2005, starting from the date of hospital diagnosis and ending in August 2006. Data were extracted from medical charts during the follow-up period. Risk and mortality associated with complications were calculated using competing...

  9. Fertility rates and perinatal outcomes of adolescent pregnancies: a retrospective population-based study.

    Science.gov (United States)

    Souza, Maria de Lourdes de; Lynn, Fiona Ann; Johnston, Linda; Tavares, Eduardo Cardoso Teixeira; Brüggemann, Odaléa Maria; Botelho, Lúcio José

    2017-04-06

    analyze trends in fertility rates and associations with perinatal outcomes for adolescents in Santa Catarina, Brazil. a population-based study covering 2006 to 2013 was carried out to evaluate associations between perinatal outcomes and age groups, using odds ratios, and Chi-squared tests. differences in the fertility rate among female adolescents across regions and time period were observed, ranging from 40.9 to 72.0 per 1,000 in mothers aged 15-19 years. Adolescents had fewer prenatal care appointments than mothers ≥20 years, and a higher proportion had no partner. Mothers aged 15-19 years were more likely to experience preterm birth (OR:1.1; CI:1.08-1.13; ppobreza social y económica. Madres adolesce

  10. Scalable Entity-Based Modeling of Population-Based Systems, Final LDRD Report

    Energy Technology Data Exchange (ETDEWEB)

    Cleary, A J; Smith, S G; Vassilevska, T K; Jefferson, D R

    2005-01-27

    The goal of this project has been to develop tools, capabilities and expertise in the modeling of complex population-based systems via scalable entity-based modeling (EBM). Our initial focal application domain has been the dynamics of large populations exposed to disease-causing agents, a topic of interest to the Department of Homeland Security in the context of bioterrorism. In the academic community, discrete simulation technology based on individual entities has shown initial success, but the technology has not been scaled to the problem sizes or computational resources of LLNL. Our developmental emphasis has been on the extension of this technology to parallel computers and maturation of the technology from an academic to a lab setting.

  11. Personality Profiles Identify Depressive Symptoms over Ten Years? A Population-Based Study

    Science.gov (United States)

    Josefsson, Kim; Merjonen, Päivi; Jokela, Markus; Pulkki-Råback, Laura; Keltikangas-Järvinen, Liisa

    2011-01-01

    Little is known about the relationship between temperament and character inventory (TCI) profiles and depressive symptoms. Personality profiles are useful, because personality traits may have different effects on depressive symptoms when combined with different combinations of other traits. Participants were from the population-based Young Finns study with repeated measurements in 1997, 2001, and 2007 (n = 1402 to 1902). TCI was administered in 1997 and mild depressive symptoms (modified Beck's depression inventory, BDI) were reported in 1997, 2001, and 2007. BDI-II was also administered in 2007. We found that high harm avoidance and low self-directedness related strongly to depressive symptoms. In addition, sensitive (NHR) and fanatical people (ScT) were especially vulnerable to depressive symptoms. high novelty seeking and reward dependence increased depressive symptoms when harm avoidance was high. These associations were very similar in cross-sectional and longitudinal analysis. Personality profiles help in understanding the complex associations between depressive symptoms and personality. PMID:21876796

  12. Effectiveness of a two-step population-based osteoporosis screening program using FRAX

    DEFF Research Database (Denmark)

    Rubin, K H; Rothmann, M J; Holmberg, T

    2018-01-01

    The Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study investigated the effectiveness of a two-step screening program for osteoporosis in women. We found no overall reduction in fractures from systematic screening compared to the current case-finding strategy. The group of moderate......- to high-risk women, who accepted the invitation to DXA, seemed to benefit from the program. INTRODUCTION: The purpose of the ROSE study was to investigate the effectiveness of a two-step population-based osteoporosis screening program using the Fracture Risk Assessment Tool (FRAX) derived from a self......-finding strategy, the two-step systematic screening strategy had no overall effect on fracture incidence. The two-step strategy seemed, however, to be beneficial in the group of women who were identified by FRAX as moderate- or high-risk patients and complied with DXA....

  13. Population-based service planning for implementation of MBCT: linking epidemiologic data to practice.

    Science.gov (United States)

    Patten, Scott B; Meadows, Graham M

    2009-11-01

    The study explored population-based service planning for mindfulness-based cognitive therapy (MBCT). Evidence suggests the usefulness of MBCT in relapse prevention for individuals reporting three or more major depressive episodes. Depression data were from the Canadian Community Health Survey. A simulation model estimated recurrence rates and population sizes to sustain MBCT therapists (each conducting two ten-person groups per year). Approximately 4.2% of the population are candidates for MBCT, and about 13 candidates would arise annually per 10,000 population. If MBCT was acceptable to 20%, for example, a population of 200,000 could support two therapists. A large proportion of the population is eligible for MBCT introduction; however, after introduction, the rate of emergence of candidates would yield a smaller patient pool, which may limit implementation in small population centers. Treatment acceptability is a key variable. These analyses highlight the potential value of epidemiologic data and simulation modeling in planning.

  14. Infertility treatment in a population-based sample: 2004-2005.

    Science.gov (United States)

    Simonsen, Sara E; Baksh, Laurie; Stanford, Joseph B

    2012-05-01

    To describe the characteristics of women seeking infertility treatment and the types of fertility treatment sought within a population-based sample. We analyzed data from the cross-sectional Pregnancy Risk Assessment Monitoring System (PRAMS) of women with a live birth using data from seven states. Logistic regression was used to determine factors associated with infertility treatment utilization. Infertility treatment was reported by 10.5% of women who were trying to become pregnant. The most common treatment reported was fertility enhancing drugs (29%), followed by assisted reproductive technology including in vitro fertilization (21%), and artificial insemination together with fertility enhancing drugs (15%). Some women reported using other types of treatment (23%). The PRAMS data provide insights into the use of infertility treatment among women giving birth in the United States. Further research is needed to understand the true prevalence of infertility, factors that influence treatment choices, and the longitudinal impact of infertility treatment on outcomes.

  15. A population-based Danish data resource with possible high validity in pharmacoepidemiological research.

    Science.gov (United States)

    Sørensen, H T; Larsen, B O

    1994-02-01

    The incomplete understanding of drug effects at the time of marketing has led to ongoing epidemiological monitoring. The Danish National Health Service covers part of the expenses for most kinds of prescription drugs. The accounting system within the pharmacies is increasingly computerized. In 1992 we found that 96% of the pharmacies were computerized. The computerized accounting systems give no information about adverse drug effects, but this can be obtained from the Danish Hospital Register by cross-checking registries, and in some cases from the register of birth and the register of congenital malformations. There is a great need for new data sources in pharmacoepidemiology. In spite of some evident methodological problems, the Danish data sources probably have high validity compared with international sources, since they are population based.

  16. Education and Successful Aging Trajectories: A Longitudinal Population-Based Latent Variable Modelling Analysis.

    Science.gov (United States)

    Cosco, Theodore D; Stephan, Blossom C M; Brayne, Carol; Muniz, Graciela

    2017-12-01

    As the population ages, interest is increasing in studying aging well. However, more refined means of examining predictors of biopsychosocial conceptualizations of successful aging (SA) are required. Existing evidence of the relationship between early-life education and later-life SA is unclear. The Successful Aging Index (SAI) was mapped onto the Cognitive Function and Aging Study (CFAS), a longitudinal population-based cohort (n = 1,141). SAI scores were examined using growth mixture modelling (GMM) to identify SA trajectories. Unadjusted and adjusted (age, sex, occupational status) ordinal logistic regressions were conducted to examine the association between trajectory membership and education level. GMM identified a three-class model, capturing high, moderate, and low functioning trajectories. Adjusted ordinal logistic regression models indicated that individuals in higher SAI classes were significantly more likely to have higher educational attainment than individuals in the lower SAI classes. These results provide evidence of a life course link between education and SA.

  17. Hepatitis B virus infection and the risk of male infertility: a population-based analysis.

    Science.gov (United States)

    Su, Fu-Hsiung; Chang, Shih-Ni; Sung, Fung-Chang; Su, Chien-Tien; Shieh, Ying-Hua; Lin, Cheng-Chieh; Yeh, Chih-Ching

    2014-12-01

    To evaluate the risk of male infertility among patients with hepatitis B virus (HBV) infection. A nationwide, population-based cohort study. Not applicable. Men infected with HBV (n = 5,138) and men without HBV infection (n = 25,690). None. Male infertility, as defined by the International Classification of Diseases, Ninth Revision, Clinical Modification. The incidence of infertility was 1.59 times higher in patients with HBV infection than in those without HBV infection (2.21 vs. 1.39 per 1,000 person-years). The risk of developing infertility remained significant among patients with HBV infection (hazard ratio 1.52, 95% confidence interval 1.20-1.92) after adjusting for covariates in a multivariate Cox proportional hazards model. The data show an increased incidence and risk of infertility among men with HBV infection compared with men without HBV. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Trends and variation in the management of oesophagogastric cancer patients: a population-based survey

    Directory of Open Access Journals (Sweden)

    Greenberg David C

    2009-12-01

    Full Text Available Abstract Background Previous evidence indicates potential variation in the quality of care of cancer patients. We aimed to examine whether recent changes in the treatment of oesophagogastric cancers have been distributed equally among different patient subgroups. Methods We analysed population-based cancer registry data about the treatment patterning of oesophagogastric cancer (other than oesophageal squamous cell carcinoma during 1995-2006. Results There were 14,077 patients aged ≥40 years (69% men. There was only limited information on stage, and no information on co-morbidity status. During successive triennia, curative surgery use decreased from 28% to 20% (p Conclusions During the study period, curative surgery decreased by a third and chemotherapy use increased by more than three-fold, reflecting improvements in the appropriateness and quality of management, but chemotherapy use, in particular, was unequal, both by socioeconomic status and gender.

  19. The clustering of smear-positive tuberculosis in Dabat, Ethiopia: a population based cross sectional study.

    Science.gov (United States)

    Tadesse, Takele; Demissie, Meaza; Berhane, Yemane; Kebede, Yigzaw; Abebe, Markos

    2013-01-01

    In Ethiopia where tuberculosis epidemic remains high, studies that describe hotspots of the disease are unavailable. This study tried to detect the spatial distribution and clustering of smear-positive tuberculosis cases in Dabat, Ethiopia. A population-based cross sectional study conducted in the Dabat Health and Demographic Surveillance System site from October 2010 to September 2011 identified smear-positive tuberculosis cases. Trained field workers collected demographic and location data from each study participant through house-to-house visits. A spatial scan statistic was used to identify purely spatial and space-time clusters of tuberculosis among permanent residents. Two significant (pTuberculosis is concentrated in certain geographic locations in Dabat, Ethiopia. This kind of clustering can be common in the country, so the National Tuberculosis Control Program can be more effective by identifying such clusters and targeting interventions.

  20. Genetic, epidemiological, and clinical aspects of hereditary pancreatitis: a population-based cohort study in Denmark

    DEFF Research Database (Denmark)

    Brusgaard, Klaus

    2010-01-01

    OBJECTIVES: In a population-based, well-defined group of patients first regarded as having pancreatitis of unknown origin (PUO), we identified, described, and compared the clinical and genetic aspects of patients with hereditary pancreatitis (HP) and with cystic fibrosis transmembrane conductance...... regulator gene (CFTR) and serine protease inhibitor Kazal type 1 gene (SPINK1) mutations with patients who retained the diagnosis of true idiopathic pancreatitis (tIP) after genetic testing for HP, SPINK1, and CFTR mutations. METHODS: Patients with PUO were identified in the Danish National Registry......, respectively, and among tIP patients 9 and 12%, respectively. Pancreatic cancer was diagnosed in 5% of the HP families. CONCLUSIONS: The genotype of the Danish population with HP differs from that of previously described cohorts. The occurrence of exocrine and endocrine insufficiency is higher among patients...

  1. Vitreous haemorrhage: a population-based study of the incidence and risk factors in Taiwan

    Directory of Open Access Journals (Sweden)

    Ching-Yu Wang

    2017-03-01

    Full Text Available AIM: To report the epidemiology and incidence of vitreous hemorrhage and to evaluate risk factors for patients with vitreous hemorrhage (VH in Taiwan. METHODS: A retrospective population-based study. Analyzing a sample of one million subjects from all enrollees of the Taiwan Health Insurance programme. All data were obtained from the Taiwan Health Insurance Research Database, which contained patient sex, date of birth, all records of clinical visits and hospitalizations, and diagnosis codes as included in the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM. The main outcome measures were the incidence and risk factors of VH. CONCLUSION: The incidence of VH is estimated being 4.8 cases per 10 000 person-years in Taiwan. Age, male gender and having been prescribed anti-coagulation drugs are associated with the incidence of VH.

  2. HLA associations and risk of posttransplant lymphoproliferative disorder in Danish population-based cohort

    DEFF Research Database (Denmark)

    Vase, Maja Ølholm; Maksten, Eva Futtrup; Strandhave, Charlotte

    2015-01-01

    . Possible associations between certain HLA types and the risk of developing PTLD have been reported by other investigators; however, results are conflicting. Methods: We conducted a retrospective, population-based study on 4295 Danish solid organ transplant patients from the Scandiatransplant database....... Having identified 93 PTLD patients in the cohort, we investigated the association of HLA types with PTLD, Epstein-Barr virus status and time to PTLD onset. The outcomes survival and PTLD were evaluated using Cox regression; mismatching, and the PTLD-specific mortality were evaluated in a competing risk...... analysis. Results: Risk of PTLD was associated with male sex (odds ratio, 1.70; 95% confidence interval, 1.07-2.71), and, in women, HLA-DR13 conferred an increased risk (odds ratio, 3.22; 95% confidence interval, 1.41-7.31). In multivariate analysis, HLA-B45 and HLA-DR13 remained independent predictive...

  3. A population-based prescription study of asthma drugs during pregnancy

    DEFF Research Database (Denmark)

    Olesen, Charlotte; Thrane, Nana; Nielsen, G.L.

    2001-01-01

    Background: Among the goals of gestational asthma, therapy is optimisation of pulmonary function. According to the US Food and Drug Administration, no asthma drugs can be considered ‘safe’ during pregnancy. Fear of adverse fetal effects may thus lead to restrictive use of asthma drugs during...... pregnancy, and no population-based studies concerning gestational asthma therapy exist. Objectives: To examine whether asthma drugs or changing intensity of asthma therapy during pregnancy was associated with deviations from expected values of gestational age, birth weight, length at birth, or malformations....... Methods: The Birth Registry was used to identify all 15,756 primiparous women who gave birth in the County of North Jutland between 1991 and 1996. According to the North Jutland Prescription Database, 303 of these women received prescriptions for asthma drugs during pregnancy. Women who did not purchase...

  4. A population-based case-control teratologic study of ampicillin treatment during pregnancy

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Sørensen, Henrik Toft

    2001-01-01

    Objective: This was a study of the association between ampicillin treatment during pregnancy and prevalence of different congenital abnormalities. Study Design: The paired analysis of case patients with congenital abnormalities and matched population control subjects was performed in the population......-based Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996. Of 38,151 pregnant women who had babies without any defects (population control group), 2632 (6.9%) had been treated with ampicillin. Of 22,865 pregnant women who had offspring with congenital abnormalities (case patients......), 1643 (7.2%) had been treated with ampicillin (crude odds ratio, 1.0; 95% confidence interval, 0.7-1.2). Of 812 mothers who were delivered of babies affected by Down syndrome (patient control subjects), 61 (7.5%) had ampicillin treatment, and these were also compared with the case group. Results...

  5. HIV/AIDS misconceptions among Latinos: findings from a population-based survey of California adults.

    Science.gov (United States)

    Ritieni, Assunta; Moskowitz, Joel; Tholandi, Maya

    2008-04-01

    Misconceptions about HIV/AIDS among Latino adults (N = 454) in California were examined using data from a population-based telephone survey conducted in 2000. Common misconceptions concerning modes of HIV transmission included transmission via mosquito or animal bite (64.1%), public facilities (48.3%), or kissing someone on the cheek (24.8%). A composite misconceptions score was constructed. Correlations between the composite measure and other HIV/AIDS-related beliefs were examined. Latinos with a higher level of misconceptions were more likely to report higher self-perceived risk of HIV infection, and discomfort with infected individuals in a school and in a food setting. Results from multiple linear regression analysis indicated that individuals 45 years and older, those who were interviewed in Spanish, and those with lower education or income levels had a higher degree of misconceptions. The results suggest the need for targeted education efforts to reduce HIV/AIDS misconceptions among Latino adults in California.

  6. Europeanization and transnational states

    DEFF Research Database (Denmark)

    Jacobsson, Bengt; Lægreid, Per; Pedersen, Ove K.

    This work investigates what happens to an organized political unit when it becomes part of a larger entity and, in particular, how increased European integration and the tentative moves towards a transnational state will affect the European Union's nation state. Europeanization and the transforma......This work investigates what happens to an organized political unit when it becomes part of a larger entity and, in particular, how increased European integration and the tentative moves towards a transnational state will affect the European Union's nation state. Europeanization...... in central government agencies. It concludes that the consequences of Europeanization can be described as the growth of a transnational administration where identities as well as loyalties are created in processes that transcend the borders of states....

  7. Children's disclosures of sexual abuse in a population-based sample.

    Science.gov (United States)

    Lahtinen, Hanna-Mari; Laitila, Aarno; Korkman, Julia; Ellonen, Noora

    2018-02-01

    Most previous studies on disclosing child sexual abuse (CSA) have either been retrospective or focused on children who already have disclosed. The present study aimed to explore the overall CSA disclosure rate and factors associated with disclosing to adults in a large population-based sample. A representative sample of 11,364 sixth and ninth graders participated in the Finnish Child Victim Survey concerning experiences of violence, including CSA. CSA was defined as having sexual experiences with a person at least five years older at the time of the experience. Within this sample, the CSA prevalence was 2.4%. Children reporting CSA experiences also answered questions regarding disclosure, the disclosure recipient, and potential reasons for not disclosing. The results indicate that most of the children (80%) had disclosed to someone, usually a friend (48%). However, only 26% had disclosed to adults, and even fewer had reported their experiences to authorities (12%). The most common reason for non-disclosing was that the experience was not considered serious enough for reporting (41%), and half of the children having CSA experiences did not self-label their experiences as sexual abuse. Relatively few children reported lacking the courage to disclose (14%). Logistic regression analyses showed that the perpetrator's age, the age of the victim at the time of abuse, and having no experiences of emotional abuse by the mother were associated with disclosing to an adult. The results contribute to understanding the factors underlying children's disclosure patterns in a population-based sample and highlight the need for age-appropriate safety education for children and adolescents. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Cancer survival in China, 2003-2005: a population-based study.

    Science.gov (United States)

    Zeng, Hongmei; Zheng, Rongshou; Guo, Yuming; Zhang, Siwei; Zou, Xiaonong; Wang, Ning; Zhang, Limei; Tang, Jingao; Chen, Jianguo; Wei, Kuangrong; Huang, Suqin; Wang, Jian; Yu, Liang; Zhao, Deli; Song, Guohui; Chen, Jianshun; Shen, Yongzhou; Yang, Xiaoping; Gu, Xiaoping; Jin, Feng; Li, Qilong; Li, Yanhua; Ge, Hengming; Zhu, Fengdong; Dong, Jianmei; Guo, Guoping; Wu, Ming; Du, Lingbin; Sun, Xibin; He, Yutong; Coleman, Michel P; Baade, Peter; Chen, Wanqing; Yu, Xue Qin

    2015-04-15

    Limited population-based cancer registry data available in China until now has hampered efforts to inform cancer control policy. Following extensive efforts to improve the systematic cancer surveillance in this country, we report on the largest pooled analysis of cancer survival data in China to date. Of 21 population-based cancer registries, data from 17 registries (n = 138,852 cancer records) were included in the final analysis. Cases were diagnosed in 2003-2005 and followed until the end of 2010. Age-standardized relative survival was calculated using region-specific life tables for all cancers combined and 26 individual cancers. Estimates were further stratified by sex and geographical area. The age-standardized 5-year relative survival for all cancers was 30.9% (95% confidence intervals: 30.6%-31.2%). Female breast cancer had high survival (73.0%) followed by cancers of the colorectum (47.2%), stomach (27.4%), esophagus (20.9%), with lung and liver cancer having poor survival (16.1% and 10.1%), respectively. Survival for women was generally higher than for men. Survival for rural patients was about half that of their urban counterparts for all cancers combined (21.8% vs. 39.5%); the pattern was similar for individual major cancers except esophageal cancer. The poor population survival rates in China emphasize the urgent need for government policy changes and investment to improve health services. While the causes for the striking urban-rural disparities observed are not fully understood, increasing access of health service in rural areas and providing basic health-care to the disadvantaged populations will be essential for reducing this disparity in the future. © 2014 UICC.

  9. Positive surgical margins at radical prostatectomy: Population-based averages within PSA and Gleason strata.

    Science.gov (United States)

    Izard, Jason P; Salazar, Marco A; Chatterjee, Suman; Lin, Daniel W; Wright, Jonathan L

    2013-01-01

    Positive surgical margins (PSM) are an important determinant of biochemical recurrence after radical prostatectomy (RP). We use a population-based cancer registry to evaluate PSM by stage, Gleason and prostate-specific antigen (PSA). We identified men undergoing RP from the Surveillance, Epidemiology and End Results (SEER) database between 2004 and 2007. Differences between those with and without PSM were compared with chi-squared tests. The proportion of cases with PSM were stratified by PSA and Gleason sum for both pT2 and pT3a tumours. Factors associated with PSM were analyzed using chi square and multivariate logistic regression analysis. A composite variable was used in a second multivariate analysis to display the odds ratio (OR) for a PSM for each discrete combination of PSA, Gleason score and pT stage. In total, 28 461 RP patients were identified and a PSM was present in 19.5%. PSM were 42% in pT3a and 16% in pT2 cases. Higher PSAs (10) were associated with higher proportions of PSM (12%, 20% and 28%, p strata compared to those with pT2 tumours, reaching 63% for those with pT3a, Gleason 8-10, PSA >10 disease. On multivariate analysis, stage was the largest predictor for PSM (OR 3.05, 95% confidence interval 2.81-3.30), although Gleason score and PSA remained statistically significant. In this population-based study of PSM after RP, the proportion of PSM vary significantly within different PSA and Gleason strata for organ-confined and extracapsular disease. These data can be used as a reference for urologist self-assessment.

  10. Children and youth with non-traumatic brain injury: a population based perspective.

    Science.gov (United States)

    Chan, Vincy; Pole, Jason D; Keightley, Michelle; Mann, Robert E; Colantonio, Angela

    2016-07-20

    Children and youth with non-traumatic brain injury (nTBI) are often overlooked in regard to the need for post-injury health services. This study provided population-based data on their burden on healthcare services, including data by subtypes of nTBI, to provide the foundation for future research to inform resource allocation and healthcare planning for this population. A retrospective cohort study design was used. Children and youth with nTBI in population-based healthcare data were identified using International Classification of Diseases Version 10 codes. The rate of nTBI episodes of care, demographic and clinical characteristics, and discharge destinations from acute care and by type of nTBI were identified. The rate of pediatric nTBI episodes of care was 82.3 per 100,000 (N = 17,977); the average stay in acute care was 13.4 days (SD = 25.6 days) and 35% were in intensive care units. Approximately 15% were transferred to another inpatient setting and 6% died in acute care. By subtypes of nTBI, the highest rates were among those with a diagnosis of toxic effect of substances (22.7 per 100,000), brain tumours (18.4 per 100,000), and meningitis (15.4 per 100,000). Clinical characteristics and discharge destinations from the acute care setting varied by subtype of nTBI; the proportion of patients that spent at least one day in intensive care units and the proportion discharged home ranged from 25.9% to 58.2% and from 50.6% to 76.4%, respectively. Children and youth with nTBI currently put an increased demand on the healthcare system. Active surveillance of and in-depth research on nTBI, including subtypes of nTBI, is needed to ensure that timely, appropriate, and targeted care is available for this pediatric population.

  11. Area-level poverty and preterm birth risk: A population-based multilevel analysis

    Directory of Open Access Journals (Sweden)

    Muglia Louis A

    2008-09-01

    Full Text Available Abstract Background Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate. Methods Population-based study utilizing Missouri's birth certificate database (1989–1997. We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990. Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty was the reference group. Results PTB th quartile (4.9%, p adjOR 1.18 (95% CI 1.03, 1.35, with a similar effect at earlier gestational ages (adjOR 1.27 (95% CI 1.06, 1.52. Conclusion Women residing in socioeconomically deprived areas are at increased risk of preterm birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies.

  12. A quantitative meta-analysis of population-based studies of premorbid intelligence and schizophrenia

    Science.gov (United States)

    Khandaker, Golam M.; Barnett, Jennifer H.; White, Ian R.; Jones, Peter B.

    2011-01-01

    Objective A premorbid IQ deficit supports a developmental dimension to schizophrenia and its cognitive aspects that are crucial to functional outcome. Better characterisation of the association between premorbid IQ and the disorder may provide further insight into its origin and etiology. We aimed to quantify premorbid cognitive function in schizophrenia through systematic review and meta-analysis of longitudinal, population-based studies, and to characterize the risk of schizophrenia across the entire range of premorbid IQ. Method Electronic and manual searches identified general population-based cohort or nested case–control studies that measured intelligence before onset of schizophrenic psychosis using standard psychometric tests, and that defined cases using contemporaneous ICD or DSM. Meta-analyses explored dose–response relationships between premorbid cognitive deficit (using full-scale, verbal and performance IQ) and risk of schizophrenia. Meta-regression analyses explored relationships with age of illness onset, change in premorbid intelligence over time and gender differences. Results Meta-analysis of 4396 cases and over 745 000 controls from 12 independent studies confirmed significant decrements in premorbid IQ (effect size − 0.43) among future cases. Risk of schizophrenia operated as a consistent dose–response effect, increasing by 3.7% for every point decrease in IQ (p IQ decrement was associated with earlier illness onset (p IQ and risk for schizophrenia, and age of illness onset argue for a widespread neurodevelopmental contribution to schizophrenia that operates across the entire range of intellectual ability. This also suggests higher IQ may be protective in schizophrenia, perhaps by increasing active cognitive reserve. PMID:21764562

  13. Hereditary ataxia and spastic paraplegia in Portugal: a population-based prevalence study.

    Science.gov (United States)

    Coutinho, Paula; Ruano, Luis; Loureiro, José L; Cruz, Vitor T; Barros, José; Tuna, Assunção; Barbot, Clara; Guimarães, João; Alonso, Isabel; Silveira, Isabel; Sequeiros, Jorge; Marques Neves, José; Serrano, Pedro; Silva, M Carolina

    2013-06-01

    Epidemiological data on hereditary cerebellar ataxia (HCA) and hereditary spastic paraplegia (HSP) are scarce. To present the prevalence and distribution of HCA and HSP in Portugal. Population-based, nationwide, systematic survey, from January 1, 1994, through April 15, 2004, in Portugal. Multiple sources of information were used (review of clinical files, active collaboration of neurologists and geneticists, and investigation of affected families), but the main source was active collaboration of general practitioners. Patients were examined by the same team of neurologists, using homogeneous inclusion criteria. The clinical data were registered, and all families were genetically tested. Overall, 1336 patients from a population of 10,322 million were diagnosed as having HCA or HSP, a prevalence of 12.9 per 100,000 population. Hereditary cerebellar ataxia was more prevalent (prevalence, 8.9 per 100,000 population; 5.6 for dominant and 3.3 for recessive ataxias) than HSP (prevalence, 4.1 per 100,000 population; 2.4 for dominant and 1.6 for recessive). Machado-Joseph disease (spinocerebellar ataxia type 3) (prevalence, 3.1 per 100,000 population), Friedreich ataxia (prevalence, 1.0 per 100,000 population), and ataxia with oculomotor apraxia (prevalence, 0.4 per 100,000 population) were the most frequent HCAs. Spastic paraplegia types 4 (prevalence, 0.91 per 100,000 population), 3 (prevalence, 0.14 per 100,000 population), and 11 (prevalence, 0.26 per 100,000 population) were the most prevalent HSPs. This population-based survey covered all the Portuguese territory and mobilized most general practitioners and health centers. To our best knowledge, this survey was the largest ever performed for HCA and HSP. Prevalence of autosomal dominant ataxias was high, particularly for Machado-Joseph disease (spinocerebellar ataxia type 3). The genetic cause has not been identified in 39.7% of the patients studied.

  14. Food-related parenting practices and adolescent weight status: a population-based study.

    Science.gov (United States)

    Loth, Katie A; MacLehose, Richard F; Fulkerson, Jayne A; Crow, Scott; Neumark-Sztainer, Dianne

    2013-05-01

    To examine food-related parenting practices (pressure-to-eat and food restriction) among mothers and fathers of adolescents and associations with adolescent weight status within a large population-based sample of racially/ethnically and socioeconomically diverse parent-adolescent pairs. Adolescents (N = 2231; 14.4 years old [SD = 2.0]) and their parents (N = 3431) participated in 2 coordinated population-based studies designed to examine factors associated with weight status and weight-related behaviors in adolescents. Adolescents completed anthropometric measurements and surveys at school. Parents (or other caregivers) completed questionnaires via mail or phone. Findings suggest that the use of controlling food-related parenting practices, including pressure-to-eat and restriction, is common among parents of adolescents. Mean restriction levels were significantly higher among parents of overweight and obese adolescents compared with nonoverweight adolescents. However, levels of pressure-to-eat were significantly higher among nonoverweight adolescents. Results indicate that fathers are more likely than mothers to engage in pressure-to-eat behaviors and boys are more likely than girls to be on the receiving end of parental pressure-to-eat. Parental report of restriction did not differ significantly by parent or adolescent gender. No significant interactions by race/ethnicity or socioeconomic status were seen in the relationship between restriction or pressure-to-eat and adolescent weight status. Given that there is accumulating evidence for the detrimental effects of controlling feeding practices on children's ability to self-regulate energy intake, these findings suggest that parents should be educated and empowered through anticipatory guidance to encourage moderation rather than overconsumption and emphasize healthful food choices rather than restrictive eating patterns.

  15. Delivery of physical therapy in the acute care setting: a population-based study.

    Science.gov (United States)

    Freburger, Janet K; Heatwole Shank, Kendra; Knauer, Stefanie R; Montmeny, Richard M

    2012-02-01

    Population-based studies on physical therapy use in acute care are lacking. The purpose of this study was to examine population-based, hospital discharge data from North Carolina to describe the demographic and diagnostic characteristics of individuals who receive physical therapy and, for common diagnostic subgroups, to identify factors associated with the receipt of and intensity of physical therapy use. This was a cross-sectional, descriptive study. Hospital discharge data for 2006-2007 from the 128 acute care hospitals in the state were examined to identify the most common diagnoses that receive physical therapy and to describe the characteristics of physical therapy users. For 2 of the most common diagnoses, logistic and linear regression analyses were conducted to identify factors associated with the receipt and intensity of physical therapy. Of the more than 2 million people treated in acute care hospitals, 22.5% received physical therapy (mean age=66 years; 58% female). Individuals with osteoarthritis (admitted for joint replacement) and stroke were 2 of the most common patient types to receive physical therapy. Almost all individuals admitted for a joint replacement received physical therapy, with little between-hospital variation. Between-hospital variation in physical therapy use for stroke was greater. Demographic and hospital-related factors were associated with physical therapy use and physical therapy intensity for both diagnoses, after controlling for illness severity and comorbidities. Data from only one state were examined, and the studied variables were limited. The use and intensity of physical therapy for stroke and joint replacement in acute care hospitals in North Carolina vary by clinical and nonclinical factors. Reasons behind the association of hospital characteristics and physical therapy use need further investigation.

  16. Predicting mortality of incident dialysis patients in Taiwan--a longitudinal population-based study.

    Directory of Open Access Journals (Sweden)

    Ping-Hsun Wu

    Full Text Available BACKGROUND: Comorbid conditions are highly prevalent among patients with end-stage renal disease (ESRD and index score is a predictor of mortality in dialysis patients. The aim of this study is to perform a population-based cohort study to investigate the survival rate by age and Charlson comorbidity index (CCI in incident dialysis patients. METHODS: Using the catastrophic illness registration of the Taiwan National Health Insurance Research Database for all patients from 1 January 1998 to 31 December 2008, individuals newly diagnosed with ESRD and receiving dialysis for more than 90 days were eligible for our study. Individuals younger than 18 years or renal transplantation patients either before or after dialysis were excluded. We calculated the CCI, age-weighted CCI by Deyo-Charlson method according to ICD-9 code and categorized CCI into six groups as index scores 15. Cox regression models were used to analyze the association between age, CCI and survival, and the risk markers of survival. RESULTS: There were 79,645 incident dialysis patients, whose mean age (± SD was 60.96 (±13.92 years; 51.43% of patients were women and 51.2% were diabetic. In cox proportional hazard models and stratifying by age, older patients had significantly higher mortality than younger patients. The mortality risk was higher in persons with higher CCI as compared with low CCI. Mortality increased steadily with higher age or comorbidity both for unadjusted and for adjusted models. For all age groups, mortality rates increased in different CCI groups with the highest rates occurring in the oldest age groups. CONCLUSIONS: Age and CCI are both strong predictors of survival in Taiwan. The older age or higher comorbidity index in incident dialysis patient is associated with lower long-term survival rates. These population-based estimates may assist clinicians who make decisions when patients need long-term dialysis.

  17. Risk factors for fractures of the distal forearm: a population-based case-control study.

    Science.gov (United States)

    Mallmin, H; Ljunghall, S; Persson, I; Bergström, R

    1994-11-01

    To evaluate the risk factors for early osteoporosis in consecutive patients with fracture of the distal forearm, a population-based case-control study was carried out using postal questionnaires supplemented by interviews when necessary. All men and women between the ages of 40 and 80 years who were resident in the County of Uppsala (population 265,000) and who sustained a fracture of the distal forearm during a defined 12-month period were initially included. Of 427 cases, 385 (90.2%) replied. Those with previous fragility fractures were excluded, leaving 367 patients in the study (mean age 61.9 +/- 10.6 years): 302 women (mean age 62.8 +/- 10.1 years) and 65 men (mean age 57.5 +/- 11.8 years). For each patient an age- and sex-matched control without previous fragility fractures was selected from the population register. The questionnaire concerned heredity, diseases and medications, general health, tobacco smoking and physical activity. Reproductive variables and postmenopausal hormone replacement therapy were analyzed extensively. In neither sex were any significant, consistent differences found with regard to chronic diseases, medications, physical activity or smoking. In females heredity for fractures (odds ratio, OR = 1.46) was associated with an increased risk. Nulliparous women had an increased risk of forearm fractures (OR = 1.72) while late menopause (OR = 0.95) and postmenopausal oestrogen therapy > 2 years (OR = 0.44) appeared to be protective. It is concluded that lifestyle factors did not discriminate between fracture patients and controls in this strict population-based investigation, suggesting that in affluent Western societies, with their high fracture rate, most individuals have an osteoporosis-prone way of life.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Seroprevalence of Helicobacter pylori in Hispanics living in Puerto Rico: A population-based study.

    Science.gov (United States)

    González-Pons, María; Soto-Salgado, Marievelisse; Sevilla, Javier; Márquez-Lespier, Juan M; Morgan, Douglas; Pérez, Cynthia M; Cruz-Correa, Marcia

    2018-02-01

    Helicobacter pylori is an important etiologic factor for peptic ulcers and gastric cancer, one of the top ten leading causes of cancer death in Puerto Rico. However, the prevalence of H. pylori infections in this population was previously unknown. The aim of this study was to examine the seroprevalence of H. pylori and its associated risk factors in Puerto Rico. A cross-sectional study was designed using an existing population-based biorepository. Seropositivity was determined using the Premier ™ H. pylori immunoassay. Helicobacter pylori seroprevalence was estimated with 95% confidence using marginal standardization following logistic regression. To assess the risk factors associated with H. pylori seropositivity, a multivariable log-binomial model was fitted to estimate the prevalence ratio (PR) and its 95% confidence interval (95% CI). A total of 528 population-based serum samples were analyzed. The mean age of the study population was 41 ± 12 years, of whom 55.3% were females. The overall seroprevalence of H. pylori was 33.0% (95% CI = 28.3%-38.1%). Increasing age and having Puerto Rico. The H. pylori seroprevalence observed in Puerto Rico is similar to the seroprevalence reported in the overall population of the United States. The association between H. pylori seroprevalence and the risk factors analyzed offers insight into the epidemiology of gastric cancer in Puerto Rico and warrants further investigation. © 2017 The Authors. Helicobacter Published by John Wiley & Sons Ltd.

  19. The Relation between Sleep Disruption and Cataract in a Large Population-Based Study.

    Science.gov (United States)

    Chen, Yanjun; Nondahl, David M; Schubert, Carla R; Klein, Barbara E K; Klein, Ronald; Cruickshanks, Karen J

    2017-04-01

    To investigate the relation between sleep disruption and nuclear cataract, as well as the impact of cataract removal on sleep, in two discrete population-based cohorts. This is a cross-sectional study of 5070 participants from three large longitudinal epidemiologic studies of age-related eye disease, hearing, olfaction, and cognition. Slit-lamp photos of the lens were obtained to grade nuclear cataract using a standardized protocol. The quality of sleep was assessed using a modified Wisconsin Sleep Cohort Study questionnaire. Multiple linear regression analyses were used to assess the associations between levels of nuclear cataract/cataract extraction and the number of sleep problems. Systemic co-morbidity data were included as potential confounders, including diabetes mellitus, obesity, hypertension, cerebrovascular disease, thyroid disease, tobacco and alcohol use, and physical component summary score and mental component summary score. The mean age of the cohort was 57.6 years (range 22-95 years). The majority of the cohort demonstrated nuclear cataract levels 2 or 3 (36.8% and 30.1%, respectively). A total of 8% of the cohort had an intraocular lens (IOL) in at least one eye. There was no statistically significant correlation between sleep problems with presence of either nuclear cataract or IOL implant (p > 0.05). In this cross-sectional, population-based study, we found no significant association between nuclear cataract or presence of IOL with poor sleep quality after adjusting for potential confounders. Studies of the longitudinal impact of nuclear cataract and cataract removal on sleep are needed to elucidate the role of nuclear cataract and cataract removal on sleep.

  20. The association of coeliac disease and microscopic colitis: a large population-based study.

    Science.gov (United States)

    Stewart, M; Andrews, C N; Urbanski, S; Beck, P L; Storr, M

    2011-06-01

    An association between microscopic colitis and coeliac disease (CD) has been suggested in literature; however, population-based data are limited. To estimate the degree of association between these two diseases and to identify possible risk factors for disease concomitance. A population-based review of all patients diagnosed with CD and microscopic colitis in a large Canadian centre over a 5-year period. Endoscopy and pathology databases were searched to identify all cases of CD and microscopic colitis diagnosed within the Calgary Health Region between 2004 and 2008. Incidence rates were age-standardised and gender-standardised to 2006 Canadian Census data. standardised incidence ratios (SIR) were used to assess disease concomitance. Over 5 years, 763 patients were diagnosed with CD, and 1106 were diagnosed with microscopic colitis. The standardised incidence of CD ranged from 10.4 to 15.7 per 100,000 population. The standardised incidence of microscopic colitis ranged from 16.9 to 26.2 per 100,000 population. Forty patients were diagnosed with both CD and microscopic colitis, 21 of whom were middle aged (40-60 years) females. Within the CD cohort, microscopic colitis occurred at an annual rate of 11.4 per 1000 cases of CD with an overall SIR of 52.7. There exists a strong association between microscopic colitis and CD with disease concomitance being approximately 50-times that expected in the general population. The concomitant diagnosis of CD and microscopic colitis largely occurs in middle-aged women. Therefore, middle-aged women with CD and diarrhoea as a presenting or persistent symptom should undergo lower endoscopy with biopsies to rule out microscopic colitis. © 2011 Blackwell Publishing Ltd.