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Sample records for prognosis a population-based study

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    cohort: 72.6%]. Thirty-day mortality was elevated for patients with Cbl levels of 601-800pmol/L or >800pmol/L, compared to patients with levels of 200-600pmol/L [(MRR (95% confidence interval): 601-800pmol/L vs. 200-600pmol/L: 1.9 (1.6-2.2); >800pmol/L vs. 200-600pmol/L: 2.7 (2.4-3.1)]. This association...... study using data from Danish medical registries during 1998-2014. The study included 25,017 patients with a cancer diagnosis and Cbl levels of 200-600pmol/L (reference/normal range), 601-800pmol/L and >800pmol/L measured up to one year prior to diagnosis, and a comparison cohort of 61,988 cancer...... using the Charlson comorbidity index. RESULTS: Survival probabilities were lower among patients with elevated Cbl levels than among patients with normal levels and among members of the comparison cohort [(1-year survival,%) Cbl: 200-600pmol/L: 69.3%; 601-800pmol/L: 49.6%; >800pmol/L: 35.8%; comparison...

  2. Incidence and late prognosis of cushing's syndrome: a population based study

    DEFF Research Database (Denmark)

    Lindholm, J; Juul, Svend; Jørgensen, Jens Otto Lunde

    2001-01-01

    The main purpose was to assess the incidence and late outcome of Cushing’s syndrome, particularly in Cushing’s disease. Information for all patients diagnosed with Cushing’s syndrome during an 11-yr period in Denmark was retrieved. The incidence was 1.2–1.7/million·yr (Cushing’s disease), 0.......6/million·yr (adrenal adenoma) and 0.2/million·yr (adrenal carcinoma). Other types of Cushing’s syndrome were rare. In 139 patients with nonmalignant disease, 11.1% had died during follow-up (median, 8.1 yr; range, 3.1–14.0), yielding a standard mortality ratio (SMR) of 3.68 [95% confidence interval (CI), 2...... separately, including a questionnaire on their perceived quality of health. In 45 patients with Cushing’s disease who had been cured through transsphenoidal neurosurgery, only 1 had died (SMR, 0.31; CI, 0.01–1.72) compared with 6 of 20 patients with persistent hypercortisolism after initial neurosurgery (SMR...

  3. A population-based study of prognosis in advanced stage follicular lymphoma managed by watch and wait

    DEFF Research Database (Denmark)

    El-Galaly, Tarec Christoffer; Bilgrau, Anders E; de Nully Brown, Peter

    2015-01-01

    Watch and wait (WAW) is a common approach for asymptomatic, advanced stage follicular lymphoma (FL), but single-agent rituximab is an alternative for these patients. In this nationwide study we describe the outcome of patients selected for WAW. A cohort of 286 out of 849 (34%) stage III-IVA FL pa...... managed by WAW had a favourable outcome and abandoning this strategy could lead to overtreatment in some patients....... patients seen between 2000 and 2011, were managed expectantly and included. The 5-year progression-free survival (PFS) was 35% [95% confidence interval (CI) 29-42]. The 10-year overall survival (OS) was 65% (95%CI 54-78), and the cumulative risk of dying from lymphoma within 10 years of diagnosis was 13......% (95%CI 7-20). Elevated lactate dehydrogenase and > four nodal regions involved were associated with a higher risk of lymphoma treatment and death from lymphoma. The WAW patients and a matched background population had similar OS during the first 50 months after diagnosis (P = 0·7), but WAW patients...

  4. A population based study of variations in operation rates for breast cancer, of comorbidity and prognosis at diagnosis: failure to operate for early breast cancer in older women.

    Science.gov (United States)

    Bates, T; Evans, T; Lagord, C; Monypenny, I; Kearins, O; Lawrence, G

    2014-10-01

    Older women are less likely to have surgery for operable breast cancer. This population-based study examines operation rates by age and identifies groups which present with early or late disease. 37 000 cancer registrations for 2007 were combined with Hospital Episode Statistics comorbidity data for England. Operation rates were examined by age, ethnicity, deprivation, comorbidity, screen-detection, tumour size, grade and nodal status. Early and late presentation were correlated with Nottingham Prognostic Index (NPI) groups and tumour size. The proportion of women not having surgery increased from 7-10% at ages 35-69 to 82% from age 90. From age 70, the proportion not having surgery rose by an average of 3.1% per year of age. Women with a Charlson Comorbidity Index score of ≥1 (which increased with age), with tumours >50 mm or who were node positive, were less likely to have surgery. Although women aged 70-79 were more likely to have larger tumours, their tumours were also more likely to have an excellent or good NPI (p women aged 0-39, the deprived and certain ethnic groups (p breast cancer. Younger women and certain ethnic groups presented with more advanced tumours. Older women had larger tumours which were otherwise of good prognosis, and this would not account for the failure to operate which may in part be related to comorbidity in this age group. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Pre- and post-bronchodilator airway obstruction are associated with similar clinical characteristics but different prognosis – report from a population-based study

    Directory of Open Access Journals (Sweden)

    Sawalha S

    2017-04-01

    Full Text Available Sami Sawalha,1 Linnea Hedman,2 Eva Rönmark,2 Bo Lundbäck,3 Anne Lindberg1 1Department of Public Health and Clinical Medicine, Division of Medicine, 2Department of Public Health and Clinical Medicine, The OLIN Unit, Division of Occupational and Environmental Medicine, Umeå University, Umeå, 3Krefting Research Center, Institution of Medicine, University of Gothenburg, Gothenburg, Sweden Introduction: According to guidelines, the diagnosis of COPD should be confirmed by post-bronchodilator (post-BD airway obstruction on spirometry; however, in clinical practice, this is not always performed. The aim of this population-based study was to compare clinical characteristics and prognosis, assessed as mortality, between subjects with airway obstruction divided into pre- but not post-BD obstruction, post-BD airway obstruction (COPD, and subjects without airway obstruction.Materials and methods: In 2002–2004, four adult population-based cohorts were reexamined with spirometry and structured interview. Subjects with airway obstruction, with a ratio of forced expiratory volume in 1 s to (forced vital capacity <0.70 (n=993, were identified together with sex- and age-matched referents (n=993. These subjects were further divided into subjects with pre- but not post-BD airway obstruction (pre- not post-BD obstruction and subjects with post-BD airway obstruction (COPD. Mortality data were collected until December 31, 2014.Results: Out of 993 subjects with airway obstruction, 736 (74% had COPD and 257 (26% pre- not post-BD obstruction. Any respiratory symptoms, allergic rhinitis, asthma, exacerbations, and comorbidities were equally common among subjects with COPD and pre- not post-BD obstruction, but less common among nonobstructive subjects. Mortality was highest among subjects with COPD and higher in men than in women. In both sexes, COPD, but not pre- not post-BD obstruction, was associated with an increased risk for death compared to those without

  6. Age-Related Disparity in Immediate Prognosis of Patients with Triple-Negative Breast Cancer: A Population-Based Study from SEER Cancer Registries.

    Directory of Open Access Journals (Sweden)

    Wenjie Zhu

    Full Text Available Triple-negative breast cancer (TNBC has been demonstrated to carry poor prognosis, but whether or not there exists any age-related variation in TNBC outcomes has yet to be elucidated. The current population-based study investigated the early survival pattern of elderly women with TNBC and identified outcome-correlated factors.We searched the Surveillance, Epidemiology, and End Results (SEER database and enrolled female primary non-metastatic TNBC cases. The patients were subdivided into elderly (≥70 years and young groups (<70 years. The survival status of elderly patients was compared to that of the younger women. The primary and secondary endpoints were cancer-specific survival (CSS and overall survival (OS respectively.9908 female TNBC patients diagnosed from 2010 to 2011 were included in the current study (20.4% elderly. Elderly patients with relatively advanced diseases exhibited distinctly worse cancer-specific (log-rank, p<0.001 and overall survival (log-rank, p<0.001 than their young counterparts. Advanced age at diagnosis (≥70 years was significantly predictive of poor outcome in terms of CSS (hazard ratio (HR, 2.125; 95% confidence interval (CI, 1.664 to 2.713; p<0.001 and OS (HR, 3.042; 95%CI, 2.474 to 3.740; p<0.001. Underuse of curative treatment especially radiotherapy was more prevalent in elderly women with stage II or III diseases than in younger patients.Elderly patients with TNBC displayed elevated early mortality within the first two years of diagnosis compared to the younger individuals. The observed lower rate of loco-regional treatment might be associated with worse cancer-specific outcome for these patients.

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

    Science.gov (United States)

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

    2014-12-30

    To study the influence of healthy lifestyle behaviour on the prognosis of occasional low back pain among men and women in a general population. Cohort study with a 4-year follow-up. General population in Stockholm County, Sweden. The study sample comprised 3938 men and 5056 women aged 18-84 from the Stockholm Public Health Cohort reporting occasional low back pain in the baseline questionnaire 2006. Lifestyle factors and potential confounders were assessed at baseline. The lifestyle factors smoking habits, alcohol consumption, leisure physical activity and consumption of fruit and vegetables were dichotomised using recommendations for a health-enhancing lifestyle and combined to form the exposure variable 'healthy lifestyle behaviour'. The exposure was categorised into five levels according to the number of healthy lifestyle factors met. The follow-up questionnaire in 2010 gave information about the outcome, long duration troublesome low back pain. Crude and adjusted binomial regression models were applied to estimate the association between the exposure and the outcome analysing men and women separately. The risk of developing long duration troublesome low back pain among women with occasional low back pain decreased with increasing healthy lifestyle behaviour (trend test: p=0.006). 21% (28/131) among women with no healthy lifestyle factor (reference) experienced the outcome compared to 9% (36/420) among women with all four factors. Compared to the reference group, the risk was reduced by 35% (RR 0.65, 95% CI 0.44 to 0.96) for women with one healthy lifestyle factor and 52% (RR 0.48, 95% CI 0.31 to 0.77) for women with all four healthy lifestyle factors. There were no clear associations found among men. Healthy lifestyle behaviour seems to decrease the risk of developing long duration troublesome low back pain among women with occasional low back pain and may be recommended to improve the prognosis. Published by the BMJ Publishing Group Limited. For permission to

  8. Population-based study of capsular warning syndrome and prognosis after early recurrent TIA.

    Science.gov (United States)

    Paul, Nicola L M; Simoni, Michela; Chandratheva, Arvind; Rothwell, Peter M

    2012-09-25

    Many guidelines recommend emergency assessment for patients with ≥2 TIAs within 7 days, perhaps in recognition of the capsular warning syndrome. However, it is unclear whether all patients with multiple TIAs are at high early risk of stroke and whether treatable underlying pathologies are more prevalent in this group. We studied clinical characteristics, Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, and risk of stroke in 1,000 consecutive patients with incident and recurrent TIAs in a prospective, population-based study (Oxford Vascular Study). Of 1,000 patients with TIAs, 170 had a further TIA within 7 days (105 within 24 hours). Multiple TIAs were not associated with carotid stenosis or atrial fibrillation, and much of the 10.6 (95% confidence interval [CI] 6.5-15.9) risk of stroke during the 7 days after the first TIA was due to patients with small-vessel disease (SVD) etiology (10 of 24 vs 8 of 146, odds ratio [OR] = 12.3, 95% CI 3.7-41.9, p warning syndrome) compared with hemisensory events (9 of 15 [60%], 95% CI 35.3-84.7 vs 1 of 9 [11.1%], 95% CI 0-31.7, p = 0.03). The 7-day risk of stroke after a recurrent TIA was similar to the risk after a single TIA in patients with non-SVD TIA (8 of 146 [5.5%] vs 76 of 830 [9.2%], OR = 0.58, 95% CI 0.25-1.3, p = 0.20). Of the 9 patients with stroke after a capsular warning syndrome, all had the recurrent TIA within 24 hours after the first TIA, and the subsequent stroke occurred within 72 hours of the second TIA in 8. The ABCD2 scores of all preceding TIAs were ≥4 in all 9 patients with capsular warning syndrome before stroke. Capsular warning syndrome is rare (1.5% of TIA presentations) but has a poor prognosis (7-day stroke risk of 60%). Otherwise, recurrent TIA within 7 days is not associated with a greater stroke risk than that after a single TIA.

  9. Pre- and post-diagnostic beta-blocker use and prognosis after colorectal cancer: Results from a population-based study.

    Science.gov (United States)

    Jansen, Lina; Weberpals, Janick; Kuiper, Josephina G; Vissers, Pauline A J; Wolkewitz, Martin; Hoffmeister, Michael; Brenner, Hermann

    2017-07-01

    Recent experimental and epidemiological studies have suggested that beta-blocker use might be associated with better cancer prognosis, but results were inconclusive and only few studies have investigated the association specifically for colorectal cancer (CRC) patients. We investigated this hypothesis using a linked dataset of the Eindhoven area of the Netherlands Cancer Registry and the PHARMO record linkage, including patients diagnosed with CRC between 1998 and 2011. Eligible patients were matched on propensity scores to control for potential confounders such as socio-demographic factors, comorbidity, cancer treatment and use of other medications. Controls were subsequently restricted to active comparators. The association between pre-diagnostic and time-dependent post-diagnostic beta-blocker use and overall survival was estimated using Cox proportional hazard regression models. Subgroup analyses by cancer site and stage and by beta-blocker type were conducted. Of 8,100 CRC patients with a median follow-up of 6.6 years, 1,813 (22%) used beta-blockers prior to diagnosis. In multivariate analysis, we observed no significant association in overall mortality for pre-diagnostic [hazard ratio 1.07, 95% confidence interval (0.96-1.19)] and post-diagnostic [1.10 (0.98-1.23)] beta-blocker use, respectively. Analyses by beta-blocker type, by cancer site, cancer stage and by cumulative dose showed no significant survival improvements for beta-blocker users. However, there was a significant association between cumulative duration of use of 1-12 months and increased overall mortality [1.20 (1.03-1.39)]. Thus, our results do not support the hypothesis of a beneficial effect of pre- or post-diagnostic beta-blocker intake on CRC prognosis, neither for specific patient subgroups nor for specific types of beta-blockers. © 2017 UICC.

  10. Prognosis and Risk Factors for Congenital Airway Anomalies in Children with Congenital Heart Disease: A Nationwide Population-Based Study in Taiwan.

    Directory of Open Access Journals (Sweden)

    Yu-Sheng Lee

    Full Text Available The mortality risk associated with congenital airway anomalies (CAA in children with congenital heart disease (CHD is unclear. This study aimed to investigate the factors associated with CAA, and the associated mortality risk, among children with CHD.This nationwide, population-based study evaluated 39,652 children with CHD aged 0-5 years between 2000 and 2011, using the Taiwan National Health Insurance Research Database (NHIRD. We performed descriptive, logistic regression, Kaplan-Meier, and Cox regression analyses of the data.Among the children with CHD, 1,591 (4.0% had concomitant CAA. Children with CHD had an increased likelihood of CAA if they were boys (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.33-1.64, infants (OR, 5.42; 95%CI, 4.06-7.24, or had a congenital musculoskeletal anomaly (OR, 3.19; 95%CI, 2.67-3.81, and were typically identified 0-3 years after CHD diagnosis (OR, 1.33; 95%CI 1.17-1.51. The mortality risk was increased in children with CHD and CAA (crude hazard ratio [HR], 2.05; 95%CI, 1.77-2.37, even after adjusting for confounders (adjusted HR, 1.76; 95%CI, 1.51-2.04. Mortality risk also changed by age and sex (adjusted HR and 95%CI are quoted: neonates, infants, and toddlers and preschool children, 1.67 (1.40-2.00, 1.93 (1.47-2.55, and 4.77 (1.39-16.44, respectively; and boys and girls, 1.62 (1.32-1.98 and 2.01 (1.61-2.50, respectively.The mortality risk is significantly increased among children with CHD and comorbid CAA. Clinicians should actively seek CAA during the follow-up of children with CHD.

  11. Impact of the number of histologically examined lymph nodes on prognosis in colon cancer : a population-based study in the Netherlands

    NARCIS (Netherlands)

    Kelder, Wendy; Inberg, Bas; Schaapveld, Michael; Karrenbeld, Arend; Grond, Joris; Wiggers, Theo; Plukker, John T.

    PURPOSE: The impact of the reported number of lymph nodes at pathologic examination of colon specimens on survival was studied. METHODS: The data of 2,281 patients with localized colon cancer were retrospectively reviewed. The effect of tumor characteristics and surgical and pathologic factors on

  12. Changes in clinical characteristics, course, and prognosis of inflammatory bowel disease during the last 5 decades: a population-based study from Copenhagen, Denmark

    DEFF Research Database (Denmark)

    Jess, Tine; Riis, Lene; Vind, Ida

    2007-01-01

    Copenhagen, Denmark (1962-2005), were assessed and evaluated. METHODS: Phenotype, initial disease course, use of medications, cumulative surgery rate, standardized incidence ratio of colorectal cancer (CRC), and standardized mortality ratio (SMR) were compared in the 3 cohorts, which had a total of 641.......01). The prevalence of upper gastrointestinal involvement and pure colonic CD varied significantly between cohorts. UC patients diagnosed in the 1990s had a higher prevalence of proctitis, received more medications, and had a milder initial disease course than did previous patients. The surgery rate decreased...

  13. Population-based studies on familiality and prognosis in patients with monoclonal gammopathies

    OpenAIRE

    Kristinsson, Sigurður Yngvi

    2009-01-01

    Monoclonal gammopathies constitute a group of diseases which have in common an overproduction of monoclonal immunoglobulins, M-proteins. Clues to their etiology have been found in studies showing familial aggregation of these diseases. We included 2,144 patients with lymphoplasmacytic lymphoma/Waldenström s macroglobulinemia (LPL/WM) and 4,458 patients with monoclonal gammopathy of undetermined significance (MGUS), their 6,177 and 14,621 first-degree relatives respectively,...

  14. Impact of Latency Duration on the Prognosis of Preterm Infants after Preterm Premature Rupture of Membranes at 24 to 32 Weeks' Gestation: A National Population-Based Cohort Study.

    Science.gov (United States)

    Lorthe, Elsa; Ancel, Pierre-Yves; Torchin, Héloïse; Kaminski, Monique; Langer, Bruno; Subtil, Damien; Sentilhes, Loïc; Arnaud, Catherine; Carbonne, Bruno; Debillon, Thierry; Delorme, Pierre; D'Ercole, Claude; Dreyfus, Michel; Lebeaux, Cécile; Galimard, Jacques-Emmanuel; Vayssiere, Christophe; Winer, Norbert; L'Helias, Laurence Foix; Goffinet, François; Kayem, Gilles

    2017-03-01

    To assess the impact of latency duration on survival, survival without severe morbidity, and early-onset sepsis in infants born after preterm premature rupture of membranes (PPROM) at 24-32 weeks' gestation. This study was based on the prospective national population-based Etude Épidémiologique sur les Petits Ȃges Gestationnels 2 cohort of preterm births and included 702 singletons delivered in France after PPROM at 24-32 weeks' gestation. Latency duration was defined as the time from spontaneous rupture of membranes to delivery, divided into 4 periods (12 hours to 2 days [reference], 3-7 days, 8-14 days, and >14 days). Multivariable logistic regression was used to assess the relationship between latency duration and survival, survival without severe morbidity at discharge, or early-onset sepsis. Latency duration ranged from 12 hours to 2 days (18%), 3-7 days (38%), 8-14 days (24%), and >14 days (20%). Rates of survival, survival without severe morbidity, and early-onset sepsis were 93.5% (95% CI 91.8-94.8), 85.4% (82.4-87.9), and 3.4% (2.0-5.7), respectively. A crude association found between prolonged latency duration and improved survival disappeared on adjusting for gestational age at birth (aOR 1.0 [reference], 1.6 [95% CI 0.8-3.2], 1.2 [0.5-2.9], and 1.0 [0.3-3.2] for latency durations from 12 hours to 2 days, 3-7 days, 8-14 days, and >14 days, respectively). Prolonged latency duration was not associated with survival without severe morbidity or early-onset sepsis. For a given gestational age at birth, prolonged latency duration after PPROM does not worsen neonatal prognosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Adolescent femicide: a population-based study.

    Science.gov (United States)

    Coyne-Beasley, Tamera; Moracco, Kathryn E; Casteel, Michael J

    2003-04-01

    Homicide is the third leading cause of deaths for girls aged 11 to 14 years and the second leading cause of death for girls aged 15 to 18 years. However, few studies examine the contextual issues of adolescent femicide, especially among 11- to 14-year-old victims. To obtain quantitative and contextual information about adolescent femicide, and to compare the context of femicide in younger vs older adolescents. Data from the North Carolina medical examiner were analyzed for all 11- to 18-year-old female homicide victims during 1990 to 1995. Police interviews were conducted for 1993 to 1995 cases to determine context, the relationship of victim and perpetrator, and criminal histories. There were 90 victims; 63 were aged 15 to 18 years, 55 were killed with firearms, and 40 were behind in school. Of 37 femicides for which law enforcement interviews were conducted, the most common contexts were altercation (n = 9), broken or desired relationship (n = 8), reckless behavior with a firearm (n = 6), retaliation (n = 5), and drug related (n = 3). Most perpetrators were men (89%; n = 33), were older than their victims (mean age difference, 8 years), and had criminal records (59%; n = 21). Seventy-eight percent of victims (n = 29) were killed by an acquaintance or intimate partner. Femicide contexts differed by age. Younger adolescents (aged 11-14 years) were more likely to be killed by a family member in the context of an argument than by an intimate partner or acquaintance in the context of a broken relationship or reckless behavior with a firearm. Many victims were engaged in high-risk behaviors, including dropping out of school, running away from home, using drugs, and dating much older men with criminal records. Intervention specialists targeting high-risk female adolescents should be aware that this population may also be at increased risk of femicide.

  16. 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...

  17. 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.

  18. 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....

  19. Prevalence, Correlates, and Prognosis of Peripheral Artery Disease in Rural Ecuador—Rationale, Protocol, and Phase I Results of a Population-Based Survey: An Atahualpa Project-Ancillary Study

    Directory of Open Access Journals (Sweden)

    Oscar H. Del Brutto

    2014-01-01

    Full Text Available Background. Little is known on the prevalence of peripheral artery disease (PAD in developing countries. Study design. Population-based study in Atahualpa. In Phase I, the Edinburgh claudication questionnaire (ECQ was used for detection of suspected symptomatic PAD; persons with a negative ECQ but a pulse pressure ≥65 mmHg were suspected of asymptomatic PAD. In Phase II, the ankle-brachial index will be used to test reliability of screening instruments and to determine PAD prevalence. In Phase III, participants will be followed up to estimate the relevance of PAD as a predictor of vascular outcomes. Results. During Phase I, 665 Atahualpa residents aged ≥40 years were enrolled (mean age: 59.5 ± 12.6 years, 58% women. A poor cardiovascular health status was noticed in 464 (70% persons of which 27 (4% had a stroke and 14 (2% had ischemic heart disease. Forty-four subjects (7% had suspected symptomatic PAD and 170 (26% had suspected asymptomatic PAD. Individuals with suspected PAD were older, more often women, and had a worse cardiovascular profile than those with nonsuspected PAD. Conclusions. Prevalence of suspected PAD in this underserved population is high. Subsequent phases of this study will determine whether prompt detection of PAD is useful to reduce the incidence of catastrophic vascular diseases in the region.

  20. 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...

  1. 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.

  2. 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...

  3. 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.

  4. 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.

  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. 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.

  7. 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.

  8. 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.

  9. 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.

  10. Epidemiology of malignant peritoneal mesothelioma: A population-based study.

    Science.gov (United States)

    Salo, Silja A S; Ilonen, Ilkka; Laaksonen, Sanna; Myllärniemi, Marjukka; Salo, Jarmo A; Rantanen, Tuomo

    2017-12-01

    Malignant peritoneal mesothelioma (MPeM) is a rare cancer of the mesothelial cells in the peritoneum with poor prognosis. Earlier reports from other countries indicate an incidence of 0.2-3 new cases per million per year. No previous studies have examined the national epidemiology of MPeM in Nordic countries. This study aimed to clarify the epidemiology of MPeM in Finland over a 12-year period. The data consisted of cancer notifications, laboratory notifications, and death certificate information in the Finnish Cancer Registry (FCR) and Statistics Finland (SF) of all MPeM patients from 2000 to 2012 in Finland. We also collected data on occupational disease compensations from the Workers' Compensation Center (WCC) of Finland. Any missing information was collected from the respective patient's file of every patient obtained from health institutions that had treated the patients. Between January 1, 2000 and December 31, 2012, 90 new MPeM cases (56 males, 34 females) occurred in Finland. Median annual incidence was four new cases, which corresponded to 0.74 new cases per million per year. MPeM was deemed an occupational disease in 21 patients (23.3%). 71 patients (78.9%) of whom had a known cause of death, with a median survival of 4 months. The number of deaths linked to other disease than mesothelioma was 28/74 (37.8%). Our study indicates that MPeM in Finland is rare and fatal, which is in accordance with previous reports from other countries. MPeM is also a fatal disease, since most of the patients died due to MPeM. Copyright © 2017. Published by Elsevier Ltd.

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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.

  19. 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

  20. 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...

  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. 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

  4. Myasthenia Gravis: a population-based epidemiological study.

    LENUS (Irish Health Repository)

    Rutledge, S

    2016-02-01

    Myasthenia Gravis (MG) is a disorder affecting components of the neuromuscular junction. Epidemiological studies show rising incidence and prevalence rates. The aim of this study was to determine the incidence and prevalence of MG in the Republic of Ireland. Data sources included patient lists from consultant neurologists and ophthalmologists, a neuroimmunology laboratory, general practitioners and the Myasthenia Gravis Association. A total of 1,715 cases were identified, of which 706 definite, probable or possible autoimmune and congenital MG cases were included. The overall prevalence rate from the data obtained is 15.38\\/100,000. The study demonstrated a female preponderance (female:male of 1.3: 1) and some geographical variation within Ireland. The average incidence rate for the years 2000 to 2009 was 11.3 per year; the rate for the current decade is 18 per year. The increasing number of diagnoses may be due to improved access to diagnostic investigations and increasing awareness of the clinical manifestations.

  5. A population-based study of the stratum corneum moisture

    Directory of Open Access Journals (Sweden)

    Pires TF

    2016-04-01

    Full Text Available Thiago de Farias Pires,1 Ana Paula Azambuja,2 Andrea Roseli Vançan Russo Horimoto,1 Mary Sanae Nakamura,2 Rafael de Oliveira Alvim,1 José Eduardo Krieger,1 Alexandre Costa Pereira1 1Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo Medical School, 2Natura Innovation and Product Technology Ltd., Cajamar, SP, Brazil Background: The stratum corneum (SC has important functions as a bound-water modulator and a primary barrier of the human skin from the external environment. However, no large epidemiological study has quantified the relative importance of different exposures with regard to these functional properties. In this study, we have studied a large sample of individuals from the Brazilian population in order to understand the different relationships between the properties of SC and a number of demographic and self-perceived variables. Methods: One thousand three hundred and thirty-nine individuals from a rural Brazilian population, who were participants of a family-based study, were submitted to a cross-sectional examination of the SC moisture by capacitance using the Corneometer® CM820 and investigated regarding environmental exposures, cosmetic use, and other physiological and epidemiological measurements. Self-perception-scaled questions about skin conditions were also applied. Results: We found significant associations between SC moisture and sex, age, high sun exposure, and sunscreen use frequency (P<0.025. In specific studied sites, self-reported race and obesity were also found to show significant effects. Dry skin self-perception was also found to be highly correlated with the objective measurement of the skin. Other environmental effects on SC moisture are also reported. Keywords: investigative dermatology, stratum corneum moisture, Corneometer, sun exposure, familial data modeling

  6. Depressive symptoms and sleep: a population-based polysomnographic study.

    Science.gov (United States)

    Castro, Laura Siqueira; Castro, Juliana; Hoexter, Marcelo Queiroz; Quarantini, Lucas Castro; Kauati, Adriana; Mello, Luiz Eugenio; Santos-Silva, Rogerio; Tufik, Sergio; Bittencourt, Lia

    2013-12-30

    The goals of the present study were to determine the prevalence of depression in the adult population of Sao Paulo, Brazil and to explore the relationship among sociodemographic, physical and psychological factors, sleep-related symptoms and polysomnography parameters. Participants of a cross-sectional study (N = 1101) were administered questionnaires and submitted to polysomnography. A score > 20 in the Beck Depression Inventory was used to describe depression. Results revealed that the prevalence of depression was 10.9%. Estimates were higher in women and were significantly higher among housewives, non-workers and individuals with lower education and income. A combination of sleep-related symptoms and impaired quality of life was 2.5 times more frequent among depressed than non-depressed. Co-morbid insomnia and anxiety were positively associated to depressive symptomatology. There were no alterations in the polysomnography parameters, in either group. The occurrence of sleep apnea with values on the apnea-hypopnea index ≥ 5 was similar and frequent in both groups (around 30%). The findings suggest that depressive symptoms were associated with low education, low income, severe comorbid symptomatology, and impaired quality of life. Considering the high prevalence of sleep apnea, these results point to potential social and financial burdens associated with the depressive symptomatology and various sleep diagnoses. © 2013 Elsevier Ireland Ltd. All rights reserved.

  7. 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.

  8. Smoking during pregnancy: A population-based study.

    Science.gov (United States)

    Oskarsdottir, Gudrun Nina; Sigurdsson, Hedinn; Gudmundsson, Kristjan G

    2017-02-01

    Tobacco is a major cause of disease and mortality in modern times. The risk of smoking in pregnancy is a serious threat to the development and future health of an unborn child. The aim of this study was to explore the epidemiological factors associated with smoking during pregnancy in a primary healthcare setting. All 856 maternity records at the Glaesibaer Health Care Centre in Reykjavik during 2006-2013 were reviewed and information on smoking habits investigated. The records showed that in 108 (12.2%) pregnancies, women smoked at first visit and 63 stopped smoking in early pregnancy, leaving 45 (5.3%) mothers smoking throughout the whole gestational period. The mean age of the smoking women was 27.8 years and for the non-smokers 29.7 years. Low social status (odds ratio (OR) = 2.66; 95% confidence interval (CI): 1.19-5.96), previous mental health diagnosis (OR = 2.7; 95% CI: 1.3-5.6), and unstable relationship with a partner (OR = 3.78; 95% CI: 2.1-7.0) were associated with smoking. Smoking fewer cigarettes was associated with a 0.04-unit lower risk of smoking during pregnancy (OR = 0.04: 95% CI: 0.02-0.08). Our results indicated that the women who smoked during pregnancy were often heavy smokers and living without a partner. They were younger, had worse mental health, and a lower social status than those pregnant women who did not smoke. Bearing in mind the consequence of smoking in pregnancy, this subgroup should get increased assistance to quit smoking before and during early pregnancy, as well as appropriate medical and social support.

  9. Exposure to indoor tanning in France: a population based study.

    Science.gov (United States)

    Benmarhnia, Tarik; Léon, Christophe; Beck, François

    2013-04-23

    Tanning lamp sessions have increased in Europe in recent years. Recent epidemiological studies have confirmed a proven link between melanoma and artificial UV exposure. However, in France, little information is available to determine the exposure of the population. This article presents the results from the 'Baromètre cancer 2010' concerning the proportion of users exposed to artificial UV radiation in France, their characteristics and level of information on the risks associated. A two stage random sampling telephone survey assisted by CATI system (household, individual) was performed from 3 April 2010 to 7 August 2010 on a sample of 3,359 people aged 15 to 75 years old. In 2010, 13.4% of the French population reported to have tanning lamp sessions at least once in their lifetime and 3.5% of the total population reported the use of artificial UV radiation over the last twelve months. Exposure over the last twelve months is most commonly seen among females (5.0%) and young population between 20-25 years old (9.6%). In addition, 3.5% of those under 18 years report having attended UV booths at least once during their lifetime even though they are forbidden to minors. Moreover, more than one the third of users reported more than 10 exposures within a year. The places of exposure cited most often were beauty salons (50%) and tanning centers (46%). Only 49.2% of those surveyed felt that they were well informed on the risks of cancer associated with UV booths. Furthermore, the population was found to have misconceptions about artificial UV radiation. One quarter of the population, believe that artificial UV radiation use before vacation protects the skin from sunburn. This first study on artificial UV radiation exposure in France has better quantified and characterized the users. It has also defined the state of knowledge and the perception of risk by the general French population. This work will contribute to determine actions of prevention to reduce cancer risk

  10. Influence of cigarette smoking on ALS outcome: a population-based study.

    Science.gov (United States)

    Calvo, Andrea; Canosa, Antonio; Bertuzzo, Davide; Cugnasco, Paolo; Solero, Luca; Clerico, Marinella; De Mercanti, Stefania; Bersano, Enrica; Cammarosano, Stefania; Ilardi, Antonio; Manera, Umberto; Moglia, Cristina; Marinou, Kalliopi; Bottacchi, Edo; Pisano, Fabrizio; Mora, Gabriele; Mazzini, Letizia; Chiò, Adriano

    2016-11-01

    To assess the prognostic influence of premorbid smoking habits and vascular risk profile on amyotrophic lateral sclerosis (ALS) phenotype and outcome in a population-based cohort of Italian patients. A total of 650 patients with ALS from the Piemonte/Valle d'Aosta Register for ALS, incident in the 2007-2011 period, were recruited. Information about premorbid cigarette smoking habits and chronic obstructive pulmonary disease (COPD) were collected at the time of diagnosis. Current smokers had a significantly shorter median survival (1.9 years, IQR 1.2-3.4) compared with former (2.3 years, IQR 1.5-4.2) and never smokers (2.7 years, IQR 1.8-4.6) (p=0.001). Also COPD adversely influenced patients' prognosis. Both smoking habits and CODP were retained in Cox multivariable model. This study has demonstrated in a large population-based cohort of patients with ALS that cigarette smoking is an independent negative prognostic factor for survival, with a dose-response gradient. Its effect is not related to the presence of COPD or to respiratory status at time of diagnosis. The understanding of the mechanisms, either genetic or epigenetic, through which exogenous factors influence disease phenotype is of major importance towards a more focused approach to cure ALS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. A nationwide population-based study of depression in Brazil.

    Science.gov (United States)

    Munhoz, Tiago N; Nunes, Bruno P; Wehrmeister, Fernando C; Santos, Iná S; Matijasevich, Alicia

    2016-03-01

    The state of mental health of the population is considered to be an important and essential component of public health. Depression is the mental disorder with greatest prevalence in several countries around the world. This was a nationwide Brazilian survey with household-based interviews. The sampling process was at random and cluster-based, and performed in three stages: census tracts, households and individuals. One inhabitant aged ≥18 years was selected per household. Individuals at greater risk of depression were identified through the Patient Health Questionnaire-9 (PHQ-9) algorithm, which uses internationally accepted diagnostic criteria. All analyses took into account sample weights. A total of 60,202 individuals were evaluated and the prevalence of positive screening for depression was 4.1% (95% CI: 3.8-4.4%). After adjustments for potential confounding factors, depression was found to be greater among women, individuals aged either 40-59 years or 80 years or over, individuals living in urban areas, those with lower educational level, smokers, and among individuals with arterial hypertension, diabetes and heart disorders. Skin colour, marital status and alcohol abuse were not associated with depression. Characteristics of respondents and non-respondents in the sample could not be compared because data about non-respondents was not available. The prevalence of positive screening for depression in Brazil was similar to other studies conducted worldwide. In Brazil, this proportion reflects a considerable absolute number of people with greater risk of depression (≈5.5 million) that may require adequate management through the health system and services. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Associations of childhood eczema severity: A US population based study

    Science.gov (United States)

    Silverberg, Jonathan I.; Simpson, Eric L.

    2014-01-01

    Little is known about predictors of eczema severity in the US population. We sought to determine the distribution and associations of childhood eczema severity in the US. We analyzed data from the 2007 National Survey of Children's Health, a prospective questionnaire-based study of a nationally representative sample of 91,642 children (0-17yr). The prevalence of childhood eczema was 12.97% (95% confidence interval [95% CI]=12.42–13.53); 67.0% (95% CI: 64.8–69.2) had mild, 26.0% (95% CI: 23.9–28.1) moderate and 7.0% (95% CI: 5.8–8.3) severe disease. There was significant statewide-variation of the distribution of eczema severity (Rao-Scott chi square, P=0.004), with highest rates of severe disease in Northeastern and Midwestern states. In univariate models, eczema severity was increased with older age, African-American and Hispanic race/ethnicity, lower household income, oldest child in the family, home with a single mother, lower paternal/maternal education level, maternal general health, maternal/paternal emotional health, dilapidated housing and garbage on the streets. In multivariate survey logistic regression models using stepwise and backward selection, moderate–severe eczema was associated with older age, lower household income and fair or poor maternal health, but inversely associated with birthplace outside the US. These data indicate that environmental and/or lifestyle factors play an important role in eczema severity. PMID:24819283

  13. Influence of arterial hypertension, type 2 diabetes and cardiovascular risk factors on ALS outcome: a population-based study.

    Science.gov (United States)

    Moglia, Cristina; Calvo, Andrea; Canosa, Antonio; Bertuzzo, Davide; Cugnasco, Paolo; Solero, Luca; Grassano, Maurizio; Bersano, Enrica; Cammarosano, Stefania; Manera, Umberto; Pisano, Fabrizio; Mazzini, Letizia; Dalla Vecchia, Laura A; Mora, Gabriele; Chiò, Adriano

    2017-11-01

    To assess the prognostic influence of pre-morbid type 2 diabetes mellitus, arterial hypertension and cardiovascular (CV) risk profile on ALS phenotype and outcome in a population-based cohort of Italian patients. A total of 650 ALS patients from the Piemonte/Valle d'Aosta Register for ALS, incident in the 2007-2011 period, were recruited. Information about premorbid presence of type 2 diabetes mellitus, arterial hypertension was collected at the time of diagnosis. Patients' CV risk profile was calculated according to the Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice (JBS2). At the univariate analysis, the presence of pre-morbid arterial hypertension was associated with a higher age at onset of ALS and a shorter survival, and patients with a high CV risk profile had a worse prognosis than those with a low CV risk profile. The Cox multivariable analysis did not confirm such findings. Type 2 diabetes mellitus did not modify either the phenotype or the prognosis of ALS patients. This study performed on a large population-based cohort of ALS patients has demonstrated that arterial hypertension, type 2 diabetes and CV risk factors, calculated using the Framingham equation, do not influence ALS phenotype and prognosis.

  14. A population based study of unintentional firearm fatalities

    OpenAIRE

    Cherry, D; Runyan, C.; Butts, J

    2001-01-01

    Objectives—To describe the circumstances of fatal unintentional firearm injuries in a statewide population in a region of the United States with high firearm fatality rates and to compare to similar data from an earlier period in the same state.

  15. Occupational skin exposure to water: a population-based study.

    Science.gov (United States)

    Anveden Berglind, I; Alderling, M; Järvholm, B; Lidén, C; Meding, B

    2009-03-01

    Occupational exposure to skin irritants, in particular to water, is an important risk factor for hand eczema. To assess occupational skin exposure to water in the general population. As part of a public health survey in Stockholm, Sweden, 18,267 gainfully employed individuals aged 18-64 years completed a questionnaire with previously validated questions regarding occupational skin exposure to water. Altogether 16% reported exposure to water for (1/2) h or more a day, and 13% reported exposure to water more than 10 times a day. Furthermore, 7% reported water exposure of more than 2 h and 6% of more than 20 times a day. Women reported more water exposure than men and many female-dominated occupations were seen to comprise water exposure. Women were also more exposed than men within the same jobs. Young adults were more exposed than older. A total of 18% were employed in high-risk occupations for hand eczema. Fifty-nine per cent of individuals employed in high-risk occupations reported water exposure at work, compared with 11% in low-risk occupations. A total of 20% of the population of working age acknowledged occupational skin exposure to water, which was found to be more common in young adults and women. Using job title as a proxy for water exposure gives an underestimation due to misclassification. In assessing occupational skin exposure to water, both exposure time and frequency should be considered.

  16. 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...

  17. Transient isolated brainstem symptoms preceding posterior circulation stroke: a population-based study.

    Science.gov (United States)

    Paul, Nicola L M; Simoni, Michela; Rothwell, Peter M

    2013-01-01

    Transient isolated brainstem symptoms (eg, isolated vertigo, dysarthria, diplopia) are not consistently classified as transient ischaemic attacks (TIAs) and data for prognosis are limited. If some of these transient neurological attacks (TNAs) are due to vertebrobasilar ischaemia, then they should be common during the days and weeks preceding posterior circulation strokes. We aimed to assess the frequency of TNAs before vertebrobasilar ischaemic stroke. We studied all potential ischaemic events during the 90 days preceding an ischaemic stroke in patients ascertained within a prospective, population-based incidence study in Oxfordshire, UK (Oxford Vascular Study; 2002-2010) and compared rates of TNA preceding vertebrobasilar stroke versus carotid stroke. We classified the brainstem symptoms isolated vertigo, vertigo with non-focal symptoms, isolated double vision, transient generalised weakness, and binocular visual disturbance as TNAs in the vertebrobasilar territory; atypical amaurosis fugax and limb-shaking as TNAs in the carotid territory; and isolated slurred speech, migraine variants, transient confusion, and hemisensory tingling symptoms as TNAs in uncertain territory. Of the 1141 patients with ischaemic stroke, vascular territory was categorisable in 1034 (91%) cases, with 275 vertebrobasilar strokes and 759 carotid strokes. Isolated brainstem TNAs were more frequent before a vertebrobasilar stroke (45 of 275 events) than before a carotid stroke (10 of 759; OR 14·7, 95% CI 7·3-29·5, pstroke vs two of 751 before a carotid stroke, OR 35·8, 8·4-153·5, pstroke, only five (8%) fulfilled the National Institute of Neurological Disorders and Stroke (NINDS) criteria for TIA. The other 54 cases were isolated vertigo (n=23), non-NINDS binocular visual disturbance (n=9), vertigo with other non-focal symptoms (n=10), isolated slurred speech, hemisensory tingling, or diplopia (n=8), and non-focal events (n=4). Only 10 (22%) of the 45 patients with isolated brainstem

  18. 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.

  19. 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

  20. The association between temporomandibular disorders and joint hypermobility syndrome: a nationwide population-based study.

    Science.gov (United States)

    Chang, Ting-Han; Yuh, Da-Yo; Wu, Yung-Tsan; Cheng, Wan-Chien; Lin, Fu-Gong; Shieh, Yi-Shing; Fu, Earl; Huang, Ren-Yeong

    2015-11-01

    This study aims to investigate the risk factors of temporomandibular disorders (TMDs), including disc or non-disc-related disorders, and joint hypermobility syndrome (JHS) retrospectively and to analyze the factors by estimating the magnitude of the association between the two conditions using a nationwide population-based dataset. A total of 975,788 eligible patients' de-identified data were obtained from a representative database composed of one million of Taiwan's population since 2004 to 2008. All associated factors, such as gender, age, facial trauma, and psychosis, which correlated with TMDs and JHS were examined. Multiple logistic regression modeling adjusted for confounding variables to determine the odds ratio of variables that made an important contribution to TMDs and JHS. For all TMDs patients, only 1.47% patients had disc-related disorders. For all JHS patients, only 3.85% patients are diagnosed with concomitant TMDs. Statistically significant association was observed between joint hypermobility and TMDs. Furthermore, the prevalence of JHS patients shows significant difference within TMD subgroups, in which 9.52% of JHS patients have disc disorders and 90.48% of JHS patients do not. All associated factors, such as gender, age, JHS, facial trauma, and psychosis, had a significant impact on the TMDs. Interestingly, patients with TMJ articular disc disorders are 6.7 times more likely to be diagnosed with JHS compared to patients without disc-related disorders. Our results confirm that there is a significant positive association between TMDs and JHS, highlighting that patients with disc-related TMDs are more likely to experience JHS than patients with TMDs without disc disorders. Individuals with TMD associated with JHS should be carefully evaluated by inter-disciplinary specialists as these factors may eventually have impact on the prognosis of TMDs and JHS.

  1. Prognostic Factors in Amyotrophic Lateral Sclerosis: A Population-Based Study.

    Science.gov (United States)

    Moura, Mirian Conceicao; Novaes, Maria Rita Carvalho Garbi; Eduardo, Emanoel Junio; Zago, Yuri S S P; Freitas, Ricardo Del Negro Barroso; Casulari, Luiz Augusto

    2015-01-01

    To determine the prognostic factors associated with survival in amyotrophic lateral sclerosis at diagnosis. This retrospective population-based study evaluated 218 patients treated with riluzole between 2005 and 2014 and described their clinical and demographic profiles after the analysis of clinical data and records from the mortality information system in the Federal District, Brazil. Cox multivariate regression analysis was conducted for the parameters found. The study sample consisted of 132 men and 86 women with a mean age at disease onset of 57.2±12.3 years; 77.6% of them were Caucasian. The mean periods between disease onset and diagnosis were 22.7 months among men and 23.5 months among women, and the mean survival periods were 45.7±47.0 months among men and 39.3±29.8 months among women. In addition, 80.3% patients presented non-bulbar-onset amyotrophic lateral sclerosis, and 19.7% presented bulbar-onset. Cox regression analysis indicated worse prognosis for body mass index (BMI) 75 years (RR: 12.47, 95% CI: 3.51-44.26), and bulbar-onset (RR: 4.56, 95% CI: 2.06-10.12). Electromyography did not confirm the diagnosis in 55.6% of the suspected cases and in 27.9% of the bulbar-onset cases. The factors associated with lower survival in amyotrophic lateral sclerosis were age >75 years, BMI <25 kg/m2, and bulbar-onset.

  2. 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

  3. 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…

  4. 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…

  5. 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

  6. 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

  7. 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.

  8. 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...

  9. 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:…

  10. 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…

  11. 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 ...

  12. 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

  13. 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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  15. 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

  16. 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

  17. 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...

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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...

  5. 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…

  6. 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

  7. 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,…

  8. 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

  9. 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%,

  10. 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...

  11. Variation in Lymph Node Evaluation in Rectal Cancer : A Dutch Nationwide Population-Based Study

    NARCIS (Netherlands)

    Elferink, M. A. G.; Siesling, S.; Lemmens, V. E. P. P.; Visser, O.; Rutten, H. J.; van Krieken, J. H. J. M.; Tollenaar, R. A. E. M.; Langendijk, J. A.

    For adequate staging and subsequent accurate estimation of prognosis, a sufficient number of lymph nodes (LNs) has to be evaluated. This study aimed to identify factors associated with adequate nodal evaluation and to determine its relationship with survival. Data from all patients with stage I to

  12. 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...

  13. Malignant urachal neoplasms: A population-based study and systematic review of literature.

    Science.gov (United States)

    Mylonas, Konstantinos S; O Malley, Padraic; Ziogas, Ioannis A; El-Kabab, Lamis; Nasioudis, Dimitrios

    2017-01-01

    To examine patient and clinicopathological features of malignant urachal neoplasms (MUN) in a population-based cohort, to investigate survival outcomes, and to review the current evidence that exists in the literature. The Surveillance, Epidemiology, and End Results database was used to identify microscopically confirmed MUN cases diagnosed between 1988 and 2012. Kaplan-Meier analysis was used to determine median and 5-year overall survival (OS) as well as cancer-specific survival (CSS) rates. Cox proportional hazards model was employed to identify variables independently associated with cancer-specific mortality. A systematic literature review was conducted in line with the PRISMA statement. A total of 420 patients with MUNs were identified. The majority were white (77.6%) and male patients (59%) who presented with low-grade (62.1%), mucinous, noncystic adenocarcinomas (42.9%). From the cohort, 19%, 15.2%, 29.5%, and 30.5% of the patients presented with American Joint Committee on Cancer Stage I to IV disease, respectively. Cancer-directed surgery was performed in 86.5% of the patients. The most common procedure performed was partial cystectomy (52.4%) followed by local tumor excision (20.7%). Median OS was 57 months (95% CI: 41.6-72.4), and median CSS was 105 months (95% CI: 61.5-148.5). Five-year OS and CSS rates were 51% and 57%, respectively. Grade and stage were independently associated with cancer-specific mortality. Mortality rates did not differ between patients who underwent partial cystectomy and radical cystectomy/exenteration (P = 0.165), even after controlling for tumor stage. A total of 16 studies reporting on 585 patients were systematically reviewed, and relevant outcomes were summarized in the Supplemental material. MUNs are usually low-grade, mucinous, noncystic adenocarcinomas diagnosed at advanced stages. Overall, the prognosis is poor, and high-grade and disease stage are independently associated with cancer-specific mortality. Copyright

  14. Opportunities for improving triple-negative breast cancer outcomes: results of a population-based study.

    Science.gov (United States)

    Rapiti, Elisabetta; Pinaud, Kim; Chappuis, Pierre O; Viassolo, Valeria; Ayme, Aurélie; Neyroud-Caspar, Isabelle; Usel, Massimo; Bouchardy, Christine

    2017-03-01

    Triple-negative breast cancer (TNBC) is associated with a poor prognosis. Surgery, radiotherapy, chemotherapy, and referral for genetic counseling are the standard of care. We assessed TNBC prevalence, management, and outcome using data from the population-based Geneva cancer registry. 2591 women had a first invasive stage I-III breast cancer diagnosed between 2003 and 2011. We compared TNBC to other breast cancers (OBC) by χ(2) -test and logistic regression. Kaplan-Meier survival curves, up to 31-12-2014, were compared using log-rank test. TNBC risk of mortality overall (OS) and for breast cancer (BCSS) was evaluated through Cox models. Linkage with the Oncogenetics and Cancer Prevention Unit (OCPU) database of the Geneva University Hospitals provided genetic counseling information. TNBC patients (n = 192, 7.4%) were younger, more often born in Africa or Central-South America than OBC, had larger and more advanced tumors. 18% of TNBC patients did not receive chemotherapy. Thirty-one (17%) TNBC women consulted the OCPU, 39% among those aged P P < 0.001). The mortality risks remained significant after adjustment for other prognostic variables. The strongest determinants of mortality were age, place of birth, and lymph node status. A substantial proportion of TNBC patients in Geneva did not receive optimal care. Over 60% of eligible women did not receive genetic counseling and 18% did not receive chemotherapy. To improve TNBC prognosis, comprehensive care as recommended by standard guidelines should be offered to all patients. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. Trends in treatment, incidence and survival of hypopharynx cancer: a 20-year population-based study in the Netherlands.

    Science.gov (United States)

    Petersen, Japke F; Timmermans, Adriana J; van Dijk, Boukje A C; Overbeek, Lucy I H; Smit, Laura A; Hilgers, Frans J M; Stuiver, Martijn M; van den Brekel, Michiel W M

    2017-10-28

    Hypopharynx cancer has the worst prognosis of all head and neck squamous cell cancers. Since the 1990s, a treatment shift has appeared from a total laryngectomy towards organ preservation therapies. Large randomized trials evaluating treatment strategies for hypopharynx cancer, however, remain scarce, and frequently this malignancy is evaluated together with larynx cancer. Therefore, our aim was to determine trends in incidence, treatment and survival of hypopharynx cancer. We performed a population-based cohort study including all patients diagnosed with T1-T4 hypopharynx cancer between 1991 and 2010 in the Netherlands. Patients were recorded by the national cancer registry database and verified by a national pathology database. 2999 patients were identified. The incidence increased significantly with 4.1% per year until 1997 and decreased non-significantly afterwards. For women, the incidence increased with 1.7% per year during the entire study period. Total laryngectomy as primary treatment significantly decreased, whereas radiotherapy and chemoradiation increased. The 5-year overall survival significantly increased from 28% in 1991-2000 to 34% in 2001-2010. Overall survival for T3 was equal for total laryngectomy and (chemo)radiotherapy, but for T4-patients the survival was significantly better after primary total laryngectomy (± adjuvant radiotherapy). This large population-based study demonstrates a shift in treatment preference towards organ preservation therapies. The 5-year overall survival increased significantly in the second decade. The assumed equivalence of organ preservation and laryngectomy may require reconsideration for T4 disease.

  20. 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...

  1. Survival rate variation with different histological subtypes of poor prognostic male anal squamous cell carcinoma: a population-based study

    Science.gov (United States)

    Rai, Kelash; Vikash, Sindhu; Chen, Liaobin; Li, Jingfeng

    2017-01-01

    Background and objective The prognosis of male anal squamous cell carcinoma (MASCC) and female anal squamous cell carcinoma (FASCC) is variable. The influence of tumor subtype on the survival rate and gender is poorly known. Our study is the largest population-based study and aims to outline the difference in survival between MASCC and FASCC patients. Methods A retrospective population-based study was performed to compare the disease-specific mortalities (DSMs) between genders related to the tumor subtypes. The Surveillance, Epidemiology, and End Results (SEER) program database was employed to obtain the data from January 1988 to December 2014. Results A total of 4,516, (3,249 males and 1,267 females), patients with anal squamous cell carcinomas (ASCC) were investigated. The 5-year DSMs were 24.18% and 18.08% for men and women, respectively. The univariate analysis of the male basaloid squamous cell carcinoma (BSCC) and cloacogenic carcinoma (CC) patients demonstrated higher DSMs (P <0.001). Moreover, in the multivariate analysis, BSCC and CC were associated with soaring DSMs in male patients (P < 0.05). Conclusions In the cohort of BSCC and CC patients, male patients demonstrated a considerable decrease in survival rate compared to females. A more precise classification of ASCC and individualized management for MASCC are warranted. PMID:29137429

  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. 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...

  5. 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.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    participant characteristics and time-to-self-reported recovery were explored in 3496 MBP cases using Cox proportional hazards models. RESULTS: The yearly incidence rate was 236 per 100,000 population during the study period, and was highest in women and in young persons. The median time-to-first reported......BACKGROUND: Traffic collisions often result in a wide range of symptoms included in the umbrella term whiplash-associated disorders. Mid-back pain (MBP) is one of these symptoms. The incidence and prognosis of different traffic injuries and their related conditions (e.g. neck pain, low back pain......, depression or others) has been investigated previously; however, knowledge about traffic collision-related MBP is lacking. The study objectives were to describe the incidence, course of recovery and prognosis of MBP after traffic collisions, in terms of global self-reported recovery. METHODS: Longitudinal...

  7. 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

  8. 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.

  9. 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.

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

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    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.

  12. 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...

  13. 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.

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

    Science.gov (United States)

    Bruins, H Max; Visser, Otto; Ploeg, Martine; Hulsbergen-van de Kaa, Christina A; Kiemeney, Lambertus A L M; Witjes, J Alfred

    2012-10-01

    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. Data were collected from the nationwide Netherlands Cancer Registry. Urachal carcinoma cases were also cross-referenced using the PALGA (Nationwide Network and Registry of Histology and Cytopathology) database. Pathology report summaries were reviewed. A total of 152 patients diagnosed with urachal carcinoma between 1989 and 2009 were included in analysis. The Sheldon staging system was used to classify urachal carcinoma. Median followup was 9.2 years. Primary outcomes were overall and relative survival. Prognostic factors were calculated using univariate and multivariate hazard regression models. The incidence of urachal carcinoma was 0.2% of all bladder cancers. A total of 45 patients (30%) presented with lymph node or distant metastasis. Five-year overall and relative survival was 45% and 48%, respectively. On multivariate analysis prognostic factors for impaired survival were lymph node metastasis (HR 1.7, 95% CI 1.2-2.6), tumor growth in the abdominal wall, peritoneum and/or adjacent organs (HR 5.2, 95% CI 2.6-10.3), distant metastasis (HR 5.3, 95% CI 2.8-9.9) and macroscopic residual tumor (HR 5.2, 95% CI 1.2-21.8). Urachal carcinoma is rare, accounting for 0.2% of all bladder cancers. Many patients present with advanced disease. The prognosis of urachal carcinoma depends mostly on tumor stage, particularly the presence or absence of metastatic disease. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  15. 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.

  16. 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.

  17. 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.

  18. Incidence of sialolithiasis in Denmark: a nationwide population-based register study.

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    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.

  19. Medication adherence in type 2 diabetes: the ENTRED study 2007, a French Population-Based Study.

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    Michel Tiv

    Full Text Available BACKGROUND: Adherence to prescribed medications is a key dimension of healthcare quality. The aim of this large population-based study was to evaluate self-reported medication adherence and to identify factors linked with poor adherence in patients with type 2 diabetes in France. METHODOLOGY: The ENTRED study 2007, a French national survey of people treated for diabetes, was based on a representative sample of patients who claimed reimbursement for oral hypoglycaemic agents and/or insulin at least three times between August 2006 and July 2007, and who were randomly selected from the database of the two main National Health Insurance Systems. Medication adherence was determined using a six-item self-administered questionnaire. A multinomial polychotomous logistic regression model was used to identify factors associated with medication adherence in the 3,637 persons with type 2 diabetes. PRINCIPAL FINDINGS: Thirty nine percent of patients reported good medication adherence, 49% medium adherence and 12% poor adherence. The factors significantly associated with poor adherence in multivariate analysis were socio-demographic factors: age 8% and existing diabetes complications; and health care-related factors: difficulties for taking medication alone, decision making by the patient only, poor acceptability of medical recommendations, lack of family or social support, need for information on treatment, reporting no confidence in the future, need for medical support and follow-up by a specialist physician. CONCLUSIONS: In a country with a high level of access to healthcare, our study demonstrated a substantial low level of medication adherence in type 2 diabetic patients. Better identification of those with poor adherence and individualised suitable recommendations remain essential for better healthcare management.

  20. Population-based, inception cohort study of the incidence, course, and prognosis of mild traumatic brain injury after motor vehicle collisions

    DEFF Research Database (Denmark)

    Cassidy, John David; Boyle, Eleanor; Carroll, Linda J

    2014-01-01

    days (95% CI, 97-103), and about 23% reported not having recovered by 1 year. Factors associated with delayed recovery included being older than 50 years, having less than a high school education, having poor expectations for recovery, having depressive symptoms, having arm numbness, having hearing......, but 23% have still not recovered by 1 year. A mix of biopsychosocial factors is associated with recovery, including a strong effect of poor expectations for recovery........ PARTICIPANTS: All adults (N=1716) incurring an MTBI in a motor vehicle collision between November 1997 and December 1999 in Saskatchewan. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Age- and sex-stratified incidence rates, time to self-reported recovery, and prognostic factors over a 1-year follow...

  1. The impact of dialysis-requiring acute kidney injury on long-term prognosis of patients requiring prolonged mechanical ventilation: nationwide population-based study.

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    Chia-Ter Chao

    Full Text Available BACKGROUND: Prolonged mechanical ventilation (PMV is increasingly common worldwide, consuming enormous healthcare resources. Factors that modify PMV outcome are still obscure. METHODS: We selected patients without preceding mechanical ventilation within the one past year and who developed PMV during index admission in Taiwan's National Health Insurance (NHI system during 1998-2007 for comparison of mortality and resource use. They were divided into three groups: (1 patients with end-stage renal diseases (ESRD before the index admission for PMV onset; (2 patients with dialysis-requiring acute kidney injury (AKI-dialysis during the hospitalization course; and (3 patients without AKI or with non dialysis-requiring AKI during the hospitalization course (non-AKI. We used a random-effects logistic regression model to identify factors associated with mortality. RESULTS: Compared with the other two groups, patients with AKI-dialysis had significantly longer mechanical ventilation, more frequent use of vasopressors, longer intensive care unit/hospital stay and higher inpatient expenditures during the index admission. Relative to non-AKI patients, patients with AKI-dialysis had an elevated mortality hazard; the adjusted relative risk ratios were 1.51 (95% confidence interval [CI]:1.46-1.56, 1.27 (95% CI: 1.23-1.32, and 1.10 (95% CI: 1.08-1.12 for mortality rates at discharge, 3 months, and 4 years after PMV, respectively. Patients with AKI-dialysis also consumed significantly higher total in-patient expenditure than the other two patient groups (p<0.001. CONCLUSIONS: Among patients that need PMV care during an admission, the presence of de novo AKI requiring dialysis significantly increased short and long term mortality, and demand for health care resources.

  2. 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.

  3. 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).

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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...

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. Nonapnea Sleep Disorders in Patients Younger than 65 Years Are Significantly Associated with CKD: A Nationwide Population-Based Study.

    Directory of Open Access Journals (Sweden)

    Hugo You-Hsien Lin

    Full Text Available Nonapnea sleep disorders (NASD and sleep-related problems are associated with poor health outcomes. However, the association between NASD and the development and prognosis of chronic kidney disease (CKD has not been investigated thoroughly. We explored the association between CKD and NASD in Taiwan.We conducted a population-based study using the Taiwan National Health Insurance database with1,000,000 representative data for the period from January 1, 2000 to December 31, 2009. We investigated the incidence and risk of CKD in 7,006 newly diagnosed NASD cases compared with 21,018 people without NASD matched according to age, sex, index year, urbanization, region, and monthly income at a 1:3 ratio.The subsequent risk of CKD was 1.48-foldhigher in the NASD cohort than in the control cohort (95% confidence interval [CI] = 1.26-1.73, p< 0.001. Men, older age, type 2 diabetes mellitus, and gout were significant factors associated with the increased risk of CKD (p< 0.001. Among different types of NASDs, patients with insomnia had a 52% increased risk of developing CKD (95%CI = 1.23-1.84; P<0.01, whereas patients with sleep disturbance had a 49%increased risk of subsequent CKD (95% CI = 1.19-1.87; P<0.001. Younger women (aged < 65 years were at a high risk of CKD with NASD (adjusted hazard ratio, [HR] = 1.81; 95% CI = 1.35-2.40, p< 0.001.In this nationwide population-based cohort study, patients with NASD, particularly men of all ages and women aged younger than 65 years, were at high risk of CKD.

  16. A systematic review of the effect of retention methods in population-based cohort studies

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    Harding Seeromanie

    2011-04-01

    Full Text Available Abstract Background Longitudinal studies are of aetiological and public health relevance but can be undermined by attrition. The aim of this paper was to identify effective retention strategies to increase participation in population-based cohort studies. Methods Systematic review of the literature to identify prospective population-based cohort studies with health outcomes in which retention strategies had been evaluated. Results Twenty-eight studies published up to January 2011 were included. Eleven of which were randomized controlled trials of retention strategies (RCT. Fifty-seven percent of the studies were postal, 21% in-person, 14% telephone and 7% had mixed data collection methods. A total of 45 different retention strategies were used, categorised as 1 incentives, 2 reminder methods, repeat visits or repeat questionnaires, alternative modes of data collection or 3 other methods. Incentives were associated with an increase in retention rates, which improved with greater incentive value. Whether cash was the most effective incentive was not clear from studies that compared cash and gifts of similar value. The average increase in retention rate was 12% for reminder letters, 5% for reminder calls and 12% for repeat questionnaires. Ten studies used alternative data collection methods, mainly as a last resort. All postal studies offered telephone interviews to non-responders, which increased retention rates by 3%. Studies that used face-to-face interviews increased their retention rates by 24% by offering alternative locations and modes of data collection. Conclusions Incentives boosted retention rates in prospective cohort studies. Other methods appeared to have a beneficial effect but there was a general lack of a systematic approach to their evaluation.

  17. A systematic review of the effect of retention methods in population-based cohort studies

    Science.gov (United States)

    2011-01-01

    Background Longitudinal studies are of aetiological and public health relevance but can be undermined by attrition. The aim of this paper was to identify effective retention strategies to increase participation in population-based cohort studies. Methods Systematic review of the literature to identify prospective population-based cohort studies with health outcomes in which retention strategies had been evaluated. Results Twenty-eight studies published up to January 2011 were included. Eleven of which were randomized controlled trials of retention strategies (RCT). Fifty-seven percent of the studies were postal, 21% in-person, 14% telephone and 7% had mixed data collection methods. A total of 45 different retention strategies were used, categorised as 1) incentives, 2) reminder methods, repeat visits or repeat questionnaires, alternative modes of data collection or 3) other methods. Incentives were associated with an increase in retention rates, which improved with greater incentive value. Whether cash was the most effective incentive was not clear from studies that compared cash and gifts of similar value. The average increase in retention rate was 12% for reminder letters, 5% for reminder calls and 12% for repeat questionnaires. Ten studies used alternative data collection methods, mainly as a last resort. All postal studies offered telephone interviews to non-responders, which increased retention rates by 3%. Studies that used face-to-face interviews increased their retention rates by 24% by offering alternative locations and modes of data collection. Conclusions Incentives boosted retention rates in prospective cohort studies. Other methods appeared to have a beneficial effect but there was a general lack of a systematic approach to their evaluation. PMID:21504610

  18. 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.

  19. 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.

  20. 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.

  1. CardioBengo study protocol: a population based cardiovascular longitudinal study in Bengo Province, Angola

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    João M. Pedro

    2016-03-01

    Full Text Available Abstract Background Cardiovascular diseases and other non-communicable diseases are major causes of morbidity and mortality, responsible for 38 million deaths in 2012, 75 % occurring in low- and middle-income countries. Most of these countries are facing a period of epidemiological transition, being confronted with an increased burden of non-communicable diseases, which challenge health systems mainly designed to deal with infectious diseases. With the adoption of the World Health Organization “Global Action Plan for the Prevention and Control of non-communicable diseases, 2013–2020”, the national dimension of risk factors for non-communicable diseases must be reported on a regular basis. Angola has no national surveillance system for non-communicable diseases, and periodic population-based studies can help to overcome this lack of information. CardioBengo will collect information on risk factors, awareness rates and prevalence of symptoms relevant to cardiovascular diseases, to assist decision makers in the implementation of prevention and treatment policies and programs. Methods CardioBengo is designed as a research structure that comprises a cross-sectional component, providing baseline information and the assembling of a cohort to follow-up the dynamics of cardiovascular diseases risk factors in the catchment area of the Dande Health and Demographic Surveillance System of the Health Research Centre of Angola, in Bengo Province, Angola. The World Health Organization STEPwise approach to surveillance questionnaires and procedures will be used to collect information on a representative sex-age stratified sample, aged between 15 and 64 years old. Discussion CardioBengo will recruit the first population cohort in Angola designed to evaluate cardiovascular diseases risk factors. Using the structures in place of the Dande Health and Demographic Surveillance System and a reliable methodology that generates comparable results with other

  2. 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.

  3. 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.

  4. A genome-wide association study of neuroticism in a population-based sample.

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    Federico C F Calboli

    Full Text Available Neuroticism is a moderately heritable personality trait considered to be a risk factor for developing major depression, anxiety disorders and dementia. We performed a genome-wide association study in 2,235 participants drawn from a population-based study of neuroticism, making this the largest association study for neuroticism to date. Neuroticism was measured by the Eysenck Personality Questionnaire. After Quality Control, we analysed 430,000 autosomal SNPs together with an additional 1.2 million SNPs imputed with high quality from the Hap Map CEU samples. We found a very small effect of population stratification, corrected using one principal component, and some cryptic kinship that required no correction. NKAIN2 showed suggestive evidence of association with neuroticism as a main effect (p < 10(-6 and GPC6 showed suggestive evidence for interaction with age (p approximately = 10(-7. We found support for one previously-reported association (PDE4D, but failed to replicate other recent reports. These results suggest common SNP variation does not strongly influence neuroticism. Our study was powered to detect almost all SNPs explaining at least 2% of heritability, and so our results effectively exclude the existence of loci having a major effect on neuroticism.

  5. 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.

  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. 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...

  8. Cognition in non-demented Parkinson's disease vs essential tremor: A population-based study.

    Science.gov (United States)

    Sánchez-Ferro, Á; Benito-León, J; Louis, E D; Contador, I; Hernández-Gallego, J; Puertas-Martín, V; Bermejo-Pareja, F

    2017-11-01

    Patients with Parkinson's disease (PD) and essential tremor (ET) have a higher risk of cognitive impairment than age-matched controls. Only a few small studies (11-18 subjects per group) have directly compared the cognitive profile of these conditions. Our aim was to compare the cognitive profile of patients with these two conditions to each other and to healthy individuals in a population-based study of non-demented participants. This investigation was part of the NEDICES study, a survey of the elderly in which 2438 dementia-free participants underwent a short neuropsychological battery. We used nonparametric techniques to evaluate whether there are differences and/or a gradient of impairment across the groups (PD, ET, and controls). Also, we performed a head-to-head comparison of ET and PD, adjusting for age and education. Patients with PD (N=46) and ET (N=180) had poorer cognition than controls (N=2212). An impaired gradient of performance was evident. PD scored lower than ET, and then each of these lower than controls, in memory (P<.05) and verbal fluency (P<.001) tasks. When we compared PD and ET, the former had lower scores in verbal fluency (P<.05), whereas the later had a poorer cognitive processing speed (P<.05). This large population-based study demonstrates that both conditions influence cognitive performance, that a continuum exists from normal controls to ET to PD (most severe), and that although deficits are in many of the same cognitive domains, the affected cognitive domains do not overlap completely. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. EpiReumaPt: how to perform a national population based study - a practical guide.

    Science.gov (United States)

    Gouveia, Nélia; Rodrigues, Ana M; Ramiro, Sofia; Machado, Pedro; da Costa, Leonor Pereira; Mourão, Ana Filipa; Silva, Inês; Rego, Tânia; Laires, Pedro; André, Rui; Mauricio, Luís; Romeu, José C; Tavares, Viviana; Cerol, Jorge; Canhão, Helena; Branco, Jaime C

    2015-01-01

    The aim of this article was to describe and discuss several strategies and standard operating procedures undertaken in the EpiReumaPt study - which was the first Portuguese, national, cross-sectional population-based study of Rheumatic and Musculoskeletal Diseases (RMD). The technical procedures, legal issues, management and practical questions were studied, analyzed and discussed with relevant stakeholders. During the 1st phase of EpiReumaPt the coordination team and Centro de Estudos de Sondagens e Opinião (CESOP) worked to recruit and interview 10,661 subjects. The 2nd phase involved the participation of a multidisciplinary team, several local authorities, a specialized vehicle ("mobile unit") and a specific software program for the clinical appointments. The development of specific recruitment strategies improved the participation rate. Blood samples were collected and sent to Biobanco-IMM and to a central lab for immediate measurements. In the 3rd phase the RMD diagnosis were validated by a team of three experienced rheumatologists - clinical data, imaging and lab test results were revised according to previously published classification criteria. EpiReumaPt was a nationwide project successfully conducted, which followed critical logistic/coordination and research strategies. EpiReumaPt methodology and coordination could be used as an example for other epidemiologic endeavors and public health policies.

  10. EpiReumaPt: how to perform a national population based studya practical guide

    Directory of Open Access Journals (Sweden)

    Nélia Gouveia

    2015-04-01

    Full Text Available Background: The aim of this article was to describe and discuss several strategies and standard operating procedures undertaken in the EpiReumaPt study – which was the first Portuguese, national, cross-sectional population-based study of Rheumatic and Musculoskeletal Diseases (RMD. Methods: The technical procedures, legal issues, management and practical questions were studied, analyzed and discussed with relevant stakeholders. During the 1st phase of EpiReumaPt the coordination team and Centro de Estudos de Sondagens e Opinião (CESOP worked to recruit and interview 10,661 subjects. The 2nd phase involved the participation of a multidisciplinary team, several local authorities, a specialized vehicle (“mobile unit” and a specific software program for the clinical appointments. The development of specific recruitment strategies improved the participation rate. Blood samples were collected and sent to Biobanco-IMM and to a central lab for immediate measurements. In the 3rd phase the RMD diagnosis were validated by a team of three experienced rheumatologists - clinical data, imaging and lab test results were revised according to previously published classification criteria. Conclusion: EpiReumaPt was a nationwide project successfully conducted, which followed critical logistic/coordination and research strategies. EpiReumaPt methodology and coordination could be used as an example for other epidemiologic endeavors and public health policies.

  11. 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

  12. 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...

  13. Negative impact of rurality on lung cancer survival in a population-based study.

    Science.gov (United States)

    Westeel, Virginie; Pitard, Alexandre; Martin, Mael; Thaon, Isabelle; Depierre, Alain; Dalphin, Jean-Charles; Arveux, Patrick

    2007-07-01

    Several studies have suggested that rurality is a risk factor for worse prognosis in cancer. The study population included the 2268 lung cancer cases collected between 1981 and 1996 in the Doubs Cancer Registry (France). The numbers of patients were 849 (31.8%) in rural areas and 89 (3.3%) in very rural areas. The relative 5-year survival was 15.2% in rural areas and 13.4% in urban areas (p = 0.5), and 2.7% in very rural areas and 14.4% in extended urban areas (p = 0.02). Multivariate analyses of observed and relative survival showed that patients living in very rural areas (p < 0.0001), 65 years of age and older and having small cell carcinoma had a significantly shorter survival. This study showed that the multidimensional definition of rurality identified a population with unfavorable prognoses.

  14. 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.

  15. 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

  16. 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.

  17. 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...

  18. 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.

  19. 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...

  20. 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...

  1. 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.

  2. Design considerations for identifying breast cancer risk factors in a population-based study in Africa.

    Science.gov (United States)

    Brinton, Louise A; Awuah, Baffour; Nat Clegg-Lamptey, Joe; Wiafe-Addai, Beatrice; Ansong, Daniel; Nyarko, Kofi M; Wiafe, Seth; Yarney, Joel; Biritwum, Richard; Brotzman, Michelle; Adjei, Andrew A; Adjei, Ernest; Aitpillah, Francis; Edusei, Lawrence; Dedey, Florence; Nyante, Sarah J; Oppong, Joseph; Osei-Bonsu, Ernest; Titiloye, Nicholas; Vanderpuye, Verna; Brew Abaidoo, Emma; Arhin, Bernard; Boakye, Isaac; Frempong, Margaret; Ohene Oti, Naomi; Okyne, Victoria; Figueroa, Jonine D

    2017-06-15

    Although breast cancer is becoming more prevalent in Africa, few epidemiologic studies have been undertaken and appropriate methodologic approaches remain uncertain. We therefore conducted a population-based case-control study in Accra and Kumasi, Ghana, enrolling 2,202 women with lesions suspicious for breast cancer and 2,161 population controls. Biopsy tissue for cases prior to neoadjuvant therapy (if given), blood, saliva and fecal samples were sought for study subjects. Response rates, risk factor prevalences and odds ratios for established breast cancer risk factors were calculated. A total of 54.5% of the recruited cases were diagnosed with malignancies, 36.0% with benign conditions and 9.5% with indeterminate diagnoses. Response rates to interviews were 99.2% in cases and 91.9% in controls, with the vast majority of interviewed subjects providing saliva (97.9% in cases vs. 98.8% in controls) and blood (91.8% vs. 82.5%) samples; lower proportions (58.1% vs. 46.1%) provided fecal samples. While risk factor prevalences were unique as compared to women in other countries (e.g., less education, higher parity), cancer risk factors resembled patterns identified elsewhere (elevated risks associated with higher levels of education, familial histories of breast cancer, low parity and larger body sizes). Subjects with benign conditions were younger and exhibited higher socioeconomic profiles (e.g., higher education and lower parity) than those with malignancies, suggesting selective referral influences. While further defining breast cancer risk factors in Africa, this study showed that successful population-based interdisciplinary studies of cancer in Africa are possible but require close attention to diagnostic referral biases and standardized and documented approaches for high-quality data collection, including biospecimens. © 2017 UICC.

  3. 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.

  4. Population-based epidemiology study of autoimmune hepatitis: a disease of older women?

    Science.gov (United States)

    Ngu, Jing H; Bechly, Kristen; Chapman, Bruce A; Burt, Michael J; Barclay, Murray L; Gearry, Richard B; Stedman, Catherine A M

    2010-10-01

    The etiology of autoimmune hepatitis (AIH) is unknown, and limited epidemiological data are available. Our aim was to perform a population based epidemiological study of AIH in Canterbury, New Zealand. To calculate point prevalence, all adult and pediatric outpatient clinics and hospital discharge summaries were searched to identify all cases of AIH in the Canterbury region. Incident cases were recruited prospectively in 2008. Demographic and clinical data were extracted from case notes. Both the original revised AIH criteria and the simplified criteria were applied and cases were included in the study if they had definite or probable AIH. When the original revised criteria were used, 138 cases (123 definite and 14 probable AIH), were identified. Prospective incidence in 2008 was 2.0/100,000 (95% confidence interval [CI] 0.8-3.3/100,000). Point prevalence on 31 December 2008 was 24.5/100,000 (95% CI 20.1-28.9). Age-standardized (World Health Organization standard population) incidence and prevalence were 1.7 and 18.9 per 100,000, respectively. Gender-specific prevalence confirmed a female predominance, while ethnicity-specific prevalence showed higher prevalence in Caucasians. 72% of cases presented after 40 years of age and the peak age of presentation was in the sixth decade of life. This is the first and largest population-based epidemiology study of AIH in a geographically defined region using standardized inclusion criteria. The observed incidence and prevalence rates are among the highest reported. The present study confirms that AIH presents predominantly in older women, with a peak in the sixth decade, contrary to the classical description of the disease. © 2010 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

  5. 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

  6. 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...

  7. 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:

  8. 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

  9. 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

  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. 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…

  12. 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…

  13. 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

  14. 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.

  15. 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.

  16. 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...

  17. Increasing prevalence of nephrolithiasis and BMI among children: a population base study.

    Science.gov (United States)

    Alfandary, Hadas; Haskin, Orly; Davidovits, Miriam; Pleniceanu, Oren; Leiba, Adi; Dagan, Amit

    2017-10-20

    Epidemiological studies show an association of increased BMI with increased risk of kidney stone formation in adults. We conducted a population-based pediatric study to examine the epidemiology of nephrolithiasis in the Israeli pediatric population during a 30-year period, and to examine BMI distribution during the same period. We accessed data from the compulsory medical evaluations of 17 year- olds in Israel, prior to their enlistment for military service during 1980-2013. Candidates for the army with a history of stone disease were compared to those without such history. Of 1,908,893 candidates, 1691 reported a history of nephrolithiasis; this yields an average prevalence rate of 88.6 in 100.000. During 1980-1995, the average reported prevalence of nephrolithiasis was 69 cases per 100,000 candidates. From 1995, the reported prevalence increased by an average of 6% per year, and reached 120 per 100,000 during 2010-2012. This increased prevalence was observed for both males and females, but was more prominent among males. The mean BMI of stone formers was higher than that of the control group (22.7±3.5 vs. 22.1±3.9 kg/m2 p30 kg/m2 1.7 (1.4-2.1) compared to candidates with BMI 18.5-24.9 CONCLUSION: This large population-based study documents a rising prevalence of nephrolithiasis among children. The possible association of this finding with the rise in BMI during the same period warrants further investigation. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. Survival in pediatric medulloblastoma: a population-based observational study to improve prognostication.

    Science.gov (United States)

    Weil, Alexander G; Wang, Anthony C; Westwick, Harrison J; Ibrahim, George M; Ariani, Rojine T; Crevier, Louis; Perreault, Sebastien; Davidson, Tom; Tseng, Chi-Hong; Fallah, Aria

    2017-03-01

    Medulloblastoma is the most common form of brain malignancy of childhood. The mainstay of epidemiological data regarding childhood medulloblastoma is derived from case series, hence population-based studies are warranted to improve the accuracy of survival estimates. To utilize a big-data approach to update survival estimates in a contemporary cohort of children with medulloblastoma. We performed a population-based retrospective observational cohort study utilizing the Surveillance, Epidemiology, and End Results Program database that captures all children, less than 20 years of age, between 1973 and 2012 in 18 geographical regions representing 28% of the US population. We included all participants with a presumed or histologically diagnosis of medulloblastoma. The main outcome of interest is survivors at 1, 5 and 10 years following diagnosis. A cohort of 1735 children with a median (interquartile range) age at diagnosis of 7 (4-11) years, with a diagnosis of medulloblastoma were identified. The incidence and prevalence of pediatric medulloblastoma has remained stable over the past 4 decades. There is a critical time point at 1990 when the overall survival has drastically improved. In the contemporary cohort (1990 onwards), the percentage of participants alive was 86, 70 and 63% at 1, 5 and 10 years, respectively. Multivariate Cox-Regression model demonstrated Radiation (HR 0.37; 95% CI 0.30-0.46, p medulloblastoma survival. In contrast to previous reports, the majority of patients survive in the modern era, and those alive 8 years following initial diagnosis are likely a long-term survivor. The importance of minimizing treatment-related toxicity is increasingly apparent given the likelihood of long-term survival.

  19. 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.

  20. 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

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

    Directory of Open Access Journals (Sweden)

    Mikolajczyk Rafael T

    2010-12-01

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

  2. 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.

  3. 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.

  4. 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

  5. Vitreous haemorrhage: a population-based study of the incidence and risk factors in Taiwan

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    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.

  6. 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.

  7. Gender differences in presenting signs and symptoms of acute ischemic stroke: a population-based study.

    Science.gov (United States)

    Jerath, Nivedita U; Reddy, Chandan; Freeman, W David; Jerath, Aarti U; Brown, Robert D

    2011-10-01

    There are few population-based data regarding gender differences in signs and symptoms of acute ischemic stroke, and previously reported data have been inconsistent and conflicting. The goal of this study was to address the gender differences of the presenting signs and symptoms of acute ischemic stroke in a population-based study. All patients with first ischemic stroke occurring between 1985 and 1989 were identified; subjects were residents of Rochester, Minnesota. Signs and symptoms were collected via review of comprehensive medical records. Differences were identified using the Pearson χ(2) test. A total of 449 cases of first ischemic stroke were identified; 268 (60%) were women. Symptoms at ischemic stroke presentation differed between men and women. Women more commonly presented with generalized weakness (P = 0.005) and mental status change (P = 0.0001). Men more commonly presented with paresthesia (P = 0.003), ataxia (P = 0.006), and double vision (P = 0.005). Signs at ischemic stroke presentation differed between men and women. Men more commonly presented with nystagmus (P = 0.002) on examination. Significant trends were that women more commonly presented with fatigue (P = 0.02), disorientation (P = 0.04), and fever (P = 0.02), whereas men more commonly presented with sensory abnormalities (P = 0.02). There were gender differences in signs and symptoms at presentation of ischemic stroke in these study patients. In addition to selected focal symptoms, women more commonly presented with diffuse symptoms of generalized weakness, fatigue, disorientation, and mental status change. Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved.

  8. Rate of Comorbidities in Giant Cell Arteritis: A Population-based Study.

    Science.gov (United States)

    Mohammad, Aladdin J; Englund, Martin; Turesson, Carl; Tomasson, Gunnar; Merkel, Peter A

    2017-01-01

    To compare the rate of occurrence of comorbidities, including severe infections, in a population-based cohort of patients with biopsy-proven giant cell arteritis (GCA) with a reference population in Southern Sweden. The study included a population-based cohort of biopsy-proven GCA cases diagnosed between 1998 and 2010 from the Skåne region in Southern Sweden (population: 1.2 million). For each patient, 4 reference subjects were identified from the general population and matched for age, sex, area of residence, and date of diagnosis of GCA. Using the Skåne Healthcare Register, comorbidities and severe infections (requiring hospitalization) diagnosed after GCA onset were identified. The rate of the first occurrence of each comorbidity was the result of dividing the number of subjects with a given comorbidity by the person-years of followup. The rate ratio (RR; GCA:reference population) was also calculated. There were 768 patients (571 women) with GCA and 3066 reference persons included in the study. The RR were significantly elevated for osteoporosis (2.81, 95% CI 2.33-3.37), followed by venous thromboembolic diseases (2.36, 95% CI 1.61-3.40), severe infections (1.85, 95% CI 1.57-2.18), thyroid diseases (1.55, 95% CI 1.25-1.91), cerebrovascular accidents (1.40, 95% CI 1.12-1.74), and diabetes mellitus (1.29, 95% CI 1.05-1.56). The RR for ischemic heart disease was elevated, but did not reach statistical significance (1.20, 95% CI 1.00-1.44). Patients with GCA have higher rates of selected comorbidities, including severe infections, compared with a reference population. Several of these comorbidities may be related to treatment with glucocorticosteroids, emphasizing the unmet need to find alternative treatments for GCA.

  9. Bacterial meningitis in patients with HIV: A population-based prospective study.

    Science.gov (United States)

    van Veen, Kiril E B; Brouwer, Matthijs C; van der Ende, Arie; van de Beek, Diederik

    2016-03-01

    We studied occurrence, disease course, and prognosis of community-acquired bacterial meningitis in HIV-infected adults in the Netherlands. We performed a nationwide, prospective cohort study. Patients over 16 years old with bacterial meningitis were included. Data on patient history, symptoms and signs on admission, laboratory findings, radiologic examination, treatment, and outcome were collected prospectively. For HIV-positive patients additional information was collected retrospectively. From March 2006 to December 2013, 1354 episodes of community-acquired meningitis were included in the cohort. Thirteen patients were HIV-infected (1.0%). The annual incidence of bacterial meningitis was 8.3-fold higher (95%CI 4.6-15.1, P bacterial meningitis as compared to the general population despite cART therapy. Clinical presentation and outcome of patients with acute bacterial meningitis with and without HIV are similar. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  10. 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...

  11. 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...

  12. The Global Incidence of Appendicitis: A Systematic Review of Population-based Studies.

    Science.gov (United States)

    Ferris, Mollie; Quan, Samuel; Kaplan, Belle S; Molodecky, Natalie; Ball, Chad G; Chernoff, Greg W; Bhala, Nij; Ghosh, Subrata; Dixon, Elijah; Ng, Siew; Kaplan, Gilaad G

    2017-08-01

    We compared the incidence of appendicitis or appendectomy across the world and evaluated temporal trends. Population-based studies reported the incidence of appendicitis. We searched MEDLINE and EMBASE databases for population-based studies reporting the incidence of appendicitis or appendectomy. Time trends were explored using Poisson regression and reported as annual percent change (APC) with 95% confidence intervals (CI). APC were stratified by time periods and pooled using random effects models. Incidence since 2000 was pooled for regions in the Western world. The search retrieved 10,247 citations with 120 studies reporting on the incidence of appendicitis or appendectomy. During the 21st century the pooled incidence of appendicitis or appendectomy (in per 100,000 person-years) was 100 (95% CI: 91, 110) in Northern America, and the estimated number of cases in 2015 was 378,614. The pooled incidence ranged from 105 in Eastern Europe to 151 in Western Europe. In Western countries, the incidence of appendectomy steadily decreased since 1990 (APC after 1989=-1.54; 95% CI: -2.22, -0.86), whereas the incidence of appendicitis stabilized (APC=-0.36; 95% CI: -0.97, 0.26) for both perforated (APC=0.95; 95% CI: -0.25, 2.17) and nonperforated appendicitis (APC=0.44; 95% CI: -0.84, 1.73). In the 21st century, the incidence of appendicitis or appendectomy is high in newly industrialized countries in Asia (South Korea pooled: 206), the Middle East (Turkey pooled: 160), and Southern America (Chile: 202). Appendicitis is a global disease. The incidence of appendicitis is stable in most Western countries. Data from newly industrialized countries is sparse, but suggests that appendicitis is rising rapidly.

  13. 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)

  14. Cost-effectiveness of hypertension treatment: a population-based study

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    Juvenal Soares Dias da Costa

    Full Text Available CONTEXT: The cost-effectiveness of the treatment of hypertension has scarcely been investigated in population-based studies. Most data come from secondary analysis of clinical trials and administrative sources. OBJECTIVE: To describe the healthcare costs for outpatient hypertension treatment in comparison with diabetes mellitus and chronic bronchitis, and to examine the cost-effectiveness of different classes of antihypertensive drugs. DESIGN: Cross-sectional population-based study. SETTING: Urban area of Pelotas, southern Brazil. PARTICIPANTS: Individuals aged 20-69 years, identified through multi-stage probability sampling. METHODS: Participants were interviewed at home. Demographic data, education, income, smoking, previous morbidity, use of medicine and other characteristics were assessed via a pre-tested questionnaire, and blood pressure while seated was measured in a standardized way. RESULTS: Approximately 24% of the participants had high blood pressure or were taking antihypertensive drugs, and among these, 33% had had a physician consultation during the month preceding the interview. The monthly mean costs of care for hypertension (R$ 89.90, diabetes (R$ 80.64 and bronchitis (R$ 92.63 were similar. Treatment of hypertension consumed 22.9% of the per-capita income, corresponding to R$ 392.76 spent per year exclusively on antihypertensive drugs. Most of the direct costs associated with hypertension and diabetes were spent on drugs, while patients with bronchitis had greater expenditure on appointments. The cost-effectiveness relationship was more favorable for diuretics (116.3 and beta blockers (228.5 than for ACE inhibitors (608.5 or calcium channel blockers (762.0. CONCLUSION: The costs of hypertension care are mainly dependent on the expenditure on blood pressure-lowering drugs. Treatment of hypertension with diuretics or beta blockers was more cost-effective than treatment with ACE inhibitors and calcium channel blockers.

  15. Utility of EEG Activation Procedures in Epilepsy: A Population-Based Study.

    Science.gov (United States)

    Baldin, Elisa; Hauser, W A; Buchhalter, Jeffrey R; Hesdorffer, Dale C; Ottman, Ruth

    2017-11-01

    No previous population-based study has addressed the contribution of activation procedures to the yield of epileptiform abnormalities on serial EEGs. We assessed yield of activation-related epileptiform abnormalities and predictors of finding an activation-related abnormality with multiple EEGs in a population-based study of newly diagnosed epilepsy. We used the resources of the Rochester Epidemiology Project to identify 449 residents of Rochester, Minnesota with a diagnosis of newly diagnosed epilepsy at age 1 year or older, between 1960 and 1994, who had at least one EEG. Information on all activation procedures (i.e., sleep, hyperventilation, and photic activation) and seizure/epilepsy characteristics was obtained by comprehensive review of medical records. At the first EEG, the yield of epileptiform abnormalities was greatest for individuals 1 to 19 years of age at diagnosis, for each activation procedure. The yield in patients aged 1 to 19 versus ≥20 years was 21.6% versus 10.3% for sleep, 6.5% versus 3.3% for photic stimulation, and 10.3% versus 5% for hyperventilation. Among young people (aged 1-19 years), sleep was associated with an increased likelihood of finding an activation-related abnormality on any EEG. The likelihood of finding an activation-related abnormality on any EEG was decreased for postnatal symptomatic and for unknown etiology. Among activation procedures, sleep showed the highest yield of epileptiform abnormalities. There was a low yield for photic stimulation and hyperventilation. Within each activation procedure, younger age at diagnosis had the greatest yield. Sleep is the most effective activation procedure, especially in younger patients, and should be performed when possible.

  16. Physical Activity as Protective Factor against Dementia: A Prospective Population-Based Study (NEDICES).

    Science.gov (United States)

    Llamas-Velasco, Sara; Contador, Israel; Villarejo-Galende, Alberto; Lora-Pablos, David; Bermejo-Pareja, Félix

    2015-11-01

    The aim of this study was to analyze whether physical activity (PA) is a protective factor for the incidence of dementia after 3 years of follow-up. The Neurological Disorders in Central Spain (NEDICES) is a prospective population-based survey of older adults (age 65 years and older) that comprised 5278 census-based participants at baseline (1994-1995). A broad questionnaire was used to assess participants' sociodemographic characteristics, health status, and lifestyle. Subsequently, a modified version of Rosow-Breslau questionnaire was applied to classify individuals' baseline PA into groups (i.e., sedentary, light, moderate, and high). Cox regression models adjusted for several covariates (age, sex, education, previous stroke, alcohol consumption, hypertension, health related variables) were carried out to estimate the association between the PA groups and risk of dementia at the 3-year follow-up (1997-1998). A total of 134 incident dementia cases were identified among 3105 individuals (56.6% female; mean age=73.15 ± 6.26) after 3 years. Hazard ratios (HRs) of the light, moderate, and high PA groups (vs. sedentary group) were 0.40 (95% confidence interval {CI} [0.26, 0.62]; p<.001), 0.32 (95% CI [0.20, 0.54]; p<.001) and 0.23 (95% CI [0.13, 0.40]; p<.001), respectively. Even after controlling for covariates and the exclusion of doubtful dementia cases, HRs remained significant. However, a supplementary analysis showed that the dose-effect hypothesis did not reach statistical significance. PA is a protective factor of incident dementia in this population-based cohort.

  17. Targeted genetic testing for familial hypercholesterolaemia using next generation sequencing: a population-based study.

    Science.gov (United States)

    Norsworthy, Penny J; Vandrovcova, Jana; Thomas, Ellen R A; Campbell, Archie; Kerr, Shona M; Biggs, Jennifer; Game, Laurence; Soutar, Anne K; Smith, Blair H; Dominiczak, Anna F; Porteous, David J; Morris, Andrew D; Scotland, Generation; Aitman, Timothy J

    2014-06-23

    Familial hypercholesterolaemia (FH) is a common Mendelian condition which, untreated, results in premature coronary heart disease. An estimated 88% of FH cases are undiagnosed in the UK. We previously validated a method for FH mutation detection in a lipid clinic population using next generation sequencing (NGS), but this did not address the challenge of identifying index cases in primary care where most undiagnosed patients receive healthcare. Here, we evaluate the targeted use of NGS as a potential route to diagnosis of FH in a primary care population subset selected for hypercholesterolaemia. We used microfluidics-based PCR amplification coupled with NGS and multiplex ligation-dependent probe amplification (MLPA) to detect mutations in LDLR, APOB and PCSK9 in three phenotypic groups within the Generation Scotland: Scottish Family Health Study including 193 individuals with high total cholesterol, 232 with moderately high total cholesterol despite cholesterol-lowering therapy, and 192 normocholesterolaemic controls. Pathogenic mutations were found in 2.1% of hypercholesterolaemic individuals, in 2.2% of subjects on cholesterol-lowering therapy and in 42% of their available first-degree relatives. In addition, variants of uncertain clinical significance (VUCS) were detected in 1.4% of the hypercholesterolaemic and cholesterol-lowering therapy groups. No pathogenic variants or VUCS were detected in controls. We demonstrated that population-based genetic testing using these protocols is able to deliver definitive molecular diagnoses of FH in individuals with high cholesterol or on cholesterol-lowering therapy. The lower cost and labour associated with NGS-based testing may increase the attractiveness of a population-based approach to FH detection compared to genetic testing with conventional sequencing. This could provide one route to increasing the present low percentage of FH cases with a genetic diagnosis.

  18. Epidemiology of emergency department visits for opioid overdose: a population-based study.

    Science.gov (United States)

    Hasegawa, Kohei; Brown, David F M; Tsugawa, Yusuke; Camargo, Carlos A

    2014-04-01

    To evaluate the rate of emergency department (ED) visits for opioid overdose and to examine whether frequent ED visits for opioid overdose are associated with more hospitalizations, near-fatal events, and health care spending. Retrospective cohort study of adults with at least 1 ED visit for opioid overdose between January 1, 2010, and December 31, 2011, derived from population-based data of State Emergency Department Databases and State Inpatient Databases for 2 large and diverse states: California and Florida. Main outcome measures were hospitalizations for opioid overdose, near-fatal events (overdose involving mechanical ventilation), and hospital charges during the year after the first ED visit. The analytic cohort comprised 19,831 unique patients with 21,609 ED visits for opioid overdose. During a 1-year period, 7% (95% CI, 7%-7%; n=1389 patients) of the patients had frequent (2 or more) ED visits, accounting for 15% (95% CI, 14%-15%; n=3167) of all opioid overdose ED visits. Middle age, male sex, public insurance, lower household income, and comorbidities (such as chronic pulmonary disease and neurological diseases) were associated with frequent ED visits (all Popioid overdose resulted in hospitalizations; patients with frequent ED visits for opioid overdose had a higher likelihood of hospitalization (adjusted odds ratio, 3.98; 95% CI, 3.38-4.69). In addition, 10.0% (95% CI, 10%-10%; n=2161) of the ED visits led to near-fatal events; patients with frequent ED visits had a higher likelihood of a near-fatal event (adjusted odds ratio, 2.27; 95% CI, 1.96-2.66). Total charges in Florida were $208 million (95% CI, $200-$219 million). In this population-based cohort, we found that frequent ED visits for opioid overdose were associated with a higher likelihood of future hospitalizations and near-fatal events. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  19. Leptin and variables of body adiposity, energy balance, and insulin resistance in a population-based study. The Hoorn Study

    NARCIS (Netherlands)

    Ruige, J B; Dekker, J M; Blum, W F; Stehouwer, C D; Nijpels, G; Mooy, J; Kostense, P J; Bouter, L M; Heine, R J

    OBJECTIVE: Leptin is thought to play a key role in the control of body weight. There is a complex interrelationship between leptin and insulin or insulin resistance, but it is unknown how leptin is regulated. We therefore explored, in a large population-based study of 2,484 Caucasian subjects aged

  20. The Epidemiology of Functional Gastrointestinal Disorders in Mexico: A Population-Based Study

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    Aurelio López-Colombo

    2012-01-01

    Full Text Available Aims. The frequency of functional gastrointestinal disorders (FGIDs in the general population of Mexico is unknown. Methods. To determine the prevalence of FGIDs, associated depression, and health care utilization, a population-based sampling strategy was used to select 500 households in the State of Tlaxcala, in central Mexico. Household interviews were conducted by two trained physicians using the Rome II Modular Questionnaire, a health-care and medication used questionnaire and the CES-D depression scale. Results. The most common FGIDs were IBS: 16.0% (95% CI: 12.9–19.5; functional bloating: 10.8% (8.2–13.9; unspecified functional bowel disorder: 10.6% (8.0–13.6; and functional constipation (FC: 7.4% (5.3–10.1. Uninvestigated heartburn was common: 19.6% (16.2–23.4. All FGIDs were equally prevalent among both genders, except for IBS (P=0.001, IBS-C (P<0.001, IBS-A/M (P=0.049, and FC (P=0.039 which were more frequent in women. Subjects with FGIDs reported higher frequencies of medical visits: 34.6 versus 16.8%; use of medications: 40.7 versus 21.6%; (both P<0.001; and reported depression: 26.7 versus 6.7%, (P<0.001. Conclusion. In this first population-based study of FGIDs in Mexico, heartburn, IBS, functional distension, and FC were common. Only IBS, IBS-C, IBS-A/M, and FC were more frequent in women. Finally, FGIDs in Mexico had an increased burden of health care utilization and depression.

  1. The epidemiology of functional gastrointestinal disorders in Mexico: a population-based study.

    Science.gov (United States)

    López-Colombo, Aurelio; Morgan, Douglas; Bravo-González, Dalia; Montiel-Jarquín, Alvaro; Méndez-Martínez, Socorro; Schmulson, Max

    2012-01-01

    Aims. The frequency of functional gastrointestinal disorders (FGIDs) in the general population of Mexico is unknown. Methods. To determine the prevalence of FGIDs, associated depression, and health care utilization, a population-based sampling strategy was used to select 500 households in the State of Tlaxcala, in central Mexico. Household interviews were conducted by two trained physicians using the Rome II Modular Questionnaire, a health-care and medication used questionnaire and the CES-D depression scale. Results. The most common FGIDs were IBS: 16.0% (95% CI: 12.9-19.5); functional bloating: 10.8% (8.2-13.9); unspecified functional bowel disorder: 10.6% (8.0-13.6); and functional constipation (FC): 7.4% (5.3-10.1). Uninvestigated heartburn was common: 19.6% (16.2-23.4). All FGIDs were equally prevalent among both genders, except for IBS (P = 0.001), IBS-C (P < 0.001), IBS-A/M (P = 0.049), and FC (P = 0.039) which were more frequent in women. Subjects with FGIDs reported higher frequencies of medical visits: 34.6 versus 16.8%; use of medications: 40.7 versus 21.6%; (both P < 0.001); and reported depression: 26.7 versus 6.7%, (P < 0.001). Conclusion. In this first population-based study of FGIDs in Mexico, heartburn, IBS, functional distension, and FC were common. Only IBS, IBS-C, IBS-A/M, and FC were more frequent in women. Finally, FGIDs in Mexico had an increased burden of health care utilization and depression.

  2. Characteristics of fetuses evaluated due to suspected anencephaly: a population-based cohort study in southern Brazil

    Directory of Open Access Journals (Sweden)

    Emanuele Pelizzari

    Full Text Available CONTEXT AND OBJECTIVE: Anencephaly is considered to be the most common type of neural tube defect. Our aim was to assess the clinical and gestational features of a cohort of fetuses with suspected anencephaly. DESIGN AND SETTING: Population-based retrospective cohort study in a referral hospital in southern Brazil. METHODS: The sample consisted of fetuses referred due to suspected anencephaly, to the Fetal Medicine Service of Hospital Materno Infantil Presidente Vargas, between January 2005 and September 2013. Clinical, radiological, pathological and survival data were gathered. RESULTS: Our sample was composed of 29 fetuses. The diagnosis of suspected anencephaly was made on average at 21.3 weeks of gestation. Seven fetuses had malformations that affected other organs, and these included oral clefts (n = 4 and congenital heart defects (n = 2. In 16 cases, there was termination of pregnancy (n = 12 or intrauterine death (n = 4. Regarding those who were born alive (n = 13, all of them died in the first week of life. After postnatal evaluation, the diagnosis of anencephaly was confirmed in 22 cases (75.9%. Other conditions included amniotic band disruption complex (6.9%, microhydranencephaly (6.9%, merocrania (3.4% and holoprosencephaly (3.4%. CONCLUSIONS: Different conditions involving the cranial vault may be confused with anencephaly, as seen in our sample. However, these conditions also seem to have a poor prognosis. It seems that folic acid supplementation is not being properly performed.

  3. 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...

  4. 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

  5. The socioeconomics of diabetes from a developing country: a population based cost of illness study.

    Science.gov (United States)

    Tharkar, Shabana; Devarajan, Arutselvi; Kumpatla, Satyavani; Viswanathan, Vijay

    2010-09-01

    To assess the annual health care expenditure for a patient with diabetes and extrapolate the same to country specific prevalence estimates for 2010. This population based, cost of illness study collected retrospective data for last 12 months on direct costs (medical and non-medical) through records, indirect cost through human capital approach and intangible cost by contingent valuation method from diabetes patients. Out of 4677 subjects screened, 1050 had diabetes and 718 participated in the survey. The median annual direct and indirect cost associated with diabetes care was estimated at 25,391 INR ($525.5) and 4970 INR ($102.8), respectively. Extrapolating the direct and indirect estimates to Indian population, the annual costs for diabetes would be 1541.4 billion INR ($31.9 billion) in 2010. Two-way sensitivity analysis assuming 10% variation in both prevalence of diabetes and in treatment costs resulted in an estimated cost range of 1230 billion INR ($25.5 billion) to 1837.3 billion INR ($38.0 billion). Keeping the future diabetes explosion in mind, this heavy economic burden highlights the urgent need for the decision makers to allocate resources for planning and implementing strategies in prevention and management of diabetes and its complications. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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…

  11. 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

  12. 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

  13. 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

  14. 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…

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

    Science.gov (United States)

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

    2014-10-01

    Released prisoners have high suicide rates compared with the general population, but little is known about risk factors and possible causal pathways. We conducted a population-based cohort study to investigate rates and risk factors for suicide in people previously imprisoned. We identified individuals released from prison in Sweden between January 1, 2005, and December 31, 2009, through linkage of national population-based registers. Released prisoners were followed from the day of release until death, emigration, new incarceration, or December 31, 2009. Survival analyses were conducted to compare incidence rates and psychiatric morbidity with nonconvicted population controls matched on gender and year of birth. We identified 38,995 releases among 26,985 prisoners (7.6% female) during 2005-2009. Overall, 127 suicides occurred, accounting for 14% of all deaths after release (n = 920). The mean suicide rate was 204 per 100,000 person-years, yielding an incidence rate ratio of 18.2 (95% CI, 13.9-23.8) compared with general population controls. Previous substance use disorder (hazard ratio [HR] = 2.1; 95% CI, 1.4-3.2), suicide attempt (HR = 2.5; 95% CI, 1.7-3.7), and being born in Sweden versus abroad (HR = 2.1; 95% CI, 1.2-3.6) were independent risk factors for suicide after release. Released prisoners are at high suicide risk and have a slightly different pattern of psychiatric risk factors for suicide compared with the general population. Results suggest appropriate allocation of resources to facilitate transition to life outside prison and increased attention to prisoners with both a previous suicide attempt and substance use disorder. © Copyright 2014 Physicians Postgraduate Press, Inc.

  16. Workplace injuries in Fiji: a population-based study (TRIP 7).

    Science.gov (United States)

    Reddy, R; Kafoa, B; Wainiqolo, I; Kool, B; Gentles, D; McCaig, E; Ameratunga, S

    2013-06-01

    Workplace injury rates in low and middle-income countries are known to be high. Contemporary data on this topic from Pacific Island countries and territories are scant. To describe the epidemiology of fatal and hospitalized workplace injuries in Fiji using a population-based trauma registry. An analysis of data from a prospective population-based surveillance registry investigated the characteristics associated with workplace injuries resulting in death or hospital admission among people aged 15 years and older in Viti Levu, the largest island in the Republic of Fiji, from October 2005 to September 2006. Incidence rates were calculated using denominator data from the 2004-05 Fiji Employment Survey. One hundred and eighty-nine individuals met the study eligibility criteria (including nine deaths). This corresponded to annual injury-related hospitalization and death rates of 73.4 and 3.7 per 100 000 workers, respectively. Males accounted for 95% of injuries, and hospitalization rates were highest among those aged 15-29 years (33 per 100 000 workers). Fijian and Indian workers had similar rates of admission to hospital (38.3 and 31.8 per 100 000 workers, respectively). Fractures (40%) and 'cuts/bites/open wounds' (32%) were the commonest types of injury while 'being hit by a person or object' (34%), falls (27%) and 'cutting or piercing' injuries (27%) were the commonest mechanisms. Overall, 7% of injuries were deemed intentional. Acknowledging the likely underestimation of the overall burden of workplace injuries, these findings support the need to identify context-specific risk factors and effective approaches to preventing workplace injuries in Fiji.

  17. 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.

  18. Incidence of prenatal alcohol exposure in Prince Edward Island: a population-based descriptive study.

    Science.gov (United States)

    Bryanton, Janet; Gareri, Joey; Boswall, Diane; McCarthy, Mary Jean; Fraser, Bonnie; Walsh, Donna; Freeman, Bridget; Koren, Gideon; Bigsby, Kathy

    2014-04-01

    Fetal alcohol spectrum disorder (FASD) is a leading preventable cause of neurodevelopmental disability in North America. The stigma associated with alcohol use and abuse during pregnancy makes it difficult to obtain information on prenatal alcohol use through self-reporting. We assessed the incidence of prenatal alcohol exposure in Prince Edward Island to facilitate future public health initiatives addressing FASD. Prenatal alcohol exposure was examined via population-based collection of meconium and analysis of fatty acid ethyl esters (FAEEs). Fatty acid ethyl esters are nonoxidative metabolites of ethanol that are produced in the fetus. Meconium FAEE concentrations of 2.0 nmol/g or greater are indicative of frequent prenatal alcohol exposure during the last 2 trimesters of pregnancy. Samples were collected from 1307 neonates between Nov. 8, 2010, and Nov. 8, 2011, in hospitals in PEI, or from those born to mothers who resided in PEI but gave birth in Halifax, Nova Scotia. Samples were frozen and shipped for analysis. Fatty acid ethyl esters were analyzed by gas chromatography-mass spectrometry and quantified by means of deuterated internal standards. Of the 1307 samples collected, 1271 samples were successfully analyzed. Positive results for FAEEs were obtained in 3.1% (n = 39) of samples collected within the first 24 hours after birth. Not all neonates exposed to heavy prenatal alcohol in utero will exhibit FASD; based on current estimates of predictive value for disease by exposure, our findings suggest that 1.3% of neonates born in PEI during this 1-year period will have FASD. In its application to an entire provincial birth cohort, this study successfully implemented a public health-centred approach for evaluating population-based risk of FASD, with implications for practice across Canada.

  19. Inflammatory cytokines as risk factors for a first venous thrombosis: a prospective population-based study.

    Directory of Open Access Journals (Sweden)

    Sverre C Christiansen

    2006-08-01

    Full Text Available BACKGROUND: In case-control studies, elevated levels of interleukins 6 and 8 have been found to be associated with an increased risk of venous thrombosis (VT. Because of the design of these studies, it remained uncertain whether these alterations were a cause or a result of the VT. In order to distinguish between the two, we set out to measure the levels of six inflammatory markers prior to thrombosis in a population-based cohort using a nested case-cohort design. METHODS AND FINDINGS: Between August 1995 and June 1997, blood was collected from 66,140 people in the second Norwegian Health Study of Nord-Trøndelag (HUNT2. We identified venous thrombotic events occurring between entry and 1 January 2002. By this date we had registered 506 cases with a first VT; an age- and sex-stratified random sample of 1,464 controls without previous VT was drawn from the original cohort. Levels of interleukins 1beta, 6, 8, 10, 12p70, and tumour necrosis factor-alpha were measured in the baseline sample that was taken 2 d to 75 mo before the event (median 33 mo. Cut-off points for levels were the 80th, 90th, and 95th percentile in the control group. With odds ratios ranging from 0.9 (95% CI: 0.6-1.5 to 1.1 (95% CI: 0.7-1.8, we did not find evidence for a relationship between VT and an altered inflammatory profile. CONCLUSIONS: The results from this population sample show that an altered inflammatory profile is more likely to be a result rather than a cause of VT, although short-term effects of transiently elevated levels cannot be ruled out.

  20. 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....

  1. 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.

  2. Dietary patterns in internal migrants in a continental country: A population-based study.

    Directory of Open Access Journals (Sweden)

    Antonio Augusto Ferreira Carioca

    Full Text Available The objective of this study was to assess the differences and similarities in dietary patterns among migrants and natives.A population-based, cross-sectional study was conducted in the city of São Paulo. The study population included internal migrants, defined as individuals born outside São Paulo city who had lived in the city for ten years or longer. The final population (n = 999 was divided into three groups: natives of São Paulo (n = 354, migrants from the Southeast (n = 349 and migrants from the Northeast (n = 296. Factor and principal component analysis was employed to derive dietary patterns. The standardized scores were compared among groups using linear regression.Differences in income per capita, years of education, self-reported race, smoking habits, alcohol consumption, nutritional status and prevalence of hypertension were found for place of birth. Three dietary patterns were identified: prudent (salad dressings, vegetables, natural flavorings, fruits, whole-grain bread, white cheeses and juices, traditional (rice, beans, bread/toast/crackers, butter/margarine, whole milk, coffee/teas, sugar, and modern (sodas, pastries/sandwiches/pizzas, yellow cheeses, pastas, sauces, alcoholic beverages, sweets, processed meats. Compared to natives, migrants from the Southeast had an inversely proportional adherence to the modern pattern whereas migrants from the Northeast had an inverse association with the prudent and modern patterns and a positive association with the traditional pattern.São Paulo natives and internal migrants from other regions of Brazil exhibited different dietary patterns. The results presented here add perspectives to be considered in the study of non-communicable diseases and its different incidences among migrants and natives.

  3. The LIFE Child study: a population-based perinatal and pediatric cohort in Germany.

    Science.gov (United States)

    Poulain, Tanja; Baber, Ronny; Vogel, Mandy; Pietzner, Diana; Kirsten, Toralf; Jurkutat, Anne; Hiemisch, Andreas; Hilbert, Anja; Kratzsch, Jürgen; Thiery, Joachim; Fuchs, Michael; Hirsch, Christian; Rauscher, Franziska G; Loeffler, Markus; Körner, Antje; Nüchter, Matthias; Kiess, Wieland

    2017-02-01

    The LIFE Child study is a large population-based longitudinal childhood cohort study conducted in the city of Leipzig, Germany. As a part of LIFE, a research project conducted at the Leipzig Research Center for Civilization Diseases, it aims to monitor healthy child development from birth to adulthood and to understand the development of lifestyle diseases such as obesity. The study consists of three interrelated cohorts; the birth cohort, the health cohort, and the obesity cohort. Depending on age and cohort, the comprehensive study program comprises different medical, psychological, and sociodemographic assessments as well as the collection of biological samples. Optimal data acquisition, process management, and data analysis are guaranteed by a professional team of physicians, certified study assistants, quality managers, scientists and statisticians. Due to the high popularity of the study, more than 3000 children have already participated until the end of 2015, and two-thirds of them participate continuously. The large quantity of acquired data allows LIFE Child to gain profound knowledge on the development of children growing up in the twenty-first century. This article reports the number of available and analyzable data and demonstrates the high relevance and potential of the study.

  4. 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...

  5. Major depressive episode among Brazilian adults: a cross-sectional population-based study.

    Science.gov (United States)

    Munhoz, Tiago N; Santos, Iná S; Matijasevich, Alicia

    2013-09-05

    Despite the fact that there is extensive scientific research on depression very few population-based studies have been conducted in Brazilian cities. A sampling design of two-stage conglomerates with probability proportional to size. All adults aged 20 or more living in the selected households were invited to participate in the study. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9) with a cutoff ≥9. The study sample comprised 2925 respondents. The prevalence of depression in the sample studied was 20.4% (95% CI 18.9;21.8). After adjustment for confounding factors according to a conceptual analysis model the following variables were associated with a higher prevalence of depression: female gender; younger age; white skin color; lower socioeconomic condition; lower education; smoking; being single or separated; being unemployed; and reporting a heart condition. Alcohol use, arterial hypertension, and diabetes mellitus were not found to be associated with depression. The difference in the proportion of males among losses and refusals compared to that in the sample analyzed. Another limitation is reverse causality bias that is a problem inherent to cross-sectional studies. Our findings support the relevance of depression as a prevalent condition among adults. It also provided evidence of the factors associated with depression, and that some are potentially modifiable risk factors may have implications for policy and health service planning. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. History of depression and risk of hyperemesis gravidarum: a population-based cohort study.

    Science.gov (United States)

    Kjeldgaard, Helena Kames; Eberhard-Gran, Malin; Benth, Jūratė Šaltytė; Nordeng, Hedvig; Vikanes, Åse Vigdis

    2017-06-01

    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 regression analyses were performed to examine the association between a lifetime history of depression and hyperemesis gravidarum. Odds ratios were adjusted for symptoms of current depression, maternal age, parity, body mass index, smoking, sex of the child, education and pelvic girdle pain. A lifetime history of depression was associated with higher odds for hyperemesis gravidarum (aOR = 1.49, 95% CI (1.23; 1.79)). Two thirds of women with hyperemesis gravidarum had neither a history of depression nor symptoms of current depression, and 1.2% of women with a history of depression developed HG. A lifetime history of depression increased the risk of HG. However, given the fact that only 1.2% of women with a history of depression developed HG and that the majority of women with HG had no symptoms of depression, depression does not seem to be a main driver in the aetiology of HG.

  7. 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...

  8. Sleep assessment in a population-based study of chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Reyes Michele

    2004-04-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a disabling condition that affects approximately 800,000 adult Americans. The pathophysiology remains unknown and there are no diagnostic markers or characteristic physical signs or laboratory abnormalities. Most CFS patients complain of unrefreshing sleep and many of the postulated etiologies of CFS affect sleep. Conversely, many sleep disorders present similarly to CFS. Few studies characterizing sleep in unselected CFS subjects have been published and none have been performed in cases identified from population-based studies. Methods The study included 339 subjects (mean age 45.8 years, 77% female, 94.1% white identified through telephone screen in a previously described population-based study of CFS in Wichita, Kansas. They completed questionnaires to assess fatigue and wellness and 2 self-administered sleep questionnaires. Scores for five of the six sleep factors (insomnia/hypersomnia, non-restorative sleep, excessive daytime somnolence, sleep apnea, and restlessness in the Centre for Sleep and Chronobiology's Sleep Assessment Questionnaire© (SAQ© were dichotomized based on threshold. The Epworth Sleepiness Scale score was used as a continuous variable. Results 81.4% of subjects had an abnormality in at least one SAQ© sleep factor. Subjects with sleep factor abnormalities had significantly lower wellness scores but statistically unchanged fatigue severity scores compared to those without SAQ© abnormality. CFS subjects had significantly increased risk of abnormal scores in the non-restorative (adjusted odds ratio [OR] = 28.1; 95% confidence interval [CI]= 7.4–107.0 and restlessness (OR = 16.0; 95% CI = 4.2–61.6 SAQ© factors compared to non-fatigued, but not for factors of sleep apnea or excessive daytime somnolence. This is consistent with studies finding that, while fatigued, CFS subjects are not sleepy. A strong correlation (0.78 of Epworth score was found only for the excessive

  9. Nitrate in drinking water and colorectal cancer - a nationwide population-based follow-up study

    DEFF Research Database (Denmark)

    Schullehner, Jörg; Hansen, Birgitte; Pedersen, Carsten Bøcker

    Importance of work and objectives Studies have suggested that nitrate in drinking water increased the risk of colorectal cancer. However, often exposure estimations and study size were insufficient to yield unequivocal results. We addressed these challenges by conducting a detailed exposure asses...... studies’ challenges of poor exposure assessment and insufficient study population sizes. It adds to the increasing body of evidence of negative chronic health effects associated with increased levels of nitrate in drinking water.......Importance of work and objectives Studies have suggested that nitrate in drinking water increased the risk of colorectal cancer. However, often exposure estimations and study size were insufficient to yield unequivocal results. We addressed these challenges by conducting a detailed exposure...... person-years. Preliminary results will be presented, indicating an increased risk for colon cancer at concentrations far below the drinking water standard (50 mg/l). Results for rectal cancer did not show the same consistent pattern. Conclusions This nationwide population-based study addresses previous...

  10. A Population-Based Study of the Fractionation of Postlumpectomy Breast Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ashworth, Allison [Division of Cancer Care and Epidemiology, Queen' s University Cancer Research Institute, Kingston, Ontario (Canada); Cancer Center of Southeastern Ontario, Kingston, Ontario (Canada); Kong, Weidong [Division of Cancer Care and Epidemiology, Queen' s University Cancer Research Institute, Kingston, Ontario (Canada); Whelan, Timothy [Juravinski Cancer Center, Hamilton, Ontario (Canada); Mackillop, William J., E-mail: william.mackillop@krcc.on.ca [Division of Cancer Care and Epidemiology, Queen' s University Cancer Research Institute, Kingston, Ontario (Canada)

    2013-05-01

    Purpose: The optimal fractionation schedule of post lumpectomy radiation therapy remains controversial. The objective of this study was to describe the fractionation of post-lumpectomy radiation therapy (RT) in Ontario, before and after the seminal Ontario Clinical Oncology Group (OCOG) trial, which showed the equivalence of 16- and 25-fraction schedules. Methods and Materials: This was a retrospective cohort study conducted by linking electronic treatment records to a population-based cancer registry. The study population included all patients who underwent lumpectomy for invasive breast cancer in Ontario, Canada, between 1984 and 2008. Results: Over the study period, 41,747 breast cancer patients received post lumpectomy radiation therapy to the breast only. Both 16- and 25-fraction schedules were commonly used throughout the study period. In the early 1980s, shorter fractionation schedules were used in >80% of cases. Between 1985 and 1995, the proportion of patients treated with shorter fractionation decreased to 48%. After completion of the OCOG trial, shorter fractionation schemes were once again widely adopted across Ontario, and are currently used in about 71% of cases; however, large intercenter variations in fractionation persisted. Conclusions: The use of shorter schedules of post lumpectomy RT in Ontario increased after completion of the OCOG trial, but the trial had a less normative effect on practice than expected.

  11. Adult Prevalence of Epilepsy in Spain: EPIBERIA, a Population-Based Study

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    Pedro J. Serrano-Castro

    2015-01-01

    Full Text Available Background. This study assesses the lifetime and active prevalence of epilepsy in Spain in people older than 18 years. Methods. EPIBERIA is a population-based epidemiological study of epilepsy prevalence using data from three representative Spanish regions (health districts in Zaragoza, Almería, and Seville between 2012 and 2013. The study consisted of two phases: screening and confirmation. Participants completed a previously validated questionnaire (EPIBERIA questionnaire over the telephone. Results. A total of 1741 valid questionnaires were obtained, including 261 (14.99% raising a suspicion of epilepsy. Of these suspected cases, 216 (82.75% agreed to participate in phase 2. Of the phase 2 participants, 22 met the International League Against Epilepsy’s diagnostic criteria for epilepsy. The estimated lifetime prevalence, adjusted by age and sex per 1,000 people, was 14.87 (95% CI: 9.8–21.9. Active prevalence was 5.79 (95% CI: 2.8–10.6. No significant age, sex, or regional differences in prevalence were detected. Conclusions. EPIBERIA provides the most accurate estimate of epilepsy prevalence in the Mediterranean region based on its original methodology and its adherence to ILAE recommendations. We highlight that the lifetime prevalence and inactive epilepsy prevalence figures observed here were compared to other epidemiological studies.

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

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    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.

  13. Bronchiectasis and increased risk of ischemic stroke: a nationwide population-based cohort study

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    Chen YF

    2017-05-01

    Full Text Available Yung-Fu Chen,1–3,* Hsuan-Hung Lin,4,* Chih-Sheng Lin,5 Battsetseg Turbat,1 Kuo-An Wang,4,6 Wei-Sheng Chung1,3,7 1Department of Healthcare Administration, 2Department of Dental Technology and Materials Science, Central Taiwan University of Science and Technology, Taichung, 3Department of Health Services Administration, China Medical University, Taichung, 4Department of Management Information Systems, Central Taiwan University of Science and Technology, Taichung, Taiwan, Republic of China; 5Department of Radiology, BenQ Medical Center, Nanjing, People’s Republic of China; 6Department of Industrial Education and Technology, National Changhua University of Education, Changhua, 7Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan, Republic of China *These authors contributed equally to this work Background: Bronchiectasis is characterized by permanent dilatation of the bronchial tree caused by recurrent airway infection and inflammation. The association of atherosclerosis and inflammation is well established. However, studies on the relationship between bronchiectasis and stroke are scant. Objective: We conducted a population-based cohort study to investigate the incidence and risk of ischemic stroke in patients with bronchiectasis. Methods: Data of 1,295 patients newly diagnosed as bronchiectasis between 2000 and 2008 were retrieved from the Taiwan National Health Insurance Research Database. A total of 6,475 controls without bronchiectasis at a ratio of 5:1 were randomly selected from the general population based on frequency-matched age and sex to the patients. All participants were followed up to the date of ischemic stroke development, censoring, or the end of 2010. The Cox proportional hazard model was used to identify the risk of ischemic stroke in patients with bronchiectasis compared with those without bronchiectasis. Results: The patients with bronchiectasis exhibited a higher incidence

  14. The clustering of smear-positive tuberculosis in Dabat, Ethiopia: a population based cross sectional study.

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    Takele Tadesse

    Full Text Available 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 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 (p<0.001 spatial and space-time clusters were identified in the study district. CONCLUSION: Tuberculosis 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.

  15. Survival benefit of statin use in ankylosing spondylitis: a general population-based cohort study.

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    Oza, Amar; Lu, Na; Schoenfeld, Sara R; Fisher, Mark C; Dubreuil, Maureen; Rai, Sharan K; Zhang, Yuqing; Choi, Hyon K

    2017-10-01

    Recent studies have shown an increase in both cardiovascular and all-cause mortality in ankylosing spondylitis (AS). We examined the potential survival benefit of statin use in AS within a general population context. We performed an incident user cohort study with time-stratified propensity score matching using a UK general population database between 1 January 2000 and 31 December 2014. To account for potential confounders, we compared propensity score-matched cohorts of statin initiators and non-initiators using 1-year cohort accrual blocks. The variables used to create the propensity score model included disease duration, body mass index, lifestyle factors, comorbidities and medication use. Using unmatched AS cohorts, statin initiators (n=1430) showed a 43% higher risk of mortality than non-initiators (n=1430) (HR=1.43; 95% CI 1.12 to 1.84). After propensity score matching, patients with AS who initiated statins (n=1108) had 96 deaths, and matched non-initiators (n=1108) had 134 deaths over a mean follow-up of 5.3 and 5.1 years, respectively. This corresponded to mortality rates of 16.5 and 23.8 per 1000 person-years (PY), respectively, resulting in an HR of 0.63 (95% CI 0.46 to 0.85) and an absolute mortality rate difference of 7.3 deaths per 1000 PY (95% CI 2.1 to 12.5). This general population-based cohort study suggests that statin initiation is associated with a substantially lower risk of mortality among patients with AS. The magnitude of the inverse association appears to be larger than that observed in randomised trials of the general population and in population-based cohort studies of patients with rheumatoid arthritis. © 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.

  16. Psoriatic Arthritis and Diabetes: A Population-Based Cross-Sectional Study

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    Dreiher, Jacob; Freud, Tamar; Cohen, Arnon D.

    2013-01-01

    Background. Diabetes has been associated with psoriasis, but little is known about the association between psoriatic arthritis and diabetes. Methods. Patients diagnosed with psoriatic arthritis by a rheumatologist were compared to age- and sex-matched patients without psoriatic arthritis regarding the prevalence of diabetes in a population-based cross-sectional study using logistic multivariate models. The study was performed utilizing the medical database of Clalit, the largest healthcare provider organization in Israel. Results. The study included 549 patients with psoriatic arthritis ≥21 years and 1,098 patients without psoriatic arthritis. The prevalence of diabetes in patients with psoriatic arthritis was increased as compared to the prevalence in patients without psoriatic arthritis (15.3% versus 10.7%, P value = 0.008). The difference was prominent among females (18.7% versus 10.3%, P < 0.001) but not among males (11.2% in patients with and without psoriatic arthritis, P = 1.000). In a multivariate analysis, psoriatic arthritis was associated with diabetes among females (OR = 1.60, 95% CI: 1.02–2.52, P = 0.040) but not among males (OR = 0.71, 95% CI: 0.42–1.22, P = 0.213). Conclusion. Our study suggests a possible association between psoriatic arthritis and diabetes in women. Women with psoriatic arthritis might be candidates for diabetes screening. PMID:23843781

  17. Emotional development in children with tics: a longitudinal population-based study.

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    Hoekstra, P J; Lundervold, A J; Lie, S A; Gillberg, C; Plessen, Kerstin J

    2013-03-01

    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 developmental trajectory of children with and without tics when they were 7-9 years old. Parents and teachers completed the strengths and difficulties questionnaire (SDQ) when the children were 7-9 years (wave 1) and 4 years later (wave 2). Using strict criteria, we identified 38 children with tics in the cohort of 4,025 children (0.94% of the total cohort) with a preponderance of boys (78.9%). 22 children (57.9%) in the group with tics had only motor tics, and 16 (42.1%) had both motor and vocal tics. Children with tics had significantly higher parent- and teacher-rated SDQ total difficulty scores and subscale scores in both waves. Children with tics experienced an increase in emotional problems and in peer problems between the first and the second wave. This study in a general population indicates that the presence of tics is associated with a range of internalizing and externalizing difficulties, as well as problems in peer relationships. Moreover, our study indicates that emotional and peer problems tend to increase over time in the group of children with tics.

  18. A population-based study on alcohol and high-risk sexual behaviors in Botswana.

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    Sheri D Weiser

    2006-10-01

    Full Text Available In Botswana, an estimated 24% of adults ages 15-49 years are infected with HIV. While alcohol use is strongly associated with HIV infection in Africa, few population-based studies have characterized the association of alcohol use with specific high-risk sexual behaviors.We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana using a stratified two-stage probability sample design. Multivariate logistic regression was used to assess correlates of heavy alcohol consumption (>14 drinks/week for women, and >21 drinks/week for men as a dependent variable. We also assessed gender-specific associations between alcohol use as a primary independent variable (categorized as none, moderate, problem and heavy drinking and several risky sex outcomes including: (a having unprotected sex with a nonmonogamous partner; (b having multiple sexual partners; and (c paying for or selling sex in exchange for money or other resources. Criteria for heavy drinking were met by 31% of men and 17% of women. Adjusted correlates of heavy alcohol use included male gender, intergenerational relationships (age gap > or =10 y, higher education, and living with a sexual partner. Among men, heavy alcohol use was associated with higher odds of all risky sex outcomes examined, including unprotected sex (AOR = 3.48; 95% confidence interval [CI], 1.65 to 7.32, multiple partners (AOR = 3.08; 95% CI, 1.95 to 4.87, and paying for sex (AOR = 3.65; 95% CI, 2.58 to 12.37. Similarly, among women, heavy alcohol consumption was associated with higher odds of unprotected sex (AOR = 3.28; 95% CI, 1.71 to 6.28, multiple partners (AOR = 3.05; 95% CI, 1.83 to 5.07, and selling sex (AOR = 8.50; 95% CI, 3.41 to 21.18. A dose-response relationship was seen between alcohol use and risky sexual behaviors, with moderate drinkers at lower risk than both problem and heavy drinkers.Alcohol use is associated with multiple risks for HIV transmission among both men

  19. Mortality in cancer patients with a history of cutaneous squamous cell carcinoma - a nationwide population-based cohort study

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    Johannesdottir Sigrun

    2012-03-01

    Full Text Available Abstract Background Cutaneous squamous cell carcinoma (SCC is associated with underlying immunosuppression, so it may be a prognostic marker in patients with subsequent cancer. We therefore conducted a nationwide population-based Danish cohort study to evaluate whether a history of cutaneuos SCC has prognostic impact in patients with one of the following index cancers: non-Hodgkin's lymphoma (NHL, or cancer of the lung, colon, rectum, breast, or prostate. Methods We used Danish medical databases, which cover the entire Danish population of 5.6 million inhabitants and linked them using the unique personal identification number assigned to all Danish residents. From 1982 through 2003, we identified 745 index cancer patients with and 79,143 without previous cutaneous SCC. Using Cox proportional hazards regression, we calculated adjusted mortality rate ratios (MRRs with 95% confidence intervals (CIs. Results Overall, previous SCC was associated with an increased mortality of cancer (MRR 1.13, 95% CI: 1.04-1.23. When examining index cancers separately, increased MRRs were found for cancer of the lung (MRR 1.23, 95% CI: 1.05-1.43, colon (MRR 1.13, 95% CI: 0.92-1.40, rectum (MRR 1.29, 95% CI: 1.00-1.67, breast (MRR 1.09, 95% CI: 0.82-1.43, and NHL (MRR 1.09, 95% CI: 0.81-1.47, but not for prostate cancer (MRR 0.99, 95% CI: 0.83-1.18. Conclusions Our results suggest that previous cutaneous SCC is associated with poor prognosis of some cancers. This finding stresses the importance of adherence to the existing recommendations of screening, diagnosis, and treatment of cancer in patients with a history of SCC.

  20. Childhood gender-typed behavior and adolescent sexual orientation: A longitudinal population-based study.

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    Li, Gu; Kung, Karson T F; Hines, Melissa

    2017-04-01

    Lesbian and gay individuals have been reported to show more interest in other-sex, and/or less interest in same-sex, toys, playmates, and activities in childhood than heterosexual counterparts. Yet, most of the relevant evidence comes from retrospective studies or from prospective studies of clinically referred, extremely gender nonconforming children. In addition, findings are mixed regarding the relation between childhood gender-typed behavior and the later sexual orientation spectrum from exclusively heterosexual to exclusively lesbian/gay. The current study drew a sample (2,428 girls and 2,169 boys) from a population-based longitudinal study, and found that the levels of gender-typed behavior at ages 3.5 and 4.75 years, although less so at age 2.5 years, significantly and consistently predicted adolescents' sexual orientation at age 15 years, both when sexual orientation was conceptualized as 2 groups or as a spectrum. In addition, within-individual change in gender-typed behavior during the preschool years significantly related to adolescent sexual orientation, especially in boys. These results suggest that the factors contributing to the link between childhood gender-typed behavior and sexual orientation emerge during early development. Some of those factors are likely to be nonsocial, because nonheterosexual individuals appear to diverge from gender norms regardless of social encouragement to conform to gender roles. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. Wealth Inequality and Mental Disability Among the Chinese Population: A Population Based Study.

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    Wang, Zhenjie; Du, Wei; Pang, Lihua; Zhang, Lei; Chen, Gong; Zheng, Xiaoying

    2015-10-19

    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 that was derived from a principal component analysis of 10 household assets and four other variables related to wealth. Logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for mental disability for each category, with the lowest quintile category as the referent. Confounding variables under consideration were age, gender, residence area, marital status, ethnicity, education, current employment status, household size, house type, homeownership and living arrangement. The distribution of various types and severities of mental disability differed significantly by wealth index category in the present population. Wealth index category had a positive association with mild mental disability (p for trend mental disability (p for trend wealth index category had a significant, inverse association with mental disability when all severities of mental disability were taken into consideration. This study's results suggest that wealth is a significant factor in the distribution of mental disability and it might have different influences on various types and severities of mental disability.

  2. Association Between Migraine and Dry Eye Disease: A Nationwide Population-Based Study.

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    Yang, Soonwon; Kim, Woojun; Kim, Hyun Seung; Na, Kyung-Sun

    2017-06-01

    Despite the possible association between migraine and dry eye disease (DED), there are only a few studies investigating this link in a relatively limited number of patients. Therefore, we have analyzed the relationship between migraine and DED in the Korean population. This population-based cross-sectional study included 14 329 adults participating in the fifth annual Korea National Health and Nutrition Examination Survey from 2010 to 2012. Migraine, DED diagnosis, and DED symptoms were assessed using questionnaires and surveys. Data were analyzed using logistic regression to determine the association of migraine with DED while controlling for demographic, lifestyle, and medical factors. Individuals with migraine were more likely to report a DED diagnosis (14.4% vs. 8.2%, p migraine and DED diagnosis was significant after adjustments (OR, 1.577; 95% CI, 1.340-1.855). The association between migraine and DED symptoms showed a similar pattern (OR, 1.304; 95%CI, 1.151-1.502). Although a causal relationship was not revealed, we found that patients who had a lifetime history of migraine were more likely to suffer from DED than individuals who did not present with headaches; this association may require confirmation. Large prospective cohort studies are required to evaluate the association between migraine and DED, as well as the influence of DED treatment on the frequency and severity of migraine attacks.

  3. Diagnosis of alpha-1 antitrypsin deficiency: a population-based study

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    Barrecheguren M

    2016-05-01

    Full Text Available Miriam Barrecheguren,1,2 Mónica Monteagudo,3 Pere Simonet,3–5 Carl Llor,6 Esther Rodriguez,1,7 Jaume Ferrer,1,2,7 Cristina Esquinas,1 Marc Miravitlles1,2,7 1Department of Pneumology, Vall d´Hebron University Hospital, 2Medicine Department, Autonomous University of Barcelona (UAB, 3IDIAP Jordi Gol, 4Departament Ciències Clíniques, Universitat de Barcelona, Barcelona, 5Primary Care Centre Viladecans-2, Viladecans, 6Primary Care Centre Via Roma, Barcelona, 7CIBER of Respiratory Diseases (CIBERES, Spain Introduction: Alpha-1 antitrypsin deficiency (AATD remains an underdiagnosed condition despite initiatives developed to increase awareness. The objective was to describe the current situation of the diagnosis of AATD in primary care (PC in Catalonia, Spain.Methods: We performed a population-based study with data from the Information System for Development in Research in Primary Care, a population database that contains information of 5.8 million inhabitants (80% of the population of Catalonia. We collected the number of alpha-1 antitrypsin (AAT determinations performed in the PC in two periods (2007–2008 and 2010–2011 and described the characteristics of the individuals tested.Results: A total of 12,409 AAT determinations were performed (5,559 in 2007–2008 and 6,850 in 2010–2011, with 10.7% of them in children. As a possible indication for AAT determination, 28.9% adults and 29.4% children had a previous diagnosis of a disease related to AATD; transaminase levels were above normal in 17.7% of children and 47.1% of adults. In total, 663 (5.3% individuals had intermediate AATD (50–100 mg/dL, 24 (0.2% individuals had a severe deficiency (<50 mg/dL, with a prevalence of 0.19 cases of severe deficiency per 100 determinations. Nine (41% of the adults with severe deficiency had a previous diagnosis of COPD/emphysema, and four (16.7% were diagnosed with COPD within 6 months.Conclusion: The number of AAT determinations in the PC is low in

  4. Health-related behavior and quality of life among the elderly: a population-based study

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    Margareth Guimarães Lima

    2011-06-01

    Full Text Available OBJECTIVE: To assess the association between health-related behaviors and quality of life among the elderly. METHODS: A population-based cross-sectional study was carried out including 1,958 elderly living in four areas in the state of São Paulo, southeastern Brazil, 2001/2002. Quality of life was assessed using the Medical Outcomes Study SF-36-Item Short Form Health Survey instrument. This instrument's eight subscales and two components were the dependent variables. Independent variables were physical activity, weekly frequency of alcohol consumption and smoking. Multiple linear regression models were used to control for the effect of gender, age, schooling, work, area of residence and number of chronic conditions. RESULTS: Physical activity was positively associated with the eight SF-36 subscales. The stronger associations were found for role-physical (β=11.9, physical functioning (β=11.3 and physical component. Elderly individuals who consumed alcohol at least once a week showed a better quality of life than those did not consume alcohol. Compared to non-smokers, smokers had a poorer quality of life for the mental component (β=-2.4. CONCLUSIONS: The study results showed that physical activity, moderate alcohol consumption and no smoking are positively associated with a better quality of life in the elderly.

  5. Incidence, prevalence, and survival of moyamoya disease in Korea: a nationwide, population-based study.

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    Ahn, Il Min; Park, Dong-Hyuk; Hann, Hoo Jae; Kim, Kyoung Hoon; Kim, Hyun Jung; Ahn, Hyeong Sik

    2014-04-01

    There is a scarcity of information on the epidemiology and natural course of moyamoya disease. The aim of this study was to investigate the nationwide epidemiological features of moyamoya disease in Korea, including incidence, prevalence, and survival. We used the data from nationwide, population-based Health Insurance Review and Assessment Service claims database and Rare Intractable Disease registration program, which includes physician-certified diagnoses based on uniform criteria for moyamoya disease from 2007 to 2011. Age-specific incidence and prevalence were calculated, and survival was examined using Kaplan-Meier method. The total number of patients with moyamoya disease was 8154 in 2011, with a female-to-male ratio of 1.8. The incidence from 2007 to 2011 was 1.7 to 2.3/10(5), and the prevalence in 2011 was 16.1/10(5). In total, 66.3% of patients aged 0 to 14 years underwent surgery, whereas only 21.5% in the older than 15 years age group underwent surgery. The 1- and 5-year survival rates of adult patients were 96.9% and 92.9%, respectively, and of child patients were 99.6% and 99.3%, respectively. The prevalence and incidence presented in this study are higher than those in previous studies. This study demonstrates that the burden of moyamoya disease in Korea is substantial.

  6. Falls among the elderly: risk factors in a population-based study

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    Iara Guimarães Rodrigues

    2014-09-01

    Full Text Available Purpose: The aim of the present study was to identify factors associated with the occurrence of falls among elderly adults in a population-based study (ISACamp 2008. Methods: A population-based cross-sectional study was carried out with two-stage cluster sampling. The sample was composed of 1,520 elderly adults living in the urban area of the city of Campinas, São Paulo, Brazil. The occurrence of falls was analyzed based on reports of the main accident occurred in the previous 12 months. Data on socioeconomic/demographic factors and adverse health conditions were tested for possible associations with the outcome. Prevalence ratios (PR were estimated and adjusted for gender and age using the Poisson multiple regression analysis. Results: Falls were more frequent, after adjustment for gender and age, among female elderly participants (PR = 2.39; 95% confidence interval (95%CI 1.47 - 3.87, elderly adults (80 years old and older (PR = 2.50; 95%CI 1.61 - 3.88, widowed (PR = 1.74; 95%CI 1.04 - 2.89 and among elderly adults who had rheumatism/arthritis/arthrosis (PR = 1.58; 95%CI 1.00 - 2.48, osteoporosis (PR = 1.71; 95%CI 1.18 - 2.49, asthma/bronchitis/emphysema (PR = 1,73; 95%CI 1.09 - 2.74, headache (PR = 1.59; 95%CI 1.07 - 2.38, mental common disorder (PR = 1.72; 95%CI 1.12 - 2.64, dizziness (PR = 2.82; 95%CI 1.98 - 4.02, insomnia (PR = 1.75; 95%CI 1.16 - 2.65, use of multiple medications (five or more (PR = 2.50; 95%CI 1.12 - 5.56 and use of cane/walker (PR = 2.16; 95%CI 1.19 - 3,93. Conclusion: The present study shows segments of the elderly population who are more prone to falls through the identification of factors associated with this outcome. The findings can contribute to the planning of public health policies and programs addressed to the prevention of falls.

  7. A Bayesian Approach to Identifying New Risk Factors for Dementia: A Nationwide Population-Based Study.

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    Wen, Yen-Hsia; Wu, Shihn-Sheng; Lin, Chun-Hung Richard; Tsai, Jui-Hsiu; Yang, Pinchen; Chang, Yang-Pei; Tseng, Kuan-Hua

    2016-05-01

    Dementia is one of the most disabling and burdensome health conditions worldwide. In this study, we identified new potential risk factors for dementia from nationwide longitudinal population-based data by using Bayesian statistics.We first tested the consistency of the results obtained using Bayesian statistics with those obtained using classical frequentist probability for 4 recognized risk factors for dementia, namely severe head injury, depression, diabetes mellitus, and vascular diseases. Then, we used Bayesian statistics to verify 2 new potential risk factors for dementia, namely hearing loss and senile cataract, determined from the Taiwan's National Health Insurance Research Database.We included a total of 6546 (6.0%) patients diagnosed with dementia. We observed older age, female sex, and lower income as independent risk factors for dementia. Moreover, we verified the 4 recognized risk factors for dementia in the older Taiwanese population; their odds ratios (ORs) ranged from 3.469 to 1.207. Furthermore, we observed that hearing loss (OR = 1.577) and senile cataract (OR = 1.549) were associated with an increased risk of dementia.We found that the results obtained using Bayesian statistics for assessing risk factors for dementia, such as head injury, depression, DM, and vascular diseases, were consistent with those obtained using classical frequentist probability. Moreover, hearing loss and senile cataract were found to be potential risk factors for dementia in the older Taiwanese population. Bayesian statistics could help clinicians explore other potential risk factors for dementia and for developing appropriate treatment strategies for these patients.

  8. Kawasaki disease and subsequent risk of allergic diseases: a population-based matched cohort study.

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    Kuo, Ho-Chang; Chang, Wei-Chiao; Yang, Kuender D; Yu, Hong-Ren; Wang, Chih-Lu; Ho, Shu-Chen; Yang, Chun-Yuh

    2013-03-23

    The risk of allergic diseases among Kawasaki disease (KD) patients relative to the general population is not known. The aim of this study was to perform a population-based cohort study to investigate the risk of allergic diseases among children after KD in Taiwan- a country with the third highest incidence of KD in the world. Data were obtained from the Taiwan National Health Insurance Research Database. In total, 253 patients who were 5 years of age or younger and had a first-time hospitalization with a diagnosis of KD between 1997 and 2005 were included as the study cohort and 1,012 non-KD patients matched for age and sex were included as comparison cohort. Multivariate Cox proportional hazard regression model was used to adjust for confounding and to compare the 6-year allergic-free survival rate between these two cohorts. The incidence rate of allergic diseases (184.66 per 1000 person-year) was significantly higher in the KD cohort than in the control cohort (124.99 per 1000 person-years). After adjusting for potential confounders, the adjusted hazard ratios of asthma and allergic rhinitis were 1.51 (95% confidence interval = 1.17-1.95) and 1.30 (95% confidence interval = 1.04-1.62), respectively. We conclude that KD patients were at an increased risk for allergic diseases compared with the comparison cohort.

  9. Profiles of sedentary and non-sedentary young men ? a population-based MOPO study

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    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...

  10. Perceived weight discrimination in England: a population-based study of adults aged ⩾50 years.

    Science.gov (United States)

    Jackson, S E; Steptoe, A; Beeken, R J; Croker, H; Wardle, J

    2015-05-01

    Despite a wealth of experimental studies on weight bias, little is known about weight discrimination at the population level. This study examined the prevalence and socio-demographic correlates of perceived weight discrimination in a large population-based sample of older adults. Data were from 5307 adults in the English Longitudinal Study of Ageing; a population-based cohort of men and women aged ⩾50 years. Weight discrimination was reported for five domains (less respect/courtesy; treated as less clever; poorer treatment in medical settings; poorer service in restaurants/stores; threatened/harassed) at wave 5 (2010-2011). Height and weight were measured at wave 4 (2008-2009). We used logistic regression to test the odds of weight discrimination in relation to weight status, age, sex, wealth, education and marital status. Perceived weight discrimination in any domain was reported by 4.6% of participants, ranging from 0.8% in the normal-weight participants through 0.9, 6.7, 24.2 and 35.1% in individuals who were overweight or met criteria for class I, II and III obesity. Overall, and in each situation, odds of perceived weight discrimination were higher in younger and less wealthy individuals. There was no interaction between weight status and any socio-demographic variable. Relative to normal-weight participants, odds ratios for any perceived weight discrimination were 1.13 (95% confidence interval 0.53-2.40) in those who were overweight, 8.86 (4.65-16.88) in those with class I obesity, 35.06 (18.30-67.16) in class II obese and 56.43 (27.72-114.87) in class III obese. Our results indicate that rates of perceived weight discrimination are comparatively low in individuals who are overweight or have class I obesity, but for those with class II/III obesity, >10% had experienced discrimination in each domain, and >20% had been treated with less respect or courtesy. These findings have implications for public policy and highlight the need for effective interventions

  11. Excessive daytime sleepiness and body composition: a population-based study of adults.

    Directory of Open Access Journals (Sweden)

    Amie C Hayley

    Full Text Available BACKGROUND: Excessive daytime sleepiness (EDS is often associated with increased adiposity, particularly when assessed in the context of samples of sleep-disordered patients; however, it is unclear if this relationship is sustained among non-clinical, population-based cohorts. This study aimed to investigate the relationship between EDS and a number of body composition markers among a population-based sample of men and women. METHODS: This study assessed 1066 women aged 21-94 yr (median = 51 yr, IQR 35-66, and 911 men aged 24-92 yr (median = 60 yr, IQR 46-73 who participated in the Geelong Osteoporosis Study (GOS between the years 2001 and 2008. Total body fat mass was determined from whole body dual-energy X-ray absorptiometry scans, and anthropometric parameters (weight, height, and waist circumference were measured. Lifestyle and health information was collected via self-report. Sleepiness was assessed using the Epworth Sleepiness Scale (ESS. Scores of ≥ 10 were considered indicative of EDS. RESULTS: Women: After adjusting for age, alcohol intake, antidepressant medication use and physical activity, EDS was associated with greater waist circumference and body mass index (BMI. EDS was also associated with 1.5-1.6-fold increased odds of being overweight or obese. Men: After adjusting for age, alcohol use, physical activity and smoking status, EDS was associated with greater BMI. These findings were not explained by the use of sedative or antidepressant medication. EDS was also associated with 1.5-fold increased likelihood of being obese, independent of these factors. No differences in lean mass, %body fat, or %lean mass were detected between those with and without EDS for men or women. CONCLUSIONS: These data suggest that EDS is associated with several anthropometric adiposity profiles, independent of associated lifestyle and health factors. Among women, symptoms of EDS are pervasive at both overweight and obese BMI classifications

  12. Association between blood lead and blood pressure: a population-based study in Brazilian adults.

    Science.gov (United States)

    Almeida Lopes, Ana Carolina Bertin de; Silbergeld, Ellen Kovner; Navas-Acien, Ana; Zamoiski, Rachel; Martins, Airton da Cunha; Camargo, Alissana Ester Iakmiu; Urbano, Mariana Ragassi; Mesas, Arthur Eumann; Paoliello, Monica Maria Bastos

    2017-03-14

    Environmental lead exposure among adults may increase blood pressure and elevate the risk of hypertension. The availability of data on blood lead levels (BLL) in adult Brazilian population is scarce and population-based studies are important for screening the population exposure and also to evaluate associations with adverse health effects. The goal of this study was to examine the association of BLL with blood pressure and hypertension in a population-based study in a city in Southern Brazil. A total of 948 adults, aged 40 years or older, were randomly selected. Information on socioeconomic, dietary, lifestyle and occupational background was obtained by orally administered household interviews. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured according to the guidelines VI Brazilian Guidelines on Hypertension. BLL were measured by inductively coupled plasma mass spectrometry technique. Multiple linear and logistic regression models were performed to evaluate associations of BLL with SBP and DBP, and with the chance of hypertension and of elevated SBP and DBP. The geometric mean of BLL was 1.97 μg/dL (95%CI:1.90-2.04 μg/dL). After multivariable adjustment, participants in the quartile 4 of blood lead presented 0.06 mm/Hg (95%CI, 0.04-0.09) average difference in DBP comparing with those in quartile 1. Participants in the 90th percentile of blood lead distribution had 0.07 mmHg (95% CI, 0.03 to 0.11) higher DBP compared with those participants in the 10th percentile of blood lead. The adjusted OR for hypertension was 2.54 (95% CI, 1.17-5.53), comparing the highest to the lowest blood lead quartiles. Compared with participants in the 10th percentile of blood lead, participants in the 90th percentile presented higher OR for hypertension (OR: 2.77; 95% CI, 1.41 to 5.46). At low concentrations, BLL were positively associated with DBP and with the odds for hypertension in adults aged 40 or older. It is important to enforce lead

  13. 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

  14. Secondary breast cancer: a 5-year population-based study with review of the literature.

    Science.gov (United States)

    Klingen, Tor Audun; Klaasen, Herman; Aas, Hans; Chen, Ying; Akslen, Lars A

    2009-10-01

    Secondary tumours in the breast are rare. Based on literature, an incidence of 0.4-2% is reported. In this population-based study, secondary breast tumours from a 5-year period (2001-2005), not including metastasis from contralateral breast carcinoma, were reviewed (Vestfold County, Norway). A total of 722 patients with breast malignancies were found in this population (89.3% from Vestfold County Hospital). Ten of these, approximately 1.4%, were metastatic tumours, representing four cutaneous melanomas, three pulmonary carcinomas and three malignant lymphomas. The tumours were often solitary, palpable and close to the skin. Radiologically, the lesions mostly resembled primary carcinomas by mammography and ultrasound, which differs from other studies. Comparison with a known primary tumour and use of immunohistochemical profiling is of crucial importance. Melanoma markers (Melan-A, HMB-45, S-100 protein), lung cancer markers (Cytokeratins, TTF1, Chromogranin, Synapthophysin) and lymphoid markers (CD3, CD20) usually help to confirm a secondary breast tumour diagnosis. This approach is especially indicated in diffusely growing tumours with lack of glandular structure and high-grade cytological features, and staining for ER and GCDFP15 may be helpful. Thus, the diagnosis of a breast metastasis may be suspected by careful mammography and ultrasound imaging, although some cases have atypical radiological features, and histological examination might be necessary to ensure a correct diagnosis and appropriate treatment.

  15. Persistence with dimethyl fumarate in relapsing-remitting multiple sclerosis: a population-based cohort study.

    Science.gov (United States)

    Eriksson, Irene; Cars, Thomas; Piehl, Fredrik; Malmström, Rickard E; Wettermark, Björn; von Euler, Mia

    2018-02-01

    To describe patients initiating dimethyl fumarate (DMF) and measure persistence with DMF, discontinuation, and switching in treatment-naïve DMF patients and patients switching to DMF from other multiple sclerosis disease-modifying treatments (DMTs). A population-based cohort study of all Stockholm County residents initiating DMF from 9 May 2014 until 31 May 2017. All data were derived from a regional database that collects individual-level data on healthcare and drug utilization of all residents. The study outcomes were persistence with DMF and DMF discontinuation and switching to other DMTs. Persistence was measured as the number of days until either DMF discontinuation (treatment gap ≥ 60 days) or switching to another DMT. The study included 400 patients (median follow-up = 2.5 years). The majority had previously been treated with other DMTs (61%). Throughout the follow-up period, 124 patients (31%) discontinued DMF and 114 patients (29%) switched treatment. Overall, 34% of patients initiating DMF stopped treatment within 1 year and only 43% of patients remained on DMF at 2 years from treatment initiation. DMF had a rapid market uptake likely due to high expectations held by both patients and clinicians. However, persistence with DMF in routine clinical practice was found to be low.

  16. Psychosocial risk factors associated with cyberbullying among adolescents: a population-based study.

    Science.gov (United States)

    Sourander, Andre; Brunstein Klomek, Anat; Ikonen, Maria; Lindroos, Jarna; Luntamo, Terhi; Koskelainen, Merja; Ristkari, Terja; Helenius, Hans

    2010-07-01

    To our knowledge, no population study examining psychosocial and psychiatric risk factors associated with cyberbullying among adolescents exists. To study cross-sectional associations between cyberbullying and psychiatric and psychosomatic problems among adolescents. Population-based cross-sectional study. Finland. The sample consists of 2215 Finnish adolescents aged 13 to 16 years with complete information about cyberbullying and cybervictimization. Self-reports of cyberbullying and cybervictimization during the past 6 months. In the total sample, 4.8% were cybervictims only, 7.4% were cyberbullies only, and 5.4% were cyberbully-victims. Cybervictim-only status was associated with living in a family with other than 2 biological parents, perceived difficulties, emotional and peer problems, headache, recurrent abdominal pain, sleeping difficulties, and not feeling safe at school. Cyberbully-only status was associated with perceived difficulties, hyperactivity, conduct problems, low prosocial behavior, frequent smoking and drunkenness, headache, and not feeling safe at school. Cyberbully-victim status was associated with all of these risk factors. Among cybervictims, being cyberbullied by a same-sex or opposite-sex adult, by an unknown person, and by a group of people were associated with fear for safety, indicating possible trauma. Both cyberbullying and cybervictimization are associated with psychiatric and psychosomatic problems. The most troubled are those who are both cyberbullies and cybervictims. This indicates the need for new strategies for cyberbullying prevention and intervention.

  17. Air Pollution and the Risk of Cardiac Defects: A Population-Based Case-Control Study.

    Science.gov (United States)

    Hwang, Bing-Fang; Lee, Yungling Leo; Jaakkola, Jouni J K

    2015-11-01

    Previous epidemiologic studies have assessed the role of the exposure to ambient air pollution in the development of cardiac birth defects, but they have provided somewhat inconsistent results. To assess the associations between exposure to ambient air pollutants and the risk of cardiac defects, a population-based case-control study was conducted using 1087 cases of cardiac defects and a random sample of 10,870 controls from 1,533,748 Taiwanese newborns in 2001 to 2007.Logistic regression was performed to calculate odds ratios for 10 ppb increases in O3 and 10 μg/m increases in PM10. In addition, we compared the risk of cardiac defects in 4 categories-high exposure (>75th percentile); medium exposure (75th to 50th percentile); low exposure (percentile); reference (percentile) based on the distribution of each pollutant. The risks of ventricular septal defects (VSD), atrial septal defects (ASD), and patent ductus arteriosus (PDA) were associated with 10 ppb increases in O3 exposure during the first 3 gestational months among term and preterm babies. In comparison between high PM10 exposure and reference category, there were statistically significant elevations in the effect estimates of ASD for all and terms births. In addition, there was a negative or weak association between SO2, NO2, CO, and cardiac defects.The study proved that exposure to outdoor air O3 and PM10 during the first trimester of gestation may increase the risk of VSD, ASD, and PDA.

  18. Splenectomy and increased subsequent cancer risk: a nationwide population-based cohort study.

    Science.gov (United States)

    Sun, Li-Min; Chen, Hsuan-Ju; Jeng, Long-Bin; Li, Tsai-Chung; Wu, Shih-Chi; Kao, Chia-Hung

    2015-08-01

    Splenectomy has been suggested to have an impact on immunological function, and subsequent development of cancer has been recognized as a possible adverse effect of splenectomy. This study evaluated the possible association between splenectomy and malignancy in Taiwan. A cohort study consisted of including 2,603 patients with nontraumatic and 2,295 patients with traumatic splenectomy, and then randomly frequency matched with 4 participants without splenectomy. The Cox proportional hazard regression analysis was conducted to estimate the influence of splenectomy on cancer risk. Both nontraumatic and traumatic splenectomy had a significantly higher risk for overall cancer development (adjusted hazard ratios are 2.64 and 1.29 for nontraumatic and traumatic reasons, respectively). After adjusting for age, sex, and comorbidities, patients with splenectomy were associated with significantly higher risks for developing certain gastrointestinal tract cancers, other head and neck cancers, and hematological malignancies, and the phenomenon is more prominent in nontraumatic splenectomy group. This nationwide population-based study found that people with splenectomy have higher risks of developing overall cancer, as well as certain site-specific cancers, especially for patients with nontraumatic reasons. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. 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...

  20. Treatment profile and complications associated with cryotherapy for localized prostate cancer: A population-based study

    Science.gov (United States)

    Roberts, Calpurnyia B.; Jang, Thomas L.; Shao, Yu-Hsuan; Kabadi, Shaum; Moore, Dirk F.; Lu-Yao, Grace L.

    2011-01-01

    The aim of this study was to assess the treatment patterns and 3 to 12-month complication rates associated with receiving prostate cryotherapy in a population-based study. Men > 65 years diagnosed with incident localized prostate cancer in Surveillance Epidemiology End Results (SEER) - Medicare linked database from 2004 to 2005 were identified. A total of 21,344 men were included in the study, of which 380 were treated initially with cryotherapy. Recipients of cryotherapy versus aggressive forms of prostate therapy (i.e. radical prostatectomy or radiation therapy) were more likely to be older, have one co-morbidity, low income, live in the South, and be diagnosed with indolent cancer. Complication rates increased from 3 to 12 months following cryotherapy. By the twelfth month, the rates for urinary incontinence, lower urinary tract obstruction, erectile dysfunction, and bowel bleeding reached 9.8%, 28.7%, 20.1%, and 3.3%, respectively. Diagnoses of hydronephrosis, urinary fistula, or bowel fistula were not evident. The rates of corrective invasive procedures for lower urinary tract obstruction and erectile dysfunction were both <2.9% by the twelfth month. Overall, complications post cryotherapy were modest; however, diagnoses for lower urinary tract obstruction and erectile dysfunction were common. PMID:21519347

  1. Menopausal hormone therapy and pancreatic cancer risk in women: a population-based matched cohort study.

    Science.gov (United States)

    Sadr-Azodi, Omid; Konings, Peter; Brusselaers, Nele

    2017-12-01

    The role of menopausal hormone therapy (MHT) in the development of pancreatic cancer is inconclusive owing to small studies and lack of proper study design. This population-based matched cohort study included all Swedish women who used systemic MHT between 1 July 2005 and 31 December 2012. For each user of MHT, three never-users of MHT were randomly selected, matched for childbirth, history of thromboembolic events, and previous hysterectomy, as well as for year of birth, diabetes, obesity, and smoking- or alcohol-related disorders. Multivariable conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between MHT use and pancreatic cancer. The effect of MHT duration on pancreatic cancer development was calculated using multivariable Poisson regression. There were 290,186 ever-users of MHT and 870,165 matched never-users. During the follow-up, 311 (0.0011%) ever-users of MHT and 1220 (0.0014) never-users developed pancreatic cancer. In a multivariable adjusted model, ever-users had a 23% reduced risk (OR 0.77; 95% CI: 0.68-0.87) of pancreatic cancer. This risk decreased by 35% (incidence rate ratio (IRR) 0.65; 95% CI: 0.33-1.27) in women who used MHT 1-2 years and by 60% (IRR 0.40; 95% CI: 0.18-0.88) in women who used MHT ≥ 3 years compared to women with pancreatic cancer.

  2. Cognition in school-aged children with "active" 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

    2015-01-01

    There is a lack of population-based data on specific cognitive profiles in childhood epilepsy. This study sought to determine the frequency of impairments in global cognition and aspects of working memory and processing speed in a population-based sample of children with "active" epilepsy (on antiepileptic Drugs (AEDs), and/or had a seizure in the last year). Factors significantly associated with global and specific difficulties in cognition were also identified. A total of 85 (74% of eligible population) school-aged children (5-15 years) with "active" epilepsy underwent comprehensive psychological assessment including assessment of global cognition, working memory, and processing speed. Scores on cognitive subtests were compared via paired-samples t tests. The factors associated with cognitive difficulties were analyzed via linear regression. A total of 24% of children were functioning below IQ 50, and 40% had IQ scores below 70. Scores on the Processing Speed Index were significantly lower than scores on the Verbal or Performance indexes on Wechsler instruments. The Coding subtest was a significant weakness compared with the other Wechsler subtests. A total of 58% of children displayed "memory underachievement" (memory score 1 SD below assessed IQ) on at least one of the four administered working memory subtests. Factors significantly associated with globally impaired cognition included being on polytherapy (β = -13.0; 95% CI [-19.3, -6.6], p = .000) and having attention-deficit/hyperactivity disorder (ADHD; β = -11.1, 95% CI [-3.0, -19.3], p = .008). Being on polytherapy was also associated with lower scores on the working memory and processing speed composite scores. Having developmental coordination disorder (DCD) was associated with a lower score on the processing speed composite. There is a high rate of global and specific cognitive difficulties in childhood epilepsy. Difficulties are most pronounced in aspects of working memory and processing speed

  3. Serum Fatty Acids and Risk of Cutaneous Melanoma: A Population-Based Case-Control Study

    Directory of Open Access Journals (Sweden)

    Marco Vinceti

    2013-01-01

    Full Text Available Background. Some observational studies have suggested that excess dietary intake of polyunsaturated fatty acids such as linoleic acid increases cutaneous melanoma risk. We aimed at examining the association between serum fatty acids and melanoma risk by conducting a population-based case-control study in a northern Italy community. Methods. The percentage composition of 12 fatty acids was determined in 51 newly diagnosed melanoma patients and 51 age- and sex-matched population controls by extracting total lipids from serum samples using thin layer and gas chromatography. Conditional logistic regression was used to estimate the relative risk of melanoma associated with tertiles of percentage composition of each fatty acid as well as groupings including saturated, monounsaturated, and polyunsaturated fatty acids. Results. We found a slightly increased melanoma risk for stearic and arachidic acids proportion, with and without adjustment for potential confounders. For an n-3 polyunsaturated fatty acid, docosapentaenoic acid, we found a male-specific direct association with melanoma risk. No other associations emerged for the other saturated, monounsaturated, and polyunsaturated fatty acids, individually or grouped by type. Conclusions. These findings do not suggest a major role of fatty acids, including linoleic acid, on risk of cutaneous melanoma, though their evaluation is limited by the small sample size.

  4. Hyperlipidemia Is Associated with Chronic Urticaria: A Population-Based Study

    Science.gov (United States)

    Wang, Kuo-Hsien; Chen, Chao-Hung

    2016-01-01

    The etiology of chronic urticaria (CU) is diverse, with chronic infections and inflammation being reported as considerable contributing factors. Although the prevalence of metabolic syndrome was found to be significantly elevated in patients with CU, no one has specifically estimated the effects on CU following hyperlipidemia. This study aimed to examine the association between hyperlipidemia and CU using a population-based dataset in Taiwan. This study included 9798 adults with CU as cases and 9798 sex- and age-matched controls. These patients were examined for whether they had received a prior diagnosis of hyperlipidemia. We used conditional logistic regression analyses to calculate the odds ratio (OR) and its corresponding 95% confidence interval (CI) for having been previously diagnosed with hyperlipidemia between cases and controls. In total, 7066 (36.1%) patients had received a prior diagnosis of hyperlipidemia, including 4287 (43.8%) among CU cases and 2779 (28.4%) among controls. The conditional logistic regression revealed that the OR of prior hyperlipidemia for cases was 1.97 (95% CI: 1.85~2.09) compared to the controls. Furthermore, compared to patients without CU, patients with CU independently experienced a 1.65-fold (95% CI = 1.55~1.76; phyperlipidemia diagnosis, after adjustments were made. We concluded that CU was associated with having received a prior diagnosis of hyperlipidemia. PMID:26964045

  5. Stalking experiences and associated factors--a controlled population-based study from Norway.

    Science.gov (United States)

    Narud, Kjersti; Friestad, Christine; Dahl, Alv A

    2014-07-01

    Stalking is a considerable health problem. In order to develop interventions for victims, more knowledge is needed concerning prevalence, stress and coping related to stalking as well as associated symptomatology in the victims. This is the first population-based study of stalking in Norway. To examine the prevalence of stalking in relation to gender and time, and the association with indicators of socio-demographic status and mental health. A cross-sectional case-control questionnaire design. The sample, 5000 Norwegians aged 20-59 years, was nationally representative according to gender, 10-year age groups and county of living. A total of 248 (5%) of the mailed envelops were returned due to wrong address, leaving 4752 individuals as possible respondents. Among them 1520 (32%) returned the questionnaire, but 98 of them had to be discarded due to lack of completion, giving a sample of 1422 valid questionnaires (30%). The total weighted lifetime prevalence of stalking was 8.1% (95% CI 6.6-9.4%), for females 11.8% (95% CI 10.2-13.5%) and for males 4.3% (95% CI 3.2-5.3%) [corrected]. The point prevalence of current stalking was 2.8% (95% CI 2.0-3.7%). The stalked individuals had a significantly poorer social situation and mental health than the controls. Few significant group differences were observed between males and females exposed to stalking. The prevalence of stalking was within the range observed by questionnaire studies in other cultures.

  6. Prevalence of toothache and associated factors: a population-based study in southeast iran.

    Science.gov (United States)

    Kakoei, Shahla; Parirokh, Masoud; Nakhaee, Nouzar; Jamshidshirazi, Forogh; Rad, Maryam; Kakooei, Sina

    2013-01-01

    This study was carried out to estimate toothache prevalence among adult residents in Kerman. This cross-sectional, population-based study was conducted among individuals aged over 18 years (n=1800). The relevant data on the prevalence of toothache and associated factors were collected by interviewing the individuals in their homes and filling out a questionnaire designed by the examiners. Prevalence of toothache and associated factors that patients recalled previous to their interview were analyzed by chi-square test and multivariate logistic regression analysis. Nine hundred ninety-one individuals (55.1%) reported toothache during the 6 months before the interview. The participants who flossed daily, had regular dental visits, and had higher education showed a significantly lower prevalence of toothache (Pdental floss (OR=1.5), or having a mental or psychological illness (OR=1.5) were more likely to have a history of toothache. High prevalence of toothache (more than half) among residents of Kerman shows a serious and major public health problem. Toothache prevalence in middle aged adults, lower education, bigger family size, lower dental hygiene habit and/or those having mental or psychological illness were more common in the city of Kerman.

  7. Racial and Ethnic Disparities in Oncotype DX Test Receipt in a Statewide Population-Based Study.

    Science.gov (United States)

    Davis, Brigette A; Aminawung, Jenerius A; Abu-Khalaf, Maysa M; Evans, Suzanne B; Su, Kevin; Mehta, Rajni; Wang, Shi-Yi; Gross, Cary P

    2017-03-01

    Background: Racial disparities have been reported in breast cancer care, yet little is known about disparities in access to gene expression profiling (GEP) tests. Given the impact of GEP test results, such as those of Oncotype DX (ODx), on treatment decision-making for hormone receptor-positive (HR+) breast cancer, it is particularly important to assess disparities in its use. Methods: We conducted a retrospective population-based study of 8,784 patients diagnosed with breast cancer in Connecticut during 2011 through 2013. We assessed the association between race, ethnicity, and ODx receipt among women with HR+ breast cancer for whom NCCN does and does not recommend ODx testing, using bivariate and multivariate logistic analyses. Results: We identified 5,294 women who met study inclusion criteria: 83.8% were white, 6.3% black, and 7.4% Hispanic. Overall, 50.9% (n=4,131) of women in the guideline-recommended group received ODx testing compared with 18.5% (n=1,163) in the nonrecommended group. More white women received the ODx test compared with black and Hispanic women in the recommended and nonrecommended groups (51.4% vs 44.6% and 47.7%; and 21.2% vs 9.0% and 9.7%, respectively). After adjusting for tumor and clinical characteristics, we observed significantly lower ODx use among black (odds ratio [OR], 0.64; 95% CI, 0.47-0.88) and Hispanic women (OR, 0.59; 95% CI, 0.45-0.77) compared with white women in the recommended group and in the guideline-discordant group (blacks: OR, 0.39; 95% CI, 0.20-0.78, and Hispanics: OR, 0.44; 95% CI, 0.23-0.85). Conclusions: In this population-based study, we identified racial disparities in ODx testing. Disparities in access to innovative cancer care technologies may further exacerbate existing disparities in breast cancer outcomes. Copyright © 2017 by the National Comprehensive Cancer Network.

  8. Cigarette smoking, nicotine dependence and anxiety disorders: a systematic review of population-based, epidemiological studies

    Directory of Open Access Journals (Sweden)

    Moylan Steven

    2012-10-01

    Full Text Available Abstract Background Multiple studies have demonstrated that rates of smoking and nicotine dependence are increased in individuals with anxiety disorders. However, significant variability exists in the epidemiological literature exploring this relationship, including study design (cross-sectional versus prospective, the population assessed (random sample versus clinical population and diagnostic instrument utilized. Methods We undertook a systematic review of population-based observational studies that utilized recognized structured clinical diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders (DSM or International Classification of Diseases (ICD for anxiety disorder diagnosis to investigate the relationship between cigarette smoking, nicotine dependence and anxiety disorders. Results In total, 47 studies met the predefined inclusion criteria, with 12 studies providing prospective information and 5 studies providing quasiprospective information. The available evidence suggests that some baseline anxiety disorders are a risk factor for initiation of smoking and nicotine dependence, although the evidence is heterogeneous and many studies did not control for the effect of comorbid substance use disorders. The identified evidence however appeared to more consistently support cigarette smoking and nicotine dependence as being a risk factor for development of some anxiety disorders (for example, panic disorder, generalized anxiety disorder, although these findings were not replicated in all studies. A number of inconsistencies in the literature were identified. Conclusions Although many studies have demonstrated increased rates of smoking and nicotine dependence in individuals with anxiety disorders, there is a limited and heterogeneous literature that has prospectively examined this relationship in population studies using validated diagnostic criteria. The most consistent evidence supports smoking and nicotine dependence as

  9. Cigarette smoking, nicotine dependence and anxiety disorders: a systematic review of population-based, epidemiological studies

    Science.gov (United States)

    2012-01-01

    Background Multiple studies have demonstrated that rates of smoking and nicotine dependence are increased in individuals with anxiety disorders. However, significant variability exists in the epidemiological literature exploring this relationship, including study design (cross-sectional versus prospective), the population assessed (random sample versus clinical population) and diagnostic instrument utilized. Methods We undertook a systematic review of population-based observational studies that utilized recognized structured clinical diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD)) for anxiety disorder diagnosis to investigate the relationship between cigarette smoking, nicotine dependence and anxiety disorders. Results In total, 47 studies met the predefined inclusion criteria, with 12 studies providing prospective information and 5 studies providing quasiprospective information. The available evidence suggests that some baseline anxiety disorders are a risk factor for initiation of smoking and nicotine dependence, although the evidence is heterogeneous and many studies did not control for the effect of comorbid substance use disorders. The identified evidence however appeared to more consistently support cigarette smoking and nicotine dependence as being a risk factor for development of some anxiety disorders (for example, panic disorder, generalized anxiety disorder), although these findings were not replicated in all studies. A number of inconsistencies in the literature were identified. Conclusions Although many studies have demonstrated increased rates of smoking and nicotine dependence in individuals with anxiety disorders, there is a limited and heterogeneous literature that has prospectively examined this relationship in population studies using validated diagnostic criteria. The most consistent evidence supports smoking and nicotine dependence as increasing the risk of

  10. 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.

  11. Firearm and Nonfirearm Homicide in 5 South African Cities: A Retrospective Population-Based Study

    Science.gov (United States)

    Thompson, Mary Lou; Myers, Jonathan E.

    2014-01-01

    Objective. We assessed the effectiveness of South Africa’s Firearm Control Act (FCA), passed in 2000, on firearm homicide rates compared with rates of nonfirearm homicide across 5 South African cities from 2001 to 2005. Methods. We conducted a retrospective population-based study of 37 067 firearm and nonfirearm homicide cases. Generalized linear models helped estimate and compare time trends of firearm and nonfirearm homicides, adjusting for age, sex, race, day of week, city, year of death, and population size. Results. There was a statistically significant decreasing trend regarding firearm homicides from 2001, with an adjusted year-on-year homicide rate ratio of 0.864 (95% confidence interval [CI] = 0.848, 0.880), representing a decrease of 13.6% per annum. The year-on-year decrease in nonfirearm homicide rates was also significant, but considerably lower at 0.976 (95% CI = 0.954, 0.997). Results suggest that 4585 (95% CI = 4427, 4723) lives were saved across 5 cities from 2001 to 2005 because of the FCA. Conclusions. Strength, timing and consistent decline suggest stricter gun control mediated by the FCA accounted for a significant decrease in homicide overall, and firearm homicide in particular, during the study period. PMID:24432917

  12. 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.

  13. Caesarean Delivery and Postpartum Maternal Mortality: A Population-Based Case Control Study in Brazil.

    Science.gov (United States)

    Esteves-Pereira, Ana Paula; Deneux-Tharaux, Catherine; Nakamura-Pereira, Marcos; Saucedo, Monica; Bouvier-Colle, Marie-Hélène; Leal, Maria do Carmo

    2016-01-01

    Cesarean delivery rates continue to increase worldwide and reached 57% in Brazil in 2014. Although the safety of this surgery has improved in the last decades, this trend is a concern because it carries potential risks to women's health and may be a modifiable risk factor of maternal mortality. This paper aims to investigate the risk of postpartum maternal death directly associated with cesarean delivery in comparison to vaginal delivery in Brazil. This was a population-based case-control study performed in eight Brazilian states. To control for indication bias, deaths due to antenatal morbidity were excluded. We included 73 cases of postpartum maternal deaths from 2009-2012. Controls were selected from the Birth in Brazil Study, a 2011 nationwide survey including 9,221 postpartum women. We examined the association of cesarean section and postpartum maternal death by multivariate logistic regression, adjusting for confounders. After controlling for indication bias and confounders, the risk of postpartum maternal death was almost three-fold higher with cesarean than vaginal delivery (OR 2.87, 95% CI 1.63-5.06), mainly due to deaths from postpartum hemorrhage and complications of anesthesia. Cesarean delivery is an independent risk factor of postpartum maternal death. Clinicians and patients should consider this fact in balancing the benefits and risks of the procedure.

  14. Firearm and nonfirearm homicide in 5 South African cities: a retrospective population-based study.

    Science.gov (United States)

    Matzopoulos, Richard G; Thompson, Mary Lou; Myers, Jonathan E

    2014-03-01

    We assessed the effectiveness of South Africa's Firearm Control Act (FCA), passed in 2000, on firearm homicide rates compared with rates of nonfirearm homicide across 5 South African cities from 2001 to 2005. We conducted a retrospective population-based study of 37 067 firearm and nonfirearm homicide cases. Generalized linear models helped estimate and compare time trends of firearm and nonfirearm homicides, adjusting for age, sex, race, day of week, city, year of death, and population size. There was a statistically significant decreasing trend regarding firearm homicides from 2001, with an adjusted year-on-year homicide rate ratio of 0.864 (95% confidence interval [CI] = 0.848, 0.880), representing a decrease of 13.6% per annum. The year-on-year decrease in nonfirearm homicide rates was also significant, but considerably lower at 0.976 (95% CI = 0.954, 0.997). Results suggest that 4585 (95% CI = 4427, 4723) lives were saved across 5 cities from 2001 to 2005 because of the FCA. Strength, timing and consistent decline suggest stricter gun control mediated by the FCA accounted for a significant decrease in homicide overall, and firearm homicide in particular, during the study period.

  15. Assessment of kidney function in the elderly: a population-based study.

    Science.gov (United States)

    Dutra, Marina Constante; Uliano, Estevão José Muller; Machado, Danúbia Felippe Grassi de Paula; Martins, Tatiana; Schuelter-Trevisol, Fabiana; Trevisol, Daisson José

    2014-01-01

    Chronic kidney disease (CKD) affects all age groups, and its prevalence has increased during recent years. CKD is divided into six stages, according to the renal function of patients: 1. Normal renal function without kidney damage; 2. Kidney damage with normal renal function; 3. Mild renal insufficiency; 4. Moderate renal insufficiency or lab tests failure; 5. Severe renal insufficiency or clinical failure; 6. End stage of chronic renal failure. This study was intended to assess renal function in elderly patients and identifying the presence of factors associated with those changes. A cross-sectional population-based study was performed. Elderly patients were surveyed between September 2010 and May 2011. Kidney function was assessed by determining of serum creatinine, and estimation of the glomerular filtration rate by the CKD-EPI equation. In all, 822 elderly were surveyed; 61.6% were women; 92.2% were Caucasian; and most (61.0%) were aged between 60 and 69 years. With regard to the glomerular filtration rate, 26.2% had a normal rate; 60.2% showed a slight decrease; 13.0% a moderate decrease; 0.5% severe kidney function decline; and 0.1% extreme fall. Increasing age was associated with kidney damage by decreased glomerular filtration rate (p kidney damage, and 13.6% showed moderate to severe dysfunction.

  16. 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

  17. Sexual violence, mood disorders and suicide risk: a population-based study

    Directory of Open Access Journals (Sweden)

    Thaíse Campos Mondin

    2016-03-01

    Full Text Available Abstract This article seeks to analyze the association between sexual violence, manic and depressive episodes, and suicide risk among young adults. This is a cross-sectional population-based study carried out with young people between 18 and 24 years of age in a town in southern Brazil. The sample was selected through clusters. The prevalence of sexual violence, manic, depressive and mixed episodes and suicide risk were evaluated, as well as the association between them. The chi-square test and Poisson regression were used for statistical analysis. The study sample comprised 1,560 subjects. Among these, 3.1% had suffered sexual violence at some point in their life. The prevalence of depressive, mixed episodes, and (hypomanic episodes were 10%, 2.4% and 2.3%, respectively. Suicide risk had a prevalence of 8.6% in the total sample. Young people who have suffered sexual violence are more likely to be subject to mood changes or suicide risk than those who have not (p < 0.05, except for the occurrence of (hypomanic episodes. These results revealed a strong association between sexual violence and depressive and mixed episodes and suicide risk.

  18. Quality of life of menopausal women in the island of Majorca: a population based study.

    Science.gov (United States)

    Calvo-Pérez, Andrés; Campillo-Artero, Carlos

    2013-06-01

    To explore demographic and epidemiological characteristics surrounding menopause among women of Majorca, estimate their health related quality of life (QOL), and ascertain wheather they differ from those of the mainland population of menopausal women. A cross-sectional population-based study was conducted with a sample of 428 women. The Cervantes questionnaire for measuring QOL during menopause was used. Among women in Majorca, the mean QOL is better than the national mean of the Spain reference population. It declines with age and levels off at menopause. In menopausal women, QOL improves slightly in tandem with educational level. 29% of menopausal women were on some form of therapy, most commonly a mix of estrogens and gestagens (36%). Only a weak association was detected between being menopausal and QOL. The Cervantes questionnaire allows periodic study sample cut-offs to determine whether changes in sociodemographic and disease-related variables are also accompanied by changes in self-perceived QOL. It is much better in menopausal women in Majorca than in those in the Spanish mainland.

  19. 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.

  20. Allergic rhinitis and associated risk of migraine among children: a nationwide population-based cohort study.

    Science.gov (United States)

    Wang, I-Chung; Tsai, Jeng-Dau; Lin, Cheng-Li; Shen, Te-Chun; Li, Tsai-Chung; Wei, Chang-Ching

    2016-03-01

    Increased frequency of migraine was reported in adults with allergic rhinitis (AR). Although migraine is less common in children than in adults, it can begin in early childhood and persist into adulthood. We conducted this population-based cohort study to investigate the incidence and subsequent risk of migraine in children with AR. From 2000 to 2007, 461,850 children with recently diagnosed AR and 460,718 non-AR controls were included in the study. By the end of 2008, incidences of migraine in both cohorts, the AR to non-AR cohort hazard ratios (HRs), and confidence intervals (CIs) were measured. The incidence of migraine during the study period was 3.2-fold higher in the AR cohort (95% CI, 2.97 to 3.46) than in the non-AR cohort (11.4 vs 3.49 per 10000 person-years). The risk was greater for boys than for girls, and for children aged 4 visits (p risk of migraine development in the AR cohort was highest within the first year after AR diagnosis (HR 4.89; 95% CI, 3.98 to 6.00). Children with AR were more likely to have migraine without aura than migraine with aura. Children with AR had a higher incidence and subsequent risk of migraine. Physicians should be more aware of migraine in children with AR who complain of headache. © 2015 ARS-AAOA, LLC.

  1. A population-based study of premorbid scholastic achievement among patients with psychiatric disorders.

    Science.gov (United States)

    Ullman, Vardit Zerem; Hornik-Lurie, Tzipi; Reichenberg, Abraham

    2017-07-01

    Population-based studies of premorbid cognitive functioning in schizophrenia have found verbal deficits and low IQ scores. It remains unclear, however, whether premorbid deficits are specific to schizophrenia, compared with other psychiatric disorders. Moreover, studies using school-based measures are few and their results inconsistent. This study assesses the eighth-grade (ages 13-14; n=11, 418) scholastic performance of adults with psychiatric disorders (n=194, 1.7, particularly with schizophrenia (n=86, 0.8%), comparing the results with those of their normative peers. The researchers examined report cards of eighth-graders at state secular schools in Jerusalem over a ten-year period (1978-1988), applying ANOVA and logistic regression models to evaluate associations between school performance and subsequent psychiatric hospitalization. The findings indicated that participants hospitalized with varied psychiatric disorders had lower grades in mathematics, gym, handcraft and academic core subjects, with significantly lower overall scores. Amended logistic regression models indicate that reduced performance (in mathematics, gym, handcraft and overall scores) was correlated with an increasing likelihood of hospitalization for the psychiatric disorders group and the subgroup with schizophrenia-related ailments. These results imply that eighth-grade school performance in core subjects is poorer among persons later hospitalized with psychiatric disorders than that of their classmates. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  2. Isotretinoin Use and the Risk of Inflammatory Bowel Disease: A Population-Based Cohort Study

    Science.gov (United States)

    Alhusayen, Raed O.; Juurlink, David N.; Mamdani, Muhammad M.; Morrow, Richard L.; Shear, Neil H.; Dormuth, Colin R.

    2013-01-01

    Limited evidence suggests that isotretinoin may be associated with inflammatory bowel disease (IBD). To explore this association, we conducted a retrospective population-based cohort study in British Columbia, Canada, among participants who were newly treated with isotretinoin or topical acne medications. The entire population of untreated provincial residents aged 12–29 years served as the reference group. During the 12-year study period, we identified 46,922 participants treated with isotretinoin, 184,824 treated with a topical acne medication, and 1,526,946 untreated individuals. Compared with untreated individuals, we observed no significant association between isotretinoin use and IBD (rate ratio (RR) 1.14; 95% confidence interval (CI) 0.92–1.41). As expected, we found no association with topical acne medications (RR 1.11; 95% CI 0.99–1.24). In prespecified secondary analyses, isotretinoin was associated with IBD among individuals aged 12–19 years (RR 1.39; 95% CI 1.03–1.87) and topical acne medications were associated with ulcerative colitis (RR 1.19; 95% CI 1.00–1.42). Our primary analyses found no association between isotretinoin and IBD. In prespecified secondary analyses, some evidence was found of associations with isotretinoin as well as topical acne medications, suggesting a possible association between IBD and acne itself. Additional research is needed to explore this possibility. PMID:23096714

  3. Association between obesity measures and albuminuria: A population-based study.

    Science.gov (United States)

    Ren, Meng; Sun, Kan; Li, Feng; Qi, Yi Qin; Lin, Diao Zhu; Li, Na; Li, Yan; Yan, Li

    2016-04-01

    The effects of obesity on the micro vascular diseases have drawn much attention. The aim of the study was to investigate the relationship between obesity measures and albuminuria in Chinese population. We conducted a population-based cross-sectional study in 8600 subjects aged 40 years or older from a community in Guangzhou. Urinary albumin excretion and creatinine were measured and urinary albumin-to-creatinine ratio (ACR) was calculated as urinary albumin divided by creatinine. Low-grade albuminuria was classified as the highest quartile of ACR in participants without increased urinary albumin excretion. Increased urinary albumin excretion was defined according to the ACR ranges greater or equal than 30 mg/g. Pearson's correlation analysis and multivariate linear regression analysis revealed that body mass index (BMI), waist circumference and body fat content were significantly correlated with ACR (all Palbuminuria and increased urinary albumin excretion gradually increased across the BMI, waist circumference and body fat content quartiles (all P for trendalbuminuria and increased urinary albumin excretion in logistic regression analysis after adjustment for age, sex, physical activity, fasting plasma glucose, triglycerides, low-density lipoprotein cholesterol and HbA1c (all P<0.05). Obesity measures are associated with urinary albumin excretion in middle-aged and elderly Chinese. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Inverse Association of Parkinson Disease With Systemic Lupus Erythematosus: A Nationwide Population-based Study.

    Science.gov (United States)

    Liu, Feng-Cheng; Huang, Wen-Yen; Lin, Te-Yu; Shen, Chih-Hao; Chou, Yu-Ching; Lin, Cheng-Li; Lin, Kuen-Tze; Kao, Chia-Hung

    2015-11-01

    The effects of the inflammatory mediators involved in systemic lupus erythematous (SLE) on subsequent Parkinson disease have been reported, but no relevant studies have focused on the association between the 2 diseases. This nationwide population-based study evaluated the risk of Parkinson disease in patients with SLE.We identified 12,817 patients in the Taiwan National Health Insurance database diagnosed with SLE between 2000 and 2010 and compared the incidence rate of Parkinson disease among these patients with that among 51,268 randomly selected age and sex-matched non-SLE patients. A Cox multivariable proportional-hazards model was used to evaluate the risk factors of Parkinson disease in the SLE cohort.We observed an inverse association between a diagnosis of SLE and the risk of subsequent Parkinson disease, with the crude hazard ratio (HR) being 0.60 (95% confidence interval 0.45-0.79) and adjusted HR being 0.68 (95% confidence interval 0.51-0.90). The cumulative incidence of Parkinson disease was 0.83% lower in the SLE cohort than in the non-SLE cohort. The adjusted HR of Parkinson disease decreased as the follow-up duration increased and was decreased among older lupus patients with comorbidity.We determined that patients with SLE had a decreased risk of subsequent Parkinson disease. Further research is required to elucidate the underlying mechanism.

  5. Risk and protective factors for chronic diseases in adults: a population-based study

    Directory of Open Access Journals (Sweden)

    Danielle Cristina Guimarães da Silva

    Full Text Available Abstract The article describes the relative frequency ok of risk and protective behaviors for chronic non-communicable diseases (NCDs in adults residing in Viçosa, Brazil. A cross-section-al population-based study including 1,226 adults living in the municipality. We used a structured questionnaire containing questions sociodemographic and behavioral The risk and protection factors evaluated were: smoking, physical activity, excessive consumption of alcohol and food consumption. The proportion of risk and protection factors was calculated in the total population, according to gender, education and socioeconomic status. The studied population has a high frequency of risk factors for NCDs, such as excessive consumption of alcoholic beverages, habit of consuming whole milk, habit of eating meat with visible fat, regular consumption of soft drinks and 78.5% did not achieve the minimum recommendation for physical activity in leisure time. With regard to protective factors, 86.2% of the population reported regular consumption of fruits and vegetables, and 73%, of beans. It was found the highest frequency of risk factors in among males, in younger people and middle socioeconomic status. This population has an urgent need for public policy of municipal planning to change this current scenario.

  6. Prevalence of platelet dysfunction and abnormal coagulation: results of a population-based study.

    Science.gov (United States)

    Marxsen, Jan H; Forchheim, Sonja; Zuske-Matthäus, Alexandra; Wagner, Thomas

    2009-01-01

    The prevalence of impairments in the hemostatic process is unknown in acutely ill people. Data on hemostasis (PFA 100) and the coagulation cascade of 1015 people are presented here, establishing a cohort of unselected emergency patients in a population-based approach. A high prevalence of reduced platelet function (38%) was found, which was more frequent than expected. In contrast, there was a lower prevalence (20%) of abnormal plasmatic coagulation, which was almost always explained by medication, whereas medication could not predict abnormal platelet function. Moreover, a history of disproportionate bleeding did not correlate well with abnormal platelet or coagulation factor function and could not substitute for a screening in this setting. The effect of acetylsalicylic acid (ASA) on PFA-closure time was frequently missing (34%), indicating a considerable prevalence of ASA nonresponse among the study population. These data should be applicable in similar settings. The high prevalence of unexpectedly abnormal platelet function in acute illness as well as the high prevalence of possible ASA nonresponders suggests a functional platelet assay to be effective in screening certain subpopulations of emergency patients.

  7. A population-based case-control study of colorectal cancer in Majorca. I. Dietary factors.

    Science.gov (United States)

    Benito, E; Obrador, A; Stiggelbout, A; Bosch, F X; Mulet, M; Muñoz, N; Kaldor, J

    1990-01-15

    A population-based case-control study was conducted between July 1984 and February 1988 in the Spanish island of Majorca; 286 incident colorectal cancer cases, 295 population controls and 203 hospital controls were interviewed using a food frequency questionnaire. In a multivariate analysis, an increased risk of colon cancer was found for high consumption of fresh meats (RR = 2.87) while a high consumption of cruciferous vegetables afforded protection (RR = 0.48). For rectal cancer an increased risk was associated with dairy products (RR = 3.08) while a protection was afforded by consumption of cruciferae (RR = 0.50). For colorectal cancer, the cereal food group also showed an increase in risk (RR = 1.92). When cases were compared to hospital controls, the effects of cruciferae in colon and rectum and those of dairy products in rectal cancer remained. The magnitude of the RR estimates was decreased for most comparisons, although in general terms the direction of the associations was the same. In addition, univariate analyses of food groups also suggested significant increases in risk of colorectal cancer for increasing consumption of cereals, potatoes, pastry, eggs and number of meals per day. An indication was found of a reduction in risk for consumers of coffee. An analysis based on risk scores was also conducted and a 4-fold increase in the risk of colorectal cancer and a highly significant statistical trend was found for high consumption of fresh meat, dairy products and cereals combined with low consumption of cruciferae.

  8. Prenatal care and adverse pregnancy outcomes among women with depression: a nationwide population-based study.

    Science.gov (United States)

    Chen, Chia-Hui; Lin, Herng-Ching

    2011-05-01

    To evaluate the quantity of prenatal care as a risk factor for giving birth to low birth weight (LBW), preterm, and small for gestational age (SGA) infants in a sample of women diagnosed with depressive disorder. Our study used a population-based dataset, Taiwan's National Health Insurance Research Database, which we linked to Taiwan's birth certificate registry to identify a total of 5283 new mothers with depressive disorder. Multivariate logistic regression analyses were performed to measure the risk of giving birth to LBW, preterm, and SGA infants, relating to the number of prenatal care visits (10 or more, 8 to 9, and 7 or less) made by mothers with depressive disorder. After adjusting for a woman's age, monthly income, urbanization level of place of residence, geographic location, marital status, substance abuse, arterial hypertension, diabetes, anemia, coronary heart disease, malpresentation, insufficient or excessive fetal growth, placenta or previa abruption, and infant's sex and parity, regression analyses revealed that mothers with a history of depressive disorder who received prenatal care 7 times or less were 4.21 (95% CI 3.34 to 5.32, P depressive disorder who received prenatal care visits 10 times or more. Mothers with a history of depressive disorder who make fewer prenatal care visits were at an increased risk of LBW, SGA, and preterm birth, compared with women with a history of depressive disorder who made an adequate number of prenatal visits.

  9. Fertility rates and perinatal outcomes of adolescent pregnancies: a retrospective population-based study

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes de Souza

    Full Text Available ABSTRACT Objective: analyze trends in fertility rates and associations with perinatal outcomes for adolescents in Santa Catarina, Brazil. Methods: 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. Results: 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; p<0.001, have an infant with low birthweight (OR:1.1; CI:1.10-1.15; p<0.001 and low Apgar score at 5 minutes (OR:1.4; CI:1.34-1.45; p<0.001 than mothers ≥20 years, with the odds for adverse outcomes greater for those aged 10-14 years. Conclusion: this study provides evidence of fertility rates among adolescents remaining higher in regions of social and economic deprivation. Adolescent mothers and their infants more likely to experience adverse perinatal outcomes. Nurses, public health practitioners, health and social care professionals and educators need to work collaboratively to better target strategies for adolescents at greater risk; to help reduce fertility rates and improve outcomes.

  10. Gambling-related harms among adolescents: a population-based study.

    Science.gov (United States)

    Raisamo, Susanna; Halme, Jukka; Murto, Antti; Lintonen, Tomi

    2013-03-01

    Internationally, and also in Europe, adolescent gambling is increasingly recognized as an important public health issue. Most research on adolescent gambling, however, is prevalence-focused and population-based studies are scarce. Few studies have examined gambling-related harms among adolescents. In a national sample, we examined self-experienced harms related to gambling and the relationship between reported harms and gambling behavior among Finnish adolescents. A national survey of 12-18-year-olds was conducted in Finland in 2011 (N = 4,566). Main measures were frequency of gambling and gambling-related harms reported during the past 6 months. The relationship between reported harms and gambling behavior was assessed using logistic regression analysis. Overall, 44% had gambled during the past 6 months. Of the sample, 12% were frequent gamblers (at least weekly) and 32% were occasional gamblers (monthly or less often). Compared to occasional gamblers, frequent gamblers were more likely to experience harms. The most commonly reported harms among frequent gamblers were "felt guilty or shameful due to gambling" (17%) followed by "problems with relationships" (13%) and "disruptions of daily rhythm" (10%). In age and gender-adjusted analysis, daily gamblers were significantly more likely to report all different types of harms when compared to other groups. These findings suggest that when planning and targeting youth gambling prevention and harm reduction strategies the nature and extent to which gambling may contribute to the different types of harms are important to consider.

  11. Bipolar disorder and the risk of fracture: A nationwide population-based cohort study.

    Science.gov (United States)

    Su, Jian-An; Cheng, Bi-Hua; Huang, Yin-Cheng; Lee, Chuan-Pin; Yang, Yao-Hsu; Lu, Mong-Liang; Hsu, Chung-Yao; Lee, Yena; McIntyre, Roger S; Chin Lin, Tzu; Chin-Hung Chen, Vincent

    2017-08-15

    The co-primary aims are: 1) to compare the risk of fracture between adults with bipolar disorder and those without bipolar disorder; and 2) to assess whether lithium, anticonvulsants and antipsychotics reduce risk of fracture among individuals with bipolar disorder. The analysis herein is a population-based retrospective cohort study, utilizing the National Health Insurance (NHI) medical claims data collected between 1997 and 2013 in Taiwan. We identified 3705 cases with incident diagnoses of bipolar disorder during study period and 37,050 matched controls without bipolar diagnoses. Incident diagnosis of fracture was operationalized as any bone fracture after the diagnosis of bipolar disorder or after the matched index date for controls. Bipolar patients had significantly higher risk of facture when compared to matched controls (17.6% versus 11.7%, respectively pbipolar disorder and a prior history of psychiatric hospitalization were had higher risk for bone fracture than those without prior history of psychiatric hospitalization when compared to match controls. Higher cumulative dose of antipsychotics or mood stabilizers did not increase the risk of fracture. The diagnoses of bipolar disorder were not confirmed with structured clinical interview. Drug adherence, exact exposure dosage, smoking, lifestyle, nutrition and exercise habits were unable to be assessed in our dataset. Bipolar disorder is associated with increased risk of fracture, and higher cumulative dose of mood stabilizers and antipsychotics did not further increase the risk of fracture. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Relationship of birth weight with congenital cardiovascular malformations in a population-based study.

    Science.gov (United States)

    Petrossian, Robert A; Kuehl, Karen S; Loffredo, Christopher A

    2015-08-01

    A known comorbidity of congenital cardiovascular malformations is low birth weight, but the reasons for this association remain obscure. This retrospective study examines the relationship between congenital cardiovascular malformations and the birth weight of singletons, taking into account differences in gestational age and other factors. Using data from the retrospective, population-based Baltimore-Washington Infant Study, six types of congenital cardiovascular malformations were investigated in comparison with controls (n=3519) through linear regression: d-transposition of the great arteries (n=187), other conotruncal heart defects (n=361), endocardial cushion defects (n=281), left heart obstructive lesions (n=507), atrial septal defects (n=281), and membranous ventricular septal defects (n=622). Infants with conotruncal heart defects (-218 g), endocardial cushion defects with Down syndrome (-265 g), endocardial cushion defects without Down syndrome (-194 g), left heart obstructive lesions (-143 g), atrial septal defects (-150 g), and membranous ventricular septal defects (-127 g) showed significant birth weight deficits, adjusting for gestational age, and other covariates. Infants with d-transposition of the great arteries (-67 g) did not show significant birth weight deficits compared with the control group. The degree of birth weight decrement appears to be highly related to the specific type of congenital cardiovascular malformation. As a whole, these infants do not exhibit low birth weights solely because of being premature, and thus other mechanisms must underlie these associations.

  13. Normal range of cambridge low contrast test; a population based study.

    Science.gov (United States)

    Ostadimoghaddam, Hadi; Fotouhi, Akbar; Hashemi, Hassan; Yekta, Abbas Ali; Heravian, Javad; Abdolahinia, Tahereh; Norouzi Rad, Reza; Asgari, Soheila; Khabazkhoob, Mehdi

    2014-01-01

    To determine the range of contrast sensitivity (CS) and its determinants in a normal population, Mashhad, Iran. In this cross-sectional population based study, 4,453 individuals were invited of whom 3,132 persons agreed to participate (response rate, 70.4%). CS data from 2,449 eligible individuals were analyzed. CS was determined using the Cambridge low contrast square-wave grating test, and its associations with age, gender, best-corrected visual acuity (BCVA) and manifest refraction spherical equivalent (MRSE) refractive error, were analyzed. Mean age of the participants was 29.1±17.3 (range, 4-89) years and 66.4% were female. Mean CS was 239.6±233.3 and 234.6±228.6 cps in right and left eyes, respectively. Mean binocular CS was 310.9±249.0 cps. Multiple linear regression showed that CS was inversely correlated with older age (β=-1.1, PCambridge low-contrast grating test reported herein may serve as a reference for the general population in Iran. Our findings can be used for both research and clinical applications, particularly for evaluations of the outcomes of refractive surgery. In the current study, CS was lower in older subjects, myopic individuals and patients with lower BCVA.

  14. Virtual colleagues, virtually colleagues--physicians' use of Twitter: a population-based observational study.

    Science.gov (United States)

    Brynolf, Anne; Johansson, Stefan; Appelgren, Ester; Lynoe, Niels; Edstedt Bonamy, Anna-Karin

    2013-01-01

    To investigate potential violations of patient confidentiality or other breaches of medical ethics committed by physicians and medical students active on the social networking site Twitter. Population-based cross-sectional observational study. The social networking site Twitter (Swedish-speaking users, n=298819). Physicians and medical students (Swedish-speaking users, n=237) active on the social networking site Twitter between July 2007 and March 2012. Postings that reflect unprofessional behaviour and ethical breaches among physicians and medical students. In all, 237 Twitter accounts were established as held by physicians and medical students and a total of 13 780 tweets were analysed by content. In all, 276 (1.9%) tweets were labelled as 'unprofessional'. Among these, 26 (0.2%) tweets written by 15 (6.3%) physicians and medical students included information that could violate patient privacy. No information on the personal ID number or names was disclosed, but parts of the patient documentation or otherwise specific indicatory information on patients were found. Unprofessional tweets were more common among users writing under a pseudonym and among medical students. In this study of physicians and medical students on Twitter, we observed potential violations of patient privacy and other breaches of medical ethics. Our findings underline that every physician and medical student has to consider his or her presence on social networking sites. It remains to be investigated if the introduction of social networking site guidelines for medical professionals will improve awareness.

  15. Discordant associations of lipid parameters with albuminuria and chronic kidney disease: a population-based study.

    Science.gov (United States)

    Sun, Kan; Lin, Diaozhu; Li, Feng; Huang, Chulin; Qi, Yiqin; Xue, Shengneng; Tang, Juying; Yang, Chuan; Li, Yan; Ren, Meng; Yan, Li

    2015-11-25

    Although dyslipidemia is related to the pathogenesis of renal insufficiency, which routinely available lipid measure is more applicable in estimation of kidney function is still uncertain. Our objective was to evaluate inconsistent associations of lipid profiles with both albuminuria and chronic kidney disease (CKD). We performed a population-based study in 9730 subjects aged 40 years or older. Definitions of abnormalities in albumin excretion were according to the latest guidelines of American Diabetes Association's Standards of Medical Care. CKD was defined as estimated glomerular filtration rate (eGFR) albuminuria. There were 2274 (23.4%) participants categorized as low-grade albuminuria, 639 (6.6%) participants categorized as increased urinary albumin excretion and 689 (7.1%) participants categorized as CKD. Triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), Non HDL-C to HDL-C ratio, TG to HDL-C ratio were significantly correlated with urinary albumin to creatinine ratio (ACR), serum creatinine and eGFR (all P albuminuria were observed after adjustments for potential confounding factors. Our study lends support to discordant associations of lipid parameters with albuminuria and renal function. TG to HDL-C ratio is a better marker than other routine lipid measures for identifying renal insufficiency and should be given more consideration in the clinical practice.

  16. 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.

  17. Level of neurotoxic metals in amyotrophic lateral sclerosis: A population-based case-control study.

    Science.gov (United States)

    Bocca, Beatrice; Forte, Giovanni; Oggiano, Riccardo; Clemente, Simonetta; Asara, Yolande; Peruzzu, Angela; Farace, Cristiano; Pala, Salvatore; Fois, Alessandro Giuseppe; Pirina, Pietro; Madeddu, Roberto

    2015-12-15

    The association between exposure to toxic metals and amyotrophic lateral sclerosis (ALS) was explored in a population-based case-control study in the Sardinia island (Italy), a region characterized by elevated rates of ALS cases. In 34 patients with ALS (mean age, 62 ± 10 years) and 30 controls (mean age, 65 ± 11 years), Al, Cd, Hg, Mn and Pb were determined in blood, hair and urine by sector field inductively coupled mass spectrometry. Results indicated that, in blood, concentrations of Al (p=0.045) and Pb were higher (p=0.026) in ALS patients than in control subjects. In hair, a depletion of Al (p=0.006) and Mn (p=0.032) concentrations in ALS subjects respect to controls was found. In urine, no significant differences between cases and controls were observed. Thus, some metals seemed to be associated with ALS degeneration, but a definitive conclusion is still far considering the multiple risk factors (genetic mutations, environmental toxicants and stressors) involved in the disease. Finally, the interpretation that deregulated metal concentrations can be a consequence of the degenerative process, rather than a cause, is also valid. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Lower utilization of cervical cancer screening by nurses in Taiwan: a nationwide population-based study.

    Science.gov (United States)

    Chung, Shiu-Dong; Pfeiffer, Stefani; Lin, Herng-Ching

    2011-01-01

    Using a nationwide population-based database in Taiwan, this study compares use of Pap smear testing by nurses and the general population. We compared 1093 practicing female nurses and 5465 randomly selected female patients from the 2006 National Health Insurance (NHI) database to evaluate the likelihood of receiving at least one Pap smear during a three-year period. We found that 48.9% of the nurses and 56.2% of comparison subjects received a Pap test from 2004 to 2006 in Taiwan. Regression analysis showed that practicing female nurses were less likely to receive a Pap smear compared with the general population (OR=0.42, 95% CI=0.35-0.50, pambulatory care visits, urbanization level and the geographic location of the communities where subjects resided. Nurses were less likely to undergo cervical screening than the general population, despite ease of access and a national health insurance system providing universal coverage to residents of Taiwan. Efforts to raise the Pap screening rate among nurses may require addressing unique cultural and occupational concerns. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Subarachnoid hemorrhage and hormonal factors in women. A population-based case-control study.

    Science.gov (United States)

    Longstreth, W T; Nelson, L M; Koepsell, T D; van Belle, G

    1994-08-01

    To determine the degree to which endogenous and exogenous hormonal factors influence the risk for subarachnoid hemorrhage in women. A population-based case-control study. King County, Washington. 103 women with an incident, spontaneous subarachnoid hemorrhage and 2 age- and sex-matched controls per case-patient who were identified through random-digit dialing. Information on exposures was collected during in-person interviews of case-patients, controls, and their surrogates. Premenopausal women, especially those without a history of smoking or hypertension, were at a reduced risk for subarachnoid hemorrhage compared with age-matched postmenopausal women (odds ratio, 0.24; 95% CI, 0.09 to 0.68). The use of hormone replacement therapy was associated with a reduced risk (odds ratio, 0.47; CI, 0.26 to 0.86); the reduction was significantly greater in women who had smoked than in those that had never smoked. Of the 23 premenopausal case-patients, 74% were either menstruating when hemorrhaging occurred or had had their last menstrual period 21 or more days before hemorrhaging compared with the expected 43% (difference, 31%; CI, 4% to 58%). Premenopausal women are at reduced risk for subarachnoid hemorrhage, especially those without a history of smoking or hypertension. Hormone replacement therapy reduced the risk only in postmenopausal women who had ever smoked. Among women still menstruating, the risk for hemorrhage was greatest in the perimenstrual period.

  20. Lichen Simplex Chronicus Associated With Erectile Dysfunction: A Population-Based Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Chao-Kuei Juan

    Full Text Available An association between lichen simplex chronicus (LSC and sexual dysfunction was explored. However, no data are available from investigations into the relationship between erectile dysfunction (ED and LSC.This retrospective population-based cohort study aimed to clarify the risk of ED associated with LSC.By using the Taiwan National Health Insurance Research dataset, we identified 5611 male patients who had been newly diagnosed with LSC from 2000 to 2004. The date of diagnosis was identified as the index date. LSC patients with incomplete demographic information or with a history of ED before the index date were excluded. In total, 22444 age-matched patients without LSC were randomly selected as the non-LSC group based on a 1:4 ratio. Subsequence occurrence of ED was measured until 2011. The association between LSC and the risk of developing ED was estimated using Cox proportional hazard regression model.After adjusting for age and comorbidities, patients with LSC had a 1.74-fold greater risk of developing ED compared with those without LSC (95% confidence interval=1.44-2.10. LSC patients with comorbidities including diabetes, hyperlipidemia, hypertension, cardiovascular disease, peripheral arterial disease, chronic obstructive pulmonary disease, chronic kidney disease, depression, and anxiety were at a higher risk of ED compared with the non-LSC patients without comorbidities.LSC confers a greater risk in the development of ED. Physicians should be aware of the potential of ED occurrence in LSC patients.

  1. Seasonal affective disorder and alcohol abuse disorder in a population-based study.

    Science.gov (United States)

    Morales-Muñoz, Isabel; Koskinen, Seppo; Partonen, Timo

    2017-07-01

    Seasonal affective disorder (SAD) is a recurrent major depressive disorder with a seasonal pattern, which is characterized by sad mood, low energy, longer sleep duration and carbohydrate craving. Furthermore, seasonal changes in mood and behavior may be closely related to alcohol use disorder (AUD). Nevertheless, there is scarce research on the study of cognitive impairments in SAD and AUD. We aimed to examine the relationship between the prevalence between SAD and AUD patients, and how cognitive functioning might be related to these variables. To do this, a sample of 8135 Finnish subjects was invited to take part in the population-based Health 2011 Survey, of whom 5903 did participate and 4554 were interviewed for mental health status with the Munich version of Composite International Diagnostic Interview. They also completed the modified Seasonal Pattern Assessment Questionnaire, the Mini-Mental State Examination, the category (animals) verbal fluency test, and the Rey Auditory Verbal Learning Test. Our results reveal the existence of a strong link between SAD and AUD in a large sample of Finnish population, as well as association between SAD and short-term memory problems. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  2. Is kiwifruit allergy a matter in kiwifruit-cultivating regions? A population-based study.

    Science.gov (United States)

    Haktanir Abul, Mehtap; Dereci, Selim; Hacisalihoglu, Sadan; Orhan, Fazil

    2017-02-01

    Although kiwifruit is known as a common cause of food allergy, population-based studies concerning the prevalence of kiwifruit allergy do not exist. We aimed to determine the prevalence and clinical characteristics of IgE-mediated kiwifruit allergy in 6-18-year-old urban schoolchildren in a region where kiwifruit is widely cultivated. This cross-sectional study recruited 20,800 of the randomly selected 6-18-year-old urban schoolchildren from the Rize city in the eastern Black Sea region of Turkey during 2013. Following a self-administered questionnaire completed by the parents and the child, consenting children were invited for skin prick tests (SPTs) and oral food challenges (OFCs). Children with suspected IgE-mediated kiwifruit were skin prick tested with kiwifruit (commercial allergen and prick-to-prick test with fresh kiwifruit) and a pre-defined panel of allergens (banana, avocado, latex, sesame seed, birch, timothy, hazel, cat, Dermatophagoides pteronyssinus, and Dermatophagoides farinae). All children with a positive SPT to kiwifruit were invited for an open OFC. The prevalence of IgE-mediated kiwifruit allergy was established using open OFCs. The response rate to the questionnaire was 75.9% (15783/20800). The estimated prevalence of parental-perceived IgE-mediated kiwifruit allergy was 0.5% (72/15783) (95% CI, 0.39-0.61%). Of the 72 children, 52 (72.2%) were skin tested, and 17 (32.7%) were found to be positive to kiwifruit with both commercial extract and kiwifruit. The most frequently reported symptoms in kiwifruit SPT-positive children were cutaneous (n = 10, 58.8%) followed by gastrointestinal (n = 6, 35.3%) and bronchial (n = 4, 23.5%). Oral symptoms were reported in six (35.3%) children. All children who were kiwifruit positive by SPT were found positive during the oral challenge. The confirmed prevalence of IgE-mediated kiwifruit allergy by means of open OFC in 6-18-year-old urban schoolchildren living in Rize city was 0.10% (95% CI, 0

  3. 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.

  4. Physical activity and perceived insecurity from crime in adults: a population-based study.

    Directory of Open Access Journals (Sweden)

    Márcio de Almeida Mendes

    Full Text Available The present study aimed to describe the perception of safety from crime in the neighborhood and to evaluate its association with leisure-time and transport-related physical activity in adults.A cross-sectional population based study was conducted in the urban area of Pelotas, Brazil, in 2012. Perceived insecurity from crime in the neighborhood was measured using the Neighborhood Environment Walkability Scale (NEWS and the City Stress Inventory (CSI. Physical activity was measured using an adapted version of the leisure and transportation sections of the long version of the International Physical Activity Questionnaire.Overall, 52.3% (95%CI49.0; 55.6 of the participants reported perceived exposure to an unsafe neighborhood. Subjects who practiced 150 or more minutes per week of physical activity during leisure-time and transportation were 10.5% (95%CI9.0; 12.0 and 51.7% (95%CI 48.7; 54.7, respectively. There were no significant associations between physical activity (leisure-time or transport-related and perceived insecurity from crime, neither in unadjusted nor in adjusted analyses.There was no evidence that the perception of safety from crime is associated to higher physical activity levels among Brazilian adults.

  5. Playing board games, cognitive decline and dementia: a French population-based cohort study.

    Science.gov (United States)

    Dartigues, Jean François; Foubert-Samier, Alexandra; Le Goff, Mélanie; Viltard, Mélanie; Amieva, Hélène; Orgogozo, Jean Marc; Barberger-Gateau, Pascale; Helmer, Catherine

    2013-08-29

    To study the relationship between board game playing and risk of subsequent dementia in the Paquid cohort. A prospective population-based study. In the Bordeaux area in South Western France. 3675 non-demented participants at baseline. The risk of dementia during the 20 years of follow-up. Among 3675 non-demented participants at baseline, 32.2% reported regular board game playing. Eight-hundred and forty participants developed dementia during the 20 years of follow-up. The risk of dementia was 15% lower in board game players than in non-players (HR=0.85, 95% CI 0.74 to 0.99; p=0.04) after adjustment on age, gender, education and other confounders. The statistical significance disappeared after supplementary adjustment on baseline mini-mental state examination (MMSE) and depression (HR=0.96, 95% CI 0.82 to 1.12; p=0.61). However, board game players had less decline in their MMSE score during the follow-up of the cohort (β=0.011, p=0.03) and less incident depression than non-players (HR=0.84; 95% CI 0.72 to 0.98; pboard game playing on the risk of dementia could be mediated by less cognitive decline and less depression in elderly board game players.

  6. Medication Responsiveness of Motor Symptoms in a Population-Based Study of Parkinson Disease

    Directory of Open Access Journals (Sweden)

    Yvette M. Bordelon

    2011-01-01

    Full Text Available We assessed degree of Parkinson disease motor symptom improvement with medication among subjects enrolled in an ongoing, population-based study in Central California. The motor section of the unified Parkinson disease rating scale (UPDRS was performed on subjects in both OFF and ON medication states, and difference between these scores was used as an indicator of symptomatic benefit. Higher OFF minus ON scores correlated with more severe baseline symptoms. There was equivalent improvement on the motor UPDRS scale for subjects divided according to medication classes used: levodopa alone 7.3 points, levodopa plus other medications 8.5 points, and dopamine agonists but not levodopa 6.1 points. In addition, there was no difference in the magnitude of improvement when subjects were divided according to Parkinson disease subtype, defined as tremor dominant, akinetic-rigid, or mixed. In this community-based sample, these values are within the range of a clinically important difference as defined by previous studies.

  7. Increased Risk of Hemorrhagic Stroke in Patients with Migraine: A Population-Based Cohort Study

    Science.gov (United States)

    Kuo, Cheng-Ya; Yen, Ming-Fang; Chen, Li-Sheng; Fann, Ching-Yuan; Chiu, Yueh-Hsia; Chen, Hsiu-Hsi; Pan, Shin-Liang

    2013-01-01

    Objective Previous studies on the association between migraine and the risk of developing hemorrhagic stroke (HS) have generated inconsistent results. The aim of the present population-based, age- and sex- matched follow-up study was to investigate whether migraine is associated with an increased risk of HS. Method A total of 20925 persons with at least two ambulatory visits in 2001 with the principal diagnosis of migraine were enrolled in the migraine group. The non-migraine group consisted of 104625, age- and sex- matched, randomly sampled subjects without migraine. The two-year HS-free survival rates for these 2 groups were estimated using the Kaplan-Meier method. Cox proportional hazards regression was used to estimate the effect of migraine on the occurrence of HS. Results During the 2 year follow-up, 113 subjects in the migraine group (0.54%) and 255 in the non-migraine group (0.24%) developed HS. The crude hazard ratio (HR) for developing HS in the migraine group was 2.22 compared to the non-migraine group (95% confidence interval [CI]: 1.78–2.77, pmigraine was linked to an increased risk of HS. PMID:23372843

  8. A population-based study on dementia and stroke in 97 year olds.

    Science.gov (United States)

    Andersson, Mats; Guo, Xinxin; Börjesson-Hanson, Anne; Liebetrau, Martin; Östling, Svante; Skoog, Ingmar

    2012-07-01

    the number of nonagenarians increases dramatically worldwide. to examine the prevalence of stroke/transient ischaemic attack (TIA) and dementia, their inter-relationship and their relation to 2-year mortality and institutionalisation in 97 year olds. a population-based sample of 97 year olds (n=591) was examined. Information on stroke/TIA was obtained from self-reports, key informants and hospital discharge registers. Dementia was diagnosed according to DSM-III-R criteria. the response rate was 65%. The prevalence of dementia was 32.7% in men and 59.3% in women (P<0.001). The prevalence of stroke/TIA was 21.5% (17.8% in men, 22.3% in women). Stroke/TIA was related to dementia in women (odds ratio=1.9, 95% CI: 1.2-3.0), but not in men. Dementia, but not stroke/TIA, was related to 2-year mortality and institutionalisation in logistic regression models. dementia was very common in this age group, and related to mortality and institutionalisation. Stroke/TIA in 97 year olds showed less association with dementia, mortality and institutionalisation than reported in studies of younger elderly populations. The finding that stroke was not associated with dementia in men needs to be taken cautiously due to the small number of men. The findings also emphasise that more studies are needed to scrutinise the aetiology of dementia in nonagenarians.

  9. Insulin resistance, the metabolic syndrome, and risk of incident cardiovascular disease: a population-based study

    DEFF Research Database (Denmark)

    Jeppesen, Jørgen; Hansen, Tine W; Rasmussen, Susanne

    2007-01-01

    -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...... Cholesterol Education Program (NCEP) criteria, and we quantified IR by the homeostasis model assessment (HOMA-IR). Prevalence of MetSyn was 21% according to IDF criteria and 16% according to NCEP criteria. Accordingly, we defined IDF-HOMA-IR as belonging to the highest 21% of the HOMA-IR distribution......, smoking, and low-density lipoprotein cholesterol, and with IDF-HOMA-IR and IDF-MetSyn included in the same model, the relative risk of an end point was 1.67 (95% confidence interval [CI] 1.22 to 2.29) for IDF-HOMA-IR and 1.16 (95% CI 0.84 to 1.60) for IDF-MetSyn. The corresponding figures for NCEP...

  10. Peripartum cardiomyopathy is associated with increased uric acid concentrations: A population based study.

    Science.gov (United States)

    Sagy, Iftach; Salman, Amjad Abu; Kezerle, Louise; Erez, Offer; Yoel, Idan; Barski, Leonid

    Peri-partum cardiomyopathy (PPCM) is a clinical heart failure that usually develops during the final stage of pregnancy or the first months following delivery. High maternal serum uric acid concentrations have been previous associated with heart failure and preeclampsia. 1) To explored the clinical characteristics of PPCM patients; and 2) to determine the association between maternal serum uric acid concentrations and PPCM. This is a retrospective population based case control study. Cases and controls were matched 1:4 (for gestational age, medical history of cardiac conditions and creatinine); conditional logistic regression was used to identify clinical parameters that were associated with PPCM. The prevalence of peripartum cardiomyopathy at our institution was 1-3832 deliveries (42/160,964). In a matched multivariate analysis high maternal serum uric acid concentrations were associated with PPCM (O.R 1.336, 95% C.I 1.003-1.778). Uric acid concentrations were higher within the Non-Jewish patients and mothers of male infant with PPCM in compare to those without PPCM (p value 0.003 and 0.01 respectively). PPCM patients had increased maternal serum uric acid concentrations. This observation aligns with previous report regarding the increased uric acid concentration in women with preeclampsia and congestive heart failure, suggestive of a common underlying mechanism that mediates the myocardial damage. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Perinatal risk factors for future SLE: a population-based nested case-control study.

    Science.gov (United States)

    Arkema, E V; Simard, J F

    2015-07-01

    To investigate the association between perinatal characteristics and the offspring's risk of lupus using population-based registers in Sweden. We conducted a nested case-control study, identifying systemic lupus erythematosus (SLE) cases from the National Patient Register and controls sampled from the general population matched on birth year, sex, and residential county. We obtained data on the mother's health and age during pregnancy and characteristics of labor and delivery from the Medical Birth Register (births from 1973 through 2008) for cases and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression models overall and separately for males and females. We identified 774 cases and 3337 controls. Age at which SLE was first observed ranged from 0 to 36 years old. High birth weight was not a risk factor for SLE and did not differ by sex. Males had a 2.4-fold increased odds of SLE if born preterm (SLE, particularly among females (first born vs. not OR = 0.77, 95% CI 0.64, 0.94; continuous birth order OR = 1.12. 95% CI 1.02, 1.24). Being born first was associated with reduced odds of SLE and the odds of SLE increased by 12% for every additional birth. Preterm birth was associated with increased odds in males only. Unlike previous work, high birth weight was not a risk factor for SLE. © The Author(s) 2015.

  12. Incidence and prevalence of idiopathic inflammatory myopathies in Sweden: a nationwide population-based study.

    Science.gov (United States)

    Svensson, John; Arkema, Elizabeth V; Lundberg, Ingrid E; Holmqvist, Marie

    2017-05-01

    To estimate the incidence rate and prevalence of idiopathic inflammatory myopathies (IIMs) in Sweden across clinical subgroups, age, sex, educational level and place of residence and to assess the robustness of register-based case definitions. IIM was identified from the Swedish National Patient Register and the Swedish Rheumatology Quality Register. The base case definition required ⩾2 visits indicating IIM (first ever with a consecutive visit within 1-12 months for incident cases) and the robustness was tested by applying a more liberal and a stricter definition. Using the base case definition, 558 incident IIM patients were identified between 2007 and 2011. The incidence was estimated to 11 (13 for women and 9.7 for men) per 1 000 000 person years and was stable across case definitions. Incidence increased with age and peaked at the 50-79 years age groups. No differences were observed between different levels of education and place of residence. We identified 1267 IIM patients on 1 January 2012 corresponding to a prevalence of 14 per 100 000. We present nationwide register-based incidence and prevalence estimates for IIM, robust across three different case definitions. In contrast to many other reports, we did not find incidence by age to be bimodal and we found no explanation of incidence variation across education and residency. These register-based case definitions can be included in future population-based studies to better understand disease aetiology, risk factors and comorbidities.

  13. Risk for schizophrenia in intercountry adoptees: a Danish population-based cohort study.

    Science.gov (United States)

    Cantor-Graae, Elizabeth; Pedersen, Carsten Bøcker

    2007-11-01

    Increasing numbers of intercountry adoptees are reaching adulthood, the age of onset for most serious mental disorders. Little is known about the development of schizophrenia in intercountry adoptees, a group with potentially increased vulnerability. The aim of this study was to investigate the risk of developing schizophrenia in adoptees and in non-adoptees. Utilising data from the Danish Civil Registration System, we established a population-based cohort of 1.06 million persons resident in Denmark before the age of 15, whose legal mother lived in Denmark at the child's birth. Intercountry adoptees were identified as children born abroad. Record linkage provided information on psychiatric admissions. Intercountry adoptees had an increased relative risk (RR) (RR = 2.90, 95% CI 2.41-3.50) of developing schizophrenia compared to native Danes. The increased risk was independent of age at onset and age at, or region of, adoption, and was not attributable to mental illness in a foster parent, the foster parent's age, or to urbanisation. The foster mother's own biological offspring had also an increased risk of developing schizophrenia (1.92, 95% CI 1.23-3.02). Young adult intercountry adoptees are at increased risk for schizophrenia. Although the underlying cause is unknown, a complex interplay of factors presumably may be involved, including heredity, adversity prior to adoption, and post-adoption adjustment difficulties during upbringing.

  14. Association between tobacco use in pregnancy and placenta-associated syndromes: a population-based study.

    Science.gov (United States)

    Aliyu, Muktar H; Lynch, O'Neil; Wilson, Ronee E; Alio, Amina P; Kristensen, Sibylle; Marty, Phillip J; Whiteman, Valerie E; Salihu, Hamisu M

    2011-04-01

    Cigarette smoking is an established risk factor for adverse perinatal outcomes. The purpose of this study is to examine the association between maternal smoking in pregnancy and the occurrence of placental-associated syndromes (PAS). We analyzed data from a population-based retrospective cohort of singleton deliveries that occurred in the state of Missouri from 1989 through 2005 (N = 1,224,133). The main outcome was PAS, a composite outcome defined as the occurrence of placental abruption, placenta previa, preeclampsia, small for gestational age, preterm or stillbirth. We used logistic regression models to generate adjusted odd ratios and their 95 percent confidence intervals. Non-smoking gravidas served as the referent category. The overall prevalence of prenatal smoking was 19.6%. Cigarette smoking in pregnancy was associated with the composite outcome of placental syndromes (odds ratio, 95% confidence interval = 1.59, 1.57-1.60). This association showed a dose-response relationship, with the risk of PAS increasing with increased quantity of cigarettes smoked. Similar results were observed between smoking in pregnancy and independent risks for abruption, previa, SGA, stillbirth, and preterm delivery. Maternal smoking in pregnancy is a risk factor for the development of placenta-associated syndrome. Smoking cessation interventions in pregnancy should continue to be encouraged in all maternity care settings.

  15. Subsequent vitiligo after hematopoietic stem cell transplantation: A nationwide population-based cohort study from Korea.

    Science.gov (United States)

    Bae, Jung Min; Choi, Kwang Hyun; Jung, Han Mi; Kim, Sook Young; Kim, Miri; Kim, Gyung Moon; Yu, Dong Soo; Lee, Young Bok

    2017-03-01

    Subsequent vitiligo after hematopoietic stem cell transplantation (HSCT) has been described sporadically in case series. To investigate the incidence and risk factors of subsequent vitiligo after HSCT. A nationwide, population-based cohort study was performed using the Korean National Health Insurance Claims Database from 2009 to 2013. All HSCT recipients who had undergone HSCT between 2010 and 2011 and not treatment for vitiligo in 2009 (to exclude preexisting active vitiligo) were included in the HSCT recipient group, and an age- and sex-matched control group without HSCT was also established. A total of 2747 HSCT recipients and 8241 controls were enrolled. Newly acquired vitiligo occurred in 1.06% of HSCT recipients between 2010 and 2013, and there was a significant increase (OR 3.130, 95% CI 1.859-5.271) in cases of vitiligo in HSCT recipients compared with controls (0.34%). Allogeneic HSCT (OR 5.593, 95% CI 1.628-19.213) and bone marrow-sourced stem cells (as compared with peripheral blood-sourced stem cells; OR 2.492, 95% CI 1.114-5.576) were independently associated with the development of vitiligo after HSCT. Medical record review was not available. Vitiligo developed at a significantly increased rate after HSCT compared with controls. Allogeneic HSCT and bone marrow-sourced stem cells were independent risk factors. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  16. Risk of Clostridium difficile Infection in Patients With Celiac Disease: A Population-Based Study.

    Science.gov (United States)

    Lebwohl, Benjamin; Nobel, Yael R; Green, Peter H R; Blaser, Martin J; Ludvigsson, Jonas F

    2017-12-01

    Patients with celiac disease are at increased risk for infections such as tuberculosis, influenza, and pneumococcal pneumonia. However, little is known about the incidence of Clostridium difficile infection (CDI) in patients with celiac disease. We identified patients with celiac disease based on intestinal biopsies submitted to all pathology departments in Sweden over a 39-year period (from July 1969 through February 2008). We compared risk of CDI (based on stratified Cox proportional hazards models) among patients with celiac disease vs. without celiac disease (controls) matched by age, sex, and calendar period. We identified 28,339 patients with celiac disease and 141,588 controls; neither group had a history of CDI. The incidence of CDI was 56/100,000 person-years among patients with celiac disease and 26/100,000 person-years among controls, yielding an overall hazard ratio (HR) of 2.01 (95% confidence interval (CI), 1.64-2.47; Pceliac disease (HR, 5.20; 95% CI, 2.81-9.62; Pceliac disease and controls. In a large population-based cohort study, patients with celiac disease had significantly higher incidence of CDI than controls. This finding is consistent with prior findings of higher rates of other infections in patients with celiac disease, and suggests the possibility of altered gut immunity and/or microbial composition in patients with celiac disease.

  17. Induced abortion and breast cancer: results from a population-based case control study in China.

    Science.gov (United States)

    Wu, Jun-Qing; Li, Yu-Yan; Ren, Jing-Chao; Zhao, Rui; Zhou, Ying; Gao, Er-Sheng

    2014-01-01

    To determine whether induced abortion (IA) increases breast cancer (BC) risk. A population-based case-control study was performed from Dec, 2000 to November, 2004 in Shanghai, China, where IA could be verified through the family planning network and client medical records. Structured questionnaires were completed by 1,517 cases with primary invasive epithelial breast cancer and 1,573 controls frequency- matched to cases for age group. The information was supplemented and verified by the family planning records. Statistical analysis was conducted with SAS 9.0. After adjusting for potential confounders, induced abortions were not found to be associated with breast cancer with OR=0.94 (95%CI= 0.79-1.11). Compared to parous women without induced abortion, parous women with 3 or more times induced abortion (OR=0.66, 95%CI=0.46 to 0.95) and women with 3 or more times induced abortion after the first live birth (OR=0.66, 95%CI =0.45 to 0.97) showed a lower risk of breast cancer, after adjustment for age, level of education, annual income per capita, age at menarche, menopause, parity times, spontaneous abortion, age at first live birth, breast-feeding, oral contraceptives, hormones drug, breast disease, BMI, drinking alcohol, drinking tea, taking vitamin/calcium tablet, physical activity, vocation, history of breast cancer, eating the bean. The results suggest that a history of induced abortions may not increase the risk of breast cancer.

  18. Religious discrimination and common mental disorders in England: a nationally representative population-based study.

    Science.gov (United States)

    Jordanova, Vesna; Crawford, Mike J; McManus, Sally; Bebbington, Paul; Brugha, Traolach

    2015-11-01

    Although the impact of discrimination on mental health has been increasingly discussed, the effect of religious discrimination has not been examined systematically. We studied the prevalence of perceived religious discrimination and its association with common mental disorders in a nationally representative population-based sample in England. We used data from the Adult Psychiatric Morbidity Survey 2007 that represents all adults age 16 years and over living in private households in England. Common mental disorders were ascertained using the Revised Clinical Interview Schedule. Experience of discrimination was assessed by a computer-assisted self-report questionnaire and potential paranoid traits by the Psychosis Screening Questionnaire. From the total of 7318 participants, 3873 (52.4%) reported adhering to religion. 108 subjects (1.5%) reported being unfairly treated in the past 12 months due to their religion. Non-Christian religious groups were more likely to report perceived religious discrimination compared to Christians (OR 11.44; 95% CI 7.36-17.79). People who experienced religious discrimination had increased prevalence of all common mental disorders. There was a two-fold increase in the risk of common mental disorders among people who reported experience of religious discrimination independent of their ethnicity, skin colour or suspected paranoid traits. The impact of perceived religious discrimination on mental health should be given more consideration in treatment and future preventative policies.

  19. Mood disorders and biological rhythms in young adults: A large population-based study.

    Science.gov (United States)

    Mondin, Thaíse Campos; Cardoso, Taiane de Azevedo; Souza, Luciano Dias de Mattos; Jansen, Karen; da Silva Magalhães, Pedro Vieira; Kapczinski, Flávio; da Silva, Ricardo Azevedo

    2017-01-01

    It is known that sleep disturbance has been considered a trait-marker of mood disorders. However, the role of disruptions in biological rhythms, such as eating, activity, and social patterns, needs to be better understood. To assess the differences in biological rhythms in subjects with bipolar disorder, major depressive disorder, and healthy controls. We also tested the association between disruptions of biological rhythms and circadian preferences. A cross-sectional, population-based study with a representative sample of 1023 young adults. Bipolar disorder and depression were diagnosed using The Mini International Neuropsychiatric Interview - PLUS and DSM Structured Clinical Interview. Self-reported biological rhythms and circadian preference were assessed using the Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN). Bipolar disorders and depression subjects presented higher rates of disruption in biological rhythms when compared to healthy controls even after adjusting for sex, socioeconomic status, alcohol, tobacco, illicit drug use, anxiety disorder and psychotropic medication use. Euthymic subjects showed higher biological rhythm disruption when compared to controls. Higher disruption in biological rhythms was observed in subjects with evening preferences. Higher disruption in biological rhythms occurs in individuals with depression and bipolar disorder even on periods of euthymia. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Serum Gamma - Glutamyltransferase Is Associated with Albuminuria: A Population-Based Study

    Science.gov (United States)

    Lin, Diaozhu; Qi, Yiqin; Xu, Mingtong; Li, Na; Huang, Chulin; Ren, Meng; Li, Yan; Yan, Li

    2014-01-01

    Background Serum γ - glutamyltransferase (GGT) is implicated in the pathogenesis of endothelial dysfunction and atherosclerosis. Albuminuria is a marker of endothelial damage and correlated with structural and functional integrity of the vasculature. Our objective was to evaluate the association between serum GGT level and prevalence of albuminuria in a Chinese population. Materials and Methods We conducted a population-based cross-sectional study in 9,702 subjects aged 40 years or older. Increased urinary albumin excretion was defined according to the urinary albumin-to-creatinine ratio (ACR) ranges greater or equal than 30 mg/g. Low-grade albuminuria was defined according to the highest quartile of ACR in participants without increased urinary albumin excretion. Results The prevalence of low-grade albuminuria and increased urinary albumin excretion were respectively 23.4% and 6.6% in this population and gradually increased across the sex-specific serum GGT quartiles (all P for trend albuminuria and 1.55 (95% CI, 1.18–2.04) for increased urinary albumin excretion. In subgroup analysis, significant relationship of serum GGT level with both low-grade albuminuria and increased urinary albumin excretion were detected in women, younger subjects, overweight subjects and in those with hypertension or glomerular filtration rate greater than 90 (all P <0.05). Conclusion Serum GGT level is associated with urinary albumin excretion in middle-aged and elderly Chinese. PMID:25500578

  1. Why are babies weaned early? Data from a prospective population based cohort study.

    Science.gov (United States)

    Wright, C M; Parkinson, K N; Drewett, R F

    2004-09-01

    The recommended age of introduction of solids food to the diet of infants (weaning) has recently been increased in the UK to 6 months, but most babies are still weaned before the age of 4 months. To examine what predicts the age of weaning and how this relates to weight gain and morbidity using data from a population based cohort. Parents of 923 term infants born in a defined geographical area and recruited shortly after birth were studied prospectively using postal questionnaires, weaning diaries, and routinely collected weights, of whom 707 (77%) returned data on weaning. The median age of first weaning solids was 3.5 months, with 21% commencing before 3 months and only 6% after 4 months of age. Infants progressed quickly to regular solids with few reported difficulties, even when weaned early. Most parents did not perceive professional advice or written materials to be a major influence. The strongest independent predictors of earlier age at weaning were rapid weight gain to age 6 weeks, lower socioeconomic status, the parents' perception that their baby was hungry, and feeding mode. Weight gain after 6 weeks was unrelated to age of weaning. Babies weaned before 3 months, compared to after 4 months, had an increased risk of diarrhoea. Social factors had some influence on when weaning solids were introduced, but the great majority of all infants were established on solids before the previously recommended age of 4 months, without difficulty. Earlier weaning was associated with an increased rate of minor morbidity.

  2. Risk and risk perception of knee osteoarthritis in the US: a population-based study.

    Science.gov (United States)

    Michl, G L; Katz, J N; Losina, E

    2016-04-01

    We sought to investigate risk perception among an online cohort of younger US adults compared with calculated risk estimates. We recruited a population-based cohort 25-44 years of age with no history of knee osteoarthritis (OA) using Amazon's Mechanical Turk, an online marketplace used extensively for behavioral research. After collecting demographic and risk factor information, we asked participants to estimate their 10-year and lifetime risk of knee OA. We compared perceived risk with risk derived from the OA risk calculator (OA Risk C), an online tool built on the basis of the validated OA Policy Model. 375 people completed the study. 21% reported having 3+ risk factors for OA, 25% reported two risk factors, and 32% reported one risk factor. Using the OA Risk C, we calculated a mean lifetime OA risk of 25% and 10-year risk of 4% for this sample. Participants overestimated their lifetime and 10-year OA risk at 48% and 26%, respectively. We found that obesity, female sex, family history of OA, history of knee injury, and occupational exposure were all significantly associated with greater perceived lifetime risk of OA. Risk factors are prevalent in this relatively young cohort. Participants consistently overestimated their lifetime risk and showed even greater overestimation of their 10-year risk, suggesting a lack of knowledge about the timing of OA onset. These data offer insights for awareness and risk interventions among younger persons at risk for knee OA. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  3. Association between habitual daytime napping and metabolic syndrome: a population-based study.

    Science.gov (United States)

    Lin, Diaozhu; Sun, Kan; Li, Feng; Qi, Yiqin; Ren, Meng; Huang, Chulin; Tang, Juying; Xue, Shengneng; Li, Yan; Yan, Li

    2014-12-01

    Our objective was to evaluate the association between habitual daytime napping and the prevalence of metabolic syndrome. We conducted a population-based study of 8,547 subjects aged 40 years or older. Metabolic syndrome was defined according to a harmonized definition from a joint statement and the recommended thresholds for the Chinese population. Information about sleep duration was self-reported. The prevalence of metabolic syndrome in the no daytime napping group, the 0 to 1 hour daytime napping group and the more than 1 hour daytime napping group were 35.0%, 36.0% and 44.5% among the females (Pnapping hours were positively associated with parameters of metabolic syndrome in the female subjects, including waist circumference, systolic blood pressure, triglycerides and fasting plasma glucose (Pnapping females, napping for more than 1 hour was independently associated with an increased prevalence of metabolic syndrome (odds ratio 1.39, 95% confidence interval, 1.13-1.72). Compared to the female subjects in the no daytime napping group, those habitually napped for more than 1 hour exhibited 46% and 26% increases in the prevalence of central obesity and hypertriglyceridemia (all Pnapping hours and metabolic syndrome among the male subjects. Daytime napping is associated with an increased prevalence of metabolic syndrome in middle-aged non-obese Chinese women. Copyright © 2014. Published by Elsevier Inc.

  4. Dizziness and the Acute Vestibular Syndrome at the Emergency Department: A Population-Based Descriptive Study.

    Science.gov (United States)

    Ljunggren, Micaela; Persson, Julia; Salzer, Jonatan

    2017-11-13

    Dizziness is a common occurrence witnessed at emergency departments (EDs). This study aims to describe the epidemiology and management of dizzy patients with and without an acute vestibular syndrome (AVS) in the ED at Umeå University Hospital. A total of n = 2,126 ED dizziness visits during 3 years were identified. Data were obtained through retrospective review of medical records. Cases were stratified based on presentation, including AVS and neurological deficits. The outcomes analyzed included cerebrovascular causes of dizziness. A Poisson distribution was assumed when calculating incidence CIs. Dizziness accounted for 2.1% of all ED visits, incidence 477/100,000 inhabitants (95% CI 457-498). Among dizzy patients, 19.2% had an AVS, incidence 92/100,000 inhabitants (95% CI 74-113). Top medical diagnostic groups were otovestibular (15.1%), cardiovascular (8.7%) and neurological diseases (7.7%), including stroke and transitory ischemic attack (4.8%). Cerebrovascular causes of dizziness were more common among those with an AVS (10.0%) vs. those without (3.6%), p < 0.01. The risk for cerebrovascular causes of dizziness, although low in an unselected cohort, increases with the presence of neurological signs and an AVS. These population-based data may be useful when planning and implementing dizziness and AVS management algorithms at EDs. © 2017 S. Karger AG, Basel.

  5. Bacterial meningitis in solid organ transplant recipients: a population-based prospective study.

    Science.gov (United States)

    van Veen, K E B; Brouwer, M C; van der Ende, A; van de Beek, D

    2016-10-01

    Solid organ transplant (SOT) recipients are at risk of infections of the central nervous system. However, the incidence and clinical course of bacterial meningitis in SOT recipients are unclear. We studied occurrence, disease course, and prognosis of bacterial meningitis in SOT recipients in the Netherlands. All patients with a medical history of solid organ transplantation were selected from our nationwide prospective cohort study on community-acquired bacterial meningitis in patients >16 years old, performed from March 1, 2006 to October 31, 2014. Data on patient history, symptoms and signs on admission, treatment, and outcome were collected prospectively. For transplant recipients, additional information was collected retrospectively. We identified 6 SOT recipients, all receiving renal transplants. The annual incidence of bacterial meningitis was 7-fold higher (95% confidence interval [CI] 2.94-17.02, P bacterial meningitis (fever, neck stiffness, and change in mental status). Seizures were common, occurring in 33% of patients. Streptococcus pneumoniae and Listeria monocytogenes were identified in 2 patients each, and Escherichia coli and Pseudomonas aeruginosa were both identified once. Four of 6 patients (67%) had an unfavorable functional outcome. Bacterial meningitis is a rare but devastating complication of solid organ transplantation. SOT recipients are at high risk for developing meningitis, and recognition of this condition may be difficult, owing to atypical clinical manifestation. © 2016 The Authors. Transplant Infectious Disease Published by John Wiley & Sons Ltd.

  6. Functional disability for mobility in adults: a population-based study

    Directory of Open Access Journals (Sweden)

    Cristhiane Yumi Yonamine

    Full Text Available Abstract Introduction: Functional disability is an important health indicator associated with worse quality of life. Objective: To estimate the prevalence of functional disability for mobility and to identify factors associated with difficulty going up and down stairs in adults aged 40 years or over. Methods: Cross-sectional, population-based study, with residents of the Municipality of Cambé, PR, interviewed in 2011. The dependent variable was the difficulty of going up and down stairs. Analysis of associated factors was performed using Poisson regression for each subgroup (40 - 59 years and 60 years or older. Results: In total, 24% of the subjects presented some kind of difficulty going up stairs (p < .01. In both subgroups, a significantly higher prevalence in women, among those inactive during leisure time and those with a history of cerebrovascular disease was observed. In the subgroup aged 40 to 59 years, age 50 - 59 years, hypertension, diabetes and falls in the previous 12 months were also associated with the outcome. Conclusion: The results suggest the need to expand the actions of health promotion, prevention and control of chronic conditions, especially among middle-aged people.

  7. Does obesity increase the risk of hot flashes among midlife women?: a population-based study.

    Science.gov (United States)

    Saccomani, Sylvio; Lui-Filho, Jeffrey Frederico; Juliato, Cassia Raquel; Gabiatti, Jose Roberto; Pedro, Adriana Orcesi; Costa-Paiva, Lucia

    2017-09-01

    To evaluate the association between vasomotor symptoms and obesity in climacteric women. We conducted a cross-sectional population-based study of 749 women aged 45 to 60 years. The dependent variable was intensity of menopausal symptoms evaluated by the menopause rating scale questionnaire. Independent variables were sociodemographic and clinical characteristics, and obesity evaluated by body mass index. There was no significant difference in the majority of clinical and sociodemographic characteristics between the body mass index groups. Obese women had less physical activity (P = 0.019) and a higher prevalence of hypertension (P hot flashes increased progressively and were higher for participants with body mass index greater than 30 kg/m (P = 0.027). Joint and muscle pain scores also increased with increased body mass index (P women (body mass index >30 kg/m) (P hot flash scores were higher body mass index, presence of urinary urgency, and vaginal dryness. We found that menopausal symptoms, including vasomotor, joint, and urinary symptoms, were related to obesity. Hot flashes were associated with higher body mass index, urinary urgency, and vaginal dryness. Understanding this relationship may contribute to the development of healthcare strategies aimed at minimizing the impact of obesity on several health issues of climacteric women.

  8. Pneumoconiosis increases the risk of peripheral arterial disease: a nationwide population-based study.

    Science.gov (United States)

    Shen, Chih-Hao; Lin, Te-Yu; Huang, Wen-Yen; Chen, Hsuan-Ju; Kao, Chia-Hung

    2015-05-01

    This nationwide population-based retrospective cohort study was used to evaluate the association between pneumoconiosis and peripheral arterial disease (PAD). We identified 3374 patients with pneumoconiosis from the catastrophic illness registry who were newly diagnosed from 2000 to 2005; 13,496 patients without pneumoconiosis from Longitudinal Health Insurance Database 2000 (LHID2000) were randomly frequency matched according to sex, age, and index year and used as a nonpneumoconiosis group. Multivariate Cox proportional hazards regression was used to calculate adjusted hazard ratios (HRs) of PAD in the pneumoconiosis group compared with the nonpneumoconiosis group. The mean follow-up years were 7.44 years in the pneumoconiosis group and 8.17 years in the nonpneumoconiosis group. The incidence density rate of PAD was 1.25 times greater in the pneumoconiosis group than in the nonpneumoconiosis group (8.37 vs 6.70 per 1000 person-years). After adjusting for sex, age, and comorbidities, the adjusted HRs of PAD for the pneumoconiosis group were 1.30 (95% CI = 1.08-1.57), compared with the nonpneumoconiosis group. The combined impacts of patients with pneumoconiosis and diabetes, hyperlipidemia, hypertension, ischemic heart disease, chronic obstructive pulmonary disease, and asthma showed a significant by joint association with PAD risk compared with patients with no pneumoconiosis and no counterpart comorbidity. Patients with pneumoconiosis have an independently higher risk of developing PAD. Physicians should include pneumoconiosis in evaluating PAD risk.

  9. Education level and survival after oesophageal cancer surgery: a prospective population-based cohort study.

    Science.gov (United States)

    Brusselaers, Nele; Ljung, Rickard; Mattsson, Fredrik; Johar, Asif; Wikman, Anna; Lagergren, Pernilla; Lagergren, Jesper

    2013-12-03

    This study aimed to investigate whether a higher education level is associated with an improved long-term survival after oesophagectomy for cancer. A prospective, population-based cohort study. Sweden-nationwide. 90% of all patients with oesophageal and cardia cancer who underwent a resection in Sweden in 2001-2005 were enrolled in this study (N=600; 80.3% male) and followed up until death or the end of the study period (2012). The study exposure was level of education, defined as compulsory (≤9 years), moderate (10-12 years) or high (≥13 years). The main outcome measure was overall 5-year survival after oesophagectomy. Cox regression was used to estimate the associations between education level and mortality, expressed as HRs with 95% CIs, with adjustment for sex, age, tumour stage, histological type, complications, comorbidities and annual surgeon volume. The patient group with highest education was used as the reference category. Among the 600 included patients, 281 (46.8%) had compulsory education, 238 (39.7%) had moderate education and 81 (13.5%) had high education. The overall 5-year survival rate was 23.1%, 24.4% and 32.1% among patients with compulsory, moderate and high education, respectively. After adjustment for confounders, a slightly higher, yet not statistically significantly increased point HR was found among the compulsory educated patients (HR 1.08, 95% CI 0.80 to 1.47). In patients with tumour stage IV, increased adjusted HRs were found for compulsory (HR 2.88, 95% CI 1.07 to 7.73) and moderately (HR 2.83, 95% CI 1.15 to 6.95) educated patients. No statistically significant associations were found for the other tumour stages. This study provides limited evidence of an association between lower education and worse long-term survival after oesophagectomy for cancer.

  10. The Prevalence and Causes of Primary Infertility in Iran: A Population-Based Study.

    Science.gov (United States)

    Kazemijaliseh, Hadigheh; Ramezani Tehrani, Fahimeh; Behboudi-Gandevani, Samira; Hosseinpanah, Farhad; Khalili, Davood; Azizi, Fereidoun

    2015-04-19

    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. 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 below one year were excluded from the study. Data was collected by using validated ad-hoc questionnaires. Descriptive and inferential statistics were used for data analysis. The mean (SD) of age and marriage age of the studied women were 40.3 (9.3) and 20.6 (4.49) years, respectively; the overall prevalence of lifetime primary infertility among couples was 17.3% (185/1067). Ovulatory disorder (39.7%) and male factors (29.1%) were the main causes of primary infertility. In addition, 31 (17%) of the women were diagnosed with more than one cause. According to the logistic regression analysis, primary infertility was independently related to the old age of women (OR: 1.37; 95% CI: 1.14-13.63, P.value: 0.001), higher BMI (OR: 1.95; 95% CI: 1.87-4.14, P.value: 0.003), active smoking (OR: 1.47; 95% CI: 1.38-3.53, P.value: 0.012) and higher educational level (OR: 2.23; 95% CI: 1.12-5.53, P.value: 0.03). The prevalence of primary infertility in Iran was higher than the worldwide trends of infertility, indicating that understanding such risks help healthcare providers and policy makers to design and implement interventions to slow down this trend.

  11. Risk of anxiety and depressive disorders in patients with myocardial infarction: A nationwide population-based cohort study.

    Science.gov (United States)

    Feng, Hsin-Pei; Chien, Wu-Chien; Cheng, Wei-Tung; Chung, Chi-Hsiang; Cheng, Shu-Meng; Tzeng, Wen-Chii

    2016-08-01

    Anxiety and depressive symptoms are associated with adverse cardiovascular events after an acute myocardial infarction (MI). However, most studies focusing on anxiety or depression have used rating scales or self-report methods rather than clinical diagnosis. This study aimed to investigate the association between psychiatrist-diagnosed psychiatric disorders and cardiovascular prognosis.We sampled data from the National Health Insurance Research Database; 1396 patients with MI were recruited as the study cohort and 13,960 patients without MI were recruited as the comparison cohort. Cox proportional hazard regression models were used to examine the effect of MI on the risk of anxiety and depressive disorders.During the first 2 years of follow-up, patients with MI exhibited a significantly higher risk of anxiety disorders (adjusted hazard ratio [HR] = 5.06, 95% confidence interval [CI]: 4.61-5.54) and depressive disorders (adjusted HR = 7.23, 95% CI: 4.88-10.88) than those without MI did. Greater risk for anxiety and depressive disorders was observed among women and patients aged 45 to 64 years following an acute MI. Patients with post-MI anxiety had a 9.37-fold (95% CI: 4.45-19.70) higher risk of recurrent MI than those without MI did after adjustment for age, sex, socioeconomic status, and comorbidities.This nationwide population-based cohort study provides evidence that MI increases the risk of anxiety and depressive disorders during the first 2 years post-MI, and post-MI anxiety disorders are associated with a higher risk of recurrent MI.

  12. Carbon monoxide poisoning and subsequent cardiovascular disease risk: a nationwide population-based cohort study.

    Science.gov (United States)

    Lee, Feng-You; Chen, Wei-Kung; Lin, Cheng-Li; Kao, Chia-Hung

    2015-03-01

    Carbon monoxide (CO) poisoning is considered one of the most crucial health concerns. Few studies have investigated the correlation between CO poisoning and the risk of developing cardiovascular diseases (CVDs). Therefore, we conducted a population-based, longitudinal cohort study in Taiwan to determine whether patients with CO poisoning are associated with higher risk of developing subsequent CVDs, including arrhythmia, coronary artery disease (CAD) and congestive heart failure (CHF). This retrospective study used the National Health Insurance Research Database. The study cohort comprised all patients aged ≥20 years with a diagnosis of CO poisoning and hospitalized during 2000 to 2011 (N = 8381), and the comparison cohort comprised randomly selected non-CO-poisoned patients (N = 33,524) frequency-matched with the study cohort by age, sex, and the year of index date. Each patient was individually tracked to identify those who develop CVD events during the follow-up period. Cox proportional hazards regression model was performed to calculate the hazard ratios of CVDs after adjusting for possible confounders. The overall incidences of arrhythmia, CAD, and CHF were higher in the patients with CO poisoning than in the controls (2.57 vs 1.25/1000 person-years, 3.28 vs 2.25/1000 person-years, and 1.32 vs 1.05/1000 person-years, respectively). After adjusting for age, sex, and comorbidities, the patients with CO poisoning were associated with a 1.83-fold higher risk of arrhythmia compared with the comparison cohort, and nonsignificantly associated with risk of CAD and CHF. CO-poisoned patients with coexisting comorbidity or in high severity were associated with significantly and substantially increased risk of all 3 CVDs. CO poisoning is associated with increased risk of subsequent development of arrhythmia. Future studies are required to explore the long-term effects of CO poisoning on the cardiovascular system.

  13. Fibromyalgia and Risk of Dementia-A Nationwide, Population-Based, Cohort Study.

    Science.gov (United States)

    Tzeng, Nian-Sheng; Chung, Chi-Hsiang; Liu, Feng-Cheng; Chiu, Yu-Hsiang; Chang, Hsin-An; Yeh, Chin-Bin; Huang, San-Yuan; Lu, Ru-Band; Yeh, Hui-Wen; Kao, Yu-Chen; Chiang, Wei-Shan; Tsao, Chang-Hui; Wu, Yung-Fu; Chou, Yu-Ching; Lin, Fu-Huang; Chien, Wu-Chien

    2018-02-01

    Fibromyalgia is a syndrome of chronic pain and other symptoms and is associated with patient discomfort and other diseases. This nationwide matched-cohort population-based study aimed to investigate the association between fibromyalgia and the risk of developing dementia, and to clarify the association between fibromyalgia and dementia. A total of 41,612 patients of age ≥50 years with newly diagnosed fibromyalgia between January 1, and December 31, 2000 were selected from the National Health Insurance Research Database of Taiwan, along with 124,836 controls matched for sex and age. After adjusting for any confounding factors, Fine and Gray competing risk analysis was used to compare the risk of developing dementia during the 10 years of follow-up. Of the study subjects, 1,704 from 41,612 fibromyalgia patients (21.23 per 1,000 person-years) developed dementia when compared to 4,419 from 124,836 controls (18.94 per 1,000 person-years). Fine and Gray competing risk analysis revealed that the study subjects were more likely to develop dementia (hazard ratio: 2.29, 95% CI: 2.16-2.42; P Fibromyalgia was associated with increased risk of all types of dementia in this study. The study subjects with fibromyalgia had a 2.77-fold risk of dementia in comparison to the control group. Therefore, further studies are needed to elucidate the underlying mechanisms of the association between fibromyalgia and the risk of dementia. Copyright © 2018 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  14. Clinical Characteristics and Outcome of Hepatic Sarcoidosis: A Population-Based Study 1976-2013.

    Science.gov (United States)

    Ungprasert, Patompong; Crowson, Cynthia S; Simonetto, Douglas A; Matteson, Eric L

    2017-10-01

    Data on clinical manifestations and outcome of hepatic sarcoidosis are scarce. This study aimed to use a population-based cohort of patients with incident sarcoidosis to better describe the characteristics of hepatic sarcoidosis. A cohort of incident cases of sarcoidosis in Olmsted County, MN, USA, from 1976 to 2013 was identified from the database. Diagnosis was verified by individual medical record review. Confirmed cases of sarcoidosis were then reviewed for liver involvement. Data on clinical manifestations, imaging study, liver biochemical tests, treatment, and outcome were collected. Cumulative incidence of cirrhosis adjusted for the competing risk of death was estimated. A total of 345 cases of incident sarcoidosis were identified. Of these, 19 cases (6%) had liver involvement (mean age 46.1 years, 53% female and 79% Caucasian). Most patients had asymptomatic liver disease and were discovered in pursuit of abnormal biochemical tests and imaging studies. Alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) were elevated in the majority of patients (88 and 90%, respectively). Elevated transaminases were less common and less severe. About half of patients had abnormal imaging study with hypodense nodular lesions being the most common abnormality (six patients) followed by hepatomegaly (three patients). Liver biopsy revealed non-caseating granuloma in 88% (14 of 16 patients). A total of four patients developed cirrhosis. Involvement of the liver by sarcoidosis was seen in 6% of patients with sarcoidosis. The majority of patients were asymptomatic. Elevated ALP and GGT were the most common abnormal biochemical tests. Liver biopsy revealed non-caseating granuloma in almost all cases. Cirrhosis was seen in a significant number of patients. Generalizability of the observations to other populations may be limited, as the studied population was predominantly Caucasian. The prevalence of liver disease may be higher in more diverse populations.

  15. Family history and stroke outcome in a bi-ethnic, population-based stroke surveillance study

    Directory of Open Access Journals (Sweden)

    Uchino Ken

    2005-10-01

    Full Text Available Background The genetic epidemiology of ischemic stroke remains relatively unstudied, and information about the genetic epidemiology of ischemic stroke in populations with significant minority representation is currently unavailable. Methods The Brain Attack Surveillance in Corpus Christi project (BASIC is a population-based stroke surveillance study conducted in the bi-ethnic community of Nueces County, Texas, USA. Completed ischemic strokes were identified among patients 45 years or older seen at hospitals in the county between January 1, 2000 – December 31, 2002. A random sample of ischemic stroke patients underwent an in-person interview and detailed medical record abstraction (n = 400. Outcomes, including initial stroke severity (NIH stroke scale, age at stroke onset, 90-day mortality and functional outcome (modified Rankin scale ≥2, were studied for their association with family history of stroke among a first degree relative using multivariable logistic and linear regression. A chi-square test was used to test the association between family history of stroke and ischemic stroke subtype. Results The study population was 53.0% Mexican American and 58.4% female. Median age was 73.2 years. Forty percent reported a family history of stroke among a first degree relative. Family history of stroke was borderline significantly associated with stroke subtype (p = 0.0563. Family history was associated with poor functional outcome in the multivariable model (OR = 1.87; 95% CI: 1.14–3.09. Family history was not significantly related to initial stroke severity, age at stroke onset, or 90-day mortality. Conclusion Family history of stroke was related to ischemic stroke subtype and to functional status at discharge. More research is needed to understand whether stroke subtype would be a useful selection criterion for genetic association studies and to hypothesize about a possible genetic link to recovery following ischemic stroke.

  16. Cortical thickness and inattention/hyperactivity symptoms in young children: a population-based study.

    Science.gov (United States)

    Mous, S E; Muetzel, R L; El Marroun, H; Polderman, T J C; van der Lugt, A; Jaddoe, V W; Hofman, A; Verhulst, F C; Tiemeier, H; Posthuma, D; White, T

    2014-11-01

    While many neuroimaging studies have investigated the neurobiological basis of attention deficit hyperactivity disorder (ADHD), few have studied the neurobiology of attention problems in the general population. The ability to pay attention falls along a continuum within the population, with children with ADHD at one extreme of the spectrum and, therefore, a dimensional perspective of evaluating attention problems has an added value to the existing literature. Our goal was to investigate the relationship between cortical thickness and inattention and hyperactivity symptoms in a large population of young children. This study is embedded within the Generation R Study and includes 6- to 8-year-old children (n = 444) with parent-reported attention and hyperactivity measures and high-resolution structural imaging data. We investigated the relationship between cortical thickness across the entire brain and the Child Behavior Checklist Attention Deficit Hyperactivity Problems score. We found that greater attention problems and hyperactivity were associated with a thinner right and left postcentral gyrus. When correcting for potential confounding factors and multiple testing, these associations remained significant. In a large, population-based sample we showed that young (6- to 8-year-old) children who show more attention problems and hyperactivity have a thinner cortex in the region of the right and left postcentral gyrus. The postcentral gyrus, being the primary somatosensory cortex, reaches its peak growth early in development. Therefore, the thinner cortex in this region may reflect either a deviation in cortical maturation or a failure to reach the same peak cortical thickness compared with children without attention or hyperactivity problems.

  17. Increasing Incidence Rate of Cervical Cerclage in Pregnancy in Australia: A Population-Based Study.

    Science.gov (United States)

    Lu, Corrine; Lim, Boon; Robson, Stephen J

    2016-09-12

    Data published from the United States have demonstrated that the use of cervical cerclage has fallen in the period 1998-2013. This is in contrast to recommendations in Australia. We examined this trend using data from the Australian Institute of Health and Welfare (AIHW). Retrospective population-based study. Data from the Australian Institute of Health and Welfare procedural database were used to determine the total number of cervical cerclage sutures inserted during the period 2004 to 2013. Population datasets were used to calculate age-stratified incidence rates of cerclage. There was a significant increase in the rate of cervical cerclage in women aged 25 to 34 years and in the 35 years and older age group. The incidence of preterm birth was stable for gestations of 32 to 36 weeks, but slightly increased in the 20 to 27 week and 28 to 31 week gestational age groups. Further research into cervical cerclage and the use of vaginal progesterone for the prevention of preterm birth would be valuable.

  18. Intelligence in children with hydrocephalus, aged 4-15 years: a population-based, controlled study.

    Science.gov (United States)

    Dalen, K; Bruarøy, S; Wentzel-Larsen, T; Laegreid, L M

    2008-06-01

    The aim of this population-based study is to investigate IQ and IQ-related factors in children with hydrocephalus (HC). Psychometric intelligence was assessed in subjects below the age of 7.3 years (N=52, F=18, M=34) with the Wechsler Preschool and Primary Scale of Intelligence - Revised (WPPSI-R) and for children above the age of 7.3 years (N=29, F=6, M=23) with the Wechsler Intelligence Scale for Children - Revised (WISC-R). The controls were matched according to age, gender, and geographic variables. All children were living in western Norway. 57 children had infantile HC (IH) and 24 had childhood HC (CH). Children with myelomeningocele (MMC), traumatic brain injury (TBI), or intracranial tumours were excluded. IQ levels were found to be significantly higher in the control group than in the HC groups. The Kaufman factors showed a similar pattern, with lowest values in IH, and CH intermediate between IH and NC. The results demonstrate that HC affects IQ. More specific cognitive profiles, such as non-verbal learning disabilities, are not detectable when using the Wechsler tests. For this purpose, other tests and models for analyses may be recommended.

  19. [Adolescent health: a population-based study in Campinas, São Paulo State, Brazil].

    Science.gov (United States)

    Braz, Marici; Barros Filho, Antonio A; Barros, Marilisa B A

    2013-09-01

    We estimated the prevalence of chronic diseases and other health problems reported by adolescents in relation to social and demographic variables and nutritional status. This cross-sectional population-based survey analyzed data from the Health Survey in Campinas, São Paulo State, Brazil, 2008. We used descriptive statistics and associations between variables with the chisquare test. Prevalence of chronic diseases among adolescents was 19.17%, with asthma showing the highest prevalence (7.59%), followed by heart disease (1.96%), hypertension (1.07%), and diabetes 0.21%. Prevalence rates were 61.53% for health problems, 40.39% for allergy, and 24.83% for frequent headache or migraine. After multivariate analysis using Poisson regression, the factors associated with chronic disease were age 15 to 19 years (PR = 1.38), not attending school (PR = 1.46), having children (PR = 1.84), and obesity (PR = 1.54). Female gender (PR = 1.12) was statistically associated with health problems. The study illustrates that adolescence is a life stage in which chronic disease and health problems can occur.

  20. Association of mitochondrial DNA haplogroups and vascular complications of diabetes mellitus: A population-based study.

    Science.gov (United States)

    Martikainen, Mika H; Rönnemaa, Tapani; Majamaa, Kari

    2015-07-01

    We investigated whether mitochondrial (mtDNA) haplogroups and maternal family history of diabetes mellitus were associated with vascular diabetes mellitus complications in a population-based cohort of 299 Finnish diabetes mellitus patients with disease onset in young adult age. We found that haplogroup U was more prevalent among patients with no vascular diabetes mellitus complications than among those with at least one complication (p = 0.038). Haplogroup U was also more prevalent among the patients who reported maternal family history of diabetes mellitus than among those who did not (p = 0.0013). Furthermore, haplogroup U was more prevalent among patients with maternal family history of diabetes mellitus but no vascular diabetes mellitus complications than among those with at least one vascular diabetes mellitus complication but no maternal family history of diabetes mellitus (p = 0.0003 for difference). These findings suggest that different mtDNA-related factors may influence the risk of diabetes mellitus per se and the risk of vascular diabetes mellitus complications. Further studies are, however, warranted to replicate and elaborate on these results. © The Author(s) 2015.

  1. Drownings in Minnesota, 1980-85: a population-based study.

    Science.gov (United States)

    Hedberg, K; Gunderson, P D; Vargas, C; Osterholm, M T; MacDonald, K L

    1990-09-01

    We conducted a population-based study of drownings in Minnesota from 1980 through 1985. Five hundred and forty-one drownings (2.1 per 100,000 person-years) were identified from death certificates and from incident reports filed with the Minnesota Department of Natural Resources. Most drownings (334, 62 percent) occurred during summer months (May-August) and involved boating (42 percent) and swimming (35 percent) events. However, 62 drownings (11 percent) occurred during winter months (December-February) and primarily involved snowmobiles and motor vehicles (71 percent) breaking through ice on lakes and waterways. The risk of drowning, estimated by the ratio of drownings to number of water-related activities, was highest during March and April, when the ice on lakes and waterway surfaces is melting, and during October and November, when lake and waterway surfaces are starting to freeze. Drowning rates were highest for males (3.7 per 100,000 person-years), persons 15 to 25 years of age (3.3 per 100,000 person-years), and children less than 5 years of age (2.5 per 100,000 person-years). These data can be used to target prevention strategies, particularly in northern climates.

  2. Evaluation of a Hockey Deceased Organ Donation Awareness Campaign: A Population-Based Cohort Study

    Science.gov (United States)

    Naylor, Kyla L.; McKenzie, Susan; Cherry, Cindy; McArthur, Eric; Li, Alvin H.; McCallum, Megan K.; Kim, S. Joseph; Prakash, Versha; Knoll, Gregory A.; Garg, Amit X.

    2017-01-01

    Background: The Kidney Foundation of Canada developed a pilot campaign to educate persons attending junior hockey league games in London, Ontario, Canada, on deceased organ donation. Objective: To evaluate the impact of a hockey campaign on the number of new organ and tissue donor registrants. Design: Population-based retrospective cohort study. Setting: Residents of London, Ontario. Patients: We included 255 476 individuals eligible to register for organ donation with a London, Ontario postal code. Measurements: We compared the number of new deceased organ donor registrants in London, Ontario, during the campaign period (March 12 to April 16, 2015) with 3 different time periods (December 30, 2014 to February 3, 2015; February 4 to March 11, 2015; April 17 to May 22, 2015). We also compared registration rates in London with 2 Ontario cities (Kitchener-Waterloo and Hamilton) matching in a 1:1 ratio on age, sex, and income quintile. Methods: To compare registrations across time periods, we used binomial regression with an identity link function and generalized estimating equations with an independence correlation structure. We used modified Poisson regression to compare registration rates between cities. Results: During the campaign period, there were slightly more registrations (1218 registered of 252 832 unregistered individuals [0.48%]) compared with an earlier time period (risk difference: 0.09%; 95% confidence interval [CI]: 0.05%-0.12%). However, there was no significant difference compared with 2 time periods immediately before and after the campaign. London had slightly more registrations during the campaign period compared with the matched city of Hamilton (1180 registered of 236 582 unregistered individuals [0.50%] vs 490 registered of 236 582 unregistered individuals [0.21%]; risk ratio: 2.41; 95% CI: 2.17-2.68). The registration rate in London did not significantly differ from Kitchener-Waterloo. Limitations: Unable to conclude whether the minor increase

  3. Evaluation of a Hockey Deceased Organ Donation Awareness Campaign: A Population-Based Cohort Study.

    Science.gov (United States)

    Naylor, Kyla L; McKenzie, Susan; Cherry, Cindy; McArthur, Eric; Li, Alvin H; McCallum, Megan K; Kim, S Joseph; Prakash, Versha; Knoll, Gregory A; Garg, Amit X

    2017-01-01

    The Kidney Foundation of Canada developed a pilot campaign to educate persons attending junior hockey league games in London, Ontario, Canada, on deceased organ donation. To evaluate the impact of a hockey campaign on the number of new organ and tissue donor registrants. Population-based retrospective cohort study. Residents of London, Ontario. We included 255 476 individuals eligible to register for organ donation with a London, Ontario postal code. We compared the number of new deceased organ donor registrants in London, Ontario, during the campaign period (March 12 to April 16, 2015) with 3 different time periods (December 30, 2014 to February 3, 2015; February 4 to March 11, 2015; April 17 to May 22, 2015). We also compared registration rates in London with 2 Ontario cities (Kitchener-Waterloo and Hamilton) matching in a 1:1 ratio on age, sex, and income quintile. To compare registrations across time periods, we used binomial regression with an identity link function and generalized estimating equations with an independence correlation structure. We used modified Poisson regression to compare registration rates between cities. During the campaign period, there were slightly more registrations (1218 registered of 252 832 unregistered individuals [0.48%]) compared with an earlier time period (risk difference: 0.09%; 95% confidence interval [CI]: 0.05%-0.12%). However, there was no significant difference compared with 2 time periods immediately before and after the campaign. London had slightly more registrations during the campaign period compared with the matched city of Hamilton (1180 registered of 236 582 unregistered individuals [0.50%] vs 490 registered of 236 582 unregistered individuals [0.21%]; risk ratio: 2.41; 95% CI: 2.17-2.68). The registration rate in London did not significantly differ from Kitchener-Waterloo. Unable to conclude whether the minor increase in deceased organ donor registration was the result of the campaign or other factors (e

  4. Statin Safety in Chinese: A Population-Based Study of Older Adults.

    Science.gov (United States)

    Li, Daniel Q; Kim, Richard B; McArthur, Eric; Fleet, Jamie L; Hegele, Robert A; Shah, Baiju R; Weir, Matthew A; Molnar, Amber O; Dixon, Stephanie; Tu, Jack V; Anand, Sonia; Garg, Amit X

    2016-01-01

    Compared to Caucasians, Chinese achieve a higher blood concentration of statin for a given dose. It remains unknown whether this translates to increased risk of serious statin-associated adverse events amongst Chinese patients. We conducted a population-based retrospective cohort study of older adults (mean age, 74 years) newly prescribed a statin in Ontario, Canada between 2002 and 2013, where 19,033 Chinese (assessed through a validated surname algorithm) were matched (1:3) by propensity score to 57,099 non-Chinese. This study used linked healthcare databases. The follow-up observation period (mean 1.1, maximum 10.8 years) was similar between groups, as were the reasons for censoring the observation period (end of follow-up, death, or statin discontinuation). Forty-seven percent (47%) of Chinese were initiated on a higher than recommended statin dose. Compared to non-Chinese, Chinese ethnicity did not associate with any of the four serious statin-associated adverse events assessed in this study [rhabdomyolysis hazard ratio (HR) 0.61 (95% CI 0.28 to 1.34), incident diabetes HR 1.02 (95% CI 0.80 to 1.30), acute kidney injury HR 0.90 (95% CI 0.72 to 1.13), or all-cause mortality HR 0.88 (95% CI 0.74 to 1.05)]. Similar results were observed in subgroups defined by statin type and dose. We observed no higher risk of serious statin toxicity in Chinese than matched non-Chinese older adults with similar indicators of baseline health. Regulatory agencies should review available data, including findings from our study, to decide if a change in their statin dosing recommendations for people of Chinese ethnicity is warranted.

  5. 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.

  6. Incidence of, phenotypes of and survival from small bowel cancer in Denmark, 1994-2010: a population-based study.

    Science.gov (United States)

    Bojesen, Rasmus Dahlin; Andersson, Mikael; Riis, Lene Buhl; Nielsen, Ole Haagen; Jess, Tine

    2016-09-01

    Small bowel cancer (SBC) is a rare and highly heterogeneous disease in respect to both anatomical distribution and histological morphology. We aimed to conduct a Danish nationwide population-based cohort study of the incidence of, phenotypes of, stage of, synchronous/metachronous cancer occurrence of and survival from SBC during 1994-2010. The study population included all individuals aged 16 years or older living in Denmark during 1994-2010 (n = 7,070,142). Patients with SBC were identified through the Danish Cancer Registry. Incidence rates were calculated overall and according to the anatomical origin and morphological subtype. Patients were followed up from the date of cancer diagnosis to the date of emigration, death or the end of the study (31 December 2010). SBC was diagnosed in 1088 patients during 1994-2010. The total annual incidence of SBC was 1.10 per 100,000 [95 % confidence interval (CI) 1.04 to 1.17 per 100,000], with an annual percentage change of 1.9 % (95 % CI 0.6-3.1 %, p = 0.003) during the observation period. This increase was mainly explained by an increase in the occurrence of duodenal adenocarcinomas, with an annual percentage change of 7.5 % (95 % CI 4.9-10.2 %, p cancer at the time of diagnosis and 32 % had one or more synchronous/metachronous cancers. All morphological subtypes were associated with poor 5-year prognoses, in particular duodenal adenocarcinomas, with a 5-year survival rate of only 16 % (95 % CI 12-22 %). The incidence of SBC has increased in recent decades, mainly because of a large increase in the incidence of duodenal adenocarcinomas, which are also associated with the poorest prognosis.

  7. Sleep and use of electronic devices in adolescence: results from a large population-based study.

    Science.gov (United States)

    Hysing, Mari; Pallesen, Ståle; Stormark, Kjell Morten; Jakobsen, Reidar; Lundervold, Astri J; Sivertsen, Børge

    2015-02-02

    Adolescents spend increasingly more time on electronic devices, and sleep deficiency rising in adolescents constitutes a major public health concern. The aim of the present study was to investigate daytime screen use and use of electronic devices before bedtime in relation to sleep. A large cross-sectional population-based survey study from 2012, the youth@hordaland study, in Hordaland County in Norway. Cross-sectional general community-based study. 9846 adolescents from three age cohorts aged 16-19. The main independent variables were type and frequency of electronic devices at bedtime and hours of screen-time during leisure time. Sleep variables calculated based on self-report including bedtime, rise time, time in bed, sleep duration, sleep onset latency and wake after sleep onset. Adolescents spent a large amount of time during the day and at bedtime using electronic devices. Daytime and bedtime use of electronic devices were both related to sleep measures, with an increased risk of short sleep duration, long sleep onset latency and increased sleep deficiency. A dose-response relationship emerged between sleep duration and use of electronic devices, exemplified by the association between PC use and risk of less than 5 h of sleep (OR=2.70, 95% CI 2.14 to 3.39), and comparable lower odds for 7-8 h of sleep (OR=1.64, 95% CI 1.38 to 1.96). Use of electronic devices is frequent in adolescence, during the day as well as at bedtime. The results demonstrate a negative relation between use of technology and sleep, suggesting that recommendations on healthy media use could include restrictions on electronic devices. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Association between schizophrenia and urinary calculi: a population-based case-control study.

    Directory of Open Access Journals (Sweden)

    Shih-Ping Liu

    Full Text Available BACKGROUND: People with schizophrenia have been demonstrated to have higher overall morbidity and all-cause mortality rates from general medical conditions. However, little attention has been given to the urinary system of people with schizophrenia. As no direct evidence has been reported demonstrating a link between schizophrenia and urinary calculi, this study utilized a population-based case-control study design to investigate the possibility of an association between schizophrenia and the occurrence of urinary calculi. METHOD: This study used data from the Taiwan Longitudinal Health Insurance Database. Cases consisted of 53,965 urinary calculi patients newly diagnosed between 2002 and 2008. In total, 269,825 controls were randomly selected and matched with the cases in terms of age and sex. Each person was traced to discern whether he had previously received a diagnosis of schizophrenia. Conditional logistic regression models were performed for the analysis. RESULTS: A total of 3,119 (1.0% subjects had been diagnosed with schizophrenia prior to the index date. This included 0.7% of the patients with urinary calculi, and 1.0% of the controls. A prior diagnosis of schizophrenia was independently associated with a 30% decrease (95% CI = 0.62-0.76 in the occurrence of urinary calculi. The reduction was even more remarkable in males (38%, 95% CI = 0.55-0.71 and in elder individuals independent of gender (48% in those aged >69, 95% CI = 0.36-0.77. CONCLUSION: Our findings suggest that there is an inverse association between schizophrenia and urinary calculi. Future studies are needed to elucidate the mechanisms by which schizophrenia negatively associates with urinary calculi.

  9. Childhood ADHD and risk for substance dependence in adulthood: a longitudinal, population-based study.

    Directory of Open Access Journals (Sweden)

    Sharon Levy

    Full Text Available Adolescents with attention-deficit/hyperactivity disorder (ADHD are known to be at significantly greater risk for the development of substance use disorders (SUD compared to peers. Impulsivity, which could lead to higher levels of drug use, is a known symptom of ADHD and likely accounts, in part, for this relationship. Other factors, such as a biologically increased susceptibility to substance dependence (addiction, may also play a role.This report further examines the relationships between childhood ADHD, adolescent- onset SUD, and substance abuse and substance dependence in adulthood.Individuals with childhood ADHD and non-ADHD controls from the same population-based birth cohort were invited to participate in a prospective outcome study. Participants completed a structured neuropsychiatric interview with modules for SUD and a psychosocial questionnaire. Information on adolescent SUD was obtained retrospectively, in a previous study, from medical and school records. Associations were summarized using odds ratios (OR and 95% CIs estimated from logistic regression models adjusted for age and gender.A total of 232 ADHD cases and 335 non-ADHD controls participated (mean age, 27.0 and 28.6 years, respectively. ADHD cases were more likely than controls to have a SUD diagnosed in adolescence and were more likely to have alcohol (adjusted OR 14.38, 95% CI 1.49-138.88 and drug (adjusted OR 3.48, 95% CI 1.38-8.79 dependence in adulthood. The subgroup of participating ADHD cases who did not have SUD during adolescence were no more likely than controls to develop new onset alcohol dependence as adults, although they were significantly more likely to develop new onset drug dependence.Our study found preliminary evidence that adults with childhood ADHD are more susceptible than peers to developing drug dependence, a disorder associated with neurological changes in the brain. The relationship between ADHD and alcohol dependence appears to be more complex.

  10. Effect of Age on Breast Cancer Patient Prognoses: A Population-Based Study Using the SEER 18 Database.

    Science.gov (United States)

    Chen, Hai-Long; Zhou, Mei-Qi; Tian, Wei; Meng, Ke-Xin; He, Hai-Fei

    2016-01-01

    Age is an important risk factor for breast cancer, but data regarding whether patient age at diagnosis is related to breast cancer survival are conflicting. This population-based study evaluated the effect of age on breast cancer prognosis and identified outcome-related factors. We searched the Surveillance, Epidemiology, and End Results (SEER) database and enrolled female primary non-metastatic cases. Patients were subdivided into seven groups, and analyses of the associations between age and overall survival (OS) and breast cancer-specific survival (BCSS) were carried out using the Kaplan-Meier method and Cox regression model, respectively. We also assessed differences in survival among three specific age groups, using the ages of 30 and 50 years as cut-offs. Stratified analyses regarding race, histology, grade, stage and hormone receptor status were also carried out. A total of 133,057 female patients diagnosed with breast cancer from 2004 to 2008 were included in the current study (6.4% aged 40 to 49 years and 60 to 69 years exhibited significantly better OS and BCSS, respectively (log-rank, paged women exhibited distinctly better OS (log-rank, page groups. Following adjustments for potential confounding factors, middle-age at breast cancer diagnosis was shown to be an independent predictor of favourable outcomes in terms of OS, but not BCSS (for OS, HR, 0.92; 95%CI, 0.87-0.98; p = 0.007; for BCSS, HR, 0.94; 95%CI, 0.80-1.01; p = 0.075, using the young group as reference). Stratified analysis showed that middle-age was significantly associated with increased survival, except among patients with stage III disease, and that elderly women faced worse prognoses than younger patients. Our results indicate that younger breast cancer patients exhibit more aggressive disease than older patients. Middle-aged patients exhibit better OS and BCSS than young and elderly patients but exhibit BCSS rates similar to those of young patients after adjustments for confounders

  11. Testing the circadian gene hypothesis in prostate cancer: a population-based case-control study.

    Science.gov (United States)

    Zhu, Yong; Stevens, Richard G; Hoffman, Aaron E; Fitzgerald, Liesel M; Kwon, Erika M; Ostrander, Elaine A; Davis, Scott; Zheng, Tongzhang; Stanford, Janet L

    2009-12-15

    Circadian genes are responsible for maintaining the ancient adaptation of a 24-hour circadian rhythm and influence a variety of cancer-related biological pathways, including the regulation of sex hormone levels. However, few studies have been undertaken to investigate the role of circadian genes in the development of prostate cancer, the most common cancer type among men (excluding nonmelanoma skin cancer). The current genetic association study tested the circadian gene hypothesis in relation to prostate cancer by genotyping a total of 41 tagging and amino acid-altering single nucleotide polymorphisms (SNP) in 10 circadian-related genes in a population-based case-control study of Caucasian men (n = 1,308 cases and 1,266 controls). Our results showed that at least one SNP in nine core circadian genes (rs885747 and rs2289591 in PER1; rs7602358 in PER2; rs1012477 in PER3; rs1534891 in CSNK1E; rs12315175 in CRY1; rs2292912 in CRY2; rs7950226 in ARNTL; rs11133373 in CLOCK; and rs1369481, rs895521, and rs17024926 in NPAS2) was significantly associated with susceptibility to prostate cancer (either overall risk or risk of aggressive disease), and the risk estimate for four SNPs in three genes (rs885747 and rs2289591 in PER1, rs1012477 in PER3, and rs11133373 in CLOCK) varied by disease aggressiveness. Further analyses of haplotypes were consistent with these genotyping results. Findings from this candidate gene association study support the hypothesis of a link between genetic variants in circadian genes and prostate cancer risk, warranting further confirmation and mechanistic investigation of circadian biomarkers in prostate tumorigenesis.

  12. Sleep and use of electronic devices in adolescence: results from a large population-based study

    Science.gov (United States)

    Hysing, Mari; Pallesen, Ståle; Stormark, Kjell Morten; Jakobsen, Reidar; Lundervold, Astri J; Sivertsen, Børge

    2015-01-01

    Objectives Adolescents spend increasingly more time on electronic devices, and sleep deficiency rising in adolescents constitutes a major public health concern. The aim of the present study was to investigate daytime screen use and use of electronic devices before bedtime in relation to sleep. Design A large cross-sectional population-based survey study from 2012, the youth@hordaland study, in Hordaland County in Norway. Setting Cross-sectional general community-based study. Participants 9846 adolescents from three age cohorts aged 16–19. The main independent variables were type and frequency of electronic devices at bedtime and hours of screen-time during leisure time. Outcomes Sleep variables calculated based on self-report including bedtime, rise time, time in bed, sleep duration, sleep onset latency and wake after sleep onset. Results Adolescents spent a large amount of time during the day and at bedtime using electronic devices. Daytime and bedtime use of electronic devices were both related to sleep measures, with an increased risk of short sleep duration, long sleep onset latency and increased sleep deficiency. A dose–response relationship emerged between sleep duration and use of electronic devices, exemplified by the association between PC use and risk of less than 5 h of sleep (OR=2.70, 95% CI 2.14 to 3.39), and comparable lower odds for 7–8 h of sleep (OR=1.64, 95% CI 1.38 to 1.96). Conclusions Use of electronic devices is frequent in adolescence, during the day as well as at bedtime. The results demonstrate a negative relation between use of technology and sleep, suggesting that recommendations on healthy media use could include restrictions on electronic devices. PMID:25643702

  13. Addictive behaviors related to opioid use for chronic pain: a population-based study.

    Science.gov (United States)

    Højsted, Jette; Ekholm, Ola; Kurita, Geana Paula; Juel, Knud; Sjøgren, Per

    2013-12-01

    The growing body of research showing increased opioid use in patients with chronic pain coupled with concerns regarding addiction encouraged the development of this population-based study. The goal of the study was to investigate the co-occurrence of indicators of addictive behaviors in patients with chronic non-cancer pain in long-term opioid treatment. The study combined data from the individual-based Danish Health Survey in 2010 and the official Danish health and socio-economic, individual-based registers. From a simple random sample of 25,000 adults (16 years or older) living in Denmark, 13,281 individuals were analyzed through multiple logistic regression analyses to assess the association between chronic pain (lasting ≥6 months), opioid use, health behavior, and body mass index. Six potential addictive behaviors were identified: daily smoking; high alcohol intake; illicit drug use in the past year; obesity; long-term use of benzodiazepines; and long-term use of benzodiazepine-related drugs. At least 2 of the 6 addictive behaviors were observed in 22.6% of the long-term opioid users with chronic pain compared with 11.5% of the non-opioid users with chronic pain and 8.9% of the individuals without chronic pain. Thus, a strong association was demonstrated between long-term opioid use and the clustering of addictive behaviors. An intricate relationship between chronic pain, opioid use, and addictive behaviors was observed in this study, which deserves both clinical attention and further research. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Åberg, Katarina; Norman, Mikael; Ekéus, Cecilia

    2014-01-22

    Very few studies have investigated the neonatal outcomes after vacuum extraction delivery (VE) in the preterm period and the results of these studies are inconclusive. The objective of this study was to describe the use of VE for preterm delivery in Sweden and to compare rates of neonatal complications after preterm delivery by VE to those found after cesarean section during labor (CS) or unassisted vaginal delivery (VD). Data was obtained from Swedish national registers. In a population-based cohort from 1999 to 2010, all live-born, singleton preterm infants in a non-breech presentation at birth, born after onset of labor (either spontaneously, by induction, or by rupture of membranes) by VD, CS, or VE were included, leaving a study population of 40,764 infants. Logistic regression analyses were used to calculate adjusted odds ratios (AOR), using unassisted vaginal delivery as reference group. VE was used in 5.7% of the preterm deliveries, with lower rates in earlier gestations. Overall, intracranial hemorrhage (ICH) occurred in 1.51%, extracranial hemorrhage (ECH) in 0.64%, and brachial plexus injury in 0.13% of infants. Infants delivered by VE had higher risks for ICH (AOR = 1.84 (95% CI: 1.09-3.12)), ECH (AOR = 4.48 (95% CI: 2.84-7.07)) and brachial plexus injury (AOR = 6.21 (95% CI: 2.22-17.4)), while infants delivered by CS during labor had no increased risk for these complications, as compared to VD. While rates of neonatal complications after VE are generally low, higher odds ratios for intra- and extracranial hemorrhages and brachial plexus injuries after VE, compared with other modes of delivery, support a continued cautious use of VE for preterm delivery.

  15. Mode of delivery and the probability of subsequent childbearing: a population-based register study.

    Science.gov (United States)

    Elvander, C; Dahlberg, J; Andersson, G; Cnattingius, S

    2015-11-01

    To investigate the relationship between mode of first delivery and probability of subsequent childbearing. Population-based study. Nationwide study in Sweden. A cohort of 771 690 women who delivered their first singleton infant in Sweden between 1992 and 2010. Using Cox's proportional-hazards regression models, risks of subsequent childbearing were compared across four modes of delivery. Hazard ratios (HRs) were calculated, using 95% confidence intervals (95% CIs). Probability of having a second and third child; interpregnancy interval. Compared with women who had a spontaneous vaginal first delivery, women who delivered by vacuum extraction were less likely to have a second pregnancy (HR 0.96, 95% CI 0.95-0.97), and the probabilities of a second childbirth were substantially lower among women with a previous emergency caesarean section (HR 0.85, 95% CI 0.84-0.86) or an elective caesarean section (HR 0.82, 95% CI 0.80-0.83). There were no clinically important differences in the median time between first and second pregnancy by mode of first delivery. Compared with women younger than 30 years of age, older women were more negatively affected by a vacuum extraction with respect to the probability of having a second child. A primary vacuum extraction decreased the probability of having a third child by 4%, but having two consecutive vacuum extraction deliveries did not further alter the probability. A first delivery by vacuum extraction does not reduce the probability of subsequent childbearing to the same extent as a first delivery by emergency or elective caesarean section. © 2014 Royal College of Obstetricians and Gynaecologists.

  16. Risk of Ventricular Arrhythmia with Citalopram and Escitalopram: A Population-Based Study.

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    Elena Qirjazi

    Full Text Available The risk of ventricular arrhythmia with citalopram and escitalopram is controversial. In this study we investigated the association between these two drugs and the risk of ventricular arrhythmia.We conducted a population-based retrospective cohort study of older adults (mean age 76 years from 2002 to 2012 in Ontario, Canada, newly prescribed citalopram (n = 137 701 or escitalopram (n = 38 436, compared to those prescribed referent antidepressants sertraline or paroxetine (n = 96 620. After inverse probability of treatment weighting using a propensity score, the baseline characteristics of the comparison groups were similar. The primary outcome was a hospital encounter with ventricular arrhythmia within 90 days of a new prescription, assessed using hospital diagnostic codes. The secondary outcome was all-cause mortality within 90 days.Citalopram was associated with a higher risk of a hospital encounter with ventricular arrhythmia compared with referent antidepressants (0.06% vs. 0.04%, relative risk [RR] 1.53, 95% confidence intervals [CI]1.03 to 2.29, and a higher risk of mortality (3.49% vs. 3.12%, RR 1.12, 95% CI 1.06 to 1.18. Escitalopram was not associated with a higher risk of ventricular arrhythmia compared with the referent antidepressants (0.03% vs. 0.04%, RR 0.84, 95% CI 0.42 to 1.68, but was associated with a higher risk of mortality (2.86% vs. 2.63%, RR 1.09, 95% CI 1.01 to 1.18.Among older adults, initiation of citalopram compared to two referent antidepressants was associated with a small but statistically significant increase in the 90-day risk of a hospital encounter for ventricular arrhythmia.

  17. Risk of Ventricular Arrhythmia with Citalopram and Escitalopram: A Population-Based Study.

    Science.gov (United States)

    Qirjazi, Elena; McArthur, Eric; Nash, Danielle M; Dixon, Stephanie N; Weir, Matthew A; Vasudev, Akshya; Jandoc, Racquel; Gula, Lorne J; Oliver, Matthew J; Wald, Ron; Garg, Amit X

    2016-01-01

    The risk of ventricular arrhythmia with citalopram and escitalopram is controversial. In this study we investigated the association between these two drugs and the risk of ventricular arrhythmia. We conducted a population-based retrospective cohort study of older adults (mean age 76 years) from 2002 to 2012 in Ontario, Canada, newly prescribed citalopram (n = 137 701) or escitalopram (n = 38 436), compared to those prescribed referent antidepressants sertraline or paroxetine (n = 96 620). After inverse probability of treatment weighting using a propensity score, the baseline characteristics of the comparison groups were similar. The primary outcome was a hospital encounter with ventricular arrhythmia within 90 days of a new prescription, assessed using hospital diagnostic codes. The secondary outcome was all-cause mortality within 90 days. Citalopram was associated with a higher risk of a hospital encounter with ventricular arrhythmia compared with referent antidepressants (0.06% vs. 0.04%, relative risk [RR] 1.53, 95% confidence intervals [CI]1.03 to 2.29), and a higher risk of mortality (3.49% vs. 3.12%, RR 1.12, 95% CI 1.06 to 1.18). Escitalopram was not associated with a higher risk of ventricular arrhythmia compared with the referent antidepressants (0.03% vs. 0.04%, RR 0.84, 95% CI 0.42 to 1.68), but was associated with a higher risk of mortality (2.86% vs. 2.63%, RR 1.09, 95% CI 1.01 to 1.18). Among older adults, initiation of citalopram compared to two referent antidepressants was associated with a small but statistically significant increase in the 90-day risk of a hospital encounter for ventricular arrhythmia.

  18. Prenatal Exposure to Folic Acid and Antidepressants and Language Development: A Population-Based Cohort Study.

    Science.gov (United States)

    Handal, Marte; Skurtveit, Svetlana; Roth, Christine; Hernandez-Diaz, Sonia; Selmer, Randi

    2016-08-01

    The aim of the study was to determine the effect of simultaneous use of folic acid supplements and selective serotonin reuptake inhibitors (SSRIs) by pregnant women on language development in their offspring at the age of 3 years. We conducted a cohort study of 45,266 women with 51,747 singleton pregnancies in the population-based Norwegian Mother and Child Cohort study (1999-2008). The association between the use of SSRIs with and without concomitant folic acid and language competence in the offspring was investigated using multinomial logistic regression. Self-reported use of folic acid supplements and SSRIs was prospectively collected in 4-week intervals during pregnancy and validated with prescription data and plasma concentrations, respectively. The children's language competence was measured by a validated language grammar rating scale and classified into 3 categories. Women reported the use of folic acid in 44,417 (85.8%) and SSRI in 372 (0.7%) of the pregnancies, 260 used the 2 simultaneously. Compared with women who used folic acid and no SSRIs, the adjusted relative risk ratio of lower language competence rose with the increased duration of simultaneous use of folic acid and SSRIs. After simultaneous use at 4 to 8 four-week intervals, the relative risk ratio reached 4.5 (95% confidence interval, 2.5-8.0) and 5.7 (2.5-13.0) for the intermediate and most delayed category, respectively, using the best language competence category as the reference. The use of SSRIs without folic acid was not significantly associated with an increased risk. We detected a significant association between long-term use of SSRIs during pregnancy and delayed language competence in the offspring only when folic acid supplementation was used concomitantly. This surprising result warrants further studies.

  19. Spontaneous Abortion, Stillbirth and Hyperthyroidism: A Danish Population-Based Study

    Science.gov (United States)

    Andersen, Stine Linding; Olsen, Jørn; 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 maternal hyperthyroidism for up to 2 years after the pregnancy [hospital diagnosis/prescription of antithyroid drug (ATD)]. The Cox proportional hazards model was used to estimate adjusted hazard ratio (aHR) with 95% confidence interval (CI) for spontaneous abortion (gestational age hyperthyroidism was diagnosed before/during the pregnancy (n = 5,229), spontaneous abortion occurred more often both in women treated before the pregnancy alone [aHR 1.28 (95% CI 1.18-1.40)] and in women treated with ATD in early pregnancy [1.18 (1.07-1.31)]. When maternal hyperthyroidism was diagnosed and treated for the first time in the 2-year period after the pregnancy (n = 2,361), there was a high risk that the pregnancy under study had terminated with a stillbirth [2.12 (1.30-3.47)]. Conclusions Both early (spontaneous abortion) and late (stillbirth) pregnancy loss were more common in women suffering from hyperthyroidism. Inadequately treated hyperthyroidism in early pregnancy may have been involved in spontaneous abortion, and undetected high maternal thyroid hormone levels present in late pregnancy may have attributed to an increased risk of stillbirth. PMID:25538898

  20. Diagnosis of alpha-1 antitrypsin deficiency: a population-based study.

    Science.gov (United States)

    Barrecheguren, Miriam; Monteagudo, Mónica; Simonet, Pere; Llor, Carl; Rodriguez, Esther; Ferrer, Jaume; Esquinas, Cristina; Miravitlles, Marc

    2016-01-01

    Alpha-1 antitrypsin deficiency (AATD) remains an underdiagnosed condition despite initiatives developed to increase awareness. The objective was to describe the current situation of the diagnosis of AATD in primary care (PC) in Catalonia, Spain. We performed a population-based study with data from the Information System for Development in Research in Primary Care, a population database that contains information of 5.8 million inhabitants (80% of the population of Catalonia). We collected the number of alpha-1 antitrypsin (AAT) determinations performed in the PC in two periods (2007-2008 and 2010-2011) and described the characteristics of the individuals tested. A total of 12,409 AAT determinations were performed (5,559 in 2007-2008 and 6,850 in 2010-2011), with 10.7% of them in children. As a possible indication for AAT determination, 28.9% adults and 29.4% children had a previous diagnosis of a disease related to AATD; transaminase levels were above normal in 17.7% of children and 47.1% of adults. In total, 663 (5.3%) individuals had intermediate AATD (50-100 mg/dL), 24 (0.2%) individuals had a severe deficiency (<50 mg/dL), with a prevalence of 0.19 cases of severe deficiency per 100 determinations. Nine (41%) of the adults with severe deficiency had a previous diagnosis of COPD/emphysema, and four (16.7%) were diagnosed with COPD within 6 months. The number of AAT determinations in the PC is low in relation to the prevalence of COPD but increased slightly along the study period. The indication to perform the test is not always clear, and patients detected with deficiency are not always referred to a specialist.

  1. 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...

  2. The incidence of inflammatory bowel disease in Northern China: a prospective population-based study.

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    Hong Yang

    Full Text Available AIMS & BACKGROUNDS: Although inflammatory bowel diseases (IBD are emerging and increasing in China, epidemiologic data are rarely available. This study was to investigate the epidemiological and clinical characteristics of IBD in Northern China. METHODS: This is a prospective, population-based study of incidence of IBD in Daqing, Heilongjiang province of Northern China from March 1, 2012 to February 28, 2013. All incident patients with IBD were clinically identified by IBD specialist group from five main General Hospitals covering the healthcare service for 1,343,364 residents in the urban areas of Daqing. IBD cases included in this study were followed-up for three months for diagnosis confirmation. RESULTS: A total of 27 new IBD cases including 25 cases of ulcerative colitis (UC and 2 cases of Crohn's disease (CD were identified. The population at risk was 1,343,364 person years. Age-adjusted incidence for total IBD, CD and UC were 1.77, 0.13, and 1.64 per 100,000 population, respectively. A male predominance was found in CD patients (male to female ratio was 2 ∶ 0. In contrast, no obvious gender predominance was found in UC patients (male to female ratio was 1 ∶ 1.1. CD patients were diagnosed at an average age of 39.5 years. The main disease phenotypes of UC were distal colitis with a 24% of proctitis and 56% of left-sided colitis. The mean diagnostic age of UC patients was 48.9 years. CONCLUSIONS: This is the first report on the incidence of IBD in the Northern Chinese population. A lower incidence of IBD, similar male predominance for CD, similar disease phenotype of UC, and lower disease activity was observed in Daqing compared to that in Southern China.

  3. Exhaled nitric oxide in a population-based study of Southern California Schoolchildren

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    Avol Edward L

    2009-04-01

    Full Text Available Abstract Background Determinants of exhaled nitric oxide (FeNO need to be understood better to maximize the value of FeNO measurement in clinical practice and research. Our aim was to identify significant predictors of FeNO in an initial cross-sectional survey of southern California schoolchildren, part of a larger longitudinal study of asthma incidence. Methods During one school year, we measured FeNO at 100 ml/sec flow, using a validated offline technique, in 2568 children of age 7–10 yr. We estimated online (50 ml/sec flow FeNO using a prediction equation from a separate smaller study with adjustment for offline measurement artifacts, and analyzed its relationship to clinical and demographic characteristics. Results FeNO was lognormally distributed with geometric means ranging from 11 ppb in children without atopy or asthma to 16 ppb in children with allergic asthma. Although effects of atopy and asthma were highly significant, ranges of FeNO for children with and without those conditions overlapped substantially. FeNO was significantly higher in subjects aged > 9, compared to younger subjects. Asian-American boys showed significantly higher FeNO than children of all other sex/ethnic groups; Hispanics and African-Americans of both sexes averaged slightly higher than non-Hispanic whites. Increasing height-for-age had no significant effect, but increasing weight-for-height was associated with decreasing FeNO. Conclusion FeNO measured offline is a useful biomarker for airway inflammation in large population-based studies. Further investigation of age, ethnicity, body-size, and genetic influences is needed, since they may contribute to substantial variation in FeNO.

  4. Excessive daytime sleepiness is associated with an exacerbation of migraine: A population-based study.

    Science.gov (United States)

    Kim, Jiyoung; Cho, Soo-Jin; Kim, Won-Joo; Yang, Kwang Ik; Yun, Chang-Ho; Chu, Min Kyung

    2016-12-01

    Previous studies have shown that migraine and sleep disturbances are closely associated. Excessive daytime sleepiness (EDS) is a common symptom of various types of sleep disturbance. Findings from clinic-based studies suggest that a high percentage of migraineurs experience EDS. However, the prevalence and clinical impact of EDS among migraineurs at the population level have rarely been reported. The objective of this study was to investigate the prevalence and impact of EDS among migraineurs using a population-based sample in Korea. We selected a stratified random sample of Koreans aged 19 to 69 years and evaluated them using a semi-structured interview designed to identify EDS, headache type, and the clinical characteristics of migraine. If the score on the Epworth Sleepiness Scale (ESS) was more than or equal to 11, the participant was classified as having EDS. Of the 2,695 participants that completed the interview, 143 (5.3 %) and 313 (11.6 %) were classified as having migraine and EDS, respectively. The prevalence of EDS was significantly higher in participants with migraine (19.6 %) and non-migraine headache (13.4 %) compared to non-headache controls (9.4 %). Migraineurs with EDS had higher scores on the Visual Analogue Scale (VAS) for headache intensity (6.9 ± 1.8 vs. 6.0 ± 1.9, p = 0.014) and Headache Impact Test-6 (59.8 ± 10.2 vs. 52.5 ± 8.2, p migraine symptoms.

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

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    Rosero-Bixby Luis

    2012-06-01

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

  6. Severe maternal morbidity: A population-based study of an expanded measure and associated factors.

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    Victoria Lazariu

    Full Text Available Severe maternal morbidity conditions such as sepsis, embolism and cardiac arrest during the delivery hospitalization period can lead to extended length of hospital stays, life-long maternal health problems, and high medical costs. Most importantly, these conditions also contribute to the risk of maternal death. This population-based observational study proposed and evaluated the impact of expanding the Centers for Disease Control and Prevention (CDC measure of severe maternal morbidity by including additional comorbidities and intensive care admissions during delivery hospitalizations and examined associated factors. A New York State linked hospitalization and birth record database was used. Study participants included all New York State female residents, ages 10 to 55 years, who delivered a live infant in a New York acute care hospital between 2008 and 2013, inclusive. Incidence trends for both severe maternal morbidity measures were evaluated longitudinally. Associations between covariates and the two severe maternal morbidity measures were examined with logistic regression models, solved using generalized estimating equations and stratified by method of delivery. The New York expanded severe maternal morbidity measure identified 34,478 cases among 1,352,600 hospital deliveries (estimated incidence 2.55% representing a 3% increase in the number of cases compared to the CDC measure. Both estimates increased over the study period (p 1.5 included most measured comorbidities (e.g., pregnancy-induced hypertension, placentation disorder, multiple births, preterm birth, no prenatal care, hospitalization prior to delivery, higher levels of perinatal care birthing facilities and race/ethnicity. Expanding the measure for severe maternal morbidity during delivery to capture intensive care admissions provides a more sensitive estimate of disease burden. Perinatal regionalization in New York appears effective in routing high risk pregnancies to higher

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

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    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. Antiarrhythmic drug usage and prostate cancer: a population-based cohort study

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    Li-Ting Kao

    2018-01-01

    Full Text Available Even though the relationship between antiarrhythmic drug usage and subsequent prostate cancer (PCa risk has recently been highlighted, relevant findings in the previous literature are still inconsistent. In addition, very few studies have attempted to investigate the association between sodium channel blockers or potassium channel blockers for arrhythmia and the subsequent PCa risk. Therefore, this cohort study aimed to find the relationship between antiarrhythmic drug usage and the subsequent PCa risk using a population-based dataset. The data used in this study were derived from the Longitudinal Health Insurance Database 2005, Taiwan, China. We respectively identified 9988 sodium channel blocker users, 3663 potassium channel blocker users, 65 966 beta-blocker users, 23 366 calcium channel blockers users, and 7031 digoxin users as the study cohorts. The matched comparison cohorts (one comparison subject for each antiarrhythmic drug user were selected from the same dataset. Each patient was tracked for a 5-year period to define those who were subsequently diagnosed with PCa. After adjusting for sociodemographic characteristics, comorbidities, and age, Cox proportional hazard regressions found that the hazard ratio (HR of subsequent PCa for sodium channel blocker users was 1.12 (95% confidence interval [CI]: 0.84-1.50, for potassium channel blocker users was 0.89 (95% CI: 0.59-1.34, for beta-blocker users was 1.08 (95% CI: 0.96-1.22, for calcium channel blocker users was 1.14 (95% CI: 0.95-1.36, and for digoxin users was 0.89 (95% CI: 0.67-1.18, compared to their matched nonusers. We concluded that there were no statistical associations between different types of antiarrhythmic drug usage and subsequent PCa risk.

  9. Hip fracture history and risk of nonmelanoma skin cancer: a Danish population-based study

    Directory of Open Access Journals (Sweden)

    Lamberg AL

    2011-11-01

    Full Text Available Anna Lei Lamberg1,2, Anne Braae Olesen1,2, Annette Østergaard Jensen11Department of Clinical Epidemiology, 2Department of Dermatology, Aarhus University Hospital, DenmarkBackground: Vitamin D deficiency is associated with osteoporotic fractures, such as hip fracture. Sun exposure, the natural source of vitamin D, is the main risk factor for basal cell carcinoma (BCC and squamous cell carcinoma (SCC. In this study, we examined the association between a history of hip fracture and risk of BCC and SCC.Methods: We conducted a population-based case-controlled study using data on BCC and SCC cases registered in the Danish Cancer Registry from 1990–2005. For each case, we selected five population controls matched by age and gender. We used conditional logistic regression to compute odds ratios (OR and 95% confidence intervals (CI, while adjusting for chronic diseases and socioeconomic status.Results: A history of hip fracture was associated with a decreased risk of BCC (OR 0.90, 95% CI 0.85–0.94, which was most pronounced in cases of tumors on the trunk, extremities, or at multiple sites. We found no association for SCC (OR 1.07, 95% CI 0.98–1.17.Conclusion: Our study showed an inverse association between history of hip fracture and risk of BCC, but not of SCC. Sun exposure, resulting in vitamin D synthesis, may explain the link between the two diseases.Keywords: hip fracture, vitamin D, sunlight, basal cell carcinoma, squamous cell carcinoma

  10. Reduced risk of dyslipidaemia with oolong tea consumption: a population-based study in southern China.

    Science.gov (United States)

    Yi, Deqing; Tan, Xuerui; Zhao, Zhiguo; Cai, Yingmu; Li, Yiming; Lin, Xiuying; Lu, Sailan; Chen, Yongsong; Zhang, Qingying

    2014-04-28

    Experimental studies have suggested that tea consumption could lower the risk of dyslipidaemia. However, epidemiological evidence is limited, especially in southern China, where oolong tea is the most widely consumed beverage. We conducted a population-based case-control study to evaluate the association between consumption of tea, especially oolong tea, and risk of dyslipidaemia in Shantou, southern China, from 2010 to 2011. Information on tea consumption, lifestyle characteristics and food consumption frequency of 1651 patients with newly diagnosed dyslipidaemia and 1390 controls was obtained using a semi-quantitative questionnaire. Anthropometric variables and serum biochemical indices were determined. Drinking more than 600 ml (2 paos) of green, oolong or black tea daily was found to be associated with the lowest odds of dyslipidaemia risk (Pconsumption, but only oolong tea consumption was found to be associated with low HDL-cholesterol levels. A dose-response relationship between duration of tea consumption and risk of dyslipidaemia (OR 0.10, 95% CI 0.06, 0.16), as well as that between amount of dried tea leaves brewed and risk of dyslipidaemia (OR 0.34, 95% CI 0.24, 0.48), was found. Moreover, consumption of oolong tea for the longest duration was found to be associated with 3.22, 11.99 and 6.69% lower blood total cholesterol, TAG and LDL-cholesterol levels, respectively. In conclusion, the present study indicates that long-term oolong tea consumption may be associated with a lower risk of dyslipidaemia in the population of Shantou in southern China.

  11. Frailty and cardiovascular risk in community-dwelling elderly: a population-based study.

    Science.gov (United States)

    Ricci, Natalia Aquaroni; Pessoa, Germane Silva; Ferriolli, Eduardo; Dias, Rosangela Correa; Perracini, Monica Rodrigues

    2014-01-01

    Evidence suggests a possible bidirectional connection between cardiovascular disease (CVD) and the frailty syndrome in older people. To verify the relationship between CVD risk factors and the frailty syndrome in community-dwelling elderly. This population-based study used data from the Fragilidade em Idosos Brasileiros (FIBRA) Network Study, a cross-sectional study designed to investigate frailty profiles among Brazilian older adults. Frailty status was defined as the presence of three or more out of five of the following criteria: unintentional weight loss, weakness, self-reported fatigue, slow walking speed, and low physical activity level. The ascertained CVD risk factors were self-reported and/or directly measured hypertension, diabetes mellitus, obesity, waist circumference measurement, and smoking. Of the 761 participants, 9.7% were characterized as frail, 48.0% as pre-frail, and 42.3% as non-frail. The most prevalent CVD risk factor was hypertension (84.4%) and the lowest one was smoking (10.4%). It was observed that among those participants with four or five risk factors there was a higher proportion of frail and pre-frail compared with non-frail (Fisher's exact test: P=0.005; P=0.021). Self-reported diabetes mellitus was more prevalent among frail and pre-frail participants when compared with non-frail participants (Fisher's exact test: P≤0.001; P≤0.001). There was little agreement between self-reported hypertension and hypertension identified by blood pressure measurement. Hypertension was highly prevalent among the total sample. In addition, frail and pre-frail older people corresponded to a substantial proportion of those with more CVD risk factors, especially diabetes mellitus, highlighting the need for preventive strategies in order to avoid the co-occurrence of CVD and frailty.

  12. 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.

  13. Clinical Features Associated With Individuals at Higher Risk of Melanoma: A Population-Based Study.

    Science.gov (United States)

    Watts, Caroline G; Madronio, Christine; Morton, Rachael L; Goumas, Chris; Armstrong, Bruce K; Curtin, Austin; Menzies, Scott W; Mann, Graham J; Thompson, John F; Cust, Anne E

    2017-01-01

    The identification of a subgroup at higher risk of melanoma may assist in early diagnosis. To characterize melanoma patients and the clinical features associated with their melanomas according to patient risk factors: many nevi, history of previous melanoma, and family history of melanoma, to assist with improving the identification and treatment of a higher-risk subgroup. The Melanoma Patterns of Care study was a population-based observational study of physicians' reported treatment of 2727 patients diagnosed with an in situ or invasive primary melanoma over a 12-month period from October 2006 to 2007 conducted in New South Wales. Our analysis of these data took place from 2015 to 2016. Age at diagnosis and body site of melanoma. Of the 2727 patients with melanoma included, 1052 (39%) were defined as higher risk owing to a family history of melanoma, multiple primary melanomas, or many nevi. Compared with patients with melanoma who were at lower risk (ie, without any of these risk factors), the higher-risk group had a younger mean age at diagnosis (62 vs 65 years, P history, 59 years for those with many nevi, and 69 years for those with a previous melanoma). These age differences were consistent across all body sites. Among higher-risk patients, those with many nevi were more likely to have melanoma on the trunk (41% vs 29%, P history of melanoma were more likely to have melanomas on the limbs (57% vs 42%, P history were more likely to have melanoma on the head and neck (21% vs 15%, P = .003). These findings suggest that a person's risk factor status could be used to tailor surveillance programs and education about skin self-examination.

  14. Risk of congenital heart defects in the offspring of smoking mothers: a population-based study.

    Science.gov (United States)

    Sullivan, Patrick M; Dervan, Leslie A; Reiger, Sheridan; Buddhe, Sujatha; Schwartz, Stephen M

    2015-04-01

    To conduct a population-based study examining the occurrence of congenital heart defects (CHDs) in relation to maternal smoking during the first trimester of pregnancy. This retrospective case-control study used Washington State birth certificates from 1989 to 2011 and linked hospital discharge International Classification of Diseases, 9th revision, codes to identify singleton nonsyndromic CHD cases and determine maternal prenatal smoking status. We calculated ORs from multivariate logistic regression models to compare maternal first-trimester smoking status (any and daily number of cigarettes) among 14,128 cases, both overall and by phenotype, and 60,938 randomly selected controls frequency matched on birth year. Offspring of mothers reporting cigarette use in the first trimester of pregnancy were more likely to be born with a CHD (aOR 1.16 [1.08-1.24]) independent of demographic characteristics and other prenatal risk factors for CHDs. Maternal smoking was most strongly associated with pulmonary valve anomalies (aOR 1.48 [95% CI: 1.15-1.90]), pulmonary artery anomalies (aOR 1.71 [1.40-2.09]), and isolated atrial septal defects (aOR 1.22 [1.08-1.38]). The association between maternal smoking and CHDs was stronger with increasing number of daily cigarettes and among older (35+ years) mothers compared with younger mothers. We provide evidence that maternal smoking during pregnancy is a risk factor for select CHD phenotypes. Maternal smoking may account for 1.4% of all CHDs. New findings include a strong dose-dependence of the association and augmented risk in older mothers. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Wealth Inequality and Mental Disability Among the Chinese Population: A Population Based Study

    Directory of Open Access Journals (Sweden)

    Zhenjie Wang

    2015-10-01

    Full Text Available 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 that was derived from a principal component analysis of 10 household assets and four other variables related to wealth. Logistic regression analysis was used to estimate the odds ratio (OR and 95% confidence interval (CI for mental disability for each category, with the lowest quintile category as the referent. Confounding variables under consideration were age, gender, residence area, marital status, ethnicity, education, current employment status, household size, house type, homeownership and living arrangement. The distribution of various types and severities of mental disability differed significantly by wealth index category in the present population. Wealth index category had a positive association with mild mental disability (p for trend <0.01, but had a negative association with extremely severe mental disability (p for trend <0.01. Moreover, wealth index category had a significant, inverse association with mental disability when all severities of mental disability were taken into consideration. This study’s results suggest that wealth is a significant factor in the distribution of mental disability and it might have different influences on various types and severities of mental disability.

  16. Medical intervention in parent-reported infant gastro-oesophageal reflux: A population-based study.

    Science.gov (United States)

    Hua, Sun; Peters, Rachel L; Allen, Katrina J; Dharmage, Shyamali C; Tang, Mimi Lk; Wake, Melissa; Foskey, Rebecca; Heine, Ralf G

    2014-11-12

    To report the cumulative incidence, health-seeking behaviour and medical intervention of infants with gastro-oesophageal reflux (GOR) in the first year of life. The HealthNuts study is a longitudinal, population-based study. At 12 months of age, infants underwent skin prick testing to food allergens, including cows milk. Parents completed a questionnaire on GOR symptoms, food allergy and treatments. Factors associated with seeking health care for infants with GOR were modelled using logistic regression. Of 4674 infants, parents reported GOR in 1054 (23%; 95% confidence interval (CI) 21.4-23.8). Parents consulted a medical practitioner in 662 (64%) cases. Symptoms commenced in the first month in 411 (48%) and resolved within 6 months in 703 (75%) infants. Factors associated with doctor consultation for GOR were prematurity (adjusted odds ratio (aOR) 1.94; 95% CI 1.43-2.63) and family history of atopy (aOR 1.64; 95% CI 1.1-2.43). Eight per cent of infants (371/4674; 95% CI 7.2-8.7) received anti-reflux medication and 6% (296/4674; 95% CI 5.7-7.1) changed formula. Parents were more likely to seek treatment if they perceived their infant to be unsettled (aOR 2.55; 95% CI 1.26-5.17) and if the duration of GOR was prolonged (aOR 3.36 for symptoms >6 months; 95% CI 1.83-6.17). In the first year of life, approximately 14% of the population seek medical advice for GOR symptoms. The use of anti-reflux medication in the general community remains high, despite the absence of evidence that it is appropriate or effective for uncomplicated GOR. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  17. Inequalities of quality of life in unemployed young adults: A population-based questionnaire study

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    Edén Lena

    2007-03-01

    Full Text Available Abstract Background It is well known that unemployment is a great problem both to the exposed individual and to the whole society. Unemployment is reported as more common among young people compared to the general level of unemployment. Inequity in health status and life-satisfaction is related to unemployment. The purpose of this population-based study was to describe QOL among unemployed young people compared to those who are not unemployed, and to analyse variables related to QOL for the respective groups. Methods The sample consisted of 264 young unemployed individuals and 528 working or studying individuals as a reference group. They all received a questionnaire about civil status, educational level, immigration, employment status, self-reported health, self-esteem, social support, social network, spare time, dwelling, economy and personal characteristics. The response rate was 72%. The significance of differences between proportions was tested by Fisher's exact test or by χ2 test. Multivariate analysis was carried out by means of a logistic regression model. Results Our results balance the predominant picture of youth unemployment as a principally negative experience. Although the unemployed reported lower levels of QOL than the reference group, a majority of unemployed young adults reported good QOL, and 24% even experienced higher QOL after being unemployed. Positive QOL related not only to good health, but also to high self-esteem, satisfaction with spare time and broad latitude for decision-making. Conclusion Even if QOL is good among a majority of unemployed young adults, inequalities in QOL were demonstrated. To create more equity in health, individuals who report reduced subjective health, especially anxiety need extra attention and support. Efforts should aim at empowering unemployed young adults by identifying their concerns and resources, and by creating individual programmes in relation not only to education and work, but also

  18. Elevated plasma vitamin B12 levels and risk of venous thromboembolism among cancer patients: A population-based cohort study.

    Science.gov (United States)

    Arendt, Johan Frederik Håkonsen; Farkas, Dóra Körmendiné; Pedersen, Lars; Sørensen, Henrik Toft

    2017-08-01

    Both venous thromboembolism (VTE) and high plasma vitamin B12 levels (cobalamin, Cbl) are markers of occult cancer and aggressive cancer with a poor prognosis. In this population-based cohort study, we assessed VTE risk among cancer patients with high plasma Cbl levels. We used Danish health registries to identify a Cb1 cohort of 25,310 cancer patients with a plasma Cbl measurement prior to cancer diagnosis. The cohort was subdivided according to Cbl levels (pmol/L): 200-600 (population reference range), 601-800 and >800. All VTE events were considered provoked and categorised as either cancer-associated if no other provoking factors were present before VTE or provoked by other risk factors (surgery, trauma, or pregnancy). We calculated cumulative incidence proportions and adjusted hazard ratios computed from Cox regression analysis (reference: plasma Cbl of 200-600pmol/L) for the risk of VTE before and after the cancer diagnosis date (index date). The risk of cancer-associated VTE 30days after index date increased with higher Cbl levels. The cumulative incidence (95% CI) by Cbl levels was: 200-600pmol/L: 0.24 (0.18-0.31); 601-800pmol/L: 0.63 (0.34-1.09); >800pmol/L: 0.86 (0.49-1.40). Adjusted hazard ratios (95% CI) were: 601-800 vs. 200-600: 2.55 (1.32-4.92); >800 vs. 200-600: 2.36 (1.19-4.71). We found similar results for VTE provoked by other risk factors and for VTE occurring before index date, but scarcity of events produced uncertain risk estimates. We demonstrated an association between high plasma Cbl levels and risk of VTE in cancer patients. Any clinical implications warrant further study. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Apgar-score in children prenatally exposed to antiepileptic drugs: a population-based cohort study.

    Science.gov (United States)

    Christensen, Jakob; Pedersen, Henrik Søndergaard; Kjaersgaard, Maiken Ina Siegismund; Parner, Erik Thorlund; Vestergaard, Mogens; Sørensen, Merete Juul; Olsen, Jørn; Bech, Bodil Hammer; Pedersen, Lars Henning

    2015-09-10

    It is unknown if prenatal exposure to antiepileptic drugs (AEDs) increases the risk of low Apgar score in offspring. Population-based study using health registers in Denmark. We identified all 677 021 singletons born in Denmark from 1997 to 2008 and linked the Apgar score from the Medical Birth Register with information on the women's prescriptions for AEDs during pregnancy from the Danish Register of Medicinal Product Statistics. We used the Danish National Hospital Registry to identify mothers diagnosed with epilepsy before birth of the child. Results were adjusted for smoking and maternal age. Among 2906 children exposed to AEDs, 55 (1.9%) were born with an Apgar score ≤7 as compared with 8797 (1.3%) children among 674 115 pregnancies unexposed to AEDs (adjusted relative risk (aRR)=1.41 (95% CI 1.07 to 1.85). When analyses were restricted to the 2215 children born of mothers with epilepsy, the aRR of having a low Apgar score associated with AED exposure was 1.34 (95% CI 0.90 to 2.01) When assessing individual AEDs, we found increased, unadjusted RR for exposure to carbamazepine (RR=1.86 (95% CI 1.01 to 3.42)), valproic acid (RR=1.85 (95% CI 1.04 to 3.30)) and topiramate (RR=2.97 (95% CI 1.26 to 7.01)) when compared to unexposed children. Prenatal exposure to AEDs was associated with increased risk of being born with a low Apgar score, but the absolute risk of a low Apgar score was Apgar score associated with certain AEDs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Induced abortion, pregnancy loss and intimate partner violence in Tanzania: a population based study

    Science.gov (United States)

    2012-01-01

    Background Violence by an intimate partner is increasingly recognized as an important public and reproductive health issue. The aim of this study is to investigate the extent to which physical and/or sexual intimate partner violence is associated with induced abortion and pregnancy loss from other causes and to compare this with other, more commonly recognized explanatory factors. Methods This study analyzes the data of the Tanzania section of the WHO Multi-Country Study on Women's Health and Domestic Violence, a large population-based cross-sectional survey of women of reproductive age in Dar es Salaam and Mbeya, Tanzania, conducted from 2001 to 2002. All women who answered positively to at least one of the questions about specific acts of physical or sexual violence committed by a partner towards her at any point in her life were considered to have experienced intimate partner violence. Associations between self reported induced abortion and pregnancy loss with intimate partner violence were analysed using multiple regression models. Results Lifetime physical and/or sexual intimate partner violence was reported by 41% and 56% of ever partnered, ever pregnant women in Dar es Salaam and Mbeya respectively. Among the ever pregnant, ever partnered women, 23% experienced involuntary pregnancy loss, while 7% reported induced abortion. Even after adjusting for other explanatory factors, women who experienced intimate partner violence were 1.6 (95%CI: 1.06,1.60) times more likely to report an pregnancy loss and 1.9 (95%CI: 1.30,2.89) times more likely to report an induced abortion. Intimate partner violence had a stronger influence on induced abortion and pregnancy loss than women's age, socio-economic status, and number of live born children. Conclusions Intimate partner violence is likely to be an important influence on levels of induced abortion and pregnancy loss in Tanzania. Preventing intimate partner violence may therefore be beneficial for maternal health and

  1. Induced abortion, pregnancy loss and intimate partner violence in Tanzania: a population based study

    Directory of Open Access Journals (Sweden)

    Stöckl Heidi

    2012-03-01

    Full Text Available Abstract Background Violence by an intimate partner is increasingly recognized as an important public and reproductive health issue. The aim of this study is to investigate the extent to which physical and/or sexual intimate partner violence is associated with induced abortion and pregnancy loss from other causes and to compare this with other, more commonly recognized explanatory factors. Methods This study analyzes the data of the Tanzania section of the WHO Multi-Country Study on Women's Health and Domestic Violence, a large population-based cross-sectional survey of women of reproductive age in Dar es Salaam and Mbeya, Tanzania, conducted from 2001 to 2002. All women who answered positively to at least one of the questions about specific acts of physical or sexual violence committed by a partner towards her at any point in her life were considered to have experienced intimate partner violence. Associations between self reported induced abortion and pregnancy loss with intimate partner violence were analysed using multiple regression models. Results Lifetime physical and/or sexual intimate partner violence was reported by 41% and 56% of ever partnered, ever pregnant women in Dar es Salaam and Mbeya respectively. Among the ever pregnant, ever partnered women, 23% experienced involuntary pregnancy loss, while 7% reported induced abortion. Even after adjusting for other explanatory factors, women who experienced intimate partner violence were 1.6 (95%CI: 1.06,1.60 times more likely to report an pregnancy loss and 1.9 (95%CI: 1.30,2.89 times more likely to report an induced abortion. Intimate partner violence had a stronger influence on induced abortion and pregnancy loss than women's age, socio-economic status, and number of live born children. Conclusions Intimate partner violence is likely to be an important influence on levels of induced abortion and pregnancy loss in Tanzania. Preventing intimate partner violence may therefore be beneficial

  2. Can Insomnia in Pregnancy Predict Postpartum Depression? A Longitudinal, Population-Based Study

    Science.gov (United States)

    Dørheim, Signe K.; Bjorvatn, Bjørn; Eberhard-Gran, Malin

    2014-01-01

    Background Insomnia and depression are strongly interrelated. This study aimed to describe changes in sleep across childbirth, and to evaluate whether insomnia in pregnancy is a predictor of postpartum depression. Methods A longitudinal, population-based study was conducted among perinatal women giving birth at Akershus University Hospital, Norway. Women received questionnaires in weeks 17 and 32 of pregnancy and eight weeks postpartum. This paper presents data from 2,088 of 4,662 women with complete data for insomnia and depression in week 32 of pregnancy and eight weeks postpartum. Sleep times, wake-up times and average sleep durations were self-reported. The Bergen Insomnia Scale (BIS) was used to measure insomnia. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure depressive symptoms. Results After delivery, sleep duration was reduced by 49 minutes (to 6.5 hours), and mean sleep efficiency was reduced from 84% to 75%. However, self-reported insomnia scores (BIS) improved from 17.2 to 15.4, and the reported prevalence of insomnia decreased from 61.6% to 53.8%. High EPDS scores and anxiety in pregnancy, fear of delivery, previous depression, primiparity, and higher educational level were risk factors for both postpartum insomnia and depression. Insomnia did not predict postpartum depression in women with no prior history of depression, whereas women who recovered from depression had residual insomnia. Limitations Depression and insomnia were not verified by clinical interviews. Women with depressive symptoms were less likely to remain in the study. Conclusions Although women slept fewer hours at night after delivery compared to during late pregnancy, and reported more nights with nighttime awakenings, their self-reported insomnia scores improved, and the prevalence of insomnia according to the DSM-IV criteria decreased. Insomnia in pregnancy may be a marker for postpartum recurrence of depression among women with previous depression. PMID

  3. Can insomnia in pregnancy predict postpartum depression? A longitudinal, population-based study.

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    Signe K Dørheim

    Full Text Available BACKGROUND: Insomnia and depression are strongly interrelated. This study aimed to describe changes in sleep across childbirth, and to evaluate whether insomnia in pregnancy is a predictor of postpartum depression. METHODS: A longitudinal, population-based study was conducted among perinatal women giving birth at Akershus University Hospital, Norway. Women received questionnaires in weeks 17 and 32 of pregnancy and eight weeks postpartum. This paper presents data from 2,088 of 4,662 women with complete data for insomnia and depression in week 32 of pregnancy and eight weeks postpartum. Sleep times, wake-up times and average sleep durations were self-reported. The Bergen Insomnia Scale (BIS was used to measure insomnia. The Edinburgh Postnatal Depression Scale (EPDS was used to measure depressive symptoms. RESULTS: After delivery, sleep duration was reduced by 49 minutes (to 6.5 hours, and mean sleep efficiency was reduced from 84% to 75%. However, self-reported insomnia scores (BIS improved from 17.2 to 15.4, and the reported prevalence of insomnia decreased from 61.6% to 53.8%. High EPDS scores and anxiety in pregnancy, fear of delivery, previous depression, primiparity, and higher educational level were risk factors for both postpartum insomnia and depression. Insomnia did not predict postpartum depression in women with no prior history of depression, whereas women who recovered from depression had residual insomnia. LIMITATIONS: Depression and insomnia were not verified by clinical interviews. Women with depressive symptoms were less likely to remain in the study. CONCLUSIONS: Although women slept fewer hours at night after delivery compared to during late pregnancy, and reported more nights with nighttime awakenings, their self-reported insomnia scores improved, and the prevalence of insomnia according to the DSM-IV criteria decreased. Insomnia in pregnancy may be a marker for postpartum recurrence of depression among women with previous

  4. Hormone Receptor Status Does Not Affect Prognosis in Metaplastic Breast Cancer: A Population-Based Analysis with Comparison to Infiltrating Ductal and Lobular Carcinomas

    National Research Council Canada - National Science Library

    Paul Wright, G; Davis, Alan T; Koehler, Tracy J; Melnik, Marianne K; Chung, Mathew H

    2014-01-01

    Metaplastic breast cancer is a rare histologic variant among breast cancers. We sought to investigate the impact of hormone receptor status in metaplastic breast cancer and compare outcomes with common histologic variants of breast...

  5. Risk Profiles for Injurious Falls in People Over 60: A Population-Based Cohort Study.

    Science.gov (United States)

    Ek, Stina; Rizzuto, Debora; Fratiglioni, Laura; Johnell, Kristina; Xu, Weili; Welmer, Anna-Karin

    2018-01-16

    Although falls in older adults are related to multiple risk factors, these factors have commonly been studied individually. We aimed to identify risk profiles for injurious falls in older adults by detecting clusters of established risk factors and quantifying their impact on fall risk. Participants were 2,566 people, aged 60 years and older, from the population-based Swedish National Study on Aging and Care in Kungsholmen. Injurious falls was defined as hospitalization for or receipt of outpatient care because a fall. Cluster analysis was used to identify aggregation of possible risk factors including chronic diseases, fall-risk increasing drugs (FRIDs), physical and cognitive impairments, and lifestyle-related factors. Associations between the clusters and injurious falls over 3, 5, and 10 years were estimated using flexible parametric survival models. Five clusters were identified including: a "healthy", a "well-functioning with multimorbidity", a "well-functioning, with multimorbidity and high FRID consumption", a "physically and cognitively impaired", and a "disabled" cluster. The risk of injurious falls for all groups was significantly higher than for the first cluster of healthy individuals in the reference category. Hazard ratios (95% confidence intervals) ranged from 1.71 (1.02-2.66) for the second cluster to 12.67 (7.38-21.75) for the last cluster over 3 years of follow-up. The highest risk was observed in the last two clusters with high burden of physical and cognitive impairments. Risk factors for injurious fall tend to aggregate, representing different levels of risk for falls. Our findings can be useful to tailor and prioritize clinical and public health interventions.

  6. Relationship between Polycystic Ovarian Syndrome and Subsequent Gestational Diabetes Mellitus: A Nationwide Population-Based Study.

    Directory of Open Access Journals (Sweden)

    Mei-Lien Pan

    Full Text Available This nationwide population-based study aims to explore the relationship between polycystic ovarian syndrome (PCOS and subsequent gestational diabetes mellitus (GDM.Data from 1998-2012 Taiwan National Health Insurance Research Database were used for this study. ICD9-CM codes 256.4X and 648.X were used separately for the diagnoses of PCOS and GDM, which were further confirmed by records of blood tests or ultrasonography to ensure the accuracy of the diagnoses. Women diagnosed at 45 years of age, and those diagnosed with overt diabetes mellitus or GDM prior to PCOS were excluded. During pregnancy, each woman with a previous diagnosis of PCOS was age-matched to 10 women without PCOS. Odds ratios (ORs for risk of GDM were calculated by logistic regression analysis with adjustment for economic status and co-morbidities.Among 7,629 eligible women with a valid PCOS diagnosis, 3,109 (42.87% had subsequent pregnancies. GDM occurred frequently among women with a history of PCOS as compared to those without PCOS (20.46% vs. 10.54%, p0.05. If not used after conception, OHAs did not reduce the risk of GDM (adjusted OR = 1.20; 95% CI:0.88-1.62.A history of PCOS is a significant and independent risk factor for development of GDM. Medication for PCOS or pre-pregnancy use of OHAs does not reduce the risk of GDM. When at-risk women become pregnant, they require closer surveillance for maternal and fetal well-being, and should follow a strict diet and adhere to weight gain control to avoid obstetric complications due to GDM.

  7. Trends in diet quality among adolescents, adults and older adults: A population-based study

    Directory of Open Access Journals (Sweden)

    Samantha Caesar de Andrade, PhD

    2016-12-01

    Full Text Available This study aimed to monitor diet quality and associated factors in adolescents, adults and older adults from the city of São Paulo, Brazil. We conducted a cross-sectional population-based study involving 2376 individuals surveyed in 2003, and 1662 individuals in 2008 (Health Survey of São Paulo, ISA-Capital. Participants were of both sexes and aged 12 to 19 years old (adolescents, 20 to 59 years old (adults and 60 years old or over (older adults. Food intake was assessed using the 24-h dietary recall method while diet quality was determined by the Brazilian Healthy Eating Index (BHEI-R. The prevalence of descriptive variables for 2003 and 2008 was compared adopting a confidence interval of 95%. The means of total BHEI-R score and its components for 2003 and 2008 were compared for each age group. Associations between the BHEI-R and independent variables were evaluated for each survey year using multiple linear regression analysis. Results showed that the mean BHEI-R increased (54.9 vs. 56.4 points over the five-year period. However, the age group evaluation showed a deterioration in diet quality of adolescents, influenced by a decrease in scores for dark-green and orange vegetables and legumes, total grains, oils and SoFAAS (solid fat, alcohol and added sugar components. In the 2008 survey, adults had a higher BHEI-R score, by 6.1 points on average, compared to adolescents. Compared to older adults, this difference was 10.7 points. The diet quality remains a concern, especially among adolescents, that had the worst results compared to the other age groups.

  8. Prevalence and factors associated with neck pain: a population-based study.

    Science.gov (United States)

    Genebra, Caio Vitor Dos Santos; Maciel, Nicoly Machado; Bento, Thiago Paulo Frascareli; Simeão, Sandra Fiorelli Almeida Penteado; Vitta, Alberto De

    Neck pain is a musculoskeletal condition with high prevalence that may affect the physical, social, and psychological aspects of the individual, contributing to the increase in costs in society and business. To determine the prevalence of neck pain and associated factors in a population-based sample of adults aged 20 and more. Cross-sectional study based on a population survey. A total number of 600 individuals were interviewed in their homes, and the following data were collected: (1) participant characteristics (demographic, socioeconomic, and work-related aspects) using a pre-coded questionnaire; (2) physical activity level using the IPAQ; and (3) musculoskeletal symptoms using the Nordic questionnaire. Descriptive, bivariate, and Poisson regression analyses were performed. The prevalence of neck pain was 20.3% (95% CI 17.3-23.7). The adjusted analyses showed that individuals who were widowers or separated (PR=2.26; 1.42-5.88), had a low income (PR=1.32; 1.22-6.27) or low educational level (PR=1.83; 1.02-5.26), worked while sitting and leaning (PR=1.55; 1.08-2.40), and who reported having two or more diseases (PR=1.71; 1.55-6.31) remained associated with neck pain. This study reveals the high prevalence of neck pain and remarkable association with widowed/separated people who have low income and low educational level, who perform their occupational activities in sitting and leaning positions, and who reported having two or more diseases. Knowledge of these risk factors will contribute to the development of forms of assistance in which neck pain can be prevented and better managed. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  9. Identifying women at risk for postpartum anxiety: a prospective population-based study.

    Science.gov (United States)

    Dennis, C-L; Falah-Hassani, K; Brown, H K; Vigod, S N

    2016-12-01

    To develop a multifactorial model to predict anxiety symptomatology at 8 weeks postpartum. In a population-based study, 522 women in a health region near Vancouver, Canada, completed questionnaires at 1, 4, and 8 weeks postpartum. Questionnaires included risk factors measured at 1 week (sociodemographic, biological, pregnancy-related, life stressors, social support, obstetric, and maternal adjustment). Sequential logistic regression was completed to develop a predictive model of anxiety symptomatology at 8 weeks (State-Trait Anxiety Inventory score >40). The prevalence of anxiety symptomatology at 1, 4, and 8 weeks postpartum was 22.6%, 17.2%, and 14.8% respectively. In multivariable models, anxiety symptomatology at 1 week (aOR 2.78, 95% CI: 1.04-7.43), multiparous parity (aOR 3.29, 95% CI: 1.28-8.48), history of psychiatric problems (aOR 3.07, 95% CI: 1.19-7.97), perceived stress (1 SD increase: aOR 4.92, 95% CI: 2.62-9.26), and childcare stress (1 SD increase: aOR 1.63, 95% CI: 1.01-2.64) were independent predictors of anxiety symptomatology at 8 weeks. While a significant proportion of women experience anxiety symptomatology following childbirth, multiparous women with a psychiatric history who have high levels of diverse stress are at greatest risk. These key factors may be used to promote early identification and secondary preventive interventions. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Walking speed, processing speed, and dementia: a population-based longitudinal study.

    Science.gov (United States)

    Welmer, Anna-Karin; Rizzuto, Debora; Qiu, Chengxuan; Caracciolo, Barbara; Laukka, Erika J

    2014-12-01

    Slow walking speed has been shown to predict dementia. We investigated the relation of walking speed, processing speed, and their changes over time to dementia among older adults. This study included 2,938 participants (age 60+ years) in the population-based Swedish National study on Aging and Care in Kungsholmen, Sweden, who were free from dementia and severe walking impairment at baseline. Walking speed was assessed with participants walking at their usual pace and processing speed was defined by a composite measure of standard tests (digit cancellation, trail making test-A, pattern comparison). Dementia at 3- and 6-year follow-ups was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Of the 2,232 participants who were reassessed at least once, 226 developed dementia. Logistic regression models showed that each standard deviation slower baseline walking speed or decline in walking speed over time increased the likelihood of incident dementia (odds ratios 1.61, 95% confidence interval [CI] 1.31-1.98; and 2.58, 95% CI 2.12-3.14, respectively). Adjustment for processing speed attenuated these associations (odds ratios 1.26, 95% CI 1.01-1.58 and 1.76, 95% CI 1.33-2.34). Mixed-effects models revealed statistical interactions of time with dementia on change in walking and processing speed, such that those who developed dementia showed accelerated decline. At baseline, poorer performance in processing speed, but not in walking speed, was observed for persons who developed dementia during the study period. Processing speed may play an important role for the association between walking speed and dementia. The slowing of walking speed appears to occur secondary to slowing of processing speed in the path leading to dementia. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Temporal trends in lipid testing among children and adolescents: A population based study

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    Swetha Sriram

    2017-12-01

    Full Text Available Unfavorable lipid levels during childhood are associated with subsequent development of atherosclerotic cardiovascular disease. The American Academy of Pediatrics and National Heart, Lung and Blood Institute in 2011 recommended universal lipid screening for children between ages 9–11 years and between ages 17–21 years. The objective of the study was to determine temporal trends in lipid testing among children and young adults in a mid-western population. The Rochester Epidemiology Project database was used to identify lipid testing in ages 2–21 years (n = 51,176 in the Olmsted County population from January 1, 2008 through December 31, 2014. Generalized estimating equations with Poisson distribution were used to test for temporal trends in lipid testing across the age groups. There was modest increase in lipid testing in children in the age groups, 9–11 years and 17–21 years (1.5% in 2008 to 2.2% in 2014, P < 0.001 and 4.4% in 2008 to 4.6% in 2014, P = 0.02, respectively. There was a significant decrease in proportion of 17–21 year olds with elevated total cholesterol (16.2% in 2008 to 11.6% in 2014; P = 0.01 and non-high density lipoprotein cholesterol (22.6% in 2008 to 12.6% in 2014; P < 0.001. In this population-based study, rates of lipid testing increased minimally only in the last six years. Further longitudinal studies are warranted to improve guideline dissemination and address attitudes, practices and barriers to lipid testing in children and young adults.

  12. Antioxidants and breast cancer risk- a population-based case-control study in Canada

    Directory of Open Access Journals (Sweden)

    Morrison Howard

    2011-08-01

    Full Text Available Abstract Background The effect of antioxidants on breast cancer is still controversial. Our objective was to assess the association between antioxidants and breast cancer risk in a large population-based case-control study. Methods The study population included 2,362 cases with pathologically confirmed incident breast cancer (866 premenopausal and 1,496 postmenopausal and 2,462 controls in Canada. Intakes of antioxidants from diet and from supplementation as well as other potential risk factors for breast cancer were collected by a self-reported questionnaire. Results Compared with subjects with no supplementation, 10 years or longer supplementation of zinc had multivariable-adjusted odds ratios (OR and 95% confidence intervals (CI of 0.46 (0.25-0.85 for premenopausal women, while supplementation of 10 years or longer of multiple vitamin, beta-carotene, vitamin C, vitamin E and zinc had multivariable-adjusted ORs (95% CIs of 0.74 (0.59, 0.92, 0.58 (0.36, 0.95, 0.79 (0.63-0.99, 0.75 (0.58, 0.97, and 0.47 (0.28-0.78, respectively, for postmenopausal women. No significant effect of antioxidants from dietary sources (including beta-carotene, alpha-carotene, lycopene, lutein and zeaxanthin, vitamin C, vitamin E, selenium and zinc or from supplementation less than 10 years was observed. Conclusions This study suggests that supplementation of zinc in premenopausal women, and supplementation of multiple vitamin, beta-carotene, vitamin C, vitamin E and zinc in postmenopausal women for 10 or more years may protect women from developing breast cancer. However, we were unable to determine the overall effect of total dose or intake from both diet and supplement.

  13. Effects of Pediatric Burns on Gastrointestinal Diseases: A Population-Based Study.

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    Boyd, James H; Wood, Fiona M; Randall, Sean M; Fear, Mark W; Rea, Suzanne; Duke, Janine M

    The systemic responses triggered by burns have been shown to include effects on the gastrointestinal tract. However, it is not clear if these changes lead to long-term gastrointestinal morbidity in patients with burns. The aim of this study was to assess if pediatric burns are associated with increased hospital use for gastrointestinal diseases after discharge for the initial injury. A population-based longitudinal study was performed using linked hospital and death data from Western Australia for children younger than 15 years when hospitalized for a first burn injury (n = 10,436) between 1980 and 2012, along with a frequency-matched noninjury comparison cohort, randomly selected from Western Australia's birth registrations (n = 40,819). Crude admission rates and cumulative length of stay for digestive diseases were calculated. Negative binomial and Cox proportional hazards regression modeling were used to generate incidence rate ratios (IRRs) and hazard ratios, respectively. After discharge, the pediatric burn cohort experienced twice the rate of gastrointestinal disease admissions (IRR, 95% confidence interval [CI]: 2.03, 1.56-2.65), spent over twice as long in hospital (IRR, 95% CI: 2.23, 1.67-2.98), and had a higher rate of first-time or incident gastrointestinal disease admissions (hazard ratio, 95% CI: 1.18, 1.08-1.29) when compared with the uninjured cohort, after adjusting for demographic and preexisting health factors. Children who experience a burn injury hospitalization are at increased risk of postburn hospital service use for gastrointestinal diseases when compared with uninjured children.

  14. Identification of fungal candidates for asthma protection in a large population-based study.

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    Mueller-Rompa, Susanne; Janke, Tobias; Schwaiger, Karin; Mayer, Melanie; Bauer, Johann; Genuneit, Jon; Braun-Fahrlaender, Charlotte; Horak, Elisabeth; Boznanski, Andrzej; von Mutius, Erika; Ege, Markus J

    2017-02-01

    Exposure to molds has been related to asthma risk both positively and negatively, depending on the environmental setting. The pertinent results are based on generic markers or culturing methods although the majority of present fungi cannot be cultured under laboratory conditions. The aim of the present analysis was to assess environmental dust samples for asthma-protective fungal candidates with a comprehensive molecular technique covering also non-cultivable and non-viable fungi. Mattress dust samples of 844 children from the GABRIELA study were analyzed by polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) of the fungus-specific internal transcribed spacer (ITS) region. Known asthma candidate species were tested for their associations with asthma, and further gel positions were sought to explain the above. As a second, data-driven, analysis, we tested the association of each individual gel position with asthma. In the hypothesis-driven approach, Penicillium chrysogenum emerged with an odds ratio of 0.80 (95% confidence interval 0.66-0.96; p = 0.020). The effect size was changed by 39% toward the null when adjusting for the two bands 683 (DNA of Metschnikowia sp., Aureobasidium spp.) and 978 (DNA of Epicoccum spp., Galactomyces spp., uncultured Penicillium). The data-driven approach yielded an additional band (containing DNA of Pseudotaeniolina globosa) with reduced risk of asthma (OR = 0.80 [0.66-0.96], p = 0.012). A large population-based study revealed several fungal taxa with inverse associations with childhood asthma. Molds produce a variety of bioactive compounds with detrimental but also beneficial immunoregulatory capacities, which renders them promising targets for further asthma research. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Fear of childbirth and elective caesarean section: a population-based study.

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    Størksen, Hege Therese; Garthus-Niegel, Susan; Adams, Samantha S; Vangen, Siri; Eberhard-Gran, Malin

    2015-09-17

    This population-based cohort study aimed to investigate the demographic and psychosocial characteristics associated with fear of childbirth and the relative importance of such fear as a predictor of elective caesarean section. A sample of 1789 women from the Akershus Birth Cohort in Norway provided data collected by three self-administered questionnaires at 17 and 32 weeks of pregnancy and 8 weeks postpartum. Information about the participants' childbirths was obtained from the hospital records. Eight percent of the women reported fear of delivery, defined as a score of ≥85 on the Wijma Delivery Expectancy Questionnaire. Using multivariable logistic regression models, a previous negative overall birth experience exerted the strongest impact on fear of childbirth, followed by impaired mental health and poor social support. Fear of childbirth was strongly associated with a preference for elective caesarean section (aOR 4.6, 95% CI 2.9-7.3) whereas the association of fear with performance of caesarean delivery was weaker (aOR 2.4, 95% CI 1.2-4.9). The vast majority (87%) of women with fear of childbirth did not, however, receive a caesarean section. By contrast, a previous negative overall birth experience was highly predictive of elective caesarean section (aOR 8.1, 95% CI 3.9-16.7) and few women without such experiences did request caesarean section. Results suggest that women with fear of childbirth may have identifiable vulnerability characteristics, such as poor mental health and poor social support. Results also emphasize the need to focus on the subjective experience of the birth to prevent fear of childbirth and elective caesarean sections on maternal request. Regarding the relationship with social support, causality has to be interpreted cautiously, as social support was measured at 8 weeks postpartum only.

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

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

    2014-09-01

    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 adjustment for possible confounders. Women with an elective cesarean delivery, fetus in breech presentation or a fetus with congenital anomalies were excluded. Results were reported separately for women with a vaginal delivery or a cesarean delivery at first pregnancy. Prevalence of birth asphyxia, a 5-min Apgar score Apgar score of Apgar score in the subsequent pregnancy was 1.1% (odds ratio 2.1, 95% confidence interval 1.4-3.3). This recurrence risk was present in women with a previous vaginal delivery (odds ratio 2.1, 95% confidence interval 1.2-3.5) and in women with a previous cesarean delivery (odds ratio 3.8, 95% confidence interval 1.7-8.5). Among women with a small-for-gestational-age infant in the subsequent pregnancy and a previous vaginal delivery, the recurrence risk was 4.8% (adjusted odds ratio 5.8, 95% confidence interval 2.0-16.5). Women with birth asphyxia of the first born have twice the risk of renewed asphyxia at the next birth compared to women without birth asphyxia of the first born. This should be incorporated in the risk assessment of pregnant women. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  17. School performance for children with cleft lip and palate: a population-based study.

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    Bell, J C; Raynes-Greenow, C; Turner, R; Bower, C; Dodson, A; Nicholls, W; Nassar, N

    2017-03-01

    Educational attainment is important in shaping young people's life prospects. To investigate whether being born with orofacial cleft (OFC) affects school performance, we compared school test results between children born with and without OFC. Using record-linked datasets, we conducted a population-based cohort study of children liveborn in Western Australia 1980-2010 with a diagnosis of OFC on the Register of Developmental Anomalies, and a random sample of 6603 children born without OFC. We compared odds ratios for meeting national minimum standards in five domains (reading, numeracy, writing, spelling, grammar and punctuation), and adjusted OR (aOR) for children with cleft lip only (CLO), cleft lip and palate (CL + P) and cleft palate only (CPO) for each domain. Results from two testing programs (WALNA and NAPLAN) were available for 3238 (89%) children expected to participate. Most met the national minimum standards. Compared with children without OFC, children with CPO were less likely to meet minimum standards for NAPLAN reading (aOR 0.57 [95%CI 0.34, 0.96]) grammar and punctuation (aOR 0.49 [95%CI 0.32, 0.76]), WALNA writing (aOR 0.66 [95%CI 0.47, 0.92]), and WALNA and NAPLAN numeracy (aOR 0.64 [95%CI 0.43, 0.95] and aOR 0.47 [95%CI 0.28, 0.82]), respectively. Children with CL + P had significantly lower odds for reaching the spelling standard in NAPLAN tests (aOR 0.52 [95%CI 0.29, 0.94]). Children with CLO had similar odds for reaching all minimum standards. Children born with OFC, particularly children with CPO, should be monitored to identify learning difficulties early, to enable intervention to maximize school attainment. © 2016 John Wiley & Sons Ltd.

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

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    Juan-Pablo Millet

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

  19. The Moli-sani project: computerized ECG database in a population-based cohort study.

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    Iacoviello, Licia; Rago, Livia; Costanzo, Simona; Di Castelnuovo, Augusto; Zito, Francesco; Assanelli, Deodato; Badilini, Fabio; Donati, Maria Benedetta; de Gaetano, Giovanni

    2012-01-01

    Computerized electrocardiogram (ECG) acquisition and interpretation may be extremely useful in handling analysis of data from large cohort studies and exploit research on the use of ECG data as prognostic markers for cardiovascular disease. The Moli-sani project (http://www.moli-sani.org) is a population-based cohort study aiming at evaluating the risk factors linked to chronic-degenerative disease with particular regard to cardiovascular disease and cancer and intermediate metabolic phenotypes such as hypertension, diabetes, dyslipidemia, obesity, and metabolic syndrome. Between March 2005 and April 2010, 24 325 people aged 35 years or older, living in the Molise region (Italy), were randomly recruited. A follow-up based on linkage with hospital discharge records and mortality regional registry and reexamination of the cohort is ongoing and will be repeated at prefixed times. Each subject was administered questionnaires on personal and medical history, food consumption, quality of life (FS36), and psychometry. Plasma serum, cellular pellet, and urinary spots were stored in liquid nitrogen. Subjects were measured blood pressure, weight, height, and waist and hip circumferences, and underwent spirometry to evaluate pulmonary diffusion capacity, gas diffusion, and pulmonary volumes. Standard 12-lead resting ECG was performed by a Cardiette ar2100-view electrocardiograph and tracings stored in digital standard communication protocol format for subsequent analysis. The digital ECG database of the Moli-sani project is currently being used to assess the association between physiologic variables and pathophyiosiologic conditions and parameters derived from the ECG signal. This computerized ECG database represents a unique opportunity to identify and assess prognostic factors associated with cardiovascular and metabolic diseases. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Performance of Different Gastric Cancer Screening Methods in Korea: A Population-Based Study

    Science.gov (United States)

    Choi, Kui Son; Jun, Jae Kwan; Park, Eun-Cheol; Park, Sohee; Jung, Kyu Won; Han, Mi Ah; Choi, Il Ju; Lee, Hoo-Yeon

    2012-01-01

    Background There is a lack of agreement on which gastric cancer screening method is the most effective in the general population. The present study compared the relative performance of upper-gastrointestinal series (UGIS) and endoscopy screening for gastric cancer. Methods A population-based study was conducted using the National Cancer Screening Program (NCSP) database. We analyzed data on 2,690,731 men and women in Korea who underwent either UGIS or endoscopy screening for gastric cancer between January 1, 2002 and December 31, 2005. Final gastric cancer diagnosis was ascertained through linkage with the Korean Central Cancer Registry. We calculated positivity rate, gastric cancer detection rate, interval cancer rate, sensitivity, specificity, and positive predictive value of UGIS and endoscopy screening. Results The positivity rates for UGIS and endoscopy screening were 39.7 and 42.1 per 1,000 screenings, respectively. Gastric cancer detection rates were 0.68 and 2.61 per 1,000 screenings, respectively. In total, 2,067 interval cancers occurred within 1 year of a negative UGIS screening result (rate, 1.17/1,000) and 1,083 after a negative endoscopy screening result (rate, 1.17/1,000). The sensitivity of UGIS and endoscopy screening to detect gastric cancer was 36.7 and 69.0%, respectively, and specificity was 96.1 and 96.0%. The sensitivity of endoscopy screening to detect localized gastric cancer was 65.7%, which was statistically significantly higher than that of UGIS screening. Conclusion Overall, endoscopy performed better than UGIS in the NCSP for gastric cancer. Further evaluation of the impact of these screening methods should take into account the corresponding costs and reduction in mortality. PMID:23209638

  1. Performance of different gastric cancer screening methods in Korea: a population-based study.

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    Kui Son Choi

    Full Text Available BACKGROUND: There is a lack of agreement on which gastric cancer screening method is the most effective in the general population. The present study compared the relative performance of upper-gastrointestinal series (UGIS and endoscopy screening for gastric cancer. METHODS: A population-based study was conducted using the National Cancer Screening Program (NCSP database. We analyzed data on 2,690,731 men and women in Korea who underwent either UGIS or endoscopy screening for gastric cancer between January 1, 2002 and December 31, 2005. Final gastric cancer diagnosis was ascertained through linkage with the Korean Central Cancer Registry. We calculated positivity rate, gastric cancer detection rate, interval cancer rate, sensitivity, specificity, and positive predictive value of UGIS and endoscopy screening. RESULTS: The positivity rates for UGIS and endoscopy screening were 39.7 and 42.1 per 1,000 screenings, respectively. Gastric cancer detection rates were 0.68 and 2.61 per 1,000 screenings, respectively. In total, 2,067 interval cancers occurred within 1 year of a negative UGIS screening result (rate, 1.17/1,000 and 1,083 after a negative endoscopy screening result (rate, 1.17/1,000. The sensitivity of UGIS and endoscopy screening to detect gastric cancer was 36.7 and 69.0%, respectively, and specificity was 96.1 and 96.0%. The sensitivity of endoscopy screening to detect localized gastric cancer was 65.7%, which was statistically significantly higher than that of UGIS screening. CONCLUSION: Overall, endoscopy performed better than UGIS in the NCSP for gastric cancer. Further evaluation of the impact of these screening methods should take into account the corresponding costs and reduction in mortality.

  2. Pregnancy outcome after gestational exposure to erythromycin – a population-based register study from Norway

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    Romøren, Maria; Lindbæk, Morten; Nordeng, Hedvig

    2012-01-01

    AIMS Erythromycin is a macrolide antibiotic indicated for respiratory tract infections, genital chlamydia and skin infections. It has recently been suggested that erythromycin use in the first trimester of pregnancy can increase the risk of congenital cardiovascular malformations. This study aimed to determine whether erythromycin exposure in the first trimester is associated with cardiovascular or other malformations. METHODS We studied 180 120 women in Norway who were pregnant during 2004–2007. Data on all live births stillbirths and induced abortions after 12 gestational weeks from The Medical Birth Registry of Norway (MBRN) were linked to information from the Norwegian prescription database (NorPD). We compared the pregnancy outcomes of women who had taken erythromycin (n= 1786, 1.0%), penicillin V (n= 4921, 2.7%) or amoxicillin (n= 1599, 0.9%) in their first trimester with outcomes of women who had not taken any systemic antibiotics (n= 163 653, 90.9%) during this period. RESULTS The risk of cardiovascular malformations was not significantly different with or without exposure to erythromycin in the first trimester (adjusted OR = 1.2 [95% CI 0.8, 1.8]) or in the most vulnerable period of heart formation (adjusted OR = 1.6 [95% CI 0.9–3.0]). Sub-analyses showed that the risk for any specific malformations was not increased with erythromycin, macrolides, penicillin V or amoxicillin compared with no antibiotic use in first trimester. CONCLUSIONS This large, population-based register study did not find that exposure to erythromycin or macrolides in the first trimester of pregnancy was associated with fetal cardiovascular or other malformations. These results suggest that the risk of erythromycin use during early pregnancy, if any, is low. PMID:22463376

  3. Cell-cycle protein expression in a population-based study of ovarian and endometrial cancers

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    Ashley S. Felix

    2015-02-01

    Full Text Available Aberrant expression of cyclin-dependent kinase (CDK inhibitors is implicated in the carcinogenesis of many cancers, including ovarian and endometrial cancers. We examined associations between CDK inhibitor expression, cancer risk factors, tumor characteristics, and survival outcomes among ovarian and endometrial cancer patients enrolled in a population-based case control study. Expression (negative vs. positive of three CDK inhibitors (p16, p21, p27 and ki67 was examined with immunohistochemical staining of tissue microarrays. Logistic regression was used to estimate adjusted odds ratios (ORs and 95% confidence intervals (CIs for associations between biomarkers, risk factors, and tumor characteristics. Survival outcomes were available for ovarian cancer patients and examined using Kaplan-Meier plots and Cox proportional hazards regression. Among ovarian cancer patients (n=175, positive p21 expression was associated with endometrioid tumors (OR=12.22, 95% CI=1.45-102.78 and higher overall survival (log-rank p=0.002. In Cox models adjusted for stage, grade, and histology, the association between p21 expression and overall survival was borderline significant (hazard ratio=0.65, 95% CI=0.42-1.05. Among endometrial cancer patients (n=289, positive p21 expression was inversely associated with age (OR ≥ 65 years of age=0.25, 95% CI=0.07-0.84 and current smoking status (OR: 0.33, 95% CI 0.15, 0.72 compared to negative expression. Our study showed heterogeneity in expression of cell-cycle proteins associated with risk factors and tumor characteristics of gynecologic cancers. Future studies to assess these markers of etiological classification and behavior may be warranted.

  4. Psychosocial work factors and social inequalities in psychological distress: a population-based study.

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    Duchaine, Caroline S; Ndjaboué, Ruth; Levesque, Manon; Vézina, Michel; Trudel, Xavier; Gilbert-Ouimet, Mahée; Dionne, Clermont E; Mâsse, Benoît; Pearce, Neil; Brisson, Chantal

    2017-01-18

    Mental health problems (MHP) are the leading cause of disability worldwide. The inverse association between socioeconomic position (SEP) and MHP has been well documented. There is prospective evidence that factors from the work environment, including adverse psychosocial work factors, could contribute to the development of MHP including psychological distress. However, the contribution of psychosocial work factors to social inequalities in MHP remains unclear. This study evaluates the contribution of psychosocial work factors from two highly supported models, the Demand-Control-Support (DCS) and the Effort-Reward Imbalance (ERI) models to SEP inequalities of psychological distress in men and women from a population-based sample of Quebec workers. Data were collected during a survey on working conditions, health and safety at work. SEP was evaluated using education, occupation and household income. Psychosocial work factors and psychological distress were assessed using validated instruments. Mean differences (MD) in the score of psychological distress were estimated separately for men and women. Low education level and low household income were associated with psychological distress among men (MD, 0.56 (95% CI 0.06; 1.05) and 1.26 (95% CI 0.79; 1.73) respectively). In men, the contribution of psychosocial work factors from the DCS and the ERI models to the association between household income and psychological distress ranged from 9% to 24%. No clear inequalities were observed among women. These results suggest that psychosocial work factors from the DCS and the ERI models contribute to explain a part of social inequalities in psychological distress among men. Psychosocial factors at work are frequent and modifiable. The present study supports the relevance of targeting these factors for the primary prevention of MHP and for health policies aiming to reduce social inequalities in mental health.

  5. Live delivery outcome after tubal sterilization reversal: a population-based study.

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    Malacova, Eva; Kemp-Casey, Anna; Bremner, Alexandra; Hart, Roger; Stewart, Louise Maree; Preen, David Brian

    2015-10-01

    To determine the cumulative incidence of live delivery in women who underwent reversal of tubal sterilization. Population-based retrospective cohort study. Hospitals in Western Australia. All women aged 20-44 years, with a history of hospital admission for tubal sterilization, who subsequently underwent reversal of sterilization during the period 1985 to 2009 in Western Australia (n = 1,898). Data regarding reversal of sterilization and prior tubal sterilization were extracted from routinely collected administrative hospital separation records, until commencement of IVF treatment. First live-delivery rates. There were 969 first live deliveries observed during the study period. The overall cumulative live-delivery rate was 20% (95% confidence interval [CI] 18-23) within the first year after reversal, 40% (95% CI 38-42) at 2 years, 51% (95% CI 48-53) at 5 years, and 52% (95% CI 50-55) at 10 years. The 5-year cumulative live-delivery rate was significantly lower in women who were aged 40-44 years (26%) compared with younger women (aged 20-29, 30-34, and 35-39 years) (50%, 56%, and 51%, respectively). Women undergoing reversal of sterilization before they reach age 40 years have at least a 50% chance of delivering a live baby within the next 5 years. Up to that age, there is no significant difference in live deliveries. The live-delivery rate halves after the age of 40 years. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Psychosocial work factors and social inequalities in psychological distress: a population-based study

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    Caroline S. Duchaine

    2017-01-01

    Full Text Available Abstract Background Mental health problems (MHP are the leading cause of disability worldwide. The inverse association between socioeconomic position (SEP and MHP has been well documented. There is prospective evidence that factors from the work environment, including adverse psychosocial work factors, could contribute to the development of MHP including psychological distress. However, the contribution of psychosocial work factors to social inequalities in MHP remains unclear. This study evaluates the contribution of psychosocial work factors from two highly supported models, the Demand-Control-Support (DCS and the Effort-Reward Imbalance (ERI models to SEP inequalities of psychological distress in men and women from a population-based sample of Quebec workers. Methods Data were collected during a survey on working conditions, health and safety at work. SEP was evaluated using education, occupation and household income. Psychosocial work factors and psychological distress were assessed using validated instruments. Mean differences (MD in the score of psychological distress were estimated separately for men and women. Results Low education level and low household income were associated with psychological distress among men (MD, 0.56 (95% CI 0.06; 1.05 and 1.26 (95% CI 0.79; 1.73 respectively. In men, the contribution of psychosocial work factors from the DCS and the ERI models to the association between household income and psychological distress ranged from 9% to 24%. No clear inequalities were observed among women. Conclusions These results suggest that psychosocial work factors from the DCS and the ERI models contribute to explain a part of social inequalities in psychological distress among men. Psychosocial factors at work are frequent and modifiable. The present study supports the relevance of targeting these factors for the primary prevention of MHP and for health policies aiming to reduce social inequalities in mental health.

  7. Does marriage protect against hospitalization with pneumonia? A population-based case-control study.

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    Mor, Anil; Ulrichsen, Sinna P; Svensson, Elisabeth; Berencsi, Klara; Thomsen, Reimar W

    2013-01-01

    To reduce the increasing burden of pneumonia hospitalizations, we need to understand their determinants. Being married may decrease the risk of severe infections, due to better social support and healthier lifestyle. In this population-based case-control study, we identified all adult patients with a first-time pneumonia-related hospitalization between 1994 and 2008 in Northern Denmark. For each case, ten sex- and age-matched population controls were selected from Denmark's Civil Registration System. We performed conditional logistic regression analysis to estimate the odds ratios (ORs) for pneumonia hospitalization among persons who were divorced, widowed, or never married, as compared with married persons, adjusting for age, sex, 19 different comorbidities, alcoholism-related conditions, immunosuppressant use, urbanization, and living with small children. The study included 67,162 patients with a pneumonia-related hospitalization and 671,620 matched population controls. Compared with controls, the pneumonia patients were more likely to be divorced (10% versus 7%) or never married (13% versus 11%). Divorced and never-married patients were much more likely to have previous diagnoses of alcoholism-related conditions (18% and 11%, respectively) compared with married (3%) and widowed (6%) patients. The adjusted OR for pneumonia-related hospitalization was increased, at 1.29 (95% confidence interval [CI]: 1.25-1.33) among divorced; 1.15 (95% CI: 1.12-1.17) among widowed; and 1.33 (95% CI: 1.29-1.37) among never-married individuals as compared with those who were married. Married individuals have a decreased risk of being hospitalized with pneumonia compared with never-married, divorced, and widowed patients.

  8. Does marriage protect against hospitalization with pneumonia? A population-based case-control study

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    Mor A

    2013-10-01

    Full Text Available Anil Mor, Sinna P Ulrichsen, Elisabeth Svensson, Klara Berencsi, Reimar W Thomsen Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark Background: To reduce the increasing burden of pneumonia hospitalizations, we need to understand their determinants. Being married may decrease the risk of severe infections, due to better social support and healthier lifestyle. Patients and methods: In this population-based case-control study, we identified all adult patients with a first-time pneumonia-related hospitalization between 1994 and 2008 in Northern Denmark. For each case, ten sex- and age-matched population controls were selected from Denmark's Civil Registration System. We performed conditional logistic regression analysis to estimate the odds ratios (ORs for pneumonia hospitalization among persons who were divorced, widowed, or never married, as compared with married persons, adjusting for age, sex, 19 different comorbidities, alcoholism-related conditions, immunosuppressant use, urbanization, and living with small children. Results: The study included 67,162 patients with a pneumonia-related hospitalization and 671,620 matched population controls. Compared with controls, the pneumonia patients were more likely to be divorced (10% versus 7% or never married (13% versus 11%. Divorced and never-married patients were much more likely to have previous diagnoses of alcoholism-related conditions (18% and 11%, respectively compared with married (3% and widowed (6% patients. The adjusted OR for pneumonia-related hospitalization was increased, at 1.29 (95% confidence interval [CI]: 1.25-1.33 among divorced; 1.15 (95% CI: 1.12-1.17 among widowed; and 1.33 (95% CI: 1.29-1.37 among never-married individuals as compared with those who were married. Conclusion: Married individuals have a decreased risk of being hospitalized with pneumonia compared with never-married, divorced, and widowed patients

  9. Occupational Chronic Obstructive Pulmonary Disease in a Danish Population-Based Study.

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    Würtz, Else Toft; Schlünssen, Vivi; Malling, Tine Halsen; Hansen, Jens Georg; Omland, Øyvind

    2015-08-01

    The aim was to explore the impact of occupation on chronic obstructive pulmonary disease (COPD) in a cross-sectional population-based study among subjects aged 45 to 84 years. In a stratified sampling 89 general practitioners practices (GPP) in Denmark recruited 3106 males and 1636 females through the Danish Civil Registration System. COPD was defined by spirometry by the 2.5(th)-centile Lower Limit of Normal of FEV1 and FEV1/FVC. Information about smoking, occupational exposure and the respective occupations were obtained from questionnaires. Occupations followed the Danish adaptation of The International Standard Classification of Occupations, revision 1988 (DISCO-88). Exposure to vapour, gas, dust (organic and inorganic), and fume (VGDF) in each occupation (yes/no) was evaluated by two independent specialist in occupational medicine. Exposures were divided in no, low, medium, and high exposure as 0, COPD study prevalence was 5.0%. Of 372 DISCO-88 codes 72 were identified with relevant exposure to VGDF. 46% of the participants reported at least one occupation with VGDF exposure. Adjusted for smoking, age, sex, and GPP a dose-dependent association of COPD was found among workers in jobs with high organic dust exposure, with OR 1.56 (95% CI 1.09-2.24). Restricted to agriculture the OR was 1.59 (95% CI: 1.08-2.33). No association was observed for workers in jobs with inorganic dust, fume/gas, or vapour exposures. In summary, occupational organic dust exposure was associated to the prevalence of COPD.

  10. Increased Risk of Acute Pancreatitis in Patients with Rheumatoid Arthritis: A Population-Based Cohort Study

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    Chang, Chi Ching; Chiou, Chi Sheng; Lin, Hsiu Li; Wang, Li Hsuan; Chang, Yu Sheng; Lin, Hsiu-Chen

    2015-01-01

    The study was conducted to determine whether patients with rheumatoid arthritis (RA) are at increased risk of acute pancreatitis compared with those without RA and to determine if the risk of acute pancreatitis varied by anti-RA drug use. We used the large population-based dataset from the National Health Insurance (NHI) program in Taiwan to conduct a retrospective cohort study. Patients newly diagnosed with RA between 2000 and 2011 were referred to as the RA group. The comparator non-RA group was matched with propensity score, using age and sex, in the same time period. We presented the incidence density by 100,000 person-years. The propensity score and all variables were analyzed in fully adjusted Cox proportional hazard regression. The cumulative incidence of acute pancreatitis was assessed by Kaplan-Meier analysis, with significance based on the log-rank test. From claims data of one million enrollees randomly sampled from the Taiwan NHI database, 29,755 adults with RA were identified and 119,020 non- RA persons were matched as a comparison group. The RA cohort had higher incidence density of acute pancreatitis (185.7 versus 119.0 per 100,000 person-years) than the non-RA cohort. The adjusted hazard ratio (HR) was 1.62 (95% CI [confidence interval] 1.43–1.83) for patients with RA to develop acute pancreatitis. Oral corticosteroid use decreased the risk of acute pancreatitis (adjusted HR 0.83, 95% CI 0.73–0.94) but without a dose-dependent effect. Current use of disease modifying anti-rheumatic drugs or tumor necrosis factor blockers did not decrease the risk of acute pancreatitis. In conclusion, patients with RA are at an elevated risk of acute pancreatitis. Use of oral corticosteroids may reduce the risk of acute pancreatitis. PMID:26262880

  11. Annoyance and health symptoms and their influencing factors: a population-based air pollution intervention study.

    Science.gov (United States)

    Stenlund, T; Lidén, E; Andersson, K; Garvill, J; Nordin, S

    2009-04-01

    Interventions for reducing air pollution are important means for improving public health. The role of psychological factors in understanding annoyance and health symptoms due to air pollution is limited and further investigation is required. This study aimed to investigate the effects of an intervention to reduce air pollution (predominantly dust and soot) with respect to perceived pollution, risk perception, annoyance and health symptoms. Another objective was to test a model that describes inter-relations between air pollution, perceived pollution, health risk perception, annoyance and health symptoms. An interventional, population-based questionnaire study. Surveys were performed before (pre-test) and after (post-test) closure of a sinter plant. Instead, pellets were shipped to the community's harbour for steel production. Individuals in the community aged 18-75 years were selected at random for participation in the pre-test (n=738; 74% of the sample participated) and post-test (n=684; 68% of the sample participated). The two samples were representative of the populations at the two points in time, and thus not identical. After the sinter plant was closed, the environment was perceived as being less dusty, the residents were more positive in their risk perception, and they reported less annoyance due to dust, soot and odorous substances. No difference was found for health symptoms between the pre-test and the post-test. Based on path analyses, a model is proposed of inter-relations between air pollution, perceived pollution, health risk perception, annoyance and health symptoms. The intervention was successful with respect to perceived dust and soot pollution; to annoyance attributed to dust, soot and odorous substances; and to risk perception. The path analyses suggest that perceived pollution and health risk perception play important roles in understanding and predicting environmentally induced annoyance and health symptoms.

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

    Science.gov (United States)

    Aarsand, Aasne Karine; Sandberg, Sverre

    2010-01-01

    The porphyrias comprise a heterogeneous group of rare, primarily hereditary, metabolic diseases caused by a partial deficiency in one of the eight enzymes involved in the heme biosynthesis. Our aim was to assess whether acute or cutaneous porphyria has been associated with excess risks of adverse pregnancy outcomes. A population-based cohort study was designed by record linkage between the Norwegian Porphyria Register, covering 70% of all known porphyria patients in Norway, and the Medical Birth Registry of Norway, based on all births in Norway during 1967–2006. The risks of the adverse pregnancy outcomes preeclampsia, delivery by caesarean section, low birth weight, premature delivery, small for gestational age (SGA), perinatal death, and congenital malformations were compared between porphyric mothers and the rest of the population. The 200 mothers with porphyria had 398 singletons during the study period, whereas the 1,100,391 mothers without porphyria had 2,275,317 singletons. First-time mothers with active acute porphyria had an excess risk of perinatal death [adjusted odds ratio (OR) 4.9, 95% confidence interval (CI) 1.5–16.0], as did mothers with the hereditable form of porphyria cutanea tarda (PCT) (3.0, 1.2–7.7). Sporadic PCT was associated with an excess risk of SGA [adjusted relative risk (RR) 2.0, 1.2–3.4], and for first-time mothers, low birth weight (adjusted OR 3.4, 1.2–10.0) and premature delivery (3.5, 1.2–10.5) in addition. The findings suggest women with porphyria should be monitored closely during pregnancy. PMID:20978938

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

    Science.gov (United States)

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

    2011-02-01

    The porphyrias comprise a heterogeneous group of rare, primarily hereditary, metabolic diseases caused by a partial deficiency in one of the eight enzymes involved in the heme biosynthesis. Our aim was to assess whether acute or cutaneous porphyria has been associated with excess risks of adverse pregnancy outcomes. A population-based cohort study was designed by record linkage between the Norwegian Porphyria Register, covering 70% of all known porphyria patients in Norway, and the Medical Birth Registry of Norway, based on all births in Norway during 1967-2006. The risks of the adverse pregnancy outcomes preeclampsia, delivery by caesarean section, low birth weight, premature delivery, small for gestational age (SGA), perinatal death, and congenital malformations were compared between porphyric mothers and the rest of the population. The 200 mothers with porphyria had 398 singletons during the study period, whereas the 1,100,391 mothers without porphyria had 2,275,317 singletons. First-time mothers with active acute porphyria had an excess risk of perinatal death [adjusted odds ratio (OR) 4.9, 95% confidence interval (CI) 1.5-16.0], as did mothers with the hereditable form of porphyria cutanea tarda (PCT) (3.0, 1.2-7.7). Sporadic PCT was associated with an excess risk of SGA [adjusted relative risk (RR) 2.0, 1.2-3.4], and for first-time mothers, low birth weight (adjusted OR 3.4, 1.2-10.0) and premature delivery (3.5, 1.2-10.5) in addition. The findings suggest women with porphyria should be monitored closely during pregnancy.

  14. Outcomes of patients with microscopic colitis treated with corticosteroids: a population-based study.

    Science.gov (United States)

    Gentile, Nicole M; Abdalla, Adil A; Khanna, Sahil; Smyrk, Thomas C; Tremaine, William J; Faubion, William A; Kammer, Patricia P; Sandborn, William J; Loftus, Edward V; Pardi, Darrell S

    2013-02-01

    To evaluate the outcomes of corticosteroid-treated microscopic colitis (MC) in a population-based cohort, and to compare these outcomes in patients treated with prednisone or budesonide. A historical cohort study of Olmsted County, Minnesota residents diagnosed with collagenous or lymphocytic colitis (LC) between 1986 and 2010 was performed using the Rochester Epidemiology Project. Of 315 patients with MC, 80 (25.4%) were treated with corticosteroids. The median age at colitis diagnosis was 66.5 years (range: 16-95) and 78.7% were female. Forty patients (50%) had LC and 40 (50%) had collagenous colitis. Prednisone was used in 17 patients (21.2%) and budesonide in 63 (78.8%); 56 (75.6%) had complete response and 15 (20.3%) had partial response. Patients treated with budesonide had a higher rate of complete response than those treated with prednisone (82.5 vs. 52.9%; odds ratio, 4.18; 95% CI, 1.3-13.5). Six patients were lost to follow-up. The remaining 74 had a median follow-up of 4 years (range 0.2-14). Fifty patients out of the 71 who responded (70.4%) had a recurrence after corticosteroid discontinuation. Patients treated with budesonide were less likely to recur than those treated with prednisone (hazard ratio, 0.38; 95% CI, 0.18-0.85; P=0.02). After 397 person years of follow-up in the 73 patients with long-term data, 47 (64.4%) required maintenance with corticosteroids. Patients with MC often respond to corticosteroid therapy, but with a high relapse rate. Budesonide had a higher response rate and a lower risk of recurrence than prednisone.

  15. Dietary patterns associated with fall-related fracture in elderly Japanese: a population based prospective study

    Directory of Open Access Journals (Sweden)

    Yaegashi Nobuo

    2010-06-01

    Full Text Available Abstract Background Diet is considered an important factor for bone health, but is composed of a wide variety of foods containing complex combinations of nutrients. Therefore we investigated the relationship between dietary patterns and fall-related fractures in the elderly. Methods We designed a population-based prospective survey of 1178 elderly people in Japan in 2002. Dietary intake was assessed with a 75-item food frequency questionnaire (FFQ, from which dietary patterns were created by factor analysis from 27 food groups. The frequency of fall-related fracture was investigated based on insurance claim records from 2002 until 2006. The relationship between the incidence of fall-related fracture and modifiable factors, including dietary patterns, were examined. The Cox proportional hazards regression model was used to examine the relationships between dietary patterns and incidence of fall-related fracture with adjustment for age, gender, Body Mass Index (BMI and energy intake. Results Among 877 participants who agreed to a 4 year follow-up, 28 suffered from a fall-related fracture. Three dietary patterns were identified: mainly vegetable, mainly meat and mainly traditional Japanese. The moderately confirmed (see statistical methods groups with a Meat pattern showed a reduced risk of fall-related fracture (Hazard ratio = 0.36, 95% CI = 0.13 - 0.94 after adjustment for age, gender, BMI and energy intake. The Vegetable pattern showed a significant risk increase (Hazard ratio = 2.67, 95% CI = 1.03 - 6.90 after adjustment for age, gender and BMI. The Traditional Japanese pattern had no relationship to the risk of fall-related fracture. Conclusions The results of this study have the potential to reduce fall-related fracture risk in elderly Japanese. The results should be interpreted in light of the overall low meat intake of the Japanese population.

  16. School performance in children with type 1 diabetes: a contemporary population-based study.

    Science.gov (United States)

    Cooper, Matthew N; McNamara, Kaitrin A R; de Klerk, Nicholas H; Davis, Elizabeth A; Jones, Timothy W

    2016-03-01

    Our aim was to examine the school performance of children with type 1 diabetes in comparison to their peers, exploring changes over time, and the impact of clinical factors on school performance. The study included data on 666 children with type 1 diabetes from the Western Australia Children's Diabetes Database. (WACDD), a population-based registry, and 3260 school and school year matched non-diabetic children. Records from the National Assessment Program - Literacy and Numeracy (NAPLAN) (2008-2011), which examines four educational outcome domains and is administered annually to all years 3, 5, 7, and 9 children in Australia, were sourced for both groups. Clinical data were obtained for the children with diabetes from the WACDD. No significant difference was observed between those with type 1 diabetes and their peers, across any of the tested domains and school years analysed. No decline over time was observed, and no decline following diagnosis was observed. Type 1 diabetes was associated with decreased school attendance, 3% fewer days attended per year. Poorer glycaemic control [higher haemoglobin A1c (HbA1c)] was associated with a lower test score [0.2-0.3 SD per 1% (10.9 mmol/mol) increase in HbA1c], and with poorer attendance [1.8% decrease per 1% (10.9 mmol/mol) increase in HbA1c]. No association was observed with history of severe hypoglycaemia, diabetic ketoacidosis or age of onset and school test scores. These results suggest that type 1 diabetes is not associated with a significant decrement in school performance, as assessed by NAPLAN. The association of poorer glycaemic control with poorer school performance serves as further evidence for clinicians to focus on improving glycaemic control. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Care seeking for fatal illness episodes in Neonates: a population-based study in rural Bangladesh

    Directory of Open Access Journals (Sweden)

    Ali Mohammed

    2011-10-01

    Full Text Available Abstract Background Poor neonatal health is a major contributor to under-five mortality in developing countries. A major constraint to effective neonatal survival programme has been the lack of population level data in developing countries. This study investigated the consultation patterns of caregivers during neonatal fatal illness episodes in the rural Matlab sub-district of eastern Bangladesh. Methods Neonatal deaths were identified through a population-based demographic surveillance system in Matlab ICDDR,B maternal and child health (MCH project area and an adjoining government service area. Trained project staff administered a structured questionnaire on care seeking to mothers at home who had experienced a neonatal death. Univariate, bivariate and binary multivariate logistic regressions were performed to describe care seeking during the fatal illness episode. Results Of the 365 deaths recorded during 2003 and 2004, 84% died in the early (0-7 days neonatal period, with the remaining deaths occurring over the subsequent 8 to 28 days. The first resort of care by parents was a qualified doctor or paramedic in 37% of cases, followed by traditional and unqualified health care providers in 25%, while 38% sought no care. Thus, almost two thirds (63% of neonates who died received only traditional and unqualified care or no care at all during their final illness episode. About 22% sought care from more than one provider, including 6% from 3 or more providers. Such plurality in care seeking was more likely among male infants, in the late neonatal period, and in the MCH project area. Conclusions The high proportion of neonatal deaths that had received traditional care or no medical care in a rural area of Bangladesh highlights the need to develop community awareness about prompt medical care seeking for neonatal illnesses and to improve access to effective health care. Integration of traditional care providers into mainstream health programs should

  18. The prevalence of glaucoma in a population-based study of Hispanic subjects: Proyecto VER.

    Science.gov (United States)

    Quigley, H A; West, S K; Rodriguez, J; Munoz, B; Klein, R; Snyder, R

    2001-12-01

    To determine the prevalence of glaucoma in a population-based sample of Hispanic adults older than 40 years. Using 1990 census data for Arizona, groups of persons living in sections of the city in Nogales and Tucson were randomly selected with a probability proportional to the Hispanic population older than 40 years. We tried to recruit all eligible adults in homes with 1 self-described Hispanic adult. Detailed ocular examinations at a local clinic included visual acuity testing, applanation tonometry, gonioscopy, an optic disc evaluation, and a threshold visual field test. Open-angle glaucoma (OAG) was defined using a proposed international system for prevalence surveys, including threshold visual field defect and optic disc damage. Angle-closure glaucoma was defined as bilateral appositional angle closure, combined with optic nerve damage (judged by field and disc as for OAG). Examinations were conducted in 72% (4774/6658) of eligible persons, with a 1.97% prevalence (95% confidence interval, 1.58%-2.36%) of OAG (94 persons). The age-specific OAG prevalence increased nonlinearly from 0.50% in those aged 41 to 49 years to 12.63% in those 80 years and older. Angle-closure glaucoma was detected in 5 persons (0.10%). Sex, blood pressure, and cigarette smoking were not significant OAG risk factors. Only 36 (38%) of the 94 persons with OAG were aware of their OAG before the study. Screening results with an intraocular pressure higher than 22 mm Hg (in the eye with a higher pressure) would miss 80% of the OAG cases. The prevalence of OAG in Hispanic persons was intermediate between reported values for white and black persons. The prevalence increased more quickly with increasing age than in other ethnic groups. Glaucoma was the leading cause of bilateral blindness.

  19. Relationship between neighborhood socioeconomic status and venous thromboembolism: results from a population-based study.

    Science.gov (United States)

    Kort, D; van Rein, N; van der Meer, F J M; Vermaas, H W; Wiersma, N; Cannegieter, S C; Lijfering, W M

    2017-12-01

    Essentials Literature on socioeconomic status (SES) and incidence of venous thromboembolism (VTE) is scarce. We assessed neighborhood SES with VTE risk in a population of over 1.4 million inhabitants. Higher neighborhood SES was associated with lower incidence of VTE. These findings are helpful to inform policy and resource allocation in health systems. Background The association between socioeconomic status and arterial cardiovascular disease is well established. However, despite its high burden of disability-adjusted life years, little research has been carried out to determine whether socioeconomic status is associated with venous thromboembolism. Objective To determine if neighborhood socioeconomic status is associated with venous thromboembolism in a population-based study from the Netherlands. Methods We identified all patients aged 15 years and older with a first event of venous thromboembolism from inhabitants who lived in the urban districts of The Hague, Leiden and Utrecht in the Netherlands in 2008-2012. Neighborhood socioeconomic status was based on the status score, which combines educational level, income and unemployment on a four-digit postal code level. Incidence rate ratios of venous thromboembolism were calculated for different levels of neighborhood socioeconomic status, with adjustments for age and sex. Results A total of 7373 patients with a first venous thromboembolism (median age 61 years; 50% deep vein thrombosis) were identified among more than 1.4 million inhabitants. Higher neighborhood SES was associated with lower incidence of VTE. In the two highest status score groups (i.e. the 95-99th and > 99th percentile), the adjusted incidence rate ratios were 0.91 (95% confidence interval [CI], 0.84-1.00) and 0.80 (95% CI, 0.69-0.93), respectively, compared with the reference status score group (i.e. 30-70th percentile). Conclusions High neighborhood socioeconomic status is associated with a lower risk of first venous thromboembolism. © 2017

  20. Perceived Stress, Multimorbidity, and Risk for Hospitalizations for Ambulatory Care-sensitive Conditions: A Population-based Cohort Study.

    Science.gov (United States)

    Prior, Anders; Vestergaard, Mogens; Davydow, Dimitry S; Larsen, Karen K; Ribe, Anette R; Fenger-Grøn, Morten

    2017-02-01

    Psychiatric disorders are associated with an increased risk for ambulatory care-sensitive condition (ACSC)-related hospitalizations, but it remains unknown whether this holds for individuals with nonsyndromic stress that is more prevalent in the general population. To determine whether perceived stress is associated with ACSC-related hospitalizations and rehospitalizations, and posthospitalization 30-day mortality. Population-based cohort study with 118,410 participants from the Danish National Health Survey 2010, which included data on Cohen's Perceived Stress Scale, followed from 2010 to 2014, combined with individual-level national register data on hospitalizations and mortality. Multimorbidity was assessed using health register information on diagnoses and drug prescriptions within 39 condition categories. Being in the highest perceived stress quintile was associated with a 2.13-times higher ACSC-related hospitalization risk (95% CI, 1.91, 2.38) versus being in the lowest stress quintile after adjusting for age, sex, follow-up time, and predisposing conditions. The associated risk attenuated to 1.48 (95% CI, 1.32, 1.67) after fully adjusting for multimorbidity and socioeconomic factors. Individuals with above reference stress levels experienced 1703 excess ACSC-related hospitalizations (18% of all). A dose-response relationship was observed between perceived stress and the ACSC-related hospitalization rate regardless of multimorbidity status. Being in the highest stress quintile was associated with a 1.26-times insignificantly increased adjusted risk (95% CI, 0.79, 2.00) for ACSC rehospitalizations and a 1.43-times increased adjusted risk (95% CI, 1.13, 1.81) of mortality within 30 days of admission. Elevated perceived stress levels are associated with increased risk for ACSC-related hospitalization and poor short-term prognosis.

  1. Antibiotic prescribing patterns in out-of-hours primary care: A population-based descriptive study

    Science.gov (United States)

    Moth, Grete; Christensen, Morten Bondo; Vedsted, Peter

    2014-01-01

    Abstract Objective. To describe the frequency and characteristics of antibiotic prescribing for different types of contacts with the Danish out-of-hours (OOH) primary care service. Design. Population-based observational registry study using routine registry data from the OOH registration system on patient contacts and ATC-coded prescriptions. Setting. The OOH primary care service in the Central Denmark Region. Subjects. All contacts with OOH primary care during a 12-month period (June 2010–May 2011). Main outcome measures. Descriptive analyses of antibiotic prescription proportions stratified for type of antibiotic, patient age and gender, contact type, and weekdays or weekend. Results. Of the 644 777 contacts registered during the study period, 15.0% received an antibiotic prescription: 26.1% resulted from clinic consultations, 10.7% from telephone consultations, and 10.9% from home visits. The prescription proportion was higher for weekends (17.6%) than for weekdays (10.6%). The most frequently prescribed antibiotic drugs were beta-lactamase sensitive penicillins (34.9%), antibiotic eye drops (21.2%), and broad-spectrum penicillins (21.0%). Most antibiotic eye drops (73%) were prescribed in a telephone consultation. Most antibiotics were prescribed at 4–6 p.m. on weekdays. Young infants received most antibacterial eye drops (41.3%), patients aged 5–17 years and 18–60 years received most beta-lactamase sensitive penicillins (44.6% and 38.9%, respectively), while patients aged 60 + years received most broad-spectrum penicillins (32.9% of all antibiotic prescriptions). Conclusion. Antibiotics were most often prescribed in clinic consultations, but, in absolute terms, many were also prescribed by telephone. The high prescription proportion, particularly antibacterial eye drops for young infants, suggests room for improvement in rational antibiotic use. PMID:25350313

  2. Association of Coffee Consumption with MRI Markers and Cognitive Function: A Population-Based Study.

    Science.gov (United States)

    Araújo, Larissa Fortunato; Mirza, Saira Saeed; Bos, Daniel; Niessen, Wiro J; Barreto, Sandhi Maria; van der Lugt, Aad; Vernooij, Meike W; Hofman, Albert; Tiemeier, Henning; Ikram, M Arfan

    2016-05-03

    Coffee is one of the most widely consumed beverages worldwide and has been of considerable interest in research on cognition and dementia. To investigate the effect of coffee on preclinical brain MRI markers of dementia and cognitive performance. In 2,914 participants from the population-based Rotterdam Study (mean age: 59.3±7.2 years, 55% females), we assessed coffee consumption, performed brain MRI, and assessed cognition at baseline. To study cognitive change, cognitive assessment was repeated after 5 years of follow-up. Coffee consumption was analyzed continuously (per cup increase) and in categories (0-1, >1-3, >3 cups/day). Using logistic and linear regression, associations of coffee consumption with lacunar infarcts and brain tissue volumes on MRI, and cognitive performance (cross-sectional and longitudinal) were investigated, adjusting for relevant confounders. We found that higher coffee consumption was associated with a lower prevalence of lacunar infarcts [odds ratio per cup increase: 0.88 (95% CI:0.79;0.98)], and smaller hippocampal volume [difference: -0.01 (95% CI:-0.02;0.00)]. Also, we found that the highest category of coffee consumption was associated with better performance on the Letter Digit Substitution Task [difference: 1.13(95% CI:0.39;1.88)], Word Fluency test [0.74(95% CI:0.04,1.45)], Stroop interference task [1.82(95% CI:0.23;3.41)], and worse performance on the 15-Word Learning test delayed recall [-0.38(95% CI:-0.74;-0.02)]. These associations were not found when cognition was analyzed longitudinally. We found complex associations between coffee consumption, brain structure, and cognition. Higher coffee consumption was cross-sectionally associated with a lower occurrence of lacunar infarcts and better executive function, but also with smaller hippocampal volume and worse memory function.

  3. Survival Trends in Elderly Patients with Glioblastoma in the United States: a Population-based Study.

    Science.gov (United States)

    Shah, Binay Kumar; Bista, Amir; Sharma, Sandhya

    2016-09-01

    Concomitant and adjuvant temozolomide along with radiotherapy following surgery (the Stupp regimen) is the preferred therapy for young patients with glioblastoma as well as for elderly (>70 years) ones with favorable risk factors. This study investigated the survival trend since the introduction of the use of the Stupp regimen in elderly patients in a population-based setting. Surveillance, Epidemiology, and End Results 18 database was used to identify patients aged ≥70 years with glioblastoma as the first primary cancer diagnosed from 1999 to 2010. Chi-square test, Kaplan-Meier analysis with log-rank test and Cox proportional hazard method were used for analysis. A total of 5,575 patients were included in the survival analysis. Survival in Stupp era (year of diagnosis ≥2005) was significantly better compared to the pre-Stupp era with p<0.001 by log-rank test, with 1-, 2- and 3-year overall survival of 18.8% vs. 12.9%, 6.5% vs. 2.1% and 3.1% vs. 0.9% respectively, and hazard ratio for death in 3 years in the Stupp era was 0.87 (95% confidence interval=0.82-0.92; p<0.001) when compared with the pre-Stupp era. Factors such as younger age (<85 years), female sex, married status, Caucasian race and total resection favored better survival compared to their counterparts. This study shows that the survival of elderly patients with glioblastoma has improved since the introduction of the Stupp regimen. However, there are significant differences in survival rates among various cohorts. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  4. Clozapine use in childhood and adolescent schizophrenia: A nationwide population-based study.

    Science.gov (United States)

    Schneider, Carolina; Papachristou, Efstathios; Wimberley, Theresa; Gasse, Christiane; Dima, Danai; MacCabe, James H; Mortensen, Preben Bo; Frangou, Sophia

    2015-06-01

    Early onset schizophrenia (EOS) begins in childhood or adolescence. EOS is associated with poor treatment response and may benefit from timely use of clozapine. This study aimed to identify the predictors of clozapine use in EOS and characterize the clinical profile and outcome of clozapine-treated youths with schizophrenia. We conducted a nationwide population-based study using linked data from Danish medical registries. We examined all incident cases of EOS (i.e., cases diagnosed prior to their 18th birthday) between December 31st 1994 and December 31st 2006 and characterized their demographic, clinical and treatment profiles. We then used multivariable cox proportional hazard models to identify predictors of clozapine treatment in this patient population. We identified 662 EOS cases (1.9% of all schizophrenia cases), of whom 108 (17.6%) had commenced clozapine by December 31st 2008. Patients had on average 3 antipsychotic trials prior to clozapine initiation. The mean interval between first antipsychotic treatment and clozapine initiation was 3.2 (2.9) years. Older age at diagnosis of schizophrenia [HR=1.2, 95% CI (1.05-1.4), p=0.01], family history of schizophrenia [HR=2.1, 95% CI (1.1-3.04), p=0.02] and attempted suicide [HR=1.8, 95% CI (1.1-3.04), p=0.02] emerged as significant predictors of clozapine use. The majority of patients (n=96, 88.8%) prescribed clozapine appeared to have a favorable clinical response as indicated by continued prescription redemption and improved occupational outcomes. Our findings support current recommendations for the timely use of clozapine in EOS. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.

  5. Use of lipid-lowering agents in rheumatoid arthritis: a population-based cohort study.

    Science.gov (United States)

    Akkara Veetil, Bharath Manu; Myasoedova, Elena; Matteson, Eric L; Gabriel, Sherine E; Crowson, Cynthia S

    2013-07-01

    Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease and mortality. Lipid-lowering therapy is reportedly underused in patients with RA. Longitudinal cohort studies comparing use of lipid-lowering medications in patients with RA versus the general population are lacking. Cardiovascular risk factors, lipid measures, and use of lipid-lowering agents were assessed in a population-based inception cohort of patients with RA and a cohort of non-RA subjects followed from January 1, 1988, to December 31, 2008. The National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATPIII) guidelines were assessed at the time of each lipid measure throughout followup. Time from meeting guidelines to initiation of lipid-lowering agents was assessed using Kaplan-Meier methods. The study population included 412 RA and 438 non-RA patients with ≥ 1 lipid measure during followup and no prior use of lipid-lowering agents. Rates of lipid testing were lower among patients with RA compared to non-RA subjects. Among patients who met NCEP ATPIII criteria for lipid-lowering therapy (n = 106 RA; n = 120 non-RA), only 27% of RA and 26% of non-RA subjects initiated lipid-lowering agents within 2 years of meeting the guidelines for initiation. There was substantial undertreatment in both the RA and the non-RA cohorts who met NCEP ATPIII criteria for initiation of lipid-lowering agents. Patients with RA did not have as frequent lipid testing as individuals in the general population.

  6. Childhood hunger and depressive symptoms in adulthood: Findings from a population-based study.

    Science.gov (United States)

    Stickley, Andrew; Leinsalu, Mall

    2018-01-15

    Several studies have linked childhood hunger to an increased risk for later depression. However, as yet, there has been little research on this relation in adults of all ages or whether there are sex differences in this association. The current study examined these issues using data from a national population-based sample. Data were analyzed from 5095 adults aged 25-84 collected during the Estonian Health Interview Survey 2006. Information was obtained on the frequency of going to bed hungry in childhood and on depressive symptoms using the Emotional State Questionnaire (EST-Q). Logistic regression analysis was used to examine the association between hunger and depression while controlling for other demographic, socioeconomic and health-related variables. In a fully adjusted model, going to bed hungry in childhood either sometimes or often was associated with significantly increased odds for depressive symptoms. When the analysis was stratified by sex the association was more evident in men where any frequency of childhood hunger was linked to adult depression while only women who had experienced hunger often had higher odds for depressive symptoms in the final model. Data on childhood hunger were retrospectively reported and may have been affected by recall bias. We also lacked information on potentially relevant variables such as other childhood adversities that might have been important for the observed associations. Childhood hunger is associated with an increased risk for depressive symptoms among adults. Preventing hunger in childhood may be important for mental health across the life course. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Mechanical Ventilation for Acute Stroke: A Multi-state Population-Based Study.

    Science.gov (United States)

    Lahiri, Shouri; Mayer, Stephan A; Fink, Matthew E; Lord, Aaron S; Rosengart, Axel; Mangat, Halinder S; Segal, Alan Z; Claassen, Jan; Kamel, Hooman

    2015-08-01

    Mechanical ventilation is frequently performed in patients with ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). In this study, we used statewide administrative claims data to examine the rates of use, associated conditions, and in-hospital mortality rates for mechanically ventilated stroke patients. We used statewide administrative claims data from three states and ICD-9-CM codes to identify patients admitted with stroke and those who received mechanical ventilation and tracheostomy. Descriptive statistics and exact 95 % confidence intervals were used to report rates of mechanical ventilation, tracheostomy, and in-hospital mortality. Logistic regression analysis was performed to identify conditions associated with mechanical ventilation based on previously described risk factors. 798,255 hospital admissions for stroke were identified. 12.5 % of these patients underwent mechanical ventilation. This rate varied by stroke type: 7.9 % for IS, 29.9 % for ICH, and 38.5 % for SAH. Increased age was associated with a decreased risk of receiving mechanical ventilation (RR per decade, 0.91). Of stroke patients who underwent mechanical ventilation, 16.3 % received a tracheostomy. Mechanical ventilation was more likely to occur in association with status epilepticus (RR, 5.1), pneumonia (RR, 4.9), sepsis (RR, 3.6), and hydrocephalus (RR, 3.3). In-hospital mortality rate for mechanically ventilated stroke patients was 52.7 % (46.8 % for IS, 61.0 % for ICH, and 54.6 % for SAH). In this large population-based sample, over half of mechanically ventilated stroke patients died in the hospital despite the fact that younger patients were more likely to receive mechanical ventilation. Future studies are indicated to elucidate mechanical ventilation strategies to optimize long-term outcomes after severe stroke.

  8. Antibiotic prescribing patterns in out-of-hours primary care: a population-based descriptive study.

    Science.gov (United States)

    Huibers, Linda; Moth, Grete; Christensen, Morten Bondo; Vedsted, Peter

    2014-12-01

    To describe the frequency and characteristics of antibiotic prescribing for different types of contacts with the Danish out-of-hours (OOH) primary care service. Population-based observational registry study using routine registry data from the OOH registration system on patient contacts and ATC-coded prescriptions. The OOH primary care service in the Central Denmark Region. All contacts with OOH primary care during a 12-month period (June 2010-May 2011). Descriptive analyses of antibiotic prescription proportions stratified for type of antibiotic, patient age and gender, contact type, and weekdays or weekend. Of the 644 777 contacts registered during the study period, 15.0% received an antibiotic prescription: 26.1% resulted from clinic consultations, 10.7% from telephone consultations, and 10.9% from home visits. The prescription proportion was higher for weekends (17.6%) than for weekdays (10.6%). The most frequently prescribed antibiotic drugs were beta-lactamase sensitive penicillins (34.9%), antibiotic eye drops (21.2%), and broad-spectrum penicillins (21.0%). Most antibiotic eye drops (73%) were prescribed in a telephone consultation. Most antibiotics were prescribed at 4-6 p.m. on weekdays. Young infants received most antibacterial eye drops (41.3%), patients aged 5-17 years and 18-60 years received most beta-lactamase sensitive penicillins (44.6% and 38.9%, respectively), while patients aged 60 + years received most broad-spectrum penicillins (32.9% of all antibiotic prescriptions). Antibiotics were most often prescribed in clinic consultations, but, in absolute terms, many were also prescribed by telephone. The high prescription proportion, particularly antibacterial eye drops for young infants, suggests room for improvement in rational antibiotic use.

  9. Hypothyroidism and pregnancy loss: comparison with hyperthyroidism and diabetes in a Danish population-based study.

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    Andersen, Stine Linding; Olsen, Jørn; Laurberg, Peter

    2016-12-01

    Hypothyroidism is a common endocrine disease. The frequency of pregnancy loss in women with known hypothyroidism as opposed to women with a later diagnosis of hypothyroidism has not been evaluated and compared with other common endocrine diseases. Population-based cohort study using Danish nationwide registers. All pregnancies in Denmark, 1997-2008, resulting in live birth (n = 732 533), spontaneous abortion (n = 112 487) or stillbirth (n = 2937) were identified together with information on maternal hypothyroidism, hyperthyroidism and diabetes. Cox model was used to estimate adjusted hazard ratio (aHR) with 95% confidence interval (95%CI) for spontaneous abortion and stillbirth, reference: no hypo- or hyperthyroidism or diabetes (n = 824 310). We identified 4951 pregnancies where maternal hypothyroidism was diagnosed before the pregnancy (group 1) and 2464 pregnancies where maternal hypothyroidism was diagnosed in the 2-year period after the pregnancy (group 2). In group 1, 825 pregnancies (16·7%) resulted in spontaneous abortion which was more frequent than in nonexposed (13·2%), (aHR 1·19 (95%CI 1·12-1·27)), and of the same magnitude as in hyperthyroidism (17·2%, P = 0·5) and diabetes (17·5%, P = 0·2) diagnosed before the pregnancy. In group 2, the frequency was 12·2% (aHR 0·92 (0·84-1·02)). In group 2, 16 pregnancies (0·65%) resulted in stillbirth which was more frequent than in nonexposed (0·36%), (aHR 1·81 (1·11-2·97)), of the same magnitude as in hyperthyroidism (0·82%, P = 0·5) and less frequent than in diabetes (2·9%, P hyperthyroidism and in particular diabetes. We hypothesize that undetected or insufficiently treated maternal disease in the pregnancy may be of causal importance. © 2016 John Wiley & Sons Ltd.

  10. Chronic Musculoskeletal Disabilities following Snake Envenoming in Sri Lanka: A Population-Based Study.

    Directory of Open Access Journals (Sweden)

    Subashini Jayawardana

    2016-11-01

    Full Text Available Snakebite is a major public health problem in agricultural communities in the tropics leading to acute local and systemic impairments with resultant disabilities. Snakebite related long-term musculoskeletal disabilities have been a neglected area of research. We conducted a population-based, cross-sectional study in an agricultural community to describe the chronic musculoskeletal disabilities of snake envenoming.A sample representative of residents of a single district in a region of high incidence of snake envenoming was recruited to identify ever snakebite victims. They were evaluated for chronic musculoskeletal disabilities that had developed immediately or within four weeks after the snakebite and persisted over three months. In-depth interviews, validated musculoskeletal functional assessment criteria and specialists' examinations were utilised. Among the 816 victims, 26 (3.2%, 95% confidence interval: 2.2-4.6% had musculoskeletal disabilities, persisting on average for 13.4 years (SD = 14.4. The disabilities were mostly in lower limbs (61.5% and ranged from swelling (34.6%, muscle wasting (46.1%, reduced motion (61.5%, reduced muscle power (50%, impaired balance (26.9%, chronic non-healing ulcers (3.85%, abnormal gait (3.85%, fixed deformities (19.2% to amputations (15.4%. Based on disability patterns, six snakebite-related musculoskeletal syndromes were recognised. The offending snakes causing disabilities were cobra (30.8%, Russell's viper (26.9% and hump-nosed viper (7.7%. Cobra bites manifested muscle wasting (87.5%, reduced muscle power (87.5%, joint stiffness (62.5% and deformities (37.5% while viper bites manifested impaired balance (42.8%, pain (71.4% and swelling (71.4%.Snakebite envenoming is associated with considerable long-term musculoskeletal disabilities. Facilities for specialized care and rehabilitation need to be established in high risk areas.

  11. Prevalence of sun exposure and its associated factors in southern Brazil: a population-based study*

    Science.gov (United States)

    Duquia, Rodrigo Pereira; Menezes, Ana Maria Baptista; de Almeida, Hiram Larangeira; Reichert, Felipe Fossati; dos Santos, Iná da Silva; Haack, Ricardo Lanzetta; Horta, Bernardo Lessa

    2013-01-01

    BACKGROUND Sunlight exposure is responsible for a large number of dermatological diseases. OBJECTIVE We estimated the prevalence of sunlight exposure and its associated factors in adults from southern Brazil in a cross-sectional, population-based study. METHODS We investigated a representative sample of individuals aged ≥ 20 years (n=3,136). Sunlight exposure and its associated factors were evaluated in two distinct situations: at leisure time and at work. The time period investigated ranged from December 2004 to March 2005, comprising 120 days of the highest ultraviolet index in the urban area of the city of Pelotas, in southern Brazil. The participants were asked about sunlight exposure for at least 20 minutes between 10 A.M. and 4 P.M. The analysis was stratified by sex, and sunlight exposure was grouped into five categories. RESULTS Among the 3,136 participants, prevalence of sunlight exposure at the beach was 32.8% (95% CI, 30.3 - 35.2) and 26.3% (95% CI, 24.2 28.3) among men and women, respectively. The prevalence at work was 39.8% (95% CI, 37.2 - 42.4) among men and 10.5% (95% CI, 9.1 - 12.0) among women. Age was inversely associated with sunlight exposure. Family income and achieved schooling were positively associated with sunlight exposure at leisure time and inversely associated with sunglight exposure at work. Self-reported skin color was not associated. Knowledge of any friend or relative who has been affected by skin cancer was positively associated with sunlight exposure among men at work. CONCLUSION Despite the media campaigns on the harmful effects of excessive sunlight exposure, we found a high prevalence of sunlight exposure during a period of high ultraviolet index. PMID:24068126

  12. The Incidence of Japanese Encephalitis in Taiwan—A Population-Based Study

    Science.gov (United States)

    Hsu, Li-Ching; Chen, Yu-Ju; Hsu, Feng-Kuang; Huang, Jyh-Hsiung; Chang, Chi-Ming; Chou, Pesus; Lin, I-Feng; Chang, Feng-Yee

    2014-01-01

    Background A mass Japanese encephalitis (JE) vaccination program targeting children was launched in Taiwan in 1968, and the number of pediatric JE cases substantially decreased thereafter. The aim of this study was to elucidate the long-term trend of JE incidence, and to investigate the age-specific seroprevalence of JE-neutralizing antibodies. Methodology/Principal Findings A total of 2,948 laboratory-confirmed JE cases that occurred between 1966 and 2012 were analyzed using a mandatory notification system managed by the Centers for Disease Control, Taiwan. A total of 6,594 randomly-sampled serum specimens obtained in a nationwide population-based survey in 2002 were analyzed to estimate the seroprevalence of JE-neutralizing antibodies in the general population. The average annual JE incidence rate of the group aged 30 years and older was 0.167 cases per 100,000 people between 2001 and 2012, which was higher than the 0.052 cases per 100,000 people among those aged under 30 years. These seroepidemiological findings indicate that the cohort born between 1963 and 1975, who generally received two or three doses of the vaccine and were administered the last booster dose more than 20 years ago, exhibited the lowest positive rate of JE-neutralizing antibodies (54%). The highest and second highest antibody rates were observed, respectively, in the oldest unvaccinated cohort (86%) and in the youngest cohort born between 1981 and 1986, who received four doses 10–15 years ago (74%). Conclusion/Significance Over the past decade, the main age group of the confirmed JE cases in Taiwan shifted from young children to adults over 30 years of age. People who were born between 1963 and 1975 exhibited the lowest seroprevalence of JE-neutralizing antibodies. Thus, the key issue for JE control in Taiwan is to reduce adult JE cases through a cost-effective analysis of various immunization strategies. PMID:25058573

  13. Life events, salivary cortisol, and cognitive performance in nondemented subjects: a population-based study.

    Science.gov (United States)

    Ouanes, Sami; Castelao, Enrique; Gebreab, Sirak; von Gunten, Armin; Preisig, Martin; Popp, Julius

    2017-03-01

    Older people are particularly exposed to stressful events, known to activate the hypothalamus-pituitary-adrenal axis resulting in increased cortisol levels. High cortisol has been associated with deleterious effects on cognition. We hypothesized that stressful life events could increase cortisol secretion leading to cognitive impairment. A cross-sectional analysis was conducted using data from Colaus/PsyColaus, a longitudinal population-based study among Lausanne residents. Salivary cortisol samples were obtained from 796 nondemented subjects aged at least 65. A neuropsychological battery was used to assess cognitive performance and determine the Clinical Dementia Rating Sum of Boxes (CDRSOB). Lifetime life events and their subjective impact were assessed using a validated questionnaire. The total impact of life events was associated neither with cortisol area under the curve (AUC) nor with CDRSOB nor with any cognitive domain performance. The CDRSOB was associated with the cortisol AUC, controlling for age, sex, body mass index, education and depressive symptoms (p = 0.003; B = 0.686 [0.240; 1.333]; r = 0.114). This association between CDRSOB and the cortisol AUC remained significant after controlling for life events total impact (p = 0.040; B = 0.591 [0.027; 1.155]; r = 0.106). These findings do not support the hypothesis that stressful life events increase cortisol secretion leading to cognitive impairment. The association of higher cortisol levels with poorer cognition might be not a mere reflection of stressful events but rather explained by other factors, yet to be elucidated. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. The clustering of other chronic inflammatory diseases in inflammatory bowel disease: a population-based study.

    Science.gov (United States)

    Bernstein, Charles N; Wajda, Andre; Blanchard, James F

    2005-09-01

    We aimed to discern the relative risk for several chronic inflammatory conditions in patients with ulcerative colitis (UC) and Crohn's disease. We used the population-based University of Manitoba IBD Database that includes longitudinal files on all patients from all health system contacts identified by International Classification of Diseases, 9th revision, Clinical Modification codes for visit diagnosis. From the provincial database we extracted a control cohort matching the IBD patients 10:1 by age, sex, and geography. We considered a potential comorbid disease to be present if the patient had 5 or more health system contacts for that diagnosis. The comorbid disease period prevalence was analyzed separately for patients with UC and Crohn's disease and a prevalence ratio was calculated comparing the IBD populations with the matched cohort. There were 8072 cases of IBD from 1984 to 2003, including UC (n = 3879) and Crohn's disease (n = 4193). There was a mean of approximately 16 person-years of coverage for both patients and control patients. Both UC and Crohn's disease patients had a significantly greater likelihood of having arthritis, asthma, bronchitis, psoriasis, and pericarditis than population controls. An increased risk for chronic renal disease and multiple sclerosis was noted in UC but not Crohn's disease patients. The most common nonintestinal comorbidities identified were arthritis and asthma. The finding of asthma as the most common comorbidity increased in Crohn's disease patients compared with the general population is novel. These may be diseases with common causes or complications of one disease that lead to the presentation with another. Studies such as this should encourage further research into the common triggers in the organ systems that lead to autoimmune diseases.

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

    Science.gov (United States)

    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

    2014-10-14

    To assess the implementation and first results of a term perinatal internal audit by a standardised method. Population-based cohort study. All 90 Dutch hospitals with obstetric/paediatric departments linked to community practices of midwives, general practitioners in their attachment areas, organised in perinatal cooperation groups (PCG). The population consisted of 943 registered term perinatal deaths occurring in 2010-2012 with detailed information, including 707 cases with completed audit results. Participation in the audit, perinatal death classification, identification of substandard factors (SSF), SSF in relation to death, conclusive recommendations for quality improvement in perinatal care and antepartum risk selection at the start of labour. After the introduction of the perinatal audit in 2010, all PCGs participated. They organised 645 audit sessions, with an average of 31 healthcare professionals per session. Of all 1102 term perinatal deaths (2.3/1000) data were registered for 86% (943) and standardised anonymised audit results for 64% (707). In 53% of the cases at least one SSF was identified. Non-compliance to guidelines (35%) and deviation from usual professional care (41%) were the most frequent SSF. There was a (very) probable relation between the SSF and perinatal death for 8% of all cases. This declined over the years: from 10% (n=23) in 2010 to 5% (n=10) in 2012 (p=0.060). Simultaneously term perinatal mortality decreased from 2.3 to 2.0/1000 births (pperinatal audit is implemented nationwide in all obstetrical units in the Netherlands in a short time period. It is possible that the audit contributed to the decrease in term perinatal mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.